Health Related Behaviours in Normal Weight and Overweight Preschoolers of a Large Pan-European Sample: The ToyBox-Study

The aim of this study was to investigate the associations of health related behaviours (HRB) with Body Mass Index (BMI) in preschoolers, and to study the likelihood of being overweight/obese in relation to compliance with recommended HRB. The sample consisted of 3301 normal weight and overweight/obese preschoolers (mean age: 4.7 years; 52% boys, 85% normal weight) from six European countries (Belgium, Bulgaria, Germany, Greece, Poland, Spain). Height and weight were measured, total daily step counts were registered during six days, and HRB were assessed with validated parental surveys in 2012. Multiple linear and logistic regression analyses were performed. Only few HRB were significantly associated with BMI. In boys, higher water intake and higher soft drink and higher fruit consumption were significantly associated with higher BMI. Boys drinking less water than recommended were less likely to be overweight/obese (OR = 0.60), while boys who consume soft drinks were more likely to be overweight/obese (OR = 1.52). In girls, higher water intake, higher vegetable consumption, and more TV time on weekend days were significantly associated with higher BMI. Girls eating less vegetables than recommended were less likely to be overweight/obese (OR = 0.62), and girls who engaged in quiet play for more than 90 minutes on weekend days were more likely to be overweight/obese (OR = 1.64). In general, the associations between HRB and BMI or being overweight/obese were limited and mainly related to dietary intake. Awareness campaigns for caregivers should stress that HRB of young children are important and independent of children’s weight status.     

The Imaginary Part of Coherency in Autism: Differences in Cortical Functional Connectivity in Preschool Children

Cognition arises from the transient integration and segregation of activity across functionally distinct brain areas. Autism Spectrum Disorders (ASD), which encompass a wide range of developmental disabilities, have been presumed to be associated with a problem in cortical and sub-cortical dynamics of coordinated activity, often involving enhanced local but decreased long range coordination over areas of integration. In this paper we challenge this idea by presenting results from a relatively large population of ASD children and age-matched controls during a face-processing task. Over most of the explored domain, children with ASD exhibited enhanced synchronization, although finer detail reveals specific enhancement/reduction of synchrony depending on time, frequency and brain site. Our results are derived from the use of the imaginary part of coherency, a measure which is not susceptible to volume conduction artifacts and therefore presents a credible picture of coordinated brain activity. We also present evidence that this measure is a good candidate to provide features in building a classifier to be used as a potential biomarker for autism.     

Sex-Based Differences in Asthma among Preschool and School-Aged Children in Korea

The purpose of this study was to explore risk factors related to asthma prevalence among preschool and school-aged children using a representative national dataset from the Korea National Health and Nutrition Examination Survey (KNHANES) conducted from 2009–2011. We evaluated the demographic information, health status, household environment, socioeconomic status, and parents’ health status of 3,542 children aged 4–12 years. A sex-stratified multivariate logistic regression was used to obtain adjusted prevalence odds ratios (ORs) and 95% confidence intervals after accounting for primary sample units, stratification, and sample weights. The sex-specific asthma prevalence in the 4- to 12-year-old children was 7.39% in boys and 6.27% in girls. Boys and girls with comorbid atopic dermatitis were more likely to have asthma than those without atopic dermatitis (boys: OR = 2.20, p = 0.0071; girls: OR = 2.33, p = 0.0031). Boys and girls with ≥1 asthmatic parent were more likely to have asthma than those without asthmatic parents (boys: OR = 3.90, p = 0.0006; girls: OR = 3.65, p = 0.0138). As girls got older, the prevalence of asthma decreased (OR = 0.90, p = 0.0408). Girls residing in rural areas were 60% less likely to have asthma than those residing in urban areas (p = 0.0309). Boys with ≥5 family members were more likely to have asthma than those with ≤3 family members (OR = 2.45, p = 0.0323). The factors related to asthma prevalence may differ depending on sex in preschool and school-aged children. By understanding the characteristics of sex-based differences in asthma, individualized asthma management plans may be established clinically.     

Differences in Innate Cytokine Responses between European and African Children

Although differences in immunological responses between populations have been found in terms of vaccine efficacy, immune responses to infections and prevalence of chronic inflammatory diseases, the mechanisms responsible for these differences are not well understood. Therefore, innate cytokine responses mediated by various classes of pattern-recognition receptors including Toll-like receptors (TLR), C-type lectin receptors (CLRs) and nucleotide-binding oligomerisation domain-like receptors (NLRs) were compared between Dutch (European), semi-urban and rural Gabonese (African) children. Whole blood was stimulated for 24 hours and the pro-inflammatory tumor necrosis factor (TNF) and the anti-inflammatory/regulatory interleukin-10 (IL-10) cytokines in culture supernatant were measured by enzyme-linked immunosorbent assay (ELISA). Gabonese children had a lower pro-inflammatory response to poly(I:C) (TLR3 ligand), but a higher pro-inflammatory response to FSL-1 (TLR2/6 ligand), Pam3 (TLR2/1 ligand) and LPS (TLR4 ligand) compared to Dutch children. Anti-inflammatory responses to Pam3 were also higher in Gabonese children. Non-TLR ligands did not induce substantial cytokine production on their own. Interaction between various TLR and non-TLR receptors was further assessed, but no differences were found between the three populations. In conclusion, using a field applicable assay, significant differences were observed in cytokine responses between European and African children to TLR ligands, but not to non-TLR ligands.     

The Development of Elementary Forms of Thinking in Preschool Children

Among the new problems that society has posed to the educational system, that of developing preschool children's intellectual ability is of special importance. One of the central questions of intellectual training is developing children's thinking.     

Effect and Process Evaluation of a Cluster Randomized Control Trial on Water Intake and Beverage Consumption in Preschoolers from Six European Countries: The ToyBox-Study

BackgroundWithin the ToyBox-study, a kindergarten-based, family-involved intervention was developed to prevent overweight and obesity in European preschoolers, targeting four key behaviours related to early childhood obesity, including water consumption. The present study aimed to examine the effect of the ToyBox-intervention (cluster randomized controlled trial) on water intake and beverage consumption in European preschoolers and to investigate if the intervention effects differed by implementation score of kindergartens and parents/caregivers.MethodA sample of 4964 preschoolers (4.7±0.4 years; 51.5% boys) from six European countries (Belgium, Bulgaria, Germany, Greece, Poland, Spain) was included in the data analyses. A standardized protocol was used and parents/caregivers filled in socio-demographic data and a food-frequency questionnaire. To assess intervention effects, multilevel repeated measures analyses were conducted for the total sample and for the six country-specific samples. Based on the process evaluation questionnaire of teachers and parents/caregivers, an implementation score was constructed. To assess differences in water intake and beverage consumption by implementation score in the total sample, multilevel repeated measures analyses were performed.ResultsLimited intervention effects on water intake from beverages and overall beverage consumption were found. However, important results were found on prepacked fruit juice consumption, with a larger decrease in the intervention group compared to the control group. However, also a decline in plain milk consumption was found. Implementation scores were rather low in both kindergartens and parents/caregivers. Nevertheless, more favorable effects on beverage choices were found in preschoolers whose parents/caregivers and kindergarten teachers had higher implementation scores compared to those with lower implementation scores.ConclusionThe ToyBox-intervention can provide the basis for the development of more tailor-made interventions. However, new strategies to improve implementation of interventions should be created.     

The Effectiveness of Different Interventions to Promote Poison Prevention Behaviours in Households with Children: A Network Meta-Analysis

Background

There is evidence from 2 previous meta-analyses that interventions to promote poison prevention behaviours are effective in increasing a range of poison prevention practices in households with children. The published meta-analyses compared any intervention against a “usual care or no intervention” which potentially limits the usefulness of the analysis to decision makers. We aim to use network meta-analysis to simultaneously evaluate the effectiveness of different interventions to increase prevalence of safe storage of i) Medicines only, ii) Other household products only, iii) Poisons (both medicines and non-medicines), iv) Poisonous plants; and v) Possession of poison control centre (PCC) telephone number in households with children.

Methods

Data on the effectiveness of poison prevention interventions was extracted from primary studies identified in 2 newly-undertaken systematic reviews. Effect estimates were pooled across studies using a random effects network meta-analysis model.

Results

28 of the 47 primary studies identified were included in the analysis. Compared to usual care intervention, the intervention with education and low cost/free equipment elements was most effective in promoting safe storage of medicines (odds ratio 2.51, 95% credible interval 1.01 to 6.00) while interventions with education, low cost/free equipment, home safety inspection and fitting components were most effective in promoting safe storage of other household products (2.52, 1.12 to 7.13), safe storage of poisons (11.10, 1.60 to 141.50) and possession of PCC number (38.82, 2.19 to 687.10). No one intervention package was more effective than the others in promoting safe storage of poisonous plants.

Conclusion

The most effective interventions varied by poison prevention practice, but education alone was not the most effective intervention for any poison prevention practice. Commissioners and providers of poison prevention interventions should tailor the interventions they commission or provide to the poison prevention practices they wish to promote.

Highlights

• Network meta-analysis is useful for comparing multiple injury-prevention interventions.
• More intensive poison prevention interventions were more effective than education alone.
• Education and low cost/free equipment was most effective in promoting safe storage of medicines.
• Education, low cost/free equipment, home safety inspection and fitting was most effective in promoting safe storage of household products and poisons.
• Education, low cost/free equipment and home inspection were most effective in promoting possession of a poison control centre number.
• None of the intervention packages was more effective than the others in promoting safe storage of poisonous plants.

     

The Curious Relation between Theory of Mind and Sharing in Preschool Age Children

Young children have long been known to act selfishly and gradually appear to become more generous across middle childhood. While this apparent change has been well documented, the underlying mechanisms supporting this remain unclear. The current study examined the role of early theory of mind and executive functioning in facilitating sharing in a large sample (N = 98) of preschoolers. Results reveal a curious relation between early false-belief understanding and sharing behavior. Contrary to many commonsense notions and predominant theories, competence in this ability is actually related to less sharing. Thus, the relation between developing theory of mind and sharing may not be as straightforward as it seems in preschool age children. It is precisely the children who can engage in theory of mind that decide to share less with others.     

The Development of Analysis of Words into Their Sounds by Preschool Children

Sensation and perception undergo intensive development during the first years of an infant's life. One of the sensory processes that is earliest to take shape is phonemic hearing.     

The Presence of a Therapy Dog Results in Improved Object Recognition Performance in Preschool Children

ABSTRACT

The purpose of this study was to determine whether the presence of a dog would have an impact on object recognition memory performance of preschool children. This work represents an extension of previous research which found that preschoolers require fewer instructional prompts to complete this type of memory task when in the presence of a dog. If children require fewer instructional prompts it is possible that they are better able to focus on the task itself and as a result, improved memory performance is likely. Because the earlier experiment utilized a very simple version of the task that was readily completed by the preschool children, the overall performance data were at ceiling. The current study, involving 20 preschool children, included a manipulation of task difficulty through varying the number of distracters (one versus four) present at test. Increasing the number of distractors in a simple recognition task is known to make that task more challenging, and thus performance was expected to be slower and less accurate in the four distracter conditions relative to the one-distracter conditions. The collaborators in the study were either a therapy dog or a human. A two-way repeated measures design was used such that each child served as his/her own control and was tested in each of four separate conditions: dog present (one and four distracters) and human present (one and four distracters). The results showed that the preschool children performed the object recognition task faster and more accurately in the presence of the therapy dog relative to a human and also in the one-distracter versus four-distracter condition. The authors conclude that these effects result from increased focus and/or motivation resulting from the presence of the dog.     

The Microbiota of the Gut in Preschool Children With Normal and Excessive Body Weight

The aim of this study was to investigate the gut microbiota in preschool children with and without overweight and obesity. Twenty overweight or obese children and twenty children with BMI within the normal range (age: 4–5 years) were recruited from the south of Sweden. The gut microbiota was accessed by quantitative PCR (qPCR) and terminal restriction fragment length polymorphism and calprotectin was measured in feces. Liver enzymes were quantified in obese/overweight children. The concentration of the gram‐negative family Enterobacteriaceae was significantly higher in the obese/overweight children (P = 0.036), whereas levels of Desulfovibrio and Akkermansia muciniphila‐like bacteria were significantly lower in the obese/overweight children (P = 0.027 and P = 0.030, respectively). No significant differences were found in content of Lactobacillus, Bifidobacterium or the Bacteroides fragilis group. The diversity of the dominating bacterial community tended to be less diverse in the obese/overweight group, but the difference was not statistically significant. Concentration of Bifidobacterium was inversely correlated to alanine aminotransferase (ALT) in obese/overweight children. The fecal levels of calprotectin did not differ between the study groups. These findings indicate that the gut microbiota differed among preschool children with obesity/overweight compared with children with BMI within the normal range.     

Social and Individual Components of Animal Contact in Preschool Children

ABSTRACT

Humans are generally biophilic. Still, for unknown reasons, interest in animals varies substantially among individuals. Our goal was to investigate how differential interest of children towards animals might be related to social competence and personality. We proposed two alternatives: 1) Children may compensate for potential deficits in social competence by resorting to animals, and 2) Socially well-connected children may show a particular interest in animals. We focused on relationships between age, gender, family background, play behavior, personality components, and contact with rabbits in 50 children (22 boys/28 girls; 3 to 7 years of age) at a preschool in Krems/Austria. Data were analyzed using GLM. We found that each one of these variables had significant impact on intensity of engagement with the rabbits. In general, girls, children with siblings, and children without pets were more oriented towards the rabbits than were boys, children without siblings, or pet-owning children. The older the children, the less frequently they occupied themselves with the rabbits but the longer they remained when they did engage them. Furthermore, we found that the more “Confident/Respected” (PCA factor 1) and less “Patient/Calm,” “Cheerful/Sociable,” and “Solitary” (PCA factors 2–4) the children, the more time they spent in direct occupation with rabbits. Most effects of the investigated variables varied between boys and girls. By and large, our findings support the hypothesis that the “socially competent” children were particularly interested in the animals. Also, children's social styles, as evinced in interactions with peers, were generally reflected in how they interacted with the rabbits.     

Accelerated Growth in Early Life and Obesity in Preschool Chilean Children

In Chile, childhood obesity rates are high. The purpose of this article is to compare BMI growth characteristics of normal (N), overweight (OW), and obese (OB) 5‐year olds from 0 to 5 years and explore the influence of some prenatal factors on these patterns of growth. The study was done on a retrospective cohort of 1,089 5‐year olds with birth weight >2,500 g. Weight and height were obtained from records at nine occasions (0–36 months); at 52 and 60 months, we measured them. At 60 months, children were classified as N, OW, and OB. At each age, BMI and z‐score of BMI (BMI Z) differences were compared among groups. The influence of birth weight, pre‐pregnancy BMI, and prenatal variables (weight gain, smoking, and presence of diabetes and preeclampsia) on BMI Z differences between N and OB was also explored. Adiposity rebound (AR) was not observed for the N, although for the OW, it occurred ～52 months and for the OB at ～24 months. BMI Z differences between N and OB were significant from birth, but were greatest between 6–12 and 36–52 months. Additional adjustment by birth weight, pre‐pregnancy BMI, and prenatal variables decreased the BMI Z differences for the first 24 months with virtually no effect after this age. Accelerated growth in OB children from post‐transition countries occurs immediately after birth, much earlier than the AR. The influence of prenatal factors on adiposity acquisition may extend at most until 2 years of life, although BMI gains thereafter are more related to postnatal variables.     

Dog Bite Prevention: Effect of a Short Educational Intervention for Preschool Children

This study aimed to investigate whether preschool children can learn how to interpret dogs’ behaviours, with the purpose of helping avoid dog bites. Three- to five-year-old children (N = 70) were tested on their ability to answer questions about dogs’ emotional states before and after participating in either an educational intervention about dog behaviour (intervention group) or an activity about wild animals (control group). Children who had received training about dog behaviour (intervention group) were significantly better at judging the dogs’ emotional states after the intervention compared to before. The frequency with which they referred to relevant behaviours in justifying their judgements also increased significantly. In contrast, the control group’s performance did not differ significantly between the two testing times. These results indicate that preschool children can be taught how to correctly interpret dogs’ behaviours. This implies that incorporating such training into prevention programmes may contribute to reducing dog bite incidents.