This study examined the relationship between adherence to 24 h movement guidelines (24 h MGs) and internalising and externalising behavioural problems in Chinese children aged 3-6 years, with a specific focus on the differences between weekdays and weekends. The guidelines include recommendations for physical activity (PA), screen time (ST), and sleep duration (SD). The results indicated a stronger association between adherence to these guidelines and behavioural problems on weekends compared to weekdays. Specifically, the odds of experiencing internalising problems were 1.33 higher (95% CI: 1.05-1.69) when not satisfying all three behaviours compared to not satisfying one or two. Moreover, on weekends, when ST was not fulfilled, there was a higher likelihood of externalising behaviour problems compared to when it was fulfilled (OR, 1.18, 95% CI, 1.01-1.38), and when all three behaviours were not met, the likelihood was even higher (OR, 1.50, 95% CI, 1.04-2.18). Children who met all three guidelines had fewer internalising and externalising behavioural problems, suggesting a potential beneficial effect on mental health. The study revealed that a higher adherence to these recommendations corresponded to a lower risk of mental health problems. Additionally, higher screen time was linked to an increase in externalising behavioural issues. These findings underscore the importance of adherence to 24 h MGs for optimal mental health in children. Future interventions should consider these behavioural factors and incorporate strategies to promote adherence to these guidelines, particularly on weekends.

The 24-hour movement guidelines (24-h MG) recommend behaviors (physical activity, screen time, sleep) to aid appropriate physical and mental development in early childhood. This research examined parents\' digital media habits (DMH), engagement (DME), and awareness (DMA) among parents in relation to their preschool-aged children\'s 24-h MG in Japan and identified and compared the modifiable determinants of adherence to 24-h MG in urban and rural regions. This cross-sectional study included 867 participants and data were obtained from the International Ipreschooler Surveillance Study Among Asians and OtheRs (IISSAAR). The results revealed that adherence to weekend screen time recommendations and weekday sleep duration were higher in the urban region. The parents\' digital media variables that predicted moderate-intensity to vigorous-intensity physical activity among preschool-aged children were parents\' DME and DMA in the urban regions and parents\' DME in the rural regions. The children\'s screen time was significantly associated with parents\' DMH, DME, and DMA in the urban regions and with parents\' DMH and DMA in the rural regions (p < 0.005, p < 0.001, respectively). This study confirmed that parents\' DMH, DME, and DMA are strong predictors of adherence to 24-h MG among preschool-aged children living in both rural and urban regions in Japan.

To investigate the compliance rates of health-related behaviors among Chinese preschool children, and to explore how supportive family environment, parental behavior, sociodemographic and community factors affect children\'s health-related behavior comprehensively.
Preschool children aged 3 to 6 years were chosen from 5760 villages (residential) committees from 471 counties (districts) of 31 provinces by use of a stratified random sampling procedure, with 10,967 preschool children aged 3-6 years old included. The survey was conducted from September 2020 to November 2020.
The proportion of Chinese preschool children who met the moderate to vigorous physical activity (MVPA), screen time behavior (ST), and sleep behavior (SLP) guidelines were 62.3%, 52.8%, and 53.8%. Among the supportive family environment factors, parents\' time with their children on weekends had the most significant impact on children\'s MVPA, ST, and SLP, with the odds ratio (OR) values of 2.18 (95%CI:1.97, 2.40), 0.69 (0.63, 0.76), and 1.62 (1.48, 1.79), respectively. Among the parental behavior factors, the mother\'s exercise frequency had a strong association with the children\'s MVPA and SLP, with OR values of 1.65 (1.50, 1.83) and 1.24 (1.13, 1.37), respectively; the mother\'s screen time was inversely associated with the children\'s ST with an OR value of 0.47 (0.44, 0.51).
Different types of family environments were associated with the different levels of MVPA, ST and SLP among Chinese preschool children. In addition to the influence of parents\' education and family income, parents could also improve their children\'s behaviors by providing a supportive family environment. The more of these factors presented in a family, the more likely it was for children to meet the guidelines. Therefore, for those families whose children\'s health-related behaviors needed to be improved, the parents should create supportive family environments, such as by playing less on mobile phone and spending more time with children.

Background: Child care settings significantly influence children\'s physical activity (PA) and screen time (ST) behaviors, yet less research has been conducted in family child care homes (FCCHs) than in child care centers. While a few studies have measured family child care providers\' (FCCPs\') PA practices, none have used observation to assess which specific evidence-based, best practice guidelines FCCPs met or did not meet, and no previous studies have included Latinx providers. This article examines FCCPs\' adherence to PA and ST best practice guidelines using primarily observational methods with diverse FCCPs (including Latinx). Methods: We examined baseline data from a cluster randomized trial including surveys and observational data collected at the FCCH to assess whether providers met specific PA and ST best practices from the Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) and the American Academy of Pediatrics. Results: Providers completed a telephone survey and participated in two full-day observations (n = 127; 72% Hispanic). Overall, only 4 of 14 PA and ST best practices were met by >50% of providers including: leading a planned PA class more than once a week; no ST during meal or snack; not modeling sedentary behavior; and providing families with information about children\'s ST. Best practices least likely to be met (<20% of providers) include: providing children with >60 minutes of outdoor play daily; providing children with >45 minutes of adult-led PA each day; participating in outdoor PA with children; participating in indoor PA with children; prompting and praising children for being active; and talking with children informally about the importance of PA. Conclusions: While FCCPs engage in some positive PA and ST practices, many providers do not meet best practice guidelines. There is a need for more research about how to overcome providers\' personal and environmental barriers for meeting these guidelines as well as interventions and supports to overcome these barriers. Clinical Trial Registration Number NCT0245645.

The interactions between movement behaviors (physical activity, screen time, and sleep) affect the health of preschool children. Therefore, we examined the status of adherence to combinations of 24-hour movement guidelines (24-h MG) in Japanese preschool children and determined the associations between overweight/obesity and adherence to these 24-h MG. This cross-sectional study was conducted with 421 children aged 3-5 years (216 boys and 199 girls) living in the northeastern region of Japan. To evaluate the 24-h MG, physical activity over one week was measured using a three-axis accelerometer. For screen time and sleep duration, a questionnaire survey was conducted. Children who failed to meet all the 24-h MG had a higher probability of overweight/obesity than those who met all the 24-h MG (odds ratio 1.139, 95% confidence interval: 1.009, 1.285). The percentage of adherence to the 24-h MG was 91.6% for physical activity, 82.5% for sleep duration, and 33.7% for screen time, and only 21.5% of the children adhered to all three areas of the guidelines. Our findings have important implications for developing public health policies and effective intervention programs for preschool children.

OBJECTIVE: The definition and diagnosis of asthma are the subject of controversy that is particularly intense in the case of individuals in the first years of life, due to reasons such as the difficulty of performing objective pulmonary function tests or the high frequency with which the symptoms subside in the course of childhood. Since there is no consensus regarding the diagnosis of asthma in preschool children, a systematic review has been carried out.
METHODS: A systematic search was made of the clinical guidelines published in the last 10 years and containing information referred to the concept or diagnosis of asthma in childhood - including the first years of life (infants and preschool children). A series of key questions were established, and each selected guide was analyzed in search of answers to those questions. The review protocol was registered in the international prospective register of systematic reviews (PROSPERO), with registration number CRD42017074872.
RESULTS: Twenty-one clinical guidelines were selected: 10 general guides (children and adults), eight pediatric guides and three guides focusing on preschool children. The immense majority accepted that asthma can be diagnosed from the first years of life, without requiring pulmonary function tests or other complementary techniques. The response to treatment and the exclusion of other alternative diagnoses are key elements for establishing the diagnosis. Only one of the guides denied the possibility of diagnosing asthma in preschool children.
CONCLUSIONS: There is generalized although not unanimous agreement that asthma can be diagnosed in preschool children.

暂无摘要。

OBJECTIVE: Public health organizations recommend that preschool-aged children accumulate at least 3h of physical activity (PA) daily. Objective monitoring using pedometers offers an opportunity to measure preschooler\'s PA and assess compliance with this recommendation. The purpose of this study was to derive step-based recommendations consistent with the 3h PA recommendation for preschool-aged children.
METHODS: The study sample comprised 916 preschool-aged children, aged 3 to 6years (mean age=5.0±0.8years). Children were recruited from kindergartens located in Portugal, between 2009 and 2013. Children wore an ActiGraph GT1M accelerometer that measured PA intensity and steps per day simultaneously over a 7-day monitoring period. Receiver operating characteristic (ROC) curve analysis was used to identify the daily step count threshold associated with meeting the daily 3hour PA recommendation.
RESULTS: A significant correlation was observed between minutes of total PA and steps per day (r=0.76, p<0.001). The optimal step count for ≥3h of total PA was 9099 steps per day (sensitivity (90%) and specificity (66%)) with area under the ROC curve=0.86 (95% CI: 0.84 to 0.88).
CONCLUSIONS: Preschool-aged children who accumulate less than 9000 steps per day may be considered Insufficiently Active.

In 2008, the Alberta government released the Alberta Nutrition Guidelines for Children and Youth (ANGCY) as a resource for child care facilities to translate nutrition recommendations into practical food choices. Using a multiple case study method, early adoption of the guidelines was examined in two child care centres in Alberta, Canada. Key constructs from the Diffusion of Innovations framework were used to develop an interview protocol based on the perceived characteristics of the guidelines (relative advantage, compatibility, complexity, trialability and observability) by child care providers. Analysis of the ANGCY was conducted by a trained qualitative researcher and validated by an external qualitative researcher. This entailed reviewing guideline content, layout, organisation, presentation, format, comprehensiveness and dissemination to understand whether characteristics of the guidelines affect the adoption process. Data were collected through direct observation, key informant interviews and documentation of field notes. Qualitative data were analysed using content analysis. Overall, the guidelines were perceived positively by child care providers. Child care providers found the guidelines to have a high relative advantage, be compatible with current practice, have a low level of complexity, easy to try and easy to observe changes. It is valuable to understand how child care providers perceive characteristics of guidelines as this is the first step in identifying the needs of child care providers with respect to early adoption and identifying potential educational strategies important for dissemination.