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Playwork is a recognised profession in the United Kingdom (UK) and is currently a growing area of interest internationally. However, debates about the nature and purpose of playwork have raged in the playwork field since the profession was invented in the early adventure playgrounds. This study is the first to capture data about what the now international playwork workforce understands to be the purpose of playwork. The International Playwork Census (IPC) was an online survey which asked participants from 19 different countries about their knowledge and experience of playwork. This paper reports on one question from the IPC: what is the purpose of playwork? A thematic analysis was undertaken from 193 responses on what was considered "the purpose of playwork" and three themes emerged: Facilitate and Provide for children's play; Support and Advocate. This paper describes how these three themes reflect both the historical change in understandings of the purpose of playwork and how different understandings of playwork are developed through the experience of practitioners working in range of different contexts.

The aim of this study was to compare bibliometric indicators of scientific productivity in physical activity (PA) in children and adolescents with Autism spectrum disorder (ASD) and Down syndrome (DS) in the PubMed database. A bibliometric study was conducted for the last 5 years (2017 to 2021). The data collected for each article were: year of publication, language of publication, country, journal name, and type of paper. The results showed that there was higher scientific productivity in the population with DS (20 studies) relative to their counterparts with ASD (31 studies). The language of publication in both cases was English. There were 10 countries that published on PA in ASD and 14 countries that published on DS. Overall, the greatest interest in publishing on PA in children and adolescents with ASD was in North America (6 studies), followed by Asia (5 studies) and Europe (4 studies). In the DS population it was in Europe (13 studies), North America (9 studies) and South America (4 studies). Nineteen journals were identified that published in the ASD population and 29 journals in DS. Six experimental studies were identified in ASD and 7 in DS. There was a higher scientific productivity with original studies. There was a positive trend of increasing scientific productivity over the years in both populations. We suggest the need to promote research on PA in both populations, regardless of the type of study, as it is an indicator of overall health status.

A thematic content analysis of the seven issues (35 papers and two editorials) of the "International Research in Early Childhood Education" ("IRECE") journal published by Monash University in Melbourne, Victoria was conducted to explore the themes over its five years of publication. Publications were grouped into defined data chunks by year and Leximancer was used to discover concepts and themes. Five dominant themes emerged: children/s; childhood; learning; parent/s and teacher/s. Pathway analyses were then conducted to more fully understand and describe each theme. Data were used to visually represent the most frequently appearing terms to form a tag cloud, which in turn contributes to the development of a "folksonomy" for the journal. Finally, mentions of geographic regions were also explored which positively reflected on international focus of the journal.

This paper advances an approach, 'child as method', as a resource for interrogating models of development in childhood and education. Kuan-Hsing Chen's (2010) book "Asia as method" has generated interest across childhood and educational studies. Here 'child as method' is presented as a related intervention. Just as "Asia as method" (re)considers the status of the national and transnational, so 'child as method' helps explicate the ways 'child' and 'development' are linked across economic, sociocultural and individual trajectories. The example of translation is discussed in relation to sociocultural approaches and how together these might inform childhood and educational studies debates. The notion of 'method' at work (as framework, technique or narrative) is also clarified as informed by feminist and decolonisation approaches. It is argued that 'child as method' offers strategies for resisting abstraction and remaining attentive to forces and relations of (re)production at issue within adult-child and child-state-development relations.

Background: The Lidcombe Program is a stuttering treatment approach for children between the ages of 3 and 6 years. Most papers about the Lidcombe Program, however, are based on studies conducted in native English-speaking countries. The aim of this paper is to systematically review the delivery and implementation of the Lidcombe Program in non-native English-speaking countries. Summary: A resource search was conducted between October and November 2019. Scopus, PubMed, ASHA, Cochrane Library, ERIC, Google Scholar, and SpeechBITE databases and reference lists of relevant papers were searched for the identification process. Joanna Briggs Institute tools were used for the appraisal of the studies. The search yielded 8 studies conducted in non-native English-speaking countries. The Lidcombe Program is efficacious in non-native English-speaking countries when delivered to both preschool and young school age children who stutter. It is reported to be delivered with minor changes and challenges. The number of weekly clinic visits and the total time needed to reach zero or near-zero stuttering levels with the Lidcombe Program can be up to 3 times greater in non-native English-speaking countries than in native English-speaking countries, mostly due to the increased time needed to introduce the parental verbal contingencies. Key Messages: Speech and language therapists practicing in non-native English-speaking countries are encouraged to use the Lidcombe Program for both preschool and young school age children who stutter, although this can take more time than that reported in native English-speaking countries. Further investigation to explore the therapy process with children and parents in non-native English-speaking countries is needed. [ABSTRACT FROM AUTHOR]

The Programme for International Student Assessment (PISA) and Trends in Mathematics and Science Study are two highly respected studies of school pupils' academic achievement. English policy-makers have been disappointed with school children's performance on these tests, particularly in comparison to the strong results of young people from East Asia. In this paper, we provide new insight into the England--East Asia gap in school children's mathematics skills. We do so by considering how cross-national differences in math test scores change between ages 10 and 16. Our results suggest that, although average math test scores are higher in East Asian countries, this achievement gap does not increase between ages 10 and 16. We thus conclude that reforming the secondary school system may not be the most effective way for England to "catch up" with the East Asian nations in the PISA math rankings. Rather, earlier intervention, during pre-school and primary school, may be needed instead.

Rabindranath Tagore (1861-1941), Asia's first Nobel laureate, was a man of myriad gifts, but he sought to articulate a single global vision. He believed that for our flourishing we must strive towards "the other and the beyond". In so doing we discover that, as we seek, we are ourselves being sought. Tagore believed that we find our meaning and fulfilment relationally; in our relationships one with another, to be sure, but fundamentally in our kinship with all that is. We must be liberated, Tagore believed, from the bounds of our separateness and so discover a wholeness larger than our individual well-being. That wholeness is ultimately realised in our union with the eternal Divine Spirit. In the establishment of his "poet's school" at Shantiniketan Tagore sought to make his ideals come true. This paper will focus on Tagore's understanding of childhood and on the pattern of education by which, he believed, the spirit of the child may be nurtured. It will also enter a plea that we return to someone whose neglect in the West has been much to its loss. (Contains 4 notes.)

With an increasing number of children diagnosed with Autism-Spectrum-Disorder in Canada, this paper focuses on how their mothers, as Asian immigrant women, experience the process of diagnosis and learn to parent their children. By taking two Asian (Korean and Chinese) mothers' critical personal narratives as major data sources, this paper aims to explore the diagnosis process of Autism-Spectrum-Disorder through a sociocultural lens on the intersectionality of (im)migrants and their cultural competence, and argues that their identity (re)construction and learning for parenting take place at the intersectionality of race, gender, class, and disability. This paper highlights possible implications for everyone involved in this 'medical' process, in the context of Canadian or other similar multicultural societies. Asian immigrant mothers usually have to deal with children with Autism-Spectrum-Disorder (ASD) and they have bitter experience of mistreatment tied to race, gender and class. This study reveals how Asian immigrant mothers struggled in their integration to Canadian society as well as their experiences of denial into Canada's medical system. The stories of these two women shed lights on the social and cultural aspects of immigrant mothers' learning strategies, including how they utilize accessible resources and networks for their children's treatment and diagnosis. This paper suggests that policymakers need to consider the social and cultural aspects of diagnosis in immigrant families to better fit their needs and provide them appropriate medical and social support. [ABSTRACT FROM AUTHOR]

Background: Up to 1.45 billion people currently suffer from soil transmitted helminth infection, with the largest burden occurring in Africa and Asia. Safe and cost effective deworming treatment exists, but there is a debate about mass distribution of this treatment in high prevalence settings. While the World Health Organization recommends mass administration of anthelmintic drugs for preschool and school-aged children in high (>20%) prevalence settings, and several long run follow up studies of an influential trial have suggested large benefits that persist over time, recent systematic reviews have called this recommendation into question. Methods and findings: This paper analyzes the long-term impact of a cluster-randomized trial in eastern Uganda that provided mass deworming treatment to preschool aged children from 2000 to 2003 on the numeracy and literacy skills of children and young adults living in those villages in 2010-2015. This study uses numeracy and literacy data collected seven to twelve years after the end of the deworming trial in a randomly selected subset of communities from the original trial, by an education-focused survey that had no relationship to the deworming study. Building on an earlier working paper which used data from 2010 and 2011 survey rounds, this paper uses an additional four years of numeracy and literacy data (2012, 2013, 2014, and 2015). Aggregating data from all survey rounds, the difference between numeracy scores in treatment versus control communities is 0.07 standard deviations (SD) (95% CI -0.10, 0.24, p = 0.40), the difference in literacy scores is 0.05 SD (95% CI -0.16, 0.27, p = 0.62), and the difference in total scores is 0.07 SD (95% CI -0.11, 0.25, p = 0.44). There are significant differences in program impact by gender, with numeracy and literacy differentially positively affected for girls, and by age, with treatment effects larger for the primary school aged subsample. There are also significant treatment interactions for those living in households with more treatment-eligible children. There is no evidence of differential treatment effects on age at program eligibility or number of years of program eligibility. Conclusions: Mass deworming of preschool aged children in high prevalence communities in Uganda resulted in no statistically significant gains in numeracy or literacy 7-12 years after program completion. Point estimates were positive but imprecise; the study lacked sufficient power to rule out substantial positive effects or more modest negative effects. However, there is suggestive evidence that deworming was relatively more beneficial for girls, primary school aged children, and children living in households with other treated children. Research approval: As this analysis was conducted on secondary data which is publicly available, no research approval was sought or received. All individual records were anonymized by the data provider prior to public release. [ABSTRACT FROM AUTHOR]

In studies of academic resilience, researchers seek to identify factors that protect against adverse effects caused by risk and stress, and which ultimately assist students to be academically successful. However, because relatively few studies are conducted in Asian settings, Western-based research may have limited application for policy and prevention in the Asian context. It is therefore important to expand the context and culture in which resilience research takes place. This paper highlights academic resilience factors among Asian students that are located in the multiple levels of the social ecology (including individual, peers, family and school). This is consistent with results from the Western context. However, it also reports on some differences in academic resilience factors that are found both within Asian countries and between Asian and Western countries. From these results, we might thus conclude that alongside pan-human factors, Asian students’ academic success can also be considered in part due to uniquely Asian attributes. This reaffirms the importance of considering culture and national context in studies of academic resilience. Taken as a whole, this collection of papers showcases multiple approaches to building academic resilience and empowering students and their educators and caregivers across the Asian region. [ABSTRACT FROM PUBLISHER]

The author comments on the article "Intercountry adoption of children from Asia in the twenty-first century," by Peter Selman, which suggested that Asian countries should play a significant role in protecting the best interests of the children. She explores the importance of ethnic and racial identities for international adoptees and the possibility of openness in international adoption.

Background: Streptococcus pneumoniae (S. pneumoniae), Haemophilus influenzae (H. influenzae), and Neisseria meningitidis (N. meningitidis) are leading causes of childhood bacterial meningitis and preventable by vaccines. The aim of this hospital-based sentinel surveillance is to describe the epidemiological characteristics of pneumococcal meningitis, including disease burden, and to provide baseline data on pneumococcal serotype distribution to support decision making for pneumococcal conjugate vaccine (PCV) introduction in Vietnam. Methods: Surveillance for probable bacterial meningitis in children 1–59 months of age is conducted in three tertiary level pediatric hospitals: one in Hanoi and two in Ho Chi Minh City. Cerebrospinal fluid (CSF) specimens were collected via lumbar puncture from children with suspected meningitis. Specimens were transferred immediately to the laboratory department of the respective hospital for cytology, biochemistry, and microbiology testing, including culture. PCR testing was conducted on CSF specimens for bacterial detection (S. pneumoniae, H. influenzae, and N. meningitidis) and pneumococcal serotyping. Results: During 2015–2018, a total of 1,803 children with probable bacterial meningitis were detected; 1,780 had CSF specimens available for testing. Of 245 laboratory-confirmed positive cases, the majority were caused by S. pneumoniae (229,93.5%). Of those with S. pneumoniae detected, over 70% were caused by serotypes included in currently available PCV products; serotypes 6 A/6B (27.1%), 14 (19.7%), and 23 F (16.2%) were the most common serotypes. Children with laboratory-confirmed pneumococcal meningitis were more likely to live in Hanoi (p < 0.0001) and children 12–23 months of age were at greater odds (OR = 1.65, 95% CI: 1.11, 2.43; p = 0.006) of having confirmed pneumococcal meningitis compared to children < 12 months of age when compared to those without laboratory-confirmed bacterial meningitis. Additionally, children with confirmed pneumococcal meningitis were more likely to exhibit signs and symptoms consistent with clinical meningitis compared to negative laboratory-confirmed meningitis cases (p < 0.0001) and had a greater odds of death (OR = 6.18, 95% CI: 2.98, 12.86; p < 0.0001). Conclusions: Pneumococcal meningitis contributes to a large burden of bacterial meningitis in Vietnamese children. A large proportion are caused by serotypes covered by PCVs currently available. Introduction of PCV into the routine immunization program could reduce the burden of pneumococcal meningitis in Viet Nam. [ABSTRACT FROM AUTHOR]

This paper aims to describe the prevalent forms of intimate partner violence (IPV), and the factors associated with IPV among women and men living in the two migrant communities of Baglung district, Nepal. 357 adult women and men were enrolled following a family model, interviewing young married women with daughter-in-law status in the home, their husbands, and mothers-in-law and fathers-in-laws using an electronic questionnaire. Random effects regression modelling compared men and women, as well as young married women with daughter-in-law status and older women with mothers-in-law with status. 28.6% of women had ever experienced physical and/or sexual violence by an intimate partner compared to 18.2% of men ever perpetrated these forms of violence against their wives. Being older, male controlling behaviour and poor relations with husband increased women’s IPV in their lifetime while perceptions that the mother-in-law is kind were protective. Being ashamed of being unemployed and childhood trauma were associated with men perpetrating IPV in their lifetime. Borrowing money or food increased young married women’s lifetime IPV risk while mother-in-law cruelty and male control increased older married women’s lifetime IPV exposure. Factors associated with IPV in the past year among men were being younger, job seeking, experiences of childhood trauma and depression exposure among men while difficulty accessing money for emergencies, holding inequitable gender attitudes, and depression was associated with women’s increased IPV exposure. Unemployment stress, holding inequitable gender attitudes and mother-in-law kindness were associated with young women’s increased IPV risk and hunger, mother-in-law cruelty and depression with older women’s IPV risk. There is a need to critically challenge harmful social and gender norms by using approaches that are sensitive to young married women’s position and unequal gender relations in the family. IPV prevention interventions need to employ a holistic approach that combines changing social and gender norms and improving socioeconomic conditions of women living in migrant communities. [ABSTRACT FROM AUTHOR]

Background: Bangladesh is one of the most anemia prone countries in South Asia. Children of age under five years and women of reproductive age are particularly vulnerable in this region. Although several studies have investigated the risk factors of anemia, only few have explored its association with malnutrition, despite its high prevalence in the same group. The objective of this paper is to investigate the association of malnutrition with anemia by conducting separate analyses for under-five children and women of reproductive age using data from the nationally representative 2011 Bangladesh Demographic and Health Survey. Methods: Two binary outcome variables are considered separately: presence of anemia in children under five years of age (Hb<11.0 g/dl) and presence of anemia in women of childbearing age (Hb<12.0 g/dl). The exposures of interest corresponding to these two outcomes are stunting (low height-for-age) and low BMI (<18.5 kg/m2), respectively. Preliminary analysis involves estimating the association between exposure and outcome while controlling for a single confounder by computing adjusted odds ratios (adjOR) using the Cochran-Mantel-Haenszel approach in stratified analysis. Later, associations between the exposures and outcomes are estimated separately for under-five children and women of reproductive age by fitting multivariable regression models that adjust simultaneously for several confounders. Results: The prevalence of anemia is found to be higher among both the stunted children and women with low BMI compared to their healthy counterparts (Children: 56% vs 48%; women: 50% vs 43%). Furthermore, stunted children and women with low BMI have significantly increased odds of developing anemia, as reflected by the adjusted ORs of 1.76 (95% CI:1.10–2.83) and 1.81 (95% CI: 1.11–3.48), respectively. The association of stunting with anemia in children was modified by their age and socio-economic condition, where risk of being anemic decreases with increasing age but with a lower rate for stunted children from richest family. In addition, stunted children of anemic mothers are at greater risk of being anemic compared to non-stunted children of anemic or non-anemic mothers. Again the association between BMI and anemia in women is modified by the level of education, with risk of anemia being lowest among women with low BMI and higher education. Conclusion: Evidence–based policies targeting the vulnerable groups are required to combat anemia and nutritional deficiencies simultaneously under the same program. [ABSTRACT FROM AUTHOR]

Dental caries and vitamin D inadequacy are known to affect children worldwide. Vitamin D has a vital role in tooth formation. There is growing evidence linking suboptimal serum vitamin D level with dental caries in children. This paper reviews the literature on both the prevalence of dental caries and of vitamin D deficiency in children in four Asian regions, discusses their associated risk factors, and reviews the global evidence on the association between dental caries and vitamin D in children. Caries prevalence in children ranged from 40% to 97% in Eastern Asia, 38–73.7% in Southern Asia, and 26.5–74.7% in Western Asian countries. Moreover, a higher prevalence of vitamin D deficiency in Asian children was identified, even in countries in equatorial regions, ranging from 2.8% to 65.3% in Eastern Asia, 5–66.7% in Southern Asia, 4–45.5% in Western Asia and 38.1–78.7% in Central Asian countries. Obesity, age, female gender, higher latitude, season, darker skin pigmentation, sunlight protection behaviors, less sunlight exposure and low intake of food containing vitamin D were important factors associated with lower serum vitamin D in Asia. Suboptimal vitamin D level in children may be a significant risk factor for dental caries, and requires further research to ascertain such an association in children in Asia, as well as to understand its exact influence on caries risk and development. [ABSTRACT FROM AUTHOR]

In the context of ecological and economic change, this paper identifies the impact of ongoing transformations in young people's labour contribution in four natural resource-dependent regions in India, Vietnam and China. Children's work is important to maximise household labour productivity, while also endowing them with the ecological knowledge necessary to sustain key productive livelihood activities. However, today, an increased emphasis on education and the out-migration of youth is reducing their labour contribution, particularly in the more economically developed case study communities in Northern Vietnam and China. While selective in its extent, these changes have increased the labour burden of older household members and women, while the economic opportunities young people aspire to following schooling or migration frequently prove elusive in a competitive liberalised economy. Another implication of young people diverting their labour and learning away from traditional natural resource-based livelihood activities is the loss of valuable ecological knowledge. [ABSTRACT FROM PUBLISHER]

The continually growing number of Asian migrant workers, the majority of whom are in the prime of their reproductive lives and leave families including children behind in their home countries, raises important questions about how families are sustained across transnational spaces. It is our aim in this paper to enhance understanding of the complex relationship between migration and the family in Asia by exploring bonding and parenting efforts between migrant parents and their left-behind children across time and space. In doing so, we draw on and engage with the literature on global householding, transnational families and emotion. Using qualitative data collected from in-depth interviews with carers of left-behind children in Northern Vietnam, the paper also sheds light on children's attitudes and reactions to their parents' migration as well as changes in their feelings over time. [ABSTRACT FROM PUBLISHER]

This paper examines the impact of in utero exposure to the Asian influenza pandemic of 1957 upon childhood development. Outcome data are provided by the National Child Development Study (NCDS), a panel study where all members were potentially exposed in the womb. Epidemic effects are identified using geographic variation in a surrogate measure of the epidemic. Results point to multiple channels linking fetal health shocks to childhood outcomes: physical development is intpeded, but only when mothers had certaht health eharacteristics; by contrast, the negative effects on cognitive development appear general across the cohort. [ABSTRACT FROM AUTHOR]

Since its inception at the start of the 20th century, play environmental design in Asia, Europe, United States, and in other countries has advanced dramatically from the traditional playgrounds of isolated metal pieces of play equipment to today's creative spaces of imaginative play activities that are designed to high standards of safety and durability. This paper describes the significance of a quality designed outdoor classroom in early childhood education. Next, the paper will highlight key points to help designers and architects understand and appreciate the stages that young children pass through as they develop one's physical, emotional, social, and intellectual abilities. We will then proceed with a discussion of design concepts that are needed to enrich the quality of children's outdoor play environments and finally, what standards and regulations are present in early childhood outdoor design? [ABSTRACT FROM AUTHOR]

Despite progress in reducing hunger and malnutrition since the 1990s, many still suffer from undernutrition and food insecurity, particularly women and young children, resulting in preterm birth, low birthweight and stunting, among other conditions. Helen Keller International (HKI) has addressed malnutrition and household food insecurity through implementation of an Enhanced Homestead Food Production (EHFP) programme that increases year ‐ round availability and intake of diverse micronutrient ‐ rich foods and promotes optimal nutrition and hygiene practices among poor households. This paper reviews the evolution and impact of HKI's EHFP programme and identifies core components of the model that address the underlying determinants of stunting. To date, evaluations of EHFP have shown impact on food production, consumption by women and children and household food security. Sale of surplus produce has increased household income, and the use of a transformative gender approach has empowered women. EHFP has also realized nutrition improvements in many project sites. Results from a randomized control trial (RCT) in Baitadi district, Nepal showed a significant improvement in a range of practices known to impact child growth, although no impact on stunting. Additional non ‐ RCT evaluations in Kailali district of Nepal, demonstrated a 10.5% reduction in stunting and in the Chittagong Hill Tracts in Bangladesh, revealed an 18% decrease in stunting. Based on evidence, the EHFP has evolved into an integrated package that includes agriculture, nutrition, water/hygiene/sanitation, linkages to health care, women's empowerment, income generation and advocacy. Closing the stunting gap requires long ‐ term exposure to targeted multi ‐ sectoral solutions and rigorous evaluation to optimize impact. [ABSTRACT FROM AUTHOR]

Sedentary behaviour (SB) has emerged as a potential risk factor for metabolic health in youth. Knowledge on the determinants of SB in youth is necessary to inform future intervention development to reduce SB. A systematic review was conducted to identify predictors and determinants of SB in youth. Pubmed, Embase, CINAHL, PsycINFO and Web of Science were searched, limiting to articles in English, published between January 2000 and May 2014. The search strategy was based on four key elements and their synonyms: (a) sedentary behaviour, (b) determinants, (c) types of sedentary behaviours, (d) types of determinants. The full protocol is available from PROSPERO (PROSPERO 2014:CRD42014009823). Cross-sectional studies were excluded. The analysis was guided by the socio-ecological model. 37 studies were selected out of 2654 identified papers from the systematic literature search. Most studies were conducted in Europe (n = 13), USA (n = 11), and Australia (n = 10). The study quality, using the Qualsyst tool, was high with a median of 82 % (IQR: 74-91 %). Multiple potential determinants were studied in only one or two studies. Determinants were found at the individual, interpersonal, environmental and policy level but few studies examined a comprehensive set of factors at different levels of influences. Evidence was found for age being positively associated with total SB, and weight status and baseline assessment of screen time being positively associated with screen time (at follow-up). A higher playground density and a higher availability of play and sports equipment at school were consistently related to an increased total SB, although these consistent findings come from single studies. Evidence was also reported for the presence of safe places to cross roads and lengthening morning and lunch breaks being associated with less total SB. Future interventions to decrease SB levels should especially target children with overweight or obesity and should start at a young age. However, since the relationship of many determinants with SB remains inconsistent, there is still a need for more longitudinal research on determinants of SB in youth. [ABSTRACT FROM AUTHOR]

Background: Evidence from studies conducted in nutritionally deprived children in low- and middle-income countries (LIMC) in past decades showed little or no population-level catch-up in linear growth (mostly defined as reductions in the absolute height deficit) after 2 years of age. Recent studies, however, have reported population-level catch-up growth in children, defined as positive changes in mean height-for-age z-scores (HAZ). The aim of this paper was to assess whether population-level catch-up in linear growth is found when height-for-age difference (HAD: child's height compared to standard, expressed in centimeters) is used instead of HAZ. Our premise is that HAZ is inappropriate to measure changes in linear growth over time because they are constructed using standard deviations from cross-sectional data.Methods: We compare changes in growth in populations of children between 2 and 5 years using HAD vs. HAZ using cross-sectional data from 6 Demographic and Health Surveys (DHS) and longitudinal data from the Young Lives and the Consortium on Health-Orientated Research in Transitional Societies (COHORTS) studies.Results: Using HAD, we find not only an absence of population-level catch-up in linear growth, but a continued deterioration reflected in a decrease in mean HAD between 2 and 5 years; by contrast, HAZ shows either no change (DHS surveys) or an improvement in mean HAZ (some of the longitudinal data). Population-level growth velocity was also lower than expected (based on standards) in all four Young Lives data sets, confirming the absence of catch-up growth in height.Discussion: We show no evidence of population-level catch-up in linear growth in children between 2 to 5 years of age when using HAD (a measure more appropriate than HAZ to document changes as populations of children age), but a continued deterioration reflected in a decrease in mean HAD.Conclusions: The continued widening of the absolute height deficit after 2 years of age does not challenge the critical importance of investing in improving nutrition during the first 1000 days (i.e., from conception to 2 years of age), but raises a number of research questions including how to prevent continued deterioration and what is the potential of children to benefit from nutrition interventions after 2 years of age. Preventing, rather than reversing linear growth retardation remains the priority for reducing the global burden of malnutritionworldwide. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses topics within the issue including ongoing conversation about creativity and creative pedagogy; development of students' creative learning; and positioning of creativity in education in Asian societies within educational policy.

An introduction is presented in which the editor discusses various reports within the issue on topics including children's involvement in migration in Asia, transnational movements, and sociocultural conceptions of children and childhood.

This study aimed to obtain implications on childrearing and childcare practices for achieving children's well-being through analyzing factors predicting children's well-being during the COVID-19 pandemic in eight Asian countries. We primarily focused on "resilience," the ability to cope with and recover from difficult situations, which had been confirmed from previous studies as a positive factor towards children's development in the context of hardships. We also chose other potential predictors referring to Bronfenbrenner's ecological systems theory, including mothers' concerns about COVID-19, household income, number of playmates, support from childcare facilities/schools, family environments, and children's lifestyles, and examined how these predictor variables predict children's well-being. We found that children's resilience strongly predicted their well-being, which was common in all eight countries. Family factors and children's daily life factors were also associated with children's well-being. The country-specific analysis also indicated the importance of support from childcare facilities/schools on well-being. Well-being and resilience are both psychological constructs and often studied as important indicators of child health. Resilience has been spot-lighted as an effective protective factor for children experiencing adversities such as the COVID-19 pandemic. We have found that resilience was the strongest predictor of well-being among other factors even during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Aim The dramatic rise in childhood obesity incidence in developing countries is related to nutrition and lifestyle transition. The aim of this review was to evaluate the quality and reporting of dietary assessment methods used in studies examining the relationship between dietary outcome and childhood obesity in developing Asian countries. Methods A three-step search strategy was conducted in databases between inception and 2011 with an English language restriction. Inclusion criteria were any cross-sectional or cohort studies in children ≤18 years who resided in developing countries in Asian region that included reporting on dietary intake. Papers were screened with standardised tools for quality and dietary methodology reporting. Results The search process identified 2080 studies and 15 studies (in 16 articles) met inclusion criteria. The most commonly used dietary assessment method was dietary questionnaires (n = 10), followed by 24-hour diet recall (n = 4), food frequency questionnaire (n = 3) and an unweighed food record (n = 1). For dietary methodology reporting, 12 out of 16 articles were rated as 'poor', 3 rated as 'acceptable' and 1 as 'excellent'. Conclusions The quality rating was influenced by the dietary assessment tool chosen, and a quality rating of 'poor' was mostly obtained by studies using non-standardised, non-validated study-specific dietary questionnaires. Significant gaps were identified in dietary intake methodological quality and hence, there is an urgent need for valid dietary measures and reporting of dietary intake among overweight children for studies conducted in Asian region. [ABSTRACT FROM AUTHOR]

A new social policy tool emerged a little more than a decade in Latin America and in Asia that brought immediate relief in the form of cash to poor families with children and conditioned the benefits on behavioral changes that would affect the long-term well-being of beneficiary households. By conditioning benefits on school attendance and obtaining health care and social support services, many countries, especially those in Latin America, were able to reverse intergenerational and intractable poverty rates. These programs, conditional cash transfers (CCTs) spread quickly throughout Latin America but have also become popular in other parts of the world. This paper looks at how CCTs have been used as a child policy strategy in Asia, summarizing the forms it has taken and the effectiveness of the programs in six Asian countries, and ends with a discussion of lessons learned from these experiences. [ABSTRACT FROM AUTHOR]

This systematic review and meta-analysis summarises the literature on parental acceptance, parental hesitancy, uptake, and the associated factors of seasonal influenza vaccination (SIV) among children aged 6–59 months. Studies were sourced from the following platforms: PubMed, Web of Science, MEDLINE, and EMBASE databases. A random-effects model was used to evaluate the prevalence and 95% confidence intervals (CI) of parental acceptance, parental hesitancy, and SIV uptake in the last flu season and lifetime among children. A total of 36 studies were included for analysis. The overall prevalence was 64% for parental acceptance (95% CI: 51–75%), 34% for parental hesitancy (95% CI: 22–48%), 41% for SIV uptake in the last flu season (95% CI: 33–50%), and 46% for SIV uptake in a lifetime (95% CI: 20–74%). Associated factors of parental acceptance/hesitancy and uptake included the age of the children or parents, parental education level, household income level, ethnicity, and other modifiable factors, including perceived benefits, perceived barriers, perceived severity, perceived susceptibility, and cues to action related to SIV. Meta-regression analyses revealed regional differences in parental acceptance (Americas: 79% vs. Asia: 60%). The results provided implications informing us of the development of intervention programs targeting parents to improve SIV coverage among young children. [ABSTRACT FROM AUTHOR]

Rapid genomic testing (rGT) enables genomic information to be available in a matter of hours, allowing it to be used in time-critical settings, such as intensive care units. Although rGT has been shown to improve diagnostic rates in a cost-effective manner, it raises ethical questions around a range of different areas, including obtaining consent and clinical decision-making. While some research has examined the perspectives of parents and genetics health professionals, the attitudes of intensive care clinicians remain under-explored. To address this gap, we administered an online survey to English-speaking neonatal/paediatric intensivists in Europe, Australasia and North America. We posed two ethical scenarios: one relating to obtaining consent from the parents and the second assessing decision-making regarding the provision of life-sustaining treatments. Descriptive statistics were used to analyse the data. We received 40 responses from 12 countries. About 50–75% of intensivists felt that explicit parental consent was necessary for rGT. About 68–95% felt that a diagnosis from rGT should affect the provision of life-sustaining care. Results were mediated by intensivists' level of experience. Our findings show divergent attitudes toward ethical issues generated by rGT among intensivists and suggest the need for guidance regarding ethical decision-making for rGT. [ABSTRACT FROM AUTHOR]

It is unclear whether there is any association between psychological distress and unhealthy dietary habits among adolescents in low- and middle-income countries. We aimed to estimate the prevalence of these factors in South-East Asia region and investigate their associations. We used data from the Global School-based Health Survey for nine South-East Asian countries. Psychological distress was defined by presence of ≥ 2 factors from loneliness, anxiety, suicide ideation, suicide planning and suicide attempt. We assessed inadequate fruit intake, inadequate vegetable intake, daily soft drink and weekly fast-food consumption. We used random-effects meta-analysis to estimate pooled prevalence. Logistic regressions were used to estimate OR of unhealthy dietary behaviours for psychological distress. Among 30 013 adolescents (56 % girls) aged 12–15 years, the prevalence of psychological distress was 11·0 %, with girls reporting slightly higher than boys (11·8 % v. 10·1 %). The prevalence of inadequate fruit intake, inadequate vegetable intake, daily soft drink consumption and weekly fast-food consumption was 42 %, 26 %, 40 % and 57 %, respectively. Psychological distress was associated with inadequate fruit intake (pooled OR = 1·20, 95 % CI 1·03, 1·40), inadequate vegetable intake (pooled OR = 1·17, 1·05, 1·31) and daily soft drink consumption (pooled OR = 1·14, 1·03, 1·26); but not with weekly fast-food consumption (pooled OR = 1·13, 0·96, 1·31). We observed substantial cross-country variations in prevalence and OR estimates. In conclusion, South-East Asian adolescents have significant burden of psychological distress and unhealthy dietary behaviours, with those having psychological distress are more likely to have unhealthy dietary behaviours. Our findings will guide preventative interventions and inform relevant policies around adolescent nutrition in the region. [ABSTRACT FROM AUTHOR]

Background: Migration-flows pose the risk of poliovirus reintroduction from endemic countries to Greece. This study aims to evaluate serologic-immunity/vaccination against poliomyelitis in newly-arriving migrant children. Methods: Demographic-immunisation data and blood-serum were obtained from migrants 1-14years-old, referred to a hospital-clinic in Athens-Greece within three months from arrival. Immunity to polioviruses-1-3 was determined by serum-neutralizing-antibodies(WHO guidelines). Titers ≥ 1:8 were considered positive. Results: From 9/2010 to 9/2013, 274 children(150 refugees/124 immigrants), mean age 7.1years-old, were enrolled. Only 57(20.8%) of them presented with vaccination-records. Children originated mainly from Asia(n = 198), Eastern Europe(n = 28), Middle East(n = 24) and Africa(n = 24) with 160(58.4%) from polio-endemic-countries(Afghanistan-112(40.8%), Pakistan-24(8.8%) and India-24(8.8%)). Seropositivity against polio-1-2&3 was 84.3%, 86.1% and 74.5%, respectively. Immigrants, had higher seroprotective rates against polioviruses-1-2&3 than refugees(polio-1:p = 0.002;polio-2:p = 0.004,polio-3:p < 0.001). Seronegativity to 1PVs-2PVs and all three polio serotypes was found in 37(13.5%),12 (4.4%), and 30 children(10.9%) respectively. Increasing number of vaccine-doses, and younger-age, were positively-associated with seropositivity. Discussion: A remarkable fraction of newly-arrived migrant-children were seronegative to one or more polioviruses. [ABSTRACT FROM AUTHOR]

There has been growing interest in the social-emotional development of children. However, the social-emotional development of children in Asia remains a knowledge gap. This systematic review identifies and summarizes existing studies on children's social-emotional development in Asia. We conducted a systematic review using the Guidelines for Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). We reviewed 45 studies that met the inclusion criteria, and they were from 12 Asian countries, primarily the East Asia region (China and Hong Kong). Most of the studies were cross-sectional in design (n = 28, 62.2%). Six themes emerged, including (a) social-emotional development (overall) (n = 24, 53.3%); (b) social competence (n = 7, 15.6%); (c) emotional development (n = 5, 11.1%); (d) social-emotional learning (n = 3, 6.7%); (e) problem behavior (n = 3, 6.7%); (f) self-regulation (n = 2, 4.4%); and (g) both social-emotional learning and problem behavior (n = 1, 2.2%). The findings highlighted the paucity of studies, the need for examining more diverse variables in a similar population, and the low quality of intervention studies in social-emotional research in Asia. Research gaps indicate the need for more social-emotional and ethnocultural studies in other Asian regions. Parent and teacher knowledge of children's social-emotional functioning should be examined more closely in future research. [ABSTRACT FROM AUTHOR]

Background: Non‐pharmacologic interventions might be effective to reduce the incidence of delirium in pediatric intensive care units (PICU). Aim: To explore expert opinions and generate informed consensus decisions regarding the content of a non‐pharmacologic delirium bundle to manage delirium in PICU patients. Study design: A two‐round online Delphi study was conducted from February to April 2021. PICU experts (nurses, physicians, researchers, physical therapists, play specialists, and occupational therapists) located in Europe, North America, South America, Asia, and Australia participated. Results: We developed a questionnaire based on the outcomes of a comprehensive literature search in the domains: 1) cognition support; 2) sleep support; and 3) physical activity support. Under these domains, we listed 11 strategies to promote support with 61 interventions. Participants rated the feasibility of each intervention on a 9‐point Likert scale (ranging from 1 strongly disagree to 9 strongly agree). A disagreement index and panel median were calculated to determine the level of agreement among experts. In the second round, participants reassessed the revised statements and ranked the interventions in each domain in order of importance for age groups: 0–2, 3–5, and 6–18 years of age. During the first Delphi round, 53 of 74 (72%) questionnaires were completed, and in the second round 45 of 74 (61%) were completed. Five of the highest ranked interventions across the age groups were: 1) developing a daily routine, 2) adjusting light exposure according to the time of day, 3) scheduling time for sleep, 4) providing eyeglasses and hearing aids if appropriate, 5) encouraging parental presence. Conclusions: Based on expert consensus, we developed an age‐specific non‐pharmacologic delirium bundle of interventions to manage delirium in PICU patients. Relevance to Clinical Practice: An age‐specific Non‐Pharmacological Delirium bundle is now ready to be tested in the PICU and will hopefully reduce pediatric delirium. [ABSTRACT FROM AUTHOR]

South Asia is home to the largest number of stunted children worldwide: 65 million or 37% of all South Asian children under 5 were stunted in 2014. The costs to society as a result of stunting during childhood are high and include increased mortality, increased morbidity (in childhood and later as adults), decreased cognitive ability, poor educational outcomes, lost earnings and losses to national economic productivity. Conversely, investing in nutrition provides many benefits for poverty reduction and economic growth. This article draws from analyses conducted in four sub ‐ Saharan countries to demonstrate that investments in nutrition can also be very cost ‐ effective in South Asian countries. Specifically, the analyses demonstrate that scaling up a set of 10 critical nutrition ‐ specific interventions is highly cost ‐ effective when considered as a package. Most of the interventions are also very cost ‐ effective when considered individually. By modelling cost ‐ effectiveness of different scale ‐ up scenarios, the analysis offers insights into ways in which the impact of investing in nutrition interventions can be maximized under budget constraints. Rigorous estimations of the costs and benefits of nutrition investments, similar to those reported here for sub ‐ Saharan countries, are an important next step for all South Asian countries in order to drive political commitment and action and to enhance allocative efficiency of nutrition resources. [ABSTRACT FROM AUTHOR]

Objective: Pharmacotherapy of depression in children and adolescents is complex. In the absence of research into the efficacy and safety of antidepressants in this group of patients, their off-label prescription is common. This paper aimed to illustrate the prescription pattern of antidepressants in children and adolescents from major psychiatric centres in Asia. Methods: The Research on Asia Psychotropic Prescription Pattern on Antidepressants worked collaborati vely in 2013 to study the prescription pattern of antidepressants in Asia using a unified research protocol and questionnaire. Forty psychiatric centres from 10 Asian countries / regions participated and 2321 antidepressant prescriptions were analysed. Results: A total of 4.7% antidepressant prescriptions were for children and adolescents. Fluoxetine, sertraline, and escitalopram were the most common antidepressants prescribed for children and adolescents. Almost one-third (30.3%) of prescriptions were for diagnoses other than depressive and anxiety disorders. There was less antidepressant polypharmacy and concomitant use of benzodiazepine, but more concomitant use of antipsychotics in children and adolescents compared with adults. Conclusion: Off-label use of antidepressants in children and adolescents was reported by 40 Asian psychiatric institutions that participated in the study. In-service education and regulatory mechanisms should be reinforced to ensure efficacy and safety of antidepressants in children and adolescents. [ABSTRACT FROM AUTHOR]

Background Anthrax is a toxin-mediated zoonotic disease caused by Bacillus anthracis , with a worldwide distribution recognized for millennia. Bacillus anthracis is considered a potential biowarfare agent. Methods We completed a systematic review for clinical and demographic characteristics of adults and children hospitalized with anthrax (cutaneous, inhalation, ingestion, injection [from contaminated heroin], primary meningitis) abstracted from published case reports, case series, and line lists in English from 1880 through 2018, assessing treatment impact by type and severity of disease. We analyzed geographic distribution, route of infection, exposure to anthrax, and incubation period. Results Data on 764 adults and 167 children were reviewed. Most cases reported for 1880 through 1915 were from Europe; those for 1916 through 1950 were from North America; and from 1951 on, cases were from Asia. Cutaneous was the most common form of anthrax for all populations. Since 1960, adult anthrax mortality has ranged from 31% for cutaneous to 90% for primary meningitis. Median incubation periods ranged from 1 day (interquartile range [IQR], 0–4) for injection to 7 days (IQR, 4–9) for inhalation anthrax. Most patients with inhalation anthrax developed pleural effusions and more than half with ingestion anthrax developed ascites. Treatment and critical care advances have improved survival for those with systemic symptoms, from approximately 30% in those untreated to approximately 70% in those receiving antimicrobials or antiserum/antitoxin. Conclusions This review provides an improved evidence base for both clinical care of individual anthrax patients and public health planning for wide-area aerosol releases of B. anthracis spores. [ABSTRACT FROM AUTHOR]

To examine the relationship between relative deprivation and social anxiety, which affects mental health, and investigate the mediating role of perceived control and the moderating role of belief in a just world (BJW) in an understudied population in Asia, we surveyed 1573 rural-to-urban migrant children (48% female; 푀age = 12.3, SD = 1.7) in southeast China. Relative deprivation was positively correlated with social anxiety; perceived control partially mediated this connection. Moreover, BJW moderated the indirect effect, which was stronger for male migrant children with lower levels of BJW. The limitations and practical implications of this study are discussed. [ABSTRACT FROM AUTHOR]

Objective: The association between methylenetetrahydrofolate reductase (MTHFR) C677 > T polymorphisms and pediatric acute lymphoblastic leukemia (ALL) risk in Asia is controversial. The aim of this meta-analysis was to further assess the relationship between MTHFRC677 > T polymorphisms and pediatric ALL for Chinese children. Materials and Methods: Studies about the MTHFR C677 > T polymorphisms and pediatric ALL risk were searched in the Medline, PubMed, EMBASE, Wanfang and CNIK databases. The genotype of the case and control group were extracted and pooled by meta-analysis. The association between ALL risk and C677 > T polymorphisms was demonstrated by odds ratio (OR) and its 95% confidence interval (CI). Results: Twelve articles were included in this study with 1803 ALL cases and 4146 controls. In recessive genetic model (TT vs. CC + CT), the OR was 0.37 (95%CI: 0.31-0.43); in dominant genetic model (TT + CT vs. CC) the OR was 0.94 (95%CI: 0.82-1.06); and in the homozygous model the OR was 0.84 (95%CI: 0.69-1.03). Conclusion: The results indicated that Asian children with TT genotype of MTHFR gene may have less risk of developing ALL. [ABSTRACT FROM AUTHOR]

The prevalence of obesity has reached alarming levels, affecting virtually both developed and developing countries of all socio-economic groups, irrespective of age, sex or ethnicity. Concerning childhood obesity, it has been estimated that worldwide over 22 million children under the age of 5 are severely overweight, and one in 10 children are overweight. This global average reflects a wide range of prevalence levels, with the prevalence of overweight in Africa and Asia averaging well below 10% and in the Americas and Europe above 20%. The proportion of school-age children affected will almost double by 2010 compared with the most recently available surveys from the late 1990s up to 2003. In the European Union, the number of children who are overweight is expected to rise by 1.3 million children per year, with more than 300,000 of them becoming obese each year without urgent action to counteract the trend. By 2010 it is estimated that 26 million children in E.U. countries will be overweight, including 6.4 million who will be obese. Moreover, in the U.S.A. the prevalence of obesity in adolescents has increased dramatically from 5% to 13% in boys and from 5% to 9% in girls between 1966-70 and 1988-91. In this review paper we present the epidemiology of obesity in children and adolescents, including prevalence rates, trends, and risk factors associated with this phenomenon. [ABSTRACT FROM AUTHOR]

The Society for International Nutrition Research sponsored a Symposium titled "Women's Voices, Women's Choices: The Challenge of Nutrition and HIV/AIDS in Asia and Africa" at Experimental Biology 2004 to highlight the challenges facing RIV-positive women living in resource-poor settings of Asia and Africa, when it comes to the everyday decisions they are forced to make about their own health and nutrition, and the health and the nutrition of their children. This introductory paper summarizes the rationale for this session, including a summary of the evidence for women's increased vulnerability to HIV, the nutritional impacts of HIV infection, and the special infant feeding and nutritional concerns facing HIV-positive pregnant and lactating mothers in Africa and Asia. The issue of nutrition and HIV/AIDS is addressed here from an intergenerational perspective, using new data from qualitative research, clinical trials, and behavioral interventions in India, Malawi, South Africa, Tanzania, and Zimbabwe, to illustrate important concerns, using study participants' own words to convey key messages, The focus is on women, because they are shouldering much of the burden of HIV infection in terms of their numbers and in their responsibilities for providing food and care for orphans and HIV-affected family members. Infant feeding choices are also considered in this review, because of the vast implications that not breast-feeding at all and stopping breast-feeding early have on the nutritional well-being of HIV-exposed children, as well as the positive contribution of breast-feeding to child nutrition and survival worldwide. [ABSTRACT FROM AUTHOR]

To conduct a systematic literature review to evaluate the global incidence of intraventricular hemorrhage grade 2–4 among extremely preterm infants. We performed searches in MEDLINE and Embase for intraventricular hemorrhage and prematurity cited in English language observational studies published from May 2006 to October 2017. Included studies analyzed data from infants born at ≤28 weeks' gestational age and reported on intraventricular hemorrhage epidemiology. Ninety-eight eligible studies encompassed 39 articles from Europe, 31 from North America, 25 from Asia, five from Oceania, and none from Africa or South America; both Europe and North America were included in two publications. The reported global incidence range of intraventricular hemorrhage grade 3–4 was 5–52% (Europe: 5–52%; North America: 8–22%; Asia: 5–36%; Oceania: 8–13%). When only population-based studies were included, the incidence range of intraventricular hemorrhage grade 3–4 was 6–22%. The incidence range of intraventricular hemorrhage grade 2 was infrequently documented and ranged from 5–19% (including population-based studies). The incidence of intraventricular hemorrhage was generally inversely related to gestational age. Intraventricular hemorrhage is a frequent complication of extremely preterm birth. Intraventricular hemorrhage incidence range varies by region, and the global incidence of intraventricular hemorrhage grade 2 is not well documented. [ABSTRACT FROM AUTHOR]

Aim: Acute respiratory infection (ARI) is the most commonly reported disease in children. This study was conducted to investigate the epidemiology of mortality from ARI and its relationship with the Human Development Index (HDI) in children under the age of 5 years. Subjects and methods: The study data included the HDI, neonatal mortality rates, and the mortality of children under the age of 5 years due to ARIs retrieved from the World Bank. In this study, the bivariate correlation method was employed and a significance level of less than 0.05 was considered. Results: The mortality of children under the age of 5 years (r = − 0.784, p < 0.0001) and neonatal death (r = − 0.792, p < 0.0001) induced by ARIs was negatively correlated with the HDI. There was also a significant negative correlation between neonatal death caused by ARIs and gross national income (GNI) per capita per 1000 lives (r = − 0.453, p < 0.001), mean years of schooling (r = − 0.645, p < 0.001), life expectancy at birth (r = − 0.801, p < 0.001), and expected years of schooling (r = − 0.736, p < 0.001). A negative and significant correlation was also observed between the ARI-induced mortality of children under the age of 5 years and GNI per capita per 1000 lives (r = − 0.469, p < 0.001), mean years of schooling (r = − 0.619, p < 0.001), life expectancy at birth (r = − 0.771, p < 0.001), and expected years of schooling (r = − 0.756, p < 0.01). Conclusion: The components of the HDI are directly related to ARI deaths. Therefore, a careful analysis of these indicators in countries with a low HDI can be effective in promoting health and reducing ARI-related mortality in children. [ABSTRACT FROM AUTHOR]

Background: Vaccine preventable diseases are still the most common cause of childhood mortality, with an estimated 3 million deaths every year, mainly in Africa and Asia. An estimate of 29% deaths among children aged 1-59 months were due to vaccine preventable diseases. Despite the benefits of childhood immunisation, routine vaccination coverage for all recommended Expanded Programme on Immunization vaccines has remained poor in some African countries, such as Nigeria (31%), Ethiopia (43%), Uganda (55%) and Ghana (57%). The aim of this study is to collate evidence on the factors that influence childhood immunisation uptake in Africa, as well as to provide evidence for future researchers in developing, implementing and evaluating intervention among African populations which will improve childhood immunisation uptake.Methods: We conducted a systematic review of articles on the factors influencing under-five childhood immunisation uptake in Africa. This was achieved by using various keywords and searching multiple databases (Medline, PubMed, CINAHL and Psychology & Behavioral Sciences Collection) dating back from inception to 2020.Results: Out of 18,708 recorded citations retrieved, 10,396 titles were filtered and 324 titles remained. These 324 abstracts were screened leading to 51 included studies. Statistically significant factors found to influence childhood immunisation uptake were classified into modifiable and non-modifiable factors and were further categorised into different groups based on relevance. The modifiable factors include obstetric factors, maternal knowledge, maternal attitude, self-efficacy and maternal outcome expectation, whereas non-modifiable factors were sociodemographic factors of parent and child, logistic and administration factors.Conclusion: Different factors were found to influence under-five childhood immunisation uptake among parents in Africa. Immunisation health education intervention among pregnant women, focusing on the significant findings from this systematic review, would hopefully improve childhood immunisation uptake in African countries with poor coverage rates. [ABSTRACT FROM AUTHOR]

Summary: In this meta-analysis, we analyzed 9 cross-sectional studies for an association between type 1 diabetes mellitus (T1DM) and bone mineral density (BMD) in children. We found that BMD Z-scores were significantly reduced in children with T1DM. Introduction: Recent cross-sectional studies have examined how T1DM influences bone health in children and adolescents, but the relationship between T1DM and BMD remains unclear due to conflicting reports. Methods: In this meta-analysis, we systematically searched PubMed, Cochrane library, and Web of Science databases (for publications through March 12, 2020), and calculated weight mean difference (WMD) along with 95% confidence intervals (CI) using a random-effects model. Heterogeneity was evaluated using the I2 method. The Newcastle-Ottawa Scale was used to assess the quality of the included studies. Results: Data were analyzed from 9 eligible studies, including a total of 1522 children and adolescents. These data were tested for an association between T1DM and BMD. This analysis found a significant decrease in BMD Z-score in the whole body (pooled WMD, − 0.47, 95% CI, − 0.92 to − 0.02, I2 = 80.2%) and lumbar spine (pooled WMD, − 0.41, 95% CI, − 0.69 to − 0.12, I2 = 80.3%) in children and adolescents with T1DM, which was consistent in published studies from Asia and South America, but inconsistent in the North America and Europe. Importantly, the differences in BMD Z-scores were independent of age, level of glucose control (HbA1c), and prepubertal stage. Sensitivity analyses did not modify these findings. Funnel plot and the Egger test did not reveal significant publication bias. Conclusion: This meta-analysis suggests that T1DM may play a role in decreasing BMD Z-scores in the whole body and lumbar spine in children. [ABSTRACT FROM AUTHOR]

Background: Commercial growing up milks (GUMs) targeted at children from 12 to 36 months of age are a rapidly growing industry, particularly across the Asia Pacific. Methods: The present study assessed the frequency of use and socio‐demographic and child associations of commercial GUM feeding in children, aged between 12 and 36 months, in capital cities in four Asia Pacific countries. Mothers of children aged between 12 and 36 months were surveyed, assessing GUM feeding frequency in the past month. A market research company database was used to survey across Asia Pacific urban cities, including Bangkok Thailand, Jakarta Indonesia, Singapore and Australian Capital Cities (ACC). Results: More than 1000 women (n = 1051) were surveyed (Bangkok, n = 263; Jakarta, n = 275; ACC, n = 252; Singapore, n = 261). The mean (SD) age of mothers was 32.4 (5.3) years and that of children was 23.6 (6.7) months. In total, 62.7% of the children were fed GUMs more than once per week with significant country variance. In comparison with ACC, Asian countries were significantly more likely to feed GUMs ≥once per week: Bangkok [odds ratio (OR) = 5.7, 95% confidence interval (CI) = 3.8–8.6]; Jakarta (OR = 3.5, 95% CI = 2.3–5.5); and Singapore (OR = 7.4, 95% CI = 4.9‐11.1). Associations of GUM feeding included: maternal tertiary education; mothers younger than 30 years; working full time; and feeding of commercial infant formula under 12 months. Conclusions: This is the first published study to explore commercial GUM feeding in and between countries. The incidence of GUM feeding, in contrast to international recommendations, signals the need for further research into the drivers for GUM feeding and its contribution to the diet. [ABSTRACT FROM AUTHOR]

Purpose: Intracranial germ cell tumors (IGCTs) account for 8–15% of brain tumors in children in Eastern Asia and typically occur at the age of puberty. Recently, adjuvant therapy has been modified to ameliorate post-treatment complications such as cognitive dysfunction, in patients with IGCT. However, endocrine problems remain to be resolved. There is reluctance to use growth hormone (GH) at an early stage after treatment for IGCT because of the risk of tumor recurrence; however, GH replacement must be administered before the onset of puberty in children with short stature. There is little guidance on this issue due to a lack of literature on the risks of GH replacement therapy in patients with IGCT. This study aimed to evaluate the safety of GH replacement. Methods: In this retrospective study, 6 patients with IGCT who were under the age of 18 years when they started GH replacement therapy were reviewed. Histopathological analysis and/or analysis of tumor markers was used to confirm a diagnosis. Results: All six cases who underwent GH replacement therapy showed no recurrence. GH replacement therapy was administered in 5 patients for short stature and all achieved a height within ± 2.0 standard deviation. Conclusion: GH replacement for children with IGCT was safe in our case series. Placental alkaline phosphatase levels in cerebrospinal fluid can be used to facilitate the decision on when to initiate GH replacement. [ABSTRACT FROM AUTHOR]

High numbers of children and adolescents in South‐East Asia are traumatized by either natural disasters or human‐made violence. Addressing traumatic sequelae in local populations with empirically based trauma treatments is challenged by the insufficiency inappropriately trained mental health provision. To meet this need for qualified therapists, the humanitarian/trauma capacity‐building organization, Trauma Aid Germany, trained 37 therapists in psychotraumatology, including trauma stabilization. This study analyses the impact of trauma stabilization as a sole treatment intervention for post‐traumatic stress (PTS) problems in children and adolescents. Each client was screened for PTS problems pre‐ and post‐treatment using the Child Behaviour Checklist. Trauma stabilization (including psychoeducation) was the focus for subsequent data analysis. Those excluded were clients in receipt of trauma confrontation interventions. Trauma stabilization, as a sole treatment intervention, appeared to be sufficiently effective in reducing the PTS problems. The data set suggests that trauma stabilization has the potential to be effective, efficient, and sufficient treatment intervention for PTS problems in children and adolescents. Trauma stabilization techniques have the advantage of being relatively straightforward to teach and easy to integrate into practice. They are clinically safe, flexible, adaptable to the development stage and age of the client, and culturally and spiritually sensitive. A further advantage of trauma stabilization interventions is that they are bespoke – adjusted and adapted to the specific needs of the client. The discussion considers the implications for the potential utilization of mental health nurses and paraprofessionals in low‐ and middle‐income countries in trauma stabilization interventions. [ABSTRACT FROM AUTHOR]

Good nutrition in the first "1000 days," including breastfeeding and appropriate complementary foods, prepares for a healthy childhood and adult life, also contributes to the prevention of the double burden of malnutrition. Exclusive breastfeeding provides all required nutrients until an infant is around 6 months of age when complementary foods are needed. A literature review was undertaken of complementary foods in the Asia Pacific region. The foods being used at present are often of low nutrient density may provide insufficient amounts of some critical nutrients, and generally the variety is limited. Guidelines for complementary feeding are provided to assist in education and in public health planning. [ABSTRACT FROM AUTHOR]

Background: Despite a high mortality rate in childhood, there is limited evidence on the causes and outcomes of paediatric bloodstream infections from low- and middle-income countries (LMICs). We conducted a systematic review and meta-analysis to characterize the bacterial causes of paediatric bloodstream infections in LMICs and their resistance profile. Methods: We searched Pubmed and Embase databases between January 1st 1990 and October 30th 2019, combining MeSH and free-text terms for "sepsis" and "low-middle-income countries" in children. Two reviewers screened articles and performed data extraction to identify studies investigating children (1 month-18 years), with at least one blood culture. The main outcomes of interests were the rate of positive blood cultures, the distribution of bacterial pathogens, the resistance patterns and the case-fatality rate. The proportions obtained from each study were pooled using the Freeman-Tukey double arcsine transformation, and a random-effect meta-analysis model was used. Results: We identified 2403 eligible studies, 17 were included in the final review including 52,915 children (11 in Africa and 6 in Asia). The overall percentage of positive blood culture was 19.1% [95% CI: 12.0–27.5%]; 15.5% [8.4–24.4%] in Africa and 28.0% [13.2–45.8%] in Asia. A total of 4836 bacterial isolates were included in the studies; 2974 were Gram-negative (63.9% [52.2–74.9]) and 1858 were Gram-positive (35.8% [24.9–47.5]). In Asia, Salmonella typhi (26.2%) was the most commonly isolated pathogen, followed by Staphylococcus aureus (7.7%) whereas in Africa, S. aureus (17.8%) and Streptococcus pneumoniae (16.8%) were predominant followed by Escherichia coli (10.7%). S. aureus was more likely resistant to methicillin in Africa (29.5% vs. 7.9%), whereas E. coli was more frequently resistant to third-generation cephalosporins (31.2% vs. 21.2%), amikacin (29.6% vs. 0%) and ciprofloxacin (36.7% vs. 0%) in Asia. The overall estimate for case-fatality rate among 8 studies was 12.7% [6.6–20.2%]. Underlying conditions, such as malnutrition or HIV infection were assessed as a factor associated with bacteraemia in 4 studies each. Conclusions: We observed a marked variation in pathogen distribution and their resistance profiles between Asia and Africa. Very limited data is available on underlying risk factors for bacteraemia, patterns of treatment of multidrug-resistant infections and predictors of adverse outcomes. [ABSTRACT FROM AUTHOR]