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The article discusses a study by F. Zhang and colleagues which reported 20-metre shuttle run test (20mSRT) scores from Chinese school students. Topics include caution against the use of fallacious methods of estimating and interpreting the peak VO2 of children and adolescents, an appreciation for the researchers for raising the profile of pediatric health and well-being in China, and suggestions for researchers in China and elsewhere.

The paper presents a analysis of quantitative and qualitative dimensions of global research output (3488 records) on "Impact of COVID-19 on Children and Adolescents", based on indexed publications in Scopus database. The global publications on this theme averaged 8.31 citations per paper. About 1.49% share of its total publications in this area received external funding support. The 145 countries partcipitated in global research output on "Impact of COVID-19 on Children and Adults", of which the top 10 countries accounted for 85.21% and more than 100% share of global publications and citations. The USA, U.K. and Italy leads in global publications ranking and productivity as against China (3.16), U.K (1.28) and USA (1.27) leading in terms of relative of relative citation index. The 412 organizations and 661 authors participated in global research on this theme, with top 15 most productive organizations and authors contributing 21.07% and 4.30% global publications share and 38.05% and 12.98% global citations share. Harvard Medical School, USA, Huazhong University of Science and Technology, China and Tongji Medical College, China leads the world as the most productive organizatons (with 480, 67 and 63 publications) and Huazhong University of Science and Technology, China (31.97 and 3.85), Tongji Medical College, China (19.92 and 2.40) and Children Hospital of Philadelphia, USA (19.30 and 2.32) leading as the most impactful organizations in the world in terms of citation per paper and relative citation index. D.Buonsensov, C.Calvo and X. Lu were the most productive authors (with 15, 12 and 12 papers) and X.Lu (103.83 and 12.49), A. Licari ( 40.11 and 4.83) and G.L. Marseglia( 34.09 and 4.1) were the most impactful authors. JAMA Pediatrics, Pediatrics Infectious Disease Journal and Acta Paediatrica International Journal of Pediatrics were the most productive journals (with 71, 60 and 58 papers) and Pediatrics (36.59, JAMA Pediatrics (19.49) and Acta Paediatrica International Journal of Pediatrics (14.93) were the most impactful journals. [ABSTRACT FROM AUTHOR]

Background: Most studies of associations between parental support behaviours for physical activity (PA) and children's moderate-to-vigorous physical activity (MVPA) have been conducted in developed countries, and they have focused on maternal or parental support behaviours. Children's MVPA time (i.e., weekdays vs. weekends) has not been adequately differentiated. This paper investigated the associations of paternal and maternal support behaviours for PA with the proportion of children who met the MVPA recommendations on weekdays and weekends in China.Methods: Cross-sectional data of 517 father-child dyads and 1422 mother-child dyads were analysed. The children recorded PA diaries on 7 consecutive days to assess their MVPA time. The father or mother completed a questionnaire concerning their support for children's PA. Multivariate logistic regression was used to investigate the independent effects of paternal and maternal support behaviours for PA on whether children met the MVPA recommendations for weekdays, weekends, and the whole week.Results: Significantly fewer children met the MVPA recommendations on weekends (37.8%) than on weekdays (62.8%). Higher paternal (odds ratio [OR] = 1.098, 95% confidence interval [CI]: 1.009-1.195) and maternal (OR = 1.076, 95% CI: 1.021-1.134) total support behaviour scores were associated with higher odds of children meeting the MVPA recommendations on weekends, after controlling for covariates. Paternal PA knowledge-sharing with the child was positively associated with children meeting the MVPA recommendations on weekends (OR = 1.319, 95% CI: 1.055-1.649); it tended to be associated with children meeting the MVPA recommendations on weekdays and throughout the week, although these associations were not statistically significant. Maternal reservation of PA time for the child was positively associated with a higher likelihood of children meeting the MVPA recommendations on weekdays (OR = 1.160, 95% CI: 1.025-1.313), weekends (OR = 1.241, 95% CI: 1.097-1.403), and throughout the week (OR = 1.214, 95% CI: 1.076-1.369).Conclusions: Paternal and maternal support behaviours for PA should be enhanced on weekends to increase children's MVPA. Fathers should share PA knowledge with children and mothers should reserve PA time for children every day. [ABSTRACT FROM AUTHOR]

Most research has used individual or group features to explain why migrants have different preferred number of children. However, these features can be identified and subdivided infinitely, with none of them broadly answering the question "why migrants desire more or less children"? This paper identified "environmental shocks", which are a common experience for all migrants, as determinants of dissimilar preferred number of children across internal migrants in China. Environmental shocks refer to the uncertainty experienced by physical and sociocultural changes in the environment. Environmental shocks were treated as a variable rather than a constant in the analysis because shocks may differ between migrants. By sampling the 1667 internal migrants who participated in China's 2015 General Social Survey, a quantitative analysis revealed that a farther migration distance (meaning greater environmental shocks) leads to lower preferred number of children for migrants. However, the mitigation of environmental shocks by the period at the current residence has no significant influence. Semi-structured interviews conducted with internal migrants in China revealed that the time since migration could mitigate environmental shocks and increase desired number of children, but the time since migration brings other challenges that may decrease preferred number of children. This study improves our understanding of the determinants of migrants' childbearing willingness and suggests that the government need to help weaken the impact of environmental shocks and uncertainties on migrants to prevent their preferred number of children from decreasing. [ABSTRACT FROM AUTHOR]

Background: Lack of physical activity is a growing problem in China, due to the fast economic development and changing living environment over the past two decades. The aim of this review is to summarize the factors related to physical activity in Chinese children and adolescents during this distinct period of development. Methods: A systematic search was finished on Jan 10th, 2017, and identified 2200 hits through PubMed and Web of Science. English-language published studies were included if they reported statistical associations between factors and physical activity. Adapted criteria from the Strengthening The Reporting of OBservational studies in Epidemiology (STROBE) statement and evaluation of the quality of prognosis studies in systematic reviews (QUIPS) were used to assess the risk of bias of the included studies. Related factors that were reported in at least three studies were summarized separately for children and adolescents using a semi-quantitative method. Results: Forty two papers (published 2002-2016) were included. Most designs were cross-sectional (79%), and most studies used questionnaires to assess physical activity. Sample size was above 1000 in 18 papers (43%). Thirty seven studies (88%) showed acceptable quality by methodological quality assessment. Most studies reported a low level of physical activity. Boys were consistently more active than girls, the parental physical activity was positively associated with children and adolescents' physical activity, children in suburban/rural regions showed less activity than in urban regions, and, specifically in adolescents, self-efficacy was positively associated with physical activity. Family socioeconomic status and parental education were not associated with physical activity in children and adolescents. Conclusions: The studies included in this review were large but mostly of low quality in terms of study design (cross-sectional) and methods (questionnaires). Parental physical activity and self-efficacy are promising targets for future physical activity promotion programmes. The low level of physical activity raises concern, especially in suburban/rural regions. Future research is required to enhance our understanding of other influences, such as the physical environment, especially in early childhood. [ABSTRACT FROM AUTHOR]

This paper reports the development and baseline data of a vignettes-based measure of gender equality. Methods: Vignettes were developed through 3-day long focus groups. After piloting in 13 sites and repiloting a revised version in 6 countries, responses were categorized by the construct tapped and a scoring system developed. Finalized vignettes were then tested in DR Congo, Ecuador and China. Results: Young adolescents can successfully respond to vignettes; and can differentiate self from hypothetical protagonists of same and opposite sex. Response differences by sex of respondent and protagonist were statistically significant across a range of scenarios and settings. Conclusion: This is the first vignettes-based measure for young adolescents assessing young adolescent perceptions of relationships differentiated by sex of the protagonist. [ABSTRACT FROM AUTHOR]

Limited data exist related to low birth weight (LBW) incidence and risk factors in Western China. This paper aims to assess LBW and its relationship with antenatal care (ANC) in the poor counties of Western China. A community-based study in rural Western China was conducted in 2011. A kernel distribution was used to estimate the adjusted LBW incidence, and associations between LBW and socio-demographic or maternal factors were examined using multilevel logistic regression. Among 8,964 participants, 65.7% were weighed at birth. Crude LBW incidence was 6.6% and the adjusted rate was 9.3%. The study revealed that risk factors of LBW are being female, raised within a minority group, and with a family income below the national poverty line. For maternal risk factors, LBW was positively associated with not attending at least five or eight ANC visits, not receiving any ANC during the first trimester, and not having access to assess certain ANC content (weight, blood pressure, blood test, urine test, B-scan ultrasound, and folic acid supplement). There is urgent need to promote quality ANC in poor and rural areas of Western China and to prioritize vulnerable women and children who will benefit from quality ANC. [ABSTRACT FROM AUTHOR]

This paper aimed to investigate the role of parental education in child disability in China. We used nationally representative data from China’s National Sample Survey on Disability, iterated twice, in 1987 and 2006, with data of 764,718 children aged 0–14 years. Logit models were used for statistical analysis. Results showed that the prevalence of child disability was significantly associated with each parent’s education. Maternal education was more important than paternal education in child disability in both surveys. The analysis of marginal effect indicated a one-year increase in maternal and paternal schooling led to an average decrease of 0.121% and 0.091% in the probability of child disability in 1987, and 19 years later, these figures had dwindled to 0.091% and 0.072%, respectively. [ABSTRACT FROM AUTHOR]

Background: Gender disparities in China are concentrated in poor rural areas and among poor households. The difference in intelligence between boys and girls is less clear in rural China. The purpose of this paper was to assess sex differences in the intellectual function of early school-aged children in rural China.Methods: One thousand seven hundred forty four early school-aged offspring of women who had participated in a prenatal supplementation trial with different combinations of micronutrients and continued to reside in two rural counties in China were followed. We measured their Full-Scale IQ (FSIQ), Verbal Comprehension Index (VCI), Working Memory Index (WMI), Perceptual Reasoning Index (PRI) and Processing Speed Index (PSI) using the Wechsler Intelligence Scale for Children (WISC-IV). Multilevel analyses were used to assess sex differences in intellectual functioning in 7-10-year-old children in rural China.Results: Boys' adjusted mean FSIQ score was 0.97 points higher (95% CI: -2.22 - 0.28) than that of girls. Girls obtained higher mean WMI and PSI scores, with 1.32 points (95% CI: 0.14 - 2.51) and 3.10 points (95% CI: 1.82-4.38) higher adjusted means, respectively. Boys' adjusted mean VCI and PRI scores were significantly higher than those of girls, and the mean differences were 2.44 points (95% CI: 0.95 - 3.94) and 3.68 points (95% CI: 2.36 - 5.01), respectively.Conclusions: There is no evidence to suggest sex differences in the general intelligence of early school-aged children in rural China. However, a difference in general intelligence between 10-year-old boys and girls was evident. Girls and boys in rural China tended to show different specific cognitive abilities. [ABSTRACT FROM AUTHOR]

Background: With regard to the global childhood obesity epidemic, it is imperative that effective lifestyle interventions are devised to combat childhood obesity. This paper describes the development and implementation of a comprehensive (a combination of diet and physical activity (PA)), social cognitive behaviour modification intervention using accelerometry and a dietary diary to tackle child overweight and obesity. The comprehensive intervention effect was evaluated in a comparison with diet only, PA only and a no-treatment control group.Methods: A pilot study was conducted with a non-randomized cluster design. Four hundred thirty-eight overweight and obese children aged 7-12 years from ten primary schools in Beijing were recruited to receive a one-year intervention. Participants were allocated into one of four groups: the comprehensive intervention group; the PA only group (Happy 10 program); the diet only group (nutrition education program); and a control group. The effects of intervention on adiposity, blood pressure, and biochemical indicators were assessed by examining 2-way interactions (time × intervention) in linear mixed models. Means and 95 % confidence intervals (CI) for the adjusted changes between post-intervention and baseline relative to changes in the control group were calculated and reported as effect sizes.Results: The percentage of body fat in the comprehensive intervention group showed a significant relative decrease (adjusted change: -1.01 %, 95 % CI: (-1.81, -0.20) %) compared with the PA only, diet only or control groups (P < 0.001). Systolic blood pressure significantly decreased in the comprehensive intervention group (adjusted change: -4.37 mmHg, 95 % CI: (-8.42, -0.33) mmHg), as did diastolic blood pressure (adjusted change: -5.50 mmHg, 95 % CI (-8.81, -2.19) mmHg) (P < 0.05). Compared with the other two intervention groups and the control group, positive adjusted changes in fasting glucose in the comprehensive group were found, although not for the biochemical lipid metabolism indicators. Positive but non-significant adjusted changes in body mass index and waist circumference were observed.Conclusions: Compared with the diet or PA only intervention groups, the current comprehensive program had superior positive effects on body fat percentage and blood pressure but not on the biochemical lipid metabolism indicators in Chinese overweight and obese children. Future randomized controlled trials and long-term follow-up studies are required to elaborate the findings of the current intervention.Trial Registration: ClinicalTrials.gov identifier: NCT02228434. [ABSTRACT FROM AUTHOR]

ABSTRACT. Much research on the relationship between migration and fertility has centred on the impacts of migration on childbearing behaviour. This paper reverses this traditional orientation by examining one way in which fertility behaviour, embedded within a patrilineal society, may influence the migration opportunities of married women. The paper begins by discussing issues relating to gender and migration before outlining previously defined models of the migration fertility relationship. One of these models, selection, is used as the basis for further discussion. The context of migration, fertility and selection in terms of gender issues and sex preference patterns in China is presented. Using fertility and migration histories from a survey of a migration population in Beijing, China, to examine women's mobility patterns this paper suggests that the sex of a child can act as a selection factor in the migration of married women. Sex preferences exhibited by the survey respondents are outlined. The implications for migration and household studies are discussed. [ABSTRACT FROM AUTHOR]

Background: In recent years, obesity has become the major public health problems worldwide. The detection rate of obesity is alarmingly rising among children and adolescents in China, whose population of 120 million are in range of obesity. It was estimated that 8% of her children are obese.Methods: Publications between 2009 and 2014 on the obesity prevalence among primary school students in China were retrieved from PubMed, online Chinese periodical full-text databases of VIP, CNKI and Wanfang. Meta Analyst software was used to sum up and analyze the detection rates included in the previously retrieved literatures.Results: After evaluation of the quality of the articles, 18 papers were finally included in our study, and the total sample sizes on the obesity investigation were 247547, in which 26466 were obesity. Meta-analysis findings showed that the pooled prevalence of obesity in primary school students is 10.0 %( 95% CI: 7.2%-13.5%).Conclusion: Our results indicated that the obesity prevalence status in China was still troublesome, for the situation will go worse if we currently fail to take effective and practical measures. [ABSTRACT FROM AUTHOR]

Phthalates have been strictly banned in children's products in many countries. However, as a product with a high frequency of daily contact with children, stationery is not strictly regulated for phthalates in many countries and the occurrences and risks of phthalates in stationery are rarely reported. In this study, the contents of sixteen types of common phthalates in stationery were determined and the exposure risk of these phthalates to children was also estimated. The total contents of phthalates in all stationery ranged from 5.56 to 3.46 × 105 μg/g, with a median value of 1.48 × 104 μg/g. Polyvinyl chloride (PVC) desk mats (DMs) contained the highest contents of phthalates among all types of stationery. Percutaneous absorption and hand-to-mouth ingestion levels of phthalates for school-age children from the DMs were 2.03 × 10−5 - 10.14 μg/kg-Bw/day and 2.14 × 10−5 - 10.67 μg/kg-Bw/day, respectively. Di-2-ethylhexyl phthalate (DEHP) had the highest proportion, detection rate, and exposure level among all measured phthalates. Our study revealed that phthalates in PVC stationery, especially classroom DMs, at both contents and exposure risks, were higher than those in many other children's plastic products. It was necessary to strengthen the management of plastic stationery from the perspective of materials and phthalates addition. [Display omitted] • High levels of phthalates have been found in stationery for children in China. • The highest phthalate content was found in PVC desk mats. • DEHP predominated among the detected phthalates. • Percutaneous exposure of DEHP from desk mats contributed greatly to the daily exposure dose for school-age children. [ABSTRACT FROM AUTHOR]

Background: The prevalence of autism spectrum conditions (ASC) is 1% in developed countries, but little data are available from mainland China, Hong Kong and Taiwan. This study synthesizes evidence relating to the prevalence of ASC in these areas and assesses the effects of research methodology on prevalence estimates. Methods: Systematic literature searches were conducted in PubMed, Web of Knowledge, China Web of Knowledge and Weipu databases, as well as relevant papers published from 1987 to 2011, reporting prevalence estimates of ASC or childhood autism in mainland China, Hong Kong and Taiwan. Summary estimates of prevalence were calculated with a random effects model. The effects of research methodology on the prevalence estimates were assessed using a meta-regression model. Results: There were 25 studies eligible for review, 18 of which were suitable for inclusion in a meta-analysis. Pooled prevalence of childhood autism was 11.8 per 10,000 individuals (95% confidence interval (CI): 8.2, 15.3) in mainland China. Pooled prevalence of ASC was 26.6 per 10,000 (95% CI: 18.5, 34.6) in three areas. Substantial heterogeneity was identified between studies (I2>75%). The prevalence estimate of childhood autism was most strongly associated with the choice of screening instrument. After adjustment for age group, the odds ratio for prevalence estimates when using the Autism Behavior Checklist (ABC) as the screening instrument compared with those using the Clancy Autism Behavior Scale (CABS) was 0.29 (95% CI: 0.12, 0.69), and 1.79 (95% CI: 0.70, 4.55; P= 0.20) when using the Checklist for Autism in Toddlers (CHAT) compared to the CABS. Conclusions: The available studies investigating the prevalence of ASC in China, Hong Kong and Taiwan have focused mainly on childhood autism rather than the whole spectrum. The prevalence estimates are lower than estimates from developed countries. Studies using more recently developed screening instruments reported higher prevalence than older ones. However, available studies have methodological weaknesses and therefore these results lack comparability with those from developed countries. Our findings indicate a potential under-diagnosis and under-detection of ASC in mainland China, Hong Kong and Taiwan, and a need to adopt more advanced methods for research of ASC in these areas. [ABSTRACT FROM AUTHOR]

Aims. To explore whether Astragalus or its formulations could prevent upper respiratory infection in children with nephrotic syndrome and how best to use it. Methods. We transformed a common clinical question in practice to an answerable question according to the PICO principle. Databases, including the Cochrane Library (Issue 5, 2012), PUBMED (1966-2012.8), CBM (1978-2012.8), VIP (1989-2012.8), and CNKI (1979-2012.8), were searched to identify Cochrane systematic reviews and clinical trials. Then, the quality of and recommendations from the clinical evidence were evaluated using the GRADEpro software. Results. The search yielded 537 papers. Only two studies with high validity were included for synthesis calculations. The results showed that Astragalus granules could effectively reduce URTI in children with nephrotic syndrome compared with prednisone treatment alone (23.9% versus 42.9%; RR = 0.56 and 95% CI = 0.33-0.93). The dose of Astragalus granules was 2.25 gram (equivalent to 15 gram crude Astragalus) twice per day, at least for 3-6 months. The level of evidence quality was low, but we still recommended the evidence to the patient according to GRADEpro with the opinion of the expert. Followup showed the incidence of URTI in this child decreased significantly. Conclusions. Astragalus granules may reduce the incidence of URTI in children with nephrotic syndrome. [ABSTRACT FROM AUTHOR]

Background: Overuse of antibiotics contributes to the development of antimicrobial resistance. Objective:This study aims to assess the condition of antibiotic use at health facilities at county, township and village levels in rural Guangxi, China. Methods:We conducted a cross-sectional study of outpatient antibiotic prescriptions in 2014 for children aged 2–14 years with upper respiratory infections (URI). Twenty health facilities were randomly selected, including four county hospitals, eight township hospitals and eight village clinics. Prescriptions were extracted from the electronic records in the county hospitals and paper copies in the township hospitals and village clinics. Results:The antibiotic prescription rate was higher in township hospitals (593/877, 68%) compared to county hospitals (2736/8166, 34%) and village clinics (96/297, 32%) (p < 0.001). Among prescriptions containing antibiotics, county hospitals were found to have the highest use rate of broad-spectrum antibiotics (82 vs 57% [township], vs 54% [village],p < 0.001), injectable antibiotics (65 vs 43% [township], vs 33% [village],p < 0.001) and multiple antibiotics (47 vs 15% [township], vs 0% [village],p < 0.001). Logistic regression showed that the likelihood of prescribing an antibiotic was significantly associated with patients being 6–14 years old compared with being 2–5 years old (adjusted odds ratio [aOR] = 1.3, 95% CI 1.2–1.5), and receiving care at township hospitals compared with county hospitals (aOR = 5.0, 95% CI 4.1–6.0). Prescriptions with insurance copayment appeared to lower the risk of prescribing antibiotics compared with those without (aOR = 0.8, 95% CI 0.7–0.9). Conclusions:Inappropriate use of antibiotics was high for outpatient childhood URI in the four counties of Guangxi, China, with the highest rate found in township hospitals. A significant high proportion of prescriptions containing antibiotics were broad-spectrum, by intravenous infusion or with multiple antibiotics, especially at county hospitals. Urgent attention is needed to address this challenge. [ABSTRACT FROM PUBLISHER]

The article focuses on the research paper "Change in hepatitis B virus (HBV) large surface antigen variant prevalence 13 years after implementation of a universal vaccination program in China" by T. Bian and others. Topics discussed include the frequency and nature of variants of the envelope protein of hepatitis B virus in Chinese children in 1992, rise in the prevalence of HBV mutants in adults immunized against HBV in Taiwan and use of plasma-derived and recombinant vaccines in China.