Resident Children Research Articles

Nutritional Status of Under Five Year Children Residing in Selected Wards of Barahachhetra Municipality, Sunsari, Nepal: a Cross-sectional Study

Background: The nutrition of under five children reflects a country’s health status. We aimed to assess the nutritional status of the under five year children of selected wards of Barahachhetra municipality, Sunsari. Methods: In this cross-sectional study, we enrolled 167 under five year children in ward no. 4 and 5 of Barahachhetra municipality. Height/ length, mid- upper arm circumference (MUAC), weight and clinical signs of malnutrition were noted. The relevant information regarding the predictors of malnutrition was obtained from parents/ caregiver. Results: Nearly half (47.9%) of the children were in the age group 25-59 months with almost equal gender distribution. About one-tenth of children (11.3%) had MUAC less than 12.5 cm, 20.4% of children were wasted, 47.2% were stunted and more than a quarter (29.6%) were underweight. The MUAC was significantly associated with per capita income (p = 0.01). Wasting was significantly associated with the age of the children (p = 0.005) and occupation of their father (p = 0.002). Underweight was significantly associated with their age (p = 0.007), ethnicity (p = 0.03), parents’ education (mother: p = 0.02, father: p = 0.002), parents’ age (mother: p = 0.04, father: p = 0.02) and fathers’ occupation. Conclusion: Substantial number of under five year children were malnourished. One-fourth of the children were wasted, nearly half were stunted, and more than a quarter of the children were underweight. Malnutrition (as per MUAC) and stunting were higher among younger children (6-24 months) whereas wasting and underweight were higher among older children (25-59 months).

The charm of country life? Impact of rural childhood residence on physical and mental health in later life.

Most studies of geographic health disparities are focused on adult rural residence. However, previous studies have shown that the residential area in which one grows up during childhood has lasting impacts on adult health. In one of the only studies to date to examine the impact of rural childhood residence on mental health in middle-aged and older adults, Murchland and colleagues (2019) evaluated inequalities by childhood residence and noted elevated depressive symptoms were more common among those living in rural areas compared to those living in non-rural areas. The current study expands the model proposed by Murchland and colleagues to include further antecedents related to rural childhood residence, and to include multiple outcomes of physical and mental health among middle-aged and older adults. Participants included 4614 individuals aged 40 or older recruited as part of the Midlife in the United States (MIDUS) study. Consistent with Murchland's model, childhood rurality played an important part in middle-aged and older adult's health, despite not having a direct influence. Rurality status was impacted by parental education level and SES during childhood, and was associated with the level of education obtained by the participants (and thus their occupation), which played a direct role in their current health status. Mental and physical health had differential predictors. The study was limited by its non-diverse sample and self-reported measures. Further research into the impact of childhood rurality on health is needed, utilizing comprehensive self-reported and observed outcome measures.

Migration for co‐residence among long‐distance couples: The role of local family ties and gender

AbstractWhen long‐distance couples start living together, the decision about where to co‐reside has important repercussions, as long‐distance moves often lead to the loss of local ties. Drawing on Danish population register data on long‐distance opposite‐sex couples and cross‐classified multi‐level statistical analyses, we explore each partner's share in the total distance moved at the start of their co‐residence. We examine the influence of local ties to family and gender asymmetries. Our findings indicate that women tend to bridge the larger share of the distance when moving into co‐residence. Living close to non‐resident children, parents or siblings and having resident children lower one's share in the total distance moved. Men's local ties to non‐resident family have more influence than women's, while women's resident children seem to exert more influence. Our results suggest that traditional gender patterns shape couples' decision‐making about where to live together and who migrates the greater share of the distance.

Impact of Sociodemographic Features and Lifestyle on Cognitive Performance of Peruvian Adults.

Cognitive impairment and dementia may result from a combination of modifiable and nonmodifiable risk and protective factors, such as the environment, educational attainment, time devoted to cognitively stimulating activities, and physical activity. This study aimed to investigate the mediating role of sociodemographic characteristics and lifestyle factors in the years of education and cognitive performance in Peruvian adults. This cross-sectional study included 1,478 subjects assessed by Addenbrooke's Cognitive Examination Revised (ACE-R). Using mediation models, we evaluated the mediation role of parents' educational level, reading time (RT), and physical activity time (PAT) in the years of education (IYE) and cognitive performance. People who reported having lived in an urban area during their childhood are estimated to have, on average, 2.085 years more formal education than those who lived in rural areas. In addition, 49% of cognitive performance scores are explained by the mediation effect of reading and physical activity time in the IYE. This implies that higher levels of education, mediated by RT and PAT per week, are 1.596 units associated with higher scores on the ACE-R. Despite the fact that nonmodifiable factors (i.e., childhood residence area, parents' educational level) seem to exert an effect on older adults' cognition, their influence is mediated by other factors that are indeed modifiable (i.e., reading time, physical activity engagement). In this sense, lifestyle changes could help prevent or decrease the risk of cognitive impairment and reduce the disease's impact on vulnerable environments in Latin American and Caribbean countries.

Whom do married and divorced parents consider kin?

ABSTRACT Despite the potential importance of kin to divorced parents in particular, prior research rarely studied how kinship patterns vary between married and divorced parents, nor within-group variations depending upon postdivorce residence arrangements and repartnering. We estimated mixed-effects logistic regression models using data from samples of Dutch married (N = 1,336) and divorced parents (N = 3,464) to predict the extent to which parents considered various blood relatives and (former) in-laws kin (i.e. parents, siblings, aunts/uncles, nieces/nephews, and cousins) and investigated differences within the divorced group per residence arrangements and repartnering. We found that married and divorced parents barely differed in the extent to which they considered blood relatives kin, but differences were large for (former) in-laws, and particularly great when parents did not reside with their biological child. Repartnered divorced parents were less likely to consider their former in-laws kin than single divorced parents but considered their new in-laws kin to high extents. For both blood relatives and (former) in-laws, parents were most often, and cousins least often considered kin. These results indicate that kinship patterns only differ for in-laws between married and divorced parents. Resident children may lead parents to consider former in-laws kin, whereas repartnering leads to exclusion of former in-laws.

Childhood anaemia levels among under-5 children in Namibia and their associated sociodemographic factors: A multivariate ordinal modelling approach.

Anaemia is a serious global public health problem with high prevalence (>40%) in children particularly in low- and middle-income countries including Namibia with a current 46.1% prevalence rate. This study was aimed at examining the sociodemographic factors influencing the occurrence of childhood anaemia levels in Namibia. A multivariate ordinal regression model was applied to statistically identify potential sociodemographic factors associated with anaemia levels among children under-5 years old using data collected from the 2013 NDHS. The odds of having mild anaemia level was lower for sociodemographic characteristics such as mother's age, total children ever born, health insurance coverage, child's residency, child's age and main language spoken at home. The odds of having moderate anaemia level was higher for characteristics such as mother's age, place of residence, highest education level and child's diarrhoea status, while it was lower for characteristics such as age of head of household, total children ever born, health insurance coverage and sex of child. Similarly, the odds of having severe anaemia level was higher for characteristics such as region, place of residence, highest education level, number of household members, wealth index, health insurance coverage, child's residency and child's diarrhoea status, while it was lower for characteristics such as total children ever born and sex of child. It is therefore recommended that the policies and practices concerning anaemia diagnosis, treatment and prevention in the country be substantially revised by policy-makers, starting with the known prevalent causes and identified sociodemographic factors from this study.

Residential green space and waist circumference affect telomere shortening in childhood: the longitudinal ChiBS study

BackgroundTelomere shortening, recognised as one of the most well known biomarkers of biological ageing, is susceptible to various environmental and lifestyle factors, encompassed in the exposome. Research shows that telomere length is substantially determined early in life and that exposures in childhood can have important consequences in setting telomere length later in life and thus the lifespan of an individual. We explored the associations between 17 exposures and longitudinal telomere change in a child population. MethodsChildren up to the age of 9 years, from Aalter, Belgium, were enrolled in 2008 and 2010 and followed-up for 5 or 7 years (up to 2015). Relative telomere length was measured at baseline (2008 or 2010) and at follow-up, in 2015, through quantitative real-time PCR. Exposures and lifestyle factors comprised: body-mass index, waist circumference, dietary habits (ie, sugar-rich and fat-rich food intake and vegetables and fruit intake), psychosocial stress (ie, negative events, emotions, and behaviour), sleep duration, physical activity, and residential environmental quality (long-term black carbon and particulate matter exposure and residential green space). Green space was estimated from high-resolution land cover data within several buffers (50–3000 m) around the child's residence. Cross-sectional and longitudinal analyses were done by means of linear regression models, adjusting for length of follow-up, age, sex, and socioeconomic status. Effect size was expressed as β, the standardised regression coefficient of the linear regression, and was calculated by multiplying the unstandardised regression coefficient by the standard deviation of the predictor variable and dividing by the standard deviation of the outcome variable. Written informed consent was obtained from all parents. Children aged 12 years and older also provided written informed consent. Children younger than 12 years gave verbal consent. Findings150 children (77 [51%] boys and 73 [49%] girls) aged 2·8–10·3 years (median 5·9 years [IQR 4·9–7·1]) at baseline were included in the longitudinal analysis, which showed that higher residential green space at baseline was associated with inferior telomere shortening (β=0·261; p=0·0018), whereas a higher baseline waist circumference was associated with more telomere attrition (β=–0·287; p=0·0015). These predictors were confirmed via lasso variable selection and correction for multiple testing. In addition, children with more unhealthy exposures had significantly more telomere shortening over the follow-up period than did children with less unhealthy baseline exposures (β=–0·200; p=0·017). InterpretationResidential green space and waist circumference were identified as predictors of telomere shortening in childhood. These results further showcase the benefits of a healthy lifestyle from an early age and the importance of a green environment in promoting molecular longevity from childhood onwards. FundingResearch Foundation Flanders (Brussels, Belgium; project number G073315N).

Diarrhea Causative For Resident Children in General Zahraa Hospital under age group (1 month to 6 years )

This study was undertaken around diarrhea causative for resident children in general Al_Zahraa Hospital under (1 month to 6 years ) during time period from 1/8/2005 to 1/11/2005. In order to determine diarrhea causative and assistance agents to infection occurrence, check have been perform for one hundred samples involve water and food quality which given to child depend on sterilization and sanitation , state (15 samples) out (100 samples) were used the water of streams nearthier house ., (15 samples) they use sterilize water . We have been diagnosis 95 state out I hundred recorded bacterial infections , 4 state recrded parastic infections and one state recorded as diarrhea illness causative by increase in use of antibiotics as treatment for tonsillitis. I have been isolate of Eschrichia coli and Salmonella ssp. , bacteria ratio 96.84% and 3.15% respectively concern bacterial infection .state these study (37) case cause is parasitic as well as bacteria .We have been causative parasitic diagnosis as (Entamoeba histolytica and Giardia lamblia parasitic) ratio 26.75% and 16% respectively. Scince this study the most infection by bacteria we have been determine quantity ,quality druq which possible to give as active treatment to diarrhea resistance , we have been analysis isolate sensitive of diagnosis bacteria under these study to 6 types of antibiotics , where demonstrate all these bacterial isolate high resistance against both antibiotic (Erythromycine and Oxacilline ) , ratio 4.2% and 6.3% respectively, and demonstrate high sensitive by 1.42% for Tapromycine antibiotic.

A Pilot Study on Effectiveness of Competence Building Interventional Package on Life Skills and Assertive Behaviour Among Children Residing in Selected Orphanages of Bagalkot District

Children residing in orphanages are going through different challenges in the current scenario. It will affect their socialization and failures in scholastic behavior. A Quasi experimental time series design using Pre-test post-test control group design was used for the present study. Stratified proportional sampling technique, using computer generated random sequence numbers was used to select samples. Out of 20 samples 10 allotted in experimental and 10 in control group. Orphan children aged between 10 to 18 years were selected as samples. The data was analyzed by using descriptive and inferential statistics. The study results depicted mean pre post test score of children in experimental group was 183.4+ 19.66 which increased to 209.5 + 15 in posttest whereas the mean pre-test score of control group was 193.45+ 13.52 which increased to 196.7 + 18.03 in post-test. The calculated t value was 10.207 with P value < 0.000, The mean Assertive behavior post test score (87.70+ 13.08) of children in experimental group is significantly higher than post test (73.5 + 6.55) scores of control group (U=10.500, P<0.01) which shows that the competence building interventional package was effective in improving the Life skills and Assertive behavior among orphan children in experimental group as compared to control group. The study concluded that. Interventional programmes on life skills and assertive training are effective improving the Psychological and mental wellbeing of orphans. Keywords: Competence Building Interventional Package, Life Skills, Assertive Behaviour, Children, Orphanages of Bagalkot District

Exposure to Pesticides and Respiratory Health Outcomes in Children Residing in Imperial Valley, CA

Exposure to Pesticides and Respiratory Health Outcomes in Children Residing in Imperial Valley, CA

Prevalence and determinants of sunburns and sun protection behaviors among children: A nationwide cross-sectional survey in Switzerland

BACKGROUND: High exposure to solar ultraviolet radiation in early life increases the risk of developing skin cancer later, with increasing risk related to an increasing number of sunburns. Switzerland has high incidence rates of skin cancer compared to surrounding countries. We aimed to estimate the prevalence of sunburns and sun protection behaviors and their potential determinants among children in Switzerland. METHODS: In February 2019, we sent questionnaires to the parents of a random sample of 8,221 Swiss resident children. The questionnaires of 2,841 children were returned (response rate 35%). In spring and summer of the same year, follow-up questionnaires were sent to these children (response rate ~50%). Parents were asked about their child regarding protection measures, number of sunburns in the previous year, and skin phototype. We calculated the prevalence of sunburns and sun-protective behaviors (wearing a hat, seeking for shade, and use of sunscreen) by season, sociodemographic characteristics and skin phototype. RESULTS: Among participating children, 39.9% had at least one sunburn in the previous year, of whom 20.5% had a severe sunburn. When outside on a sunny day, 50.3% of the children wore a hat in summer (46.8% in spring), 21.1% (19.8%) sought shade more than half of the time, and 53.6% (43.5%) wore sunscreen. Prevalence of sunburns and of severe sunburns was higher among older children, boys, and children with sensitive skin. Protective measures were more frequent among younger children, girls, and children with sensitive skin. Prevalence of both outcomes varied substantially between regions. Sunburn prevalence was associated with lower use of sun protection. CONCLUSIONS: Compared to previous regional studies in Switzerland, we found a lower prevalence of sunburns and of protection behaviors, with important regional heterogeneity. Our results should help tailor sun exposure prevention measures to specific age groups and regions. KEYWORDS : sunburn, children, skin cancer

Individual Differences in Relative Telomere Length in Mentally Healthy Subjects: The Effect of TERT Gene Polymorphism and Urban Residency.

The changes in the telomere length caused by the terminal underreplication in the existing literature are related to depressive disorders. However, the use of the telomere length as a biomarker of depressive states is ambiguous, which is due to the effect of various environmental factors on both the psychoemotional state and cellular aging of an organism. In order to identify the possible use of the relative telomere length (RTL) measured in peripheral blood leukocytes as a biomarker of enhanced liability to depression prior to the clinical symptoms, as well as to determine the link between telomere length, sociodemographic factors, allelic variants of the genes involved in the regulation of telomere elongation, and depression level, the association analysis of reverse transcriptase (TERT rs7726159), telomerase RNA component (TERC rs1317082), and the CST complex encoding protein (OBFC1 rs2487999) gene polymorphisms was performed with RTL and depression level in mentally healthy individuals (N = 1065) aged 18–25 years. Together with genetic variants, the examined regression models included various sociodemographic parameters as predictors. As a result of statistical analysis, we failed to observe the association between RTL and individual differences in depression level in the studied sample. Nevertheless, multiple regression analysis allowed us to construct a statistically significant model of individual variance in RTL (P = 4.3е–4; r2 = 0.018), which included rs7726159 in the TERT gene (P = 0.020; β = 0.078) and such environmental predictors as age (P = 0.001; β = –0.027) and place of residence in childhood (urban/rural area) (P = 0.048; β = 0.063). The data obtained confirm the involvement of TERT gene variants and age in telomere length in mentally healthy individuals aged 18–25 years and indicate a negative effect of urban residency on telomere length shortening, which reflects the cellular aging of an organism.

Post-COVID Syndrome in Children Residing in the Kabardino-Balkarian Republic

A study which included 97 children who had COVID-19 during the period from September 2021 to January 2022 was conducted. This article discusses the symptoms occurring after COVID-19 infection. The analysis of the results showed that the largest proportion among sick children was in patients with reduced cognitive functions, an increased level of neuroticism, depressed state and emotional instability. The most common comorbidities were the diseases of the gastrointestinal tract, respiratory and cardiovascular systems.

Diversifying Neighborhoods, Diversifying Schools? The Relationship Between Neighborhood Racial Change and School Segregation in New York City

College-educated White households have increasingly opted to live in central urban neighborhoods, transforming many parts of the urban core. While there is emerging evidence that schools may play a key part in this process, little is known about the extent of racial contract between children of gentrifier households and original residents. This study examines NYC’s gentrifying areas, and the changing racial diversity in schools. Using data from the Census and the National Center for Educational Statistics, this study finds that schools in NYC’s gentrifying areas have seen a reduction in racial segregation, more in traditional public schools than in charters. While this trend may be promising, high levels of segregation persist. Policy and research implications are discussed.

Green and blue spaces and lung function in the Generation XXI cohort: a life-course approach.

Exposure to natural environments may affect respiratory health. This study examined the association of exposure to green and blue spaces with lung function in children, and assessed the mediation effect of air pollution and physical activity. The study used data from the Generation XXI, a population-based birth cohort from the Porto Metropolitan Area (Portugal). Residential Normalised Difference Vegetation Index (NDVI) at different buffers (100, 250 and 500 m), the accessibility to urban green spaces (UGS) within 400 and 800 m and the minimum distance to the nearest UGS and to the nearest blue spaces were assessed at birth, 4, 7 and 10 years of age. Three life-course measures were calculated: averaged exposure, early-life exposure (birth) and exposure trend over time (change in exposure). Forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) and forced expiratory flow between 25% and 75% of FVC (FEF25-75%) at 10 years were used as outcomes. To assess associations, linear regression models and path analysis were used. This study included 3278 children. The adjusted models showed that increasing the NDVI exposure over time within 100 m of the child's residence was associated with higher values of FEV1 (L) and FEF25-75% (L·s-1) (β 0.01, 95% CI 0.0002-0.03 and β 0.02, 95% CI 0.001-0.05, respectively). No significant associations were observed for the remaining measures of exposure, and no mediation effect was found for pollution or physical activity. Increasing exposure to greenness at close proximity from residences was associated with improved lung function. While the mechanism remains unknown, this study brings evidence that city greening may improve children's respiratory health.

Conceptualizing Resilience among Adolescents Who are Orphaned and Living in Institutional Care in India

ABSTRACT Issues related to problems with institutional models of care for at-risk children in India have long been addressed by conversations around de-institutionalization. Researchers, however, believe that despite the benefits of family-based alternative care, there are multiple practical constraints in the stated transition. Fostering resilience among institutionalized children has been considered a worthier goal for intervention. The purpose of this study was to understand the pattern of resilience among adolescents with experience of family disruption due to parental loss and resultant relocation to an institutional set-up. Study 1 utilized semi-structured interviews with eight institutional caretakers in the age range of 28–50 years, and study 2 involved focus groups with 19 resilient adolescents in the age range of 14–19 years. Data from the both studies was thematically analyzed. Findings showed that against the backdrop of pre-admission adversities, resilience was conceptualized as a realization about the need to achieve in life and acquisition of a set of culturally sanctioned behavioral attributes. Resources within the institutional context itself were found to have fostered these resilient outcomes. Our findings suggest that by offering resident children needed resources, institutional care holds the potential to provide a permanent and stable living arrangement when other options are unfeasible.

A Tertiary Care Hospital's Observations on the Prevalence and Antibiotic Sensitivity of the Most Common Organisms Causing Urinary Tract Infections in Children

Objective: The purpose of this research was to evaluate the antibiotic resistance profile of urinary tract infection-causing bacteria and their prevalence among children presenting to a tertiary care hospital. Study Design: Cross-sectional/ Descriptive study Place and Duration: This study was carried out at Khyber Teaching Hospital, Peshawar from June, 2021 to May 2022. Methods: Total 112 suspected cases (children) of UTI with ages 6-months to 14 years were presented. After receiving parental agreement, we documented the children's age, gender, residence, and parental education level.It was decided to perform a urine dipstick test to check for nitrites and leucocytes, and then analyze the leucocytes and bacteria under the microscope. Antimicrobial resistance was tested using the modified Kirby-Bauer disc diffusion technique with a panel of antimicrobials.SPSS 20.0 was used to analyze all data. Results: Among 112 included cases, 58 (51.8%) were males and the rest were 54 (48.2%) female children. Frequency of leucocytes and nitrites by urine dipstick method was 30 (26.8%) and 12 (10%) but under the microscope, number of leucocytes were 15 (13.4%) and bacteria was 9 (8.03%). There were 65 (58.04%) gram positive and majority were females and 47 (41.96%) were gram negative cases. We found E.coli was the most prevalent microorganism found in 46 (70.8%) cases, 5 (7.7%) Klebsiella spp. and Pseudomonas spp. was 4 (6.2%). We found that microorganism were highly resistant (100%) to antibiotics ceftazidime, cefoperazone, ampicillin and ofloxacin while ciprofloxacin, cefuroxime and ceftriaxone showed high sensitivity. Conclusion: We observed that E.coli was the most frequent bacteria in UTI urine samples. Antimicrobial resistance in UTI-causing pathogens is worrying. It's crucial to monitor UTI-causing microbes' antibiotic susceptibility trends. Keywords:UTI, E.coli, Klebsiella spp., Resistance, Sensitivity

Predictors of exceeding emergency under-five mortality thresholds using small-scale survey data from humanitarian settings (1999 – 2020): considerations for measles vaccination, malnutrition, and displacement status

BackgroundQuantifying the effect of measles containing vaccine (MCV) coverage and the prevalence of global acute malnutrition (GAM) on mortality levels in populations of displaced and crisis-affected resident children is important for intervention programming in humanitarian emergencies.MethodsA total of 1597 surveys containing data on under-five death rate, population status (internally displaced, refugee, or crisis-affected resident), measles containing vaccine coverage, and global acute malnutrition were extracted from the Complex Emergency Database (CE-DAT). Under-five mortality rates were dichotomized to those exceeding critical levels or otherwise. A Bayesian multivariable mixed-effect logistic regression model was used to assess the association between an under-five death rate (U5DR) exceeding this threshold and population status (i.e., internally displaced, refugees or residents), GAM prevalence (proxy for food security), and MCV coverage.ResultsThe prevalence of GAM, MCV and U5DR were higher in internally displaced children (IDC) with values of 14.6%, 69.9% and 2.07 deaths per 10 000 per day, respectively. Refugee populations had lower average under-five mortality rate (0.89 deaths per 10 000 per day), GAM of 12.0% and the highest measles containing vaccine coverage (80.0%). In crisis-affected residents the prevalence of GAM, MCV and average U5DR are 11.1%, 65.5% and 1.20 deaths per 10 000 per day respectively. In mixed-effect logistic model taking 2 deaths per 10 000 children less than five years old per as emergency threshold (Model III); MCV (AOR = 0.66, 95% Highest Density Interval (HDI): 0.57, 0.78), GAM (AOR = 1.79, 95% HDI: 1.52, 2.12) were associated with a reduction of the odds of U5DR exceeding critical level accounting for country-specific levels of variability. The odds of U5DR exceeding critical level (2/10000/day) in crisis-affected resident children and refugees were 0.36 (95% HDI: 0.22, 0.58) and 0.25(95% HDI: 0.11, 0.55) less than amongst IDP children adjusting for GAM and MCV. In considering country specific yearly median U5DR (model IV) the odds of U5DR exceeding twice the median U5DR were associated with MCV (AOR = 0.72, 95% HDI: 0.64, 0.82), GAM (AOR = 1.53, 95%HDI: 1.34, 1.76). The odds of U5DR exceeding critical level in crisis-affected resident children was 0.30(95% HDI: 0.20, 0.45) less than IDP children, after adjusting for MCV and GAM. We found no difference between the odds of U5DR exceeding twice the country level median U5DR in the refugee population compared to the IDPs.ConclusionsIn this study vaccination coverage and global acute malnutrition (proxy for food security) were associated with U5DR exceeding critical level. The emergency threshold for IDPs and affected residents is significantly different and consistent across the different outcomes, whereas the result is inconsistent for IDPs and refugees. Continued improvement in measles vaccination coverage and reduction of malnutrition in humanitarian emergencies have the potential to minimize the deterioration of mortality level amongst children in emergency settings. To generate a robust understanding of the critical level of child mortality in displaced and affected resident populations, studies accounting for the impact of the duration of displacement, contextual factors in humanitarian settings, and the level of humanitarian assistance provided are needed.

Rates of emergency room visits and hospitalizations among refugee and resident children in a tertiary hospital in Turkey.

Refugee children, as compared to resident children, are more likely to present to the ED with high acuity conditions and at a younger age resulting in higher rates of inpatient admissions. Strategies to increase access to preventive health care services for young refugee children should be explored to decrease ED and hospital services and improve health outcomes. • Children are the most affected victims of armed conflicts in terms of health outcomes. • Refugees prefer to access healthcare through the emergency department. • Refugee children were more likely to present as urgent when compared to resident children. • Admission to neonatal and intensive care units was more frequent among refugee than resident children.

Objectively measured external building quality, Census housing vacancies and age, and serum metals in an adult cohort in Detroit, Michigan.

Residentially derived lead pollution remains a significant problem in urban areas across the country and globe. The risks of childhood residence in housing contaminated with lead-based paint are well-established, but less is known about the effects of housing quality on adult lead exposure. To evaluate the effects of residential-area housing age, vacancy status, and building quality on adult lead exposures. We evaluated the effect of Census block group housing vacancy proportion, block group housing age, and in-person survey evaluated neighborhood building quality on serum levels of lead, mercury, manganese, and copper among a representative cohort of adults in Detroit, Michigan, from 2008-2013 using generalized estimating equations. Participants in Census block groups with higher proportions of vacant and aged housing had non-significantly elevated serum lead levels. We identified similar positive associations between residence in neighborhoods with poorer objectively measured building quality and serum lead. Associations between Census vacancies, housing age, objectively measured building quality, and serum lead were stronger among participants with a more stable residential history. Vacant, aged, and poorly maintained housing may contribute to widespread, low-level lead exposure among adult residents of older cities like Detroit, Michigan. US Census and neighborhood quality data may be a useful tool to identify population-level lead exposures among US adults. Using longitudinal data from a representative cohort of adults in Detroit, Michigan, we demonstrate that Census data regarding housing vacancies and age and neighborhood survey data regarding housing quality are associated with increasing serum lead levels. Previous research has primarily focused on housing quality and lead exposures among children. Here, we demonstrate that area-level metrics of housing quality are associated with lead exposures among adults.