Objective: This study aimed to determine the relationships among vitamin D, calcium, phosphorus, andalkaline phosphatase levels in children (aged 0–12 years) and their mothers, and to assess the prevalence of vitamin Ddeficiency in both groups attending a secondary care hospital in Majmaah, Saudi Arabia. Furthermore, we examinedhow these biochemical parameters correlate with each other to inform potential nutritional interventions for thispopulation.Methods: 75 mothers and children between the ages of 0 and 12 who were admitted to the King Khalid hospital inMajmaah city between February 2015 and March 2016 participated in this study. This observational, retrospective,cross-sectional, hospital-based study was conducted at the pediatric division of King Khalid Hospital in Majmaah city.Results: The study group comprised 62.7% male and 37.3% female children. Mothers aged 20 to 40 accounted for 96%of the population, while those aged 40 and older accounted for 4%. Nearly 98.7% of mothers had serum calciumlevels>2.6 mmol/L. While 84% of children had serum phosphorus levels over 1.5 mmol/L. With statistically significant pvalues <0.05, vitamin D positively correlates with calcium (r = 0.327; p = 0.004) and phosphorus (r = 0.251; p = 0.030).However, it shows a negative correlation with alkaline phosphatase in children (r = -0.083; p = 0.480). 10.7% of childrenand 42.7% of mothers had serious vitamin D deficiency, respectively.Conclusion: This study highlights a significant correlation between vitamin D levels and calcium and phosphorus inchildren and mothers, with vitamin D positively associated with these minerals. These results underscore the criticalneed for targeted nutritional interventions to address vitamin D deficiency and improve bone health among children andmothers in this regional population. We recommend community-level screening and supplementation programs targetingmother–child dyads, alongside food fortification policies in Saudi Arabia. Future longitudinal studies with larger samplesizes are warranted to validate the causal relationship between maternal and child vitamin D status and to guideevidence-based regional nutrition policies.
Breastfeeding is recognized as the most secure and optimal approach to infant nourishment. In situationswhere breastfeeding is insufficient or unavailable, donor human milk from reputable human milk banks is a viablealternative to breast milk. The objective of this paper was to conduct a comprehensive review of the microbiologicalsafety associated with the utilization of donated human milk for infant feeding. Donated human milk is prone tocontamination during collection, storage or transportation; therefore, all efforts should be taken to render itmicrobiologically safe as it is fed to infants, who are more prone to infection. Donor human milk collected, processed andstored under hygienic conditions can be safely used for infant feeding in the absence of the mother’s own milk.
Background: Phototherapy is the standard treatment for neonatal indirect hyperbilirubinemia. However, it mayaffect calcium-phosphorus metabolism and vitamin D status in neonates.Objective: To evaluate changes in serum calcium, phosphorus, and 25-hydroxyvitamin D levels after phototherapy inneonates with indirect hyperbilirubinemia.Methods: An observational prospective study was conducted over six months at Ain Shams University hospitals. Sixtyneonates with indirect hyperbilirubinemia requiring phototherapy were included. Total and direct bilirubin, serum calcium,phosphorus, and serum 25 OH vitamin D were measured before initiation and after 48 hours of phototherapy.Results: Phototherapy significantly reduced total serum bilirubin. However, it was also associated with a decline in serumcalcium and phosphorus levels. Additionally, vitamin D levels increased.Conclusion: Phototherapy effectively reduced bilirubin levels but was associated with decreased serum calcium andphosphorus levels and increased serum 25-hydroxyvitamin D levels. Monitoring of mineral status during phototherapymay therefore be beneficial.
Background: Lack of access to adequate water, sanitation and hygiene in schools in developing countries is aglobal problem. Such a lack has been proven to enhance serious health and psychological risks associated with poortoilet hygiene in schools, particularly for vulnerable groups such as students with disabilities, bladder conditions, andteachers. In Cross River State, WASH was introduced to mitigate illness, absenteeism, and long-term health issuesstemming from inadequate sanitation, yet there appears to be a lack of empirical data assessing whether the initiativehas effectively addressed these concerns.Objective: The purpose of this study was to examine the hygiene conditions among students and teachers in publicsecondary schools in Cross River State.Methods: This study adopted a cross-sectional descriptive survey design to assess environmental hygiene conditions,hygiene knowledge, and hygiene practices among students and teachers in public secondary schools. Using aquestionnaire, data were collected and analysed accordingly.Results: Results showed poor environmental hygiene conditions (students: M = 2.19; teachers: M = 2.42), high hygieneknowledge (students: M = 3.28; teachers: M = 3.62), and low-to-moderate hygiene practices (students: M = 2.45;teachers: M = 2.94).Conclusions: Poor environmental hygiene conditions may increase students’ vulnerability to infection, absenteeism, andreduced learning engagement. The action required is to ensure that the much-needed sanitation and hygiene facilitiesare provided in secondary schools and that the environment is conducive to teaching and learning. Lastly, this work hasthe potential to make important contributions to achieving the United Nations’ Sustainable Development Goals.
Background: Hospital-acquired malnutrition is a critical yet often underrecognized condition in pediatricinpatients and is associated with adverse clinical outcomes, including prolonged hospitalization and increased morbidity.Reliable screening tools such as STRONGkids are essential to facilitate early identification, but their diagnosticperformance may vary across settings.Methods: This diagnostic accuracy study with prospective in-hospital follow-up was conducted among pediatricinpatients aged 1 month to 18 years in Wangaya Regional General Hospital, Denpasar, from September to November2025. STRONGkids screening was performed within 24 hours of admission. Hospital-acquired malnutrition wasdetermined based on percentage body weight loss measured at admission and discharge. Diagnostic performance wasassessed using sensitivity, specificity, predictive values, likelihood ratios, and ROC curve analysis, with optimal cut-offdetermined by the Youden Index.Results: Among 92 pediatric inpatients, hospital-acquired malnutrition occurred in 34.7%. No significant associationswere observed between malnutrition and sex, age, baseline nutritional status, diagnosis, disease category, or length ofhospital stay (all p > 0.05), although baseline nutritional status showed a near-significant trend (p = 0.072). Receiveroperating characteristic analysis demonstrated moderate discriminative ability of STRONGkids (AUC = 0.676). A cut-offscore of ≥1 yielded the highest Youden Index (0.558), with a sensitivity of 87.5%, specificity of 68.3%, positive predictivevalue of 59.6%, and negative predictive value of 91.1%.Conclusion: STRONGkids is a valuable screening tool for early detection of hospital-acquired malnutrition in pediatricinpatients, supporting routine universal nutritional screening.
Introduction: Acute malnutrition (wasting) is a major public health problem that contributes significantly tomorbidity and mortality among children under five years of age. Although nutrition intervention programmes have proveneffective, a key challenge in wasting management is the high rate of recurrence after interventions, which continues tosustain the burden of malnutrition. This study aimed to identify factors associated with recurrent wasting among childrenaged 6-59 months in Maros Regency.Methods: A cross-sectional study was conducted in 2025 at Mandai and Turikale Primary Health Centres, involving 250children with a previous history of wasting selected through purposive sampling. Maternal characteristics were assessedusing a structured questionnaire. Data were analysed using the chi-square test and multivariable logistic regression. Dueto the cross-sectional design, causal relationships cannot be established.Results: The prevalence of wasting recurrence was 26.8%. Multivariable logistic regression analysis showed thatadequate maternal nutritional status was independently associated with a lower likelihood of wasting recurrence (OR =0.14; 95% CI: 0.06-0.28; p < 0.001). Similarly, favourable maternal psychosocial conditions, particularly lower levels ofanxiety, were significantly associated with reduced odds of recurrence (OR = 0.06; 95% CI: 0.00-0.59; p = 0.016).Appropriate maternal caregiving practices were also associated with decreased likelihood of recurrent wasting (OR =0.30; 95% CI: 0.09-0.92; p = 0.03). Household income showed a marginal association with wasting recurrence but didnot reach statistical significance in the adjusted model.Conclusion: Maternal nutritional status, psychosocial well-being, and caregiving practices were significantly associatedwith the recurrence of wasting among children aged 6-59 months. These findings suggest that maternal-related factorsare important correlates of wasting recurrence. However, given the cross-sectional design, the results should beinterpreted as associations rather than causal relationships. Further longitudinal studies are warranted to betterunderstand potential causal pathways.
Purpose: Early Childhood Caries (ECC) remains a major child health problem in Indonesia despite ongoingpreventive efforts. ECC is closely associated with poor dietary habits, excessive and unmonitored sugar consumption,and even influences social and cultural aspects. This study aimed to explore socio-cultural, behavioral, and nutritionalfactors affecting early childhood oral health within Holistic Integrative Early Childhood Education (PAUD HI) settings inPadang City, Indonesia. Methods: A sequential mixed-methods study was conducted. The quantitative phase involved258 parents of children aged 1–6 years selected from six PAUD HI institutions. Data were collected usingquestionnaires, and analysis was performed using univariate, bivariate, and multivariate logistic regression. Followingthis was the qualitative phase, in which 12 parents and 3 school representatives were asked to explain and contextualizethe initial quantitative findings. In analyzing this data, Miles and Huberman's thematic approach was used.Results: There was no statistically significant association between parental oral health behavior and knowledge(OR=8.607, p=0.165), attitude (OR=2.207, p=0.132), belief (OR=0.425, p=0.230), health information exposure(OR=2.512, p=0.186), healthcare support (OR=2.031, p=0.201), or access to health facilities (OR=5.330, p=0.126). Theresults reveal that no final multivariate regression model was obtained. Sociocultural factors strongly influence habitsthrough family toothbrushing routines, parenting power dynamics, children’s emotional attachment, traumatic dentalexperiences, and inconsistent control of children's sugar consumption, which are all the results of influences within andoutside family settings. These findings elucidate why there is a gap between what parents understand and how theyactually implement oral health care practices properly on their children.Conclusion: Risk factors for ECC do not only come from parents’ dental knowledge but also from children’s social andcultural environments. Implementing effective socio-cultural approaches reduces ECC risks, for example, by providingeducation to parents and children on proper nutritional habits and how to incorporate them into daily routines.
Background: Early-life microbial colonisation plays a pivotal role in shaping the infant immune system andinfluencing susceptibility to allergic diseases.Objective: This study aimed to establish the relationship between the characteristics of the gut microbiota and thedevelopment of allergen sensitisation in infants during their first year of life.Methods: The research was conducted in Poland at the Medical University of Warsaw between January 2022 and May2023. The methodology involved prospective monitoring of 112 full-term infants, with sequential collection of faecalsamples and microbiota analysis using 16S rRNA gene sequencing at 1, 3, 6, and 12 months of age. Immunologicalassessment included the determination of total and specific IgE, flow cytometric cell typing, and multiplex analysis ofserum cytokine levels.Findings: The results indicated that infants with signs of sensitisation showed a reduction in microbial alpha-diversityfrom the 1st month of life (Shannon index: 2.15 vs 2.47), with statistically significant differences emerging from the 3rdmonth (p<0.05). Beta-diversity based on the Bray-Curtis metric revealed a persistent divergence in microbialcommunities depending on sensitisation status, most pronounced at 6 and 12 months. Sensitised infants exhibited anincreased relative abundance of pro-inflammatory taxa, including Escherichia/Shigella and Klebsiella, whereas nonsensitised infants were dominated by immunoprotective microorganisms such as Bifidobacterium and Faecalibacterium.Furthermore, sensitised infants demonstrated early and sustained elevations in total and specific IgE, as well as a shift inthe immune response towards a Th2 profile, characterised by increased levels of IL-4 and IL-5, a reduction in CD4+ Tcells, and an increase in the proportion of CD19+ and NK cells.Conclusion: The findings confirm the critical role of microbial diversity in immunological calibration and the developmentof the allergic phenotype. The results may be used in clinical practice by paediatricians, immunologists, and allergists forearly diagnosis and risk assessment of allergic diseases in children, as well as in the development of microbiota-targetedinterventions and sensitisation prevention strategies within primary healthcare and perinatal monitoring programmes.
Background: This study aimed to summarize and analyze data from 2020 to the first half of 2025 on obesity inchildren and adolescents in Poland, focusing on its prevalence, pathogenesis, and consequences for the respiratory,cardiovascular, and musculoskeletal systems.Methods: The work synthesizes results from 52 studies conducted in Poland and abroad, applying epidemiological,clinical, functional, and molecular approaches.Findings: The findings confirm a rising prevalence of childhood obesity in Poland, with gender and regional disparities:overweight prevalence reaches 32-36%, obesity- 12-14%, with higher rates in rural areas and among boys.Pathogenetically, key roles are played by neuroendocrine dysregulation of appetite, insulin resistance, and socioeconomic and genetic influences. Respiratory effects include reduced lung capacity, impaired ventilation, high risk ofobstructive sleep apnea (13-59%), and aggravated asthma with heightened inflammation and reduced treatmentefficacy. Cardiovascular issues affect about 6% of adolescents with hypertension, alongside early endothelialdysfunction, dyslipidemia, and myocardial hypertrophy linked to insulin resistance and systemic inflammation.Musculoskeletal consequences include joint overload, postural defects, flat feet, impairedmotor coordination, anddecreased quality of life, with 30-60% of obese children showing such dysfunctions.Conclusions: These results highlight the urgency of early detection and multidisciplinary management of pediatricobesity, integrating national and sociocultural considerations in Poland.
Background: Participation in endurance sports among children and adolescents is increasing. Pediatricathletes differ physiologically from adults due to ongoing somatic growth, biological maturation, and endocrinedevelopment, which modify both adaptive responses and injury susceptibility.Aim: This review synthesizes current evidence on physiological adaptations to endurance training in youth and examinesthe major musculoskeletal, cardiovascular, metabolic, endocrine, and psychosocial risks associated with high trainingloads.Materials and Methods: A narrative review of literature published between January 1990 and January 2026 wasconducted using PubMed and MEDLINE, supplemented by consensus statements from major sports medicineorganizations.Results: Endurance performance improvements in youth are influenced more by neuromuscular maturation than by largecentral cardiovascular adaptations, with modest training-induced changes in VO₂ max before puberty. The developingmusculoskeletal system demonstrates high adaptive plasticity but increased vulnerability to overuse injuries, includingphyseal stress injuries and bone stress injuries. Inadequate energy availability may disrupt endocrine function and impairgrowth and bone development.Conclusions: While endurance training promotes beneficial physiological adaptations, the developing athlete remainsvulnerable to overuse injuries, low energy availability, psychosocial stressors, and long-term health risks. Recognition ofthese mechanisms is essential for accurate risk interpretation and safe training practices.
Background: Congenital haemangiomas are rare vascular tumours in children, and their complex aetiologyinvolving genetic, hormonal, and environmental factors remains insufficiently understood.Purpose: This study aims to systematise and analyse data on the aetiological risk factors for congenital haemangiomasin children. The main objective was to identify key trends and patterns related to the aetiology of the disease.Methods: A structured review of 46 published sources (2013-2025) was conducted, including peer-reviewed articles,clinical case reports, and molecular studies. 91% of the included sources were published within the last 5-6 years.Materials were examined using thematic analysis, comparative methods, and systematic organisation, integrating bothquantitative and qualitative approaches to assess genetic, hormonal, environmental, and perinatal risk determinants.Findings: Genetic mutations, such as missense mosaic mutations in GNAQ and GNA11, as well as the pathogenicsomatic variant PIK3CA (p.His1047Gln) with an allele frequency of 8.3%, play a key role in the pathogenesis ofcongenital haemangiomas. Mutations in the VEGF-A and TIE2 genes also contribute to their development. Newbornswith large placental chorioangiomas are more likely to develop haemangiomas. Oestrogens stimulate the proliferation ofvascular cells; approximately 60% of children with periorbital haemangiomas are girls, which indicates the role of femalesex hormones in the pathogenesis of haemangiomas, and hypoxia affects the expression of angiogenic inducer 61.Klippel-Trénaunay syndrome can cause haemangiomas, especially when internal organs are affected. Data showed thatinfantile haemangiomas occur in 75% of children with a gestational age of less than 33 weeks and in 57% of childrenwith a gestational age of 33 to 37 weeks. Hyperemesis gravidarum can cause deficiencies of essential micronutrients inthe mother, increasing the risk of congenital haemangioma by 1.75 times. The use of medications during pregnancy alsoincreases the risk of developing a congenital hemangioma by 1.8 timesConclusion: The results of the study can be used to develop new approaches to the diagnosis and treatment ofcongenital hemangiomas in children, as well as to create more accurate and personalised treatment methods thataccount for genetic and environmental risk factors.
Objectives: Adolescent girls living in coastal areas are nutritionally vulnerable due to limited access to diverse and nutrient-rich foods. This study aimed to provide an overview of the nutritional profile and potential vulnerability to anemia among adolescent girls in this area. Methods: A descriptive cross-sectional study was conducted in January 2025 among 159 adolescent girls aged 11-18 years in the coastal area of Galesong Selatan, Takalar Regency, Indonesia. Data on hemoglobin levels and dietary intake were collected using Hemocue 301 and two non-consecutive 24-hour recalls. Diet quality was assessed using the Diet Quality Index for Adolescents (DQI-A) adapted to Indonesian guidelines, and all data were analyzed descriptively. Results: The prevalence of anemia among adolescent girls was 42.8%, with 23.9% classified as mild and 18.9% as moderate anemia. The median DQI-A score was 40.33, with subcomponent scores of DQ: 5.95, DD: 71.43, and DE: 40.14, indicating overall poor diet quality. Most participants had moderate dietary diversity (60.4%) and low dietary equilibrium, with 73.0% consuming less than half of the recommended daily nutrient intake (<50% RDA). The average intake of energy, protein, iron, folate, and vitamin C was markedly below the RDA, showing substantial nutrient inadequacy. Although weekend intake was slightly higher, nutrient levels remained insufficient to meet daily requirements. Conclusions: Improving adolescent diet quality through balanced, micronutrient-rich food intake and adherence to ironfolic acid supplementation is essential not only to prevent anemia but also to strengthen vascular health and reduce future risks of congenital vascular anomalies. The findings can inform school-based nutrition education, local food optimization, and policy planning to support adolescent health in coastal communities.
Background: Stunting management in Semarang City remains sectoral and has yet to involve early childhood education centres. This study investigates early childhood education services, nutritional status, and the impact of services on stunting prevalence and designs a stunting intervention model. Methods: A cross-sectional survey was conducted to collect data from 314 integrated early childhood education centres in Semarang City, with 20 selected for anthropometric data collection. Nutritional status was classified as wasting, stunting, and underweight. Dummy variable regression analysis was used to determine the impact of services on stunting prevalence. Results: The integrated early childhood education (IECE) was considered good in 55.97% of cases, while 44.03% were rated as less satisfactory. The prevalence of stunted students (29%) was the highest, followed by underweight and wasting. The prevalence of stunting was higher among male students than female students, and the rate of stunting in boys increased with age. Although the influence of early childhood education services on stunting reduction was found to be very weak, it remains a positive factor in lowering stunting prevalence. Enhancing the quality of IECE through an integrated intervention model, especially targeting nutrition and health among young children, represents a significant opportunity to implement effective non-medical interventions to reduce stunting, as evidenced by service-delivery rates. Conclusion: IECE service was found to be effective in reducing the prevalence of student stunting. These findings imply an urgent need for coordinated, targeted actions that leverage existing policy frameworks to improve service quality and focus interventions on the most vulnerable groups.
Background: The relevance of this study is determined by the need to develop an effective model of rehabilitation for children with type 1 diabetes mellitus (T1DM), considering medical, psychological, and social factors in the context of increasing chronic morbidity among the paediatric population. The purpose of the study is to substantiate the applicability of the biopsychosocial approach within the rehabilitation system for children with T1DM. Methods: Within a multidimensional review of the literature, approaches to the comprehensive evaluation of the functional state of children with T1DM are synthesised, encompassing clinical and laboratory indicators, psychological and emotional aspects of adaptation, and social determinants. Findings: It is established that the effectiveness of biological rehabilitation depends on the combination of individualised insulin therapy, nutritional regimen modification, physical activity, and the correction of oxidative stress. The psychological and emotional component includes identifying emotional difficulties, particularly during adolescence, and implementing psychoeducational and psychotherapeutic interventions to facilitate the stabilisation of behavioural responses. Institutional support and interdisciplinary cooperation ensure the application of an individualised approach in clinical practice. Conclusion: The implementation of the biopsychosocial approach enables comprehensive attention to the needs of children with T1DM, adapts rehabilitation pathways to the social environment, and improves the quality of care during long-term follow-up. The practical value of the study lies in developing a foundation for enhancing multidisciplinary paediatric endocrinology programmes that can be adapted within healthcare systems.
This literature review synthesizes empirical evidence from 10 studies published between 2016 and 2025 to examine the relationship between breastfeeding and cognitive development in early childhood. The review aims to elucidate the extent to which breastfeeding influences cognitive outcomes while accounting for moderating factors such as socioeconomic status, maternal education, and genetic predispositions. Utilizing a systematic methodology, the review analyzes study designs, sample characteristics, measurement tools, and key findings. Results indicate a consistent positive association between breastfeeding duration and cognitive performance, particularly in language and executive functions, although this association is moderated by environmental and familial factors. Limitations include potential confounding variables, reliance on self-reported data, and variability in assessment methods. The review concludes that breastfeeding may be a significant contributor to early cognitive development, warranting policies that promote breastfeeding. Future research should focus on longitudinal designs and causal mechanisms to better understand this relationship.
Objectives: This study aimed to comprehensively assess the dental status of children aged 5-11 years residing in areas with naturally fluoridated water. The study included 486 children, selected by age and permanent residence using randomisation in Kyzyl-Suu and a continuous survey in Orgochor. Dental status was assessed according to World Health Organization recommendations using the KPUp+kpp and KPUz+kpz indices, while oral hygiene was evaluated using the Fedorov-Volodkina index. Methods: The concentration of fluorides in drinking water was determined by the potentiometric method, with multiple samples collected at different times of day. Statistical processing of the data involved the use of the standard error of the mean (m), Student's t-test, and quantile-quantile plots to assess distribution normality. The results showed that the prevalence of caries among children aged 5-11 years ranged from 93.1% to 100%, depending on age group and place of residence: in Kyzyl-Suu it reached 100% in all groups except 10-11 years (96.0%), while in Orgochor it varied from 93.1% (7 years) to 98.5% (10-11 years), with a clear age-related trend towards a decline in the incidence of deciduous teeth caries and a simultaneous increase in the intensity of damage to permanent teeth. Findings: In Orgochor, where the fluoride concentration was 1.44 mg/l, a moderate decrease in caries activity was observed; however, the incidence of fluorosis reached 27.3%. More than 60% of children had unsatisfactory or poor oral hygiene, which further aggravated the risk of dental diseases. The relationships identified between fluoride levels, hygiene conditions, and the prevalence of pathology indicate a complex interdependence of risk factors in the study population. Conclusions: The findings underscore the need for comprehensive sanitary control, educational programmes, and regular monitoring of drinking water quality to prevent dental diseases in paediatric populations.
Background: Central venous catheters (CVCs) are essential for neonatal intensive care but are strongly associated with catheter-related bloodstream infections (CRBSI), which significantly increase morbidity, mortality, and hospital stay. The optimal antiseptic for neonatal skin disinfection remains debated, with chlorhexidine-alcohol solutions increasingly recommended but still under investigation for safety and efficacy. Objective: To compare the effectiveness of 2% chlorhexidine in 70% isopropyl alcohol versus 70% alcohol alone in reducing catheter-related bloodstream infections among neonates requiring CVCs. Methods: A prospective randomized controlled trial was conducted on 100 neonates admitted to the NICU at Ain Shams University Hospital. Participants were randomly assigned to two groups: Group A (alcohol-only antisepsis) and Group B (chlorhexidine-alcohol antisepsis). Data collected included patient demographics, catheter type and duration, infection rates, blood culture results, inflammatory markers, and clinical outcomes. Results: Group B (chlorhexidine-alcohol) demonstrated significantly lower rates of positive blood cultures (notably Klebsiella and E. coli) compared to Group A. The incidence of infection was highest in neonates with percutaneous central venous catheters (PCVCs) and umbilical venous catheters (UVCs), while peripherally inserted central catheters (PICCs) showed the lowest infection burden. Mean catheter duration was 9-11 days, with most infections occurring beyond the seventh day. Hemoglobin and hematocrit levels declined significantly over time in infected cases. Group B also required fewer escalations to second-line antibiotics. Conclusions: Using 2% chlorhexidine in 70% isopropyl alcohol significantly reduced catheter-related bloodstream infections (CRBSIs) in neonates, compared to 70% alcohol alone. Peripherally inserted central catheters (PICCs) exhibited the lowest infection rates, highlighting the importance of both antiseptic selection and catheter type in neonatal infection prevention protocols.
Purpose: The increase in the number of premature births in the Kyrgyz Republic was accompanied by the growth of the proportion of newborns with very low (VLBW)and extremely low birth weight (ELBW), which required a systematic analysis of the survival. The study aimed to determine the dynamics of survival among newborns in these groups for 2019-2024, accounting for regional differences. Material and Methods: Kaplan-Meier curves and the log-rank test were used to assess statistical significance. Data, including medical records, reports from perinatal centres, and official statistics from the National Statistical Committee of the Kyrgyz Republic, were collected from all regions of the country, with an emphasis on regional differences in neonatal care infrastructure. Results: The survival of newborns weighing 1,000 to 1,499 grams increased from 23.4% to 51.8%, accompanied by a reduction in early neonatal mortality from 48% to 26%. Among children weighing less than 1,000 grams, survival increased from 2.2% to 8.6%, at remained low. It was established that the most pronounced improvement was observed in the southern regions of the country, whereas in the northern and mountainous areas, the lag remained. The main factors driving positive dynamics were the expansion of antenatal care, the equipping of hospitals with intensive care equipment, and improvements in staff qualifications. Conclusion: The practical significance of the study lies in the justification for further development of neonatal care infrastructure to reduce infant mortality and balance regional differences in Kyrgyzstan.
Objective: This study aimed to investigate the effects of a Breastfeeding Support Program for Couples Based on Self-Determination Theory on Breastfeeding Outcomes. Method: The study was carried out between 01.12.2021 and 15.03.2023 with a randomized controlled educational intervention design, where couples who presented to & Idot;zmir Torbal & imath; Family Health Center (FHC) No 1 were included in a Breastfeeding Support Program for Couples in the intervention group and Standard Breastfeeding Education in the control group by a midwife by the 32nd week of pregnancy. Results: Significant positive relationships were identified between the Breastfeeding Support Scale for Couples scores of the mothers and those of the fathers at the 15th day, 2nd month, 4th month, and 6th month in the postpartum period (p<0.01). At 6 months, among couples who participated in the Breastfeeding Support Program for Couples (intervention group), as Breastfeeding Support Scale scores increased, mothers' Breastfeeding Motivation Scale scores increased. It was determined that the breastfeeding efficacy levels of the mothers in the intervention and control groups started to increase after the 7th day in the postpartum period, and their mean Breastfeeding Self-Efficacy Scale scores were high. The mothers who participated in the Breastfeeding Support Program for Couples had a lower rate of experiencing Nipple Pain and Trauma and a higher rate of feeding their babies exclusively with breastmilk in the first six months of the postpartum period. Conclusion: In conclusion, fathers who participated in the Breastfeeding Support Program for Couples improved the breastfeeding outcomes of their partners, the program was effective in reducing nipple problems, and mothers who participated in the program had a higher rate of feeding their babies exclusively with breastmilk in the first six months of the postpartum period.
Background: Neurodevelopmental disorders, including autism spectrum disorders (ASD), are increasingly diagnosed in children, but low awareness, delays in diagnosis, and poor service coordination complicate therapy and negatively affect family quality of life. Objective: This study aimed to assess the importance of early detection of ASD and the role of therapeutic interventions in improving child development and family well-being. Methods: Using a qualitative approach, the study involved interviews with 20 pairs of parents of children with ASD and thematic analysis, considering gender, age, and behavioral characteristics, supplemented by the Parental Stress Scale. Results: Early diagnosis (before age 3, 60%) was associated with faster progress compared to late diagnosis. In the early diagnosis group, behavioral therapy, sensory integration, and speech therapy led to improvements in non-verbal communication, reduced sensory hypersensitivity, and decreased aggression. In the late-diagnosis group, with greater use of behavioral therapy and individual education plans, progress was slower, with improvements in speech, reduced aggression, and less social isolation. Parents reported reduced anxiety and improved family relationships, especially in early-diagnosis cases. Barriers included delays in diagnosis (18-24 months), stigma, and inadequate infrastructure. Conclusion: The findings highlight the effectiveness of early intervention and the need for standardized diagnostic procedures, parent education programs, professional training, and improved infrastructure to support families raising children with ASD. These results can guide intersectoral cooperation, policy development, and support strategies for families.
