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This study aims to compare the demographic, clinical characteristics, and outcomes of burn injuries in toddler and preschool children, and to validate the American Burn Association (ABA) Burn Triage Decision Matrix in the Turkish pediatric population.
Methods
A retrospective analysis was conducted on 684 pediatric burn patients (494 toddlers, 190 preschoolers) admitted to our burn center over a 5-year period. Variables including gender, burn etiology, burn area, depth, treatment modalities, complications, length of hospital stay, and mortality were analyzed. The performance of the ABA Burn Triage Decision Matrix was evaluated in both groups.
Results
Scalding was the predominant cause of burns in both groups, with a significant difference in the involvement of anterior trunk (p = 0.027). The mean Total Body Surface Area (TBSA) was comparable between the groups (p = 0.286). There was no significant difference in mortality rates (p = 0.385), treatment modalities, and complications. The ABA Burn Triage Decision Matrix demonstrated consistency in triaging the severity of burn injuries, with a notable discrepancy observed in the moderate risk category of toddler group.
Conclusions
This study highlights the distinct characteristics and outcomes of burn injuries in different pediatric age groups. The ABA Burn Triage Decision Matrix’s validation suggests its utility in enhancing triage accuracy and resource allocation in pediatric populations, especially in disaster-prone regions.
Moral emotions such as shame, guilt and pride are crucial to young children’s social-emotional development. Due to the restrictions caused by hearing loss in accessing the social world, deaf and hard of hearing (DHH) children may encounter extra difficulties in their development of moral emotions. However, little research so far has investigated the development trajectory of moral emotions during preschool years in DHH children. The present study used a longitudinal design to explore the development trajectories of shame, guilt, and pride, in a sample of 259 Chinese DHH and typically hearing (TH) preschoolers aged 2 to 6 years old. The results indicated that according to parent reports, DHH children manifested lower levels of guilt and pride compared to their TH peers, yet the manifested levels of shame, guilt, and pride increased throughout the preschool time at a similar pace in all children. Moreover, whilst guilt and pride contributed to increasing levels of psychosocial functioning over the preschool years, shame contributed to lower social competence and more externalizing behaviors in DHH and TH preschoolers. The outcomes imply that early interventions and adjustment to hearing loss could be useful to safeguard the social development of children with severe hearing loss, and cultural variances shall be taken into consideration when studying moral emotions in a Chinese cultural background.
Children’s eating habits are established early in life and parents play a major role therein. Pregnancy is a teachable moment for the promotion of healthy eating because many women are concerned about their babies’ health and have frequent contact with healthcare providers. We aimed to investigate the association between diet quality during pregnancy and the offspring. A total of 691 sets of data on pregnant mothers and their 3-year-old offspring were obtained from the Seiiku Boshi cohort study. Dietary intake was assessed using a validated food frequency questionnaire for mothers in mid-to-late pregnancy and a validated diet history questionnaire for Japanese preschool children at the 36-month checkup. Diet quality was scored using the Japanese Food Guide Spinning Top. Maternal diet quality score was categorised into quartiles, and the association between offspring and maternal diet quality score, adjusted for socioeconomic factors, was assessed using multiple linear regression. The total offspring diet quality score showed a linear trend with the maternal diet quality score (the mean increments (confidential intervals) for each quartile were –0.12 (–1.32–1.08), 1.54 (0.34–2.73), and 1.22 (0.03–2.42)). In particular, offspring vegetable dishes scored higher in all quartiles of maternal vegetable dish scores than in the lowest quartile (0.69 (0.21–1.17), 0.97 (0.50–1.45), and 1.36 (0.88–1.83)). A high diet quality score during pregnancy was positively associated with that of offspring, suggesting the importance of nutritional education in pregnant women to improve their diet quality.
This study assessed the relationship between preschoolers’ directly and indirectly assessed emotion word comprehension. Forty-nine two-to-five-year-old Norwegian children were assessed in a tablet-based 4-alternative forced choice (AFC) task on their comprehension of six basic and six complex emotions using facial expression photographs. Parents reported emotion word comprehension and production of the same words. Parent-reported emotion word production interacted with age to predict preschoolers’ performance, with a parent-child alignment only observed for older children. Parent-reported word comprehension did not significantly predict accuracy. The results suggest that, in preschoolers, direct and indirect assessments might address distinct representational levels of emotion word comprehension.
The Swedish Wechsler Preschool and Primary Scale of Intelligence (WPPSI-IV) is commonly used for assessing young children belonging to the Swedish-speaking minority in Finland (Finland-Swedes), but there is no information about the generalizability of this test and its norms to this minority. Cross-cultural comparisons of WPPSI-IV are also scarce. We compared the performance of Finland-Swedish children to the Scandinavian norms of the Swedish WPPSI-IV and explored the relationship between sociodemographic factors (age, sex, parental education level, bilingualism) and the performance.
Method:
The Swedish WPPSI-IV was administered to 79 typically developing 5–6-year-old Finland-Swedish children assessed for The FinSwed Study. Their performance was compared to the Scandinavian norms using MANOVA, t-test, and confidence interval comparisons. Associations with sociodemographic variables were explored using regression analyses.
Results:
Finland-Swedish children performed, on average, 1/3 SD higher than the Scandinavian norms, a difference which was statistically significant with medium-sized effects. However, individual subtests and indexes did not differ significantly from the norms. Significant associations with sociodemographic factors were found for some but not all index scores.
Conclusions:
This study provides clinically important information for using the Swedish WPPSI-IV with the Finland-Swedish minority and demonstrates aspects that clinicians working with this minority should take into account. The results are presumably partly explained by characteristics of the present sample, and partly by cultural and linguistic differences between the Finland-Swedish population and the Scandinavian countries. The findings also illustrate that cross-cultural differences in cognitive performance may be present even between similar cultures with the same language.
We investigated the association of household food insecurity (HFI) with developmental delays in 36–59-month-old preschool children (n 7005) using cross-sectional data from the 2018 Ecuadorian National Health and Nutrition Survey. HFI was assessed with the Food Insecurity Experience Scale and developmental delays with the Early Childhood Development Index. Log-binomial regression models estimated the association of HFI with global (overall) developmental delay (GDD) and delays in four individual developmental domains, adjusting for covariates. Nearly half of the children lived in households with marginal (24⋅5 %) or moderate-severe HFI (21⋅7 %). Eighteen percent were identified with GDD. Delays in the individual domains of literacy-numeracy, social-emotional, physical and cognitive development were identified for 64, 21⋅5, 3⋅3 and 3⋅1 %, respectively. GDD was more likely among preschool children from households with marginal (aPR = 1⋅29; 95 % C.I. = 1⋅10, 1⋅49) and moderate-severe HFI (aPR = 1⋅30; 95 % C.I. = 1⋅11, 1⋅51). Social-emotional development delays were also more likely among those from households with marginal (aPR = 1⋅36; 95 % C.I. = 1⋅19, 1⋅56) and moderate-severe HFI (aPR = 1⋅33; 95 % C.I. = 1⋅15, 1⋅54) different from the other three domains. Several other potentially modifiable risk (violent discipline, maternal depressive symptoms) and protective factors (adequate child stimulation, higher maternal education, handwashing with soap/detergent) were also independently associated with GDD and/or literacy-numeracy and cognitive delays. Our findings suggest that HFI is an independent risk factor for GDD and social-emotional developmental delays in Ecuadorian preschoolers. They underscore the importance of strengthening and expanding poverty reduction, food security and early childhood development policies and interventions to improve the opportunities for children to achieve their full developmental potential.
The present study aims to develop a quantitative food frequency questionnaire (FFQ) to assess free sugar intake as a whole and at the food group levels, retrospectively, over the past 3 months among 4 to 5-year-old preschool children in the Colombo district, Sri Lanka. Then, to assess its reliability and relative validity. In the development phase, three 24-hour dietary recalls (24 hDRs) of 518 preschool children were collected from caregivers. Based on that, a 67-item FFQ was developed, including commonly consumed free sugar-containing food items. The validation study was conducted among another 108 preschool children. The relative validity of the FFQ was assessed by comparing it with the 24 hDRs. The test–retest reliability was assessed by repeated application of the FFQ to the same population after 6 weeks. Wilcoxon sign rank test, cross-classification with weighted Kappa statistic, Spearman rank correlation and Bland–Altman plots were used for comparison. Comparing the free sugar intake calculated by the two methods showed no difference (P = 0⋅13), a good correlation (0⋅89), good agreement in cross-classifying participants (78⋅4 % correctly classified) and a good agreement in Bland–Altman plots. Repeated application of the FFQ yielded; no differences in free sugar intake values (P = 0⋅45) a good correlation (0⋅71), acceptable agreement in cross-classifying participants (52⋅3 % correctly classified) and acceptable agreement in the Bland–Altman plot. Results were the same for all food groups. According to the results, the newly developed quantitative FFQ provides a relatively valid and reliable measure for quantifying free sugar intake among preschool children as a whole or by food group.
Parental and pregnancy characteristics can affect proportions and tissue composition of the child’s bodyand thereforecan influence their present and future health, as well as overall wellbeing. The aim of this study was to examine the differences between selected parental and birth-related parameters among preschool (3-7 years of age) children of varying adiposity status (n=541 girls and n=571 boys).The research was carried out in 20 randomly selected kindergartens in Krakow (Poland). Thickness of 6 skinfolds (biceps, triceps, subscapular, suprailiac, abdominal and calf) was measured. Sum of skinfolds was calculated and participants were divided into low, normal or high body fat groups. Birth-related characteristics were obtained using a questionnaire filled out by the children’s parents. Children of mothers who gained the most gestational weight were characterised by high adiposity. Preschoolers with the highest birth weight, body length and head circumference had the greatest adiposity. Children of relatively younger mothers had higher body fat, in comparison to the rest of the study group. Parents of preschoolers in the high adiposity category were characterised by a greater body mass, compared to the parents of children in other body fat groups and that boys with the highest adiposity relatively more often had a close relative with obesity. Children in varying adiposity categories differed in terms of some birth-related factors. Particular attention should be paid to familial and parental characteristics, because they may influence the child’s predisposition to excess adiposity deposition later in life.
To examine the mediating effects of maternal perception of child weight (weight perception) and concern about overweight (weight concern) on the paths between child weight and maternal feeding practices.
Setting:
Pudong District, Shanghai, China.
Participants:
A convenience sample of 1164 mothers who were primary caregivers of preschool children.
Results:
Sixty per cent of the mothers perceived their overweight/obese children as normal weight or even underweight. The disagreement between actual child weight and maternal weight perception was statistically significant (Kappa = 0·212, P < 0·001). Structural equation modelling indicated that weight perception fully mediated the relationship between child BMI Z-scores and pressure to eat. Weight concern fully mediated the relationships between child BMI Z-scores and the other three feeding practices. The serial mediating effects of weight perception and concern were statistically significant for the paths between child BMI Z-score and monitoring (β = 0·035, P < 0·001), restriction (β = 0·022, P < 0·001), and food as a reward (β = –0·017, P < 0·05).
Conclusion:
Child weight may influence maternal feeding practices through weight perception and concern. Thus, interventions are needed to increase the accuracy of weight perception, which may influence several maternal feeding practices and thereby contribute to child health.
To determine whether the ‘Read for Nutrition’ programme would increase liking and consumption of broccoli (a target vegetable) in preschool children and test acceptability and practicality of the programme.
Design:
Pilot pre-post intervention study, where childcare teachers received training and coaching followed by reading the book ‘Monsters Don’t Eat Broccoli’ multiple times with the children during a three-week intervention.
Setting:
Five classrooms of Educare, Lincoln, Nebraska in 2018.
Participants:
Sixty-nine (11 to 16 children per classroom) preschool-aged children and sixteen teachers (minimum, three per classroom).
Results:
Average total consumption of broccoli increased 35 % (0·14 ounces or 0·05th cup) after the ‘Read for Nutrition’ programme (t = 2·66; P = 0·01; 95 % CIs (0·035, 0·246)) for all children. Proportional consumption increased for children who received ≥ five exposures to the book (t46 = 2·77; P = 0·008). Exposures to the book predicted proportional consumption (β = 0·365; P = 0·002). Liking of broccoli increased (W69 = 2·2, P = 0·03) as well. Teachers rated the programme as acceptable, practical and enjoyable to children and to themselves.
Conclusions:
Programmes such as ‘Read for Nutrition’ have the potential to improve children’s vegetable liking and consumption in early care and education settings with only book readings and no exposure to a real vegetable.
Over recent decades much research has analyzed the relevance of 9- to 20- month-old infants’ early imitation skills (object- and language-based imitation) for language development. Yet there have been few systematic comparisons of the joint relevance of these imitative behaviors later on in development. This correlational study investigated whether multimodal imitation (gestural, prosodic, and lexical components) and object-based imitation are related to narratives and sociopragmatics in preschoolers. Thirty-one typically developing 3- to 4-year-old children performed four tasks to assess multimodal imitation, object-based imitation, narrative abilities, and sociopragmatic abilities. Results revealed that both narrative and sociopragmatic skills were significantly related to multimodal imitation, but not to object-based imitation, indicating that preschoolers’ ability to imitate socially relevant multimodal cues is strongly related to language and sociocommunicative skills. Therefore, this evidence supports a broader conceptualization of imitation behaviors in the field of language development that systematically integrates prosodic, gestural, and verbal linguistic patterns.
Early years caregivers can play a key role in young children’s eating and the prevention of childhood obesity. The UK National Diet and Nutrition Survey (NDNS) is a large representative survey collecting detailed food and nutrition consumption data. Using these data, the aim of this study was to investigate the relationship between dietary intake of preschool children in the UK aged 2 to 4 years and accompanying adult/s. Nutrition consumption data from 1218 preschool children from years 1 to 8 of the 2008–2016 NDNS were accessed. Dietary data were captured using 3 or 4 day estimated food diaries. Regression analyses revealed significant differences in consumption when children were not accompanied by their parents. Compared with when children were with parents, children consumed significantly more energy dense meals (0·32 kJ/g, 95% CI 0·1–0·6 kJ/g), energy (62 kJ/g, (95% CI 27–97 kJ)) Na (19 mg, (95 % CI 6, 32)), added sugars (0·6 g, (95 % CI 0·1, 1·1)), vegetables (3 g, (95 % CI 1, 4)), total grams (12 g, (95 % CI 3, 21)) and saturated fat (0·2 g, (95 % CI 0·1, 0·4)) per eating occasion when accompanied by wider family. When children were accompanied by a formal childcare provider, they consumed significantly lower energy dense meals (−0·9 kJ/g, (95% CI −1·4 – −0·3 kJ/g)), less added sugars (−1·6 g, (95 % CI −2·4, −0·8)) and more fruit (12 g, (95 % CI 3, 21)) per eating occasion than when they were with their parents. The results demonstrate that non-parental caregivers might be an important target to promote healthy eating in young children. Further research is needed to establish which caregivers would benefit most.
Emotion regulation is a key world to understand many human behaviors. Preschool children can exhibite disturbing behaviors that could interfeer with their integration, development and learning abilities. One way to understand these behaviors is their “immature” emotional regulation process. Helping children acquiring this ability can help to solve these disturbances’, which can lead to mental health problems.
Objectives
To experiment with a new acceptance and committment therapy protocol in preschool children
Methods
It is a qualitative interventional study that relies on issues to enable the recognition and regulation of emotions. a protocol was implemented which consists of activities and techniques useful to help children recognize, regulate and accept their emotions, with the support of the educator.
Results
All six selected children accepted to undergo the therapy till the end of the eight sessions. at fisrt, they were enable to recognise some emtions. it was the most difficult for them to recognise body expression of emotion. they had also difficulties find the different worlds to express them and to enact them.Throw different activities, we tried to help children visualize their emotions, imagine them under different faces and play with them. Children were introduced to mindfulness and emotional regulation technics. After One month of the intervention, children were still able to recognize emotions and to propose technics to regulate them. their score on the CBCL were below 70 one month after the intervention.
Conclusions
Even at an early age of 4 years, ACT seems to be possible and helpful for children.
The presence of excessive mirror overflow in children with Attention Deficit/Hyperactivity Disorder (ADHD) is discussed in numerous published reports. These reports, however, include a limited age range in their samples. The objective of this study is to examine the effects of diagnosis and sex on mirror overflow and standard deviation (SD) of tap time in children with and without ADHD across a larger age range (5–12 years) of children.
Methods:
One-hundred and forty-eight children with ADHD and 112 age- and sex-matched typically developing (TD) children completed a finger sequencing task. Mirror overflow, SD of tap time, and mean tap time were measured using finger twitch transducers.
Results:
Results reveal a significant diagnostic effect on mirror overflow such that boys and girls with ADHD demonstrate increased overflow compared to same-sex TD children. Boys with ADHD demonstrated more variable tap times compared to TD boys; no diagnostic effect was observed in the girls.
Conclusions:
Boys with ADHD exhibit anomalous motor variability; girls with ADHD show similar levels of variability as TD girls. Boys and girls with ADHD exhibit similar levels of excessive mirror overflow. This lack of sex differences on mirror overflow is distinct from reports finding sex effects on overflow and could result from an examination of a broader age range than is included in prior reports. Adolescent data would provide a greater understanding of the trajectory of anomalous mirror overflow across development. Examination of functional and structural connectivity would expand the current understanding of the neurobiological foundation of motor overflow.
A validation study of an interviewer-administered, seven-day semi-quantitative food frequency questionnaire (7-d SQFFQ) was conducted in Bangladeshi rural preschool age children. Using a cross-sectional study design, 105 children from 103 households were randomly selected. For the SQFFQ, a list of commonly consumed foods was adapted from the Bangladesh national micronutrient survey 2011–12. The data on the actual number of times and the amount of the children's consumption of the foods in the preceding 1 week were collected by interviewing the mothers. The intake was compared with two non-consecutive days 24-h dietary recalls conducted within 2 weeks after the SQFFQ. Validity was assessed by the standard statistical tests. After adjusting for the energy intake and de-attenuation for within-subject variation, the food groups (cereals, animal source foods, milk and the processed foods) had ‘good’ correlations between the methods (rho 0⋅65–0⋅93; P < 0⋅001). Similarly, the macronutrients (carbohydrate, protein and fats) had ‘good’ correlations (rho 0⋅50–0⋅75; P < 0⋅001) and the key micronutrients (iron, zinc, calcium, vitamin A, etc.) demonstrated ‘good’ correlations (rho 0⋅46–0⋅85; P < 0⋅001). The variation in classifying the two extreme quintiles by the SQFFQ and the 24-h recalls was <10 %. The results from Lin's concordance coefficients showed a ‘moderate’ to ‘excellent’ absolute agreement between the two methods for food groups, and nutrients (0⋅21–0⋅90; P < 0⋅001). This interviewer-administered, 7-d SQFFQ with an open-ended intake frequency demonstrated adequate validity to assess the dietary intake for most nutrients and suitable for dietary assessments of young children in Bangladesh.
Early childhood mental health consultation (ECMHC) has been promoted by the federal government as a promising model for reducing early childhood expulsions and suspensions and is now implemented by numerous states. Despite growing ECMHC proliferation, this study is only the second randomized controlled trial of ECMHC, extending the methodologies of the first to include assessment of effects on random peers. Classrooms were assigned randomly to treatment or waitlist-control condition (n = 51 classrooms, 57 preschool teachers, and 190 preschoolers). Evaluation measures were collected at both pretreatment and posttreatment, following approximately six consultation visits. Classroom and teacher outcomes were evaluated with ordinary least squares regressions, while hierarchical linear modeling was used to evaluate child-level outcomes, accounting for the nested study design. Treatment children (both the target children who prompted the referral for ECMHC and random peers) evidenced significant improvements in social and emotional skills. Promising trend findings were noted for child behavior problem reduction and teacher pedagogical approach and locus of control. No significant effects were found on likelihood of expulsion and classroom mental health climate. This is the first ECMHC to demonstrate effects on nontarget peers in a rigorous randomized controlled trial. Programmatic and methodologic limitations and implications are discussed.
To identify the relationship between preschool children’s dietary diversity and parents’ care behaviours related to their diet including contents of foods and snacks, mealtime practice and parent–child communication.
Design:
Cross-sectional study. Data were extracted from the National Nutrition Survey on Preschool Children in 2015 by Japan’s Ministry of Health, Labour and Welfare.
Setting:
The distribution of food diversity score (FDS) (maximum of eight points) was confirmed. The participants were divided into higher (≥4 points) and lower (≤3 points) food diversity groups. A comparison between the two groups examined parents’ socio-economic status, children’s health and living conditions, and parental care concerning children’s diets (thirteen items). A multiple regression analysis was performed relating FDS to the factors of parental socio-economic status and child health, and a logistic regression analysis was conducted to identify factors of parental care related to the higher food diversity group.
Participants:
2143 persons from households with children aged 2–6 years.
Results:
Parental care concerning children’s diets was the factor most strongly associated with children’s FDS. Those factors most strongly associated with higher food diversity were nutritional balance of foods (OR: 1·76; 95 % CI 1·44, 2·16; P < 0 0001), snack contents (OR: 1·41; 95 % CI 1·07, 1·86; P = 0·014) and regular mealtimes (OR: 1·30; 95 % CI 1·08, 1·55; P = 0·005).
Conclusions:
The findings indicate the importance of parents paying attention to the contents of children’s foods and snacks, ensuring that children eat regularly, and increasing the diversity of their diets.
To examine the association between the amount of time spent at childcare and diet quality in 668 Japanese children aged 1·5–6 years.
Design:
A cross-sectional design was used. Dietary information was collected using dietary records (1 d for children aged 1·5–2 years and 2 d for children aged 3–6 years). Diet quality was assessed by counting the number of nutrients not meeting the Japanese Dietary Reference Intakes (DRI). Each child’s guardian reported the average amount of time spent at childcare per d for the previous 1 month.
Setting:
In total, 315 childcare centres located in twenty-four areas in Japan.
Participants:
In total, 753 children aged 1·5–6 years who attend childcare facilities.
Results:
After adjustment for potential confounders, OR for the low diet quality (≥ 5 of twenty nutrients not meeting DRI) in long (≥10 h/d) v. medium (8–10 h/d) childcare hours was 4·81 (95 % CI 1·96, 11·8) among children aged 5–6 years. There was no significant association in children aged 1·5–2 and 3–4 years.
Conclusion:
This study showed that long time spent at childcare was strongly associated with low diet quality among children aged 5–6 years, but not those aged 1·5–2 and 3–4 years. More research is needed to clarify different associations in each age group.
The present study investigated whether 4- and 5-year-old Mandarin-speaking children are able to process garden-path constructions in real time when the working memory burden associated with revision and reanalysis is kept to minimum. In total, 25 4-year-olds, 25 5-year-olds, and 30 adults were tested using the visual-world paradigm of eye tracking. The obtained eye gaze patterns reflect that the 4- and 5-year-olds, like the adults, committed to an initial misinterpretation and later successfully revised their initial interpretation. The findings show that preschool children are able to revise and reanalyze their initial commitment and then arrive at the correct interpretation using the later-encountered linguistic information when processing the garden-path constructions in the current study. The findings also suggest that although the 4-year-olds successfully processed the garden-path constructions in real time, they were not as effective as the 5-year-olds and the adults in revising and reanalyzing their initial mistaken interpretation when later encountering the critical linguistic cue. Taken together, our findings call for a fine-grained model of child sentence processing.
To associate dietary patterns and food neophobia in low-income preschoolers.
Design:
This was a cross-sectional study using a semi-structured questionnaire for socio-demographic data, birth conditions and breast-feeding history. Food neophobia was assessed using an adapted version of the Child Food Neophobia Scale. Children’s nutritional status was assessed using BMI-for-age and height-for-age Z-scores. Dietary patterns were estimated using a semi-quantitative FFQ through exploratory factor analysis. Multiple linear regression was used to test for an association between food neophobia and dietary pattern adherence.
Setting:
Philanthropic childhood education schools in Aracaju, an urban community in northeastern Brazil, between July and December 2017.
Participants:
Two hundred fourteen children aged 3–6 years and their parents.
Results:
The percentages of low/medium and high food neophobia among preschoolers were 85·9 % and 11·2 %, respectively. Children with high food neophobia more frequently consumed ultra-processed foods rich in sugars (snacks, filled and unfilled cookies and sweets), as well as protein-rich foods (white meat, cheese and yogurt). Three dietary patterns were identified (traditional, snacks and school snacks). Children with a high level of neophobia had lower adherence to traditional dietary patterns.
Conclusions:
A high level of food neophobia among socially vulnerable preschoolers is an eating behaviour related to unhealthy eating and is associated with the poorest diet in typical foods.