Child Health Research Articles

How Should Clinicians Partner With Families to Promote Children's Sleep Health?

Short sleep duration, poor sleep quality, and irregular timing of sleep are prevalent sleep troubles for children, but fully assessing children's sleep environments and effectively promoting children's overall sleep health is nearly impossible during brief clinical encounters. This commentary on a case suggests strategies for navigating this problem with a patient- and family-centered approach that prioritizes identifying family sleep-related beliefs, values, and goals and maintaining flexibility when offering evidence-based recommendations to improve children's sleep.

Exposure to Multiple Natural Disasters and Externalising and Internalising Behavior: A Longitudinal Study of Adolescents

PurposeAs natural disasters become more frequent and more severe, there is a corresponding need to understand their relationship with child and adolescent mental health, and in particular, to understand exposure to multiple natural disasters. This study assesses the relationship between exposure to both single and multiple disasters and adolescent internalising and externalising behavior. MethodsThe study used five waves of a nationally representative longitudinal Australian dataset. Exposure to sudden-onset (fires, floods, storms) and slow-onset (drought) disasters was collected across five waves. Adolescent internalising and externalising behavior collected in the final three waves using the self-reported Strengths and Difficulties Questionnaire. Random effects regressions assessed sudden- and slow-onset disasters and multiple disaster exposure, controlling for geographic and socioeconomic variables. ResultsExposure to multiple disasters was associated with adverse adolescent outcomes. Two or more sudden- and slow-onset disaster exposures in the last 12 months was related to more conduct problems. Exposure to multiple sudden-onset disasters in the current and previous waves was related to increased problems with peers. A single exposure to either sudden- or slow-onset disasters was not associated with Strengths and Difficulties Questionnaire outcomes. DiscussionThe study findings suggest that multiple exposure to disasters has a negative association with adolescent wellbeing. These findings suggest that, rather than adapting to disasters, youth exposed to multiple disasters suffer more than their peers, including peers exposed to a single disaster.

Policies to curb fossil fuel pollution and mitigate climate change benefit child and adult health and the economy, but assessments can do better

Abstract

Psychosocial Assessment Tool 2.0 and Long-term Mental Health Outcomes in Childhood Cancer.

To identify childhood cancer patients and their families at the greatest risk for psychosocial difficulties, this study examined the predictive validity of the Psychosocial Assessment Tool 2.0 (PAT2.0) on caregiver and patient-reported mental health outcomes at 1-year follow-up. The PAT2.0 was administered to caregivers a median of 0.08 years after cancer diagnosis. A brief psychosocial screening battery (Family Symptom Inventory and PROMIS v1.0 Pediatric Profile-25) was administered to patient-caregiver dyads (n=53) ∼1-year later. Linear regressions support the longitudinal predictive validity of the PAT2.0 for caregiver-reported child and caregiver mental health symptoms and child-reported peer relationships difficulties.

Dental Caries and Erosive Tooth Wear Among 12-Year-Old Hong Kong Children

ObjectiveThis is to investigate the dental caries, erosive tooth wear status, and oral health-related habits of 12-year-old Hong Kong children. MethodsThis cross-sectional survey recruited 12-year-old children using clustered random sampling from 3 main districts. The trained examiner examined the children's caries status using the criteria recommended by the World Health Organization and recorded their caries experience using the decayed, missing, and filled tooth (DMFT) index. The children's tooth wear status was determined using the Basic Erosive Wear Examination (BEWE) index. Their oral hygiene practice was collected using a self-administered questionnaire. ResultsWe recruited 445 children and 396 children participated (response rate: 89%). Their mean DMFT was 0.29 ± 0.73. Seventy children (18%, 70/396) had caries experience (DMFT > 0) and they had 116 teeth suffered from caries. Among these 116 carious teeth, 75 teeth (65%, 75/116) were filled (FT), one tooth (1%, 1/116) was extracted (MT), and 40 teeth (34%, 40/116) were carious (DT). Five children had more than one decayed tooth (DT > 1), and one child had the highest number of decayed teeth (DT) at 4. BEWE results showed 284 (72%, 284/396) children had no erosive tooth wear (BEWE = 0). No child had severe erosive tooth wear (BEWE = 3). However, children consuming lemon tea or lemonade and vitamin C drinks 3 times a week or more showed significantly higher BEWE scores. Additionally, 380 (96%, 380/396) children brushed their teeth daily and 116 children (29%, 116/396) flossed their teeth. ConclusionMost 12-year-old Hong Kong children had neither caries experience nor tooth wear, and their oral health-related habits were satisfactory. SignificanceThis study updated the caries status of the permanent dentition of 12-year-old Hong Kong children. The information offers updated oral health data for the local, regional, and global authorities for planning effective public health programs to improve the oral health of children.

Hospitalisations for chronic conditions among care experienced and general population children and young people: evidence from the Children’s Health in Care in Scotland (CHiCS) cohort study, 1990–2016

ObjectiveThere is limited evidence on how the physical health of children and young people (CYP) who are care experienced (eg, in foster or out-of-home care) compares to the general population....

Breastfeeding in infancy and cardiovascular disease in middle-aged and older adulthood: a prospective study of 0.36 million UK Biobank participants

BackgroundCardiovascular disease originates in early life. We aimed to investigate the association between breastfeeding in infancy and cardiovascular disease in adult life. MethodsWe followed 364,240 participants from UK Biobank aged 40–73 years from 2006 – 2010 to 2021. Information on breastfeeding in infancy was self-reported by questionnaire. Cox proportional hazard regression models were used to estimate the hazard ratios (HR) and 95% confidence intervals (CI) for the association between breastfeeding and cardiovascular disease in middle-aged and older adulthood. The multivariable Cox models were used by adjusting for the age (used as the time scale), sex, ethnicity, assessment centre, birth weight, multiple birth status, maternal smoking during pregnancy, Townsend deprivation index, smoking status, alcohol drinker status, physical activity, and menopausal status for women. Binary and multinomial multivariable logistic regression models were used to explore the associations of breastfeeding in infancy with cardiovascular disease risk factors including obesity, body composition, metabolic and inflammatory disorders. ResultsDuring a median of 12.6 years of follow-up, we documented 29,796 new cases of cardiovascular disease, including 24,797 coronary heart disease and 6229 stroke. The multivariable adjusted HRs for breastfed versus non-breastfed were 0.94 (95% CI: 0.91, 0.96) for cardiovascular disease, 0.94 (95% CI: 0.91, 0.96) for coronary heart disease, and 0.95 (95% CI: 0.89, 1.01) for stroke. Furthermore, the strength of observed association between breastfeeding and cardiovascular disease seems to decrease with age (P for interaction <0.001), and increase with polygenic risk for cardiovascular disease (P for interaction <0.001). Consistently, breastfeeding in infancy was associated with cardiovascular disease risk factors including lower body mass index 0.92 (95% CI: 0.89, 0.95), body fat percentage 0.85 (95% CI: 0.83, 0.87), android to gynoid fat ratio 0.89 (95% CI: 0.83, 0.96), visceral adipose tissue 0.92 (95% CI: 0.84, 1.01), as well as lower C-reactive protein level 0.95 (95% CI: 0.94, 0.97) and a lower risk of metabolic syndrome 0.89 (95% CI: 0.85, 0.92). ConclusionsBreastfeeding in infancy was associated with a lower risk of cardiovascular disease in middle-aged and older adulthood. Promoting breastfeeding is vital not only for promoting child health, but also for halting the increasing trend of cardiovascular disease in adults.

Pathogen distribution and infection patterns in pediatric severe pneumonia: A targeted next-generation sequencing study

ObjectiveSevere pneumonia in children represents a significant clinical challenge due to its high incidence and associated mortality. This study aimed to assess the distribution of pathogens and patterns of infection in pediatric patients with severe pneumonia. MethodsThis study included 110 pediatric patients diagnosed with severe pneumonia, who were admitted to Guangxi Maternal and Child Health Hospital between July 2021 and November 2023. Pathogen-targeted next-generation sequencing (tNGS) was employed to identify respiratory pathogens in these cases. ResultsPathogens were detected in 109 out of 110 cases, yielding a positive detection rate of 99.09%. Among these cases, 25 (22.72%) involved single-pathogen infections, while 84 (76.36%) were characterized by mixed infections. The infection pattern in children with severe pneumonia was relatively common with bacterial-viral coinfection (28.2%, 31/110). A total of 39 pathogens were identified from the 110 children with severe pneumonia, with the top three pathogens being Mycoplasma pneumoniae (30.91%, 34/110), Human Respiratory Syncytial Virus Type A (26.36%, 29/110), and Human Herpesvirus (18.18%, 20/110). Notably, 38.2% (13/34) of the cases were found to have macrolide-resistant Mycoplasma pneumoniae (MRMP). Additionally, 40% (44/110) of the children required admission to the intensive care unit (ICU). ConclusionThe application of tNGS demonstrates significant utility in the detection of pathogens in pediatric patients with severe pneumonia. The predominant pathogens identified in this study are Mycoplasma pneumoniae, Human Respiratory Syncytial Virus, and Human Herpesvirus. Furthermore, mixed infections involving multiple pathogens were observed in 76.36% of the cases, and a substantial proportion (40%) of these patients necessitated intensive care.

Spontaneous Umbilical Cord Vascular Rupture during Labor: A Retrospective Analysis of 12 Cases.

Umbilical cord vascular rupture is a rare and severe condition that can occur during labor, leading to adverse outcomes for the fetus before as well as after delivery. Prompt diagnosis and intervention are crucial for improving the chances of a successful outcome. We aimed to analyze cases of umbilical cord vascular rupture during labor to provide insights into this challenging condition. This retrospective study evaluated the medical records of patients diagnosed with umbilical cord vessel rupture or umbilical cord hematoma at Fujian Maternity and Child Health Hospital from January 1, 2015, to May 31, 2023. The inclusion criteria included gestational age of ≥28 weeks, occurrence during labor, and availability of complete delivery data. Data on fetal heart rate (FHR) changes, delivery intervals, intraoperative findings, placental pathology, and neonatal outcomes were collected and analyzed. A total of 12 cases were analyzed. The incidence of umbilical cord vascular rupture during childbirth was 0.08%. The FHR patterns in umbilical cord rupture during delivery included baseline tachycardia, minimal or absent variability, variable or late deceleration, prolonged deceleration, and undetectable heart rate. The bradycardia-to-delivery interval (BDI) ranged from 6 to 26 minutes. Among the 12 neonates, 9 were discharged well, 2 were stillbirths, and there was 1 neonatal death. Hemorrhagic shock was common in live births. Our study highlights the significance of continuous FHR monitoring during labor and the urgent need for medical teams to respond quickly in cases of umbilical cord vascular rupture. Despite advancements in neonatal resuscitation techniques, managing cases with undetectable fetal heart activity remains clinically challenging, and even with immediate pregnancy termination, poor neonatal outcomes may still occur. · Umbilical cord vascular rupture during labor is a rare event.. · Its clinical management presents significant challenges.. · Advances in neonatal resuscitation have improved rescue success rates.. · In such cases, hemorrhagic shock is common in live births..

Predicting monotherapy resistance risk in patients with low-risk gestational trophoblastic neoplasia: integration of the systemic immune−inflammation index and the prognostic nutritional index

PurposeCurrently, there are no reliable indicators for the early identification of patients with low-risk gestational trophoblastic neoplasia (GTN) who develop resistance to monotherapy. This study aimed to evaluate the effectiveness of combining the Systemic Immune-Inflammation Index (SII) and Prognostic Nutritional Index (PNI) in detecting early resistance to monotherapy in patients with low-risk GTN.MethodsThis retrospective study included 91 patients with low-risk GTN who received initial monotherapy at Fujian Maternal and Child Health Hospital between 2013 and 2021. The SII and PNI before chemotherapy were calculated from prechemotherapy peripheral blood samples, with cut-off values determined by receiver operating characteristic (ROC) curves. The SII-PNI score ranged from 0 to 2 points and was categorized as follows: a score of 2 points indicated a high SII (≥467.02) and a low PNI (≤51.35); a score of 1 point indicated either a high SII or a low PNI; and a score of 0 points indicated neither a high SII nor a low PNI.ResultsNinety-one patients with low-risk GTN underwent monotherapy, 19 of whom developed resistance, whereas the remaining 72 did not. The SII was significantly greater in chemotherapy-resistant patients than in non-resistant patients (P=0.04), whereas the PNI was markedly lower in chemotherapy-resistant patients (P=0.002). Univariate analysis revealed that cut-off values of 467.02 for the SII (P=0.04) and 51.35 for the PNI (P=0.024) were associated with chemotherapy resistance in patients with low-risk GTN. As the SII-PNI score increased, the proportion of chemotherapy-resistant patients increased (P&amp;lt;0.001), and the time for human chorionic gonadotropin (hCG) normalization correspondingly increased (P&amp;lt;0.001). Multivariate logistic regression analysis indicated that a high SII-PNI score is an independent risk factor for chemotherapy resistance in patients with low-risk GTN (P=0.001).ConclusionA high SII and low PNI are linked to chemotherapy resistance in patients with low-risk GTN. The pretreatment SII-PNI score is a key indicator for predicting the sensitivity of patients with low-risk GTN to single-agent chemotherapy, aiding in the early identification of individuals at high risk of resistance.

Long-term health outcomes of children born by cesarean section: A nationwide population-based retrospective cohort study in Taiwan

BackgroundTaiwan had high cesarean rate which exceeded the recommended threshold (15%), set by WHO. However, there have not a comprehensive study to discuss the long-term offspring consequences of cesarean section (CS). This study aimed to show whether allergy disorders, obesity and respiratory infection of children are associated with modes of delivery, using the National Health Insurance Research Database (NHIRD) of Taiwan. MethodsThis study used the maternal and child health database of NHIRD. We included the children who birth between 2004 and 2013 and inter-linked the database of the mother and children. The participants were followed until 2018/12/31. We performed a Cox proportional hazards model to identify the association of CS with respiratory tract infection, allergy disorder, and obesity diagnosed in childhood. ResultsCS significantly increased the risk of developed childhood asthma (adjusted hazard ratio [aHR] = 1.03; 95% confidence interval [CI]: 1.02–1.03), allergy rhinitis (aHR = 1.04; 95% CI: 1.04–1.05), atopic dermatitis (aHR = 1.05; 95% CI: 1.04–1.06), respiratory tract infection (aHR = 1.07; 95% CI: 1.06–1.07) and overweight (aHR = 1.29; 95% CI: 1.18–1.40) even after adjusting with confounding factor. Development of food allergy (aHR = 1.13; 95% CI: 0.87–1.47) was not associated with cesarean section. ConclusionThis study indicated that children delivered by CS more commonly developed respiratory tract infections, asthma, allergic rhinitis, atopic dermatitis, obesity than children delivered vaginally. Among these, obesity have a stronger association with cesarean section.

The Impact of Children's Access to Public Health Insurance on Their Cognitive Development and Behavior

While a large literature examines the immediate and long-run effects of public health insurance, much less is known about the impacts of total program exposure on child developmental outcomes. This paper uses an instrumental variable strategy to estimate the effect of cumulative eligibility gain on cognitive and behavioral outcomes measured at three points during childhood. Our analysis leverages substantial variation in cumulative eligibility due to the dramatic public insurance expansions between the 1980s and 2000s. We find that increased eligibility improves child cognitive skills and present suggestive evidence on better behavioral outcomes. There are notable heterogeneous effects across the subgroups of interest. Both prenatal eligibility and childhood eligibility are important for driving gains in the test scores at older ages. Improved child health is found to be a mediator of the impact of increased eligibility.

Review of Ocular and Non-Ocular causes of Headache in Adult and Pediatric Patients; A multicenter study

Purpose: To determine ocular and non-ocular causes of headache in adult and pediatric patients in three tertiary care hospital of Multan, Pakistan Study Design: Cross-sectional study. Place and Duration of Study: This multi-centre study was conducted in Combined Military Hospital, Multan, Pakistan and The Children’s Hospital and The Institute of Child Health, Multan, Pakistan from February 2023 to September 2023. Methods: The non-probability convenience sampling technique was used. The data collection and diagnosis were done by a consultant ophthalmologist. The statistical analysis of this study was conducted using SPSS version 23. Results: The study comprised of a total of 600 patients. The mean age of the adult patients was 27.16±14.39 years ranging between 16to 80 years and the mean age of pediatric patients was 10.1±2.40 years. The patients were divided into four groups based on the etiology of headache that were ocular, non-ocular, combined ocular causes and ocular and non-ocular causes combined. The most common ocular cause was myopia in 43(14.3%) adults and 47 (15.8%) pediatric patients. However, the most common non-ocular cause was migraine in 72(24.0%) adult patients and frontal sinusitis in 43 (14.3%) pediatric patients. Conclusion: Refractive errors were the most common ocular etiology of headache in ophthalmology patients predominately myopia in the adult and pediatric population. Migraine was the most common non-ocular etiology in adult population whereas frontal sinusitis was most common in the pediatric age group.

Child health and psychosocial wellness in the context of maternal role overload and depression

AbstractObjectiveThe objective of this study was to examine the variability of child health and psychosocial outcomes in the context of maternal role overload and maternal depression.BackgroundRole overload, characterized as time‐based role stress, is commonly linked to depression in mothers. However, it remains uncertain whether maternal role overload poses a risk for negative child health and wellness. Although maternal depression is a known risk factor for poor child health and psychosocial outcomes, the outcomes themselves often reveal variability.MethodThis study aimed to investigate the heterogeneity of child health and psychosocial outcomes using latent profile analyses. Multinomial logistic regression analyses were conducted to examine differences in profile membership based on the child's experiences of maternal role overload and depression. Data were from 1,172 mother–child dyads from the Family Matters study.ResultsThe analyses unveiled four distinct profiles (i.e., moderate health/psychosocial wellness, poor health/moderate psychosocial wellness, struggling health/poor psychosocial wellness, thriving health/psychosocial wellness), each associated with varying levels of health and psychosocial wellness. Both maternal role overload and depression were found to heighten the risk of poor health and psychosocial wellness in children.ConclusionChildren with struggling and poor health and psychosocial outcomes had higher odds of maternal depression and maternal role overload than children in the thriving profile. These findings suggest that maternal role overload is a potential risk to child health and psychosocial outcomes.ImplicationsThese findings emphasize the importance of continuous depression screening in mothers and the implementation of solution‐focused interventions targeting maternal role overload.

Situational analysis of maternal and infant mortality in Kazakhstan

Background. Previous studies from Western countries have shown an association between maternal and infant mortality and sociomedical problems. The social environment, which influences the health status of mothers and infants, is a function of the economic resources and forms of production of different regions. This study, for the first time, includes the study of preventable mortality from Pregnancy, childbirth, and the perinatal period, and Congenital malformations in Kazakhstan in the context of regions. For 2015-2019, maternal mortality decreased by 16.5% in Kazakhstan. However, since the start of the pandemic in 2020, the maternal mortality ratio has increased by 2.7 times, highlighting the urgent need for action. This study aims to provide the latest maternal and infant mortality policy and analyze their mortality ratios. The findings of this study have the potential to significantly impact healthcare policies and practices, making a substantial contribution to the field of maternal and child health. Methods. The regulatory documents related to maternal and child health in the Kazakhstan health system were appraised over the last ten years. To identify changes in avoidable mortality ratio trends for the period 2011-2021, joinpoint regression was used to calculate the average annual percentage change for every age group using the JoinPoint Regression Program, Version 4.9.1.0. Results. Crude mortality associated with pregnancy, childbirth, and the postpartum period was high in the 30-34 age group from 2015 to 2018. From 2019 to 2021, there has been an increase in mortality in the 35-39 age group from 0.48 (95% CI: - 0.06; 1.03) to 4.37 (95% CI: 2.83; 5.91) per 100,000 women. In general, there is a twofold increase in mortality in the period from 2018 to 2021. Treatable mortality from pregnancy, childbirth, and puerperium fluctuated between 0.34 and 0.37 from 2015-2019, after which it rose to 1.07 in 2021 per 100.000 population. The highest increase can be seen in Atyrau, South and East Kazakhstan, Karagandy, and Almaty regions. The treatable mortality decreased in Kyzylorda and Akmola regions in the 2015-2021. Conclusion. Several regions need to increase efforts to reduce maternal mortality, which remains high nationally compared to OECD countries. This is the first study to examine the prevention of deaths from pregnancy, childbirth, and the perinatal period, as well as the development of birth defects in Kazakhstan by region, which helps physician decision-makers reconsider possible approaches to providing care at the primary health care level.

Understanding the impact of domestic violence on children's mental health and exploring effective intervention strategies

Exposure to domestic violence in the home can have profound and long-lasting effects on children's mental health and development. An extensive body of research has demonstrated the links between witnessing domestic abuse and increased risks of psychological disorders such as anxiety, depression, and post-traumatic stress disorder in affected children. However, not all children exposed to violence experience negative outcomes, and interventions can help mitigate harm. This research aims to synthesize what is known about the multifaceted psychological consequences of domestic violence exposure for children and identify effective support strategies. A comprehensive literature review was undertaken to understand prevalence rates, forms of abuse, and potential moderating and mediating factors. Key findings indicate that while abuse types, including physical, emotional, verbal, and financial violence, can all impact children's mental health, factors like age, gender, resilience characteristics, and social support networks influence outcomes. Trauma-focused therapies, parent-child interaction programs, play-based interventions, and school-based supports show promise as evidence-based approaches. Recommendations target collaboration between policymakers, practitioners, and researchers to strengthen legislation, implement multidisciplinary treatment, and conduct further longitudinal studies. The goal is to illuminate this critical issue and guide the development and evaluation of integrated systems of care focused on child wellness and family violence prevention.

Social worker as an implementer of solutions introduced by lex Kamilek

The Act of July 28, 2023 amending the Act – Family and Guardianship Code and certain other acts (Journal of Laws 2023, item 1606), in force since February 15, 2024, introduced new solutions aimed at increasing the protection of minors against harm. The changes covered several legal acts and apply to all institutions whose activities are related to the care of children, their education, upbringing, developing their interests or providing them with support. One of the entities performing tasks for a family raising a child is a social worker. Some of the legal solutions introduced by so called lex Kamilek are reflected in his daily work. First of all, as part of the procedure for ensuring protection for a child in the event of a threat to his life or health in connection with domestic violence, a social worker will be obliged, together with a police officer and a doctor, paramedic or nurse, to complete a questionnaire assessing the risk of threat to the child's life or health. Moreover, in the case of employment in institutions dealing with child care, the person must be verified in terms of information from the Register with limited access or in the Register of persons in relation to whom the State Commission for Counteracting the Sexual Exploitation of Minors under 15 years of age has issued a decision on entry in the Register and the National Criminal Register. It is also obliged to implement standards for the protection of minors.As an employee of a specific institution, he or she may be obliged to provide the Team of Experts for the Analysis of Events as a result of which a minor died or suffered serious bodily injury, certain information and documents without the obligation to maintain professional secrecy.

KNOWLEDGE AND ATTITUDE OF URBAN AND RURAL MOTHER IN AL MUKALLA CITY ABOUT VACCINATION, 2023

Vaccination is a critical public health strategy for preventing infectious diseases in children, yet vaccine hesitancy remains a significant challenge, particularly among mothers who influence their children's health decisions. This study aims to evaluate the knowledge and attitudes of mothers in urban and rural areas of Al-Mukalla, Yemen, regarding childhood vaccinations. A total of 581 women with at least one child under five participated, with data collected on their knowledge, sources of information, and attitudes towards vaccination. Results indicated that urban mothers had a higher level of awareness regarding the importance of vaccination compared to their rural counterparts, with 76% of rural mothers lacking knowledge about its significance. Urban mothers primarily relied on media (71%) and doctors (56%) as information sources, while rural mothers depended more on societal channels. Moreover, urban mothers demonstrated a more positive attitude towards vaccination, in contrast to the skepticism observed among rural mothers, influenced by cultural beliefs and misinformation. The findings highlight a critical need for targeted educational interventions to address knowledge gaps and enhance vaccine uptake, particularly in rural communities, ultimately aiming to improve child health outcomes in the region.

Characteristics of Health-Preserving Behavior of Parents Raising Children with Disabilities

The article presents the results of a study devoted to the study of health-preserving behavior of parents raising children with disabilities aged 6-10 years. The study was conducted in April-May 2024 in the Borovsky District of the Kaluga Region. The research method was a questionnaire survey of parents. The questions touched upon the implementation of such important areas of child health-preservation in the family as home nutrition, daily routine, sleep, hygiene, control over the safe use of gadgets for the child's health, the psychological climate in the family, the attitude of parents to their own health, etc. The process of interaction between parents and a medical institution and medical workers as subjects of child health-preservation was also studied. It was found that the majority of parents (85%) fully comply with the doctor's advice and prescriptions. Most parents (68%) know the specifics of the child's disease and treatment. According to 54% of parents, their children willingly follow the doctor's recommended prescriptions. 15% of parents failed to develop the skill of following doctors' recommendations in their children with disabilities. In 30% of parents, the child does not follow the doctor's orders or follows them thanks to the parents. In every third family, the sick child's sleep schedule is not followed. Only a third of parents (31%) have children who attend exercise therapy classes. Parents have a low level of health-preserving competence in the issue of healthy nutrition. The materials of the article can be used in the work of specialists in medical and social institutions, educational and public organizations, and can also be useful for researchers interested in the problem of health preservation of children with disabilities.

Uncovering individualised treatment effects for educational trials.

Large-scale Randomised Controlled Trials (RCTs) are widely regarded as "the gold standard" for testing the causal effects of school-based interventions. RCTs typically present the statistical significance of the average treatment effect (ATE), which captures the effect an intervention has had on average for a given population. However, key decisions in child health and education are often about individuals who may be very different from those averages. One way to identify heterogeneous treatment effects across different individuals, not captured by the ATE, is to conduct subgroup analyses. For example, free school meal (FSM) pupils as required for projects funded by the Education Endowment Foundation (EEF) in England. These subgroup analyses, as we demonstrate in 48 EEF-funded RCTs involving over 200,000 students, are usually not standardised across studies and offer flexible degrees of freedom to researchers, potentially leading to mixed, if not misleading, results. Here, we develop and deploy an alternative to ATE and subgroup analysis, a machine-learning and regression-based framework to predict individualised treatment effects (ITEs). ITEs could show where an intervention worked, for which individuals, and to what extent. Our findings have implications for decision-makers in fields like education, healthcare, law, and clinical practices concerning children and adolescents.