Children

ObjectiveTo assess a dose-response effect of methylphenidate use on restorative treatment needs, which served as an indicator of caries. Subjects and MethodsThis study is a retrospective cohort of military recruits aged 18-25 who served for 12 to 48 months between 2005 and 2017. The cohort included 6,875 subjects with ADHD who received treatment with methylphenidate, 6,729 subjects with ADHD who had no prescriptions for methylphenidate, and 200,000 healthy controls. The outcome was normative treatment needs: having at least one recommendation for restorative treatment during the study period. ResultsFrequency of recommendation for restorative treatment among the treated, the untreated and the control groups was 24%, 22% and 17%, respectively (p<0.0001). On multivariate analysis, the dose-response association between methylphenidate use and the odds of having at least one restorative treatment was confirmed (OR=1.006 for each additional 1 gr of methylphenidate; 95% CI [1.004:1.009]). ConclusionsSubjects with ADHD who receive chronic treatment with methylphenidate have higher restorative treatment needs than subjects with untreated ADHD and healthy controls. Our results show that chronic methylphenidate medication among young adults leads to an elevated need for restorative treatment and implies a significant impact on oral health.

IntroductionCerebral palsy (CP) causes motor deficits, which are sometimes accompanied by cognitive impairment. There are models that suggest interactions between these two domains in various populations. However, for CP, there seems to be a lack of empirical research on the subject. This scoping review aims to synthesize the literature on the specific relationships between motor and executive/attentional functions in people with CP. In addition, it seeks to identify current gaps to guide future research. MethodA systematic search of three databases was conducted. Articles were selected on a double-blind basis according to predefined eligibility criteria. Finally, the results were presented in the form of tables and a narrative synthesis. This scoping review was written in accordance with the JBI manual for evidence synthesis. ResultsEleven studies with different methodologies were included in this review. Relationships were investigated in different ways in each of the included studies. Some articles assessed executive functions and attention in parallel, while others focused on the individual domains. Five of the included studies found significant links between motor and executive functions. Likewise, five studies reported significant relationships between motor skills and attention. However, three of the included studies found no evidence of links between certain of these domains. DiscussionThis work provides empirical evidence of the links between motor and executive/attentional functions in CP. For the future, there remains a need for more high-quality empirical studies to clarify and quantify the specific relationships of motor and executive/attentional abilities.

The prevalence of children being diagnosed with Autism Spectrum Disorder has risen dramatically over recent years. Many of those children suffer from sensory processing disorders (SPD). There is no standardized treatment for this disorder and the therapies available have produced confusing and conflicting results. A search was performed for relevant studies and systematic review articles that researched treatment in this area. Data was extracted and analyzed and then organized with summary conclusions of each paper. Qualitative notes were gathered on the studies and the results of the studies were compared and contrasted. Sensory integration therapy has been shown to produce significant results and most of the conflicting data can be explained scientifically. Research is still required for the duration frequency and rate of therapy. Reviews of other therapies to treat SPD have not shown enough evidence of significant positive outcomes to be recommended. Purpose StatementThe purpose of this paper is to gather and analyze research regarding therapies for Sensory Processing Disorder in Children with Autism Spectrum Disorder. This review aims to determine the evidence of such therapies and to inform and educate practitioners regarding outcomes in their use to treat this disorder.

IntroductionCoronavirus (COVID-19) has dramatically changed the landscape of dentistry including Paediatric Dentistry. This paper explores paediatric patient data within a wider service evaluation completed within an Urgent Dental Care Centre in the North East of England and North Cumbria over a 6-week period. AimTo assess demand for the service, patient demographics and inform paediatric urgent dental care pathways. Main outcome methodsData collected included key characteristics of paediatric patients accessing Paediatric Dental Services from 23rd March to 3rd May 2020. Descriptive statistics were used for analysis. ResultsThere were 369 consultations (207 telephone, 124 face-to-face and 38 Out of Hours consultations). The mean age of children accessing the service was 7 years old. 7% of those attending face-to-face visits were reattenders. The most common diagnoses were irreversible pulpitis and dental trauma. 49% of face-to-face consultations resulted in extractions, 28% with General Anaesthetic, and 21% with Local Anaesthetic. ConclusionManagement of dental emergencies provided by the Urgent Dental Care Centre for paediatric patients has largely been effective and confirmed the efficacy of patient pathways established. O_LSTThree in Brief PointsC_LST Describes the approach adopted in the North East of England and North Cumbria to managing paediatric dental emergencies during the coronavirus pandemic Provides an overview of dental problems and management provided to paediatric patients in the first 6 weeks of the coronavirus pandemic Confirms the need for general anaesthetic services for exodontia in the paediatric population

IntroductionThe hyoid bone is deeply involved in three important body functions: deglutition, phonation and respiration. Several studies have shown that changes in the position of the hyoid bone may influence in pharyngeal size with mandibular advancement, thus a forward positioned hyoid bone may be an indicator of wide upper airways. ObjectiveTo determine the changes in the position of the hyoid bone after functional appliance treatment. Subjects and methods20 children (aged 9-13) that currently visit Hiroshima University Hospital actively undergoing FKO activator therapy volunteered for this study. Several lateral cephalometric radiographs were indicated and traced to assess hyoid bone position changes that might have occurred when actively complying with the FKO therapy, said radiographs were procured before active functional treatment (T0), during it (T1), and a year after continuous use of this appliance (T2). ANOVA tests were done to find statistical significance. ResultsThe results of these tests were analyzed and compared; it was found that, the hyoid bone is at a lower position from the mandibular plane and Frankfurt horizontal plane after FKO treatment, also the mandible is more forward after activator therapy, bringing the hyoid bone forward with it thus widening the lowest section of the upper airways. ConclusionThe FKO not only induces the proper development of the mandible, it also potentially advances the position of the hyoid bone, thus affecting positively in the opening of airways providing an improvement in the childrens breathing functions. O_LIAuthors report no conflict of interest. C_LI FundingThis research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Conflicts of interest/Competing intereststhe authors have no conflicts of interest to declare. Ethics approvalThis research has been approved by the Ethics Review Committee of Hiroshima University (No. E - 56). Consent to participateAll subjects needed to have provided informed consent from the parent or guardian prior all evaluations. This study has followed the guidelines stated in the Helsinki Declaration for clinical investigations. Consent for publicationAll subjects have provided informed consent from the parent or guardian to allow publication of acquired data.

IntroductionEarly Childhood Caries (ECC) is a major public health issue that poses significant challenges in pediatric dentistry, affecting infants and preschool children globally. Socioeconomic factors, dietary habits, and parental health literacy play crucial roles in ECCs development and progression. ObjectiveThe study aims to identify and evaluate factors contributing to ECC in pediatric patients at a university-based infant oral health clinic, with a secondary objective of assessing the effectiveness of newly developed oral health promotional materials through a pilot study. MethodsA retrospective and cross-sectional design was employed to analyze data from 514 pediatric patients. The study examined demographic information, parental and environmental factors, dietary habits, and feeding practices. Statistical analysis was conducted to identify significant predictors of ECC. The pilot study involved 10 participants who provided feedback on the content and face validity of promotional materials. ResultsKey factors associated with ECC included race, socioeconomic status, parental health literacy, dietary habits, and bottle use at night. Early detection and preventive strategies, such as regular dental checkups, were found to be critical in reducing caries risk. The pilot study showed positive feedback on promotional materials, indicating relevance, clarity, and visual appeal, with ongoing feedback used to refine the materials. ConclusionThe study highlights the importance of comprehensive preventive strategies that encompass both individual and community-level interventions. It underscores the role of early detection, preventive measures, and tailored oral health education in reducing ECC risk. Limitations include the retrospective design and potential generalization issues due to the studys focus on a single clinic. Future research should aim to address these limitations through longitudinal studies and larger, more diverse samples to validate the findings and enhance the effectiveness of oral health promotional materials.

Technology and its advancements have significantly impacted the quality of life for humans. With the progress in technology, screen dependency has also progressed in people of all ages. Despite available guidelines recent surveys indicate that the screen time in children is beyond the recommended levels. Excess screen time is known to create behavioural issues, delayed language development, poor expressive language, poor social skills, and traits like autism (aka virtual autism) in young children. Children with such traits demonstrate significant improvements in their social and language skills when screen time is reduced with adequate guidance and stimulation. The present study, thus, aimed to develop a parental education module to reduce screen time for preschool children with social communication deficits. At first, the contents of the module were developed through a parental in-depth interview conducted to find the issues faced by parents due to screen time in children, in addition to a focused literature search. A panel of experts rated the contents of the module in terms of relevance, age appropriateness and feasibility of implementation. Expert rating showed a high consensus (80%) among the raters and appropriateness of its contents. Furthermore, feedback received on the revised module revealed acceptance by the parents. The module is expected to improve the parental awareness, knowledge and attitude about the challenges of screen time in children and thereby control the effects of screen time in this group.

BackgroundAutism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by deficits in social communication and the presence of restricted interests and repetitive behaviours (Hodges et al., 2020). According to the American guidelines, the impact of disability can affect the familys well-being and have consequences for the siblings and the organisation of family life, both economically and psychologically (ASHA, 2006). Given the lack of parent-focused measures to assess these aspects, Leadbitter et al. (2018) developed the Autism Family Experience Questionnaire (AFEQ), aimed at assessing priority outcomes for parents of preschool-aged children with ASD who were previously enrolled in the Pre-school Autism Communication Trial, a randomized controlled trial study on parent-mediated intervention (Leadbitter et al., 2018; Green et al., 2010). The aim of the present study was to translate and culturally adapt into Italian the AFEQ (Leadbitter et al., 2018) and to verify the main psychometric performances of the adapted version. MethodsLinguistic validation and cross-cultural adaptation to the Italian context were based on the guidelines of Beaton et al. (2000). Once the direct and inverse translation phases were completed with the favourable opinion of the panel of experts recruited for the study, further tests on the psychometric properties of the adapted questionnaire were required. Following the consensus obtained from the authors of the original questionnaire and according to the recommendations of Polit et al. (2007) and Polit and Beck (2006), a second panel of selected experts determined the content validity of the adapted instrument through the calculation of the Content Validity Index (CVI), according to the indications for each item (I-CVI) and for the scale (S-CVI). ResultsA medical doctor and a non-medical expert, both native Italian speakers with an adequate knowledge of English, independently produced a translation. The latter were then compared and discrepancies in the translation process were resolved in a discussion. Two independent, native English-speaking translators produced reverse translations of the resulting version; neither of them had experience or knowledge of the objectives of the study nor of the healthcare sector. The two translations were similar to each other and one of them was almost identical to the original. The original questionnaire and the material obtained in the previous stages were made available to an interdisciplinary panel of experts recruited for the study. All members agreed on that T1-2 was the only accepted translated version. Analysing the I-CVI, all items exceeded the expected cut-off of [&ge;] 0.78 except for one (I-CVI value 0.6). The S-CVI reached and exceeded the cut-off when obtained with the S-CVI/Ave calculation mode, while with the S-CVI/UA the value was 0.73 and was slightly below the cut-off. Discussion and ConclusionTo the authors knowledge, this study is the first to develop an Italian version of the AFEQ questionnaire. The involvement of two translators in the forward and reverse translation phases avoided, in the former, the presence of bias and the enrichment of the synthesis process; in the latter, it facilitated the verification of the semantic equivalence of the translation. Evaluation of the final version by a panel of experts ensured its linguistic validity. The Italian version of the AFEQ obtains very positive I-CVI, S-CVI/UA-Ave values, meaning a very positive assessment of the scale items regarding their relevance for the investigated constructs. As the study is still in progress, it has not yet been possible to carry out a test of the adapted version that coincides with the final phase of the adaptation process described by Beaton et al. (2000). The work represents a first step in the Italian validation process of the questionnaire, which is still ongoing.

PurposeThis exploratory study examines the clinic-based prevalence and types of speech and language challenges among preschoolers referred by physicians to the speech-language therapy clinic of the Korle-Bu Teaching Hospital (KBTH) in Accra. It also explores the associations between preschoolers gender, age, and stuttering and highlights implications for pediatric development care. MethodThis retrospective descriptive study reviewed clinical records of preschoolers referred to the speech and language therapy unit of the KBTH. Data were extracted on age, gender, diagnosis, and referral source. Descriptive statistics were used to determine the prevalence and distribution of speech and language difficulties, and associations between demographic characteristics and disorder type were explored. ResultsOf the children referred, the majority were males, with a male-to-female ratio of approximately 3:1. The most common diagnoses were speech and language delay (87.7%), followed by stuttering (4.5%), receptive language disorder (2.6%), expressive language disorder (1.9%), articulation disorders (1.3%), and speech sound disorders (0.6%). Developmental delay was the most common medical diagnosis (48.7%). A substantial proportion of cases involved children aged 2-3 years, indicating referrals within the critical developmental window for early intervention. ConclusionSpeech and language delay was the most common communication disorder, while developmental delay was the most frequent medical condition among preschoolers referred for therapy. Findings highlight the need for increased awareness among physicians and primary care providers regarding early communication screening and referral. Strengthening multidisciplinary collaboration and integrating speech-language assessment into routine child health services could enhance early detection and intervention for communication disorders in Ghana and similar low-resource contexts.

IntroductionObstructive sleep apnea is a relatively common sleep disorder, which leads to multiple sleep arousal and hypoxemia. It also has a significant socioeconomic impact. Dentists can have a role in screening as well as treating apnea by orthodontic devices. No study has evaluated the knowledge and attitude of dental health professionals about obstructive sleep apnea (OSA) in Iran. We aimed to measure knowledge and attitude among students and faculty members of Shahid Beheshti Dental School, Tehran, Iran about OSA. Materials and MethodsWe conducted a cross-sectional survey among residents and professors in oral and maxillofacial surgery, orthodontics, and oral medicine specialties and dental students. The Obstructive Sleep Apnea Knowledge and Attitude (OSAKA) questionnaire was used to obtain the information regarding knowledge and attitude. We used Chi-square, Kruskall Wallis, Mann-Whitney U test for statistical analysis. The data were analyzed by SPSS 22.0 and a p-value lower than 0.05 considered to be significant. ResultsOne hundred ninety-seven participants, including 43 dental students, 68 dental residents, and 64 dental professors filled the survey. Mean knowledge score among all participants was 10.69{+/-}3.133. Overall, oral medicine and oral and maxillofacial surgery professors had significantly higher correct answer ratios in the knowledge section than fifth and sixth-year dental students (p<0.001). There was no significant difference among other groups (p>0.05). About attitude, 91% of respondents reported that OSA is an important or extremely important disorder. However, only 10.2% and 16.9% felt confident about the ability to manage patients with OSA and identifying patients at risk for OSA, respectively. ConclusionAll of the participants had poor knowledge but a positive attitude towards OSA. This shows the necessity of better education about OSA.

Immersive virtual reality (VR) technology shows promise as a therapeutic aid to support social communication in children with autism spectrum disorder (ASD). The main objective was to assess the feasibility of using Floreos VR headset with the BSC module curriculum as a component of behavioral therapy for preschool and school-age autistic children. Using a randomized control study design, a total of 14 participants (8 participants in the intervention group and 6 participants in the control group) received approximately 36 sessions of Floreos BSC treatment or VR control up to 3 times a week over a 12-15 week period in an in-clinic ABA therapy setting. Outcomes were measured using the validated and reliable Autism Impact Measure (AIM), which provides a composite score as well as subdomain scores for communication, social reciprocity, peer interaction, repetitive behavior, and atypical behavior. As a primary outcome measure, we evaluated change from baseline in AIM composite and subdomain scores as a function of treatment. The Floreo VR headset was well-tolerated by study participants and was incorporated without difficulty into clinical treatment sessions. No serious adverse events occurred, and no participants dropped out of the study due to undesirable side effects. Autistic children who received Floreos immersive VR BSC program showed an overall mean improvement in AIM composite score (-25) compared to those in the control group (-0.84) at a clinically meaningful level, although this did not achieve statistical significance. There was a clinically and statistically significant improvement in the AIM communication score for children in the Floreo BSC group (-5.12) compared to the control group (+3.33, p=0.02). The study findings suggest that Floreos Building Social Connections Module is safe and well-tolerated, and has the potential to enhance social communication skills and reduce challenging behaviors in autistic children.

BackgroundEarly childhood caries (ECC) remains a significant global public health concern, disproportionately affecting vulnerable and underserved populations. Integrating oral health services into primary care particularly through non-dental primary care providers (NDPCPs) offers a promising strategy for early identification and prevention. However, the extent and characteristics of such integration across global health systems remain unclear. ObjectivesThis scoping review aimed to map the available evidence on preventive oral health services (POHS) and caries risk assessment (CRA) delivered to children under six years of age by NDPCPs. Specifically, it addressed (1) the types and characteristics of POHS and CRA provided, and (2) how commonly these services are implemented in pediatric primary care settings. MethodsThe review followed the Joanna Briggs Institute (JBI) Scoping Review Framework. A comprehensive search of four databases, MEDLINE, EMBASE, CINAHL, and Web of Science was conducted for English-language studies published between 2009 and 2024. Eligible studies included primary research on CRA, fluoride varnish application, dental referrals, or oral health promotion delivered by NDPCPs (e.g., physicians, nurses, dietitians) to children under six. A total of 54 studies met the inclusion criteria and were charted, summarized, and analyzed narratively. ResultsMost studies (83%) were conducted in the United States, with additional representation from Australia, the United Kingdom, Europe, and limited low- and middle-income countries (LMIC) settings. Interventions were delivered by a wide range of NDPCPs including physicians, nurse practitioners, and health visitors, often during well-child visits. Common interventions included oral health education, CRA using structured tools, fluoride varnish application, and dental referrals. Several studies reported improved service uptake following provider training, electronic medical record (EMR) integration, or Medicaid reimbursement policies. Despite evidence of effectiveness and feasibility, no eligible studies were identified from e.g. Canada, highlighting a critical implementation gap. ConclusionsNDPCPs play an important and increasingly well-supported role in the delivery of POHS to young children. This review underscores the need for policy frameworks such as reimbursement mechanisms and interprofessional training to support oral health integration into primary care. Canada may benefit from adopting system-level policies to enable and evaluate CRA and POHS in primary care, especially for underserved and Indigenous populations.

BackgroundOtitis Media with Effusion (OME) causing hearing impairments affects [~]1 in 10 children starting school in UK/ Europe. 80% have at least one episode with most having conductive hearing loss. Studies showed children with OME hear better with bone conducting headsets. During COVID-19 we investigated whether children with deafness secondary OME, without access to audiology or grommet surgery, could be aided with bone conduction kits and the HearGlueEar app. MethodsStarting July 2020, during COVID-19, children aged 3-11 years with OME and on a grommet waiting list were invited to a single arm, prospective study. They received the kit, instructions and HearGlueEar app by post. By 3 weeks parents were asked to charge and pair the devices, attend a remote consultation and complete an OMQ-14 questionnaire. Remote follow-up lasted 3 months. Outcomes: ability to use the equipment, complete the questionnaire about childs hearing and behaviour before and with the equipment, declining grommet surgery or where deafness resolved, and give opinion about the intervention. Findings26 children enrolled. Families used the kit at home and school. Most found remote consultations positive and convenient. OMQ-14 responses were 90% positive. Comments were: "Other people have said, wow his speech is clearer.", "It is making a real difference at home.", "He said over and over again, "I can hear everybody, wow, wow, wow.", "It is no exaggeration to say this has made an astronomical improvement to his quality of life". One child reported "I can hear my best friend again". "She is getting on really well with the headphones - pairing them with the iPad at home is simply brilliant." Three families continued with the headset to avoid grommets. InterpretationPosting a bone conduction kit, HearGlueEar app and remote consultation is effective support for children with deafness secondary to OME. FundingNone

BackgroundHearing impairment is the most prevalent sensory disability globally and a condition of growing concern with around 5.3% of the population having disabling hearing loss. It has significant impacts on the individual and society. The problem is even greater for children as hearing is the main source for language, speech, and cognitive developments. MethodsA school based cross-sectional study at an elementary school in Addis Ababa, Ethiopia was conducted in May 2018. One hundred and ten students from grades 1-5 were enrolled in the study. A structured questionnaire filled by parents/caregivers. Audiometric testing and otoscopic examinations were used to determine hearing impairment and abnormal otoscopic findings respectively. Data was analyzed using SPSS version 25. Descriptive and basic statistical analysis was applied. Logistic regression was used to identify risk factors for hearing impairment. Statistical significance was declared at p values < 0.05. ResultsA total of 106 students (27.4% male and 72.6% female) were enrolled in the study. Abnormal otoscopic findings were observed among 30.2% of the participants, with wax being the commonest abnormality observed in twenty-two point eight (22.8%), pus discharge and dull tympanic membrane in 4%, foreign bodies were found in 3 of the participating students (2.8%). The prevalence of disabling hearing impairment in this study (>25db on the better hearing ear), was 34% where the majority (32.1%) had mild hearing impairment. Abnormal otoscopic finding showed significant association with hearing impairment. ConclusionThe prevalence of hearing impairment in our study is higher than WHO and other regional estimates. Given the high prevalence of HI, availability of management options for mild HI, and its underlying causes, early hearing screening programs in children should be integrated into existing systems such as the Ethiopian school health program as well as early childhood growth and development monitoring entry points.

The relationship between symbolic thinking and language abilities is a topic of intense debate. We have recently discovered three distinct phenotypes of language comprehension, which we defined as command, modifier and syntactic phenotypes (Vyshedskiy et al., 2024). Individuals in the command phenotype were limited to comprehension of simple commands, while those in the modifier phenotype showed additional comprehension of color, size, and number modifiers. Finally, individuals in the most-advanced syntactic phenotype added comprehension of spatial prepositions, verb tenses, flexible syntax, possessive pronouns, complex explanations, and fairytales. In this report we analyzed how these three language phenotypes differed in their symbolic thinking as exhibited through their drawing abilities. In a cohort of 39,654 autistic individuals 4- to 21-years-of-age, parents reported that drawing, coloring and art was manifested by 36.0% of participants. Among these individuals, representational drawing was manifested by 54.1% of individuals with syntactic-, 27.7% of those with modifier-, and 10.1% of those with command-phenotype (all pairwise differences between the phenotypes were statistically significant, p < 0.0001). The ability to draw a novel image per parents description (e.g. a three-headed horse) was reported by 34.6% of individuals with syntactic-, 7.9% of those with modifier-, and 1.9% of individuals with command-phenotype (all pairwise differences between the phenotypes were statistically significant, p < 0.0001). These results show strong association between the representational drawing ability and the syntactic-language-comprehension-phenotype, suggesting a potential benefit of drawing interventions in language therapy.

BackgroundAlthough preventable, dental caries remain a serious global public health threat. There are a number of risk factors for the development of dental caries in the general population, and in elementary school children in Thailand in particular, especially if they are from suburban areas. ObjectiveTo identify the prevalence of dental caries in the form of decayed-missing-filled teeth for the permanent (DMFT) and primary (dmft) dentition, and their risk factors among children between 6 and 12 years of age attending a public school in Chiang Rai in northern Thailand. MethodsA cross-sectional study was conducted among 6-12-year-old children attending public education at Thesaban 1 School, Chiang Saen District, Chiang Rai Province in Thailand. All school children from grades 1 to 6 were examined by trained dental students from Mae Fah Luang Universitys School of Dentistry in December 2023. Children were clinically examined for DMFT/dmft while demographic information about the children was collected from school records. Children also responded to a standardized 17-item survey about their oral health care behaviours. Descriptive and inferential statistics were used. All tests were set at 95% CI and p>0.05. ResultsA total of 232 children (100% of eligible participants) were examined and 96 (40%) responded to the survey. Most children were Buddhists (n=186, 80.1%), and had at least one permanent tooth with sealant (n=198, 85.3%); 82.5% of the 232 children exhibited dental caries/extraction/fillings in primary teeth. The average dmft was 4.1 (1.8-8.8) and the average DMFT was 1.6 (0.1-3.3). Fifty children (21.5%) had their grandparents as their main caregiver. Children who brushed their teeth without fluoridated toothpaste were 1.99 times more likely to have at least 1 permanent tooth with dental decay than children who used fluoridated toothpaste (p=0.065). ConclusionIn this study, a high percentage of dental caries was observed among children from suburban areas in the northernmost province of Thailand. Public health intervention and oral health promotion remain an immediate need among these children.

Infants undergo significant developmental changes in the first few months of life. While some risk factors increase the risk of developmental disability, such as preterm birth, the developmental trajectories of infants born pre-term (PT) and full-term (FT) present with individual variability. This study aims to investigate whether the utilization of data-driven unsupervised machine learning can identify patterns within groups of infants and categorize infants into specific developmental trajectories. Thirty-four infants, 19 FT and 15 PT, were assessed with the gross and fine motor subscales of the Bayley Scales of Infant and Toddler Development, version III (BSID-III) monthly for 2-5 visits between the ages of 1 and 6 months. Latent class growth analysis (LCGA) models were adopted to identify clusters of motor developmental trajectories during this critical time. Based on statistical significance, the linear, 2-class trend was selected as the best-fitting model for both gross and fine motor trajectories. Within this, LCGA reveals 2 developmental trends with varying beginning scores and developmental rates, including the low-baseline slow-growth (LBSG) subgroup, and the high-baseline fast-growth (HBFG) subgroup, with age (adjusted for prematurity) being equally distributed across both subgroups. Both subgroups, HBFG and LBSG, had a combination of infants born FT and PT (55% FT in HBFG, 56% FT in LBSG), supporting that preterm birth alone may not sufficiently categorize an infants developmental trajectory. The later BSID-III gross motor score showed marginal difference between groups (p = 0.062). Similarly, the fine motor model displayed a mixture of both infants born FT and PT (68% FT in HBFG, 40% FT in LBSG). In this case, the late motor composite BSID score was different between groups (p = 0.04). Our study uses a novel approach of LCGA to elucidate heterogeneous trajectories of motor development for gross and fine motor skills during the first half of life and offers potential for early identification of subgroup membership. Furthermore, these findings underscore the necessity for individualized risk assessments and intervention strategies tailored to individual needs. Ultimately, further validation of these models may provide usefulness in uncovering distinct motor development trajectories in infants. Author NoteThe authors would like to thank the infants and families who participated in these study, and Katy Kelley, Carolina Panceri, Judy Zhou, and Dana Fine for assisting with recruitment and data collection. Thank you to Eisner Health, Childrens Hospital Los Angeles, and Ventura County Medical Center for assistance with recruitment. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The studies secondarily analyzed in this work were supported by grants from the Bill & Melinda Gates Foundation [OPP1119189] (PI: B.A.S.) and the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health under Award Number R03HD096137 (PI: Smith). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Study data were collected and managed using REDCap electronic data capture tools hosted at the Southern California Clinical and Translational Science Institute at the University of Southern California NIH grant UL1TR001855 (PI: T. Buchanan). REDCap (Research Electronic Data Capture) is a secure, web-based application designed to support data capture for research studies, providing (i) an intuitive interface for validated data entry; (ii) audit trails for tracking data manipulation and export procedures; (iii) automated export procedures for seamless data downloads to common statistical packages; and (iv) procedures for importing data from external sources.

Dental caries among preschool children is prevalent and may affect their oral health-related quality of life (OHRQOL). The aim of this study was to assess the oral health-related quality of life (OHRQOL) of preschool children from Kuantan in relation to their dental caries status and severity. A cross-sectional survey using the Malay version of Early Childhood Oral Health Impact Scale (Malay-ECOHIS) involving preschool children aged three until six years old was conducted employing a convenience sampling. The dmft score of the preschool children was evaluated by a professional pediatric dentist, and the body mass index (BMI) was recorded. The caries status data was classified into either Absent (dmft = 0) or Present (dmft [&ge;] 1), while caries severity data was categorized into No Caries (dmft = 0), Moderate (dmft = 1 or 2), and High (dmft [&ge;] 3), depending on the caries experience. The Pearson Chi-square and Spearman correlation analyses were conducted. A high caries prevalence was recorded (89.1%), affecting 55 preschool children. They were more impacted than their family in terms of their OHRQOL, and those with high caries severity and those from low household income showed the lowest OHRQOL. However, since most of them were from high household income, their families were not financially impacted. It is important to not only assess the caries status of the preschool children when assessing their OHRQOL, but also their caries severity.

IntroductionPost-Intensive Care Syndrome in Pediatrics (PICS-p) is being increasingly reported and investigated in children after a critical illness. This manifests as physical, cognitive, and mental problems that affect their quality of life. This systematic review aims to explore the risk factors leading to PICS-p to inform prevention and management strategies. Method and AnalysisThis systematic review and Meta-analysis will be carried out in accordance with the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines. The inclusion studies were quantitative cohort, case control, cross section and observational. Studies conducted in the last 2.5 decade (January 1, 2000 to January 1, 2025) involving pediatric population starting 1 month to 18 years of age, discharged from PICU. PubMed,Embase, Scopus and CINAHL databases will be used to search for the relevant studies. Boolean operations and Mesh terms will be used to ensure exhaustive literature coverage. ConclusionThe review will provide an opportunity to know the risk factors non-modifiable (Age, sex, pre-existing health conditions and severity of illness) and modifiable (Delirium, sedation practice, PICU environment, Rehabilitation services and family support) that are associated with PICS-p and the findings can be used to make recommendations for targeted interventions to target interventions. Thus, by contributing toward overcoming this problem, the study is meant to improve the outcome for pediatric patients and families while decreasing future burdens due to long-lasting ailments. The outcomes are expected to shape clinical practices and policymaking in the direction of holistic care and recovery among survivors from a PICU. What is already known on this Topic?Despite growing recognition of post intensive care syndrome in pediatrics, there is no systematic review has been made regarding the factors that predispose to PICS-p in children with the age 1 month to 18 years, highlighting a huge knowledge gap. What this study hopes to add?The results of this systematic review identify risk factors linked to PICS-p and offer important new information for the future development of intervention programs for childrens risk factors modifiable and non-modifiable linked to PICS-p. How this study might affect research, practice or policy?This review is intended to present a body of evidence that will be useful in informing clinical practice and preventive efforts on preventive work for at risk children. The review will address how risk factor will help healthcare providers, researcher, policymakers, and caregivers in the long-term health and well-being of pediatric patients who will be discharged from PICUs.

ObjectivesOral health plays a crucial role in maintaining overall health and well-being, affecting over one-fifth of the population in Australia and New Zealand. Numerous cohort studies utilise The Life Course Health Development (LCHD) framework to explore oral health, highlighting the complex relationships among various influencing factors. However, a comprehensive synthesis of evidence on oral health-related cohort studies across the lifespan in Australia and New Zealand, which have unique demographic and environmental characteristics, is necessary to enhance the understanding of the diverse existing research in these regions. Therefore, this systematic mapping review aims to identify oral health-related cohort studies in Australia and New Zealand, providing details on their demographics, methods, oral health measurements, and a framework of the investigated outcomes and explanatory factors. MethodsA systematic search was conducted across five electronic databases: MEDLINE (OVID), Embase (OVID), Web of Science (ISI), Scopus, and CINAHL followed by backward citation chasing. Oral health-related cohort studies conducted in Australia and New Zealand were included. A descriptive synthesis approach was employed to summarise the studies, and results were reported in accordance with PRISMA-ScR guidelines. ResultsFrom the 226 included publications, a total of 37 cohort studies involving primary data collection and ten independent data linkage studies were identified. The geographical distribution, general characteristics, and design aspects of the identified studies were summarised. Seventy oral health measurements employed in these studies were identified and categorised. Additionally, an Evidence and Gap Map (EGM) was presented to illustrate links between 38 themes for explanatory factors and 32 themes for outcomes in the identified studies. ConclusionNumerous oral health-related cohort studies in Australia and New Zealand reveal significant variations. Over-represented study populations and measurements provide opportunities for secondary research, while under-represented areas should be the focus of future primary research. This review serves as a roadmap for researchers, policymakers, and clinicians in making evidence-based decisions to improve oral health.