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Background Parents are the primary providers of nurturing care for young children’s healthy early development. However, the literature on parenting in early childhood, especially in low- and middle-income countries, has primarily focused on mothers. In this study, we investigate how parents make meaning of fathers’ parenting roles with regards to their young children’s early health and development in rural Pakistan. Methods Data were collected between January and March 2017 through in-depth interviews with fathers ( N  = 33) and their partners ( N  = 32); as well as separate focus group discussions with fathers ( N  = 7) and mothers ( N  = 7). Data were analyzed using thematic content analysis. Results Parents described a distinct division of roles between fathers and mothers; and also several shared caregiving roles of fathers and mothers. Specifically, parents highlighted aspects of fathers’ coparenting and several common ways by which fathers supported their partners. We found that these gendered divisions in parenting roles were strongly embedded within a complex network of interacting factors across the individual, family, and sociocultural contexts of the study community. Conclusions Our findings suggest a more family-centered conceptualization of fatherhood during early childhood that encompasses both fathers’ direct engagement with their young children and their indirect contributions through coparenting, while recognizing a variety of contextual systems that shape paternal parenting. Future parenting interventions that reflect the lived experiences of both fathers and mothers as parents and partners may further enhance the nurturing care environments that are critical for promoting healthy early child development.

Household food insecurity (HFI) remains a challenge globally and is recognized as a risk factor for poor child nutritional outcomes for infants and young children. However, few studies have evaluated the associations of HFI with the growth and development of preschool children. This study assessed the association of HFI with growth and development outcomes among preschool‐aged children in rural Pakistan and explored potential differences in the magnitude of the associations by child gender and early childhood care and education (ECCE) intervention. Anthropometric and child development data from 2795 children aged 4.5–5.5 years enroled in a cluster‐randomized stepped‐wedge trial of the Youth Leaders for Early Childhood Assuring Children are Prepared for School intervention were collected across four districts in rural Sindh. HFI was assessed using the Household Food Insecurity Access Scale, and child development was measured by the International Development and Early Learning Assessment (IDELA) and a battery of executive functions tasks. Multilevel mixed‐effects models were utilized to investigate the associations between HFI and height‐for‐age (HAZ), weight‐for‐age (WAZ), BMI‐for‐age z scores and child development scores. Increasing levels of HFI were associated with lower child WAZ, lower total IDELA scores and lower emergent literacy scores (p values for trend < 0.05). No significant association was observed between HFI and executive functioning. Gender and ECCE intervention status did not modify the relationship between HFI and child growth and development outcomes (p > 0.05). Future research should investigate the synergistic potential of nutrition and ECCE programmes to improve outcomes for children and families in rural Pakistan and similar resource‐scarce settings. The trial is registered with ClinicalTrials.gov (NCT03764436). Summary Household food insecurity (HFI) in rural Pakistan was significantly associated with lower height‐for‐age and weight‐for‐age z scores among preschool‐aged children. HFI was also found to be associated with lower total school readiness scores and emergent literacy scores. The potential role of early childhood care and education programmes providing nutrition supplementation should be explored in food‐insecure settings.

Research has demonstrated the critical role that early learning experiences play in shaping children's cognitive, social, and emotional development. Nevertheless, tools for assessing children's exposure to early learning experiences remain scarce. This paper describes the initial validation of the Early Learning (EL) tool, which captures the levels of stimulation with playthings and people available to children 0-3-year-old in low-resource, international settings. We randomly sampled 200 mothers of children under 3-year-old in rural Sindh, Pakistan. We collected data on sociodemographic information, early learning, responsive caregiving, and child development. Psychometric analyses assessing the structural validity with confirmatory factor analysis and item response theory, criterion validity with Pearson correlation coefficients, and predictive validity with Ordinary Least Squares linear regression were conducted. We found that the EL tool is valid in this setting, capturing two factors of early learning: stimulation with playthings and stimulation with people. Stimulation with playthings and people were strongly and positively correlated with responsive caregiving, maternal education, and wealth, indicating criterion validity. Stimulation with playthings and people were also strongly associated with child development, measured by the Bayleys Scales of Infant Development. The EL tool is a promising instrument for measuring early learning in low- and middle-income countries, and its use can lead to more effective and inclusive monitoring and development of early learning initiatives.

After publication of the original article [1], the authors wanted to make an amendment in the Acknowledgments section as Muneera Rasheed requested to be removed. This correction article shows the original and revised version of the \"Acknowledgments\". The original article was not updated.

This study examined whether child diet and mother–child interactions mediated the effects of a responsive stimulation and nutrition intervention delivered from 2009 to 2012 to 1324 children aged 0–24 months living in rural Pakistan. Results showed that the intervention improved children's cognitive, language and motor development through child diet and mother–child interactions. Although the intervention did not improve child growth or socio‐emotional development, we observed positive indirect effects on child growth via child diet and on socio‐emotional development via both child diet and mother–child interactions. In addition, child diet emerged as a shared mechanism to improve both child growth and development, whereas mother–child interactions emerged as a distinct mechanism to improve child development. Nevertheless, our results suggest the two mechanisms were mutually reinforcing and that interventions leveraging both mechanisms are likely to be more effective at improving child outcomes than interventions leveraging only one of these mechanisms. The contents of this page will be used as part of the graphical of html only. It will not be published as part of main article. A responsive stimulation and nutrition intervention delivered to children 0–24 months of age in rural Pakistan improved children's cognitive, language and motor development throug child diet and mother‐child interactions. Although the intervention did not improve child growth or socio‐emotional development, we observed positive indirect effects on child growth via child diet and on socio‐emotional development via both child diet and mother‐child interactions. Interventions leveraging both mechanisms are likely to be more effective at improving child outcomes than interventions leveraging only one of these mechanisms. Key messages A responsive stimulation and nutrition intervention delivered to young children from birth to 24 months of age in rural Pakistan improved child cognitive, language, and motor development at 24 months, but not child growth or socio‐emotional development. Child diet and mother–child interactions mediated intervention effects on child cognitive, language and motor development. Although we found no total intervention effects on child growth and socio‐emotional development, we observed positive indirect effects on socio‐emotional development through both child diet and mother–child interactions, and positive indirect effects on child growth through child diet. Leveraging both child diet and mother–child interactions as mechanisms may help enhance intervention effects on child outcomes.

Background The Sustainable Development Goals (SDGs) highlight the importance of investments in early childhood care and education (ECCE) and youth development. Given Pakistan’s large young population, and gender and urban-rural inequalities in access to education, training, and employment, such investments offer opportunities. LEAPS is a youth-led ECCE program that trains female youth, 18–24 years, as Community Youth Leaders (CYLs) to deliver high-quality ECCE for children, 3.5–5.5 years, in rural Sindh, Pakistan. Methods We use a stepped wedge cluster-randomized trial to evaluate implementation of LEAPS. Ninety-nine clusters will be randomized to receive the intervention in one of three 7-month steps (33 clusters/step). The primary outcome is children’s school readiness (indexed by the total score on the International Development and Early Learning Assessment (IDELA)). Secondary child outcomes are children’s IDELA domain scores and executive functions. Data are collected in cross-sectional surveys of 1089 children (11 children/cluster from 99 clusters) aged 4.5–5.5 years at four timepoints (baseline and at the end of each step). Additionally, we will enroll three non-randomized youth participant open cohorts, one per step (33 CYLs: 66 comparison youth per cohort; 99:198 in total). Youth cohorts will be assessed at enrollment and every 7 months thereafter to measure secondary outcomes of youth personal and professional development, depressive symptoms, and executive functions. A non-randomized school cohort of 330 LEAPS students (10 students/cluster from 33 clusters) will also be enrolled and assessed during Step 1 after intervention rollout and at endline. The quality of the learning environment will be assessed in each LEAPS ECCE center and in a comparison center at two timepoints midway following rollout and at endline. A concurrent mixed-methods implementation evaluation will assess program fidelity and quality, and the extent to which a technical support strategy is successful in strengthening systems for program expansion. A cost evaluation will assess cost per beneficiary. Data collection for implementation and cost evaluations will occur in Step 3. Discussion Youth-led models for ECCE offer a promising approach to support young children and youth. This study will contribute to the evidence as a means to promote sustainable human development across multiple SDG targets. Trial registration ClinicalTrials.gov NCT03764436. Registered on December 5, 2018.

This study examined whether child diet and mother–child interactions mediated the effects of a responsive stimulation and nutrition intervention delivered from 2009 to 2012 to 1324 children aged 0–24 months living in rural Pakistan. Results showed that the intervention improved children's cognitive, language and motor development through child diet and mother–child interactions. Although the intervention did not improve child growth or socio-emotional development, we observed positive indirect effects on child growth via child diet and on socio-emotional development via both child diet and mother–child interactions. In addition, child diet emerged as a shared mechanism to improve both child growth and development, whereas mother–child interactions emerged as a distinct mechanism to improve child development. Nevertheless, our results suggest the two mechanisms were mutually reinforcing and that interventions leveraging both mechanisms are likely to be more effective at improving child outcomes than interventions leveraging only one of these mechanisms.

The effect of community‐based multi‐input interventions that promote health, nutrition, and development on childhood infections, and the pathways that explain these effects remain unclear. We conducted a secondary analysis of a factorial‐designed clustered randomized controlled trial (N = 1489) conducted in rural Pakistan to estimate the effects of responsive stimulation and enhanced nutrition (responsive feeding and multiple micronutrient powders (MNPs)) interventions on diarrhoea, fever, and acute respiratory infection (ARI) among children under 2 years using Poisson regression models. We used a counterfactual framework and weighting‐based approach to conduct mediation analyses through diet and care‐related factors. The responsive stimulation intervention reduced diarrhoea between 12 and 24 months of age (rate ratio (RR): 0.87; 95% CI: 0.77, 0.97), fever from 6 to 24 months (RR: 0.80; 95% CI: 0.73, 0.88), and ARI from 6 to 24 months (RR: 0.91; 95% CI: 0.83, 0.99). In contrast, enhanced nutrition increased rates of fever from 6 to 24 months (RR: 1.34; 95% CI: 1.22, 1.48). Reductions in maternal depressive symptoms partially mediated the positive effects of responsive stimulation on diarrhoea, fever, and ARI between 6 and 24 months (54.7%, 15.6%, and 49.1% mediated, respectively) and also provided positive indirect effects for the enhanced nutrition intervention on these outcomes. Improvements in meal frequency contributed to reductions in child diarrhoea for both interventions. Responsive stimulation and enhanced nutrition had contrasting effects on childhood infections, but both interventions improved diet and care‐related mediators that contributed positive indirect effects. The provision of iron‐containing MNPs may explain the overall negative effect of the enhanced nutrition package on fever. Trial Registration: Clinicaltrials.gov identifier: NCT007159636. Evidence on the effects of community‐based parenting and nutrition interventions on childhood infections and their underlying pathways is limited. We evaluated these effects in a cluster‐randomized trial in rural Pakistan, examining mediation through diet and care‐related factors. The responsive stimulation intervention reduced rates of diarrhea, fever, and acute respiratory illness, while the nutrition intervention, including provision of iron‐containing multiple micronutrient powders, increased fever. Both interventions improved diet and care‐related mediators that contributed to reductions of childhood infections, though no measured mediators explained the negative effect of nutrition packages on child fever. Strengthening inputs that support child diet and care may enhance the impact of community‐based parenting and nutrition interventions on childhood infections.

Arsenic is a toxic element and is found in natural waters throughout the globe. The purpose of present study is to demonstrate the As (V) uptake by orange peel from real ground water samples through adsorption. Different parameters such as pH, shaking speed, contact time, adsorbent dosage, concentration, volume and temperature etc, were optimized. The maximum uptake capacity was observed at pH-7. The sorption was found to be time dependent and the kinetics followed well by the Morris-weber, Pseudo second order and Elovich equations. The Freundlich, Langmuir, Dubinin Redushkevich and Flory–Huggins isotherm were used to model the adsorption behavior of arsenic retention. Thermodynamic parameters calculated from these isotherms show that the adsorption was spontaneous and endothermic in nature. Orange peel was found to be effective (~85%) for arsenic removal from real water systems containing concomitant ions.

The research studies on heritability estimates were conducted to evaluate the performance of grain yield and various yield components of six F4 segregating population originated from four parental varieties of bread wheat. The experiment was conducted in Randomized Complete Block Design with 3 replications. The results for six F4 segregating populations and their four parental wheat varieties for the traits revealed highly significant differences at P^0.01 and P< 0.05 level of probability. Different progenies showed different response for different traits. The progeny Sarsabaz x Bhittai took significantly more days to 75% maturity (128.3), more spike length (14.0 cm) and more spikelets spike-1 (21.6). Progeny Sarsabz x FD-83 showed significant increase in grain yield plant-1 (29.0g), 1000-grain weight (48.0 g) and tillers plant-1 (13.67) as compared to other progenies and the parental lines. The parent varieties Sarsabaz and Bhittai showed good performance with respect to number of tillers plant-1 (15.33) and spikelets spike-1(24.3). The progeny FD-83 x Bhittai revealed significant in number of grain spike-1 (56.7) and biological yield kg ha-1 (22960) as compared to their respective parental lines. Two progenies Nesser x Bhittai and Nesser x FD83 showed the highest heritability coupled with more genetic advance (GA) for most of the traits measured i.e., days to 75% maturity, spike length, grains spike-1 and grain yield plant-1. Four progenies viz., Sarsabaz x Bhittai, FD-83 x Bhittai, Sarsabz x FD-83 and Nesser x Sarsabz showed better performance highest heritability associated with high genetic advance for other characters tillers plant-1, spikelets spike-1,1000-grain weight and biological yield kg ha-1. These results suggest that more effective selection could be obtained from these segregating populations for specific traits originated after these combinations.