Testing prototypes with users is essential when developing new products. This qualitative study examines and organizes users’ (children) feedback on physical toy prototypes at various fidelity levels; the data collected comes from a multidisciplinary design studio class tasked with developing wooden toys for the company PlanToys. In this research, we use an organizational framework to categorize stakeholders’ feedback, which includes affirmative feedback, convergent critical feedback, and divergent critical feedback. In our analysis, the children’s feedback was compared by prototype fidelity in terms of both form and function, as well as by the feedback categorization. Findings suggest that form fidelity may bias children toward giving more divergent feedback, that function fidelity may have little impact on feedback given, that children tend to give more types of feedback on lower fidelity than higher fidelity models, and that play value, form, interaction, and function were the highest reported categories of feedback. Based on our observations, we encourage toy designers to be aware of their goals for testing with children before beginning to prototype. This paper is a resource for designers to understand how to prototype for children, as well as resource for researchers studying how specific end users influence the product design process.

Long-term health and developmental impact after in utero opioid and other substance exposures is unclear. There is an urgent need for well-designed, prospective, long-term observational studies. The HEALthy Brain and Child Development Study aims to address this need. It will require optimizing recruitment and retention of caregivers and young children in long-term research. Therefore, a scoping review of original research articles, indexed in the PubMed database and published in English between January 1, 2010, and November 23, 2023, was conducted on recruitment and retention strategies of caregiver–child (≤6 years old) dyads in observational, cohort studies. Among 2,902 titles/abstracts reviewed, 37 articles were found eligible. Of those, 29 (78%) addressed recruitment, and 18 (49%) addressed retention. Thirty-four (92%) articles focused on strategies for facilitating recruitment and/or retention, while 18 (49%) described potentially harmful approaches. Recruitment and retention facilitators included face-to-face and regular contact, establishing a relationship with study personnel, use of technology and social platforms, minimizing inconveniences, and promoting incentives. This review demonstrates that numerous factors can affect engagement of caregivers and their children in long-term cohort studies. Better understanding of these factors can inform researchers about optimal approaches to recruitment and retention of caregiver–child dyads in longitudinal research.

Anxiety and depression are highly prevalent and comorbid problems in childhood, which deserve greater understanding for effective prevention and treatment. The main aim of the present study was to explore the comorbidity between anxiety and depression symptoms using a novel and valuable approach to study comorbidity, such as network analysis. Specifically, the connectivity between symptoms and possible relevant symptoms was examined through comorbidity estimation and shortest pathway networks, as well as bridge symptoms. This study comprised 281 Spanish-speaking children aged 8–12 years (45.2% girls), whose anxiety and depression symptoms were assessed through specific brief parent-report measures. Analyses revealed that in the comorbidity network, the most central symptoms were related to depression (“No good anymore,” “Could never be as good,” “Hated self,” “Did everything wrong,” “Nobody loved him/her”) or anxiety (“Suddenly feels really scared”). Furthermore, it was found that the most central bridge symptoms, whose activation would play a key role in the activation of other domain symptoms, were anxiety symptoms such as “Trouble going to school” and “Suddenly feels really scared” and depression symptoms, such as “Could never be as good” and “Hated self.” Additionally, the shortest path network suggested the existence of different possible pathways of connection between anxiety and depression symptoms. Overall, these findings help to understand the complexity of the anxiety-depression comorbidity. It suggests the existence of central and bridge symptoms that complement previous studies, which may be potential targets for interventions to prevent and treat childhood anxiety and depression.

This study aimed to explore the combined effects of serum vitamin-D level and tobacco exposure on the risk of overweight and obesity in children. This cross-sectional study analysed the data of 11 636 children aged 2–17 years from the National Health and Nutrition Examination Surveys database between 2007 and 2018. Univariable and multivariate weighted logistic regression models were used to analyse the associations of serum vitamin-D or cotinine levels with overweight and obesity in children as well as the combined effects of serum vitamin-D and cotinine on the risk of overweight and obesity in children. Subgroup analysis was performed in terms of gender, age, race and household smokers. OR with corresponding 95 % CI was presented. The elevated risk of overweight and obesity in children was found in those with serum vitamin-D < 20 ng/ml (OR = 1·44, 95 % CI: 1·29, 1·61). Also, the odds of overweight and obesity in children was 1·14 (OR = 1·14, 95 % CI: 1·01, 1·29) in children with cotinine ≥ 0·05 ng/ml. Relative to participants with serum vitamin-D ≥ 20 ng/ml and cotinine < 0·05 ng/ml, increased risk of overweight and obesity was identified in those with serum vitamin-D < 20 ng/ml and cotinine < 0·05 ng/ml (OR = 1·45, 95 % CI: 1·26, 1·68) and serum vitamin-D < 20 ng/ml and cotinine ≥ 0·05 ng/ml (OR = 1·62, 95 % CI: 1·38, 1·91). Serum vitamin-D and cotinine exposure had combined effects on the risk of overweight and obesity in children.

This study aimed to identify meal and snack patterns and assess their association with sleep timing in schoolchildren. This is a cross-sectional study carried out in 2018/2019 with 1333 schoolchildren aged 7–14 years from public and private schools in Florianópolis, Brazil. Previous-day dietary intake data for breakfast, mid-morning snack, lunch, mid-afternoon snack, dinner and evening snack were collected using a validated online questionnaire. Sleep timing was measured by the midpoint of sleep and classified as quartiles (very early, early, late and very late). Latent class analysis was performed to identify meal and snack patterns, and multinomial logistic regression was used to assess associations. Students with very late sleep timing were less likely to consume the ‘coffee with milk, bread and cheese’ breakfast pattern compared with very early group. Also, the former were more likely to consume the ‘mixed’ breakfast pattern (healthy and unhealthy foods) compared with very early students. The latter were more likely to eat the ‘Brazilian traditional, processed meat, egg and fish’ lunch pattern to the late students and less likely to consume the ‘pasta and cheese’ lunch pattern compared with the students with later sleep timing. Students with later sleep timing were more likely to eat ultra-processed food at mid-afternoon snacks compared with early group. The study findings suggest that morning preference appears to promote healthier breakfast, lunch and afternoon snack patterns, whereas later sleep timing may pose challenges in maintaining healthy patterns at these meals/snacks.

Humanitarian crises often require urgent medical care to people of concern. Such medical aid includes assessing and treating acute medical needs and ongoing chronic health conditions. Among the people of concern there are children, who are often the most vulnerable population in humanitarian contexts because they often lack the experience, independence, and cognitive and verbal skills to deal with the ordeals they are facing. These limitations might prevent identification and diagnosis of pain. The under-diagnosis and under-treated pain by health care providers might be also due to the perceived urgency of more acute or life-threatening medical needs with limited medical equipment and personnel, lack of awareness, or assessment tools in such contexts. Additionally, due to issues of anonymity and lack of formal guidelines, there is a severe lack of standardized registration of children’s pain conditions in humanitarian crises. Finally, acute pain is also a predictor of post-traumatic stress disorder, a common outcome in such disasters. We call on health care providers to use standardized scales to assess children’s pain intensity, frequency, and duration, and to treat it appropriately. These will not only reduce children’s physical suffering but may also prevent subsequent risk of PTSD.

Greenland is the world's largest island, but only a narrow strip of land between the Inland Ice and the sea is inhabitable. Yet, the Norse chose to settle here around ad 986. During the eleventh century ad, precontact Inuit people moved into Greenland from northern Alaska via Canada. Although the two cultures faced the same climatic changes during the Little Ice Age, the Inuit thrived, while the Norse did not, for multiple causes. The authors focus on one of these causes, the hitherto overlooked contribution of young children's learning strategies to societal adaptation. The detailed analysis of a large corpus of play objects reveals striking differences between the children's material culture in the two cultures: rich and diverse in the precontact Inuit material and more limited and normative in the Norse. Drawing on insights from developmental psychology, the authors discuss possible effects of play objects on children's future adaptability in variable climatic conditions.

We report on a 7-month-old boy (4.2 kg/60 cm) with severe immunodeficiency disorder and bacterial septicaemia who was referred for an infected atrial thrombus secondary to a jugular central line. The echocardiogram showed a teardrop-shaped thrombus with a wide base adherent to the interatrial wall and a flimsy tail moving freely in the right atrium. Chest CT scan showed multiple lesions in both lungs consistent with infected micro-thrombi. The thrombus increased in size despite 2 weeks of antibiotics and anticoagulation. We applied the Indigo® Lightning® 7 aspiration system from Penumbra® (Alameda, USA) and removed percutaneously the thrombus under transoesophageal ultrasound and biplane fluoroscopic guidance. At 6 weeks of follow-up, the patient is alive, under enoxaparin with no procedure-related complication.

Twins lag behind singletons in their early psychomotor development, but little is known about how chorionicity affects this difference. We compared early psychomotor development in singletons, monochorionic (MC) twins and dichorionic (DC) twins. Our longitudinal data from the Japan Environment and Children’s Study (JECS; see Appendix) included 98,042 singletons, 577 MC twins and 1051 DC twins representing the general Japanese population. Chorionicity was evaluated by ultrasound images and complemented by postnatal pathological examinations. Five domains of psychomotor development were evaluated at 6 time points from 6 months to 3 years of age using the Ages and Stages Questionnaires (ASQ-3). The data were analyzed using linear regression models. Twins lagged behind singletons in all areas of psychomotor development during infancy. This gap decreased over time but was still noticeable at 3 years of age. More than half of this difference was attributed to twins having lower birth weight and being born earlier in gestation. MC twins showed slightly delayed development compared to DC twins, but this difference was minor compared to the overall gap between twins and singletons. Twins delay singletons in their early psychomotor development, and this delay is not specific to MC twinning.