Incidence In Children Research Articles

State-Level Indicators of Childhood Educational Quality and Incident Dementia in Older Black and White Adults

Higher educational attainment is associated with reduced dementia risk, but the role of educational quality is understudied, presenting a major evidence gap, especially as it may contribute to racial inequities. To evaluate the association between state-level educational quality during childhood and dementia risk. This cohort study analyzed longitudinal data collected from January 1, 1997, through December 31, 2019 (23-year follow-up period). The sample comprised members of Kaiser Permanente Northern California (KPNC), a large integrated health care delivery system, who completed an optional survey during 1964-1972. Eligible individuals were US born; non-Hispanic Black or non-Hispanic White; aged 65 years or older as of January 1, 1996; were still alive; and did not have a dementia diagnosis or lapse in KPNC membership greater than 90 days between January 1 and December 31, 1996. Historical state-level administrative indicators of school quality (school term length, student-teacher ratio, and attendance rates) linked to participants using birth state and birth year (with a 6-year lag) and divided into tertiles using the pooled sample. Dementia diagnoses from electronic health records between 1997 and 2019 were analyzed between March 1 and August 31, 2022. The associations of educational quality with incident dementia were estimated using Cox proportional hazards regression models. Among 21 450 KPNC members who participated in the optional survey, individuals born before availability of educational quality records (n = 87) and missing educational attainment (n = 585) were excluded. The final analytic sample was 20 778 individuals (56.5% women, 43.5% men; mean [SD] age, 74.7 [6.5] years; 18.8% Black; 81.2% White; 41.0% with less than high school education). Among Black individuals, 76.2% to 86.1% (vs 20.8%-23.3% of White individuals) attended schools in states in the lowest educational quality tertiles. Highest (vs lowest) educational quality tertiles were associated with lower dementia risk (student-teacher ratio: hazard ratio [HR], 0.88 [95% CI, 0.83-0.94]; attendance rates: HR, 0.80 [95% CI, 0.73-0.88]; term length: HR, 0.79 [95% CI, 0.73-0.86]). Effect estimates did not differ by race and were not attenuated by adjustment for educational attainment. In this cohort study, lower state-average educational quality was more common among Black individuals and associated with higher dementia risk. Differential investment in high-quality education due to structural racism may contribute to dementia disparities.

The Relationship between Family Smoking Habits and Tuberculosis Incidence in Children Aged 3-6 Years in Bandung Regency

Childhood tuberculosis in Indonesia is the third most common in the world, in 2020 the number of new child Tuberculosis cases decreased by 32.4%, this is still far from the government's target in 2024, which is 90%. Bandung Regency has 62 health centers, the highest number of child TB cases is at the Linggar Health Center, namely 42 children with Tuberculosis due to family factors that have smoking habits. The aim of the study was to determine the relationship between family smoking habits and the incidence of Tuberculosis in children aged 3–6 years in the Working Area of the Linggar Health Center. This type of research uses casecontrol with a population of 60 families with children aged 3-6 years. The sampling technique used purposive sampling, the sample is 60 families. Data collection using the Riskesdas 2018 questionnaire. Data analysis used univariate and bivariate analysis. The results of the study most of the cases (76.7%) were smokers while the controls (60%) were non-smokers. Family smoking status (P-value 0.004), type of white cigarette (P-value 0.002), number of cigarettes <12 cigarettes (P-value 0.006), duration of smoking > 19 minutes (P-value 0.000), and smoking in the house (P- value 0.001) has a relationship with TB in children. Of the five, smoking duration >19 minutes is the riskiest for TB in children (OR 19,286) because the longer the duration of family smoking, the more influential it is on the incidence of tuberculosis in children aged 3-6 years considering the content of smoking can reduce children's immunity. The conclusion of the study is that there is a relationship between family smoking habits and TB in children aged 3-6 years in the Working Area of the Linggar Health Center.

Bronchiectasis Among Adult First Nations Indigenous People - A Scoping Review

Background: Among First Nations adults living in OECD nations bronchiectasis appears at a particularly heightened rate, due to high childhood incidence, and high prevalence of associated risk factors. To date, however, the extent of the bronchiectasis disease burden among adult First Na-tions people has not been formally assessed. Methods: Two databases (Pubmed and Scopus) were reviewed for English literature published from January 2000 to March 2022 pertaining to bronchiectasis among adult First Nations indigenous people residing in OECD nations. All studies that reported on prevalence, incidence, or outcomes (i.e., hospitalisations, mortality) directly associated with bronchiectasis were included. Studies that did not provide indigenous specific, bronchiectasis specific data, or were paediatric studies were ex-cluded. Participant numbers and demographics, bronchiectasis prevalence or incidence, respiratory comorbidities and outcomes including mortality, hospitalisations or univariate or multivariate mod-elling to describe the risk of bronchiectasis and outcomes were tabulated. Results: Twenty-five studies were included, drawn from Australia (n=16), New Zealand (n=7) and North America (n=1), with most studies (n=21) reporting on referred populations. A median num-ber of participants was 241 (range 31 to 1765) (excluding nationwide hospitalisation datasets (n=3)) with a mean age of 48.4 years, and 55% females. The hospital admission rate for bronchiectasis was 3.5x to 5x higher among Māori compared to non-Māori New Zealanders, and 5x higher in indige-nous compared to non-indigenous Australians. Mortality ranged from 10 to 56% on follow-up. Conclusion: Bronchiectasis disease burden is higher among adult First Nations indigenous popula-tions, presenting earlier with high mortality and hospitalisation rate. Further studies are required to address this inequality.

Mobile Source Benzene Regulations and Risk of Childhood and Young Adult Hematologic Cancers in Alaska: A Quasi-experimental Study.

We aimed to evaluate the impact of the EPA's Mobile Source Air Toxics rules (MSAT), which targeted benzene emissions, on childhood and young adult leukemia and lymphoma incidence in Alaska. MSAT was implemented in 2011 and produced a dramatic decline in ambient benzene in Alaska. Due to previous benzene-related regulations enacted in the continental United States, MSAT had relatively modest impacts in other states. This created quasi-experimental conditions leveraged in this study. Using 2-year state-level incidence rates of childhood and young adult leukemia and lymphoma for each US state 2001-2018, we examined MSAT-attributable changes in incidence by applying a difference-in-differences approach. We found evidence of a substantial reduction associated with MSAT in incidence of childhood and young adult lymphoma (-1.23 [-1.84, -0.62] cases per 100,000), but not in leukemia (-0.13 [-0.77, 0.51] cases per 100,000). Our findings are consistent with the hypothesis that MSAT, which reduced benzene levels in Alaska, led to a decline in lymphoma incidence in children and young adults.

The Correlation between Knowledge, Attitude, and Behavior of Responsive Feeding on Stunting Incidents in Children in Karangploso Health Center, Malang Regency, Indonesia

Nationally, the prevalence of stunting decreased by 1.6% from 27.7% in 2019 to 24.4% in 2021. However, this figure is far from RPJMN 2020-2024 target of 14%. One of the sub-districts in Malang Regency with an increasing prevalence of stunting based on the Bulan Timbang on August 2021 and February 2022 is Karangploso Sub-district, which was 5.2% in August 2021 and 6.6% in February 2022. Seeing this increasing prevalence of stunting, it’s necessary to know determinants of stunting, one of which is responsive feeding. This study aims to determine the relationship between knowledge, attitudes, and responsive feeding behavior on the incidence of stunting on children in Karangploso Health Center working area. The case control approach was chosen as the research design in this observational analytic study with a sample of 30 stunted respondents and 30 non-stunted respondents who were caregivers of 12-24 month old children. Based on chi-square test, the knowledge and attitude of responsive feeding of caregivers and stunting of children in the working area of Karangploso Health Center have a relationship (p=0.001; OR=8.5) (p=0.012; OR=8.1), but responsive feeding behavior with stunting of children in the working area of Karangploso Health Center has no relationship (p=0.424).

Polymorphisms in TPT1 Pathways in Pediatric Astrocytomas.

Central nervous system tumors, especially astrocytomas, are the solid neoplasms with the highest incidence and mortality rates in childhood. The diagnosis is based on histopathological characteristics, but molecular methods have been increasingly used. Translationally controlled tumor protein (TCTP) protein, encoded by the tumor protein, translationally controlled 1 (TPT1) gene, is a multifunctional protein with an important physiological role in the cell cycle. Expression of this protein has been associated with several neoplasms, including astrocytomas in adults. However, the role of this protein in pediatric astrocytomas is largely unknown. We aim to evaluate in cases of pediatric astrocytomas, the frequency of polymorphisms in the TPT1 gene and other genes associated with its molecular pathways, such as MTOR, MDM2, TP53, and CDKN1A, correlating it with protein expression and clinical variables, in formalin-fixed, paraffin-embedded (FFPE) samples. These samples were submitted to genotyping and immunohistochemistry analyses. The most revealing results refer to the MDM2 gene, rs117039649 [G/C], in which C polymorphic allele was observed only in the glioblastomas (p = .028). The CDKN1A gene, rs3176334 [T/C] presented a homozygous polymorphic genotype only in high-grade astrocytomas, when infiltrating tumors were compared (p = .039). The immunohistochemical expression of cytoplasmic MDM2 correlated with better survival rates in patients with glioblastoma (p = .018). The presence of polymorphisms in the MDM2 and CDKN1A genes, as well as a specific correlation between MDM2 expression, suggests a likely association with risk in pediatric astrocytomas. This study sought the probable role involved in the TCTP pathway, and associated proteins, in the tumorigenesis of pediatric astrocytomas, and some could have potential impact as prognostic markers in these patients.

Novel PGM3 mutation in two siblings with combined immunodeficiency and childhood bullous pemphigoid: a case report and review of the literature

BackgroundBullous pemphigoid is the most common autoimmune subepidermal blistering disorder with a low incidence in childhood. Combined immunodeficiencies (CIDs) are a group of monogenic inborn errors of immunity (IEIs) characterized by T- and B-cell dysfunction leading to recurrent infections, lymphoproliferation, predisposition to malignancy, and autoimmunity. Here, we report two Afghan siblings with a diagnosis of CID and extremely rare manifestation of diffuse bullous pemphigoid skin lesions.Case presentationThe older sibling (patient 1) was a 32-month-old male with facial dysmorphism, protracted diarrhea, failure to thrive, recurrent oral candidiasis, recurrent otitis media with tympanic membrane perforation, who had been previously diagnosed with CID. While he was under treatment with intravenous immunoglobulin (IVIg), he developed extensive blistering lesions, which were diagnosed as childhood bullous pemphigoid. Methylprednisolone and azathioprine were added to the regimen, which resulted in a remarkable improvement of the skin lesions and also the feeding condition. However,2 weeks later, he was re-admitted to the intensive care unit (ICU) and eventually died due to fulminant sepsis. Later, his 12-month-old sister (patient 2) with similar facial dysmorphism and a history of developmental delay, food allergy, recurrent oral candidiasis, and respiratory tract infections also developed blistering skin lesions. She was under treatment for occasional eczematous lesions, and had been receiving IVIg for 3 months due to low levels of immunoglobulins. Further immunologic workup showed an underlying CID and thus treatment with IVIg continued, gradually improving her clinical condition. The genetic study of both siblings revealed a novel homozygous mutation in exon 7 of the PGM3 gene, c.845 T > C (p.Val282Ala).ConclusionsDermatologic disorders may be the presenting sign in patients with CID and mutated PGM3. This case report further extends the spectrum of skin manifestations that could be observed in PGM3 deficiency and emphasizes the importance of considering CIDs during the assessment of skin disorders, particularly if they are extensive, recurrent, refractory to treatment, and/or associated with other signs of IEIs.

The Determinants of Stunting Incidence in Children Aged 24-59 Months

Majene Regency has the second highest prevalence of stunting in West Sulawesi by having the highest number of cases found in the village of Rangas. Due to these reasons, it is necessary to research the determinants of stunting, so the studies are expected to provide input to the Majene district government in conducting interventions related to stunting. A case-control study design was used. The subjects were the children aged 12-59 months who lived in the Rangas Village which the children under five years diagnosed stunting based on measurements from the Nutrition Executors (NE) of the Public Health Center. Meanwhile, the controls were children under five years who had not been diagnosed stunting based on measurements from the Nutrition Executors (NE) of the Public Health Center. The samples were 72 respondents with a ratio of 1:1, and the under-five children's mothers as the research respondents. Purposive sampling was used. The stunting data was obtained from the health office, while the identity of the respondents, the characteristics of the mothers, and the characteristics of the children under five years were carried out directly by interview using a questionnaire and strengthened by Mother and Child Health (MCH) Book. Data analysis used the chi-Square test and multiple logistic regression tests. Multivariate analysis results showed that the incidence of stunting was influenced by several factors, including parity (OR=30.40; 95%CI: 3.86-239.43), Maternal Mid-Upper Arm Circumference (MUAC) history < 23.5 cm during pregnancy (OR=2.41; 95%CI: 1.04-5.56) and not exclusive breastfeeding (OR=3.21; 95%CI: 1.29-7.94). The conclusion of this study is parity, a history of maternal MUAC during pregnancy, and not exclusive breastfeeding are risk factors for stunting in children under five years in Banggai District. Therefore, it is necessary to improvement of health promotion strategy for pregnant women by maximizing the first 1000 days of life and campaign two healthy children needs to be maximized.

Childhood asthma is associated with development of type 1 diabetes and inflammatory bowel diseases: a Danish nationwide registry study

Asthma and autoimmune disorders might be affected by opposing immune mechanisms, T helper cells type 2 (Th2) and T helper cells type 1 (Th1) immunity, respectively. Knowledge on comorbidity can increase understanding of the underlying etiologies. We aim to examine the association between childhood asthma and subsequent risk of type 1 diabetes (T1D) and inflammatory bowel diseases (IBD) in Danish children. Children of Danish origin born during 1991–1996 were included and childhood asthma, defined as a minimum of two collected prescriptions of inhalation corticosteroids age 5–7 years, was linked to hospitalisations with either T1D or IBD after age 8. Associations between childhood asthma and incidence of T1D and IBD were analysed using sex- and year stratified Cox regression. A total of 366,200 children were included in the study, 4.9% had asthma, which increased the risk of both T1D and IBD, hazard ratios of 1.32 (1.08–1.61) and 1.27 (1.09–1.48). In this large nationwide Danish study, we found that children with asthma have increased risk of developing immune diseases T1D and IBD. This contradicts the Th1 vs Th2 paradigm and points towards shared disease mechanisms and risk factors.

Estimating the total incidence of type 1 diabetes in children and adolescents aged 0–19 years from 1990 to 2050: a global simulation-based analysis

Previous studies of type 1 diabetes in childhood and adolescence have found large variations in reported incidence around the world. However, it is unclear whether these reported incidence levels are impacted by differences in country health systems and possible underdiagnosis and if so, to what degree. The aim of this study was to estimate both the total and diagnosed incidence of type 1 diabetes globally and to project childhood type 1 diabetes incidence indicators from 1990 to 2050 for each country. We developed the type 1 diabetes global microsimulation model to simulate the natural history and diagnosis of type 1 diabetes for children and adolescents (aged 0-19 years) in 200 countries and territories, accounting for variability in underlying incidence and health system performance. The model follows an open population of children and adolescents in monthly intervals and simulates type 1 diabetes incidence and progression, as well as health system factors which influence diagnosis. We calibrated the model to published data on type 1 diabetes incidence, autoantibody profiles, and proportion of cases diagnosed with diabetic ketoacidosis from 1990 to 2020 and assessed the predictive accuracy using a randomly sampled test set of data withheld from calibration. We estimate that in 2021 there were 355 900 (95% UI 334 200-377 300) total new cases of type 1 diabetes globally among children and adolescents, of which 56% (200 400 cases, 95% UI 180 600-219 500) were diagnosed. Estimated underdiagnosis varies substantially by region, with over 95% of new cases diagnosed in Australia and New Zealand, western and northern Europe, and North America, but less than 35% of new cases diagnosed in west Africa, south and southeastern Asia, and Melanesia. The total number of incident childhood cases of type 1 diabetes is projected to increase to 476 700 (95% UI 449 500-504 300) in 2050. Our research indicates that the total global incidence of childhood and adolescent type 1 diabetes is larger than previously estimated, with nearly one-in-two children currently undiagnosed. Policymakers should plan for adequate diagnostic and medical capacity to improve timely type 1 diabetes detection and treatment, particularly as incidence is projected to increase worldwide, with highest numbers of new cases in Africa. Novo Nordisk.

Amino acid metabolism in primary bone sarcomas.

Primary bone sarcomas, including osteosarcoma (OS) and Ewing sarcoma (ES), are aggressive tumors with peak incidence in childhood and adolescence. The intense standard treatment for these patients consists of combined surgery and/or radiation and maximal doses of chemotherapy; a regimen that has not seen improvement in decades. Like other tumor types, ES and OS are characterized by dysregulated cellular metabolism and a rewiring of metabolic pathways to support the biosynthetic demands of malignant growth. Not only are cancer cells characterized by Warburg metabolism, or aerobic glycolysis, but emerging work has revealed a dependence on amino acid metabolism. Aside from incorporation into proteins, amino acids serve critical functions in redox balance, energy homeostasis, and epigenetic maintenance. In this review, we summarize current studies describing the amino acid metabolic requirements of primary bone sarcomas, focusing on OS and ES, and compare these dependencies in the normal bone and malignant tumor contexts. We also examine insights that can be gleaned from other cancers to better understand differential metabolic susceptibilities between primary and metastatic tumor microenvironments. Lastly, we discuss potential metabolic vulnerabilities that may be exploited therapeutically and provide better-targeted treatments to improve the current standard of care.

Socioeconomic inequalities in cancer incidence and access to health services among children and adolescents in China: a cross-sectional study

Despite the substantial burden caused by childhood cancer globally, childhood cancer incidence obtained in a nationwide childhood cancer registry and the accessibility of relevant health services are still unknown in China. We comprehensively assessed the most up-to-date cancer incidence in Chinese children and adolescents, nationally, regionally, and in specific population subgroups, and also examined the association between cancer incidence and socioeconomic inequality in access to health services. In this national cross-sectional study, we used data from the National Center for Pediatric Cancer Surveillance, the nationwide Hospital Quality Monitoring System, and public databases to cover 31 provinces, autonomous regions, and municipalities in mainland China. We estimated the incidence of cancer among children (aged 0-14 years) and adolescents (aged 15-19 years) in China through stratified proportional estimation. We classified regions by socioeconomic status using the human development index (HDI). Incidence rates of 12 main groups, 47 subgroups, and 81 subtypes of cancer were reported and compared by sex, age, and socioeconomic status, according to the third edition of the International Classification of Childhood Cancer. We also quantified the geographical and population density of paediatric oncologists, pathology workforce, diagnoses and treatment institutions of paediatric cancer, and paediatric beds. We used the Gini coefficient to assess equality in access to these four health service indicators. We also calculated the proportions of cross-regional patients among new cases in our surveillance system. We estimated the incidence of cancer among children (aged 0-14 years) and adolescents (aged 15-19 years) in China from Jan 1, 2018, to Dec 31, 2020. An estimated 121 145 cancer cases were diagnosed among children and adolescents in China between 2018 and 2020, with world standard age-standardised incidence rates of 122·86 (95% CI 121·70-124·02) per million for children and 137·64 (136·08-139·20) per million for adolescents. Boys had a higher incidence rate of childhood cancer (133·18 for boys vs 111·21 for girls per million) but a lower incidence of adolescent cancer (133·92 for boys vs 141·79 for girls per million) than girls. Leukaemias (42·33 per million) were the most common cancer group in children, whereas malignant epithelial tumours and melanomas (30·39 per million) surpassed leukaemias (30·08 per million) in adolescents as the cancer with the highest incidence. The overall incidence rates ranged from 101·60 (100·67-102·51) per million in very low HDI regions to 138·21 (137·14-139·29) per million in high HDI regions, indicating a significant positive association between the incidence of childhood and adolescent cancer and regional socioeconomic status (p<0·0001). The incidence in girls showed larger variation (48·45% from the lowest to the highest) than boys (36·71% from lowest to highest) in different socioeconomic regions. The population and geographical densities of most health services also showed a significant positive correlation with HDI levels. In particular, the geographical density distribution (Gini coefficients of 0·32-0·47) had higher inequalities than population density distribution (Gini coefficients of 0·05-0·19). The overall proportion of cross-regional patients of childhood and adolescent cancer was 22·16%, and the highest proportion occurred in retinoblastoma (56·54%) and in low HDI regions (35·14%). Our study showed that the burden of cancer in children and adolescents in China is much higher than previously nationally reported from 2000 to 2015. The distribution of the accessibility of health services, as a social determinant of health, might have a notable role in the socioeconomic inequalities in cancer incidence among Chinese children and adolescents. With regards to achieving the Sustainable Development Goals, policy approaches should prioritise increasing the accessibility of health services for early diagnosis to improve outcomes and subsequently reduce disease burdens, as well as narrowing the socioeconomic inequalities of childhood and adolescent cancer. National Major Science and Technology Projects of China, National Natural Science Foundation of China, Chinese Academy of Engineering Consulting Research Project, Wu Jieping Medical Foundation, Beijing Municipal Administration of Hospitals Incubating Program.

Analysis of Birth Weight and Birth Length with Stunting Incident in Children Aged 0-59 Months in Cinangka Depok

In Indonesia, the frequency of child stunting has remained high over the last decade, with an estimated 37 percent of children stunted at the national level. The prevalence of stunting in Depok accounted for 3.5% of the incidence of stunting, which means that as many as 3,675 of 105,127 children under five experienced stunting in Depok. Data from the Cinangka Primary Health Center, Depok, in 2022 showed 158 children experiencing stunting. This study aims to see whether there is a relationship between birth weight and body length with the frequency of stunting in children aged 0-59 months. With a cross-sectional study approach, primary data were obtained directly from 56 samples of children aged 0-59 months who were stunted by anthropometric examination and interviews with questionnaires. The analysis used Chi-Square statistical test. The result showed that the prevalence of stunting, low birth weight, and low birth length were 80.4%, 25%, and 48.2%. The study found no relationship between birth weight and birth length with the incidence of stunting in children aged 0 to 59 months at the Cinangka Primary Health Center, Depok. Stunting was caused by a complex set of circumstances that included not just the child's birth weight and length but also their nutritional intake, disease exposure, and therapy. The study's outcomes show that comprehensive treatments are needed to improve the stunting incidence in Cinangka Primary Health Center, Depok. Multilevel approaches should be used in interventions to address numerous elements at all levels, from the community to the individual

Multilevel Analysis of Determinants of Stunting Incidence in Children Under 5 Years in Malaka Regency, East Nusa Tenggara

Stunting is still a global nutritional problem. Stunting is a picture of the occurrence of chronic nutritional problems. Stunting caused by multiple factors, especially if it occurs in the first 1000 days of birth. Malaka Regency is one of the regions in NTT that recorded an increase in the percentage of stunting, from the previous 25% to 30% with the number of children experiencing stunting in Malaka currently reaching 4,909 people. With this number, Malaka is in 11th place with stunting in NTT (Malaka District Health Office, 2020). The purpose of the study was to determine the determinants of stunting in children under five in Malaka Regency. Research design. This research is analytic observational. This research is an observational analytic. The approach is case control and using a multilevel model which is one of the analytical techniques to determine the relationship between various variables in health with the Stata-13 program. This research was conducted by simple random sampling. The sampling technique used in this study. The sampling technique used in this study was stratified random sampling. The method used at the first level was to randomly select 10 villages in the district of Malaka, the second level to randomly select 25 integrated health care (IHC). Eight research subjects will be taken from each integrated service post so that the sample studied is 200 research subjects. Data was collected using a questionnaire and height measurement using a microtoise measuring instrument. The results of this study indicate that the factors causing stunting are exclusive breastfeeding (55.5%), Basic Sanitation (61.5%), Parenting (67.5%), and early marriage (32.0%). The results of this study indicate that the causes of stunting based on these variables have a significant difference (p &lt; 0.05). Recommendations for health workers conduct socialization and counseling about exclusive breastfeeding, the importance of hygiene practices in daily life including caring for children, maximizing the community-based total sanitation program and conducting socialization related to the influence of early marriage.

A Retrospective Study to Examine Nutrition Based Risk and Protective Factors in Relation to Diarrhoea Incidence in Children Aged Less Than Two Years in Tanzania

Background: Diarrhea disorders account for a significant portion of the morbidity and mortality burden among children in resource-constrained settings, and they are economically significant to both families and health systems. In real sense, any intervention that has shown the potential to reduce diarrhea-related mortality and morbidity is valuable in terms of the global child health agenda.&#x0D; Objective: To explore the role of nutrition based risk and protective factors on diarrhea morbidity among children aged less than two years in Tanzania.&#x0D; Methods: We analyzed household-based data on risks and preventive interventions including exclusive breastfeeding, complementary feeding, water, sanitation hygiene, and vitamin A supplementation. Data from the Tanzania Demographic Health Survey (TDHS) of 2015/2016 were used to describe odds of diarrhoea morbidity in children aged 0-5 months and 6-23 months. Multivariate logic regression models were developed to identify risk factors.&#x0D; Results: Children aged less than 5 months, who were exclusively breastfed experienced a reduction in the odds of having diarrhoea by 72% (P-value &lt;0.001), compared to those who were not exclusively breastfed. Children aged between 6 months and less than 23 months, from families with detergent at hand washing facility, experienced a reduction in the odds of having diarrhoea by 37% (P-value &lt;0.01), compared to their peers in the other group. Diarrhoea odds were predicted to be higher in higher wealth quintile as compared to lowest group by 1.39 (P-value =0.028), 1.53 (P-value &lt;0.01), 1.74 (P-value &lt;0.01) and 1.78 (P-value =0.01) for second, middle, fourth to highest groups respectively.&#x0D; Conclusions: The data has demonstrated the important role of exclusive breastfeeding and sanitation on diarrhoea occurrence amongst children aged less than 23 months in Tanzania. Yet there are areas for which it remains inconclusive and requires further work to improve insights and strength of available evidence so far.

Patterns and temporal trends in the incidence of childhood and adolescence cancer in Cyprus 1998–2017: A population-based study from the Cyprus Paediatric Oncology Registry

BackgroundDespite its rarity, cancer in children and adolescents (CAC) is a major health issue worldwide. The lack of appropriate cancer registries is an obstacle for defining its incidence and survival, and informing cancer control. As in Cyprus, CAC epidemiology has not previously been comprehensively examined, we determined incidence rates and temporal trends of cancer in the 0–19 age group during 1998–2017. MethodsWe established the population based Paediatric Oncology Registry of Cyprus (PORCY) for the period 1998–2017. World age standardised incidence rate per million children and adolescents per year (ASRW) were calculated and time trends were assessed using Joinpoint regression analysis. Comparisons were made with other countries using the International Incidence of Childhood Cancer, third volume. ResultsFor all cancers combined, for ages 0–19-years, ASRW was 203.54 (95% CI 189.49, 217.59) one of the highest rates globally. The most frequent CAC were leukaemias followed by lymphomas, specified epithelial neoplasms and central nervous system tumours, differing to what is described in most other countries. For all cancers, both combined and individual types, except thyroid carcinoma (where incidence was rising), no significant temporal variation was found. ConclusionsTo inform cancer control activities, we conducted the first ever population-based epidemiological study of childhood and adolescent cancer (0–19 years) in Cyprus. The striking findings indicate high overall incidence rates that are among the world’s highest, a higher frequency of lymphomas and thyroid cancer than brain tumours, and rising incidence for thyroid, but not for other, cancers. These novel findings, will help the formulation of hypotheses to provide explanation for the high rates for all CAC in Cyprus and may contribute to the global efforts for improving prevention of cancer in this age group.

Meconium-stained amniotic fluid during labor may be a protective factor for the offspring's childhood wheezing up to 3years of age: the Japan Environment and Children's Study.

This study revealed a decreased incidence of childhood wheezing among the children of women with meconium-stained amniotic fluid in term births. By yet unknown mechanisms, meconium-stained amniotic fluid was associated with a decreased incidence of childhood wheezing in the offspring. Further studies are required to clarify the mechanism of one's own meconium in affecting their health condition. • Meconium-stained amniotic fluid during labor is associated with several adverse perinatal outcomes, and meconium aspiration syndrome is associated with offspring's childhood asthma and wheezing. • Meconium-stained amniotic fluid during labor could be an independent protective factor for the offspring's dermatitis and skin rash. • Whole cases with meconium-stained amniotic fluid during labor were associated with a decreased incidence of offspring's childhood wheezing up to 3 years of age. • This study may shed light on the effects of simple meconium-stained amniotic fluid on offspring's childhood health.

Increase in admission rates and symptom severity of childhood and adolescent anorexia nervosa in Europe during the COVID-19 pandemic: data from specialized eating disorder units in different European countries

BackgroundThe COVID-19 pandemic, associated with confinement and social isolation, seems to have impacted the course of many mental disorders in children and adolescents. An increase in hospital admission rates for juvenile anorexia nervosa (AN) has been documented in many regions of the world. However, data from Europe are scarce.MethodsWe asked clinicians in specialized eating disorder units in hospitals of maximum care in France, Germany, Italy, Spain, Sweden, and the Netherlands to report on (i) overall (inpatient and outpatient) and (ii) inpatient admission rates for adolescents with AN during 2019 and 2020. Additionally, a modified version of the COVID Isolation Eating Scale (CIES) was used to assess the child and adolescent psychiatrists’ estimations of a possible increase in symptom severity in children and adolescents with AN during the COVID-19 pandemic and to (iii) inquire about the contributing factors perceived by the caring professionals.ResultsFour out of six representatives of European hospitals described a higher rate of overall admissions during the pandemic. Three hospitals out of six reported an increase in inpatient admissions, and two centres had constant high numbers of admissions of both outpatients and inpatients. The clinicians perceived a higher symptom severity in 2020 than in 2019, especially involving more frequent use of social media, longer duration of exercising, and more restrictive eating. They supposed an increase in social media consumption, a perceived “loss of control”, and a lack of in-person assessments and weight controls as the main contributing factors for the deterioration in AN numbers and symptomatology.ConclusionsThe COVID-19 pandemic seems to have had a deep impact on symptom severity in AN, which is mirrored by a large increase in admission rates across Europe. An increase in exercise, social media consumption, a perceived “loss of control”, and a lack of face-to-face health care seem to have contributed to this development. Further investigation is required to identify which factors may lead to the increase in incidence and deterioration of childhood and adolescent AN. Possible preventive means for the future could include educating paediatricians and health care workers about AN, regular weight assessment, and home-based treatments.

Increase in Type 1 Diabetes Incidence in Children During COVID-19.

According to this study: There was an increase in the incidence of new-onset type 1 diabetes in children during the COVID-19 pandemic.More children had diabetic ketoacidosis at the time of diagnosis.

Kamala Das: Tragedy of Contrast between Childhood and Adulthood

This paper attempts to focus on Kamala Das’s vision of her secure and happy childhood and her frustrating adulthood exploring her poems critically. Her innocent past is juxtaposed with her sexually experienced present life in many of her poems. Her nostalgia is enrooted in her exhaustion from the current situation of life. Her loneliness and dissatisfaction compel her to fall back on her childhood memories which provide her with momentary relief but at the same time make her present predicament more pathetic. It seems that her nostalgia for childhood is the outcome of her realization of the lovelessness of this cruel world of adulthood. In a very confessional tone, Mrs. Das describes the autobiographical elements of her personal life in her poems. Her ancestral house, Nalapat House, and her grandmother are one of the central themes of her poems. She compares the selfless unconditional true love of her grandmother to the sexual selfish lust of her life partner in her poems. The vivid picture of her childhood incidents in her nostalgic poem is actually a retreat for her which helps her to get some relief from her present tortured self.