Search results for: treating families of children with delays

Authors: Mustafa M. Donma, Orkide Donma

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Obesity is associated with cardiovascular disease risk factors and metabolic syndrome (MetS). In this study, associations between adipokines and adipokine as well as obesity indices were evaluated. Plasma adipokine levels may exhibit variations according to body adipose tissue mass. Besides, upon consideration of obesity as an inflammatory disease, adipokines may play some roles in this process. The ratios of proinflammatory adipokines to adiponectin may act as highly sensitive indicators of body adipokine status. The aim of the study is to present some adipokine indices, which are thought to be helpful for the evaluation of childhood obesity and also to determine the best discriminators in the diagnosis of MetS. 80 prepubertal children (aged between 6-9.5 years) included in the study were divided into three groups; 30 children with normal weight (NW), 25 morbid obese (MO) children and 25 MO children with MetS. Physical examinations were performed. Written informed consent forms were obtained from the parents. The study protocol was approved by Ethics Committee of Namik Kemal University Medical Faculty. Anthropometric measurements, such as weight, height, waist circumference (C), hip C, head C, neck C were recorded. Values for body mass index (BMI), diagnostic obesity notation model assessment Index-II (D2 index) as well as waist-to-hip, head-to-neck ratios were calculated. Adiponectin, resistin, leptin, chemerin, vaspin, progranulin assays were performed by ELISA. Adipokine-to-adiponectin ratios were obtained. SPSS Version 20 was used for the evaluation of data. p values ≤ 0.05 were accepted as statistically significant. Values of BMI and D2 index, waist-to-hip, head-to-neck ratios did not differ between MO and MetS groups (p ≥ 0.05). Except progranulin (p ≤ 0.01), similar patterns were observed for plasma levels of each adipokine. There was not any difference in vaspin as well as resistin levels between NW and MO groups. Significantly increased leptin-to-adiponectin, chemerin-to-adiponectin and vaspin-to-adiponectin values were noted in MO in comparison with those of NW. The most valuable adipokine index was progranulin-to-adiponectin (p ≤ 0.01). This index was strongly correlated with vaspin-to-adiponectin ratio in all groups (p ≤ 0.05). There was no correlation between vaspin-to-adiponectin and chemerin-to--adiponectin in NW group. However, a correlation existed in MO group (r = 0.486; p ≤ 0.05). Much stronger correlation (r = 0.609; p ≤ 0.01) was observed in MetS group between these two adipokine indices. No correlations were detected between vaspin and progranulin as well as vaspin and chemerin levels. Correlation analyses showed a unique profile confined to MetS children. Adiponectin was found to be correlated with waist-to-hip (r = -0.435; p ≤ 0.05) as well as head-to-neck (r = 0.541; p ≤ 0.05) ratios only in MetS children. In this study, it has been investigated if adipokine indices have priority over adipokine levels. In conclusion, vaspin-to-adiponectin, progranulin-to-adiponectin, chemerin-to-adiponectin along with waist-to-hip and head-to-neck ratios were the optimal combinations. Adiponectin, waist-to-hip, head-to-neck, vaspin-to-adiponectin, chemerin-to-adiponectin ratios had appropriate discriminatory capability for MetS children.

Keywords: adipokine indices, metabolic syndrome, obesity indices, pediatric obesity

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Authors: Meiying Liao, Poya Huang

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The aesthetic domain is one of the six major domains in the Taiwanese preschool curriculum, encompassing visual arts, music, and dramatic play. Its primary objective is to cultivate children’s abilities in exploration and awareness, expression and creation, and response and appreciation. The purpose of this study was to explore the effects of hosting a vocal music concert on aesthetic inspiration and learning among preschoolers in a preschool setting. The primary research method employed was a case study focusing on a private preschool in Northern Taiwan that organized a school-wide event featuring two vocalists. The concert repertoires included children’s songs, folk songs, and arias performed in Mandarin, Hakka, English, German, and Italian. In addition to professional performances, preschool teachers actively participated by presenting a children’s song. A total of 5 classes, comprising approximately 150 preschoolers, along with 16 teachers and staff, participated in the event. Data collection methods included observation, interviews, and documents. Results indicated that both teachers and children thoroughly enjoyed the concert, with high levels of acceptance when the program was appropriately designed and hosted. Teachers reported that post-concert discussions with children revealed the latter’s ability to recall people, events, and elements observed during the performance, expressing their impressions of the most memorable segments. The concert effectively achieved the goals of the aesthetic domain, particularly in fostering response and appreciation. It also inspired preschoolers’ interest in music. Many teachers noted an increased desire for performance among preschoolers after exposure to the concert, with children imitating the performers and their expressions. Remarkably, one class extended this experience by incorporating it into the curriculum, autonomously organizing a high-quality concert in the music learning center. Parents also reported that preschoolers enthusiastically shared their concert experiences at home. In conclusion, despite being a single event, the positive responses from preschoolers towards the music performance suggest a meaningful impact. These experiences extended into the curriculum, as firsthand exposure to performances allowed teachers to deepen related topics, fostering a habit of autonomous learning in the designated learning centers.

Keywords: concert, early childhood music education, aesthetic education, music develpment

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Authors: Aidan Jacobsen, Morgan Motia, David Sam, Jonathan Mudge

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Background: The Centers for Disease Control (CDC) lists vaccine requirements for children under two years old to correlate with development markers. CDC lists the coverage by age 24 months to be at least 90% nationally and 84% for Rhode Island Blackstone Valley Community Health Center (BVCHC) in Central Falls, Rhode Island, currently has a completed vaccination rate of 51% for children by the age of 24 months. Current barriers to care for up to date well child vaccinations include lack of transportation, parental work, childcare, and other social stressors. Objective: Increase the vaccination rate of children under the age of 24 months at BVCHC. Conduct a literature review to identify the common barriers preventing children under 24 months from receiving vaccinations. Reduce the barriers to expand access to vaccination care for infants Methods: Setting: Blackstone Valley Community Health Center, Pawtucket, RI Participants: (n=41), Patients between the age of 20-24 months, not up to date with the CDC vaccination recommendations and without a future appointment. QI Intervention: Patients were contacted via phone and offered an appointment during extra Saturday clinic hours in order to receive up to date vaccine care. A Saturday vaccine clinic was established specifically for patients in need of vaccines and having identified barriers to care. Conclusions: Expanding clinic hours and targeting non vaccine up –to-date patients can increase the current standard of childhood immunizations at BVCHC. Overcoming barriers preventing childhood immunization can improve access to providing up to date vaccinations. Other barriers still deter from reaching the national standard of immunizations rates.

Keywords: vaccinations, well child care, barriers to care, social determinants of health

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Authors: Farina Maqbool

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Background: It is well said that children are considered the future masons of the country and a healthy brain is found in a healthy body. Therefore, a healthy generation can be produced by giving knowledge of immunization to mothers. Immunization is the most lucrative public health intrusion that has placed the greatest effect on the health of the people. The main objective of the present study was to find out the mother’s knowledge, attitude, and practices towards childhood immunization. Methods: Multistage sampling technique was used. One hundred and sixty mothers were selected conveniently who have at least one child up to two years. Data were collected through the face to face interview. The chi-square test was used to test the significance of the association between independent and dependent variables. Data were analyzed using the Statistical Package for Social Science. Results: A higher percentage of mothers (85.0%) knew vaccine-preventable diseases. Major proportion (82.5%) of the mothers had thought that immunization is important for their child’s health. A majority (66.3%) of the respondents’ children were fully immunized, whereas 26.3 percent of them were replied negatively. Remaining 7.5 percent of the respondents’ child un-immunized Chi-square value (39.14) shows a highly significant association between the education of the respondents and receiving of all recommended vaccines for children. Gamma value shows a strong positive relationship between the variables.

Keywords: attitude, childhood, immunization, knowledge, practices

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Authors: Rafael Santos Fischer, Aloísio Leoni Schmid, Amanda Dalla-Bonna

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The life cycle analysis and the energy life cycle analysis are useful design support tools when sustainability becomes imperative. The final phase of buildings life cycle is probably the least known, on which less knowledge is available. In the Brazilian building industry, the lifespan of a building design rarely is treated as a definite design parameter. There is rather a common sense attitude to take any building demands as permanent, and to take for granted that buildings solutions are durable and solid. Housing, being a permanent issue in any society, presents a real challenge to the choice of a design lifespan. In Brazilian history, there was a contrast of the native solutions of collective, non-durable houses built by several nomadic tribes, and the stone and masonry buildings introduced by the sedentary Portuguese conquerors. Durable buildings are commonly associated with welfare. However, social dynamics makes traditional families of both parents and children be just one of several possible arrangements. In addition, a more liberal attitude towards family leads to an increase in the number of people living in alternative arrangements. Japan is an example of country where houses have been made intentionally ephemeral since the half of 20th century. The present article presents the development of a flexible housing design solution on the basis of the Design Science Research approach. A comparison in terms of energy life cycle shows how flexibility and dematerialization may point at a feasible future for housing policies in Brazil.

Keywords: adaptability, adaptable building, embodied energy, life cyclce analysis, social housing

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Authors: Anastasia V. Kovaleva, Alena A. Ryabova, Vladimir N. Kasatkin

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Background: The most simple form of entrainment to a sensory (typically auditory) rhythmic stimulus involves perceiving and synchronizing movements with an isochronous beat with one level of periodicity, such as that produced by a metronome. Children with pediatric cancer usually treated with chemo- and radiotherapy. Because of such treatment, psychologists and health professionals declare cognitive and motor abilities decline in cancer patients. The purpose of our study was to measure working memory characteristics with association with audio-motor synchronization tasks, also involved some memory resources, in children with different degrees of central nervous system lesions: posterior fossa tumors, acute lymphoblastic leukemia, and healthy controls. Methods: Our sample consisted of three groups of children: children treated for posterior fossa tumors (PFT-group, n=42, mean age 12.23), children treated for acute lymphoblastic leukemia (ALL-group, n=11, mean age 11.57) and neurologically healthy children (control group, n=36, mean age 11.67). Participants were tested for working memory characteristics with Cambridge Neuropsychological Test Automated Battery (CANTAB). Pattern recognition memory (PRM) and spatial working memory (SWM) tests were applied. Outcome measures of PRM test include the number and percentage of correct trials and latency (speed of participant’s response), and measures of SWM include errors, strategy, and latency. In the synchronization tests, the instruction was to tap out a regular beat (40, 60, 90 and 120 beats per minute) in synchrony with the rhythmic sequences that were played. This meant that for the sequences with an isochronous beat, participants were required to tap into every auditory event. Variations of inter-tap-intervals and deviations of children’s taps from the metronome were assessed. Results: Analysis of variance revealed the significant effect of group (ALL, PFT and control) on such parameters as short-term PRM, SWM strategy and errors. Healthy controls demonstrated more correctly retained elements, better working memory strategy, compared to cancer patients. Interestingly that ALL patients chose the bad strategy, but committed significantly less errors in SWM test then PFT and controls did. As to rhythmic ability, significant associations of working memory were found out only with 40 bpm rhythm: the less variable were inter-tap-intervals of the child, the more elements in memory he/she could retain. The ability to audio-motor synchronization may be related to working memory processes mediated by the prefrontal cortex whereby each sensory event is actively retrieved and monitored during rhythmic sequencing. Conclusion: Our results suggest that working memory, tested with appropriate cognitive methods, is associated with the ability to synchronize movements with rhythmic sounds, especially in sub-second intervals (40 per minute).

Keywords: acute lymphoblastic leukemia (ALL), audio-motor synchronization, posterior fossa tumor, working memory

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Authors: Michael Subbey, Kwame Takyi Danquah

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Finding a child's exceptional skills and abilities at a young age and nurturing them is a challenging process. The Social Learning Theory (SLT) of Albert Bandura is used to analyze the effects of early talent identification on children's growth and development. The study examines both the advantages and disadvantages of early talent identification and stresses the significance of a moral strategy that puts the welfare of the child first. The paper emphasizes the value of a balanced approach to early talent identification that takes into account individual differences, cultural considerations, and the child's social environment.

Keywords: early talent development, social learning theory, child development, child welfare

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Authors: Fareena Alladin

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In the Caribbean, issues of food security, health and taste are intricately linked, seen most clearly in the increasing incidence of lifestyle diseases among children coupled with a taste for high calorie and Westernized diets. In order to fully appreciate this link, the role of nutrition environments must be examined. To this end, the present study incorporates tenets of Bourdieu’s social constructivist theory with the Community Nutrition Environment Model. The aim of this study was to examine the relationships between availability of and access to healthy/unhealthy foods within nutrition environments, namely the household and school, and the development of taste preferences for healthy/unhealthy foods among primary school children in a selected educational district in Trinidad and Tobago. A cross-sectional survey of 400 children between the ages of 9 and 11 years was conducted. Data analysis was conducted using SPSS 24. Results indicated that availability of healthy food at home was positively correlated with preference for vegetables, and negatively correlated with preference for salty snacks and fast food. The availability of unhealthy food within the home was found to be negatively correlated with preference for vegetables and positively correlated with preference for salty snacks. Access to unhealthy foods at school had a positive correlation with preference for fast food. These findings highlight the role of the food environment in shaping taste preferences, and point to the need for interrogating the centrality of food security concerns in emerging health concerns of Caribbean countries. Such interrogations are a necessary part of the development of research agendas, and policy formulation and implementation.

Keywords: food security, nutrition environment, taste preference, Trinidad and Tobago

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Authors: Yaser S. Kishawi, Sadi R. Ali

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Part of Palestine, Gaza Strip (365 km2 and 1.8 million inhabitants) is considered a semi-arid zone relies solely on the Coastal Aquifer. The coastal aquifer is only source of water with only 5-10% suitable for human use. This barely cover the domestic and agricultural needs of Gaza Strip. Palestinian Water Authority Strategy is finding non-conventional water resource from treated wastewater to cover agricultural requirements and serve the population. A new WWTP project is to replace the old-overloaded Biet Lahia WWTP. The project consists of three parts; phase A (pressure line & infiltration basins - IBs), phase B (a new WWTP) and phase C (Recovery and Reuse Scheme – RRS – to capture the spreading plume). Currently, only phase A is functioning. Nearly 23 Mm3 of partially treated wastewater were infiltrated into the aquifer. Phase B and phase C witnessed many delays and this forced a reassessment of the RRS original design. An Environmental Management Plan was conducted from Jul 2013 to Jun 2014 on 13 existing monitoring wells surrounding the project location. This is to measure the efficiency of the SAT system and the spread of the contamination plume with relation to the efficiency of the proposed RRS. Along with the proposed location of the 27 recovery wells as part of the proposed RRS. The results of monitored wells were assessed compared with PWA baseline data. This was put into a groundwater model to simulate the plume to propose the best suitable solution to the delays. The redesign mainly manipulated the pumping rate of wells, proposed locations and functioning schedules (including wells groupings). The proposed simulations were examined using visual MODFLOW V4.2 to simulate the results. The results of monitored wells were assessed based on the location of the monitoring wells related to the proposed recovery wells locations (200m, 500m and 750m away from the IBs). Near the 500m line (the first row of proposed recovery wells), an increase of nitrate (from 30 to 70mg/L) compare to a decrease in Chloride (1500 to below 900mg/L) was found during the monitoring period which indicated an expansion of plume to this distance. On this rate with the required time to construct the recovery scheme, keeping the original design the RRS will fail to capture the plume. Based on that many simulations were conducted leading into three main scenarios. The scenarios manipulated the starting dates, the pumping rate and the locations of recovery wells. A simulation of plume expansion and path-lines were extracted from the model monitoring how to prevent the expansion towards the nearby municipal wells. It was concluded that the location is the most important factor in determining the RRS efficiency. Scenario III was adopted and showed an effective results even with a reduced pumping rates. This scenario proposed adding two additional recovery wells in a location beyond the 750m line to compensate the delays and effectively capture the plume. A continuous monitoring program for current and future monitoring wells should be in place to support the proposed scenario and ensure maximum protection.

Keywords: soil aquifer treatment, recovery and reuse scheme, infiltration basins, north gaza

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Authors: Vijay Samuel, Tina Thekkekkara, Shoma Ganguly

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There is no reported Hanta Seoul virus infection in children in the UK so far, making it quite challenging for clinicians in diagnosing, predicting and prognosticating the outcome of the infection to patients and parents. We report a case of a ten-year-old girl who presented with pyrexia associated with headache, photophobia and abdominal pain. The family had recently acquired two pet rats six weeks ago. She appeared flushed with peri-oral pallor, coated the strawberry tongue, inflamed tonsils and bilateral cervical lymphadenopathy. Her liver and splenic edges were palpable. Investigations showed that she was thrombocytopenic with deranged renal and liver functions. An ultrasound abdomen demonstrated a mildly enlarged spleen, peripancreatic lymph node and an acalculous cholecystitis. In view of her clinical presentation, a diagnosis of leptospirosis was considered and she was commenced on intravenous benzylpenicillin. The following day she became oliguric, developed significant proteinuria and her renal function deteriorated. Following conservative management, her urine output gradually improved along with her renal function, proteinuria and thrombocytopaenia. Serology for leptospirosis and various other viruses were negative. Following discussion with the Rare and Imported Pathogens Laboratory at Porton hanta virus serology was requested and found to be strongly positive for Seoul hanta virus. Following discharge she developed palpitations, fatigue, severe headache and cognitive difficulties including memory loss and difficulties in spelling, reading and mathematics. Extensive investigations including ECG, MRI brain and CSF studies were performed and revealed no significant abnormalities. Since 2012, there have been six cases of acute kidney injury due to Hantavirus infection in the UK. Two cases were from the Humber region and were exposure to wild rats and the other four were exposed to specially bred pet fancy rats. Hanta virus infections can cause mild flu like symptoms but two clinical syndromes are associated with severe disease including haemorrhagic fever with renal syndrome, which may be associated with thrombocytopenia and Hantavirus cardiopulmonary syndrome. Neuropsychological impairments reported following hantavirus pulmonary syndrome and following Puumala virus infection have been reported. Minor white matter lesions were found in about half of the patients investigated with MRI brain. Seoul virus has a global distribution owing to the dispersal of its carrier host rats, through global trade. Several ports in the region could explain the possible establishment of Seoul virus in local populations of rats in the Yorkshire and Humber region. The risk of infection for occupationally exposed groups is 1-3% compared to 32.9% for specialist pet rat owners. The report highlight’s the importance of routinely asking about pets in the family. We hope to raise awareness of the emergence of hantavirus infection in the UK, particularly in the Yorkshire and Humber region. Clinicians should consider hantavirus infection as a potential cause of febrile illness causing renal impairment in children. Awareness of the possible neuro-cognitive sequele would help the clinicians offer appropriate information and support to children and their families. Contacting Rare and Imported Pathogens Laboratory at Porton is a useful resource for clinicians in UK when they consider unusual infections.

Keywords: Seoul hantavirus in child Porton, UK Acute kidney injury

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Authors: Israr Ahmad, Sehrish Sabir

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Present study deals with the taxonomic and ethno medicinal uses of some Pteridophytes species present in District Bagh AJK, Pakistan. The people of District Bagh extensively use Pteridophytes for different purposes. Ethno botanical evidence and Ornamental Potential of the taxa of wild pteridophytes was documented through field trips during 2017-2018, and data was collected through a structured questionnaire, and in-depth interviews were conducted from the natives in the hilly regions. Total of 22 Pteridophytes belonging to 13 genera 9 families were collected. Out of 22 species, one species (Cystoathyriumchinense ) newly record from Pakistan. The most leading family is Pteridaceae, having 9species, followed by Dryopteridaceae, having 4species, and Aspleniaceae having 3species. The remaining families are represented by single species of each. Inhabitants of mountainous and rural zones regularly used these taxa for different remedy, which are not discussed in the previous available literature. The novel remedies reported in this research areCystoathyriumchinense decoction used for irregular menstruation, Cyclosorusopulentus crushed leaves and stem are used for the treatment of stomach disorder.Onychiumlucidumused to treatJaundice, injury, pain dysentery, common cold, and arresting bleeding. Based on these findings, it is further recommended that phytochemical studies should be conducted to explore active chemical constituents for the cure of various diseases. Conservation efforts must be done to conserve many threatened species of the research area.

Keywords: adiantum, cancer, pakistan, pteridophytes

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Authors: Esther Burkitt, Dawn Watling

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Background: Four types of patterns of simultaneous mixed emotions have been identified in middle childhood, adolescence and adulthood. The present study applied an analogue emotion scale which permits measuring of intensity of opposite valence emotions over time rather than bipolar ratings and used an exhaustive coding scheme to investigate whether children in early childhood experience previously identified and additional types of mixed emotional experiences. Methods: To explore the presence of simultaneous mixed emotion experiences in early childhood, 112 children (59 girls) aged 5 years 1 month - 7 years 2 months (X=6 years 1 month; SD = 10 months) were recruited across the UK. They were allocated on the basis of alternation by gender on class lists to one of two conditions hearing vignettes describing mixed emotion events in an age and gender matched protagonist or themselves (other, n = 57 and self, n = 55). Findings: New types of flexuous, vertical and other experiences were identified alongside sequential, prevalent, highly parallel and inverse types of experiences identified in older populations. Conclusions: The analogue emotion scale uncovered a broader range of simultaneous mixed emotional experiences than previously identified. The value of exploring the utility of the findings in emotion assessments is discussed along with suggestions to explore impacts of educational and cultural influences on children’s mixed emotional experiences.

Keywords: childhood, emotion, graphing, self

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Authors: Evridiki Zachopoulou, Vasilis Grammatikopoulos, Michail Vitoulis, Athanasios Gregoriadis

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In the last ten years, the recent economic crisis in Greece has decreased the financial ability and strength of several families when it comes to supporting their children’s studies. As a result, the number of students who are significantly delaying or even dropping out of their university studies is constantly increasing. The students who are at greater risk for academic failure are those who are facing various problems and social disadvantages, like health problems, special needs, family poverty or unemployment, single-parent students, immigrant students, etc. The ‘Umbrella’ project is a volunteer-based initiative to tackle this problem at International Hellenic University. The main purpose of the project is to provide support to disadvantaged students at a socio-emotional, academic, and practical level in order to help them complete their undergraduate studies. More specifically, the ‘Umbrella’ project has the following goals: (a) to develop a consulting-supporting network based on volunteering senior students, called ‘i-mentors’. (b) to train the volunteering i-mentors and create a systematic and consistent support procedure for students at-risk, (c), to develop a service that, parallel to the i-mentor network will be ensuring opportunities for at-risk students to find a job, (d) to support students who are coping with accessibility difficulties, (e) to secure the sustainability of the ‘Umbrella’ project after the completion of the funding of the project. The innovation of the Umbrella project is in its holistic-person-centered approach that will be providing individualized support -via the i-mentors network- to any disadvantaged student that will come ‘under the Umbrella.’

Keywords: peer mentoring, student support, socially disadvantaged students, volunteerism in higher education

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Authors: Siti Fatimah Kader Maideen, Abdul Rashid, Nur Indah Ahmad

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Introduction: Indigenous people have an increased risk of contracting zoonotic infections due to their practices. Similarly, the aborigines in Peninsular Malaysia, the Orang Asli, have a higher risk too. This study aimed to empower the Jahai children on the prevention of zoonotic infections by implementing a health promotion intervention program. Methods: A non-experimental pre and post-test interventional study was conducted among the indigenous primary school children aged between nine and 12 years in Perak, Malaysia. A structured questionnaire was used to assess the pre-and post-knowledge and attitudes towards zoonotic infections and hand hygiene practice. This is followed by three sessions of the health promotion program. Ethical approval was obtained prior to the data collection. Data were analysed using SPSS software. Results: The knowledge on whether diseases can spread from animals to humans, transmission via saliva and faeces, types of organisms that can infect, and signs and symptoms increased significantly between pre and post. Significant improvements were observed in the attitude and practices too. Conclusion: The intervention program demonstrated improvement in the knowledge, attitude, and practice among the children. The continuous program needs to be conducted for a sustainable outcome.

Keywords: health promotion, zoonotic infections, aborigines, knowledge, practice

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Authors: Ifeanyi Adigwe, Thomas Van der Walt

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Digital media has been integrated into the social and entertainment life of young children, and as such, the impact of digital media appears to affect young people of all ages and it is believed that this will continue to shape the world of young children. Since, technological advancement of digital media presents adolescents with diverse contexts, platforms and avenues to engage with digital media outside the home environment and from parents' supervision, a wide range of new challenges has further complicated the already difficult tasks for parents and altered the landscape of parenting. Despite the fact that adolescents now have access to a wide range of digital media technologies both at home and in the learning environment, parenting practices such as active, restrictive, co-use, participatory and technical mediations are important in mitigating of online risks adolescents may encounter as a result of digital media use. However, these mediation practices only focus on the home environment including digital media present in the home and may not necessarily transcend outside the home and other learning environments where adolescents use digital media for school work and other activities. This poses the question of who mediates adolescent's digital media use outside the home environment. The learning environment could be a ''loose platform'' where an adolescent can maximise digital media use considering the fact that there is no restriction in terms of content and time allotted to using digital media during school hours. That is to say that an adolescent can play the ''bad boy'' online in school because there is little or no restriction of digital media use and be exposed to online risks and play the ''good boy'' at home because of ''heavy'' parental mediation. This is the reason why parent mediation practices have been ineffective because a parent may not be able to track adolescents digital media use considering the diversity of contexts, platforms and avenues adolescents use digital media. This study argues that due to the diverse nature of digital media technology, parents may not be able to monitor the 'whereabouts' of their children in the digital space. This is because adolescent digital media usage may not only be confined to the home environment but other learning environments like schools. This calls for urgent attention on the part of teachers to understand the intricacies of how digital media continue to shape the world in which young children are developing and learning. It is, therefore, imperative for parents to liaise with the schools of their children to mediate digital media use during school hours. The implication of parents- teachers mediation practices are discussed. The article concludes by suggesting that third party mediation by teachers in schools and other learning environments should be encouraged and future research needs to consider the emergent strategy of teacher-children mediation approach and the implication for policy for both the home and learning environments.

Keywords: digital media, digital age, parent mediation, third party mediation

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Authors: Noor Ismael, Lisa Mische Lawson, Lauren Little, Murad Moqbel

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Background/Significance: Caregivers of children with Autism Spectrum Disorders (ASD) develop coping mechanisms to overcome daily challenges to successfully parent their child. There is variability in coping strategies used among caregivers of children with ASD. Capturing homogeneity among such variable groups may help elucidate targeted intervention approaches for caregivers of children with ASD. Study Purpose: This study aimed to identify groups of caregivers of children with ASD based on coping mechanisms, and to examine whether there are differences among these groups in terms of strain level. Methods: This study utilized a secondary data analysis, and included survey responses of 273 caregivers of children with ASD. Measures consisted of the COPE Inventory and the Caregiver Strain Questionnaire. Data analyses consisted of cluster analysis to group caregiver coping strategies, and analysis of variance to compare the caregiver coping groups on strain level. Results: Cluster analysis results showed four distinct groups with different combinations of coping strategies: Social-Supported/Planning (group one), Spontaneous/Reactive (group two), Self-Supporting/Reappraisal (group three), and Religious/Expressive (group four). Caregivers in group one (Social-Supported/Planning) demonstrated significantly higher levels than the remaining three groups in the use of the following coping strategies: planning, use of instrumental social support, and use of emotional social support, relative to the other three groups. Caregivers in group two (Spontaneous/Reactive) used less restraint relative to the other three groups, and less suppression of competing activities relative to the other three groups as coping strategies. Also, group two showed significantly lower levels of religious coping as compared to the other three groups. In contrast to group one, caregivers in group three (Self-Supporting/Reappraisal) demonstrated significantly lower levels of the use of instrumental social support and the use of emotional social support relative to the other three groups. Additionally, caregivers in group three showed more acceptance, positive reinterpretation and growth coping strategies. Caregivers in group four (Religious/Expressive) demonstrated significantly higher levels of religious coping relative to the other three groups and utilized more venting of emotions strategies. Analysis of Variance results showed no significant differences between the four groups on the strain scores. Conclusions: There are four distinct groups with different combinations of coping strategies: Social-Supported/Planning, Spontaneous/Reactive, Self-Supporting/Reappraisal, and Religious/Expressive. Each caregiver group engaged in a combination of coping strategies to overcome the strain of caregiving.

Keywords: autism, caregivers, cluster analysis, coping strategies

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Authors: Takeo Shibata, Arihito Endo, Chika Hiraga, Akemi Kunimatsu, Yoko Shimizu

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Introduction: A health promotion program, Yuzawa family health plan, was initiated in 2002. It has been held for fifteen years. Yuzawa Town is famous with hot springs and ski resorts. We evaluated the changes in mental status in elementary school children. Methods: questionnaires survey had been held every five years. 196 questionnaires were corrected (94 boys and 102 girls). Changes for their anxieties, loneliness, confiding, problem-solving, risk breaching, communications, happiness, and life satisfaction were evaluated by chi-square test. Results: The rate of loneliness and life dissatisfactions decreased. The rates of happiness, confiding in grandparents, and risk breaching, increased. Especially, happiness rates increased for boys, loneliness rate decreased for girls, confiding in grandparents and risk breaching rate increased for girls. Conclusion: Our health promotion programs could increase mental health status in elementary school children.

Keywords: health promotion, mental status, elementary school, loneliness, happiness

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Authors: S. D. Zalepugin, A. E. Murzich, D. G. Satskevich, A. B. Palivanov

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Introduction. The incidence of spinal injuries in patients under 18 years of age has increased significantly in recent years, which represents a significant economic, social and medical problem. The most common method of surgical stabilization of spinal fractures in pediatric patients is transpedicular posterior spinal fusion, which is widely used by spinal neurosurgeons in adult patients. Purpose of the study: This study evaluates the results of treatment of thoracolumbar spine lesions in children using the transpedicular screw fixation method. Materials and methods. From 2019 to 2024, 35 children with injuries to the thoracic and lumbar spine underwent surgical treatment using the transpedicular screw fixation method. Among the injured, girls prevailed (21 cases, 60%). The age of the victims ranged from 9 to 17 years. The main causes of damage were: catatrauma (19 cases), road accident (5 cases), sports injury (6 cases), and other reasons - 5 cases. In 5 cases, suicidal attempts occurred. Co-injury was observed in most cases (20 patients, or 57%), which is natural for high-energy injury. Vertebral-spinal injury with neurological disorders was observed in 13 patients, the disorders ranged from mild inferior (4 children) to moderate/severe paraparesis (5 patients) and inferior paraplegia (4 children). 6 children had pelvic organ dysfunction in the form of urinary and fecal retention or incontinence. All thirty-five patients, within a period of 1 to 57 days after the injury, underwent several surgical interventions from the posterior surgical access using a screw fixation method (posterior decompression + spinal fusion). In 12 cases, it was necessary to perform the second stage of surgical treatment - anterior decompression of the spinal cord or its roots. Verticalization of patients was carried out within 1 to 5 days after surgery. Results. In all patients, the nearest, up to 1 year, results were evaluated. In children operated in 2019-2021, the results were studied in terms of 3 to 5 years. The procedures used, clinical results and the quality of the fixative installation were assessed. All patients managed to achieve positive results. The use of internal fixation made it possible to carry out early verticalization of children, eliminate pain syndrome and achieve a regression of neurological disorders in most patients (especially in cases when the operation was performed early after injury - from 1 to 3 days). Within the first month, the ability to self-care was fully restored. Bone fusion was observed within 6-12 months after surgery. There were no complications after surgery. The analysis of postoperative radiographs, CT and MRI images revealed the correct standing of the screws in all cases. Conclusion. The posterior spinal fusion using the new method of screw fixation in pediatric patients allows to achieve durable stabilization of damage, begins early rehabilitation of patients and reduces the duration of hospital treatment by 2-3 times. Thus, we recommend the use of a transpedicular fixator in children as a reliable, technically feasible method for restoring spinal stability with a low risk of intra- and postoperative complications.

Keywords: pediatric patients, spinal injuries, transpedicular stabilization, operative treatment

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Authors: Vilma Zydziunaite, Monika Kelpsiene

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In early childhood and preschool education, play has an important role in learning and cognitive processes. In the context of a changing world, personal autonomy and the use of technology are becoming increasingly important for the development of a wide range of learner competencies. By integrating technology into learning environments, the educational reality is changed, promoting unusual learning experiences for children through play-based activities. Alongside this, teachers are challenged to develop encouragement and motivation strategies that empower children to act independently. The aim of the study was to reveal the changes in the roles and experiences of teachers in the application of AR technology for the enrichment of the learning process. A quantitative research approach was used to conduct the study. The data was collected through an electronic questionnaire. Participants: 319 teachers of 5-6-year-old children using AR technology tools in their educational process. Methods of data analysis: Cronbach alpha, descriptive statistical analysis, normal distribution analysis, correlation analysis, regression analysis (SPSS software). Results. The results of the study show a significant relationship between children's learning and the educational process modeled by the teacher. The strongest predictor of child learning was found to be related to the role of the educator. Other predictors, such as pedagogical strategies, the concept of AR technology, and areas of children's education, have no significant relationship with child learning. The role of the educator was found to be a strong determinant of the child's learning process. Conclusions. The greatest potential for integrating AR technology into the teaching-learning process is revealed in collaborative learning. Teachers identified that when integrating AR technology into the educational process, they encourage children to learn from each other, develop problem-solving skills, and create inclusive learning contexts. A significant relationship has emerged - how the changing role of the teacher relates to the child's learning style and the aspiration for personal leadership and responsibility for their learning. Teachers identified the following key roles: observer of the learning process, proactive moderator, and creator of the educational context. All these roles enable the learner to become an autonomous and active participant in the learning process. This provides a better understanding and explanation of why it becomes crucial to empower the learner to experiment, explore, discover, actively create, and foster collaborative learning in the design and implementation of the educational content, also for teachers to integrate AR technologies and the application of the principles of shared leadership. No statistically significant relationship was found between the understanding of the definition of AR technology and the teacher’s choice of role in the learning process. However, teachers reported that their understanding of the definition of AR technology influences their choice of role, which has an impact on children's learning.

Keywords: teacher, learner, augmented reality, collaboration, shared leadership, preschool education

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Authors: Tigist mamo, Beryl Oranga, Precious Mubanga

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High rates of child undernutrition in Ethiopia place children at significant risk, highlighting the need for low-cost, nutritious diets starting at six months of age. These diets should be diverse and rich in essential nutrients like proteins, vitamins, and minerals. However, many rural households participating in the Productive Safety Net Program (PSNP) struggle to afford fortified foods and often rely on low-protein, cereal-based diets, leading to micronutrient deficiencies. In addition, fasting practices further restrict the consumption of animal-source foods for 190 to 250 days each year, limiting dietary diversity even more. Addressing these challenges requires solutions beyond nutrition counseling, focusing on factors such as seasonality, food perishability, and safety to promote better health outcomes for children. The program's main objective is to empower caregivers with practical recipes for complementary feeding for children aged 6 to 23 months by enhancing meals with affordable ingredients like cereal, legumes, dried vegetables, and meat. The ongoing implementation research within the SPIR-II program is centered on developing a cost-effective mixed flour and exploring drying techniques to extend shelf life, ultimately addressing the delayed introduction of complementary foods and increasing nutrient-rich options in households. Saleswomen participating in the SPIR-II program have been empowered to produce easy-to-use local complementary flour and conduct door-to-door sales in their neighborhoods. Caregivers who have purchased and fed this flour to their children have reported significant improvements in their nutritional status. Additionally, SPIR-II is testing low-tech drying methods suitable for rural Ethiopian contexts to reduce food loss and promote the inclusion of nutrient-dense foods in children's diets. The paper will highlight the primary outcomes of these initiatives as they are being implemented.

Keywords: food preservation, easy-to-use mixed flour, complementary feeding, drying techniques

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Authors: Yaser S. Kishawi, Sadi R. Ali

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Part of Palestine, Gaza Strip (365 km2 and 1.8 million habitants) is considered a semi-arid zone relies solely on the Coastal Aquifer. The coastal aquifer is only source of water with only 5-10% suitable for human use. This barely covers the domestic and agricultural needs of Gaza Strip. Palestinian Water Authority Strategy is finding non-conventional water resource from treated wastewater to cover agricultural requirements and serve the population. A new WWTP project is to replace the old-overloaded Biet Lahia WWTP. The project consists of three parts; phase A (pressure line and infiltration basins-IBs), phase B (a new WWTP) and phase C (Recovery and Reuse Scheme–RRS– to capture the spreading plume). Currently, only phase A is functioning. Nearly 23 Mm3 of partially treated wastewater were infiltrated into the aquifer. Phase B and phase C witnessed many delays and this forced a reassessment of the RRS original design. An Environmental Management Plan was conducted from Jul 2013 to Jun 2014 on 13 existing monitoring wells surrounding the project location. This is to measure the efficiency of the SAT system and the spread of the contamination plume with relation to the efficiency of the proposed RRS. Along with the proposed location of the 27 recovery wells as part of the proposed RRS. The results of monitored wells were assessed compared with PWA baseline data. This was put into a groundwater model to simulate the plume to propose the best suitable solution to the delays. The redesign mainly manipulated the pumping rate of wells, proposed locations and functioning schedules (including wells groupings). The proposed simulations were examined using visual MODFLOW V4.2 to simulate the results. The results of monitored wells were assessed based on the location of the monitoring wells related to the proposed recovery wells locations (200m, 500m, and 750m away from the IBs). Near the 500m line (the first row of proposed recovery wells), an increase of nitrate (from 30 to 70mg/L) compare to a decrease in Chloride (1500 to below 900mg/L) was found during the monitoring period which indicated an expansion of plume to this distance. On this rate with the required time to construct the recovery scheme, keeping the original design the RRS will fail to capture the plume. Based on that many simulations were conducted leading into three main scenarios. The scenarios manipulated the starting dates, the pumping rate and the locations of recovery wells. A simulation of plume expansion and path-lines were extracted from the model monitoring how to prevent the expansion towards the nearby municipal wells. It was concluded that the location is the most important factor in determining the RRS efficiency. Scenario III was adopted and showed effective results even with a reduced pumping rates. This scenario proposed adding two additional recovery wells in a location beyond the 750m line to compensate the delays and effectively capture the plume. A continuous monitoring program for current and future monitoring wells should be in place to support the proposed scenario and ensure maximum protection.

Keywords: soil aquifer treatment, recovery reuse scheme, infiltration basins, North Gaza

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Authors: Renee Fabian, Jordan Davidson

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Current research on non-suicidal self-injury (NSSI) provides ample insights on best practices for caregivers and clinicians to address and reduce NSSI behavior among adolescents. However, the efficacy of evidenced-based NSSI interventions and their delivery from the perspective of adolescent patients does not receive significant attention, creating a gap between the efficacy of research-based NSSI interventions and adolescent perceptions of NSSI treatment and adolescent willingness to engage in NSSI interventions. To address the gap between practice and patient perspectives and inform more effective treatment outcomes, the current survey aims to identify major patient-reported adverse reactions to NSSI disclosures from caregivers, treating mental health clinicians, and medical professionals using a mixed methods survey of 2,500 people with a history of NSSI completed by editors at a consumer-facing health publication. Based on the analyzed results of the survey, a majority of adolescents with a history of NSSI found parents and caregivers ineffective at empathetically addressing NSSI, and a significant number of participants reported at least one treating mental health professional inadequately responded to NSSI behaviors, in addition to other findings of adverse reactions to NSSI disclosures that serve as a barrier to treatment. NSSI is a significant risk factor for future suicide attempts. Addressing patient-reported adverse reactions to NSSI disclosures in the adolescent population can remove barriers to the effectiveness of caregiver and clinician NSSI interventions and reduce the risk of NSSI-related harm and lower the risk of future suicide attempts or completions.

Keywords: adolescent self-injury, non-suicidal self-injury, patient perspectives, self-harm interventions

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Authors: Hugo Carronnier, Wassim Almouallem, Eric Branquet

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Per- and polyfluoroalkyl Substances (PFAS) are a group of man-made refractory compounds that have been widely used in a variety of industrial and commercial products since the 1940s, leading to contamination of groundwater and surface water systems. They are persistent, bioaccumulative and toxic chemicals. Foam fractionation is a potential remedial technique for treating PFAS-contaminated water, taking advantage of the high surface activity to remove them from the solution by adsorption onto the surface of the air bubbles. Nevertheless, traditional foam fractionation technology developed for PFAS is challenging and found to be ineffective in treating the less surface-active compounds. Different chemicals were the subject of investigation as amendments to achieve better removal. However, most amendments are toxic, expensive and complicated to use. In this situation, patent-pending PFAS technology overcomes these challenges by using rather biological amendments. Results from the first laboratory trial showed remarkable results using a simple and cheap BioFoam Fractionation (BioFF) process based on biomimetics. The study showed that the BioFF process is effective in removing greater than 99% of PFOA (C8), PFOS (C8), PFHpS (C7) and PFHxS (C6) in PFAS-contaminated water. For other PFAS such as PFDA (C10) and 6:2 FTAB, a slightly less stable removal between 94% and 96% was achieved while between 34% and 73% removal efficiency was observed for PFBA (C4), PFBS (C4), PFHxA (C6), and Gen-X. In sum, the advantages of the BioFF presented as a low-waste production, a cost and energy-efficient operation and the use of a biodegradable amendment requiring no separation step after treatment, coupled with these first findings, suggest that the BioFF process is a highly applicable treatment technology for PFAS contaminated water. Additional investigations are currently carried on in order to optimize the process and establish a promising strategy for on-site PFAS remediation.

Keywords: PFAS, treatment, foam fractionation, contaminated amendments

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Authors: Nandini Paliwal

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Since aviation industry is one of the fastest growing sectors of the world economy, states depend on the air transport industry to maintain or stimulate economic growth. It significantly promotes and contributes to the economic well-being of every nation as well as world in general. Because of the continuous and rapid growth in civil aviation, it is inevitably leading to congested skies, flight delays and most alarmingly, a decrease in the safety of air navigation facilities. Safety is one of the most important concerns of aviation industry that has been unanimously recognised across the whole world. The available capacity of the air navigation system is not sufficient for the demand that is being generated. It has been indicated by forecast that the current growth in air traffic has the potential of causing delays in 20% of flights by 2020 unless changes are brought in the current system. Therefore, a safe, orderly and expeditious air navigation system is needed at the national and global levels, which, requires the implementation of an air traffic management (hereinafter referred as ‘ATM’) system to ensure an optimum flow of air traffic by utilising and enhancing capabilities provided by technical advances. The objective of this paper is to analyse the applicability of national regulations in case of liability arising out of air traffic management services and whether the current legal regime is sufficient to cover multilateral agreements including the Single European Sky regulations. In doing so, the paper will examine the international framework mainly the Article 28 of the Chicago Convention and its relevant annexes to determine the responsibility of states for providing air navigation services. Then, the paper will discuss the difference between the concept of responsibility and liability under the air law regime and how states might claim sovereign immunity for the functions of air traffic management. Thereafter, the paper will focus on the cross border agreements including the bilateral and multilateral agreements. In the end, the paper will address the scheme of Single European Sky and the need for an international convention dealing with the liability of air navigation service providers. The paper will conclude with some suggestions for unification of the laws at an international level dealing with liability of air navigation service providers and the requirement of enhanced co-operation among states in order to keep pace with technological advances.

Keywords: air traffic management, safety, single European sky, co-operation

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Authors: Davit Khachatryan, Shuo Xiang

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Numerous published studies on the use of prazosin in the treatment of PTSD-related sleep disturbances in adult population have resulted in updates to the recommendation for prazosin for nightmares that showed its strength of evidence elevated from C to B in the US Department of Veterans Affairs clinical practice guideline. In addition, the American Academy of Sleep Medicine clinical practice guideline gave prazosin a level-A recommendation for the treatment of PTSD-associated nightmares. The aim of this review is to summarize the available literature for prazosin use for nightmares and other sleep disturbances in children and adolescents with PTSD. Method: A comprehensive search for studies on prazosin use for sleep disturbances in child and adolescent population with PTSD has been performed. We looked at MEDLINE, EMBASE, PsycINFO, CINAHL, AMED, Scopus, Web of Science, and Cochrane CENTRAL databases. Results: Compared to adult population with similar psychopathology, the available literature in child and adolescent population is scarce. Despite increased interest in prazosin in the management of PTSD, only six studies investigating this medication in children and adolescents have been published. Conclusion: A large randomized control trial on this topic is needed for more definite evidence on the efficacy and safety of prazosin in the treatment of nightmares in children and adolescents with PTSD.

Keywords: guidelines, prazosin, PTSD, sleep disturbance

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Authors: Lucky Farha, Martha L. Hall

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The current adaptive clothing brands are limited in numbers and specific categories. This study explores clothing challenges for children with Down syndrome and factors that influence their perception of adaptive clothing brands. Another aim of this study was to explore brands' challenges in the adaptive business and factors that influence their perceptions towards the adaptive market. In order to determine the market barriers affecting adaptive target market needs, the researcher applied Technology Acceptance Model. After interviewing and surveying parents/caregivers having children with Down syndrome and current adaptive brands, the results found education as the significant gap in the adaptive clothing market yet to be overcome. Based on the finding, several recommendations were suggested to improve the current barriers in the adaptive clothing market.

Keywords: adaptive fashion, disability, functional clothing, clothing needs assessment, down syndrome, clothing challenge

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Authors: John Acire, Wilfred Lajul, Ogwang Tom

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Using a qualitative research technique, this study investigates the influence of Early Childhood Education (ECE) on learning outcomes in lower primary schools in Gulu City, Uganda. The study, which is based on Vygotsky's sociocultural theory of human learning, fills gaps in the current literature on the influence of ECE on learning outcomes. The aims of the study include analyzing the state of learning outcomes, investigating ECE practices, and determining the influence of these practices on learning outcomes in lower primary schools. The findings highlight the critical significance of ECE in promoting children's overall development. Nursery education helps children improve their handwriting, reading abilities, and general cognitive development. Children who have received nursery education have improved their abilities to handle pencils, form letters, and engage in social interactions, highlighting the significance of fine motor skills and socializing. Despite the good elements, difficulties in implementing ECE practices were found, such as differences in teaching styles, financial limits, and potential weariness due to prolonged school hours. The study suggests focused interventions to improve the effectiveness of ECE practices, ensure their connection with educational goals and maximize their influence on children's development. The study's findings show that respondents agree on the importance of nursery education in supporting holistic development, socialization, language competency, and conceptual comprehension. Challenges in nursery education, such as differences in teaching techniques and insufficient resources, highlight the need for comprehensive measures to address these challenges. Furthermore, parental engagement in home learning activities was revealed as an important factor affecting early education outcomes. Children who were engaged at home performed better in lower primary, emphasizing the value of a supportive family environment. Finally, the report suggests measures to enhance parental participation, changes in teaching methods through retraining, and age-appropriate enrolment. Future studies might concentrate on the involvement of parents, ECE policy practice, and the influence of ECE teachers on lower primary school learning results. These ideas are intended to help create a more favorable learning environment by encouraging holistic development and preparing children for success in succeeding academic levels.

Keywords: early childhood education, learning outcomes in lower primary schools, early childhood education practices, how ECE practices influence learning outcomes in lower primary schools

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Authors: A. Venkatakrishnan, M. Juneja, S. Kapoor

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Background: Gastrointestinal dysfunction is an emerging co morbidity seen in autism and may further strengthen the association between autism and celiac disease. This is supported by increased rates (22-70%) of gastrointestinal symptoms like diarrhea, constipation, abdominal discomfort/pain, and gastrointestinal inflammation in children with the etiology of autism is still elusive. In addition to genetic factors, environmental factors such as toxin exposure, intrauterine exposure to certain teratogenic drugs, are being proposed as possible contributing factors in the etiology of Autism Spectrum Disorders (ASD) in cognizance with reports of increased gut permeability and high rates of gastrointestinal symptoms noted in children with ASD, celiac disease has also been proposed as a possible etiological factor. Despite insufficient evidence regarding the benefit of restricted diets in Autism, GFD has been promoted as an alternative treatment for ASD. This study attempts to discern any correlation between ASD and celiac disease. Objective: This cross sectional study aims to determine the proportion of celiac disease in children with ASD. Methods: Study included 155 participants aged 2-12 yrs, diagnosed as ASD as per DSM-5 attending the child development center at a tertiary care hospital in Northern India. Those on gluten free diet or having other autoimmune conditions were excluded. A detailed Performa was filled which included sociodemographic details, history of gastrointestinal symptoms, anthropometry, systemic examination, and pertinent psychological testing was done using was assessed using Developmental Profile-3(DP-3) for Developmental Quotient, Childhood Autism Rating Scale-2 (CARS-2) for severity of ASD, Vineland Adaptive Behavior Scales (VABS) for adaptive behavior, Child Behavior Checklist (CBCL) for behavioral problems and BAMBI (Brief Autism Mealtime Behavior Scales) for feeding problems. Screening for celiac was done by TTG-IgA levels, and total serum IgA levels were measured to exclude IgA deficiency. Those with positive screen were further planned for HLA typing and endoscopic biopsy. Results: A total of 155 cases were included, out of which 5 had low IgA levels and were hence excluded from the study. The rest 150 children had TTG levels below the ULN and normal total serum IgA level. History of Gastrointestinal symptoms was present in 51 (34%) cases abdominal pain was the most frequent complaint (16.6%), followed by constipation (12.6%). Diarrhea was seen in 8 %. Gastrointestinal symptoms were significantly more common in children with ASD above 5 yrs (p-value 0.006) and those who were verbal (p = 0.000). There was no significant association between socio-demographic factors, anthropometric data, or severity of autism with gastrointestinal symptoms. Conclusion: None of the150 patients with ASD had raised TTG levels; hence no association was found between ASD and celiac disease. There is no justification for routine screening for celiac disease in children with ASD. Further studies are warranted to evaluate association of Non Celiac Gluten Sensitivity with ASD and any role of gluten-free diet in such patients.

Keywords: autism, celiac, gastrointestinal, gluten

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Authors: Sony Subedi, Colleen Davison, Susan Bartels

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Objective: The aim of this study is to i) investigate the socio-demographics and living conditions of households in Haiti pre- and post 2010 earthquake, ii) determine the household prevalence of emotional and physical abuse in children (aged 2-14) after the earthquake, and iii) explore the association between earthquake-related loss and experience of emotional and physical child abuse in the household while considering potential confounding variables and the interactive effects of a number of social, economic, and demographic factors. Methods: A nationally representative sample of Haitian households from the 2005/6 and 2012 phases of the Demographic and Health Surveys (DHS) was used. Descriptive analysis was summarized using frequencies and measures of central tendency. Chi-squared and independent t-tests were used to compare data that was available pre-earthquake and post-earthquake. The association between experiences of earthquake-related loss and emotional and physical child abuse was assessed using log-binomial regression models. Results: Comparing pre-post-earthquake, noteworthy improvements were observed in the educational attainment of the household head (9.1% decrease in “no education” category) and in possession of the following household items: electricity, television, mobile-phone, and radio post-earthquake. Approximately 77.0% of children aged 2-14 experienced at least one form of physical abuse and 78.5% of children experienced at least one form of emotional abuse one month prior to the 2012 survey period. Analysis regarding the third objective (association between experiences of earthquake-related loss and emotional and physical child abuse) is in progress. Conclusions: The extremely high prevalence of emotional and physical child abuse in Haiti indicates an immediate need for improvements in the enforcement of existing policies and interventions aimed at decreasing child abuse in the household.

Keywords: Haiti earthquake, physical abuse, emotional abuse, natural disasters, children

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Authors: Leila Asadollahi

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Dry powder inhalers (DPIs) have come a long way since their creation, starting with the Spinhaler Fisons in 1967. For optimal performance, it is important to consider the interplay between formulation, device, and patient. DPIs have shown great potential in treating systemic disorders, as evidenced by their success in clinical practices. Ongoing clinical trials and market availability of DPI products for systemic disease treatment are also examined. Furthermore, the current COVID-19 pandemic has sparked increased interest in dry powder inhalation as a potential avenue for vaccines and antiviral drugs, prompting further exploration of its applications. To achieve optimal treatment outcomes for respiratory diseases, a thorough understanding of the various types of DPIs currently available is crucial. These include single-dose, multiple-unit dose, and multi-dose DPIs. This informative article delves into the administration of drugs via inhalation, examining its diverse routes of administration. Additionally, it illuminates the exciting advancements in inhalation delivery systems and investigates the latest therapeutic approaches for the treatment of respiratory ailments. Additionally, the article discusses the historical development of DPIs and the need for improved designs to enhance efficacy and patient adherence. The potential of DPIs in treating systemic diseases is also examined. Overall, this review provides valuable insights into the advancements, challenges, and future prospects of inhalation drug delivery systems, highlighting the potential they hold for respiratory and systemic disorders. The review aims to provide valuable insights into the advancements, challenges, and future prospects of inhalation drug delivery systems, highlighting the potential they hold for respiratory and systemic disorders.

Keywords: dry powder inhalers (DPIs), respiratory diseases, systemic disorders, pulmonary drug delivery

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