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OBJECTIVE: Empirical evidence underscores an association between parental stress and emotional and behavioral problems in offspring. However, a comprehensive systematic review or meta-analysis on this topic is lacking. Thus, this study aims to address the scientific inquiry: Is there a relationship between parental stress and emotional/behavioral problems in children? SOURCES: This systematic review with a meta-analysis surveyed PubMed, PsycINFO, and the Biblioteca Virtual em Saúde between August and September 2021. The present search combined terms (school-age children) AND (parental stress OR parenting stress OR family stress) AND (emotional and behavioral problems OR internalizing and externalizing problems). Eligibility criteria encompassed cross-sectional, cohort, and case-control studies published within the last five years, exploring the association between parental stress (stressful life events and parenthood-related stress disorders) and emotional/behavioral problems in school-age children. PROSPERO ID CRD42022274034. SUMMARY OF THE FINDINGS: Of the 24 studies meeting all inclusion criteria (n = 31,183) for the systematic review, nine were eligible for inclusion in the meta-analysis. The meta-analysis revealed an association between parental stress and emotional problems (COR: 0.46 [95 % CI: 0.27 - 0.61], p < 0.001, Heterogeneity = 89 %) as well as behavioral problems (COR: 0.37 [95 % CI: 0.27 - 0.46], p < 0.001, Heterogeneity = 76 %). CONCLUSIONS: These findings indicate that parental stress predicts emotional/behavioral problems in school-age children. Since these problems are related to long-term negative effects in adulthood, these results are crucial for preventing mental health problems in offspring and for screening and managing parental stress.

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INTRODUCTION: Reactance inversion (RI) has been associated with impaired peripheral airway function in persistent asthma. However, there is little to no data about the difference between asthmatic children with and without RI. This study aimed to detect clinical and lung function differences in moderate-severe asthmatic children with and without RI. METHODS: This study was conducted between 2021 and 2022 in asthmatic school-age children. Impulse oscillometry (IOS) and spirometry were performed according to ATS/ERS standards. RESULTS: A total of 62 patients, with a mean age of 8.4 years, 54.8% were males and were divided into three groups: group 1 (32.3%) with no RI, group 2 (27.4%) with RI but disappearing after bronchodilator test and group 3 (40.3%) with persistent RI after bronchodilator test. Children in groups 2 and 3 had significantly lower birth weights than in group 1. Group 2 had lower gestational age compared to group 1. FEV1 and FEF25-75 of forced vital capacity were significantly lower in groups 2 and 3. In group 3, R5, AX, R5-20, and R5-R20/R5 ratios were significantly higher. Bronchodilator responses (BDR) in X5c, AX, and R5-R20 were significantly different between groups and lower in group 3. CONCLUSION: RI is frequently found in children with moderate-severe persistent asthma, particularly in those with a history of prematurity or low birth weight. In some patients, RI disappears after the bronchodilator test; however, it, persists in those with the worst pulmonary function. RI could be a small airway dysfunction marker.

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Iodine intake in Haiti has increased in recent years thanks to the "Bon Sel" social enterprise approach to salt fortification and distribution by the market segment. However, it was uncertain whether this salt reached remote communities. This cross-sectional study aimed to assess the iodine status of school-age children (SAC) and women of reproductive age (WRA) in a remote region of the Central Plateau. A total of 400 children (9-13 years) and 322 women (18-44 years) were recruited through schools and churches, respectively. Urinary iodine (UIC) and urinary creatinine (UCC) concentrations were measured in spot samples, and thyroglobulin (Tg) on dried blood spots. Their iodine intake was estimated, and dietary information collected. The median (IQR) UIC in SAC was 130 µg/L (79-204, n = 399), and in WRA, 115 µg/L (73-173, n = 322). The median (IQR) Tg in SAC was 19.7 µg/L (14.0-27.6, n = 370), and in WRA, 12.2 µg/L (7.9-19.0, n = 183); 10% of SAC had Tg > 40 µg/L. Estimated iodine intake was 77 µg/day and 202 µg/day in SAC and WRA, respectively. Iodized table salt was rarely consumed, though bouillon was used daily; this is hypothesized to be a major contributor to dietary iodine intake. Iodine intake in this remote region seems to have improved considerably since the 2018 national survey, though SAC remain at risk. These results point to the potential effectiveness of using social business principles to deliver humanitarian solutions.

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BACKGROUND: Cardiometabolic diseases and metabolic syndrome (MetS) are becoming increasingly prevalent in low- and middle-income countries (LMICs). Cardiometabolic diseases and MetS are closely associated with low-grade systemic inflammation, which may be modified by diet. Previous studies have focused on the association of dietary inflammation with MetS and cardiometabolic risk in adult populations, but few studies have examined this issue in children, especially in LMICs. METHODS: We conducted a cross-sectional study to explore the association of dietary inflammation with cardiometabolic risk components and MetS in urban Ecuadorian children aged 6-12 years old (n = 276). A semi-quantitative food frequency questionnaire (FFQ) was used to collect data on child dietary intake. Dietary inflammation was evaluated using an energy-adjusted Dietary Inflammatory Index (DII), divided into quartiles. Data were also collected on cardiometabolic risk indicators including blood lipids, blood pressure (BP), blood glucose, body mass index, and waist circumference. Data were analyzed using multivariable linear and logistic regression. RESULTS: Child DII scores ranged from -4.87 (most anti-inflammatory) to 4.75 (most pro-inflammatory). We transformed the continuous scores into quartiles (Q): Q1 was the most anti-inflammatory (-4.87 to -3.35), Q2 was anti-inflammatory (-3.34 to -1.45), Q3 was pro-inflammatory (-1.44 to 1.08), and Q4 was the most pro-inflammatory (1.09 to 4.75). In the covariate-adjusted model, DII scores were positively associated with total blood cholesterol (p = 0.027), triglycerides (p = 0.034), and diastolic BP (p = 0.013). In addition, for every one-unit increase in DII score, MetS increased by 1.20 in the covariate-adjusted model (95% CI = 1.01,1.43). CONCLUSIONS: The findings suggest that more pro-inflammatory diets may contribute to poorer cardiometabolic health in school-age children. This is important because even small increases in child blood pressure, blood cholesterol, and glucose levels over time can damage health and lead to earlier progression to conditions such as hypertension and atherosclerosis.

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Objective: the objective of this study was to examine the anthropometric and physical profile of selected school-age children in rural and urban setting. Methods: the descriptive cross-sectional design was adopted for the study while multistage sampling techniques, which included simple random and systematic sampling techniques, were used to draw samples from the target population. The sample constitute healthy children who voluntarily participated in the study after consent for participation was given by individual parent. Anthropometric measurements for the study included height, weight, sitting height and BMI while the physical fitness tests for the study included sit and reach, handgrip strength, speed bounce, standing broad jump, 10m x 5 shuttles run and multistage fitness test. Z score, STEN score and independent T-Test were used for data analysis. Results: a total of 222 healthy children with average age of 10 years (male=112, female=109) participated in the study. The results showed that the urban children were taller (Urban=141.3±9.2m; Rural=134±21.3m), heavier (Urban=37.6±10.4kg; Rural=28.2±6.2kg), had more leg power (Urban=105.7±25.5; Rural=49.4±41.0) and arm strength (Urban=15.7±4.1; Rural=13.4±5.2) than rural children. However, the rural children had higher sit and reach score (Rural=25.3±5.8; Urban=22.8±6.0) and completed more laps in multistage fitness test (Rural=35.5±25.5; Urban=12±5.7). The statistical analysis showed that all the variables were significantly different urban and rural children (P<0.05). Conclusion: the current study shows that the children in the urban and rural settings differed in the selected anthropometric and physical variables Therefore, the physical education program and infrastructural facilities for physical activity and sport participation for school age children should be designed based on the socioeconomic status, social amenities and level of development of the host community

Objetivo: examinar o perfil antropométrico e físico de crianças em idade escolar selecionadas em ambientes rurais e urbanos. Métodos: foi realizado um estudo transversal aplicando técnicas de amostragem em vários estágios, que incluíam processos de amostragem aleatória simples e sistemática, usadas para extrair amostras da população-alvo. A amostra constitui-se de crianças saudáveis que participaram voluntariamente do estudo, após consentimento para participação dado por um dos pais. As medições antropométricas incluíram altura, peso, altura sentada e IMC, enquanto os testes de aptidão física para o estudo incluíram sentar-se e alcançar, força de preensão manual, salto de velocidade, salto em largura, corrida de vaivém de 10 x 5 metros e teste de aptidão multiestágio. Foram usados para a análise escore z, escore STEN e teste t independentemente dos dados. Resultados: um total de 222 crianças saudáveis com idade média de 10 anos (masculino=112, feminino=109) participaram do estudo. Os resultados mostraram que as crianças urbanas eram mais altas (Urbano=141,3±9,2m; Rurais=134±21,3m), mais pesadas (Urbano=37,6±10,4kg; Rurais=28,2±6,2kg), tinham mais força nas pernas (Urbano=105,7±25,5; Rurais =49,4±41,0) e força de braço (Urbano=15,7±4,1; Rural=13,4±5,2) do que as crianças da zona rural. No entanto, as crianças da zona rural tiveram maior pontuação de sentar e alcançar (Rural=25,3±5,8; Urbana=22,8±6,0) e completaram mais voltas no teste de condicionamento físico multiestágio (Rural=35,5±25,5; Urbana=12±5,7). Todas as variáveis eram significativamente diferentes entre crianças urbanas e rurais (P<0,05). Conclusão: o presente estudo mostrou que as crianças das áreas urbana e rural diferiram nas variáveis antropométricas e físicas selecionadas. Portanto, o programa de educação física e as instalações de infraestrutura para atividades físicas e participação em esportes para crianças em idade escolar devem ser projetados com base no status socioeconômico, nas comodidades sociais e no nível de desenvolvimento da comunidade anfitriã

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OBJECTIVE: Intestinal parasitic infections (IPIs) are a public health challenge in developing countries such as Colombia, causing anaemia and delayed growth and development in children. We aimed to estimate the geographical and prevalence trend of IPIs in the last 30 years in school and preschool children in Colombia. METHODS: We conducted a systematic review and meta-analysis. We identified potential manuscripts through PubMed, EMBASE, Web of Science, LILACS, Scielo and Google Scholar on the IPIs prevalence in school and preschool children in Colombia. Articles included in the qualitative analysis were published between 1990 and 2020 in English or Spanish and met the inclusion criteria. Subsequently, a random-effects meta-analysis, a meta-regression and a trend analysis were performed. RESULTS: We identified 2292 articles; 109 were included in the qualitative review, and 79 articles were included in the meta-analysis. The estimated IPI prevalence was 55% (95% CI: 48-63). By age group, the prevalence in preschool children was 37% (95% CI: 26-49) and 66% (95% CI: 52-78) in schoolchildren. The prevalence by region was heterogeneous, with the Amazon being the highest (69%) and the Santanderes the lowest (28%). In the last 20 years, the prevalence of helminthiasis has decreased (from 64.66% in 1990-1995 to 22.09% in 2016-2020). CONCLUSION: The prevalence of IPIs is high (>30%) in three of the seven regions in Colombia. Biannual administration of mass deworming in schoolchildren is recommended in the Amazon region. Public policies aiming to control IPIs should be reinforced. Further prevalence studies should include Cesar, Guaviare, Vichada and Vaupés, where the epidemiology of IPIs is unknown. SUSTAINABLE DEVELOPMENT GOALS: Good health and wellbeing, clean water and sanitation, sustainable cities and communities.

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The COVID-19 pandemic has further highlighted the deep digital divide in Mexico and the enormous challenge faced by its education system in continuing to educate the country's students while under confinement. The objective of this article was to examine the determinants of internet access, use and productive uses for school-age children in households of different socioeconomic levels. The Heckman selection model was estimated based on data taken from the Encuesta Nacional sobre Disponibilidad y Uso de Tecnologías de la Información en los Hogares (ENDUTIH or National Survey on the Availability and Use of Information Technologies in the Household) 2018. The results obtained show that the probability of having children internet accessing and usage patterns (homework, courses, and blogs) depends on level of schooling, economic status, digital skills, and place of residence, as well as the presence of electronic devices and infomediaries in the household. These findings suggest the urgent need to redesign current ICT policy with a long-term integrated vision that guarantees access to ICTs and their productive use for students immersed in an ecosystem of educational innovation for the XXI century.

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PROBLEM: Sleep disturbance is a characteristic symptom of depression, but it is also a problem in itself related to the severity of this illness. Hence, the objective of this study was to examine sleep habits and sleep problems associated with increased depressive symptoms in children. METHODS: The sample included 524 children equally distributed by gender (51.1% female), with an average age of 10.29 (SD = 1.34) years. The administered instruments were the Children's Depression Inventory (CDI; Cronbach α = 0.82) and a Sleep Habits and Sleep Problems Questionnaire (α = 0.91). FINDINGS: The mean score for the CDI was 12.51 (SD = 6.74) and 20% presented symptoms of depression. The linear regression model showed that sleep habits associated with the increase in symptoms of depression were: little sleep, hours of sleep during the week, and wake-up time on weekdays. In the same model, the associated sleep problems were: nocturnal awakenings, nightmares, and difficulty waking up. The presence of these sleep habits and sleep problems increased the score from 2.07 to 13.50 points on the CDI scale. CONCLUSIONS: Depressive symptoms increase with the presence of sleep habits related to sleep deprivation and sleep problems related to parasomnias in school-age children.

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Dietary fiber (DF) is a major substrate for the gut microbiota that contributes to metabolic health. Recent studies have shown that diet-metabolic phenotype effect might be related to individual gut microbial profiles or enterotypes. Thus, the aim of this study was to examine whether microbial enterotypes modify the association between DF intake and metabolic traits. This cross-sectional study included 204 children (6-12 years old) and 75 adults (18-60 years old). Habitual DF intake was estimated with a Food Frequency Questionnaire and biochemical, clinical and anthropometric data were obtained. Gut microbiota was assessed through 16S sequencing and participants were stratified by enterotypes. Correlations adjusting for age and sex were performed to test the associations between dietary fiber components intake and metabolic traits. In children and adults from the Prevotella enterotype, a nominal negative correlation of hemicellulose intake with insulin and HOMA-IR levels was observed (p < 0.05), while in individuals of the other enterotypes, these associations were not observed. Interestingly, the latter effect was not related to the fecal short-chain-fatty acids profile. Our results contribute to understanding the enterotype influence on the diet-phenotype interaction, which ultimate could provide evidence for their use as potential biomarkers for future precision nutrition strategies.

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Childhood obesity and T2DM have shown a recent alarming increase due to important changes in global lifestyle and dietary habits, highlighting the need for urgent and novel solutions to improve global public health. Gut microbiota has been shown to be relevant in human health and its dysbiosis has been associated with MetS, a health condition linked to the onset of relevant diseases including T2DM. Even though there have been recent improvements in the understanding of gut microbiota-host interactions, pediatric gut microbiota has been poorly studied compared to adults. This review provides an overview of MetS and its relevance in school-age children, discusses gut microbiota and its possible association with this metabolic condition including relevant emerging gut microbiome-based interventions for its prevention and treatment, and outlines future challenges and perspectives in preventing microbiota dysbiosis from the early stages of life.

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