UNASSIGNED: In 1995, the World Health Organization launched its Global School Health Initiative intending to expand this health promotion approach throughout schools globally. In this study, we aim to assess the preparedness of preschools in the adoption of intervention packages under the Nutrition Friendly School Initiative (NFSI) checklist.
UNASSIGNED: From three campuses of the Aga Khan School located in the Thatta and Sujawal districts of the Sindh province, Pakistan, all eligible preschool children were selected for this study. Using a pre-and post-intervention design, we assessed preschool preparedness using the NFSI checklist, knowledge of parents/caregivers regarding health and nutrition promoting behaviors, and anthropometric measurements (i.e., mid-upper arm circumference (MUAC), weight, and height) for preschool children. The NFSI checklist was analyzed with differential scores, while descriptive statistics were used for anthropometric and knowledge data. Continuous variables (i.e., height, weight, MUAC) were presented as means, while categorical variables (knowledge) were expressed as numbers and percentages. Paired t-tests for dependent samples were used to statistically assess mean differences in MUAC, height, weight, height-for-age Z-score, weight-for-age Z-score, weight-for-height Z-score, and changes in parental knowledge of preschool children.
UNASSIGNED: Data from 164 preschool children (ages 24-84 months, mean age 56.7 months) were analyzed over 3 months. School preparedness scores improved from 10 to 22 points (out of 26). Parental knowledge on nutrition and health increased by 7.2 points (out of 25). Children showed mean increases in MUAC (0.27 cm), weight (0.36 kg), and height (0.62 cm) (p < 0.001). Stunting and overweight/obesity rates remained the same (7.3 and 4.3%), while underweight and wasting rates dropped from 10.4 to 7.3% and 7.9 to 6.1%, respectively. The initiative effectively reduced underweight and wasting but did not impact stunting and overweight.
UNASSIGNED: The NFSI has greatly enhanced preschool readiness for nutrition-friendly schools. Engaging the private sector in addressing nutritional challenges has paved the way for future public-private partnerships to tackle malnutrition. The nutrition policy formulated through this initiative could serve as a blueprint for a National School Nutrition Policy.

BACKGROUND: This study aimed to investigate the difference between cycloplegic and noncycloplegic refraction and evaluate the pseudomyopia prevalence in Chinese preschool children during the outbreak of COVID-19.
METHODS: A cross-sectional study was conducted in the Tongzhou District of Beijing, China. Refractive error was measured under both noncycloplegic and cycloplegic conditions with autorefraction. The difference between noncycloplegic and cycloplegic spherical equivalent refraction (SER) and pseudomyopia prevalence were analyzed. Pseudomyopia was defined as SER ≤-0.50D in precycloplegic assessments and >-0.50D in post-cycloplegic assessments.
RESULTS: Out of the 1487 participants who were enrolled in the study, 1471 individuals (98.92%) between the ages of 3-6 years completed all required procedures. A statistically significant difference in refraction was observed between noncycloplegic and cycloplegic measurements, the median of difference in spherical equivalent refraction (SER) of 0.88D (dioptre)(0.50,1.38). There was a high intraclass correlation (ICC) between these two methods for cylinders (ICC = 0.864; 95% CI, 0.850-0.877). The median DSE for myopia, emmetropia and hyperopia were 0.25D (0.00, 0.38),0.25D (0.06, 0.50) and 1.00D (0.62, 1.38), an hypermetropes showed considerably greater differences than myopes and emmetropes (Kruskal-Wallis test, H = 231.023, P = 0.000). Additionally, girls displayed a greater DSE than boys. Furthermore, when comparing against-the-rule (ATR) and oblique astigmatism, it was found that with-the-rule (WTR) astigmatism had the largest DSE. The study found varying prevalence rates of myopia, emmetropia, and hyperopia with and without cycloplegia, which were 1.90% vs. 10.06%, 11.49% vs. 50.31%, and 86.61% vs. 39.63%, respectively. Additionally, the overall prevalence of pseudomyopia was determined to be 8.29%. Participants with pseudomyopia had a significantly higher mean difference in SER (DSE) compared to non-pseudomyopic participants.
CONCLUSIONS: Cycloplegic refraction is more sensitive than a noncycloplegic one for measuring refractive error in preschool children. Pseudomyopia is prevalent in preschool children during the COVID-19 outbreak period. Our study indicates the possibility that cycloplegic refraction should be performed in preschool children routinely.

\'Healthy Youngsters, Healthy Dads\' (HYHD) targets fathers to improve the health of their preschool-aged children. In a previous randomized trial, fathers and children experienced meaningful improvements in physical activity and eating behaviours. The next phase is to test the replicability and adaptability of HYHD when delivered in the community by trained facilitators. Fathers/father-figures and children aged 3-5 years were recruited from Newcastle, Australia into a 9-week, non-randomized trial with assessments at baseline, 10 weeks, and 12 months. The primary outcome was achievement of pre-registered targets for recruitment (≥ 96 dyads), attendance (≥ 70%), compliance (completing ≥ 70% of home-based tasks), fidelity (≥ 80% of content delivered as intended) and program satisfaction (≥ 4/5). Secondary outcomes included physical activity, nutrition, screen time and parenting measures. Process targets were surpassed for recruitment (140 fathers, 141 children), attendance (79% for fathers-only workshops, 81% for father-child sessions), compliance (80% of home-tasks completed), fidelity (99% for education, ≥ 97% for practical) and program satisfaction (4.8/5). Mixed effects regression models revealed significant effects in fathers for moderate-to-vigorous physical activity, co-physical activity, dietary intake and parenting practises, which were maintained at 12 months. Significant effects were also established for screen time at 10 weeks only. For children, significant effects were observed for screen time and dietary intake at 10 weeks, while effects on energy-dense, nutrient-poor foods and healthy, nutrient-dense core food intake were maintained at 12 months. Findings demonstrate the replicability and adaptability of HYHD when delivered in the community by local trained facilitators. Further investigation into how to optimally scale-up HYHD is warranted.

Giardiasis is one of the major causes of diarrhea among children. To determine the prevalence, risk factors, and genotype of Giardia intestinalis, a cross-sectional descriptive study was done on stool samples of 462 children attending three monastery primary schools from North Okkalapa Township in Yangon, Myanmar from January 2016 to February 2019. Socioeconomic data were collected using a pre-tested questionnaire after obtaining informed consent. Direct wet mount, formalin-ether sedimentation, and trichrome staining techniques were used for the primary identification and then molecular identification was carried out by conventional polymerase chain reaction (PCR)-sequencing assay. G. intestinalis was identified in 11.7% (54/462) of students. There was no significant association with water source (p=0.948) and drinking untreated water (p=0.595). The infection was more common in children with low-educated parents, unsanitary garbage disposal practices, and no restrooms. All isolates were G. intestinalis assemblage B. This is the first study characterizing human isolates in a lower region of Myanmar, at the molecular level [MOU1]. These findings pointed out the high prevalence of G. intestinalis among primary school children from densely populated and low-resource settings.

School adjustment affects children\'s future lives in many ways. This study examined the relationship between ToM skills, peer relationships, and school adjustment. Specifically, this study determined whether preschool children\'s school adjustment could be significantly predicted by theory of mind (ToM) skills and peer relationships. A total of 164 children aged 4 (34.5%), and 5 (38%) years of preschool attendance participated in the study. According to the research, children\'s age, theory of mind, peer relations, and school adjustment are closely related. It was also found that the theory of mind significantly predicted school adjustment (school liking/avoidance) and that prosocial and aggressive behavior predicted school liking.

UNASSIGNED: Jordan faces various malnutrition challenges, including undernutrition, micronutrient deficiencies, overweight, obesity, and diet-related non-communicable diseases. The country has shifted from issues of undernutrition to rising rates of overweight and obesity, while still dealing with micronutrient deficiencies. The 2010 national survey revealed high rates of iron and vitamin D deficiencies among preschool children, with about 20% experiencing vitamin A deficiencies. The goals of the 2019 Jordan National Micronutrient & Nutrition Survey (JNMNS) include assessing feeding practices of infants and young children, determining the frequency of consuming micronutrient-rich foods, evaluating causes of anemia, assessing the health status of specific subgroups, and comparing findings to the 2010 survey.
UNASSIGNED: JNMNS 2019 was a comprehensive national cross-sectional survey structured across four strata. Within each stratum, 40 primary sampling units were chosen in proportion to their size based on the 2015 Jordan census. Subsequently, the Department of Statistics conducted household listings in each PSU. Separate response rates were assumed for households and target groups, encompassing interviews, anthropometric measurements, and specimen collection. The survey aimed to collect data from 2,210 households, including interviews and anthropometry for 1,232 preschool children, with blood samples obtained from 992 of them.
UNASSIGNED: The findings revealed no severe anemia cases, but 11% of preschoolers aged 12-59 months were anemic. Iron deficiency affected 22.4%, with 5% having iron deficiency anemia. Vitamin D deficiency increased to 22.9% in 2019. Stunting and wasting rates improved slightly to 6.3 and 0.1%, respectively. Overweight and obesity rates remained stable at 6.2 and 2.1%. Anemia decreased by 5-6%, but iron deficiency rose by 7%. Vitamin A deficiency decreased, but iron deficiency anemia remained largely unchanged. Undernutrition was rare, but vitamin D deficiency affected 27.7% of preschoolers, impacting growth and immunity. Iron deficiency, affecting 25% of children, poses a risk to cognitive development. Overweight or obesity affected 9% of children, a medium public health issue according to the WHO. While malnutrition rates are low, the persistent issues of vitamin D deficiency, iron deficiency, and childhood obesity require focused attention.
UNASSIGNED: The study highlights ongoing nutritional challenges among Jordanian preschoolers. Although severe anemia was rare, 11% were anemic, and 22.4% had iron deficiency, including 5% with iron deficiency anemia. Vitamin D deficiency affected 22.9%, impacting growth and immunity. While stunting and wasting improved, childhood overweight and obesity rates remained steady. Anemia decreased, but iron deficiency rose by 7%. Despite reduced vitamin A deficiency, stable iron deficiency anemia rates indicate ongoing concerns. Overall, undernutrition is uncommon, but vitamin D and iron deficiencies, along with childhood obesity, need sustained attention and targeted interventions to improve children\'s health in Jordan.

Background Dental caries and gingivitis are preventable diseases that remain highly prevalent among children globally and, while transmissible through the transfer of oral bacteria typically from mother to child, differ from communicable diseases that are spread through direct contact, air, or vectors. Unlike communicable diseases, dental caries and gingivitis can be effectively prevented through proper oral hygiene practices and dietary modifications. Oral health education (OHE) intends to improve oral hygiene practices and reduce oral health problems. However, evidence of the impact of multiple topics in OHE on preschool children is lacking. This study aimed to examine the effects of single- versus multiple-topic OHE delivered via video presentations on the plaque and gingival status of preschool children. Methods A parallel five-arm cluster randomized controlled trial was conducted on healthy preschool children aged five and six years. Children with chronic illnesses, disabilities, or conditions that could affect their oral health or ability to participate in the OHE intervention were excluded. OHE interventions were given to children from eight of the 10 classes assigned as intervention groups, while two classes served as the control group and received no intervention. The intervention groups received one, two, or three oral health topics using specially developed animation videos, in Malay language: toothbrushing technique (T), toothbrushing technique and the effects of sugar consumption on oral health (TS), toothbrushing technique and pathogenesis of dental caries and gingivitis (TP), and toothbrushing technique, the effects of sugar consumption on oral health, and pathogenesis of dental caries and gingivitis (TSP). Plaque and gingival scores, along with oral health knowledge, attitude, and skills (KAS), were recorded before and after the intervention. The CONSORT guidelines were followed in reporting. The analyses included descriptive statistics, one-way ANOVA, effect sizes, and multivariate analysis of covariance (MANCOVA) at a 5% significance level. Results A total of 160 participants were equally distributed into five groups (n = 32). There were no baseline differences in plaque or gingival scores. All groups showed significantly lower plaque and gingival scores post-intervention (p < 0.05), with effect sizes ranging from -1.1 to -0.7. No changes in oral health (KAS) were observed. The intervention groups had significantly lower plaque and gingival scores compared to the control group (p < 0.05), but no differences were found between them after adjusting for baseline KAS (p > 0.05). Conclusions This study suggests that including multiple topics in OHE programs for preschool children may not necessarily improve oral health outcomes. Simplified OHE may be more advantageous in terms of time, cost, human resources, and organization.

To investigate the association between parenting style and child\'s dental caries. Parents presenting with their children to the Department of Pediatric Dentistry at Tufts University School of Dental Medicine for an initial exam or re-care appointment completed a demographic survey and the parenting styles and dimensions questionnaire. Recruitment of subjects started in May 2019 and ended in February of 2020. Child\'s decayed, missing, and filled teeth (dmft) index, diet score, sex, and age were recorded, as were parent\'s race, education level, and form of payment. Adjustment for confounders was done using multivariable negative binomial regression. The sample size was 210 parent/child dyads. In the multivariable analysis, parenting style and child\'s dmft were not significantly associated (p > 0.05). Parents with an education level less than high school (p = 0.02) and at the high school graduate level (p = 0.008) were significantly associated with children who had higher dmft, compared to parents with a college degree or higher. Children with excellent diet scores had significantly lower dmft than children with a diet score in the \"needs improvement\" category (p = 0.003). There was no significant evidence that parenting style is associated with child\'s dental caries. Parent\'s education level and child\'s diet score were significantly associated with child\'s dmft, less than high school (p = 0.02) and at the level of high school graduate (p = 0.008). Pediatric dental professionals should be aware of these risk indicators.

BACKGROUND: Preschool represents the budding and initial stage of bullying behavior, where perpetration of physical bullying predominates as the primary form of bullying. An in-depth understanding of the factors linked to preschool physical bullying behavior is crucial for enabling early prevention and intervention strategies.
OBJECTIVE: The purpose of this study was to examine the relationship between Theory of Mind and physical bullying behavior in 4-6 years old children in kindergarten and the mediating role of peer rejection and gender in this relationship.
METHODS: Data on perpetration of physical bullying and peer rejection were obtained from 310 preschool children (age range = 52-79 months, M = 66.85, SD = 7.04) by the peer nomination method, and their Theory of Mind was measured by the Theory of Mind Development Scale.
RESULTS: The results showed that Theory of Mind negatively predicted perpetration of physical bullying in preschool children and that Theory of Mind was related to perpetration of physical bullying in preschool children only through peer rejection. Boys were also found to have a stronger association between peer rejection and perpetration of physical bullying in preschool children than girls.
CONCLUSIONS: Peer rejection may play a mediating role between Theory of Mind and perpetration of physical bullying in preschool children. In addition, the relationship between peer rejection and perpetration of physical bullying appears to be stronger for boys than for girls. This contributes to our understanding of the relationship between Theory of Mind and perpetration of physical bullying in preschool children and has implications for how bullying prevention and intervention can be tailored to the gender of young children.

In the Chinese cultural context, the collaborative interaction characteristics among three key entities - families, kindergartens, and communities - and the mechanisms of their correlation with preschool children\'s social behavior problems have not been fully understood yet. Based on ecological systems Theory and social support theory, this study aimed to examine the correlation between parent-teacher relationships and preschool children\'s social behavior problems in Chinese kindergartens, as well as the mediating role of parents\' work-family conflict and parenting self-efficacy. Structural equation modeling was used to test the research hypotheses based on a questionnaire survey of 1,784 parents of preschool children. The main findings of this study are as follows: (1) Parents\' perceived positive parent-teacher relationships are negatively correlated with preschool children\'s social problems. (2) Parents\' work-family conflict and parenting self-efficacy mediate the relationship between parent-teacher relationships and preschool children\'s social behavior problems; (3) Parents\' work-family conflict and parenting self-efficacy play a chain mediating role in the influence of the parent-teacher relationship on preschool children\'s social behavior problems. Taken together, the results collectively further elucidate the correlation between parent-teacher relationships and preschool children\'s social behavior problems, while also discussing other relevant factors pertaining to children\'s social behavior problems. Theoretically, this study expands the understanding of how external environmental resources interact with home and family education. Practically, this research indicates that governments, early childhood education institutions, and workplaces need to strengthen their support for family education of preschool children. The findings contribute to promoting a multi-faceted co-operation aimed at enhancing the quality of early childhood education and fostering the social adaptability and holistic development of preschool children.