Child Health Research Articles

Exploring the effects of exercise on overall adiposity, targeted fat depots, and cardiometabolic risk in children with obesity

ABSTRACT Previous evidence has highlighted the role of exercise interventions in improving the health of children with overweight/obesity. This article provides an overview of the current understanding regarding exercise interventions and their impact on overall adiposity, specific fat depots, and cardiometabolic health in children with overweight/obesity. Aerobic exercise alone and combined with resistance training have been shown to improve adiposity. Furthermore, these interventions have demonstrated a significant capacity to reduce fat accumulation in various fat depots, with reductions of up to 20% in accumulated fat, potentially leading to significant cardiovascular benefits. Similar positive effects have been observed on diverse cardiometabolic health outcomes including lipids profiles, blood pressure, insulin sensitivity, and overall cardiometabolic risk in children with overweight/obesity. Data from longitudinal studies also show that promoting regular physical activity from a young age is crucial for improving long-term cardiorespiratory fitness and reducing the risk of cardiovascular diseases later in life. This review concludes that exercise interventions yield significant positive effects on overall adiposity, specific fat depots, and cardiometabolic health factors in children with overweight/obesity.

The influence of anxiety-related emotional disorders and self-esteem on obesity among Chinese children

Background Anxiety and obesity can have negative impacts on the health of children. Understanding the relationship between obesity and mental disorders in children and adolescents will help develop effective prevention and intervention strategies. This research investigates the impact of anxiety-related emotional disorders and self-esteem on obesity among Chinese children aged 6-12 in Anhui Province. Methods Utilizing a non-experimental, cross-sectional study design, data were from 136 participants collected through standardized instrument measures from Chinese children: the “Chinese screening for overweight and obesity among school-age children and adolescents” in the “Health Industry Standards of the People’s Republic of China” as the standard for identifying obesity, the Screen for Anxiety-Related Emotional Disorders (SCARED) for assessing anxiety disorder, and the Children’s Self-Esteem Scale (CSES) for evaluating self-esteem. Statistical analysis, including descriptive statistics, Pearson correlation analysis, and multiple regression analyses was performed using SPSS version 26 to determine the predictive relationships between the variables. Results The analysis revealed that anxiety-related emotional disorders and self-esteem contribute significantly to the prediction of obesity among Chinese children, accounting for a 13.7% variance. The study highlights the critical roles of anxiety-related emotional disorders and self-esteem in determining children’s obesity. It suggests that underscores the necessity for comprehensive interventions that address both physical and mental health aspects to combat childhood obesity effectively. The study concludes that addressing anxiety and self-esteem is essential for developing effective strategies to reduce obesity rates among Chinese children, meeting the research objectives, and contributing to the development of holistic health programs for children’s well-being.

GAMBARAN KECEMASAN DENTAL ANAK PADA KEGIATAN TUR EDUKASI DENTAL ANAK KE RSIGM-SA

Background: The Indonesian Health Survey states that oral health problems in the population aged ≥ 3 years are still high. Dental care is important requirement for the maintenance of children's health. One of the psychological problems that often occurs in children when undergoing dental treatment is anxiety. Anxiety towards dental care is also called dental anxiety. To overcome this anxiety can be done by fun learning education through field trip study. Field trip study aims to introduce children to real life, provide new experiences and make it an interesting place to learn.Objective : Targeting kindergartens and early childhood schools aims to invite the school community to think, behave and act to build and develop themselves to care with their dental and oral health.Method: In this community service activity, children are invited to take an educational tour to the Islamic Dental Hospital-Sultan Agung (RSIGM-SA) to recognize oral health facilities, increase knowledge about oral health and reduce dental anxiety in children.Result: Children's dental anxiety level evaluation after conducting an educational tour at RSIGM-SA, showed that the majority of children have a low level of anxiety with a high level of knowledge about oral health.Conclusion: . Educational tours can be one of the concrete applications of Tell-Show Do method in children oral health management.

Gender differentials in infant and under-five mortality in India

Perspective vista of child-health in India reclaim within the framework of Sustainable Development Goals to ensure healthy living and well-being for all at all ages. With significant young populace in India, health status of children becomes paramount undoubtedly. Study precisely traces gender differential in child mortality, highlighting role of pointers like IMR and UMR in the context of parental, socio-economic, and environmental settings. Commissioning a comprehensive approach, study evaluates data from National Family Health Survey (NFHS-4) alongside Demographic Health Survey (DHS), USAID spanning over 2015-2016. Risk of mortality was higher among male infants and under-five children compared to female. Birth order, birth spacing, mother’s age at birth, maternal and parental education were observed valuable for child survival. Birth order higher than four with birth-spacing less than two years for mothers bearing child at 35 years of age and above were deleterious for child survival. Certain socioeconomic and environmental factors appeared significantly contributory in gender differences in child mortality. High-risk zone of Central India need critical and incisive surveillance to control child mortality due to preventable causes. Planning and implementation of health programs need to consider gender gap in child mortality for maternal and child health related policies and interventions. Study emphasizes attention of policymakers and public health entrepreneurs to foresee rewarding interventions targeting the cohort of children at risk.

Optimal allocation of antenatal and young child nutrition interventions: an individual-based global burden of disease calibrated microsimulation

BackgroundUndernutrition remains a global crisis and is a focus of Sustainable Development Goals. While there are multiple known, effective interventions, complex interactions between prevention and treatment and resource constraints can lead to difficulties in allocating funding. Simulation studies that use in silico simulation can help illuminate the interactions between interventions and provide insight into the cost-effectiveness of alternative packages of options.MethodsWe developed an individual-based microsimulation model based on the Global Burden of Disease (GBD) 2021 study data to test a range of nutrition interventions, including antenatal interventions (iron and folic acid, multiple micronutrients, and balanced energy protein supplementation) and child interventions (treatment for severe acute malnutrition, treatment for moderate acute malnutrition, and wasting prevention with small-quantity lipid-based nutrient supplements). We also developed an analytic approach to process the results of the microsimulation and identify the optimal intervention funding allocation for a given budget size. We use Ethiopia as an example in this paper.ResultsIn our illustrative example of Ethiopia, the reallocation of the baseline budget to minimize disability-adjusted life years (DALYs) resulted in first funding the antenatal multiple micronutrients to their maximum coverage and then funding treatment for severe child acute malnutrition. Relative to the baseline allocation, the reallocation optimized to minimizing DALYs resulted in 592,000 fewer annual DALYs, constituting an 8.3% reduction in total DALYs in Ethiopia.For budgets larger than the baseline, our model recommended funding first targeted moderate acute malnutrition treatment, second universal moderate acute malnutrition treatment, third wasting prevention with small-quantity lipid-based nutrient supplements, and fourth balanced energy protein supplementation.ConclusionsOur simulation is a novel model for estimating optimal allocation of spending on antenatal and child health nutrition interventions which accounts for the interaction between preventive and therapeutic approaches. Our illustrative results show that an optimized reallocation of current spending can substantially improve pregnancy-related and child health without additional funding. We hope this model can add validity and confidence to prior results to aid stakeholders in funding decisions.

Tadābīr-i-Navmawlūd (Child Health Care): A Holistic Framework in Unani System of Medicine for Child Well-Being

Infancy, the critical phase from birth to early childhood, holds immense importance, with each day contributing significantly to a child's development. Globally, approximately four million neonatal deaths occur annually, with 98% of these taking place in developing countries. In these regions, many newborns succumb to mortality at home, often under the care of mothers, family members, and traditional birth attendants. In Unani Medicine, this stage is associated with the temperament known as Mizāj Ḥārr Raṭb (hot and moist), highlighting a period of rapid growth and developmental milestones. Comprehensive neonatal and child care guidelines, referred to as Tadābīr-i-Navmawlūd, encompass various aspects, including newborn care, infant feeding, management of dentition, and therapeutic principles and treatments for children.Renowned Unani scholars such as Ibn Sīnā, Zakariyya Rāzī, Ali Ibn Abbas Majūsī, Ibn Rushd, and Ibn Hubal Baghdādī have extensively discussed these topics in classical Unani texts like Al-Qānūn fi’l Ṭibb, Kitāb al-Manṣūrī, Kāmil al-Ṣanāʻa, Kitāb al-Kulliyat, and Kitāb al-Mukhtārāt fi’l Ṭibb. Their writings outline regimens and medicinal practices aimed at promoting the health and well-being of newborns, infants, and children. Keywords: Unani medicine, Tadābīr-i-Navmawlūd, child health care, infancy, Amrāḍ-i-Aṭfāl.

Insights into parental perspectives: Children's eye care in Saudi Arabia.

Despite the concerning growth in the number of children with preventable or treatable causes of blindness, parents and/or children often do not notice many eye problems due to the lack of adequate knowledge about them. Considering the lack of updated relevant literature on this topic, this study aimed to gain insights into parental perspectives regarding children's eye health and the barriers that prevent them from promptly addressing these issues. A cross-sectional online survey was randomly distributed to Saudi parents of children aged 0-18 years from February 2022 to April 2022. A total of 1265 parents (mean age=36.10±10.043 years) completed the questionnaire, and 61.3% obtained high knowledge scores. The factors associated with high knowledge scores included an educational level above high school, employment in the healthcare industry, and having a child with an eye disease.Two-thirds of the parents did not take their children for periodic eye examinations. However, parents from the central region, healthcare workers, and those having a child with an eye disease were more likely to have their children's eyes checked regularly. Moreover, 40% of parents tended to believe that routine eye checkups were unnecessary if their children had seemingly normal eyes and no eye complaints.Concerning corrective spectacle use, parents from the northern region and those with an educational level of high school or less were more likely to reject it. Our findings also showed that 25% of parents believed that eyeglasses may limit their children's daily activities. Parental knowledge of children's eye care in Saudi Arabia was acceptable.

Exploring the influence of living arrangements on mental health among adolescents during the COVID-19 pandemic: a cross-sectional study in China

BackgroundAlthough scholars have extensively explored the impact of parents on the mental health of children and adolescents during the COVID-19 pandemic, the role of living arrangements has not received sufficient attention. Furthermore, the previous studies do not investigate whether living with a father or a mother has differing impacts on the mental health of adolescents, nor does it explore potential differences between biological parents and step-parents in this regard.Study aimsThis study aims to explore the impact of various living arrangements during the COVID-19 pandemic on the mental health of adolescents, with a particular focus on parental presence and family structure.MethodsThis cross-sectional study, conducted between October and November 2020, involved over 20,000 participants. General linear regression and one-way ANOVA were used for data analysis.ResultsSignificant differences in positive mood levels were observed among different family living arrangements. Those living with both biological parents exhibited the highest positive mood. Compared to living with a father, living with a mother was associated with higher positive mood. Significant differences were also found between living with biological parents and step-parents.ConclusionThe findings underscore the nuanced relationship between living arrangements and mental health among adolescents. This study provides valuable insights into the role parents play in the mental health of young people during the COVID-19 pandemic.

Risk-Prioritised Versus Universal Medical Nutrition Therapy for Gestational Diabetes: A Retrospective Observational Study

Background: The optimal application of medical nutrition therapy (MNT) in treating gestational diabetes remains uncertain. MNT involves individualised nutrition assessment and counselling, which is labour-intensive and is not the sole type of intervention offered by clinical dietitians. Objective: To determine whether pregnancy outcomes differed for individuals with gestational diabetes who were offered MNT on a risk-prioritised (RP) versus universal basis. Methods: Observational data from two cohorts of individuals who were offered MNT only if they met the high-risk criteria following general group-based dietary education (RP1, n = 369; RP2, n = 446) were compared with a baseline cohort who were universally offered at least one MNT consultation (UM, n = 649). The RP1 cohort were seen during community-wide COVID-19 restrictions in 2021, while RP2 were seen after restrictions had lifted in 2022. Furthermore, the RP approach primarily utilised telemedicine, while the UM approach was delivered in person. Results: MNT consultations halved under the RP approach (59 vs. 119 sessions per 100 diagnoses for RP2 vs. UM) and saved more than 20 h of dietitian time per 100 diagnoses (95 vs. 73 h for RP2 vs. UM). No significant increases were observed (p < 0.05) for any pregnancy outcomes in the RP cohorts compared with the UM cohort, including usage of diabetes medications, maternal weight gain below and above target, early deliveries, induced deliveries, emergency caesarean sections, large- and small-for-gestational-age (SGA) infants, infant macrosomia, neonatal hypoglycaemia and neonatal intensive care admissions. The use of both basal insulin (27% vs. 33%, OR 0.62, 95% CI 0.46 to 0.84) and metformin (6% vs. 10%, OR 0.52, 95% CI 0.31 to 0.88) was lower in the RP1 cohort during pandemic restrictions compared with the UM cohort; however, these differences were not retained in the RP2 cohort. Additionally, there were fewer SGA infants under the RP approach, particularly for the RP2 cohort (6% vs. 11% for RP2 vs. UM, OR 0.55, 95% CI 0.34 to 0.89). Conclusions: Risk-prioritised MNT was a more efficient dietetic service approach to gestational diabetes than the universal MNT model, with comparable pregnancy outcomes. Similar approaches may represent a strategic way to address sustainable health service planning amidst the rising global prevalence of this condition. However, further research is needed to investigate consumer perspectives, wider service impacts and post-partum maternal and child health outcomes.

Parental experiences of caring for their preschool children after declining vaccines: a qualitative systematic review.

This review synthesizes qualitative research about the experiences of parental caregivers enhancing their children's health after making the decision to not vaccinate their preschool children. This review aims to help health care providers understand the parental work involved in caring for under-vaccinated or unvaccinated children. Much of the current qualitative research literature about parents who are vaccine-hesitant or who decide not to vaccinate their children focuses on parental perceptions about the safety and efficacy of vaccines and decision-making. However, limited attention has been paid to measures taken by parents to help their young children avoid contracting vaccine-preventable communicable diseases, promote resistance, and enhance their children's health. This review considered qualitative studies that described parents' experiences of caring for their young children, aged 0 to 6 years, after making the decision not to vaccinate. Studies undertaken in any context were considered. Studies that focused on young children who were unvaccinated or not fully vaccinated for reasons not related to parental refusal were excluded. The JBI methodology for systematic reviews of qualitative evidence was followed. Databases were searched from 1998 onward, and included Web of Science Core Collection, MEDLINE (Ovid), CINAHL Complete (EBSCOhost), PsycINFO (EBSCOhost), Google Scholar, and ProQuest Dissertations and Theses, with no language limits. Following critical appraisal, findings that described parental experiences and the care activities they performed relating to their young children were extracted. The JBI process of meta-aggregation was used to identify categories and synthesize findings. The ConQual approach was used to assess confidence in the findings. Forty studies, met the criteria for inclusion. The studies were conducted in 14 countries across 4 continents, with approximately 676 participants. From these studies, 115 findings were extracted and combined to form 12 categories based on similarity in meaning. Three synthesized findings included i) Parental care strategies in the home that focused on the individual and family, ii) Parental care strategies in the community, including how parents managed social interactions and community networks, and iii) Parental care strategies at the systems-level, involving the ways parents challenged societal discourses and institutional work processes. The major conclusions from this review highlight the laborious activities that parents enact to care for their children's health after declining vaccines. Care activities extended from the household to the community, encompassing myriad anticipatory and reactive measures. Parents demonstrated a strong commitment to their children's health and well-being while responding to stigma they experienced among their friends, children's teachers, and health care providers. While facing or expecting penalties related to their vaccine choices, parents reached out to like-minded peers for support and planned which next steps to take should punitive measures become overwhelming. PROSPERO CRD42021241781.

Supervised and Unsupervised Screen Time and Its Association With Physical, Mental, and Social Health of School-Going Children in Dhaka, Bangladesh: Cross-Sectional Study.

Children's screen time has substantially increased worldwide, including in Bangladesh, especially since the pandemic, which is raising concern about its potential adverse effects on their physical, mental, and social health. Parental supervision may play a crucial role in mitigating these negative impacts. However, there is a lack of empirical evidence assessing the relationship between parental screen time supervision and health outcomes among school children in Dhaka, Bangladesh. We aimed to explore the association between supervised and unsupervised screen time on the physical, mental, and social health of school-going children in Dhaka, Bangladesh. We conducted a cross-sectional descriptive study between July 2022 and June 2024. A total of 420 children, aged 6-14 years, were enrolled via the stratified random sampling method across three English medium and three Bangla medium schools in Dhaka. Data were collected through a semistructured questionnaire; anthropometry measurements; and the Bangla-validated Strength and Difficulties Questionnaire (SDQ), Pittsburgh Sleep Quality Index (PSQI) Scale, and Spencer Children Anxiety Scale (SCAS). A total of 234 out of 420 students (56%) used digital screen devices without parental supervision. We did not find a substantial difference in the duration of the daily mean use of digital devices among the supervised students (4.5 hours, SD 2.2 hours) and the unsupervised students (4.6 hours, SD 2.4 hours). According to the type of school, English medium school children had a mean higher screen time (5.46 hours, SD 2.32 hours) compared to Bangla medium school children (3.67 hours, SD 2.00 hours). Headache was significantly higher among the unsupervised digital screen users compared to those who used digital screens with parental supervision (175/336 students, 52.1% versus 161/336 students, 47.9%; P<.003). Moreover, students who used digital screens without parental supervision had poor quality of sleep. Behavioral problems such as conduct issues (119/420 students, 28.3%) and peer difficulties (121/420 students, 28.8%) were observed among the participants. However, when comparing supervised and unsupervised students, we found no statistically significant differences in the prevalence of these issues. The findings of the study showed that the lack of screen time supervision is associated with negative health effects in children. The roles of various stakeholders, including schools, parents, policy makers, and students themselves, are crucial in developing effective guidelines for managing screen use among students. Further research is needed to demonstrate causal mechanisms; identify the best interventions; and determine the role of mediators and moderators in households, surroundings, and schools.

Consensus evidence-based clinical practice guide for the diagnosis and management of osteoporosis in childhood and adolescence

BackgroundThe incidence of osteoporosis in children has increased dramatically during the last decade. This has been attributed to better survival rates of children living with chronic disorders, the increased use of medications known to have a negative impact on the children’s bones, and the increased preference for indoor activities and sedentary life in healthy children. Recent advances in pediatric osteoporosis definition, along with a lack of management recommendations or national consensus on its diagnosis and treatment, have led to a wide range of approaches being implemented to manage this illness. The aim of this work was to develop an optimal evidence-based consensus, target-oriented, on-steered therapeutic approach for children with osteoporosis. Based on 15 key clinical questions, a qualitative literature evaluation was conducted to provide evidence-based recommendations for the treatment of pediatric osteoporosis. An expert panel of 14 pediatric osteoporosis specialists conducted a Delphi survey. The level of evidence for each element was assessed using the Oxford Centre for Evidence-based Medicine (CEBM) System, when available, and/or based on the expert panel’s personal experience. All recommendations with an agreement rate of 75% or higher were included.ResultsThirty-six recommendations, categorized into 13 domains, had evidence 4 or 5 and consequently were included in the Delphi survey. This was assessed online and a response rate of 82.4% was achieved. Delphi 2 round revealed that all the recommendations achieved 75% or more level of agreement and therefore have been accepted and included in this management recommendations. Based on that an algorithm showing an approach to pediatric osteoporosis management and maintenance of therapy has been developed.ConclusionFor the management of children with osteoporosis, consulting a pediatric bone specialist is strongly advised, either by referral or by advice. This is extremely relevant because children are uniquely capable of recovering spontaneously or with the assistance of medication. This includes also vertebral fractures reshaping. Consequently, there is a huge opportunity to improve bone mass accretion and thus musculoskeletal health in children with osteoporosis.

Influence of social media on children's dietary habits

Introduction: Dietary habits refer to the consistent choices made by individuals or groups concerning their food consumption. It has a crucial influence in human health and reflects individual eating choices, which are often associated with culture, education, social background, and health status. Dietary habits may be influenced and altered by life stages and lifestyle factors, including physical activity and social interac-tion. Nutritional consumption significantly influences human health and well-being, particularly during childhood and adolescence, and directly impacts children's health due to their physical, mental, and cognitive development. Approaches: Data has been gathered from 100 children to evaluate the impact of social media on their dietary practices. The questionnaire was administered to professionals to establish its validity and subsequently its reliability. The total number of items in the questionnaire was 19. To evaluate children's behavior on social media about eating practices. The data was gathered by a simple random sampling process and analyzed using both descriptive and inferen-tial statistical techniques. Outcomes The results indicated that among 100 children, the mean age of participation was 15.66 years. The cur-rent study demonstrated a moderate impact of social media on children's food habits. The study demonstrated a substantial statistical link between children's age and hours spent on social media, as well as the impact of social media on children's food habits (p &lt; 0.05). The re-sults indicated no statistically significant differences (p &gt; 0.05) between social media usage and other demographic variables. Concludes The findings indicated that social media exerted a moderate influence on children's food habits. The study concluded that a substantial statistical link exists between children's age, hours of social media usage, and the impact of social media on children's food habits. The results indicat-ed no significant statistical differences between social media usage and other demographic variables.

PREVALENCE AND RISK FACTORS OF POSTPARTUM DEPRESSION: A SYSTEMATIC REVIEW

Abstract: Background: Postpartum depression (PPD) is a common and debilitating mental health condition affecting mothers worldwide, with significant consequences for both maternal and child health. Objective: This systematic review examines the prevalence, risk factors, screening tools, and treatment strategies for PPD, highlighting regional and socioeconomic disparities. Methods: A systematic search of PubMed, Scopus, and PsycINFO databases was conducted for studies published between January 2013 and December 2023. Eligible studies included peer-reviewed articles, longitudinal or cross-sectional studies, and randomized controlled trials focusing on postpartum populations. A total of 128 studies were included in the final synthesis. Results: PPD prevalence ranges from 10–15% in high-income countries to over 30% in low- and middle-income countries, influenced by socioeconomic, cultural, and healthcare disparities. Risk factors include hormonal fluctuations, pre-existing mental health conditions, and social determinants such as poverty, domestic violence, and inadequate partner support. Screening tools, such as the Edinburgh Postnatal Depression Scale, facilitate early detection, while treatment strategies including pharmacological interventions, psychotherapy, and integrated care models demonstrate effectiveness. Conclusion: PPD is a multifaceted condition requiring comprehensive, culturally sensitive care models to mitigate its impact. Future research should focus on longitudinal studies, personalized interventions, and the integration of mental health services into primary care to improve maternal and child outcomes globally.

Mycotoxin exposure through the consumption of processed cereal food for children (< 5years old) from rural households of Oshana, a region of Namibia.

Mycotoxin exposure from contaminated food is a significant global health issue, particularly among vulnerable children. Given limited data on mycotoxin exposure among Namibian children, this study investigated mycotoxin types and levels in foods, evaluated dietary mycotoxin exposure from processed cereal foods in children under age five from rural households in Oshana region, Namibia. Mycotoxins in cereal-based food samples (n = 162) (mahangu flour (n = 35), sorghum flour (n = 13), mahangu thin/thick porridge (n = 54), oshikundu (n = 56), and omungome (n = 4)) were determined by liquid chromatography-tandem mass spectrometry. Aflatoxin B1 (AFB1, 35.8%), zearalenone (27.2%), fumonisin B1 (FB1, 24.1%), citrinin (CIT, 12.4%) and deoxynivalenol (10.5%) were the major mycotoxins quantified. Food samples (35.8% (n = 58) and 6.2% (n = 10)) exceeded the 0.1µg/kg AFB1 and 200µg/kg FB1 EU limit for children's food, respectively. Several emerging mycotoxins including the neurotoxic 3-nitropropionic acid, moniliformin (MON), and tenuazonic acid were quantified in over 50% of all samples. Co-occurrence of AFB1, CIT, and FB1 detected in 4.9% (n = 8) samples, which could heighten food safety concerns. Regarding exposure assessment and risk characterization, average probable dietary intake for AFB1 from all ready-to-eat-foods was 0.036µg/kg bw/day, which resulted in margin of exposures (MOE) of 11 and 0.65 risk cancer cases/year/100,000 people, indicating a risk of chronic aflatoxicosis. High tolerable daily intake values for FB1, and MOE for beauvericin and MON exceeded reference values. Consumption of a diversified diet and interventions including timely planting and harvesting, best grain storage, and other standard postharvest food handling practices are needed to mitigate mycotoxin exposure through contaminated cereal foods and to safeguard the health of the rural children in Namibia.

Home Health Care Research for Children With Disability and Medical Complexity.

Pediatric home health care represents a vital system of care for children with disability and medical complexity, encompassing services provided by family caregivers and nonfamily home health care providers and the use of durable medical equipment and supplies. Home health care is medically necessary for the physiologic health of children with disability and medical complexity and for their participation and function within home, school, and community settings. While the study of pediatric home health care in the United States has increased in the last decade, its research remains primarily methodologically limited to observational studies. Dedicated funding and research efforts are needed to transform American home health care research to address multifaceted outcomes valued by families and providers as well as payers and government programs. In this paper, we review the recent literature in pediatric home health care and then propose an actional agenda that could address its missing evidence base. We posit that pediatricians should partner with family caregiving experts and patients to advance knowledge about child and family health outcomes, home health care use, new models of care, and optimal approaches to education and training while also considering meaningful approaches to address disparities. The creation of an American pediatric home health care data-sharing consortium, patient registry, and reproducible access and quality measures is also needed. Most importantly, efforts should center on patient- and family-centered health priorities, with the goal of ensuring equitable outcomes for every child and family.

Minimum acceptable diet and contributing factors among children aged 6–23 months in Afghanistan: insights from the 2022–2023 Multiple Indicator Cluster Survey

BackgroundUndernutrition among children is a public health concern in most low and middle-income countries (LMICs) and is associated with poor child growth and development. Knowledge about child feeding practices is needed for nutritional policies and programs. Hence, this study assessed the status of minimum acceptable diet (MAD) and its associated factors among children aged 6–23 months in Afghanistan.MethodsThis cross-sectional study was based on a secondary dataset of the 2022–2023 Afghanistan Multiple Indicator Cluster Survey (MICS 2022–23). Complete data from 7,876 children aged 6–23 months were analysed. The outcome variable was MAD and was defined according to the WHO and UNICEF recommendations and indicators for young child feeding practices. Bivariate and multivariate binary logistic regression analyses were used to identify factors associated with MAD.ResultsAbout 7.3% of children aged 6–23 months were fed with the recommended MAD. The likelihood of receiving MAD was higher in children aged 13–18 months [adjusted odds ratio (AOR) 2.01 (95%CI: 1.63–2.48)] and 19–23 months [2.11 (95%CI: 1.68–2.66)], in children belonging to households with higher wealth status [1.39 (95%CI: 1.04–1.87), 2.06 (95%CI: 1.51–2.82), and 3.07 (95%CI: 2.14–4.40) for the 3rd, 4th, and 5th quintile of wealth status, respectively], and in children living in rural areas [1.56 (95%CI: 1.21–2.01)]. On the other hand, the maternal age group 30–39 years [0.79 (95%CI: 0.64–0.96)] and non-institutional delivery [0.67 (95%CI: 0.54–0.83)] were associated with reduced odds of MAD.ConclusionOur study revealed that a small percentage (7.3%) of children received MAD in Afghanistan. This emphasizes the need for policies and interventions aimed at the improvement of child feeding practices to ultimately lead to better child nutrition and health in Afghanistan.

Early life microbial succession in the gut follows common patterns in humans across the globe

Characterizing the dynamics of microbial community succession in the infant gut microbiome is crucial for understanding child health and development, but no normative model currently exists. Here, we estimate child age using gut microbial taxonomic relative abundances from metagenomes, with high temporal resolution (±3 months) for the first 1.5 years of life. Using 3154 samples from 1827 infants across 12 countries, we trained a random forest model, achieving a root mean square error of 2.56 months. We identified key taxonomic predictors of age, including declines in Bifidobacterium spp. and increases in Faecalibacterium prausnitzii and Lachnospiraceae. Microbial succession patterns are conserved across infants from diverse human populations, suggesting universal developmental trajectories. Functional analysis confirmed trends in key microbial genes involved in feeding transitions and dietary exposures. This model provides a normative benchmark of “microbiome age” for assessing early gut maturation that may be used alongside other measures of child development.

Trend, clinical characteristics, and pregnancy outcomes of pregnancy associated venous thromboembolism: a retrospective analysis of nearly 10 years

Background Pregnancy-associated venous thromboembolism (PA-VTE) seriously threatens maternal health. We aimed to investigate the clinical characteristics, risk factors, treatments, and pregnancy outcomes to better prevent and treat PA-VTE. Methods PA-VTE patients were selected from 171,898 women who were registered in the Department of Obstetrics of Fujian Maternity and Child Health Hospital from January 2014 to August 2023 and delivered to calculate the incidence. Clinical data were collected to retrospectively analyze the clinical characteristics, risk factors, treatments, and pregnancy outcomes of PA-VTE. Descriptive statistical analysis was used. Results There were 122 cases of PA-VTE with an incidence of 0.71 per 1000 pregnancies; the incidence showed an upward trend and peaked in 2022 (1.24‰). Pregnant women accounted for 28.69% (35/122), the onset were 5–39+6 weeks and incidence increased with the increase of trimester, reaching the highest level in puerperium with 87 cases (71.31%). VTE was mainly found in the lower extremities (112/122); a few were found in cranial venous sinus (4/122), pelvic vein (1/122), and pulmonary embolism (PE) in five cases. 78.68% (96/122) had clinical manifestations. By Royal College of Obstetricians and Gynaecologists (RCOG) risk assessment scale, 45.71% (16/35) of antepartum patients had risk score ≥3 with a maximum of 9, distributed in eight cases in the first trimester, four cases in the second trimester, and four cases in the third trimester. Patients with risk score <3 all occurred in the second and third trimester. Primary risk factors included advanced maternal age (AMA), thrombophilia. All patients received anticoagulant therapy, and seven patients were placed inferior vena cava (IVC) filter in antepartum period. Except one case of abortion in PPROM, the rest continued pregnancy to 29+1 to 40 weeks, only one case of postpartum hemorrhage and one case of severe neonatal asphyxia. The onset time in puerperium was three hours to 28 days after delivery; 62.07% (54/87) patients were scored ≥2. The main risk factors included elective cesarean section, AMA, and preterm birth. Anticoagulant therapy was given after diagnosis; two cases were placed with IVC filter, one case was placed with left iliac vein stent and thrombolysis. Conclusions The incidence of PA-VTE showed an increasing trend over the past decade, predominantly occurring postpartum. Main risk factors included AMA, thrombophilia, preterm birth, and elective cesarean section. Higher risk scores correlated with earlier onset. Early risk assessment, appropriate prophylaxis, and standardized anticoagulation therapy resulted in favorable maternal and fetal outcomes, with temporary IVC filter placement being beneficial in selected cases.

Calling for attention to prevention and treatment of Mycoplasma pneumoniae infection in children during the fall-winter seasons

Mycoplasma pneumoniae (MP) is a common cause of community-acquired pneumonia in children in China, and it is often prevalent in the autumn and winter seasons. In the autumn and winter of 2023, a large-scale epidemic outbreak of MP pneumonia occurred nationwide in the pediatric population, which brought harm to child health, caused a heavy disease burden, imposed a challenge to the pediatric medical service system, and aroused great attention from medical administration and public health fields. The widespread prevalence of macrolide-resistant MP (MRMP) in China has become a prominent problem in pediatric clinical practice. This article reviewed the epidemiology of MP pneumonia and made evidence-based suggestions for the prevention and treatment of seasonal MP pneumonia in children in terms of the current clinical practice issues and public health concerns.