Oral health behaviour, attitude towards, and knowledge of dental caries among mothers of 0- to 3-year-old children living in Kaunas, Lithuania

Objectives This study aimed to investigate the oral health behaviours of mothers with young children and their attitudes towards dental caries. Methods The survey targeted all mothers with children under 3 years attending a primary healthcare centre (Department of Family Medicine at the Lithuanian University of Health Sciences [LSMU] Hospital) in Kaunas, Lithuania. The Bioethics Centre of the LSMU approved the study (No. BEC‐OF‐14). Of 176 mothers, 123 (69.9%) took part in the 2016–2017 study. The self‐administered questionnaire enquired about mothers' attitudes towards oral health and behaviours related to the potential transmission of oral bacteria to their children, dietary habits, tooth brushing, smoking, and background factors. The chi‐squared test and univariate/multivariate logistic regression analyses served for the statistical analysis. (p values ≤ .05 indicated statistically significant differences). Results Most (76; 68.5%) of the mothers brushed their teeth twice daily, and 97 (87.4%) reported themselves as nonsmokers. We found a statistically significant association between mothers who brushed their own teeth twice daily and those who cleaned their children's teeth likewise (OR = 5.42, 95% CI [1.28–6.63]; p = .005). We observed significant associations among mothers who gave their children sugar‐sweetened beverages (SSBs) daily and the mothers' college or lower education (OR = 6.51, 95% CI [1.59–27.19]; p = .01) and maternal tooth brushing less than twice daily (OR = 3.88, 95% CI [0.99–15.18]; p = .05). Conclusions A majority of mothers who took part in this survey did not brush their children's teeth as recommended. Mothers with a lower education and who brushed their teeth less than twice daily offered their children SSBs more frequently.publishedVersio

Childhood overweight and obesity in Europe: Changes from 2007 to 2017

The Childhood Obesity Surveillance Initiative (COSI) routinely measures height andweight of primary school children aged 6–9 years and calculates overweight andobesity prevalence within the World Health Organization (WHO) European Regionusing a standard methodology. This study examines the trends in the prevalence ofoverweight and obesity from the first round of COSI carried out in 2007/2008 to thelatest of 2015/2017 in 11 European countries in which data were collected for atleast three rounds. In total 303,155 children were measured. In general, the preva-lence of overweight and obesity among boys and girls decreased in countries withhigh prevalence (Southern Europe) and remained stable or slightly increased in North-ern European and Eastern European countries included in the analysis. Among boys, the highest decrease in overweight (including obesity) was observed in Portugal (from40.5% in 2007/2008 to 28.4 in 2015/2017) and in Greece for obesity (from 30.5% in2009/2010 to 21.7% in 2015/2017). Lithuania recorded the strongest increase in theproportion of boys with overweight (from 24.8% to 28.5%) and obesity (from 9.4% to12.2%). The trends were similar for boys and girls in most countries. Several countriesin Europe have successfully implemented policies and interventions to counteract theincrease of overweight and obesity, but there is still much to be done.The authors gratefully acknowledge support through a grant from the Russian Government in the context of the WHO European Office for the Prevention and Control of NCDs. The Ministries of health of Austria, Croatia, Greece, Italy, Malta, Norway, and the Russian Federation provided financial support for the meetings at which the protocol, data collection procedures, and analyses were discussed. Data collection in the countries included in this study was made possible through funding from: Bulgaria: Ministry of Health, National Center of Public Health and Analyses, and WHO Regional Office for Europe; Czechia: WHO grants AZV MZČR 17-31670 A MZČR-RVO EÚ 00023761, World Health Organization Regional Office for Europe, and WHO country office; Greece: International Hellenic University and Hellenic Medical Association for Obesity; Ireland: Health Service Executive; Italy: Ministry of Health and Italian National Institute of Health; Latvia: Ministry of Health and Centre for Disease Prevention and Control; Lithuania: Science Foundation of Lithuanian University of Health Sciences, Lithuanian Science Council, and WHO; Norway: Ministry of Health and Norwegian Institute of Public Health; Portugal: Ministry of Health Institutions, the National Institute of Health, Directorate General of Health, Regional Health Directorates, and the kind technical support from the Center for Studies and Research on Social Dynamics and Health (CEIDSS); Slovenia: Ministry of Education and Science and Sport of the Republic of Slovenia within the SLOfit surveillance system; and Spain: Spanish Agency for Food Safety and Nutrition (AESAN).info:eu-repo/semantics/publishedVersio

Association between characteristics at birth, breastfeeding and obesity in 22 countries: the WHO European Childhood Obesity Surveillance Initiative – COSI 2015/2017

Objectives: It was the aim of this paper to investigate the association of early-life factors, namely breastfeeding, exclusive breastfeeding and birth weight, with obesity among children. ----- Method: Data from 22 participating countries in the WHO European COSI study (round 4: 2015/2017) were collected using cross-sectional, nationally representative samples of 6- to 9-year-olds (n = 100,583). The children's standardized weight and height measurements followed a common WHO protocol. Information on the children's birth weight and breastfeeding practice and duration was collected through a family record form. A multivariate multilevel logistic regression analysis regarding breastfeeding practice (both general and exclusive) and characteristics at birth was performed. ----- Results: The highest prevalence rates of obesity were observed in Spain (17.7%), Malta (17.2%) and Italy (16.8%). A wide between-country disparity in breastfeeding prevalence was found. Tajikistan had the highest percentage of children that were breastfed for ≥6 months (94.4%) and exclusively breastfed for ≥6 months (73.3%). In France, Ireland and Malta, only around 1 in 4 children was breastfed for ≥6 months. Italy and Malta showed the highest prevalence of obesity among children who have never been breastfed (21.2%), followed by Spain (21.0%). The pooled analysis showed that, compared to children who were breastfed for at least 6 months, the odds of being obese were higher among children never breastfed or breastfed for a shorter period, both in case of general (adjusted odds ratio [adjOR] [95% CI] 1.22 [1.16-1.28] and 1.12 [1.07-1.16], respectively) and exclusive breastfeeding (adjOR [95% CI] 1.25 [1.17-1.36] and 1.05 [0.99-1.12], respectively). Higher birth weight was associated with a higher risk of being overweight, which was reported in 11 out of the 22 countries. Bulgaria, Croatia, France, Italy, Poland and Romania showed that children who were preterm at birth had higher odds of being obese, compared to children who were full-term babies. ----- Conclusion: The present work confirms the beneficial effect of breastfeeding against obesity, which was highly increased if children had never been breastfed or had been breastfed for a shorter period. Nevertheless, adoption of exclusive breastfeeding is below global recommendations and far from the target endorsed by the WHO Member States at the World Health Assembly Global Targets for Nutrition of increasing the prevalence of exclusive breastfeeding in the first 6 months up to at least 50% by 2025

Methodology and implementation of the WHO European Childhood Obesity Surveillance Initiative (COSI)

Establishment of the WHO European Childhood Obesity Surveillance Initiative (COSI)has resulted in a surveillance system which provides regular, reliable, timely, andaccurate data on children's weight status—through standardized measurement ofbodyweight and height—in the WHO European Region. Additional data on dietaryintake, physical activity, sedentary behavior, family background, and schoolenvironments are collected in several countries. In total, 45 countries in the EuropeanRegion have participated in COSI. The first five data collection rounds, between 2007and 2021, yielded measured anthropometric data on over 1.3 million children. In COSI,data are collected according to a common protocol, using standardized instrumentsand procedures. The systematic collection and analysis of these data enables inter-country comparisons and reveals differences in the prevalence of childhood thinness,overweight, normal weight, and obesity between and within populations. Furthermore,it facilitates investigation of the relationship between overweight, obesity, and poten-tial risk or protective factors and improves the understanding of the development ofoverweight and obesity in European primary-school children in order to supportappropriate and effective policy responses.The authors gratefully acknowledge support through a grant from the Russian Government in the context of the WHO European Office for the Prevention and Control of NCDs. The ministries of health of Austria, Croatia, Greece, Italy, Malta, Norway, and the Russian Federation provided financial support for the meetings at which the protocol, data collection procedures, and analyses were discussed. Data collection in countries was made possible through funding from the following: Albania: WHO through the Joint Programme on Children, Food Security and Nutrition “Reducing Malnutrition in Children,” funded by the Millennium Development Goals Achievement Fund, and the Institute of Public Health. Austria: Federal Ministry of Labor, Social Affairs, Health and Consumer Protection of Austria. Bulgaria: Ministry of Health, National Center of Public Health and Analyses, and WHO Regional Office for Europe. Bosnia and Herzegovina: WHO country office support for training and data management. Croatia: Ministry of Health, Croatian Institute of Public Health, and WHO Regional Office for Europe. Czechia: Ministry of Health of the Czech Republic, grant number 17-31670A and MZCR—RVO EU 00023761. Denmark: Danish Ministry of Health. Estonia: Ministry of Social Affairs, Ministry of Education and Research (IUT 42-2), WHO Country Office, and National Institute for Health Development. Finland: Finnish Institute for Health and Welfare. France: Santé publique France (the French Agency for Public Health). Georgia: WHO. Greece: International Hellenic University and Hellenic Medical Association for Obesity. Hungary: WHO Country Office for Hungary. Ireland: Health Service Executive. Italy: Ministry of Health. Kazakhstan: Ministry of Health of the Republic of Kazakhstan, WHO, and UNICEF. Kyrgyzstan: World Health Organization. Latvia: Ministry of Health and Centre for Disease Prevention and Control. Lithuania: Science Foundation of Lithuanian University of Health Sciences and Lithuanian Science Council and WHO. Malta: Ministry of Health. Montenegro: WHO and Institute of Public Health of Montenegro. North Macedonia: Government of North Macedonia through National Annual Program of Public Health and implemented by the Institute of Public Health and Centers of Public Health; WHO country office provides support for training and data management. Norway: the Norwegian Ministry of Health and Care Services, the Norwegian Directorate of Health, and the Norwegian Institute of Public Health. Poland: National Health Programme, Ministry of Health. Portugal: Ministry of Health Institutions, the National Institute of Health, Directorate General of Health, Regional Health Directorates, and the kind technical support from the Center for Studies and Research on Social Dynamics and Health (CEIDSS). Romania: Ministry of Health. Russian Federation: WHO. San Marino: Health Ministry, Educational Ministry, and Social Security Institute and Health Authority. Serbia: WHO and the WHO Country Office (2015-540940 and 2018/873491-0). Slovakia: Biennial Collaborative Agreement between WHO Regional Office for Europe and Ministry of Health SR. Slovenia: Ministry of Education, Science and Sport of the Republic of Slovenia within the SLOfit surveillance system. Spain: Spanish Agency for Food Safety and Nutrition. Sweden: Public Health Agency of Sweden. Tajikistan: WHO Country Office in Tajikistan and Ministry of Health and Social Protection. Turkmenistan: WHO Country Office in Turkmenistan and Ministry of Health. Turkey: Turkish Ministry of Health and World Bank.info:eu-repo/semantics/publishedVersio

Thinness, overweight, and obesity in 6‐ to 9‐year‐old children from 36 countries: The World Health Organization European Childhood Obesity Surveillance Initiative - COSI 2015-2017

In 2015-2017, the fourth round of the World Health Organization (WHO) European Childhood Obesity Surveillance Initiative (COSI) was conducted in 36 countries. National representative samples of children aged 6–9 (203,323) were measured by trained staff, with similar equipment and using a standardized protocol. This paper assesses the children's body weight status and compares the burden of childhood overweight, obesity, and thinness in Northern, Eastern, and Southern Europe and Central Asia. The results show great geographic variability in height, weight, and body mass index. On average, the children of Northern Europe were the tallest, those of Southern Europe the heaviest, and the children living in Central Asia the lightest and the shortest. Overall, 28.7% of boys and 26.5% of girls were overweight (including obesity) and 2.5% and 1.9%, respectively, were thin according to the WHO definitions. The prevalence of obesity varied from 1.8% of boys and 1.1% of girls in Tajikistan to 21.5% and 19.2%, respectively, in Cyprus, and tended to be higher for boys than for girls. Levels of thinness, stunting, and underweight were relatively low, except in Eastern Europe (for thinness) and in Central Asia. Despite the efforts to halt it, unhealthy weight status is still an important problem in the WHO European Region.The authors gratefully acknowledge support from a grant from the Russian Government in the context of the WHO European Office for the Prevention and Control of NCDs. Data collection in the countries was made possible through funding from the following: Albania: WHO through the Joint Programme on Children, Food Security and Nutrition “Reducing Malnutrition in Children,” funded by the Millennium Development Goals Achievement Fund, and the Institute of Public Health; Austria: Federal Ministry of Social Affairs, Health, Care and Consumer Protection, Republic of Austria; Bulgaria: Ministry of Health, National Center of Public Health and Analyses, WHO Regional Office for Europe; Croatia: Ministry of Health, Croatian Institute of Public Health and WHO Regional Office for Europe; Czechia: Ministry of Health of the Czech Republic, grants AZV MZČR 17-31670 A and MZČR – RVO EÚ 00023761; Cyprus: not available; Denmark: Danish Ministry of Health; Estonia: Ministry of Social Affairs, Ministry of Education and Research (IUT 42-2), WHO Country Office, and National Institute for Health Development; Finland: Finnish Institute for Health and Welfare; France: Santé publique France, the French Agency for Public Health; Georgia: WHO; Greece: International Hellenic University and Hellenic Medical Association for Obesity; Hungary: WHO Country Office for Hungary; Ireland: Health Service Executive; Italy: Ministry of Health and Italian National Institute of Health; Kazakhstan: Ministry of Health of the Republic of Kazakhstan and WHO Country Office; Kyrgyzstan: World Health Organization; Latvia: Ministry of Health, Centre for Disease Prevention and Control; Lithuania: Science Foundation of Lithuanian University of Health Sciences and Lithuanian Science Council and WHO; Malta: Ministry of Health; Montenegro: WHO and Institute of Public Health of Montenegro; North Macedonia: funded by the Government of North Macedonia through National Annual Program of Public Health and implemented by the Institute of Public Health and Centers of Public Health in the country. WHO country office provided support for training and data management; Norway: Ministry of Health and Norwegian Institute of Public Health; Poland: National Health Programme, Ministry of Health; Portugal: Ministry of Health Institutions, the National Institute of Health, Directorate General of Health, Regional Health Directorates and the kind technical support from the Center for Studies and Research on Social Dynamics and Health (CEIDSS); Romania: Ministry of Health; Russian Federation: WHO; San Marino: Health Ministry, Educational Ministry, Social Security Institute and Health Authority; Serbia: World Health Organization (Ref. File 2015-540940); Slovakia: Biennial Collaborative Agreement between WHO Regional Office for Europe and Ministry of Health SR; Slovenia: Ministry of Education, Science and Sport of the Republic of Slovenia within the SLOfit surveillance system; Spain: Spanish Agency for Food Safety and Nutrition (AESAN); Sweden: Public Health Agency of Sweden; Tajikistan: WHO Country Office in Tajikistan and Ministry of Health and Social Protection; Turkmenistan: WHO Country Office in Turkmenistan and Ministry of Health; Turkey: Turkish Ministry of Health and World Bank.info:eu-repo/semantics/publishedVersio

Effect of different physiotherapy programs on patients’ functional state treating lumbar disc herniation

Research object: the changes patients’ functional state when applying different physiotherapy programs in cases of lumbar disc herniation. Research aim: to evaluate the influence of different physiotherapy programs on patients’ functional state after intervertebral disc herniation. Research tasks: 1. Assess the participants’ of different group’s elevation angle of straight leg, at the point of which the pain is suffered, endurance of abdominal and spinal muscles before and after physiotherapy. 2. Assess the participants’ of different group’s low back pain, degree of disability and life quality before and after physiotherapy. 3. Compare effect of different physiotherapy programs when treating lumbar intervertebral disc herniation. The research was carried out in 2008-2009 at JSC “Palangos linas” hotel – rehabilitation center. 40 (19 men and 21 women) participants took part in research. Participants were divided into 2 groups: 1st group (n=20) patients, they received 20 IDD therapy procedures. 2nd group (n=20) ambulant rehabilitation patients, they received 10 physiotherapy procedures in a vertical bath. The participants were tested before and after the physiotherapy procedures . Methods: Straight leg raise test, pain evaluation, Oswestry disability index, endurance test of spinal muscles, endurance test of abdominal muscles, SF – 36 questionnaire. Conclusions: 1. After applying intervertebral differential dynamics therapy and physiotherapy in a vertical bath, straight leg elevation angle and endurance of abdominal and back muscles increased statistically significant (p0.05)

The Associations between body mass index of seven- and eight-year-old children, dietary behaviour and nutrition-related parenting practices

Background and objective: Body mass index (BMI) is one of the key indicators used to measure the growth of children. It could be affected by the children’s nutrition, which is essential for the proper development of the child. Nutrition of children could be affected by many environmental factors, for example, the socioeconomic environment of the family. The aim of this study was to identify the associations between the BMI of seven- and eight-year-old children, dietary behaviour and nutrition-related parenting practices. Materials and Methods: The study was carried out as part of theWorld Health Organization European Childhood Obesity Surveillance Initiative (WHO COSI). Data were collected using two instruments: objective anthropometric measurements and a questionnaire. The target participant group was 3969 Lithuanian first-formers. Factor analysis was used to summarise questions from the family form. Linear regression analysis was used to identify the associations between various factors and the BMI value of the children. The association between two groups of factors was analysed using Spearman correlation. Results: Factors of dietary behaviour like unhealthy food and proteins were significantly positively associated with BMI in children, while consumption of plant-based, dairy and confectionery items was significantly negatively associated with BMI. Factors of nutrition-related parenting practices like control of unhealthy food, food as a reward or punishment, and mealtime were significantly positively associated with BMI, while encouragement, pressure to eat, and liberal attitude were significantly negatively associated with BMI. The strongest associations were between control of unhealthy food and unhealthy food; cost of and preferences for food and plant-based food; variety of food and proteins; variety of food and plant-based food compared to other associations. [...]

Associations between built environment and physical activity of 7–8-year-old children. Cross-sectional results from the Lithuanian COSI study

Background and aim: Research shows that regular engagement in physical activity in childhood is associated with multiple physical and psychosocial health benefits. The data on associations between children physical activity level and built environment in Lithuania are limited. The built environment is one of many variables thought to affect children physical activity level. But consequently there is growing interest in how physical environment influences physical activity of school age children. The aim of this paper is to evaluate associations between physical activity of primary school age children and built environment (road safety, travel distance, playgrounds, etc.) in Lithuania. Materials and methods: Data were obtained participating in the WHO European Childhood Obesity Surveillance Initiative (COSI). The study protocol was granted ethical approval from Lithuanian Bioethics Committee (No. 6B-10-02). Parents/guardians provided written informed consent. A cross-sectional study was carried out in 2013. A multilevel sampling method was employed for composing a national representative sample. The representing data were collected by means of standardized questionnaires, which were filled out by 3802 parents of the selected first-formers. Results: The mean age of the first-formers was 7.3 years (SD 0.5). More than half (62.2%) of parents stated that roads to schools were safe; most (78.7%) of adults notified that children had where to play and exercise in their living area. Place of residence of family and recreation areas in living environment were significant predictors of children\u27s daily physical activity and possibility to attend sport or dancing clubs.Conclusions: Results from the national survey of 7–8-year-old children of Lithuania reveal that urban living area of families, availability of playgrounds and recreational facilities were associated with higher possibilities of children to be sufficiently physically active

Associations between overweight and obesity of 7 years old children and their daily habits

Background and Aims Daily lifestyle habits of families depend on many factors: traditions, knowledge, attitudes towards health, financial possibilities, ability to choose, etc. Our aim was to evaluate associations between excess body weight of 7 years old children and their daily habits. Methods National Lithuanian children growth surveillance study was performed in 2013. The data were collected participating in the WHO European Childhood Obesity Surveillance Initiative. 4463 first formers were participating in this study. We analysed data collected form 3838 seven years old children. Data related to children habits were collected using questionnaires addressed to their parents. Anthropometric measurements were performed at schools using standardised procedures and equipment. BMI of children was classified using IOTF cut-offs. Associations were analysed using binary logistic regression. Results The prevalence of overweight was 12.3 % (n=475), obesity – 6.1 % (n=236). The odds ratio (OR) for being overweight or obese were higher for children who never (OR 1.879, CI 1.411- 2.502) or some days (OR 1.31, CI 1.05-1.635) had breakfast compared to those, who had breakfast every day. Playing computer 3 or more hours per day on weekends (OR 1.5, CI 1.06-2.143), being brought form school by car (OR 1.521, CI 1.048-2.208) and never eating fresh vegetables (OR 1.45, CI 1.063-1.976) were main predictors to be overweight or obese. Conclusions Obesity and overweight of children were related to modifieable daily habits of children. Obesity control interventions should be focused on changing daily lifestyle habits of families