Objective This study estimated the investment in child development from three aspects-public health, public education, and family investment to establish the level of investment, to provide reference information for g...Objective This study estimated the investment in child development from three aspects-public health, public education, and family investment to establish the level of investment, to provide reference information for government decision making and to provide international comparisons. Methods Public investment in health was measured with macro data related to public health spending and child development in government expenditure. Public education investment was based on basic education data. Family investment evaluation was based on per capita family consumer spending data in different age groups to estimate the input for child development. Results Both public health investment level and the proportion of GDP rose for all age groups over time, but the overall investment level was still insufficient. Public investment in children＇s education has increased year by year, but the trends in all age groups are unbalanced with much lower investment in early childhood education. Private investment in children has increased over the period, but has declined as a percentage of GDP. International comparisons show that China＇s investment in child development is much lower than OECD countries. Conclusion The private investment in child development was the main way in China, with public finance contributing only a small proportion. Given the poor international comparisons, the government needs to review the balance of public investment to redirect more towards the development of children under the age of six to their health and education.展开更多
This article explores the intricate relationship between attachment styles formed during early childhood and the subsequent responses to traumatic events, particularly the death of a parent. Drawing on the theoretical...This article explores the intricate relationship between attachment styles formed during early childhood and the subsequent responses to traumatic events, particularly the death of a parent. Drawing on the theoretical framework of attachment theory and incorporating contemporary research, the paper discusses how parental interactions shape the neural circuitry of infants and children, influencing their ability to form secure or insecure attachments. These attachment styles, in turn, play a critical role in determining the child’s coping mechanisms when faced with trauma. This paper focuses on trying to understand how attachment theory is connected to the reaction to trauma with a highlight on the four major styles of attachments which are secure, anxious, avoidant, and disorganized to mention but a few, and how they influence stress and adversity in children. Attachment theory holds that human beings’ ability to form affectional bonds in infancy determines their patterns of relatedness across the life cycle. The type of attachment that is secure usually supports healthy adaptation and good coping mechanisms regardless of the trauma in the childhood of the child. While secure attachment mostly facilitates favorable trauma-related outcomes, anxious or avoidant attachment can exacerbate or alter the responses. The caregiving system that is avoidant attachment has implications of autonomous self-functioning which has features of suppression of the emotional response and poor search for emotional support during stress. From the principles of developmental psychology and trauma theory, the paper also focuses on the major significance of the child’s early caregivers’ interactions that define the resilience and vulnerability factor. This knowledge is therefore critical in designing specific interventions based on the improvement of coping behaviors and emotional regulatory systems of children who have been exposed to trauma. Finally, we have the synthesis of new knowledge about the role of secure attachment relationships as its fundamental element in shaping adaptive traumatization and psychological development. The article also delves into the physiological processes involved in emotional regulation and the role of cortisol in disrupting attachment. Finally, the implications of these findings for therapeutic interventions and the challenges of addressing prolonged grief and traumatic responses in clinical settings are considered.展开更多
EDITOR'S NOTE: The National Working Committee for Children and Women (NWCCW) issued a national report on child development on May 27. The three-chapter report discusses the policies adopted and actions taken by th...EDITOR'S NOTE: The National Working Committee for Children and Women (NWCCW) issued a national report on child development on May 27. The three-chapter report discusses the policies adopted and actions taken by the government to protect the legitimate rights and interests of children in the last few years. It also illustrates the improvements and progress made in children's health and education, and pinpoints the problems and future challenges facing the nation on child development issues. The full text of the report follows:展开更多
BACKGROUND Unintended pregnancy occurs when an individual or couple conceives without planning or desire,which can potentially affect a child’s physical,mental,and social well-being.This can then lead to long-term so...BACKGROUND Unintended pregnancy occurs when an individual or couple conceives without planning or desire,which can potentially affect a child’s physical,mental,and social well-being.This can then lead to long-term socioeconomic challenges for families and communities.Although its impact on child growth and development is a pressing concern,research remains limited particularly in multicenter settings.AIM To examine the long-term consequences of unintended pregnancy on the critical years of early childhood growth and development.METHODS This analytical observational study employed a case-control design and was conducted in research centers across Indonesia,encompassing those located in Central Java,Lampung,Bali,and West Nusa Tenggara.A total of 700 children aged≤5 years with histories of intended or unintended pregnancies participated.Data collection involved structured interviews and direct anthropometric and developmental assessments.Data analyses were conducted using multivariate statistics and partial least squares structural equation modeling.RESULTS Unintended pregnancy was found to have a statistically significant effect on both child growth(t=8.178;P<0.001)and child development(t=25.688;P<0.001).Key growth problems identified included underweight,undernutrition,abnormal head circumference,and stunting.Developmental challenges prominently associated with unintended pregnancy included behavioral and emotional disorders,autism spectrum disorder,attentiondeficit/hyperactivity disorder,social and motor skill deficits,as well as visual and hearing impairments.CONCLUSION Unintended pregnancy significantly affects child growth and development,underscoring the need for early intervention,quality prenatal care,and strengthened family planning policies.展开更多
BACKGROUND Neurodevelopmental delays encompass a wide range of conditions that impair cognitive,motor,and social functioning,often increasing the risk of psychiatric comorbidities.Children with these delays frequently...BACKGROUND Neurodevelopmental delays encompass a wide range of conditions that impair cognitive,motor,and social functioning,often increasing the risk of psychiatric comorbidities.Children with these delays frequently present with disorders such as attention-deficit/hyperactivity disorder(ADHD),anxiety,and behavioral disturbances,which can significantly affect development and quality of life.While genetic predisposition has been linked to these comorbidities,growing evidence highlights the role of environmental factors,including prenatal and early-life stressors.However,the interaction between genetic susceptibility and environmental influences remains poorly understood.Identifying specific genetic variants,environmental risks,and their interactions is essential for early detection and targeted interventions.AIM To investigate the combined effects of genetic and environmental factors on psychiatric comorbidities in children with neurodevelopmental delays,elucidate underlying mechanisms,and inform clinical management strategies.METHODS This retrospective cohort study included 80 children with confirmed neurodevelopmental delays and 40 age-and sex-matched typically developing controls.Comprehensive clinical and psychiatric evaluations,genetic testing(chromosomal microarray analysis and targeted next-generation sequencing),and environmental exposure assessments were conducted.Statistical analyses explored associations between genetic variants and psychiatric comorbidities,environmental risk factors,and gene-environment interactions.RESULTS Children with neurodevelopmental delays exhibited significantly higher rates of psychiatric comorbidities(70.0%)compared to controls(15.0%),with ADHD(42.5%),anxiety disorders(28.8%),and behavioral disorders(23.8%)being the most common.Pathogenic genetic variants were identified in specific pathways associated with distinct psychiatric presentations:Glutamatergic signaling variants were linked to anxiety disorders(odds ratio=3.8),dopaminergic system variants to ADHD(odds ratio=4.2),and synaptic function variants to both behavioral and anxiety disorders.Environmental factors,particularly prenatal maternal stress,early childhood adversity,and family dysfunction were strong predictors of psychiatric outcomes(β=0.42).Significant gene-environment interactions were identified,indicating that environmental exposure can moderate the effects of genetic risks on psychiatric outcomes.CONCLUSION Psychiatric comorbidities in children with neurodevelopmental delays are significantly influenced by both genetic and environmental factors,with complex interactions between the two.These findings underscore the need for integrated assessments and targeted interventions addressing both biological and environmental contributors to improve outcomes in this vulnerable population.展开更多
Background: Unsafe drinking water,poor sanitation and hygiene,exposure to household air pollution and low cognitive and socio-emotional stimulation are risk factors affecting children in low-and middle-income countrie...Background: Unsafe drinking water,poor sanitation and hygiene,exposure to household air pollution and low cognitive and socio-emotional stimulation are risk factors affecting children in low-and middle-income countries.We implemented an integrated home-environmental intervention package(IHIP),comprising a kitchen sink,hygiene education and a certified improved biomass cookstove,and an early child development(ECD)programme to improve children´s health and developmental outcomes in the rural high-altitude Andes of Peru.Methods: We conducted a one-year cluster-randomised controlled trial among 317 children<36 months divided into 4 arms(IHIP+ECD,IHIP,ECD,and Control)and 40 clusters(10 clusters per arm).ECD status(socio-emotional,fine and gross motor,communication,cognitive skills,and an overall performance)measured with the Peruvian Infant Development Scale and the occurrence of self-reported child diarrhoea from caretakers were primary outcomes.Secondary outcomes included the occurrence of acute respiratory infections and the presence of thermo-tolerant faecal bacteria in drinking water.The trial was powered to compare each intervention against its control arm but it did not allow pairwise comparisons among the four arms.Primary analysis followed the intention-to-treat principle.For the statistical analysis,we employed generalised estimating equation models with robust standard errors and an independent correlation structure.Results: We obtained ECD information from 101 children who received the ECD intervention(individually and combined with IHIP)and 102 controls.Children who received the ECD intervention performed better in all the domains compared to controls.We found differences in the overall performance(64 vs.39%,odd ratio(OR):2.8;95%confidence interval(CI):1.6–4.9)and the cognitive domain(62 vs 46%,OR:1.9;95%CI:1.1–3.5).Data analysis of child morbidity included 154 children who received the IHIP intervention(individually and combined with ECD)and 156 controls.We recorded 110,666 child-days of information on diarrhoea morbidity and observed 1.3 mean episodes per child-year in the children who received the IHIP intervention and 1.1 episodes in the controls.This corresponded to an incidence risk ratio of 1.2(95%CI:0.8–1.7).Conclusions: Child stimulation improved developmental status in children,but there was no health benefit associated with the home-environmental intervention.Limited year-round access to running water at home and the possible contamination of drinking water after boiling were two potential factors linked to the lack of effect of the home-environmental intervention.Potential interactions between ECD and home-environmental interventions need to be further investigated.展开更多
I. Introduction 1. The children of today will run the families of the 21st century. Their survival, protection and development decide, for the most part, the quality of a people and lay the foundation of human progres...I. Introduction 1. The children of today will run the families of the 21st century. Their survival, protection and development decide, for the most part, the quality of a people and lay the foundation of human progress as a whole. The 1990 World Summit for Children endorsed the "World Declaration on the Survival, Protection and Development of Children" and the "Plan of Action for Implementing the World Declaration on the Survival, Protection and Development of Children in the 1990s," (hereinafter referred to as "Declaration" and "Plan of Action" for short), In March 1991, Premier Li Peng signed the two documents on behalf of the Chinese Government, making a solemn commitment to this major undertaking. 2. The wholesome development of children has a bearing upon the future of China. The Communist Party of China and the Chinese Government have always paid close attention to the survival,展开更多
Myopia,a common cause of visual impairment,together with the global decline in physical fitness and increasing prevalence of childhood obesity,has become a prominent global health problem.The beneficial effect of incr...Myopia,a common cause of visual impairment,together with the global decline in physical fitness and increasing prevalence of childhood obesity,has become a prominent global health problem.The beneficial effect of increasing the time of outdoor activities on the incidence of myopia and physical well-being in children has been widely recognized.However,in countries with highly competitive education systems,such as China,parents and school administrators may be reluctant to increase their children's time for extracurricular outdoor activities for fear of affecting their academic performance.Therefore,it is crucial to accurately assess the role of after-school outdoor activities in preventing and controlling myopia,as well as in promoting the physical and mental development of adolescents.Schools and families should be encouraged to collaboratively support children’s engagement in outdoor activities to foster their healthy growth.Given the dual benefits of outdoor activities-improving visual health and promoting overall physical and mental well-being-it is essential to encourage schools and families to work together to support children's engagement in such activities.By doing so,it is hoped that a balanced environment can be created,one that values both academic achievement and healthy development.Policymakers,educators,and parents must recognize the long-term advantages of integrating outdoor activities into children's daily lives,as this approach can help alleviate the burden of myopia,enhance physical fitness,and support emotional and cognitive development.Ultimately,fostering a culture that views outdoor activities as an essential component of education and health will be key to ensuring the well-rounded development of future generations.展开更多
Definitive conclusions concerning the impact of exercise interventions on children＇s mental functioning are difficult to ascertain because of procedural differences among studies. A narrative review of studies was co...Definitive conclusions concerning the impact of exercise interventions on children＇s mental functioning are difficult to ascertain because of procedural differences among studies. A narrative review of studies was conducted to evaluate the role of two types of exercise interventions on children＇s cognition. Acute and chronic exercise interventions were classified as quantitative or qualitative on the basis of manipulations of task complexity and, by inference, mental engagement. Both types of interventions enhance aspects of children＇s cognition; however, their effects on metacognitive processes are unknown. The role of metacognitive processes and their regulation of children＇s behavior and academic performance are highlighted.展开更多
患儿1,男,4岁,因语言发育迟缓就诊,甲状腺功能显示游离三碘甲状腺原氨酸、游离甲状腺素持续升高,促甲状腺激素正常或升高,基因检测发现THRB基因c.1373T>C(p.Val458Ala)新生杂合突变,诊断为甲状腺激素抵抗综合征(resistance to thyroi...患儿1,男,4岁,因语言发育迟缓就诊,甲状腺功能显示游离三碘甲状腺原氨酸、游离甲状腺素持续升高,促甲状腺激素正常或升高,基因检测发现THRB基因c.1373T>C(p.Val458Ala)新生杂合突变,诊断为甲状腺激素抵抗综合征(resistance to thyroid hormone syndrome, RTH),未予特殊药物治疗,定期随访观察。患儿2,男,2岁,新生儿筛查发现促甲状腺激素升高,甲状腺功能异常持续1年10个月,伴生长迟缓及心动过速,基因检测提示THRB基因c.959G>A(p.Arg320His)新生杂合突变,诊断为垂体型RTH,予普萘洛尔控制心率。RTH临床表现异质性大,易误诊漏诊。对于不明原因甲状腺功能异常伴发育障碍的患儿,需警惕本病可能,早期THRB基因检测有助于精准诊断与治疗决策。展开更多
CHINA Guideline to Child-friendly Development Issued China has rolled out a guideline to advance child-friendly development across society,aiming to better protect minors’lawful rights and interests and promote child...CHINA Guideline to Child-friendly Development Issued China has rolled out a guideline to advance child-friendly development across society,aiming to better protect minors’lawful rights and interests and promote children’s healthy,allround growth,the National Development and Reform Commission(NDRC)said on 17 March.展开更多
Introduction: To compare the Brazilian conditional cash transfer program, the “Bolsa Família” with the similar programs found in Latin America regarding its effects in the children’s growth and development. Me...Introduction: To compare the Brazilian conditional cash transfer program, the “Bolsa Família” with the similar programs found in Latin America regarding its effects in the children’s growth and development. Methods: The systematic review contemplated the Scopus, Embase, Pubmed, Scielo and Lilacs data bases. The inclusion criteria were epidemiological quantitative, observational, descriptive and analytical studies that had as target public children contemplated by the income transfer program with health conditionalities in Latin America. Narrative reviews related to the research theme were excluded as well as systematic reviews with or without meta-analysis related to the research theme. Results: The titles and abridgements review from 1007 articles resulted in the selection of 17 complete studies. After the quality analysis of these, as well as the application of the inclusion criteria, 10 articles were included in this review. Among the types of epidemiologic studies selected to compose this systematic review, 3 are cohort analytical studies. Conclusion: Studies carried out in Brazil, Mexico, Ecuador and Nicaragua were selected and indicated the positive effects that the conditional income transfer brought to the anthropometric index from beneficiary children in the researched countries.展开更多
Fifty children with nephrotic syndrome were treated by using herbal drugs for nourishing yin to reduce pathogenic fire, strengthening qi and tonifying the kidney, and promoting blood circulation and removing blood... Fifty children with nephrotic syndrome were treated by using herbal drugs for nourishing yin to reduce pathogenic fire, strengthening qi and tonifying the kidney, and promoting blood circulation and removing blood stasis in combination with glucocorticoid and immunodepressant. The body height, secondary sex characters, age of the first spermatorrhea for male and of menarche for female children, bone age measured with roentgenograms on the left wrist in 50 cases of the treatment group were compared with those in 31 cases of the control group treated by glucocorticoid and immunodepressant. The results showed that the delay of growth and sexual development as side-effects of glucocorticoid and immunodepressant were markedly reduced by the integrated TCM-WM treatment.展开更多
Just like children are not small adults, pediatric studies are not just subgroup-adult studies. Clinical pharmacology aims to predict these effects based on drug, population and/or patient-specific pharmacokinetics(co...Just like children are not small adults, pediatric studies are not just subgroup-adult studies. Clinical pharmacology aims to predict these effects based on drug, population and/or patient-specific pharmacokinetics(concentration-time profiles) and-dynamics(concentration-effect profile). The most essential characteristics of childhood are growth and maturation. Both phenomena are most prominent during infancy making the claim that "an infant is not just a small child" as relevant compared to the paradigm that "a child is not just a small adult". From a clinical pharmacology perspective, the consequence of such a dynamic setting is extensive variability throughout childhood in both the pharmacokinetics and pharmacodynamics. Trial design probably has impact on recruitment to an even greater extent compared to adult studies. In general, if a study is designed well, with a clear clinical question with which parents and children can identify, they are likely to consider participation. Open communication with all stakeholders involved will most likely result in ethically correct, practically feasible, scientifically sound, and economical reasonable studies to provide children with the appropriate treatment. From an academic perspective, feasibility, relevance, applicability and costs of clinical pharmacological studies in children can be signifi cantly improved by new sampling concepts(e.g., saliva, urine, dried spot blood) and the systematic introduction of already known information into the trial design through model based pediatric drug development, that mainly affect feasibility of pharmacokinetic studies. In contrast, for the pharmacodynamic part of pediatric studies, development and validation of population specifi c biomarkers or robust outcome variables is urgently needed.展开更多
基金funded by National Key Project (973) of Study on Interaction Mechanism of Environment and Genetic of Birth Defect in China(No.2007CB5119001)State Key Funds of Social Science Project(Research on Disability Prevention Measurement in China,No.09&ZD072)+2 种基金National Health Baby Promotion Program(No.FP2000NO13)Education Ministry Key Program(No.02185)National Yang Zi Scholar Program,211 and 985 projects of Peking University(No.20020903)
文摘Objective This study estimated the investment in child development from three aspects-public health, public education, and family investment to establish the level of investment, to provide reference information for government decision making and to provide international comparisons. Methods Public investment in health was measured with macro data related to public health spending and child development in government expenditure. Public education investment was based on basic education data. Family investment evaluation was based on per capita family consumer spending data in different age groups to estimate the input for child development. Results Both public health investment level and the proportion of GDP rose for all age groups over time, but the overall investment level was still insufficient. Public investment in children＇s education has increased year by year, but the trends in all age groups are unbalanced with much lower investment in early childhood education. Private investment in children has increased over the period, but has declined as a percentage of GDP. International comparisons show that China＇s investment in child development is much lower than OECD countries. Conclusion The private investment in child development was the main way in China, with public finance contributing only a small proportion. Given the poor international comparisons, the government needs to review the balance of public investment to redirect more towards the development of children under the age of six to their health and education.
文摘This article explores the intricate relationship between attachment styles formed during early childhood and the subsequent responses to traumatic events, particularly the death of a parent. Drawing on the theoretical framework of attachment theory and incorporating contemporary research, the paper discusses how parental interactions shape the neural circuitry of infants and children, influencing their ability to form secure or insecure attachments. These attachment styles, in turn, play a critical role in determining the child’s coping mechanisms when faced with trauma. This paper focuses on trying to understand how attachment theory is connected to the reaction to trauma with a highlight on the four major styles of attachments which are secure, anxious, avoidant, and disorganized to mention but a few, and how they influence stress and adversity in children. Attachment theory holds that human beings’ ability to form affectional bonds in infancy determines their patterns of relatedness across the life cycle. The type of attachment that is secure usually supports healthy adaptation and good coping mechanisms regardless of the trauma in the childhood of the child. While secure attachment mostly facilitates favorable trauma-related outcomes, anxious or avoidant attachment can exacerbate or alter the responses. The caregiving system that is avoidant attachment has implications of autonomous self-functioning which has features of suppression of the emotional response and poor search for emotional support during stress. From the principles of developmental psychology and trauma theory, the paper also focuses on the major significance of the child’s early caregivers’ interactions that define the resilience and vulnerability factor. This knowledge is therefore critical in designing specific interventions based on the improvement of coping behaviors and emotional regulatory systems of children who have been exposed to trauma. Finally, we have the synthesis of new knowledge about the role of secure attachment relationships as its fundamental element in shaping adaptive traumatization and psychological development. The article also delves into the physiological processes involved in emotional regulation and the role of cortisol in disrupting attachment. Finally, the implications of these findings for therapeutic interventions and the challenges of addressing prolonged grief and traumatic responses in clinical settings are considered.
文摘EDITOR'S NOTE: The National Working Committee for Children and Women (NWCCW) issued a national report on child development on May 27. The three-chapter report discusses the policies adopted and actions taken by the government to protect the legitimate rights and interests of children in the last few years. It also illustrates the improvements and progress made in children's health and education, and pinpoints the problems and future challenges facing the nation on child development issues. The full text of the report follows:
文摘BACKGROUND Unintended pregnancy occurs when an individual or couple conceives without planning or desire,which can potentially affect a child’s physical,mental,and social well-being.This can then lead to long-term socioeconomic challenges for families and communities.Although its impact on child growth and development is a pressing concern,research remains limited particularly in multicenter settings.AIM To examine the long-term consequences of unintended pregnancy on the critical years of early childhood growth and development.METHODS This analytical observational study employed a case-control design and was conducted in research centers across Indonesia,encompassing those located in Central Java,Lampung,Bali,and West Nusa Tenggara.A total of 700 children aged≤5 years with histories of intended or unintended pregnancies participated.Data collection involved structured interviews and direct anthropometric and developmental assessments.Data analyses were conducted using multivariate statistics and partial least squares structural equation modeling.RESULTS Unintended pregnancy was found to have a statistically significant effect on both child growth(t=8.178;P<0.001)and child development(t=25.688;P<0.001).Key growth problems identified included underweight,undernutrition,abnormal head circumference,and stunting.Developmental challenges prominently associated with unintended pregnancy included behavioral and emotional disorders,autism spectrum disorder,attentiondeficit/hyperactivity disorder,social and motor skill deficits,as well as visual and hearing impairments.CONCLUSION Unintended pregnancy significantly affects child growth and development,underscoring the need for early intervention,quality prenatal care,and strengthened family planning policies.
文摘BACKGROUND Neurodevelopmental delays encompass a wide range of conditions that impair cognitive,motor,and social functioning,often increasing the risk of psychiatric comorbidities.Children with these delays frequently present with disorders such as attention-deficit/hyperactivity disorder(ADHD),anxiety,and behavioral disturbances,which can significantly affect development and quality of life.While genetic predisposition has been linked to these comorbidities,growing evidence highlights the role of environmental factors,including prenatal and early-life stressors.However,the interaction between genetic susceptibility and environmental influences remains poorly understood.Identifying specific genetic variants,environmental risks,and their interactions is essential for early detection and targeted interventions.AIM To investigate the combined effects of genetic and environmental factors on psychiatric comorbidities in children with neurodevelopmental delays,elucidate underlying mechanisms,and inform clinical management strategies.METHODS This retrospective cohort study included 80 children with confirmed neurodevelopmental delays and 40 age-and sex-matched typically developing controls.Comprehensive clinical and psychiatric evaluations,genetic testing(chromosomal microarray analysis and targeted next-generation sequencing),and environmental exposure assessments were conducted.Statistical analyses explored associations between genetic variants and psychiatric comorbidities,environmental risk factors,and gene-environment interactions.RESULTS Children with neurodevelopmental delays exhibited significantly higher rates of psychiatric comorbidities(70.0%)compared to controls(15.0%),with ADHD(42.5%),anxiety disorders(28.8%),and behavioral disorders(23.8%)being the most common.Pathogenic genetic variants were identified in specific pathways associated with distinct psychiatric presentations:Glutamatergic signaling variants were linked to anxiety disorders(odds ratio=3.8),dopaminergic system variants to ADHD(odds ratio=4.2),and synaptic function variants to both behavioral and anxiety disorders.Environmental factors,particularly prenatal maternal stress,early childhood adversity,and family dysfunction were strong predictors of psychiatric outcomes(β=0.42).Significant gene-environment interactions were identified,indicating that environmental exposure can moderate the effects of genetic risks on psychiatric outcomes.CONCLUSION Psychiatric comorbidities in children with neurodevelopmental delays are significantly influenced by both genetic and environmental factors,with complex interactions between the two.These findings underscore the need for integrated assessments and targeted interventions addressing both biological and environmental contributors to improve outcomes in this vulnerable population.
文摘Background: Unsafe drinking water,poor sanitation and hygiene,exposure to household air pollution and low cognitive and socio-emotional stimulation are risk factors affecting children in low-and middle-income countries.We implemented an integrated home-environmental intervention package(IHIP),comprising a kitchen sink,hygiene education and a certified improved biomass cookstove,and an early child development(ECD)programme to improve children´s health and developmental outcomes in the rural high-altitude Andes of Peru.Methods: We conducted a one-year cluster-randomised controlled trial among 317 children<36 months divided into 4 arms(IHIP+ECD,IHIP,ECD,and Control)and 40 clusters(10 clusters per arm).ECD status(socio-emotional,fine and gross motor,communication,cognitive skills,and an overall performance)measured with the Peruvian Infant Development Scale and the occurrence of self-reported child diarrhoea from caretakers were primary outcomes.Secondary outcomes included the occurrence of acute respiratory infections and the presence of thermo-tolerant faecal bacteria in drinking water.The trial was powered to compare each intervention against its control arm but it did not allow pairwise comparisons among the four arms.Primary analysis followed the intention-to-treat principle.For the statistical analysis,we employed generalised estimating equation models with robust standard errors and an independent correlation structure.Results: We obtained ECD information from 101 children who received the ECD intervention(individually and combined with IHIP)and 102 controls.Children who received the ECD intervention performed better in all the domains compared to controls.We found differences in the overall performance(64 vs.39%,odd ratio(OR):2.8;95%confidence interval(CI):1.6–4.9)and the cognitive domain(62 vs 46%,OR:1.9;95%CI:1.1–3.5).Data analysis of child morbidity included 154 children who received the IHIP intervention(individually and combined with ECD)and 156 controls.We recorded 110,666 child-days of information on diarrhoea morbidity and observed 1.3 mean episodes per child-year in the children who received the IHIP intervention and 1.1 episodes in the controls.This corresponded to an incidence risk ratio of 1.2(95%CI:0.8–1.7).Conclusions: Child stimulation improved developmental status in children,but there was no health benefit associated with the home-environmental intervention.Limited year-round access to running water at home and the possible contamination of drinking water after boiling were two potential factors linked to the lack of effect of the home-environmental intervention.Potential interactions between ECD and home-environmental interventions need to be further investigated.
文摘I. Introduction 1. The children of today will run the families of the 21st century. Their survival, protection and development decide, for the most part, the quality of a people and lay the foundation of human progress as a whole. The 1990 World Summit for Children endorsed the "World Declaration on the Survival, Protection and Development of Children" and the "Plan of Action for Implementing the World Declaration on the Survival, Protection and Development of Children in the 1990s," (hereinafter referred to as "Declaration" and "Plan of Action" for short), In March 1991, Premier Li Peng signed the two documents on behalf of the Chinese Government, making a solemn commitment to this major undertaking. 2. The wholesome development of children has a bearing upon the future of China. The Communist Party of China and the Chinese Government have always paid close attention to the survival,
文摘Myopia,a common cause of visual impairment,together with the global decline in physical fitness and increasing prevalence of childhood obesity,has become a prominent global health problem.The beneficial effect of increasing the time of outdoor activities on the incidence of myopia and physical well-being in children has been widely recognized.However,in countries with highly competitive education systems,such as China,parents and school administrators may be reluctant to increase their children's time for extracurricular outdoor activities for fear of affecting their academic performance.Therefore,it is crucial to accurately assess the role of after-school outdoor activities in preventing and controlling myopia,as well as in promoting the physical and mental development of adolescents.Schools and families should be encouraged to collaboratively support children’s engagement in outdoor activities to foster their healthy growth.Given the dual benefits of outdoor activities-improving visual health and promoting overall physical and mental well-being-it is essential to encourage schools and families to work together to support children's engagement in such activities.By doing so,it is hoped that a balanced environment can be created,one that values both academic achievement and healthy development.Policymakers,educators,and parents must recognize the long-term advantages of integrating outdoor activities into children's daily lives,as this approach can help alleviate the burden of myopia,enhance physical fitness,and support emotional and cognitive development.Ultimately,fostering a culture that views outdoor activities as an essential component of education and health will be key to ensuring the well-rounded development of future generations.
文摘Definitive conclusions concerning the impact of exercise interventions on children＇s mental functioning are difficult to ascertain because of procedural differences among studies. A narrative review of studies was conducted to evaluate the role of two types of exercise interventions on children＇s cognition. Acute and chronic exercise interventions were classified as quantitative or qualitative on the basis of manipulations of task complexity and, by inference, mental engagement. Both types of interventions enhance aspects of children＇s cognition; however, their effects on metacognitive processes are unknown. The role of metacognitive processes and their regulation of children＇s behavior and academic performance are highlighted.
文摘CHINA Guideline to Child-friendly Development Issued China has rolled out a guideline to advance child-friendly development across society,aiming to better protect minors’lawful rights and interests and promote children’s healthy,allround growth,the National Development and Reform Commission(NDRC)said on 17 March.
文摘Introduction: To compare the Brazilian conditional cash transfer program, the “Bolsa Família” with the similar programs found in Latin America regarding its effects in the children’s growth and development. Methods: The systematic review contemplated the Scopus, Embase, Pubmed, Scielo and Lilacs data bases. The inclusion criteria were epidemiological quantitative, observational, descriptive and analytical studies that had as target public children contemplated by the income transfer program with health conditionalities in Latin America. Narrative reviews related to the research theme were excluded as well as systematic reviews with or without meta-analysis related to the research theme. Results: The titles and abridgements review from 1007 articles resulted in the selection of 17 complete studies. After the quality analysis of these, as well as the application of the inclusion criteria, 10 articles were included in this review. Among the types of epidemiologic studies selected to compose this systematic review, 3 are cohort analytical studies. Conclusion: Studies carried out in Brazil, Mexico, Ecuador and Nicaragua were selected and indicated the positive effects that the conditional income transfer brought to the anthropometric index from beneficiary children in the researched countries.
文摘 Fifty children with nephrotic syndrome were treated by using herbal drugs for nourishing yin to reduce pathogenic fire, strengthening qi and tonifying the kidney, and promoting blood circulation and removing blood stasis in combination with glucocorticoid and immunodepressant. The body height, secondary sex characters, age of the first spermatorrhea for male and of menarche for female children, bone age measured with roentgenograms on the left wrist in 50 cases of the treatment group were compared with those in 31 cases of the control group treated by glucocorticoid and immunodepressant. The results showed that the delay of growth and sexual development as side-effects of glucocorticoid and immunodepressant were markedly reduced by the integrated TCM-WM treatment.
基金Supported by The Fund for Scientific Research,Flanders(Belgium)(FWO Vlaanderen)by a Fundamental Clinical Investigatorship(1800209N)A Research Grant(1506409N)
文摘Just like children are not small adults, pediatric studies are not just subgroup-adult studies. Clinical pharmacology aims to predict these effects based on drug, population and/or patient-specific pharmacokinetics(concentration-time profiles) and-dynamics(concentration-effect profile). The most essential characteristics of childhood are growth and maturation. Both phenomena are most prominent during infancy making the claim that "an infant is not just a small child" as relevant compared to the paradigm that "a child is not just a small adult". From a clinical pharmacology perspective, the consequence of such a dynamic setting is extensive variability throughout childhood in both the pharmacokinetics and pharmacodynamics. Trial design probably has impact on recruitment to an even greater extent compared to adult studies. In general, if a study is designed well, with a clear clinical question with which parents and children can identify, they are likely to consider participation. Open communication with all stakeholders involved will most likely result in ethically correct, practically feasible, scientifically sound, and economical reasonable studies to provide children with the appropriate treatment. From an academic perspective, feasibility, relevance, applicability and costs of clinical pharmacological studies in children can be signifi cantly improved by new sampling concepts(e.g., saliva, urine, dried spot blood) and the systematic introduction of already known information into the trial design through model based pediatric drug development, that mainly affect feasibility of pharmacokinetic studies. In contrast, for the pharmacodynamic part of pediatric studies, development and validation of population specifi c biomarkers or robust outcome variables is urgently needed.
