Search results for: children’s health
10181 The Effect of Speech-Shaped Noise and Speaker’s Voice Quality on First-Grade Children’s Speech Perception and Listening Comprehension
Authors: I. Schiller, D. Morsomme, A. Remacle
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Children’s ability to process spoken language develops until the late teenage years. At school, where efficient spoken language processing is key to academic achievement, listening conditions are often unfavorable. High background noise and poor teacher’s voice represent typical sources of interference. It can be assumed that these factors particularly affect primary school children, because their language and literacy skills are still low. While it is generally accepted that background noise and impaired voice impede spoken language processing, there is an increasing need for analyzing impacts within specific linguistic areas. Against this background, the aim of the study was to investigate the effect of speech-shaped noise and imitated dysphonic voice on first-grade primary school children’s speech perception and sentence comprehension. Via headphones, 5 to 6-year-old children, recruited within the French-speaking community of Belgium, listened to and performed a minimal-pair discrimination task and a sentence-picture matching task. Stimuli were randomly presented according to four experimental conditions: (1) normal voice / no noise, (2) normal voice / noise, (3) impaired voice / no noise, and (4) impaired voice / noise. The primary outcome measure was task score. How did performance vary with respect to listening condition? Preliminary results will be presented with respect to speech perception and sentence comprehension and carefully interpreted in the light of past findings. This study helps to support our understanding of children’s language processing skills under adverse conditions. Results shall serve as a starting point for probing new measures to optimize children’s learning environment.Keywords: impaired voice, sentence comprehension, speech perception, speech-shaped noise, spoken language processing
Procedia PDF Downloads 17910180 A Case Study on Improving Language Skills of Preschoolers by Parent-Child Reading
Authors: Hoi Yan Lau
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In Hong Kong, most families have working parents, and the primary caregivers of young children are helpers. This leads to a lack of interaction and language expression in children’s home environment, which affects their language development. This study aims to explore the effectiveness of parent-child reading in improving young children’s language skills. A 4-year-old girl and her mother are recruited to a 3 months’ parent-child reading program. There is a total of 26 reading sessions which target to enhance the parent’s skill of parent-child reading and to assess the child’s language ability. At the same time, the child’s use of language in normal classroom settings is analyzed by anecdotal records. It is shown that the parent is able to use more and better guiding questions during parent-child reading after this program, which in turn leads to more and longer response of the child during the reading sessions. The child also has an increase in Mean Length of Utterance and has a higher frequency of using complete sentences when interacting with other classmates in the classroom. It is worthwhile to further investigate the inclusion of promoting parent-child reading to enhance children’s language development in preschool curriculum planning.Keywords: Hong Kong, language skills, parent-child reading, preschoolers
Procedia PDF Downloads 15010179 Integrating Concepts in Positive Psychology with Suicide Prevention in Children and Adolescents
Authors: S. Wietrzychowski
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This systematic review incorporates concepts used in the field of positive psychology in order to integrate important elements into suicide prevention programs for children and adolescents. The goal of this review is to help students and professionals gain insight to available prevention programs for suicide and to incorporate aspects of positive psychology into these programs. Evidence-based interventions such as Positive Youth Development will be discussed in detail in its relation to prevention and positive psychology. Concepts such as hope, optimism, coping, and resilience will be related to these interventions in order to improve these interventions. The review will also explain how these programs can help prevent suicidal thoughts and/or behaviors. Research on mentorship programs and early intervention programs will be included and related to the aforementioned positive psychology concepts. Since children and adolescents are such a vulnerable population, the review will highlight specific considerations for working with children in order to prevent risk factors for suicide and to build protective factors. This review will discuss the effectiveness of school-based programs that are integrated with positive psychology. Elements of these programs that have been shown to be most effective in preventing suicide in schools will also be identified. As a result of this presentation, participants will be able to 1) List at least 2 evidence-based suicide prevention programs, 2) Understand the connection between specific positive psychology concepts and suicide prevention, 3) Identify at least 3 factors which protect against suicide, 4) Describe at least 3 risk factors for suicide, and 5) Think critically about the positive elements of suicide prevention programs.Keywords: children, adolescents, suicide, positive
Procedia PDF Downloads 36910178 Interdisciplinary Evaluations of Children with Autism Spectrum Disorder in a Telehealth Arena
Authors: Janice Keener, Christine Houlihan
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Over the last several years, there has been an increase in children identified as having Autism Spectrum Disorder (ASD). Specialists across several disciplines: mental health and medical professionals have been tasked with ensuring accurate and timely evaluations for children with suspected ASD. Due to the nature of the ASD symptom presentation, an interdisciplinary assessment and treatment approach best addresses the needs of the whole child. During the unprecedented COVID-19 Pandemic, clinicians were faced with how to continue with interdisciplinary assessments in a telehealth arena. Instruments that were previously used to assess ASD in-person were no longer appropriate measures to use due to the safety restrictions. For example, The Autism Diagnostic Observation Schedule requires examiners and children to be in very close proximity of each other and if masks or face shields are worn, they render the evaluation invalid. Similar issues arose with the various cognitive measures that are used to assess children such as the Weschler Tests of Intelligence and the Differential Ability Scale. Thus the need arose to identify measures that are able to be safely and accurately administered using safety guidelines. The incidence of ASD continues to rise over time. Currently, the Center for Disease Control estimates that 1 in 59 children meet the criteria for a diagnosis of ASD. The reasons for this increase are likely multifold, including changes in diagnostic criteria, public awareness of the condition, and other environmental and genetic factors. The rise in the incidence of ASD has led to a greater need for diagnostic and treatment services across the United States. The uncertainty of the diagnostic process can lead to an increased level of stress for families of children with suspected ASD. Along with this increase, there is a need for diagnostic clarity to avoid both under and over-identification of this condition. Interdisciplinary assessment is ideal for children with suspected ASD, as it allows for an assessment of the whole child over the course of time and across multiple settings. Clinicians such as Psychologists and Developmental Pediatricians play important roles in the initial evaluation of autism spectrum disorder. An ASD assessment may consist of several types of measures such as standardized checklists, structured interviews, and direct assessments such as the ADOS-2 are just a few examples. With the advent of telehealth clinicians were asked to continue to provide meaningful interdisciplinary assessments via an electronic platform and, in a sense, going to the family home and evaluating the clinical symptom presentation remotely and confidently making an accurate diagnosis. This poster presentation will review the benefits, limitations, and interpretation of these various instruments. The role of other medical professionals will also be addressed, including medical providers, speech pathology, and occupational therapy.Keywords: Autism Spectrum Disorder Assessments, Interdisciplinary Evaluations , Tele-Assessment with Autism Spectrum Disorder, Diagnosis of Autism Spectrum Disorder
Procedia PDF Downloads 20110177 Community Based Psychosocial Intervention Reduces Maternal Depression and Infant Development in Bangladesh
Authors: S. Yesmin, N. F.Rahman, R. Akther, T. Begum, T. Tahmid, T. Chowdury, S. Afrin, J. D. Hamadani
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Abstract: Maternal depression is one of the risk factors of developmental delay in young children in low-income countries. Maternal depressions during pregnancy are rarely reported in Bangladesh. Objectives: The purpose of the present study was to examine the efficacy of a community based psychosocial intervention on women with mild to moderate depressive illness during the perinatal period and on their children from birth to 12 months on mothers’ mental status and their infants’ growth and development. Methodology: The study followed a prospective longitudinal approach with a randomized controlled design. Total 250 pregnant women aged between 15 and 40 years were enrolled in their third trimester of pregnancy of which 125 women were in the intervention group and 125 in the control group. Women in the intervention group received the “Thinking Healthy (CBT based) program” at their home setting, from their last month of pregnancy till 10 months after delivery. Their children received psychosocial stimulation from birth till 12 months. The following instruments were applied to get the outcome information- Bangla version of Edinburgh Postnatal Depression Scale (BEPDS), Prenatal Attachment Inventory (PAI), Maternal Attachment Inventory (MAI), Bayley Scale of Infant Development-Third version (Bayley–III) and Family Care Indicator (FCI). In addition, sever morbidity; breastfeeding, immunization, socio-economic and demographic information were collected. Data were collected at three time points viz. baseline, midline (6 months after delivery) and endline (12 months after delivery). Results: There was no significant difference between any of the socioeconomic and demographic variables at baseline. A very preliminary analysis of the data shows an intervention effect on Socioemotional behaviour of children at endline (p<0.001), motor development at midline (p=0.016) and at endline (p=0.065), language development at midline (p=0.004) and at endline (p=0.023), cognitive development at midline (p=0.008) and at endline (p=0.002), and quality of psychosocial stimulation at midline (p=0.023) and at endline (p=0.010). EPDS at baseline was not different between the groups (p=0.419), but there was a significant improvement at midline (p=0.027) and at endline (p=0.024) between the groups following the intervention. Conclusion: Psychosocial intervention is found effective in reducing women’s low and moderate depressive illness to cope with mental health problem and improving development of young children in Bangladesh.Keywords: mental health, maternal depression, infant development, CBT, EPDS
Procedia PDF Downloads 26610176 Medical Radiation Exposure in a Cohort of Children Diagnosed with Solid Tumors: Single Institution Study 1985-2015
Authors: Robin L. Rohrer
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Introduction: Pre-natal or early childhood exposure to the medical radiation used in diagnosis or treatment is an identified risk for childhood cancers but can be difficult to document. The author developed a family questionnaire/interview form to identify possible exposures. Aims: This retrospective study examines pre-natal and early childhood medical radiation exposure in a cohort of children diagnosed with a solid tumor including brain tumors from 1985-2015 at the Children’s Hospital of Pittsburgh (CHP). The hospital is a tri-state regional referral center which treats about 150-180 new cases of cancer in children per year. About 70% are diagnosed with a solid tumor. Methods: Each consented family so far (approximately 50% of the cohort) has been interviewed in person or by the phone call. Medical staff and psycho- social staff referred patient families for the interview with the author. Results: Among the families interviewed to date at least one medical radiation exposure has been identified (pre-conception, pre-natal or early childhood) in over 70% of diagnosed children. These exposures have included pre-conception sinus or chest CT or X-ray in either parent, sinus CT or X-ray in the mother or diagnostic radiation of chest or abdomen in children. Conclusions: Exposures to medical radiation for a child later diagnosed with cancer may occur at several critical junctures. These exposures may well contribute to a ‘perfect storm’ in the still elusive causes of childhood cancer. The author plans to expand the study from 1975 to present to hopefully further document these junctures.Keywords: pediatric, solid tumors, medical radiation, cancer
Procedia PDF Downloads 25710175 Reality of Right to Education in States of India from the Point of Stumbling to Settling the Child
Authors: Ekroop Singh Sethi, Arshnoor Kaur, M. H. Bharath
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India is the fastest growing economy and a land of tradition, culture and realm of 19 % of the world’s children. Children are an essential part of any economy as its future GDP contributors and, therefore, it is the duty of a country to take care of its future wealth providers. Each country has its own way of child welfare. India is a developing country, has its own child welfare schemes in place, but the question is, are they really as effective as they seem? Are the schemes sufficient? And what about implementation? With 41% of the population below the age of 18, questions relating to child education and welfare require focus. Right to education is a significant act of the government of India that explains the roadmap of free and compulsory elementary education for children in India, making the India 135th country to bring education as right, involving proper support from the government to overcome the shadow of economic conditions and status which prevents children to learn and grow. But is right to education a children-centric movement? As faces the major problem of well-planned, practical curriculum and facilitators, as only 40% of grade 5 students could barely read the textbook of grade 2. Is the policy worthy of settling the child or still trapped in negative realities of the competitive environment of private VS government schools. From the steps to encouragement from the pupil's home to enlightening centers, the article focuses on level of execution, impact and difference in terms to contributing and enabling the children of India for a better tomorrow and a solution to multilayered problems of elementary education in India.Keywords: growing economy, child welfare, right to education, elementary education, private vs government schools, pupil's home, enlightening centers, execution, impact
Procedia PDF Downloads 23110174 Working Memory in Children: The Relationship with Father-Child Rough-and-Tumble Play
Authors: Robinson, E. L., Freeman, E. E.
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Over the last few decades, the social movement of involved fatherhood has stimulated a research focus on fathers, leading to an increase in the body of evidence into the paternal contributions to child development. Past research has suggested that rough-and-tumble play, which involves wrestling, chasing and tumbling, is the preferred play type of western fathers. This type of play remains underutilized and underrepresented in child developmental research as it’s perceived to be dangerous or too aggressive. The limited research available has shown a relationship between high quality rough-and-tumble play interactions, lower childhood aggression and improved child emotional regulation. The aim of this study was to examine father-child rough-and-tumble play and assess the impact on cognitive development in children aged 4-7 years. Father-child dyads completed a 10-minute rough-and-tumble play interaction, which consisted of 2 games, at the University of Newcastle. Children then completed the Wechsler Preschool & Primary Scale of Intelligence - Fourth Edition Australian and New Zealand Standardized Edition (WPPSI-IV A&NZ). Fathers reported on their involvement in various caregiving activities and on their child’s development. Analyses revealed that fathers-child play quality was positively related to working memory outcomes in children. Furthermore, the amount of rough-and-tumble play father and child did together on a regular basis was also related to working memory outcomes. While father-child play interactions remain an understudied area of research, this study outlines the importance of examining the paternal play role in children’s cognitive development.Keywords: children, development, father, executive function
Procedia PDF Downloads 18710173 Lifestyle Behaviors among Jordanian Obese Children Aged 6-9 Years: A Cross-Sectional Study
Authors: Ayman Bani Salameh
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Background: Obesity in children is in increasing in developed and developing countries, which leads to morbidity and premature mortality. Lifestyle behaviors are an important issue in minimizing this problem and subsequent complications. Thus, this study purposed to assess lifestyle behaviors, including dietary habits and physical activity, among Jordanian obese children aged 6-9 years. Methods: A cross-sectional study was conducted on 324 children aged 6-9 years using a questionnaire consisting of items measuring dietary habits (7 items) and physical activity (8 items). Results: Findings showed that obese children had bad dietary habits involved in the number of meals eaten day (M= 5.06, SD=1.14), number of snacks of sweet/ chocolates daily (M= 3. 61, SD=0.82), and number of glasses of sweet fizzy drinks/day (M= 3.39, SD=0.96). Moreover, they had poor physical activity represented in the number of playing or training in an activity like dancing, swimming, and walking in the past week (M= 0.06, SD=1.01), number of days in participating in moderate physical activity last week (M= 0.06, SD=1.01), time spending in using a computer, watching TV, watching videos or using the internet as a part of study or homework in the last week (M= 16.88, SD=2.37), and ), time spending in using a computer, watching TV, watching videos or using the internet for fun or recreation in the past week (M= 14.44, SD=2.37). Conclusion: Obese children aged 6-9 had unhealthy lifestyle behaviors, which could expose them to a high risk of increasing comorbidities associated with obesity. Therefore, this preliminary study helps develop an intervention program based on modifying unhealthy behaviors, including bad dietary habits and a sedentary lifestyle. The results provide baseline data about the strategies for developing intervention programs for weight reduction.Keywords: obesity, children, behaviors, lifestyle
Procedia PDF Downloads 7710172 Examining the Independent Effects of Early Exposure to Game Consoles and Parent-Child Activities on Psychosocial Development
Authors: Rosa S. Wong, Keith T. S. Tung, Frederick K. Ho, Winnie W. Y. Tso, King-wa Fu, Nirmala Rao, Patrick Ip
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As technology advances, exposures in early childhood are no longer confined to stimulations in the surrounding physical environments. Children nowadays are also subject to influences from the digital world. In particular, early access to game consoles can cause risks to child development, especially when the game is not developmentally appropriate for young children. Overstimulation is possible and could impair brain development. On the other hand, recreational parent-child activities, including outdoor activities and visits to museums, require child interaction with parents, which is beneficial for developing adaptive emotion regulation and social skills. Given the differences between these two types of exposures, this study investigated and compared the independent effects of early exposure to a game console and early play-based parent-child activities on children’s long-term psychosocial outcomes. This study used data from a subset of children (n=304, 142 male and 162 female) in the longitudinal cohort study, which studied the long-term impact of family socioeconomic status on child development. In 2012/13, we recruited a group of children at Kindergarten 3 (K3) randomly from Hong Kong local kindergartens and collected data regarding their duration of exposure to game console and recreational parent-child activities at that time. In 2018/19, we re-surveyed the parents of these children who were matriculated as Form 1 (F1) students (ages ranging from 11 to 13 years) in secondary schools and asked the parents to rate their children’s psychosocial problems in F1. Linear regressions were conducted to examine the associations between early exposures and adolescent psychosocial problems with and without adjustment for child gender and K3 family socioeconomic status. On average, K3 children spent about 42 minutes on a game console every day and had 2-3 recreational activities with their parents every week. Univariate analyses showed that more time spent on game consoles at K3 was associated with more psychosocial difficulties in F1 particularly more externalizing problems. The effect of early exposure to game console on externalizing behavior remained significant (B=0.59, 95%CI: 0.15 to 1.03, p=0.009) after adjusting for recreational parent-child activities and child gender. For recreational parent-child activities at K3, its effect on overall psychosocial difficulties became insignificant after adjusting for early exposure to game consoles and child gender. However, it was found to have significant protective effect on externalizing problems (B=-0.65, 95%CI: -1.23 to -0.07, p=0.028) even after adjusting for the confounders. Early exposure to game consoles has negative impact on children’s psychosocial health, whereas play-based parent-child activities can foster positive psychosocial outcomes. More efforts should be directed to propagate the risks and benefits of these activities and urge the parents and caregivers to replace child-alone screen time with parent-child play time in daily routine.Keywords: early childhood, electronic device, parenting, psychosocial wellbeing
Procedia PDF Downloads 15910171 The Place of Inclusive Education in the Transformative Education of Children with Intellectual Disabilities in Oyo State, Nigeria
Authors: Adewale Olabisi
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The society has bastion of people with diverse kinds of special needs which invariably affect the kind of education that is provided to this category of children. Most schools for pupils with intellectual disabilities seem not to be achieving the objectives it was set out to achieve. Hence, there is the need to provide transformative education for these children with intellectual disabilities which can only be achieved in an inclusive educational setting. However, achieving this has been a great challenge in Nigeria. This paper, however, dealt with the urgent need for transformative teaching for persons with intellectual disabilities in readiness for them to be accepted in the society and also enhance their self-concept and perception which in turn will make a way for their self-sustenance. Suggestions and recommendations that will better enhance the full implementation of transformative teaching for pupils with intellectual disabilities in an inclusive environment were also made.Keywords: inclusive education, transformative education, intellectual disabilities, Oyo state, Nigeria
Procedia PDF Downloads 31010170 Speech and LanguageTherapists’ Advices for Multilingual Children with Developmental Language Disorders
Authors: Rudinë Fetahaj, Flaka Isufi, Kristina Hansson
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While evidence shows that in most European countries’ multilingualism is rising, unfortunately, the focus of Speech and Language Therapy (SLT) is still monolingualism. Furthermore, there is sparse information on how the needs of multilingual children with language disorders such as Developmental Language Disorder (DLD) are being met and which factors affect the intervention approach of SLTs when treating DLD. This study aims to examine the relationship and correlation between the number of languages SLTs speak, years of experience, and length of education with the advice they give to parents of multilingual children with DLD regarding which language to be spoken. This is a cross-sectional study where a survey was completed online by 2608 SLTs across Europe and data has been used from a 2017 COST-action project. IBM-SPSS-28 was used where descriptive analysis, correlation and Kruskal-Wallis test were performed.SLTs mainly advise the parents of multilingual children with DLD to speak their native language at home. Besides years of experience, language status and the level of education showed to have no association with the type of advice SLTs give. Results showed a non-significant moderate positive correlation between SLTs years of experience and their advice regarding the native language, whereas language status and length of education showed no correlation with the advice SLTs give to parents.Keywords: quantitative study, developmental language disorders, multilingualism, speech and language therapy, children, European context
Procedia PDF Downloads 7310169 Pandemic-Era WIC Participation in Delaware, U.S.: Participants' Experiences and Challenges
Authors: McKenna Halverson, Allison Karpyn
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Introduction: The COVID-19 pandemic posed unprecedented challenges for families with young children in the United States. The Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), a federal nutrition assistance program that provides low-income mothers and young children with access to healthy foods (e.g., infant formula, milk, and peanut butter), mitigated some financial challenges for families. However, the U.S. experienced a national infant formula shortage and rising inflation rates during the pandemic, which likely impacted WIC participants’ shopping experiences and well-being. As such, this study aimed to characterize how the COVID-19 pandemic and related events impacted Delaware WIC participants’ in-store benefit redemption experiences and overall well-being. Method: The authors conducted semi-structured interviews with 51 WIC participants in Wilmington, Delaware. Survey measures included demographic questions and open-ended questions regarding participants’ experiences with WIC benefit redemption during the COVID-19 pandemic. Data were analyzed using a hybrid inductive and deductive coding approach. Findings: The COVID-19 pandemic significantly impacted WIC participants’ shopping experiences and well-being. Specifically, participants were forced to alter their shopping behaviors to account for rising food prices (e.g., used coupons, bought less food, used food banks). Additionally, WIC participants experienced significant distress during the national infant formula shortage resulting from difficulty finding formula to feed their children. Participants also struggled with in-store benefit redemption due to inconsistencies in shelf labelling, the WIC app, and low stock of WIC foods. These findings highlight the need to reexamine WIC operations and emergency food response policy in the United States during times of crisis to optimize public health and ensure federal nutrition assistance programs meeting the needs of low-income families with young children.Keywords: benefit redemption, COVID-19 pandemic, infant formula shortage, inflation, shopping, WIC
Procedia PDF Downloads 6810168 Emotional and Personal Characteristics of Children in Relation to the Parental Attitudes
Authors: Svetlana S. Saveysheva, Victoria E. Vasilenko
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The purpose of the research was to study the emotional and personal characteristics of preschool children in relation to the characteristics of child-parent interaction and deviant parental attitudes. The study involved 172 mothers and 172 children (85 boys and 87 girls) aged 4,5 to 7 years (mean age 6 years) living in St. Petersburg, Russia. Methods used were, demographic questionnaire, projective drawing method 'House-Tree-Man', Test of anxiety (Temml, Dorki, Amen), technique of studying self-esteem 'Ladder', expert evaluation of sociability and aggressiveness, questionnaire for children-parent emotional interaction (E.I. Zaharova) and questionnaire 'Analysis of family relationships' (E.G. Eidemiller, V.V. Yustitsky). Results. The greatest number of links with personal characteristics have received such parental deviant attitudes as overprotection and characteristics of authoritarian style (prohibitions, sanctions). If the mother has such peculiarities of the parental relationship, the child is characterized by lower self-esteem, increased anxiety, distrust of themselves and hostility. Children have more pronounced manifestations of aggression in a conniving and unstable style of parenting. The sensitivity of the mother is positively associated with children’s self-esteem. Unconditional acceptance of the child, the predominance of a positive emotional background, orientation to the state of the child during interaction promote the development of communication skills and reduce of aggressiveness. But the excessive closeness of the mother with the child can make it difficult to develop the communicative skills. Conclusions. The greatest influence on emotional and personal characteristics is provided by such features of the parental relation as overprotection, characteristics of authoritarian style, underdevelopment of the sphere of parental feelings, sensitivity of mother and behavioral manifestations of emotional interaction. Research is supported by RFBR №18-013-00990.Keywords: characteristics of personality, child-parent interaction, children, deviant parental attitudes
Procedia PDF Downloads 22710167 Philosophy and Value Education for Children in India
Authors: Merina Islam
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In this paper, an attempt is made to draw out the contemporary relevance of philosophy in school education of India. This paper attempt is made to inquire into the importance of philosophy for schoolchildren in the Indian cultural context. As education in philosophy for children is useful for teaching the acquisition of knowledge from the information provided, for questioning of rules in different contexts, and for the analysis of facts encountered in daily life. Ethical attitudes can neither be derived from the information provided about the moral rules, nor do they result from a practice of unquestioning obedience It includes some studies done in this field and also reports on philosophy. Many European countries emphasise on the above said theme. There are lots of work and research done by many philosophers on philosophy for children. Indian values system is different from the West and more important than others. Education has become a tool to achieve efficiency in all walks of human life whether social, political, religious or philosophical. Every nation started developing its own specific set of educational values. For India it is very necessary to increase philosophical thinking study and research. Philosophy could make significant contribution, particularly in relation to children's moral development because the Indian curriculum currently neglects this aim. A teacher can play an important role in promoting this discussion because a teacher has the capacity to influence students with their thoughts and personality and engages them in these activities. Philosophy needs to be included in the curriculum and have demonstrated cognitive and social gains in children who were explored to philosophy in their schooling.Keywords: education, ethical attitude, moral value, philosophy
Procedia PDF Downloads 28110166 Healthy, Breast Fed Bangladeshi Children Can Regulate Their Food Consumption in Each Meal and Feeding Duration When Offered with Varied Energy Density and Feeding Frequency of Complementary Foods
Authors: M. Munirul Islam, Makhduma Khatun M., Janet M. Peerson, Tahmeed Ahmed, M. Abid Hossain Mollah, Kathryn G. Dewey, Kenneth H. Brown
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Information is required on the effects of dietary energy density (ED) and feeding frequency (FF) of complementary foods (CF) on food consumption during individual meals and time expended in child feeding. We evaluated the effects of varied ED and FF of CFs on food intake and time required for child feeding during individual meals. During 9 separate, randomly ordered dietary periods lasting 3-6 days each, we measured self-determined intakes of porridges by 18 healthy, breastfed children 8-11 mo old who were fed coded porridges with energy densities of 0.5, 1.0 or 1.5 kcal/g, during 3, 4, or 5 meals/d. CF intake was measured by weighing the feeding bowl before and after every meal. Children consumed greater amounts of CFs per meal when they received diets with lower ED (p = 0.044) and fewer meals per day (p < 0.001). Food intake was less during the first meal of the day than the other meals. Greater time was expended per meal when fewer meals were offered. Time expended per meal did not vary by ED, but the children ate the lower ED diets faster (p = 0.019). Food intake velocity was also greater when more meals were offered per day (p = 0.005). These results provide further evidence of young children’s ability to regulate their energy intakes, even during infancy; and they convey information on factors that affect the amount of time that caregivers must devote to child feeding.Keywords: complementary foods, energy density, feeding frequency, young children
Procedia PDF Downloads 45610165 Strategy to Evaluate Health Risks of Short-Term Exposure of Air Pollution in Vulnerable Individuals
Authors: Sarah Nauwelaerts, Koen De Cremer, Alfred Bernard, Meredith Verlooy, Kristel Heremans, Natalia Bustos Sierra, Katrien Tersago, Tim Nawrot, Jordy Vercauteren, Christophe Stroobants, Sigrid C. J. De Keersmaecker, Nancy Roosens
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Projected climate changes could lead to exacerbation of respiratory disorders associated with reduced air quality. Air pollution and climate changes influence each other through complex interactions. The poor air quality in urban and rural areas includes high levels of particulate matter (PM), ozone (O3) and nitrogen oxides (NOx), representing a major threat to public health and especially for the most vulnerable population strata, and especially young children. In this study, we aim to develop generic standardized policy supporting tools and methods that allow evaluating in future follow-up larger scale epidemiological studies the risks of the combined short-term effects of O3 and PM on the cardiorespiratory system of children. We will use non-invasive indicators of airway damage/inflammation and of genetic or epigenetic variations by using urine or saliva as alternative to blood samples. Therefore, a multi-phase field study will be organized in order to assess the sensitivity and applicability of these tests in large cohorts of children during episodes of air pollution. A first test phase was planned in March 2018, not yet taking into account ‘critical’ pollution periods. Working with non-invasive samples, choosing the right set-up for the field work and the volunteer selection were parameters to consider, as they significantly influence the feasibility of this type of study. During this test phase, the selection of the volunteers was done in collaboration with medical doctors from the Centre for Student Assistance (CLB), by choosing a class of pre-pubertal children of 9-11 years old in a primary school in Flemish Brabant, Belgium. A questionnaire, collecting information on the health and background of children and an informed consent document were drawn up for the parents as well as a simplified cartoon-version of this document for the children. A detailed study protocol was established, giving clear information on the study objectives, the recruitment, the sample types, the medical examinations to be performed, the strategy to ensure anonymity, and finally on the sample processing. Furthermore, the protocol describes how this field study will be conducted in relation with the prevision and monitoring of air pollutants for the future phases. Potential protein, genetic and epigenetic biomarkers reflecting the respiratory function and the levels of air pollution will be measured in the collected samples using unconventional technologies. The test phase results will be used to address the most important bottlenecks before proceeding to the following phases of the study where the combined effect of O3 and PM during pollution peaks will be examined. This feasibility study will allow identifying possible bottlenecks and providing missing scientific knowledge, necessary for the preparation, implementation and evaluation of federal policies/strategies, based on the most appropriate epidemiological studies on the health effects of air pollution. The research leading to these results has been funded by the Belgian Science Policy Office through contract No.: BR/165/PI/PMOLLUGENIX-V2.Keywords: air pollution, biomarkers, children, field study, feasibility study, non-invasive
Procedia PDF Downloads 16810164 The Effect of Parents and Coaches on Preschool Children's Self-Control in Preschool Centers in District 5 of Tehran
Authors: Alieh Arasteh
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The main purpose of this study was to investigate the effect of parents and educators on the self-control of children in pre-primary schools in District 5 of Tehran. The method of this survey was a survey and post-correlation type. The statistical population of this study included all teachers and parents of children in preschool centers in the region. The 5th city of Tehran in 1397 was the number of kindergartens in 117 centers and the number of parents was 1872, the sample size of the parents was 320 and the sample size of the trainers was 76. The method of sampling in this study was randomized and clustered. The data gathering tool was Rosenbaum and Ronen (1992) self-control skills, a five-factor questionnaire NEO personality Costa and McCrae (1985) and a questionnaire on demographic characteristics, reliability using Cronbach's alpha, the data analysis was performed using the software spss24. The results of the research showed that the personality characteristics of parents, parents' socioeconomic status and personality traits of educators affect the self-control dimensions of pre-primary school children (P <0.05).Keywords: self-control, pre-primary school, the effect of parents, couches
Procedia PDF Downloads 16910163 Comparing the Efficacy of Quantitative Electroencephalogram-Based Neurofeedback Therapy Program versus Organizational Skills Training Program to Reduce the Core Symptoms among Children Group of ADHD
Authors: Radwa R. El-Saadany , Medhat Abu Zeid, Tarek Omar, Marwa S. Maqsoud
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Attention deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders characterized by attention deficit, hyperactivity, and impulsivity. Neurofeedback (NF) is one of the neurotherapy treatments that cause brain wave changes. Method: The current pseudo-experimental study with a pre–post-test design was conducted on a population of children with attention deficit hyperactivity disorder (ADHD).The sample size comprised of (30) children selected by random sampling method and assigned to two therapeutic groups: First therapeutic group received a neurofeedback program. Based on QEEG, it reached (10) children. The second therapeutic group received an organization skills training program, it reached (10) and the control group that did not receive programs, it reached (10) children. Results: There are significant differences between pre- and post-assessments among therapeutic groups in reducing the three core symptoms of ADHD in favor of post measurement. There are no significant differences between post-assessment and follow up measurement of the therapeutic groups.Keywords: QEEG-based neurofeedback therapy program, organizational skills training program, attention deficit hyperactivity disorder
Procedia PDF Downloads 6910162 Decrease of Aerobic Capacity in Twenty Years in Lithuanian 11–18 Years-Old Youth
Authors: Arunas Emeljanovas, Brigita Mieziene, Tomas Venckunas
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Background statement: Level of aerobic capacity in school age children provides important information about the current and future cardiovascular, skeletal and mental health. It is widely recognised that risk factors for modern chronic diseases of the adults have their origins in childhood and adolescence. The aim of the study was to analyse the trends of aerobic capacity across decades within groups of gender and age. Methods. The research included data of participants from the three nationally representative cohort studies performed in Lithuania in the years 1992, 2002 and 2012 among 11 to 18-years-old school children. Total of 18,294 school children were recruited for testing. Only those who had their body weight and height measured and completed 20 m shuttle endurance test were included in the analysis. The total number of students included in the analyses was 15,213 (7608 boys and 7605 girls). The permission to conduct the study was obtained from the Lithuanian Bioethics Committee (permission number BE-2-45). Major findings: Results are performed across gender and age groups. The comparison of shuttle endurance test, controlling for body mass index, indicated that in general there is a constant decrease of aerobic capacity across decades in both genders and age groups. The deterioration in aerobic capacity in boys accounted for 17 to 43 percent across age groups within decades. The biggest decrease was in 14 years-old boys. The deterioration in girls accounted for 19 to 37 percent across age groups with the highest decrease in 11 years-old girls. Though, girls had lower levels of aerobic capacity through all age groups and across three decades. Body mass index, as a covariate, accounted for up to six percent in deterioration of aerobic capacity. Final statement: The detected relationships may reflect the level and pattern of engagement in physical activity and sports where increased activity associates with superior performance in the tests because of the upregulated physiological function and instigated competitive/motivational level. The significance of the decade indirectly supports the importance of the recently changed activity among schoolchildren for this relationship.Keywords: aerobic capacity, cardiovascular health, endurance, school age children
Procedia PDF Downloads 16210161 Understanding the Manifestation of Psychosocial Difficulties in Children with Developmental Language Disorder, with a Focus on Anxiety and Social Frustration
Authors: Annabel Burnley, Michelle St. Clair, Charlotte Dack, Yvonne Wren
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Children with Developmental Language Disorder (DLD) are well documented to experience social and emotional difficulties. Despite this, there is little consensus as to how these difficulties manifest, without which the ability to develop prevention initiatives is limited. An online survey was completed by 107 parents of either child with DLD (‘DLD sample’; n=57), or typically developing children (‘typical sample’; n=50), all aged 6-12 years old. Psychosocial symptom measures were used, alongside 11 psychosocial statements generated from previous qualitative work. Qualitative interviews were then held to understand the manifestation of key difficulties in more depth (n=4). The DLD sample scored significantly higher on all psychosocial statements than the typical sample. Experiencing anxiety (80.7%), requiring routine and sameness (75.4%) and struggling to regulate their emotions (75.4%) were the most common difficulties for a majority of children with DLD. For this DLD sample, family communication and coping styles were found not to contribute to the manifestation of these difficulties. Two separate mediation models were run to understand the role of other psychosocial difficulties in the manifestation of (1) anxiety and (2) social frustration. ‘Intolerance of uncertainty was found to strongly mediate the relationship between DLD diagnosis and symptoms of anxiety. Emotion regulation was found to moderately mediate the relationship between DLD diagnosis and social frustration. Parents appear to cope well with their children’s complex psychosocial needs, but further external intervention is needed. Intervention focussing on intolerance of uncertainty and emotion dysregulation may help the management of anxiety and social frustration. Further research is needed to understand the children’s routined behaviors.Keywords: psychosocial difficulties, developmental language disorder, specific language impairment, parent, anxiety
Procedia PDF Downloads 10310160 Effects of Visual Agnosia in Children’s Linguistic Abilities: Psychoneurolinguistic Approach
Authors: Sadeq Al Yaari, Ayman Al Yaari, Adham Al Yaari, Montaha Al Yaari, Aayah Al Yaari, Sajedah Al Yaari
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Objective: The aim of the study is to examine the relationship between visual agnosia and learning delay in Yemeni children. Method: A total of 80 subjects (experimental group= 60, 30 males and 30 females and control group= 20, 10 males and 10 females) in two institutions (old and new). The age of all subjects at hand ranges between 6- and 12 years old. Pre and post-tests were administered. Results: Outline results show severe effects on the performance of the children due to visual agnosia this effect was benign in the group that received the treatment, and this can be clearly seen in their results in the post-test compared to the other group that did not receive the treatment and outcomes in general can be better understood in light of the control group.Keywords: visual, agnosia, linguistics, abilities, effects, psychoneurolinguistics
Procedia PDF Downloads 2410159 Nasopharyngeal Carriage of Streptococcus pneumoniae in Children under 5 Years of Age before Introduction of Pneumococcal Vaccine (PCV 10) in Urban and Rural Sindh
Authors: Muhammad Imran Nisar, Fyezah Jehan, Tauseef Akhund, Sadia Shakoor, Kanwal Nayani, Furqan Kabir, Asad Ali, Anita Zaidi
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Pneumococcal Vaccine -10 (PCV 10) was included in the Expanded Program of immunization (EPI) in Sindh, Pakistan in February 2013. This study was carried out immediately before the introduction of PCV 10 to establish baseline pneumococcal carriage and prevalent serotypes in naso-pharynx of children 3-11 months of age in an urban and rural community in Sindh, Pakistan. An additional sample of children aged 12 to 59 months was drawn from the urban community. Nasopharyngeal specimens were collected from a random sample of children. Samples were processed in a central laboratory in Karachi. Pneumococci were cultured on 5% Sheep Blood Agar and serotyping was performed using CDC standardized sequential multiplex PCR assay on bacterial colonies. Serotypes were then categorized into vaccine (PCV-10 and PCV-13) type and non-vaccine types. A total of 670 children were enrolled. Carriage rate for pneumococcus based on culture positivity was 74% and 79.5 % in the infant group in Karachi and Matiari respectively. Carriage rate was 78.2% for children aged 12 to 59 months in Karachi. Proportion of PCV 10 serotypes in infants was 38.8% and 33.5% in Karachi and Matiari respectively. In the older age group in Karachi, the proportion was 30.6%. Most common serotypes were 6A, 6B, 23F, 19A and 18C. This survey establishes vaccine and non-vaccine serotype carriage rate in a vaccine-naïve pediatric population among rural and urban communities in Sindh province. Annually planned surveys in the same communities will inform change in carriage rate after the introduction and uptake of PCV 10 in these communities.Keywords: Naso-Pharyngeal carriage, Pakistan, PCV10, Pneumococcus
Procedia PDF Downloads 29210158 BiLex-Kids: A Bilingual Word Database for Children 5-13 Years Old
Authors: Aris R. Terzopoulos, Georgia Z. Niolaki, Lynne G. Duncan, Mark A. J. Wilson, Antonios Kyparissiadis, Jackie Masterson
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As word databases for bilingual children are not available, researchers, educators and textbook writers must rely on monolingual databases. The aim of this study is thus to develop a bilingual word database, BiLex-kids, an online open access developmental word database for 5-13 year old bilingual children who learn Greek as a second language and have English as their dominant one. BiLex-kids is compiled from 120 Greek textbooks used in Greek-English bilingual education in the UK, USA and Australia, and provides word translations in the two languages, pronunciations in Greek, and psycholinguistic variables (e.g. Zipf, Frequency per million, Dispersion, Contextual Diversity, Neighbourhood size). After clearing the textbooks of non-relevant items (e.g. punctuation), algorithms were applied to extract the psycholinguistic indices for all words. As well as one total lexicon, the database produces values for all ages (one lexicon for each age) and for three age bands (one lexicon per age band: 5-8, 9-11, 12-13 years). BiLex-kids provides researchers with accurate figures for a wide range of psycholinguistic variables, making it a useful and reliable research tool for selecting stimuli to examine lexical processing among bilingual children. In addition, it offers children the opportunity to study word spelling, learn translations and listen to pronunciations in their second language. It further benefits educators in selecting age-appropriate words for teaching reading and spelling, while special educational needs teachers will have a resource to control the content of word lists when designing interventions for bilinguals with literacy difficulties.Keywords: bilingual children, psycholinguistics, vocabulary development, word databases
Procedia PDF Downloads 30110157 Design and Creation of a BCI Videogame for Training and Measure of Sustained Attention in Children with ADHD
Authors: John E. Muñoz, Jose F. Lopez, David S. Lopez
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Attention Deficit Hyperactivity Disorder (ADHD) is a disorder that affects 1 out of 5 Colombian children, converting into a real public health problem in the country. Conventional treatments such as medication and neuropsychological therapy have been proved to be insufficient in order to decrease high incidence levels of ADHD in the principal Colombian cities. This work demonstrates a design and development of a videogame that uses a brain computer interface not only to serve as an input device but also as a tool to monitor neurophysiologic signal. The video game named “The Harvest Challenge” puts a cultural scene of a Colombian coffee grower in its context, where a player can use his/her avatar in three mini games created in order to reinforce four fundamental aspects: i) waiting ability, ii) planning ability, iii) ability to follow instructions and iv) ability to achieve objectives. The details of this collaborative designing process of the multimedia tool according to the exact clinic necessities and the description of interaction proposals are presented through the mental stages of attention and relaxation. The final videogame is presented as a tool for sustained attention training in children with ADHD using as an action mechanism the neuromodulation of Beta and Theta waves through an electrode located in the central part of the front lobe of the brain. The processing of an electroencephalographic signal is produced automatically inside the videogame allowing to generate a report of the theta/beta ratio evolution - a biological marker, which has been demonstrated to be a sufficient measure to discriminate of children with deficit and without.Keywords: BCI, neuromodulation, ADHD, videogame, neurofeedback, theta/beta ratio
Procedia PDF Downloads 36110156 Assessing the Survival Time of Hospitalized Patients in Eastern Ethiopia During 2019–2020 Using the Bayesian Approach: A Retrospective Cohort Study
Authors: Chalachew Gashu, Yoseph Kassa, Habtamu Geremew, Mengestie Mulugeta
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Background and Aims: Severe acute malnutrition remains a significant health challenge, particularly in low‐ and middle‐income countries. The aim of this study was to determine the survival time of under‐five children with severe acute malnutrition. Methods: A retrospective cohort study was conducted at a hospital, focusing on under‐five children with severe acute malnutrition. The study included 322 inpatients admitted to the Chiro hospital in Chiro, Ethiopia, between September 2019 and August 2020, whose data was obtained from medical records. Survival functions were analyzed using Kaplan‒Meier plots and log‐rank tests. The survival time of severe acute malnutrition was further analyzed using the Cox proportional hazards model and Bayesian parametric survival models, employing integrated nested Laplace approximation methods. Results: Among the 322 patients, 118 (36.6%) died as a result of severe acute malnutrition. The estimated median survival time for inpatients was found to be 2 weeks. Model selection criteria favored the Bayesian Weibull accelerated failure time model, which demonstrated that age, body temperature, pulse rate, nasogastric (NG) tube usage, hypoglycemia, anemia, diarrhea, dehydration, malaria, and pneumonia significantly influenced the survival time of severe acute malnutrition. Conclusions: This study revealed that children below 24 months, those with altered body temperature and pulse rate, NG tube usage, hypoglycemia, and comorbidities such as anemia, diarrhea, dehydration, malaria, and pneumonia had a shorter survival time when affected by severe acute malnutrition under the age of five. To reduce the death rate of children under 5 years of age, it is necessary to design community management for acute malnutrition to ensure early detection and improve access to and coverage for children who are malnourished.Keywords: Bayesian analysis, severe acute malnutrition, survival data analysis, survival time
Procedia PDF Downloads 2810155 Evaluation of Systemic Immune-Inflammation Index in Obese Children
Authors: Mustafa M. Donma, Orkide Donma
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A growing list of cancers might be influenced by obesity. Obesity is associated with an increased risk for the occurrence and development of some cancers. Inflammation can lead to cancer. It is one of the characteristic features of cancer and plays a critical role in cancer development. C-reactive protein (CRP) is under evaluation related to the new and simple prognostic factors in patients with metastatic renal cell cancer. Obesity can predict and promote systemic inflammation in healthy adults. BMI is correlated with hs-CRP. In this study, SII index and CRP values were evaluated in children with normal BMI and those within the range of different obesity grades to detect the tendency towards cancer in pediatric obesity. A total of one hundred and ninety-four children; thirty-five children with normal BMI, twenty overweight (OW), forty-seven obese (OB) and ninety-two morbid obese (MO) participated in the study. Age- and sex-matched groups were constituted using BMI-for age percentiles. Informed consent was obtained. Ethical Committee approval was taken. Weight, height, waist circumference (C), hip C, head C and neck C of the children were measured. The complete blood count test was performed. C-reactive protein analysis was performed. Statistical analyses were performed using SPSS. The degree for statistical significance was p≤0.05. SII index values were progressively increasing starting from normal weight (NW) to MO children. There is a statistically significant difference between NW and OB as well as MO children. No significant difference was observed between NW and OW children, however, a correlation was observed between NW and OW children. MO constitutes the only group, which exhibited a statistically significant correlation between SII index and CRP. Obesity-related bladder, kidney, cervical, liver, colorectal, endometrial cancers are still being investigated. Obesity, characterized as a chronic low-grade inflammation, is a crucial risk factor for colon cancer. Elevated childhood BMI values may be indicative of processes leading to cancer, initiated early in life. Prevention of childhood adiposity may decrease the cancer incidence in adults. To authors’ best knowledge, this study is the first to introduce SII index values during obesity of varying degrees of severity. It is suggested that this index seems to affect all stages of obesity with an increasing tendency and may point out the concomitant status of obesity and cancer starting from very early periods of life.Keywords: children, C-reactive protein, systemic immune-inflammation index, obesity
Procedia PDF Downloads 16310154 Socio-Economic Child’S Wellbeing Impasse in South Africa: Towards a Theory-Based Solution Model
Authors: Paulin Mbecke
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Research Issue: Under economic constraints, socio-economic conditions of households worsen discounting child’s wellbeing to the bottom of many governments and households’ priority lists. In such situation, many governments fail to rebalance priorities in providing services such as education, housing and social security which are the prerequisites for the wellbeing of children. Consequently, many households struggle to respond to basic needs especially those of children. Although economic conditions play a crucial role in creating prosperity or poverty in households and therefore the wellbeing or misery for children; they are not the sole cause. Research Insights: The review of the South African Index of Multiple Deprivation and the South African Child Gauge establish the extent to which economic conditions impact on the wellbeing or misery of children. The analysis of social, cultural, environmental and structural theories demonstrates that non-economic factors contribute equally to the wellbeing or misery of children, yet, they are disregarded. In addition, the assessment of a child abuse database proves a weak correlation between economic factors (prosperity or poverty) and child’s wellbeing or misery. Theoretical Implications: Through critical social research theory and modelling, the paper proposes a Theory-Based Model that combines different factors to facilitate the understanding of child’s wellbeing or misery. Policy Implications: The proposed model assists in broad policy and decision making and reviews processes in promoting child’s wellbeing and in preventing, intervening and managing child’s misery with regard to education, housing, and social security.Keywords: children, child’s misery, child’s wellbeing, household’s despair, household’s prosperity
Procedia PDF Downloads 27410153 Numerical Board Game for Low-Income Preschoolers
Authors: Gozde Inal Kiziltepe, Ozgun Uyanik
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There is growing evidence that socioeconomic (SES)-related differences in mathematical knowledge primarily start in early childhood period. Preschoolers from low-income families are likely to perform substantially worse in mathematical knowledge than their counterparts from middle and higher income families. The differences are seen on a wide range of recognizing written numerals, counting, adding and subtracting, and comparing numerical magnitudes. Early differences in numerical knowledge have a permanent effect childrens’ mathematical knowledge in other grades. In this respect, analyzing the effect of number board game on the number knowledge of 48-60 month-old children from disadvantaged low-income families constitutes the main objective of the study. Participants were the 71 preschoolers from a childcare center which served low-income urban families. Children were randomly assigned to the number board condition or to the color board condition. The number board condition included 35 children and the color board game condition included 36 children. Both board games were 50 cm long and 30 cm high; had ‘The Great Race’ written across the top; and included 11 horizontally arranged, different colored squares of equal sizes with the leftmost square labeled ‘Start’. The numerical board had the numbers 1–10 in the rightmost 10 squares; the color board had different colors in those squares. A rabbit or a bear token were presented to children for selecting, and on each trial spun a spinner to determine whether the token would move one or two spaces. The number condition spinner had a ‘1’ half and a ‘2’ half; the color condition spinner had colors that matched the colors of the squares on the board. Children met one-on-one with an experimenter for four 15- to 20-min sessions within a 2-week period. In the first and fourth sessions, children were administered identical pretest and posttest measures of numerical knowledge. All children were presented three numerical tasks and one subtest presented in the following order: counting, numerical magnitude comparison, numerical identification and Count Objects – Circle Number Probe subtest of Early Numeracy Assessment. In addition, same numerical tasks and subtest were given as a follow-up test four weeks after the post-test administration. Findings obtained from the study; showed that there was a meaningful difference between scores of children who played a color board game in favor of children who played number board game.Keywords: low income, numerical board game, numerical knowledge, preschool education
Procedia PDF Downloads 34410152 Economics in Primary Schools – Positive Education and Well-being
Authors: Judit Nagy
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Many scientific studies claim that financial education should start as early as possible. Children are much more capable of and willing to absorb new concepts than adults. If we introduce children to financial knowledge early, their behaviour and attitudes to this subject will change, increasing later success in this area of life. However, poor financial decisions may entail severe consequences, not only to individuals but even to the wider society. Good financial decisions and economic attitudes may contribute to economic growth and well-being. Whilst in several countries, education about financial awareness and fundamentals is available, the understanding and acquisition of complex economic knowledge and the development of children’s independent problem-solving skills are still lacking. The results suggest that teaching economic and financial knowledge through accounting and making lectures interactive by using special tools of positive education is critical to stimulating children’s interest. Eighty percent of the students in the study liked the combined and interactive lecture. Introducing this kind of knowledge to individuals is a relevant objective, even at the societal level.Keywords: positive psychology, education innovation, primary school, gender, economics, accounting, finance, personal finance, mathematics, economic growth, well-being, sustainability
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