Somalia: supporting the child survival agenda when routine health service is broken.

Science.gov (United States)

Mirza, Imran Raza; Kamadjeu, Raoul; Assegid, Kebede; Mulugeta, Abraham

2012-03-01

Somalia, one of the most unstable countries in the world, has been without a permanent government for nearly 2 decades. With a health system in total disarray, coverage of basic health interventions remains low and, maternal and child mortality is among the highest in the world. Health partners jointly outlined an integrated package of critical child survival interventions to be delivered through a population-based delivery strategy known as Child Health Days (CHDs), to reduce child mortality. Using this strategy, key child survival interventions are delivered to the community with an objective of reaching children Somalia every 6 months. Through this strategy, immunization services were reached in remote areas, and coverage disparity between the urban and rural areas was reduced from 17% (42% urban and 25% rural) to 10% (50% urban and 60% rural). In addition, infants were reached with a third dose of diphtheria-pertussis-tetanus vaccine, achieving 51% coverage during 2009 and 66% in 2010. This paper summarizes the challenges of scaling up child interventions in the troubled context of Somalia by reviewing the planning, implementation, and achievements of CHDs as well as reflecting on challenges for the future of child survival in Somalia.

The quiet revolution. Child survival comes of age.

Science.gov (United States)

Bendahmane, D B

1994-01-01

Programs to reduce infant and child mortality have led to improvements in most countries of the world, developed and developing alike. These improvements can be seen graphically on maps produced by the USAID Child Survival Program which was launched in 1985 and which provided a "package" of health interventions that has led to a 10% mortality decline. These interventions have led to an increase in life expectancy in developing countries from 50 years in 1965 to over 60 years in 1986. Unfortunately, the children whose lives have been saved face a cruel paradox because their prospects for improving their lives are slim. They are the victims of deepening poverty, the stresses of urban life, and war and violence. In addition, the education which could allow them to escape their fate is largely denied to them. Although 90% of the children in developing countries enter school, an estimated 100 million drop out before grade 5. To make matters worse, most of the child survivors live in countries where the young age of the majority of the citizens is straining government resources. Even young people in the developed world are not immune from these problems; in the US, children are worse off than they were 25 years ago. While the struggle to increase child survival must continue, the world must also nurture the children who survive. The vicious cycle of population growth, poverty, and environmental degradation (PPE), which causes and is exacerbated by political and social instability, has been weakened by child survival programs which have reduced fertility rates. Education, especially of girls, also has a positive effect on the spiral. The effects of education, health and nutrition, and family planning programs can create a "virtuous" cycle which can increase gross domestic income and equity of income distribution (resulting in shared growth and "human capital accumulation"). Such initiatives as innovative community youth programs and new financing mechanisms can have a

From safe motherhood, newborn, and child survival partnerships to the continuum of care and accountability: moving fast forward to 2015.

Science.gov (United States)

Bustreo, Flavia; Requejo, Jennifer Harris; Merialdi, Mario; Presern, Carole; Songane, Francisco

2012-10-01

The present paper provides an overview of the Safe Motherhood Initiative, Healthy Newborn Partnership, and Child Survival Partnership and their eventual merge into the Partnership for Maternal, Newborn and Child Health (PMNCH) in 2005. The promise and past successes of the PMNCH are highlighted, with a particular focus on the PMNCH's partner-centric approach showing the importance of collaboration for progress. The aims of the strategic framework for 2012-2015 are presented within the context of the Global Strategy for Women's and Children's Health, launched in 2010, and growing political momentum to achieve Millennium Development Goals 4 and 5 (reduce child mortality and improve maternal health, respectively). The next 4 years leading to 2015 are critical, and the global community must continue to work together to ensure all women and children are reached with key interventions proven to reduce mortality. Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Partnerships for Global Child Health.

Science.gov (United States)

Steenhoff, Andrew P; Crouse, Heather L; Lukolyo, Heather; Larson, Charles P; Howard, Cynthia; Mazhani, Loeto; Pak-Gorstein, Suzinne; Niescierenko, Michelle L; Musoke, Philippa; Marshall, Roseda; Soto, Miguel A; Butteris, Sabrina M; Batra, Maneesh

2017-10-01

Child mortality remains a global health challenge and has resulted in demand for expanding the global child health (GCH) workforce over the last 3 decades. Institutional partnerships are the cornerstone of sustainable education, research, clinical service, and advocacy for GCH. When successful, partnerships can become self-sustaining and support development of much-needed training programs in resource-constrained settings. Conversely, poorly conceptualized, constructed, or maintained partnerships may inadvertently contribute to the deterioration of health systems. In this comprehensive, literature-based, expert consensus review we present a definition of partnerships for GCH, review their genesis, evolution, and scope, describe participating organizations, and highlight benefits and challenges associated with GCH partnerships. Additionally, we suggest a framework for applying sound ethical and public health principles for GCH that includes 7 guiding principles and 4 core practices along with a structure for evaluating GCH partnerships. Finally, we highlight current knowledge gaps to stimulate further work in these areas. With awareness of the potential benefits and challenges of GCH partnerships, as well as shared dedication to guiding principles and core practices, GCH partnerships hold vast potential to positively impact child health. Copyright © 2017 by the American Academy of Pediatrics.

Caregiver behavior change for child survival and development in low- and middle-income countries: an examination of the evidence.

Science.gov (United States)

Elder, John P; Pequegnat, Willo; Ahmed, Saifuddin; Bachman, Gretchen; Bullock, Merry; Carlo, Waldemar A; Chandra-Mouli, Venkatraman; Fox, Nathan A; Harkness, Sara; Huebner, Gillian; Lombardi, Joan; Murry, Velma McBride; Moran, Allisyn; Norton, Maureen; Mulik, Jennifer; Parks, Will; Raikes, Helen H; Smyser, Joseph; Sugg, Caroline; Sweat, Michael; Ulkuer, Nurper

2014-01-01

In June of 2012, representatives from more than 80 countries promulgated a Child Survival Call to Action, which called for reducing child mortality to 20 or fewer child deaths per 1,000 live births in every country by 2035. To address the problem of ending preventable child deaths, the U.S. Agency for International Development and the United Nations Children's Fund convened, on June 3-4, 2013, an Evidence Summit on Enhancing Child Survival and Development in Lower- and Middle-Income Countries by Achieving Population-Level Behavior Change. Six evidence review teams were established on different topics related to child survival and healthy development to identify the relevant evidence-based interventions and to prepare reports. This article was developed by the evidence review team responsible for identifying the research literature on caregiver change for child survival and development. This article is organized into childhood developmental periods and cross-cutting issues that affect child survival and healthy early development across all these periods. On the basis of this review, the authors present evidence-based recommendations for programs focused on caregivers to increase child survival and promote healthy development. Last, promising directions for future research to change caregivers' behaviors are given.

Caregiver Behavior Change for Child Survival and Development in Low- and Middle-Income Countries: An Examination of the Evidence

Science.gov (United States)

Elder, John P.; Pequegnat, Willo; Ahmed, Saifuddin; Bachman, Gretchen; Bullock, Merry; Carlo, Waldemar A.; Chandra-Mouli, Venkatraman; Fox, Nathan A.; Harkness, Sara; Huebner, Gillian; Lombardi, Joan; Murry, Velma McBride; Moran, Allisyn; Norton, Maureen; Mulik, Jennifer; Parks, Will; Raikes, Helen H.; Smyser, Joseph; Sugg, Caroline; Sweat, Michael

2014-01-01

In June of 2012, representatives from more than 80 countries promulgated a Child Survival Call to Action, which called for reducing child mortality to 20 or fewer child deaths per 1,000 live births in every country by 2035. To address the problem of ending preventable child deaths, the U.S. Agency for International Development and the United Nations Children's Fund convened, on June 3–4, 2013, an Evidence Summit on Enhancing Child Survival and Development in Lower- and Middle-Income Countries by Achieving Population-Level Behavior Change. Six evidence review teams were established on different topics related to child survival and healthy development to identify the relevant evidence-based interventions and to prepare reports. This article was developed by the evidence review team responsible for identifying the research literature on caregiver change for child survival and development. This article is organized into childhood developmental periods and cross-cutting issues that affect child survival and healthy early development across all these periods. On the basis of this review, the authors present evidence-based recommendations for programs focused on caregivers to increase child survival and promote healthy development. Last, promising directions for future research to change caregivers' behaviors are given. PMID:25315597

Low Child Survival Index in a Multi-Dimensionally Poor Amerindian Population in Venezuela

OpenAIRE

Villalba, Julian A.; Liu, Yushi; Alvarez, Mauyuri K.; Calderon, Luisana; Canache, Merari; Cardenas, Gaudymar; Del Nogal, Berenice; Takiff, Howard E.; De Waard, Jacobus H.

2013-01-01

Background Warao Amerindians, who inhabit the Orinoco Delta, are the second largest indigenous group in Venezuela.  High Warao general mortality rates were mentioned in a limited study 21 years ago. However, there have been no comprehensive studies addressing child survival across the entire population. Objectives To determine the Child Survival-Index (CSI) (ratio: still-living children/total-live births) in the Warao population, the principal causes of childhood death and the socio-demograph...

Child survival in big cities: the disadvantages of migrants.

Science.gov (United States)

Brockerhoff, M

1995-05-01

Data from 15 Demographic and Health Surveys are used to examine whether rural-urban migrants in developing countries experience higher child mortality after settling in towns and cities than do lifelong urban residents, and if so, what individual or household characteristics account for this. Findings indicate that children of female migrants from the countryside generally have much poorer survival chances than other urban children. This survival disadvantage is more pronounced in big cities than in smaller urban areas, among migrants who have lived in the city for many years than among recent migrants, and in urban Latin America than in urban North Africa and sub-Saharan Africa. Within big cities, higher child mortality among migrant women is clearly related to their concentration in low-quality housing, and in part to fertility patterns at early ages of children and mother's educational attainment at later ages. Excess child mortality among urban migrants may also result from factors associated with the migration process, that are outlined in this study but not included in the analysis. Evidence of moderately high levels of residential segregation of migrant women in big cities suggests that opportunities exist for urban health programs to direct interventions to this disadvantaged segment of city populations.

Increasing maternal healthcare use in Rwanda: implications for child nutrition and survival.

Science.gov (United States)

Pierce, Hayley; Heaton, Tim B; Hoffmann, John

2014-04-01

Rwanda has made great progress in improving maternal utilization of health care through coordination of external aid and more efficient health policy. Using data from the 2005 and 2010 Rwandan Demographic and Health Surveys, we examine three related questions regarding the impact of expansion of health care in Rwanda. First, did the increased use of health center deliveries apply to women across varying levels of education, economic status, and area of residency? Second, did the benefits associated with being delivered at a health center diminish as utilization became more widespread? Finally, did inequality in child outcomes decline as a result of increased health care utilization? Propensity score matching was used to address the selectivity that arises when choosing to deliver at a hospital. In addition, the regression models include a linear model to predict child nutritional status and Cox regression to predict child survival. The analysis shows that the largest increases in delivery at a health center occur among less educated, less wealthy, and rural Rwandan women. In addition, delivery at a health center is associated with better nutritional status and survival and the benefit is not diminished following the dramatic increase in use of health centers. Finally, educational, economic and residential inequality in child survival and nutrition did not decline. Copyright © 2014 Elsevier Ltd. All rights reserved.

Immunization Status and Child Survival in Uganda Edward Bbaale1 ...

African Journals Online (AJOL)

under-five mortality rate is 90 per 1,000 live births. ... 46% to 52% but still below the worldwide target of 90% (Uganda Bureau of Statistics. (UBOS) and ICF ... detrimental child-survival effects of parental poverty and low educational attainment.

Child health and child care of very young children in Bolivia, Colombia and Peru

OpenAIRE

Urke, Helga Bjørnøy

2017-01-01

With the global progress in reduction of child mortality, an increasing concern for the health, development and well-being of the surviving child has emerged. It is estimated that 250 million children are not reaching their developmental potential in developing countries, due to among others malnutrition, inadequate care and exposure to violence. In addition, structural and other social aspects of the immediate family and wider community environment of the child exert influence...

Network advocacy and the emergence of global attention to newborn survival.

Science.gov (United States)

Shiffman, Jeremy

2016-04-01

Globally 2.9 million babies die each year before reaching 28 days of life. Over the past quarter century, neonatal mortality has declined at a slower pace than post-neonatal under-five mortality: in consequence newborns now comprise 44% of all deaths to children under five years. Despite high numbers of newborn deaths, global organizations and national governments paid little attention to the issue until 2000, and resources, while growing since then, remain inadequate. This study examines the factors behind these patterns of policy attention: the delayed emergence of attention, its sudden appearance in 2000, its growth thereafter, but the dearth of resources to date. Drawing on a framework on global health networks grounded in collective action theory, the study finds that a newborn survival network helped to shift perceptions about the problem's severity and tractability, contributing to the rise of global attention. Its efforts were facilitated by pressure on governments to achieve the child survival Millennium Development Goal and by growing awareness that the neonatal period constituted a growing percentage of under-five mortality, a fact the network publicized. The network's relatively recent emergence, its predominantly technical rather than political composition and strategies, and its inability to date to find a framing of the issue that has convinced national political leaders of the issue's urgency, in part explain the insufficiency of resources. However, since 2010 a number of non-health oriented inter-governmental organizations have begun to pay attention to the issue, and several countries with high neonatal mortality have created national plans, developments which augur well for the future. The study points to two broader implications concerning how neglected global health issues come to attract attention: priority emerges from a confluence of factors, rather than any single cause; and growth in priority may depend on the creation of a broader

Rural/Urban Differences in Child Growth and Survival in Bolivia.

Science.gov (United States)

Heaton, Tim B.; Forste, Renata

2003-01-01

In Bolivia, a third of rural children are stunted, and rural infants are twice as likely to die before age 2 than urban infants. National survey data indicate child survival and development are related to maternal education and literacy, community sanitation practices, access to health care, and socioeconomic status. Parental knowledge about…

Child mortality inequalities across Rwanda districts: a geoadditive continuous-time survival analysis

Directory of Open Access Journals (Sweden)

François Niragire

2017-05-01

Full Text Available Child survival programmes are efficient when they target the most significant and area-specific factors. This study aimed to assess the key determinants and spatial variation of child mortality at the district level in Rwanda. Data from the 2010 Rwanda Demographic and Health Survey were analysed for 8817 live births that occurred during five years preceding the survey. Out of the children born, 433 had died before survey interviews were carried out. A full Bayesian geo-additive continuous-time hazard model enabled us to maximise data utilisation and hence improve the accuracy of our estimates. The results showed substantial district- level spatial variation in childhood mortality in Rwanda. District-specific spatial characteristics were particularly associated with higher death hazards in two districts: Musanze and Nyabihu. The model estimates showed that there were lower death rates among children from households of medium and high economic status compared to those from low-economic status households. Factors, such as four antenatal care visits, delivery at a health facility, prolonged breastfeeding and mothers younger than 31 years were associated with lower child death rates. Long preceding birth intervals were also associated with fewer hazards. For these reasons, programmes aimed at reducing child mortality gaps between districts in Rwanda should target maternal factors and take into consideration district-specific spatial characteristics. Further, child survival gains require strengthening or scaling-up of existing programmes pertaining to access to, and utilisation of maternal and child health care services as well as reduction of the household gap in the economic status.

Child mortality inequalities across Rwanda districts: a geoadditive continuous-time survival analysis.

Science.gov (United States)

Niragire, François; Achia, Thomas N O; Lyambabaje, Alexandre; Ntaganira, Joseph

2017-05-11

Child survival programmes are efficient when they target the most significant and area-specific factors. This study aimed to assess the key determinants and spatial variation of child mortality at the district level in Rwanda. Data from the 2010 Rwanda Demographic and Health Survey were analysed for 8817 live births that occurred during five years preceding the survey. Out of the children born, 433 had died before survey interviews were carried out. A full Bayesian geo-additive continuous-time hazard model enabled us to maximise data utilisation and hence improve the accuracy of our estimates. The results showed substantial district- level spatial variation in childhood mortality in Rwanda. District-specific spatial characteristics were particularly associated with higher death hazards in two districts: Musanze and Nyabihu. The model estimates showed that there were lower death rates among children from households of medium and high economic status compared to those from low-economic status households. Factors, such as four antenatal care visits, delivery at a health facility, prolonged breastfeeding and mothers younger than 31 years were associated with lower child death rates. Long preceding birth intervals were also associated with fewer hazards. For these reasons, programmes aimed at reducing child mortality gaps between districts in Rwanda should target maternal factors and take into consideration district-specific spatial characteristics. Further, child survival gains require strengthening or scaling-up of existing programmes pertaining to access to, and utilisation of maternal and child health care services as well as reduction of the household gap in the economic status.

Remaining missed opportunities of child survival in Peru: modelling mortality impact of universal and equitable coverage of proven interventions

OpenAIRE

Yvonne Tam; Luis Huicho; Carlos A. Huayanay-Espinoza; María Clara Restrepo-Méndez

2016-01-01

Background Peru has made great improvements in reducing stunting and child mortality in the past decade, and has reached the Millennium Development Goals 1 and 4. The remaining challenges or missed opportunities for child survival needs to be identified and quantified, in order to guide the next steps to further improve child survival in Peru. Methods We used the Lives Saved Tool (LiST) to project the mortality impact of proven interventions reaching every women and child in need, and the mor...

Effect of maternal death on child survival in rural West Africa: 25 years of prospective surveillance data in The Gambia.

Directory of Open Access Journals (Sweden)

Susana Scott

Full Text Available The death of a mother is a tragedy in itself but it can also have devastating effects for the survival of her children. We aim to explore the impact of a mother's death on child survival in rural Gambia, West Africa.We used 25 years of prospective surveillance data from the Farafenni Health and Demographic surveillance system (FHDSS. Mortality rates per 1,000 child-years up to ten years of age were estimated and Kaplan-Meier survival curves plotted by maternal vital status. Cox proportional hazard models were used to examine factors associated with child survival.Between 1st April 1989 and 31st December 2014, a total of 2, 221 (7.8% deaths occurred during 152,906 child-years of follow up. Overall mortality rate was 14.53 per 1,000 child-years (95% CI: 13.93-15.14. Amongst those whose mother died, the rate was 25.89 (95% CI: 17.99-37.25 compared to 14.44 (95% CI: 13.84-15.06 per 1,000 child-years for those whose mother did not die. Children were 4.66 (95% CI: 3.15-6.89 times more likely to die if their mother died compared to those with a surviving mother. Infants whose mothers died during delivery or shortly after were up to 7 times more likely to die within the first month of life compared to those whose mothers survived. Maternal vital status was significantly associated with the risk of dying within the first 2 years of life (p-value <0.05, while this was no longer observed for children over 2 years of age (P = 0.872. Other factors associated with an increased risk of dying were living in more rural areas, and birth spacing and year of birth.Mother's survival is strongly associated with child survival. Our findings highlight the importance of the continuum of care for both the mother and child not only throughout pregnancy, and childbirth but beyond 6 weeks post-partum.

Global Human Trafficking and Child Victimization.

Science.gov (United States)

Greenbaum, Jordan; Bodrick, Nia

2017-12-01

Trafficking of children for labor and sexual exploitation violates basic human rights and constitutes a major global public health problem. Pediatricians and other health care professionals may encounter victims who present with infections, injuries, posttraumatic stress disorder, suicidality, or a variety of other physical or behavioral health conditions. Preventing child trafficking, recognizing victimization, and intervening appropriately require a public health approach that incorporates rigorous research on the risk factors, health impact, and effective treatment options for child exploitation as well as implementation and evaluation of primary prevention programs. Health care professionals need training to recognize possible signs of exploitation and to intervene appropriately. They need to adopt a multidisciplinary, outward-focused approach to service provision, working with nonmedical professionals in the community to assist victims. Pediatricians also need to advocate for legislation and policies that promote child rights and victim services as well as those that address the social determinants of health, which influence the vulnerability to human trafficking. This policy statement outlines major issues regarding public policy, medical education, research, and collaboration in the area of child labor and sex trafficking and provides recommendations for future work. Copyright © 2017 by the American Academy of Pediatrics.

Survival associated pathway identification with group Lp penalized global AUC maximization

Directory of Open Access Journals (Sweden)

Liu Zhenqiu

2010-08-01

Full Text Available Abstract It has been demonstrated that genes in a cell do not act independently. They interact with one another to complete certain biological processes or to implement certain molecular functions. How to incorporate biological pathways or functional groups into the model and identify survival associated gene pathways is still a challenging problem. In this paper, we propose a novel iterative gradient based method for survival analysis with group Lp penalized global AUC summary maximization. Unlike LASSO, Lp (p 1. We first extend Lp for individual gene identification to group Lp penalty for pathway selection, and then develop a novel iterative gradient algorithm for penalized global AUC summary maximization (IGGAUCS. This method incorporates the genetic pathways into global AUC summary maximization and identifies survival associated pathways instead of individual genes. The tuning parameters are determined using 10-fold cross validation with training data only. The prediction performance is evaluated using test data. We apply the proposed method to survival outcome analysis with gene expression profile and identify multiple pathways simultaneously. Experimental results with simulation and gene expression data demonstrate that the proposed procedures can be used for identifying important biological pathways that are related to survival phenotype and for building a parsimonious model for predicting the survival times.

Perspectives on Child Abuse and Labour: Global Ethical Ideals Versus African Cultural Realities

Science.gov (United States)

Ajayi, A. O.; Torimiro, D. O.

2004-01-01

This article focuses on the global and African postures on the issues of child abuse and child labour. The global ethical ideals of the issues are characterized within their various theoretical perspectives while the African cultural realities are explored through the use of focus group discussion sessions, which were organized in six rural…

Child Prostitution: Global Health Burden, Research Needs, and Interventions

OpenAIRE

Willis, Brian M.; Levy, Barry S.

2002-01-01

Child prostitution is a significant global problem that has yet to receive appropriate medical and public health attention. Worldwide, an estimated 1 million children are forced into prostitution every year and the total number of prostituted children could be as high as 10 million. Inadequate data exist on the health problems faced by prostituted children, who are at high risk of infectious disease, pregnancy, mental illness, substance abuse, and violence. Child prostitution, like other form...

Poverty Mapping Project: Global Subnational Prevalence of Child Malnutrition

Data.gov (United States)

National Aeronautics and Space Administration — The Global Subnational Prevalence of Child Malnutrition dataset consists of estimates of the percentage of children with weight-for-age z-scores that are more than...

An innovation in child health: Globally reaching out to child health professionals

Directory of Open Access Journals (Sweden)

Russell Jones

2016-08-01

Full Text Available Worldwide deaths of children younger than 5 years reduced from 12.7 million in 1990 to 6.3 million in 2013. Much of this decline is attributed to an increase in the knowledge, skills, and abilities of child health professionals. In turn this increase in knowledge, skills, and abilities has been brought about by increased child-health-focused education available to child health professionals. Therefore child-health-focused education must be part of the strategy to eliminate the remaining 6.3 million deaths and to achieve the United Nations Millennium Development Goals. This article describes a child-health-focused program that was established in 1992 and operates in 20 countries: Australia, Bangladesh, Botswana, Cambodia, China, Ethiopia, Hong Kong, India, Kenya, Malawi, Mongolia, Myanmar, Sierra Leone, the Seychelles, the Solomon Islands, Tanzania, Tonga, Vanuatu, Vietnam, and Zimbabwe. The Diploma in Child Health/International Postgraduate Paediatric Certificate (DCH/IPPC course provides a comprehensive overview of evidence-based current best practice in pediatrics. This includes all subspecialty areas from infectious diseases and emergency medicine through to endocrinology, respiratory medicine, neurology, nutrition, and dietetics. Content is developed and presented by international medical experts in response to global child health needs. Content is provided to students via a combination of learning outcomes, webcasts, lecture notes, personalized study, tutorials, case studies, and clinical practice. One hundred eleven webcasts are provided, and these are updated annually. This article includes a brief discussion of the value and focus of medical education programs; a description of the DCH/IPPC course content, approaches to teaching and learning, course structure and the funding model; the most recent evaluation of the DCH/IPPC course; and recommendations for overcoming the challenges for implementing a multinational child

Survival with 98% methemoglobin levels in a school-aged child during the "festival of colors".

Science.gov (United States)

Sankar, Jhuma; Devangare, Shashikant; Dubey, N K

2013-10-01

Methemoglobin levels more than 70% have almost always been reported to have been fatal. The case of a 4-year-old boy who survived with methemoglobin levels of 98% is presented here. He was brought to the emergency department with complaints of vomiting, pain abdomen, and altered sensorium following accidental ingestion of paint thinner mixed with "Holi" colors. On examination, the child was in altered sensorium, cyanosed with saturations of 55%, who did not respond despite positive pressure ventilation with 100% oxygen. A possibility of toxic methemoglobinemia was considered and confirmed by finding of elevated methemoglobin levels of 98%. The child survived with definitive therapy with methylene blue and aggressive goal-directed approach.

Marketing child survival.

Science.gov (United States)

Grant, J P

1984-01-01

Growth monitoring charts, packets of oral rehydration salts (ORS), and vaccines, are inexpensive, life-saving, growth-protecting technologies which can enable parents to protect their children against the worst effects of poverty. Similarly, a matrix of current and easily understandable information about pregnancy, breast feeding, weaning, feeding during and immediately after illness, child spacing, and preparing and using home-made oral rehydration solutions, also could empower parents to protect the lives and the health of their children. The question arises as to how can these technologies and this information be put at the disposal of millions of families in the low-income world. The initial task of the Child Survival and Development Revolution is the communication of what is now possible, yet little is known about how to communicate information whose principal value is to the poor. There are 2 large-scale precedents: the Green Revolution, which in many instances succeeded in putting into the hands of thousands of small and large farmers the techniques and the knowledge which enabled them to double and treble the yields from their lands; and the campaign to put the knowledge and the means of family planning at the disposal of many millions of people. There are 2 lessons to be learned from these precedents: they have shown that the way to promote a people's technology and to put information at the disposal of the majority is by mobilizing all possible resources and working through all possible channels both to create the demand and to meet it; and neither the Green Revolution nor the family planning movement rally took off until they were viewed as political and economic priorities and given the full support of the nation's political leadership. Nowhere are these 2 lessons more clearly illustrated than in present-day Indonesia. Because the campaign for family planning was given high personal and political priority by the President, and because 85% of all family

Mothers’ Reading Skills and Child Survival in Nigeria: Examining the Relevance of Mothers’ Decision-Making Power

Science.gov (United States)

Smith-Greenaway, Emily

2013-01-01

Mothers’ literacy skills are emerging as a key determinant of children’s health and survival in low-income contexts, with emphasis on the cognitive and psychological agency that literacy skills provide. This work has clearly established a strong association between mothers’ reading skills—a key subcomponent of broader literacy and language skills—and child mortality. However, this relatively nascent literature has not yet considered how broader social structures condition the process. In Nigeria and in sub-Saharan Africa more broadly, gender-based social inequality constrains many mothers’ decision-making power over children’s health matters; this structural feature may condition the association between mothers’ reading skills and child mortality. This paper uses data from the 2003 Nigerian Demographic and Health Survey (N = 12,076) to test the conditionality of the relationship between mothers’ reading skills and child survival on mothers’ decision-making power, highlighting how structural realities should factor more heavily into this individual-action-oriented literature. Among Nigerian children whose mothers have decision-making power, mothers’ reading skills convey a 27 percent lower risk of child mortality; however, for children whose mothers lack decision-making power, mothers’ reading skills do not yield a significant survival advantage. Overall, these findings support the need for future work to further analyze how broader social structures condition the benefits of mothers’ reading skills for children’s health. PMID:24161100

Effects of economic downturns on child mortality: a global economic analysis, 1981-2010.

Science.gov (United States)

Maruthappu, Mahiben; Watson, Robert A; Watkins, Johnathan; Zeltner, Thomas; Raine, Rosalind; Atun, Rifat

2017-01-01

To analyse how economic downturns affect child mortality both globally and among subgroups of countries of variable income levels. Retrospective observational study using economic data from the World Bank's Development Indicators and Global Development Finance (2013 edition). Child mortality data were sourced from the Institute for Health Metrics and Evaluation. Global. 204 countries between 1981 and 2010. Child mortality, controlling for country-specific differences in political, healthcare, cultural, structural, educational and economic factors. 197 countries experienced at least 1 economic downturn between 1981 and 2010, with a mean of 7.97 downturns per country (range 0-21; SD 0.45). At the global level, downturns were associated with significant (p<0.0001) deteriorations in each child mortality measure, in comparison with non-downturn years: neonatal (coefficient: 1.11, 95% CI 0.855 to 1.37), postneonatal (2.00, 95% CI 1.61 to 2.38), child (2.93, 95% CI 2.26 to 3.60) and under 5 years of age (5.44, 95% CI 4.31 to 6.58) mortality rates. Stronger (larger falls in the growth rate of gross domestic product/capita) and longer (lasting 2 years rather than 1) downturns were associated with larger significant deteriorations (p<0.001). During economic downturns, countries in the poorest quartile experienced ∼1½ times greater deterioration in neonatal mortality, compared with their own baseline; a 3-fold deterioration in postneonatal mortality; a 9-fold deterioration in child mortality and a 3-fold deterioration in under-5 mortality, than countries in the wealthiest quartile (p<0.0005). For 1-5 years after downturns ended, each mortality measure continued to display significant deteriorations (p<0.0001). Economic downturns occur frequently and are associated with significant deteriorations in child mortality, with worse declines in lower income countries.

Assessment of Global Functioning in Adolescents with Autism Spectrum Disorders: Utility of the Developmental Disability-Child Global Assessment Scale

Science.gov (United States)

White, Susan W.; Smith, Laura A.; Schry, Amie R.

2014-01-01

Assessment of global functioning is an important consideration in treatment outcome research; yet, there is little guidance on its evidence-based assessment for children with autism spectrum disorders. This study investigated the utility and validity of clinician-rated global functioning using the Developmental Disability-Child Global Assessment…

Parent-child communication and marijuana initiation: evidence using discrete-time survival analysis.

Science.gov (United States)

Nonnemaker, James M; Silber-Ashley, Olivia; Farrelly, Matthew C; Dench, Daniel

2012-12-01

This study supplements existing literature on the relationship between parent-child communication and adolescent drug use by exploring whether parental and/or adolescent recall of specific drug-related conversations differentially impact youth's likelihood of initiating marijuana use. Using discrete-time survival analysis, we estimated the hazard of marijuana initiation using a logit model to obtain an estimate of the relative risk of initiation. Our results suggest that parent-child communication about drug use is either not protective (no effect) or - in the case of youth reports of communication - potentially harmful (leading to increased likelihood of marijuana initiation). Copyright © 2012 Elsevier Ltd. All rights reserved.

Rural-urban migration and child survival in urban Bangladesh: are the urban migrants and poor disadvantaged?

Science.gov (United States)

Islam, M Mazharul; Azad, Kazi Md Abul Kalam

2008-01-01

This paper analyses the levels and trends of childhood mortality in urban Bangladesh, and examines whether children's survival chances are poorer among the urban migrants and urban poor. It also examines the determinants of child survival in urban Bangladesh. Data come from the 1999-2000 Bangladesh Demographic and Health Survey. The results indicate that, although the indices of infant and child mortality are consistently better in urban areas, the urban-rural differentials in childhood mortality have diminished in recent years. The study identifies two distinct child morality regimes in urban Bangladesh: one for urban natives and one for rural-urban migrants. Under-five mortality is higher among children born to urban migrants compared with children born to life-long urban natives (102 and 62 per 1000 live births, respectively). The migrant-native mortality differentials more-or-less correspond with the differences in socioeconomic status. Like childhood mortality rates, rural-urban migrants seem to be moderately disadvantaged by economic status compared with their urban native counterparts. Within the urban areas, the child survival status is even worse among the migrant poor than among the average urban poor, especially recent migrants. This poor-non-poor differential in childhood mortality is higher in urban areas than in rural areas. The study findings indicate that rapid growth of the urban population in recent years due to rural-to-urban migration, coupled with higher risk of mortality among migrant's children, may be considered as one of the major explanations for slower decline in under-five mortality in urban Bangladesh, thus diminishing urban-rural differentials in childhood mortality in Bangladesh. The study demonstrates that housing conditions and access to safe drinking water and hygienic toilet facilities are the most critical determinants of child survival in urban areas, even after controlling for migration status. The findings of the study may

The impact of rural-urban migration on child survival.

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Brockerhoff, M

1994-10-01

Large rural-urban child mortality differentials in many developing countries suggest that rural families can improve their children's survival chances by leaving the countryside and settling in towns and cities. This study uses data from Demographic and Health Surveys in 17 countries to assess the impact of maternal rural-urban migration on the survival chances of children under age two in the late 1970s and 1980s. Results show that, before migration, children of migrant women had similar or slightly higher mortality risks than children of women who remained in the village. In the two-year period surrounding their mother's migration, their chances of dying increased sharply as a result of accompanying their mothers or being left behind, to levels well above those of rural and urban non-migrant children. Children born after migrants had settled in the urban area, however, gradually experienced much better survival chances than children of rural non-migrants, as well as lower mortality risks than migrants' children born in rural areas before migration. The study concludes that many disadvantaged urban children would probably have been much worse off had their mothers remained in the village, and that millions of children's lives may have been saved in the 1980s as a result of mothers moving to urban areas.

Health and Welfare of Women and Child Survival: A Key to Nation Building.

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Singh, Meharban

2018-01-06

Health of women has a profound effect on the health and welfare of communities, countries and the world at large. A large number of social, economic, educational, political and religious dimensions impact the lives of girls and women with repercussions on their health and status in society and welfare of their children. It is a sad reality that a large number of children, adolescents and women worldwide have limited or no access to essential health care services, nutrition and education. Gender inequity and discrimination against girls cannot be bridged unless there are equal opportunities for healthcare and education for boys and girls. The International Day of the Girl Child is celebrated on 11th October to create global awareness about issues of gender inequity, bias, right to education, nutrition, medical care and protection against discrimination, violence, genital mutilation and child marriages. There is a need to provide essential healthcare and nutrition to girls and women throughout their life cycle. Children are the foundation of a nation and mothers are its pillars, and no sensible government can afford to neglect the needs and rights of women and children. The government of India has launched several initiatives like National Plan of Action for the Girl Child, Preconception and Prenatal Diagnostic Techniques (PCPNDT) Act to curb female feticides and "Save Girl Child, Educate Girl Child" Yojana. But the real challenge is effective implementation of these programs without any leakage of funds and resources. The United Nations, through a series of conventions, has declared child marriages as a violation of human right. They have launched an ambitious global strategy for promotion of health of women, children and adolescents for achieving Sustainable Development Goals (SDGs) by 2030 with a focus on "Every Woman Every Child".

Effects of economic downturns on child mortality: a global economic analysis, 1981–2010

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Maruthappu, Mahiben; Watson, Robert A; Watkins, Johnathan; Zeltner, Thomas; Raine, Rosalind; Atun, Rifat

2017-01-01

Objectives To analyse how economic downturns affect child mortality both globally and among subgroups of countries of variable income levels. Design Retrospective observational study using economic data from the World Bank's Development Indicators and Global Development Finance (2013 edition). Child mortality data were sourced from the Institute for Health Metrics and Evaluation. Setting Global. Participants 204 countries between 1981 and 2010. Main outcome measures Child mortality, controlling for country-specific differences in political, healthcare, cultural, structural, educational and economic factors. Results 197 countries experienced at least 1 economic downturn between 1981 and 2010, with a mean of 7.97 downturns per country (range 0–21; SD 0.45). At the global level, downturns were associated with significant (p<0.0001) deteriorations in each child mortality measure, in comparison with non-downturn years: neonatal (coefficient: 1.11, 95% CI 0.855 to 1.37), postneonatal (2.00, 95% CI 1.61 to 2.38), child (2.93, 95% CI 2.26 to 3.60) and under 5 years of age (5.44, 95% CI 4.31 to 6.58) mortality rates. Stronger (larger falls in the growth rate of gross domestic product/capita) and longer (lasting 2 years rather than 1) downturns were associated with larger significant deteriorations (p<0.001). During economic downturns, countries in the poorest quartile experienced ∼1½ times greater deterioration in neonatal mortality, compared with their own baseline; a 3-fold deterioration in postneonatal mortality; a 9-fold deterioration in child mortality and a 3-fold deterioration in under-5 mortality, than countries in the wealthiest quartile (p<0.0005). For 1–5 years after downturns ended, each mortality measure continued to display significant deteriorations (p<0.0001). Conclusions Economic downturns occur frequently and are associated with significant deteriorations in child mortality, with worse declines in lower income countries. PMID:28589010

Child prostitution: global health burden, research needs, and interventions.

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Willis, Brian M; Levy, Barry S

2002-04-20

Child prostitution is a significant global problem that has yet to receive appropriate medical and public health attention. Worldwide, an estimated 1 million children are forced into prostitution every year and the total number of prostituted children could be as high as 10 million. Inadequate data exist on the health problems faced by prostituted children, who are at high risk of infectious disease, pregnancy, mental illness, substance abuse, and violence. Child prostitution, like other forms of child sexual abuse, is not only a cause of death and high morbidity in millions of children, but also a gross violation of their rights and dignity. In this article we estimate morbidity and mortality among prostituted children, and propose research strategies and interventions to mitigate such health consequences. Our estimates underscore the need for health professionals to collaborate with individuals and organisations that provide direct services to prostituted children. Health professionals can help efforts to prevent child prostitution through identifying contributing factors, recording the magnitude and health effects of the problem, and assisting children who have escaped prostitution. They can also help governments, UN agencies, and non-governmental organisations (NGOs) to implement policies, laws, and programmes to prevent child prostitution and mitigate its effects on children's health.

Child organ trafficking: global reality and inadequate international response.

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Bagheri, Alireza

2016-06-01

In organ transplantation, the demand for human organs has grown far faster than the supply of organs. This has opened the door for illegal organ trade and trafficking including from children. Organized crime groups and individual organ brokers exploit the situation and, as a result, black markets are becoming more numerous and organized organ trafficking is expanding worldwide. While underprivileged and vulnerable men and women in developing countries are a major source of trafficked organs, and may themselves be trafficked for the purpose of illegal organ removal and trade, children are at especial risk of exploitation. With the confirmed cases of children being trafficked for their organs, child organ trafficking, which once called a "modern urban legend", is a sad reality in today's world. By presenting a global picture of child organ trafficking, this paper emphasizes that child organ trafficking is no longer a myth but a reality which has to be addressed. It argues that the international efforts against organ trafficking and trafficking in human beings for organ removal have failed to address child organ trafficking adequately. This chapter suggests that more orchestrated international collaboration as well as development of preventive measure and legally binding documents are needed to fight child organ trafficking and to support its victims.

Remaining missed opportunities of child survival in Peru: modelling mortality impact of universal and equitable coverage of proven interventions.

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Tam, Yvonne; Huicho, Luis; Huayanay-Espinoza, Carlos A; Restrepo-Méndez, María Clara

2016-10-04

Peru has made great improvements in reducing stunting and child mortality in the past decade, and has reached the Millennium Development Goals 1 and 4. The remaining challenges or missed opportunities for child survival needs to be identified and quantified, in order to guide the next steps to further improve child survival in Peru. We used the Lives Saved Tool (LiST) to project the mortality impact of proven interventions reaching every women and child in need, and the mortality impact of eliminating inequalities in coverage distribution between wealth quintiles and urban-rural residence. Our analyses quantified the remaining missed opportunities in Peru, where prioritizing scale-up of facility-based case management for all small and sick babies will be most effective in mortality reduction, compared to other evidenced-based interventions that prevent maternal and child deaths. Eliminating coverage disparities between the poorest quintiles and the richest will reduce under-five and neonatal mortality by 22.0 and 40.6 %, while eliminating coverage disparities between those living in rural and urban areas will reduce under-five and neonatal mortality by 29.3 and 45.2 %. This projected neonatal mortality reduction achieved by eliminating coverage disparities is almost comparable to that already achieved by Peru over the past decade. Although Peru has made great strides in improving child survival, further improvement in child health, especially in newborn health can be achieved if there is universal and equitable coverage of proven, quality health facility-based interventions. The magnitude of reduction in mortality will be similar to what has been achieved in the past decade. Strengthening health system to identify, understand, and direct resources to the poor and rural areas will ensure that Peru achieve the Sustainable Development Goals by 2030.

Remaining missed opportunities of child survival in Peru: modelling mortality impact of universal and equitable coverage of proven interventions

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Yvonne Tam

2016-10-01

Full Text Available Abstract Background Peru has made great improvements in reducing stunting and child mortality in the past decade, and has reached the Millennium Development Goals 1 and 4. The remaining challenges or missed opportunities for child survival needs to be identified and quantified, in order to guide the next steps to further improve child survival in Peru. Methods We used the Lives Saved Tool (LiST to project the mortality impact of proven interventions reaching every women and child in need, and the mortality impact of eliminating inequalities in coverage distribution between wealth quintiles and urban–rural residence. Results Our analyses quantified the remaining missed opportunities in Peru, where prioritizing scale-up of facility-based case management for all small and sick babies will be most effective in mortality reduction, compared to other evidenced-based interventions that prevent maternal and child deaths. Eliminating coverage disparities between the poorest quintiles and the richest will reduce under-five and neonatal mortality by 22.0 and 40.6 %, while eliminating coverage disparities between those living in rural and urban areas will reduce under-five and neonatal mortality by 29.3 and 45.2 %. This projected neonatal mortality reduction achieved by eliminating coverage disparities is almost comparable to that already achieved by Peru over the past decade. Conclusions Although Peru has made great strides in improving child survival, further improvement in child health, especially in newborn health can be achieved if there is universal and equitable coverage of proven, quality health facility-based interventions. The magnitude of reduction in mortality will be similar to what has been achieved in the past decade. Strengthening health system to identify, understand, and direct resources to the poor and rural areas will ensure that Peru achieve the Sustainable Development Goals by 2030.

Low child survival index in a multi-dimensionally poor Amerindian population in Venezuela.

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Julian A Villalba

Full Text Available Warao Amerindians, who inhabit the Orinoco Delta, are the second largest indigenous group in Venezuela.  High Warao general mortality rates were mentioned in a limited study 21 years ago. However, there have been no comprehensive studies addressing child survival across the entire population.To determine the Child Survival-Index (CSI (ratio: still-living children/total-live births in the Warao population, the principal causes of childhood death and the socio-demographic factors associated with childhood deaths.We conducted a cross-sectional epidemiological survey of 688 women from 97 communities in 7 different subregions of the Orinoco Delta. Data collected included socio-demographic characteristics and the reproductive history of each woman surveyed. The multidimensional poverty index (MPI was used to classify the households as deprived across the three dimensions of the Human Development Index. Multivariable linear regression and Generalized Linear Model Procedures were used to identify socioeconomic and environmental characteristics statistically associated with the CSI.The average CSI was 73.8% ±26. The two most common causes of death were gastroenteritis/diarrhea (63% and acute respiratory tract Infection/pneumonia (18%.  Deaths in children under five years accounted for 97.3% of childhood deaths, with 54% occurring in the neonatal period or first year of life.  Most of the women (95.5% were classified as multidimensionally poor.  The general MPI in the sample was 0.56.   CSI was negatively correlated with MPI, maternal age, residence in a traditional dwelling and profession of the head of household other than nurse or teacher.The Warao have a low CSI which is correlated with MPI and maternal age.  Infectious diseases are responsible for 85% of childhood deaths.  The low socioeconomic development, lack of infrastructure and geographic and cultural isolation suggest that an integrated approach is urgently needed to

Low child survival index in a multi-dimensionally poor Amerindian population in Venezuela.

Science.gov (United States)

Villalba, Julian A; Liu, Yushi; Alvarez, Mauyuri K; Calderon, Luisana; Canache, Merari; Cardenas, Gaudymar; Del Nogal, Berenice; Takiff, Howard E; De Waard, Jacobus H

2013-01-01

Warao Amerindians, who inhabit the Orinoco Delta, are the second largest indigenous group in Venezuela.  High Warao general mortality rates were mentioned in a limited study 21 years ago. However, there have been no comprehensive studies addressing child survival across the entire population. To determine the Child Survival-Index (CSI) (ratio: still-living children/total-live births) in the Warao population, the principal causes of childhood death and the socio-demographic factors associated with childhood deaths. We conducted a cross-sectional epidemiological survey of 688 women from 97 communities in 7 different subregions of the Orinoco Delta. Data collected included socio-demographic characteristics and the reproductive history of each woman surveyed. The multidimensional poverty index (MPI) was used to classify the households as deprived across the three dimensions of the Human Development Index. Multivariable linear regression and Generalized Linear Model Procedures were used to identify socioeconomic and environmental characteristics statistically associated with the CSI. The average CSI was 73.8% ±26. The two most common causes of death were gastroenteritis/diarrhea (63%) and acute respiratory tract Infection/pneumonia (18%).  Deaths in children under five years accounted for 97.3% of childhood deaths, with 54% occurring in the neonatal period or first year of life.  Most of the women (95.5%) were classified as multidimensionally poor.  The general MPI in the sample was 0.56.   CSI was negatively correlated with MPI, maternal age, residence in a traditional dwelling and profession of the head of household other than nurse or teacher. The Warao have a low CSI which is correlated with MPI and maternal age.  Infectious diseases are responsible for 85% of childhood deaths.  The low socioeconomic development, lack of infrastructure and geographic and cultural isolation suggest that an integrated approach is urgently needed to improve the

Does intelligence account for the link between maternal literacy and child survival?

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Sandiford, P; Cassel, J; Sanchez, G; Coldham, C

1997-10-01

The strong and consistent correlation between maternal education and child health is now well known, and numerous studies have shown that wealth and income cannot explain the link. Policy-makers have therefore assumed that the relationship is causal and explicitly advocate schooling as a child health intervention. However, there are other factors which could account for the apparent effect of maternal education on child morbidity and mortality, one of which is intelligence. This paper examines the effect of maternal intelligence on child health and looks at the degree to which it can explain the literacy associations with child survival and risk of malnutrition. The data are from a retrospective cohort study of 1294 mothers and their 7475 offspring, of whom 454 were women who had learned to read and write as adults in Nicaragua's literacy programme, 457 were illiterate, and 383 had become literate as young girls attending school. The women's intelligence was tested using Raven's Coloured Progressive Matrices. Acquisition of literacy was strongly related to intelligence. Statistically significant associations with maternal literacy were found for under five mortality, infant mortality, and the risk of low mid-upper-arm circumference (MUAC) for age, before and after controlling for a wide range of socio-economic factors. Under five, child (one to four years), infant and post-neonatal mortality plus the risk of low height for age were significantly correlated with intelligence, but only with infant and under mortality rates did the association remain significant after controlling for socio-economic factors. A significant interaction between intelligence and literacy for under five mortality was due to literacy having a strong effect in the women of low intelligence, and a negligible effect among those of high intelligence. This study provides evidence that intelligence is an important determinant of child health among the illiterate, and that education may have the

[Accepted Manuscript] Annual Crop Yield Variation, Child Survival and Nutrition among Subsistence Farmers in Burkina Faso.

OpenAIRE

Belesova, K.; Gasparrini, A.; Sié, A.; Sauerborn, R.; Wilkinson, P.

2017-01-01

Whether year to year variation in crop yields affects the nutrition, health, and survival of subsistence farming populations is relevant to the understanding of the potential impacts of climate change. However, the empirical evidence is limited. We examined the association of child survival with inter-annual variation in food crop yield and middle-upper arm circumference (MUAC) in a subsistence farming population of rural Burkina Faso. The study was of 44,616 children < 5 years of age incl...

Empowering the Girl Child, Improving Global Health.

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Cesario, Sandra K; Moran, Barbara

The health and productivity of a global society is dependent upon the elimination of gender inequities that prevent girls from achieving their full potential. Although some progress has been made in reducing social, economic, and health disparities between men and women, gender equality continues to be an elusive goal. The Millennium Development Goals (2000-2015) and the Sustainable Development Goals (2015-2030) include intergovernmental aspirations to empower women and stress that change must begin with the girl child. Copyright © 2017 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

The effect of divorce on child survival in a rural area of Bangladesh.

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Bhuiya, A; Chowdhury, M

1997-03-01

The data for this study come from Matlab, a rural area of Bangladesh, where a continuous registration of demographic events has been maintained by the International Centre for Diarrhoeal Disease Research, Bangladesh since 1966. A total of 11,951 first marriages of Muslims that took place in the area between 1975 and 1987 were followed until the end of 1989, to examine the relationship between parental marriage breakdown and survival of first live-born children. The impact of divorce on survival of children during infancy and childhood was examined, using hazard analysis. Other independent variables included age of mother at birth, and mother's education, year of birth, sex of children, and residence at the time of childbirth. It is shown that the net odds of death among children of divorced mothers in infancy and childhood were respectively 3.2 and 1.4 times higher than those of mothers whose marriages continued. The paper also discussed the possible mechanisms which link divorce and child survival.

Public health strategies to minimize the global incidence of child abuse

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Saurabh RamBihariLal Shrivastava

2014-08-01

Full Text Available Child abuse is an extremely complicated and a multi-faceted public health concern, significantly influenced by the victim's age, the settings in which the abuse occurs, and the relationship between the victim and perpetrator. The global estimates are just the tip of the iceberg as most of it takes place in the privacy of domestic life and often goes unreported and undetected. In fact, occurrence of child abuse can be best explained by exploring the complex interaction among multiple factors at different levels. In order to counter this menace there is a definite need to involve all the stakeholders and ensure mandatory reporting of child abuse with the help of a surveillance system. To conclude, comprehensive and integrated package of services is desired to minimize the incidence of child abuse and neglect, supplemented with community-based initiatives to facilitate early detection and prolonged follow-up of victims of the abuse. [Cukurova Med J 2014; 39(4.000: 955-958

Socioeconomic development and girl child survival in rural North India: solution or problem?

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Krishnan, Anand; Dwivedi, Purva; Gupta, Vivek; Byass, Peter; Pandav, Chandrakant S; Ng, Nawi

2013-05-01

Socioeconomic development has been considered as a solution to the problem of sex differentials at birth and under-five mortality. This paper analyses longitudinal data from the Ballabgarh Health and Demographic Surveillance System (HDSS) site in north India to check its veracity. A cohort of children born between 1 January 2006 and 31 December 2011 at Ballabgarh HDSS were followed till death, emigration, 3 years of age or end of the study. Socioeconomic status (SES) was measured by caste, parental combined years of schooling and wealth index and divided into low, mid and high strata for each of them. Sex ratio at birth (SRB) was reported as the number of girls per 1000 boys. The Kaplan-Meier survival curves were drawn and a Cox Proportional HR of girls over boys was estimated. A total of 12 517 native born children (25 797 child years) were enrolled of which 710 died (death rate of 56.7/1000-live births and 27.5/1000 child-years. Socioeconomically advantaged children had significantly lower death rates. The SRB (10-16% lower) and neonatal death rate were consistently adverse for girls in the advantaged groups by all the three indicators of SES. The first month survival rates were better for girls in the lower SES categories (significant only in caste (HR 0.58; 0.37 to 0.91). High SES categories consistently showed adverse survival rates for girls (HR of 1.22 to 1.59). Better socioeconomic situation worsened the sex differentials, especially at birth. Therefore, specific interventions targeting gender issues are required, at least as a short-term measure.

Are child eating patterns being transformed globally?

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Adair, Linda S; Popkin, Barry M

2005-07-01

To examine the extent to which child dietary patterns and trends are changing globally. Diets of children 2 to 19 years of age were studied with nationally representative data from Russia and the United States, nationwide data from China, and regional data from metropolitan Cebu, Philippines. Twenty-four-hour dietary recalls were examined at several points in time to examine trends in calories consumed away from home, snacking behavior, and soft drink and modern fast food consumption. Urban-rural trends were compared. U.S. and Cebu youth consume more than one-third of their daily calories and a higher proportion of snack calories from foods prepared away from home. In contrast, away from home food consumption is minimal in Chinese and Russian children. U.S. and Cebu youth consume about one-fifth of their total daily energy from snacks, but snacks provide a much lower proportion of energy in Russia ( approximately 16%) and China (where snacks provide only approximately 1% of energy). Fast food plays a much more dominant role in the American diet ( approximately 20% of energy vs. 2% to 7% in the other countries), but as yet does not contribute substantially to children's diets in the other countries. Urban-rural differences were found to be important, but narrowing over time, for China and Cebu, whereas they are widening for Russia. This research suggests that globalization of the fast food and other modern food sectors is beginning to affect child eating patterns in several countries undergoing nutrition transition. However, the contribution of fast food and soft drinks to the diet of children remains relatively small in China, Russia, and Cebu, Philippines, relative to the United States.

Costs and benefits of implementing child survival services at a private mining company in Peru.

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Foreit, K G; Haustein, D; Winterhalter, M; La Mata, E

1991-08-01

Costs and savings of child health services were studied in a private mining company in Peru. Despite considerable outlays for medical services, few children under age 5 were vaccinated, and half of their illnesses went untreated. Children who were attended at the company clinic usually received unnecessary medication. As a result of the study, the company hired additional staff to provide integrated maternal-child preventive health care and family planning and contracted for intensive training and periodic on-site supervision. In less than 2 years, vaccination coverage reached 75%, and virtually all children under age 1 were enrolled in growth monitoring. Prescriptions were reduced by 24%, including a 67% drop in antimicrobials. The cost of the new services was $13,200 for the first 2 years. Approximately $6800 has been saved in pharmaceuticals prescribed for respiratory infection and diarrhea. Recently, two more mines adopted maternal and child health and family planning services. It is hoped that cost-benefit arguments will encourage other companies to incorporate aggressive child survival measures into their health plans.

Child Labor in the Global Economy

OpenAIRE

Eric V. Edmonds; Nina Pavcnik

2005-01-01

Few issues in developing countries draw as much popular attention as child labor. This paper begins by quantifying the extent and main characteristics of child labor. It then considers the evidence on a range of issues about child labor. Fundamentally, child labor is a symptom of poverty. Low income and poor institutions are driving forces behind the prevalence of child labor worldwide. This study concludes by assessing the policy options to reduce worldwide child labor.

The global burden of child burn injuries in light of country level economic development and income inequality.

Science.gov (United States)

Sengoelge, Mathilde; El-Khatib, Ziad; Laflamme, Lucie

2017-06-01

Child burn mortality differs widely between regions and is closely related to material deprivation, but reports on their global distribution are few. Investigating their country level distribution in light of economic level and income inequality will help assess the potential for macro-level improvements. We extracted data for child burn mortality from the Global Burden of Disease study 2013 and combined data into 1-14 years to calculate rates at country, region and income levels. We also compiled potential lives saved. Then we examined the relationship between country level gross domestic product per capita from the World Bank and income inequality (Gini Index) from the Standardized World Income Inequality Database and child burn mortality using Spearman coefficient correlations. Worldwide, the burden of child burn deaths is 2.5 per 100,000 across 103 countries with the largest burden in Sub-Saharan Africa (4.5 per 100,000). Thirty-four thousand lives could be saved yearly if all countries in the world had the same rates as the best performing group of high-income countries; the majority in low-income countries. There was a negative graded association between economic level and child burns for all countries aggregated and at regional level, but no consistent pattern existed for income inequality at regional level. The burden of child burn mortality varies by region and income level with prevention efforts needed most urgently in middle-income countries and Sub-Saharan Africa. Investment in safe living conditions and access to medical care are paramount to achieving further reductions in the global burden of preventable child burn deaths.

Assessing Community Based Improved Maternal Neonatal Child Survival (IMNCS Program in Rural Bangladesh.

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Mahfuzar Rahman

Full Text Available A community based approach before, during and after child birth has been proven effective address the burden of maternal, neonatal and child morbidity and mortality in the low and middle income countries. We aimed to examine the overall change in maternal and newborn health outcomes due the "Improved Maternal Newborn and Child Survival" (IMNCS project, which was implemented by BRAC in rural communities of Bangladesh.The intervention was implemented in four districts for duration of 5-years, while two districts served as comparison areas. The intervention was delivered by community health workers who were trained on essential maternal, neonatal and child health care services. A baseline survey was conducted in 2008 among 7, 200 women with pregnancy outcome in last year or having a currently alive child of 12-59 months. A follow-up survey was administered in 2012-13 among 4, 800 women of similar characteristics in the same villages.We observed significant improvements in maternal and essential newborn care in intervention areas over time, especially in health care seeking behaviors. The proportion of births taking place at home declined in the intervention districts from 84.3% at baseline to 71.2% at end line (P<0.001. Proportion of deliveries with skilled attendant was higher in intervention districts (28% compared to comparison districts (27.4%. The number of deliveries was almost doubled at public sector facility comparing with baseline (P<0.001. Significant improvement was also observed in healthy cord care practice, delayed bathing of the new-born and reduction of infant mortality in intervention districts compared to that of comparison districts.This study demonstrates that community-based efforts offer encouraging evidence and value for combining maternal, neonatal and child health care package. This approach might be considered at larger scale in similar settings with limited resources.

Application of random survival forests in understanding the determinants of under-five child mortality in Uganda in the presence of covariates that satisfy the proportional and non-proportional hazards assumption.

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Nasejje, Justine B; Mwambi, Henry

2017-09-07

Uganda just like any other Sub-Saharan African country, has a high under-five child mortality rate. To inform policy on intervention strategies, sound statistical methods are required to critically identify factors strongly associated with under-five child mortality rates. The Cox proportional hazards model has been a common choice in analysing data to understand factors strongly associated with high child mortality rates taking age as the time-to-event variable. However, due to its restrictive proportional hazards (PH) assumption, some covariates of interest which do not satisfy the assumption are often excluded in the analysis to avoid mis-specifying the model. Otherwise using covariates that clearly violate the assumption would mean invalid results. Survival trees and random survival forests are increasingly becoming popular in analysing survival data particularly in the case of large survey data and could be attractive alternatives to models with the restrictive PH assumption. In this article, we adopt random survival forests which have never been used in understanding factors affecting under-five child mortality rates in Uganda using Demographic and Health Survey data. Thus the first part of the analysis is based on the use of the classical Cox PH model and the second part of the analysis is based on the use of random survival forests in the presence of covariates that do not necessarily satisfy the PH assumption. Random survival forests and the Cox proportional hazards model agree that the sex of the household head, sex of the child, number of births in the past 1 year are strongly associated to under-five child mortality in Uganda given all the three covariates satisfy the PH assumption. Random survival forests further demonstrated that covariates that were originally excluded from the earlier analysis due to violation of the PH assumption were important in explaining under-five child mortality rates. These covariates include the number of children under the

The global burden of child burn injuries in light of country level economic development and income inequality

Directory of Open Access Journals (Sweden)

Mathilde Sengoelge

2017-06-01

Full Text Available Child burn mortality differs widely between regions and is closely related to material deprivation, but reports on their global distribution are few. Investigating their country level distribution in light of economic level and income inequality will help assess the potential for macro-level improvements. We extracted data for child burn mortality from the Global Burden of Disease study 2013 and combined data into 1–14 years to calculate rates at country, region and income levels. We also compiled potential lives saved. Then we examined the relationship between country level gross domestic product per capita from the World Bank and income inequality (Gini Index from the Standardized World Income Inequality Database and child burn mortality using Spearman coefficient correlations. Worldwide, the burden of child burn deaths is 2.5 per 100,000 across 103 countries with the largest burden in Sub-Saharan Africa (4.5 per 100,000. Thirty-four thousand lives could be saved yearly if all countries in the world had the same rates as the best performing group of high-income countries; the majority in low-income countries. There was a negative graded association between economic level and child burns for all countries aggregated and at regional level, but no consistent pattern existed for income inequality at regional level. The burden of child burn mortality varies by region and income level with prevention efforts needed most urgently in middle-income countries and Sub-Saharan Africa. Investment in safe living conditions and access to medical care are paramount to achieving further reductions in the global burden of preventable child burn deaths.

Employer Child Care Surviving and Thriving: Employer Child Care Trend Report #17

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Neugebauer, Roger

2010-01-01

Today employer child care is accepted as standard benefit for employees and nearly all Fortune 500 companies have gotten involved. The current recession threatened to halt the growth of employer child care as companies consolidated, cut back, and folded. However, in reviewing the status of employer child care for this trend report, it appears that…

Redefining parenthood: surviving the death of a child.

Science.gov (United States)

Nuss, Suzanne L

2014-01-01

Although dying children are often aware of their impending death, parents are reluctant to communicate with their dying child about death. The objective of this study was to examine how parents of children in the advanced stage of a life-threatening disease trajectory communicated about death. Using grounded theory methods, data were collected via interviews with 18 parents of children who had died of an advanced life-threatening disease. Ways in which parents communicated with their dying child were impacted by the degree of threat to the parental role. From the onset of their child's life-threatening illness, the sense of parental self was threatened, resulting in "Parental Vulnerability." To endure parental vulnerability, parents confronted a process of "Redefining Parenthood." Before the child's death, parents experienced (1) Protecting From Fears, (2) Protecting Normalcy, (3) Protecting Faith, (4) Experiencing Protection From Their Child, and (5) Bookmarking Memories. After the child's death, parents experienced (1) Telling the Story, (2) Making Meaning, (3) Protecting the Child's Memory, (4) Defining a New Normal, and (5) Learning to Live With Regret. Results provide new information about the experiences of parents of dying children as they communicated with their child during the dying process and as they found ways to go on with life after their child's death. Findings can be used by healthcare professionals to help support families of dying children. The field of pediatric oncology nursing would benefit from exploration of the dying child's perspective.

Understanding the role of mHealth and other media interventions for behavior change to enhance child survival and development in low- and middle-income countries: an evidence review.

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Higgs, Elizabeth S; Goldberg, Allison B; Labrique, Alain B; Cook, Stephanie H; Schmid, Carina; Cole, Charlotte F; Obregón, Rafael A

2014-01-01

Given the high morbidity and mortality among children in low- and middle-income countries as a result of preventable causes, the U.S. government and the United Nations Children's Fund convened an Evidence Summit on Enhancing Child Survival and Development in Lower- and Middle-Income Countries by Achieving Population-Level Behavior Change on June 3-4, 2013, in Washington, D.C. This article summarizes evidence for technological advances associated with population-level behavior changes necessary to advance child survival and healthy development in children under 5 years of age in low- and middle-income countries. After a rigorous evidence selection process, the authors assessed science, technology, and innovation papers that used mHealth, social/transmedia, multiplatform media, health literacy, and devices for behavior changes supporting child survival and development. Because of an insufficient number of studies on health literacy and devices that supported causal attribution of interventions to outcomes, the review focused on mHealth, social/transmedia, and multiplatform media. Overall, this review found that some mHealth interventions have sufficient evidence to make topic-specific recommendations for broader implementation, scaling, and next research steps (e.g., adherence to HIV/AIDS antiretroviral therapy, uptake and demand of maternal health service, and compliance with malaria treatment guidelines). While some media evidence demonstrates effectiveness in changing cognitive abilities, knowledge, and attitudes, evidence is minimal on behavioral endpoints linked to child survival. Population level behavior change is necessary to end preventable child deaths. Donors and low- and middle-income countries are encouraged to implement recommendations for informing practice, policy, and research decisions to fully maximize the impact potential of mHealth and multimedia for child survival and development.

Perceived reciprocal value of health professionals' participation in global child health-related work.

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Carbone, Sarah; Wigle, Jannah; Akseer, Nadia; Barac, Raluca; Barwick, Melanie; Zlotkin, Stanley

2017-05-22

Leading children's hospitals in high-income settings have become heavily engaged in international child health research and educational activities. These programs aim to provide benefit to the institutions, children and families in the overseas locations where they are implemented. Few studies have measured the actual reciprocal value of this work for the home institutions and for individual staff who participate in these overseas activities. Our objective was to estimate the perceived reciprocal value of health professionals' participation in global child health-related work. Benefits were measured in the form of skills, knowledge and attitude strengthening as estimated by an adapted Global Health Competency Model. A survey questionnaire was developed following a comprehensive review of literature and key competency models. It was distributed to all health professionals at the Hospital for Sick Children with prior international work experience (n = 478). One hundred fifty six health professionals completed the survey (34%). A score of 0 represented negligible value gained and a score of 100 indicated significant capacity improvement. The mean respondent improvement score was 57 (95% CI 53-62) suggesting improved overall competency resulting from their international experiences. Mean scores were >50% in 8 of 10 domains. Overall scores suggest that international work brought value to the hospital and over half responded that their international experience would influence their decision to stay on at the hospital. The findings offer tangible examples of how global child health work conducted outside of one's home institution impacts staff and health systems locally.

Child Prostitution as Filial Duty? The Morality of Child-Rearing in a Slum Community in Thailand

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Montgomery, Heather

2014-01-01

It has been claimed that there are universal goals of child-rearing, such as survival of the child or the promotion of their capacity to contribute to economic and social reproduction. Yet in certain circumstances parents appear to pursue child-rearing practices that actively harm children, threaten their survival and inhibit their ability to grow…

Global child health: challenges and goals in the 1990s.

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Reid, R S

1994-01-01

The UNICEF message to the pediatricians and child health experts attending the Regional Pediatric Congress of the Union of National Pediatric Societies of Turkish Republics is that the way children are conceptualized in the development process has a major impact on poverty. UNICEF argues that human resource development is the safest way out of population pressure, vanishing forests, and despoiled rivers. Thailand, South Korea, Taiwan, and Singapore are examples of countries that "sacrificed, deferred consumer gratification of the elites, and disciplined themselves" in order to provide better care for their children in terms of good nutrition, good health care, and rigorous primary and secondary education for all children. Family planning was available to all parents. The emphasis was on hygiene, immunization, clean water supplies, and sanitation. Lower infant and child mortality created confidence in child survival and parental willingness to have fewer children. The working population is healthier due to the state nutrition programs and a better skilled labor force due to education and training. These countries are no longer underdeveloped because of the priority on children for over a generation and a half. Robert Heilbroner has described this strategy for development as based on social development, human development, and protection of children aged under 5 years. The Alma Ata conference in 1976 was instrumental in focusing on the health of the child by setting a standard of health for all by the year 2000. Many countries are moving in the direction proposed in these agendas. The result has been a 33% reduction in child mortality within 10 years and greater immunization in some developing countries than in Europe and North America. Immunization rates in Ankara, Turkey; Calcutta, India; Lagos, Nigeria; and Mexico City are higher than in Washington, D.C. or New York City. The 1990 World Summit for Children found that the following rules are applicable to

Toward a psychology of human survival: Psychological approaches to contemporary global threats

International Nuclear Information System (INIS)

Walsh, R.

1989-01-01

Nuclear weapons, population explosion, resource and food-supply depletion, and environmental deterioration have been posing increasing threats to human survival. Moreover, for the first time in history, all these major global threats are human caused and can, therefore, be traced in large part to psychological origins. After a brief overview of the nature and extent of current threats, this paper suggests criteria for an adequate psychology of human survival. The causes and effects of the threats are examined from various psychological perspectives and the psychological principles underlying effective responses are deduced. The ways in which mental health professionals may contribute to this most crucial task are discussed. 76 references

Global Incorporation and Cultural Survival: The Surinamese Maroons at the Margins of the World-System

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Aonghas St.-Hilaire

2015-08-01

Full Text Available The Maroons of Suriname enter the twenty-? rst century as the only surviving, culturally and politically autonomous Maroon communities in the Americas. The paper adopts a world-systems approach to explain the evolution of the Surinamese Maroon nations vis-à-vis the ever expanding Surinamese state and global political economy, with particular attention paid to the cultural survival of the Maroon nations. Prior to emancipation, limited colonial integration and mutual fear between the Maroons and Surinamese coastal society facilitated the development of the Maroon communities as relatively independent nations. Despite the best efforts of colonial authorities after emancipation, the weak economy and infrastructure of the Surinamese colony as well as continued mutual fear and distrust enabled the Maroons to guard their autonomy. However, after the Second World War, a period of global economic expansion, the rapid development of the Suriname as an integrated political, economic and cultural unit, and the depletion of and strain on natural resources in traditional Maroon territory dealt serious blows to Maroon autonomy. Maroon cultural survival depends on the ability of the Maroon nations to navigate the rapid changes currently affecting Maroon society, guarding political autonomy and cultivating the most treasured aspects of their cultural heritage, while participating, albeit peripherally, in modern global capitalism.

Community and District Empowerment for Scale-up (CODES): a complex district-level management intervention to improve child survival in Uganda: study protocol for a randomized controlled trial.

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Waiswa, Peter; O'Connell, Thomas; Bagenda, Danstan; Mullachery, Pricila; Mpanga, Flavia; Henriksson, Dorcus Kiwanuka; Katahoire, Anne Ruhweza; Ssegujja, Eric; Mbonye, Anthony K; Peterson, Stefan Swartling

2016-03-11

Innovative and sustainable strategies to strengthen districts and other sub-national health systems and management are urgently required to reduce child mortality. Although highly effective evidence-based and affordable child survival interventions are well-known, at the district level, lack of data, motivation, analytic and planning capacity often impedes prioritization and management weaknesses impede implementation. The Community and District Empowerment for Scale-up (CODES) project is a complex management intervention designed to test whether districts when empowered with data and management tools can prioritize and implement evidence-based child survival interventions equitably. The CODES strategy combines management, diagnostic, and evaluation tools to identify and analyze the causes of bottlenecks to implementation, build capacity of district management teams to implement context-specific solutions, and to foster community monitoring and social accountability to increase demand for services. CODES combines UNICEF tools designed to systematize priority setting, allocation of resources and problem solving with Community dialogues based on Citizen Report Cards and U-Reports used to engage and empower communities in monitoring health service provision and to demand for quality services. Implementation and all data collection will be by the districts teams or local Community-based Organizations who will be supported by two local implementing partners. The study will be evaluated as a cluster randomized trial with eight intervention and eight comparison districts over a period of 3 years. Evaluation will focus on differences in uptake of child survival interventions and will follow an intention-to-treat analysis. We will also document and analyze experiences in implementation including changes in management practices. By increasing the District Health Management Teams' capacity to prioritize and implement context-specific solutions, and empowering communities to

Unique contributions of dynamic versus global measures of parent-child interaction quality in predicting school adjustment.

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Bardack, Sarah; Herbers, Janette E; Obradović, Jelena

2017-09-01

This study investigates the unique contribution of microsocial and global measures of parent-child positive coregulation (PCR) in predicting children's behavioral and social adjustment in school. Using a community sample of 102 children, ages 4-6, and their parents, we conducted nested path analytic models to identify the unique effects of 2 measures of PCR on school outcomes. Microsocial PCR independently predicted fewer externalizing and inattention/impulsive behaviors in school. Global PCR did not uniquely relate to children's behavioral and social adjustment outcomes. Household socioeconomic status was related to both microsocial and global measures of PCR, but not directly associated with school outcomes. Findings illustrate the importance of using dynamic measures of PCR based on microsocial coding to further understand how the quality of parent-child interaction is related to children's self-regulatory and social development during school transition. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Surviving and Thriving—Shifting the Public Health Response to HIV-Exposed Uninfected Children: Report of the 3rd HIV-Exposed Uninfected Child Workshop

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Amy L. Slogrove

2018-05-01

Full Text Available Great gains were achieved with the introduction of the United Nations' Millennium Development Goals, including improved child survival. Transition to the Sustainable Development Goals (SDGs focused on surviving, thriving, and transforming, representing an important shift to a broader public health goal, the achievement of which holds the promise of longer-term individual and societal benefits. A similar shift is needed with respect to outcomes for infants born to women living with HIV (WLHIV. Programming to prevent vertical HIV transmission has been successful in increasingly achieving a goal of HIV-free survival for infants born to WLHIV. Unfortunately, HIV-exposed uninfected (HEU children are not achieving comparable health and developmental outcomes compared with children born to HIV-uninfected women under similar socioeconomic circumstances. The 3rd HEU Child Workshop, held as a satellite session of the International AIDS Society's 9th IAS Conference in Paris in July 2017, provided a venue to discuss HEU child health and development disparities. A summary of the Workshop proceedings follows, providing current scientific findings, emphasizing the gap in systems for long-term monitoring, and highlighting the public health need to establish a strategic plan to better quantify the short and longer-term health and developmental outcomes of HEU children.

Ending preventable child deaths from pneumonia and diarrhoea by 2025. Development of the integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea.

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Qazi, Shamim; Aboubaker, Samira; MacLean, Rachel; Fontaine, Olivier; Mantel, Carsten; Goodman, Tracey; Young, Mark; Henderson, Peggy; Cherian, Thomas

2015-02-01

Despite the existence of low-cost and effective interventions for childhood pneumonia and diarrhoea, these conditions remain two of the leading killers of young children. Based on feedback from health professionals in countries with high child mortality, in 2009, WHO and Unicef began conceptualising an integrated approach for pneumonia and diarrhoea control. As part of this initiative, WHO and Unicef, with support from other partners, conducted a series of five workshops to facilitate the inclusion of coordinated actions for pneumonia and diarrhoea into the national health plans of 36 countries with high child mortality. This paper presents the findings from workshop and post-workshop follow-up activities and discusses the contribution of these findings to the development of the integrated Global Action Plan for the Prevention and Control of Pneumonia and Diarrhoea, which outlines the necessary actions for elimination of preventable child deaths from pneumonia and diarrhoea by 2025. Though this goal is ambitious, it is attainable through concerted efforts. By applying the lessons learned thus far and continuing to build upon them, and by leveraging existing political will and momentum for child survival, national governments and their supporting partners can ensure that preventable child deaths from pneumonia and diarrhoea are eventually eliminated. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

[Comparative evaluation of survival prognosis using MELD or Child-Pugh scores in patients with liver cirrhosis in Chile].

Science.gov (United States)

Sanhueza, Edgar; Contreras, Jorge; Zapata, Rodrigo; Sanhueza, Matías; Elgueta, Fabián; López, Constanza; Jerez, Sigrid; Jerez, Verónica; Delgado, Iris

2017-01-01

Currently, most liver units use the Child-Pugh (CP) or the Model for End-Stage Liver Disease (MELD) scores to establish survival prognosis among patients with liver cirrhosis. Which classification is superior, is not well defined. To compare CP and MELD classification scores to predict survival among adult patients with liver cirrhosis in Chile. Follow-up of 137 consecutive adult patients with liver cirrhosis aged 59 ± 12 years (55% women). The diagnosis was reached by clinical, laboratory and image studies at three different centers of Santiago. Patients were staged with CP and MELD classification scores at baseline and followed over a period of 12 months. The predictive capacity of the scores for survival was analyzed using a multivariate statistical analysis (Kaplan-Meier curves). The most common etiology was alcohol (37.9%). The actuarial survival rate was 79.6% at 12 months of follow-up. When comparing groups with areas under curve of receiver operating characteristic curves (AUROC), there was no statistically significant difference in survival between less severe and advanced disease, assessed with both survival scales. The AUROC for MELD and CP were 0.80 and 0.81, respectively. This clinical study did not find a statistically significant difference between the two classifications for the prediction of 12 months survival in patients with cirrhosis.

Annual Crop-Yield Variation, Child Survival, and Nutrition Among Subsistence Farmers in Burkina Faso.

Science.gov (United States)

Belesova, Kristine; Gasparrini, Antonio; Sié, Ali; Sauerborn, Rainer; Wilkinson, Paul

2018-02-01

Whether year-to-year variation in crop yields affects the nutrition, health, and survival of subsistence-farming populations is relevant to the understanding of the potential impacts of climate change. However, the empirical evidence is limited. We examined the associations of child survival with interannual variation in food crop yield and middle-upper arm circumference (MUAC) in a subsistence-farming population of rural Burkina Faso. The study was of 44,616 children aged Demographic Surveillance System, 1992-2012, whose survival was analyzed in relation to the food crop yield in the year of birth (which ranged from 65% to 120% of the period average) and, for a subset of 16,698 children, to MUAC, using shared-frailty Cox proportional hazards models. Survival was appreciably worse in children born in years with low yield (full-adjustment hazard ratio = 1.11 (95% confidence interval: 1.02, 1.20) for a 90th- to 10th-centile decrease in annual crop yield) and in children with small MUAC (hazard ratio = 2.72 (95% confidence interval: 2.15, 3.44) for a 90th- to 10th-centile decrease in MUAC). These results suggest an adverse impact of variations in crop yields, which could increase under climate change. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

CHILD RIGHTS IN SUB-SAHARAN AFRICA: A CALL FOR A RIGHTS-BASED GLOBAL RESEARCH AGENDA

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Dinbabo, Mulugeta

2013-05-01

Full Text Available Despite many achievements regarding child rights over the last 20 years, including improvements in many indicators such as the significant reduction in infant and child mortality; the more positive way of thinking about and listening to children; and increased response to those who abuse children, the rights of children are still insufficiently protected. Millions of children across the world suffer from the effects of extreme forms of poverty and their associated evils, such as malnourishment, stunted growth, nutritional-deficiency diseases and illiteracy. Recent figures from the International Labour Organisation (2010 show that, globally one in every six children work, 126 million children work in hazardous conditions, and the highest proportion of child labourers is in sub-Saharan Africa, where 26% of children (49 million are involved in work. These figures provide only a glimpse of the challenges and obstacles that a child faces around the world

Deciphering emerging Zika and dengue viral epidemics: Implications for global maternal–child health burden

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Ernest Tambo

2016-05-01

Full Text Available Summary: Since its discovery in 1947 in Uganda and control and eradication efforts have aimed at its vectors (Aedes mosquitoes in Latin America in the 1950s, an absolute neglect of Zika programs and interventions has been documented in Aedes endemic and epidemic-prone countries. The current unprecedented Zika viral epidemics and rapid spread in the Western hemisphere pose a substantial global threat, with associated anxiety and consequences. The lack of safe and effective drugs and vaccines against Zika or dengue epidemics further buttresses the realization from the West Africa Ebola outbreak that most emerging disease-prone countries are still poorly prepared for an emergency response. This paper examines knowledge gaps in both emerging and neglected arthropod-borne flavivirus infectious diseases associated with poverty and their implications for fostering local, national and regional emerging disease preparedness, effective and robust surveillance–response systems, sustained control and eventual elimination. Strengthening the regional and Global Health Flavivirus Surveillance-Response Network (GHFV-SRN with other models of socio-economic, climatic, environmental and ecological mitigation and adaptation strategies will be necessary to improve evidence-based national and global maternal–child health agenda and action plans. Keywords: Zika virus, Epidemics, Health, Preparedness, Surveillance, Maternal–child

Exploring the Relationship between Global Quality and Group Engagement in Toddler Child Care Classrooms

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Hooper, Alison; Hallam, Rena

2017-01-01

Toddlers' engagement with their social and physical environment is an important aspect of their experience in early care and education programs. The purpose of this research study was to examine how global quality relates to children's engagement in toddler child care classrooms. Additionally, this study explored how toddlers' group engagement…

Niger's Child Survival Success, Contributing Factors and Challenges to Sustainability: A Retrospective Analysis.

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Donela Besada

Full Text Available Household surveys undertaken in Niger since 1998 have revealed steady declines in under-5 mortality which have placed the country 'on track' to reach the fourth Millennium Development goal (MDG. This paper explores Niger's mortality and health coverage data for children under-5 years of age up to 2012 to describe trends in high impact interventions and the resulting impact on childhood deaths averted. The sustainability of these trends are also considered.Estimates of child mortality using the 2012 Demographic and Health Survey were developed and maternal and child health coverage indicators were calculated over four time periods. Child survival policies and programmes were documented through a review of documents and key informant interviews. The Lives Saved Tool (LiST was used to estimate the number of child lives saved and identify which interventions had the largest impact on deaths averted. The national mortality rate in children under-5 decreased from 286 child deaths per 1000 live births (95% confidence interval 177 to 394 in the period 1989-1990 to 128 child deaths per 1000 live births in the period 2011-2012 (101 to 155, corresponding to an annual rate of decline of 3.6%, with significant declines taking place after 1998. Improvements in the coverage of maternal and child health interventions between 2006 and 2012 include one and four or more antenatal visits, maternal Fansidar and tetanus toxoid vaccination, measles and DPT3 vaccinations, early and exclusive breastfeeding, oral rehydration salts (ORS and proportion of children sleeping under an insecticide-treated bed net (ITN. Approximately 26,000 deaths of children under-5 were averted in 2012 due to decreases in stunting rates (27%, increases in ORS (14%, the Hib vaccine (14%, and breastfeeding (11%. Increases in wasting and decreases in vitamin A supplementation negated some of those gains. Care seeking at the community level was responsible for an estimated 7,800 additional deaths

Global burden of maternal and child undernutrition and micronutrient deficiencies.

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Ahmed, Tahmeed; Hossain, Muttaquina; Sanin, Kazi Istiaque

2012-01-01

Maternal and child undernutrition and micronutrient deficiencies affect approximately half of the world's population. These conditions include intrauterine growth restriction (IUGR), low birth weight, protein-energy malnutrition, chronic energy deficit of women, and micronutrient deficiencies. Although the rates of stunting or chronic protein-energy malnutrition are increasing in Africa, the absolute numbers of stunted children are much higher in Asia. The four common micronutrient deficiencies include those of iron, iodine, vitamin A, and zinc. All these conditions are responsible directly or indirectly for more than 50% of all under-5 deaths globally. According to more recent estimates, IUGR, stunting and severe wasting are responsible for one third of under-5 mortality. About 12% of deaths among under-5 children are attributed to the deficiency of the four common micronutrients. Despite tremendous progress in different disciplines and unprecedented improvement with many health indicators, persistently high undernutrition rates are a shame to the society. Human development is not possible without taking care to control undernutrition and micronutrient deficiencies. Poverty, food insecurity, ignorance, lack of appropriate infant and young child feeding practices, heavy burden of infectious illnesses, and poor hygiene and sanitation are factors responsible for the high levels of maternal and child undernutrition in developing countries. These factors can be controlled or removed by scaling up direct nutrition interventions and eliminating the root conditions including female illiteracy, lack of livelihoods, lack of women's empowerment, and poor hygiene and sanitation. Copyright © 2013 S. Karger AG, Basel.

Child Labor: Global Offensive.

Science.gov (United States)

Sutcliffe, Peter; And Others

1993-01-01

Includes "An Evil Unbearable to the Human Heart" (Sutcliffe); "Fighting Indifference and Inaction" (Fromont); "Concerted International Action for Children"; "New Shelter for Street Kids of Ankara" (Fromont); "IPEC's International Program for Elimination of Child Labor Challenge to Brazilian…

Teaching corner: child family health international : the ethics of asset-based global health education programs.

Science.gov (United States)

Evert, Jessica

2015-03-01

Child Family Health International (CFHI) is a U.S.-based nonprofit, nongovernmental organization (NGO) that has more than 25 global health education programs in seven countries annually serving more than 600 interprofessional undergraduate, graduate, and postgraduate participants in programs geared toward individual students and university partners. Recognized by Special Consultative Status with the United Nations Economic and Social Council (ECOSOC), CFHI utilizes an asset-based community engagement model to ensure that CFHI's programs challenge, rather than reinforce, historical power imbalances between the "Global North" and "Global South." CFHI's programs are predicated on ethical principles including reciprocity, sustainability, humility, transparency, nonmaleficence, respect for persons, and social justice.

Reducing Stigma and Discrimination to Improve Child Health and Survival in Low- and Middle-Income Countries: Promising Approaches and Implications for Future Research

OpenAIRE

Nayar, Usha S.; Stangl, Anne L.; De Zalduondo, Barbara; Brady, Laura M.

2014-01-01

The social processes of stigmatization and discrimination can have complex and devastating effects on the health and welfare of families and communities, and thus on the environments in which children live and grow. The authors conducted a literature review to identify interventions for reducing the stigma and discrimination that impede child health and well-being in low- and middle-income countries, with a focus on nutrition, HIV/AIDS, neonatal survival and infant health, and early child dev...

Child mortality: preventing future child deaths and optimizing family support

NARCIS (Netherlands)

Knoeff-Gijzen, Sandra

2017-01-01

Worldwide 6.1 million live-born children under the age of five died from natural and external causes in 2014. According to the Convention on the Rights of the Child appropriate measures should be taken by State Parties to ensure the survival and development of the child to a maximum extent and to

Tracking progress towards equitable child survival in a Nicaraguan community: neonatal mortality challenges to meet the MDG 4

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Persson Lars-Åke

2011-06-01

Full Text Available Abstract Background Nicaragua has made progress in the reduction of the under-five mortality since 1980s. Data for the national trends indicate that this poor Central American country is on track to reach the Millennium Development Goal-4 by 2015. Despite this progress, neonatal mortality has not showed same progress. The aim of this study is to analyse trends and social differentials in neonatal and under-five mortality in a Nicaraguan community from 1970 to 2005. Methods Two linked community-based reproductive surveys in 1993 and 2002 followed by a health and demographic surveillance system providing information on all births and child deaths in urban and rural areas of León municipality, Nicaragua. A total of 49 972 live births were registered. Results A rapid reduction in under-five mortality was observed during the late 1970s (from 103 deaths/1000 live births and the 1980s, followed by a gradual decline to the level of 23 deaths/1000 live births in 2005. This community is on track for the Millennium Development Goal 4 for improved child survival. However, neonatal mortality increased lately in spite of a good coverage of skilled assistance at delivery. After some years in the 1990s with a very small gap in neonatal survival between children of mothers of different educational levels this divide is increasing. Conclusions After the reduction of high under-five mortality that coincided with improved equity in survival in this Nicaraguan community, the current challenge is the neonatal mortality where questions of an equitable perinatal care of good quality must be addressed.

Confronting ecological futures: global environmental crises in contemporary survival quests for young adults

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Yvonne Hammer

2010-01-01

Full Text Available This paper examines representations of societal concern in the futuristic ecological disaster fictions of three British authors: Julie Bertagna (Exodus; Zenith, Jan Mark (Riding Tycho; Voyager and Marcus Sedgwick Floodland. The depicted refugee journeys in these futuristic worlds speak into a growing global disquiet that surrounds current historic events. Environmental crises that ground the emergent world orders of depicted future societies set the scene in each coming of age frame: each survival quest embeds social and cultural issues recognisable to contemporary audiences in futuristic representations of changed world orders, limited resources, and isolated communities. Authors resist the mythic frame of a traditional quest journey − a call to journey, the engagement with growth through a road of trials and then celebrations in a return to home territory: their conclusions offer limited resolutions, the struggle to survive entrenched as a linear path. Because authors link depictions of the refugee subject with environmental degradation, apocalyptic scenarios that signify the devastating consequences of global environmental crises provide an ecocritical platform from which each author situates a discourse of protest. Interrogating contemporary political positions of ambiguity and denial their novels profile social justice issues experienced by refugee populations in contemporary society.

Newborn survival in Malawi: a decade of change and future implications.

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Zimba, Evelyn; Kinney, Mary V; Kachale, Fannie; Waltensperger, Karen Z; Blencowe, Hannah; Colbourn, Tim; George, Joby; Mwansambo, Charles; Joshua, Martias; Chanza, Harriet; Nyasulu, Dorothy; Mlava, Grace; Gamache, Nathalie; Kazembe, Abigail; Lawn, Joy E

2012-07-01

Malawi is one of two low-income sub-Saharan African countries on track to meet the Millennium Development Goal (MDG 4) for child survival despite high fertility and HIV and low health worker density. With neonatal deaths becoming an increasing proportion of under-five deaths, addressing newborn survival is critical for achieving MDG 4. We examine change for newborn survival in the decade 2000-10, analysing mortality and coverage indicators whilst considering other contextual factors. We assess national and donor funding, as well as policy and programme change for newborn survival using standard analyses and tools being applied as part of a multi-country analysis. Compared with the 1990s, progress towards MDG 4 and 5 accelerated considerably from 2000 to 2010. Malawi's neonatal mortality rate (NMR) reduced slower than annual reductions in mortality for children 1-59 months and maternal mortality (NMR reduced 3.5% annually). Yet, the NMR reduced at greater pace than the regional and global averages. A significant increase in facility births and other health system changes, including increased human resources, likely contributed to this decline. High level attention for maternal health and associated comprehensive policy change has provided a platform for a small group of technical and programme experts to link in high impact interventions for newborn survival. The initial entry point for newborn care in Malawi was mainly through facility initiatives, such as Kangaroo Mother Care. This transitioned to an integrated and comprehensive approach at community and facility level through the Community-Based Maternal and Newborn Care package, now being implemented in 17 of 28 districts. Addressing quality gaps, especially for care at birth in facilities, and including newborn interventions in child health programmes, will be critical to the future agenda of newborn survival in Malawi.

Explaining the slow transition of child-appropriate dosage formulations from the global to national level in the context of Uganda

DEFF Research Database (Denmark)

Nsabagasani, Xavier; Hansen, Ebba; Mbonye, Anthony

2015-01-01

validation meeting where preliminary findings were shared with stakeholders. Policy analysis and policy transfer theories were used to guide a deductive analysis for manifest and latent content. RESULTS: According to stakeholders, the transition to the globally recommended child-appropriate dosage...... formulations has been slow in Uganda due to a number of factors. These factors include resource constraints at the global and national levels, lack of Ministry of Health (MOH) formal commitment to the adoption of the child-appropriate dosage formulations policy and a lack of consensus between those who...... formulations still remains to be implemented in Uganda and other low income countries. This has been due to lack of resources that hindered formal transfer of the policy from the global to the local level. To achieve this transfer there is a need for resource mobilisation at both the international and local...

Association between gender inequality index and child mortality rates: a cross-national study of 138 countries

OpenAIRE

Brinda, Ethel Mary; Rajkumar, Anto P; Enemark, Ulrika

2015-01-01

BACKGROUND: Gender inequality weakens maternal health and harms children through many direct and indirect pathways. Allied biological disadvantage and psychosocial adversities challenge the survival of children of both genders. United Nations Development Programme (UNDP) has recently developed a Gender Inequality Index to measure the multidimensional nature of gender inequality. The global impact of Gender Inequality Index on the child mortality rates remains uncertain.METHODS: We employed an...

Survival analysis of colorectal cancer patients with tumor recurrence using global score test methodology

Energy Technology Data Exchange (ETDEWEB)

Zain, Zakiyah, E-mail: zac@uum.edu.my; Ahmad, Yuhaniz, E-mail: yuhaniz@uum.edu.my [School of Quantitative Sciences, Universiti Utara Malaysia, UUM Sintok 06010, Kedah (Malaysia); Azwan, Zairul, E-mail: zairulazwan@gmail.com, E-mail: farhanaraduan@gmail.com, E-mail: drisagap@yahoo.com; Raduan, Farhana, E-mail: zairulazwan@gmail.com, E-mail: farhanaraduan@gmail.com, E-mail: drisagap@yahoo.com; Sagap, Ismail, E-mail: zairulazwan@gmail.com, E-mail: farhanaraduan@gmail.com, E-mail: drisagap@yahoo.com [Surgery Department, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, 56000 Bandar Tun Razak, Kuala Lumpur (Malaysia); Aziz, Nazrina, E-mail: nazrina@uum.edu.my

2014-12-04

Colorectal cancer is the third and the second most common cancer worldwide in men and women respectively, and the second in Malaysia for both genders. Surgery, chemotherapy and radiotherapy are among the options available for treatment of patients with colorectal cancer. In clinical trials, the main purpose is often to compare efficacy between experimental and control treatments. Treatment comparisons often involve several responses or endpoints, and this situation complicates the analysis. In the case of colorectal cancer, sets of responses concerned with survival times include: times from tumor removal until the first, the second and the third tumor recurrences, and time to death. For a patient, the time to recurrence is correlated to the overall survival. In this study, global score test methodology is used in combining the univariate score statistics for comparing treatments with respect to each survival endpoint into a single statistic. The data of tumor recurrence and overall survival of colorectal cancer patients are taken from a Malaysian hospital. The results are found to be similar to those computed using the established Wei, Lin and Weissfeld method. Key factors such as ethnic, gender, age and stage at diagnose are also reported.

Measles Vaccination in the Presence or Absence of Maternal Measles Antibody: Impact on Child Survival

Science.gov (United States)

Aaby, Peter; Martins, Cesário L.; Garly, May-Lill; Andersen, Andreas; Fisker, Ane B.; Claesson, Mogens H.; Ravn, Henrik; Rodrigues, Amabelia; Whittle, Hilton C.; Benn, Christine S.

2014-01-01

Background. Measles vaccine (MV) has a greater effect on child survival when administered in early infancy, when maternal antibody may still be present. Methods. To test whether MV has a greater effect on overall survival if given in the presence of maternal measles antibody, we reanalyzed data from 2 previously published randomized trials of a 2-dose schedule with MV given at 4–6 months and at 9 months of age. In both trials antibody levels had been measured before early measles vaccination. Results. In trial I (1993–1995), the mortality rate was 0.0 per 1000 person-years among children vaccinated with MV in the presence of maternal antibody and 32.3 per 1000 person-years without maternal antibody (mortality rate ratio [MRR], 0.0; 95% confidence interval [CI], 0–.52). In trial II (2003–2007), the mortality rate was 4.2 per 1000 person-years among children vaccinated in presence of maternal measles antibody and 14.5 per 1000 person-years without measles antibody (MRR, 0.29; 95% CI, .09–.91). Possible confounding factors did not explain the difference. In a combined analysis, children who had measles antibody detected when they received their first dose of MV at 4–6 months of age had lower mortality than children with no maternal antibody, the MRR being 0.22 (95% CI, .07–.64) between 4–6 months and 5 years. Conclusions. Child mortality in low-income countries may be reduced by vaccinating against measles in the presence of maternal antibody, using a 2-dose schedule with the first dose at 4–6 months (earlier than currently recommended) and a booster dose at 9–12 months of age. Clinical Trials Registration. NCT00168558. PMID:24829213

Child prostitution in Thailand.

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Lau, Carmen

2008-06-01

Child prostitution is an old, global and complex phenomenon, which deprives children of their childhood, human rights and dignity. Child prostitution can be seen as the commercial sexual exploitation of children involving an element of forced labour, and thus can be considered as a contemporary form of slavery. Globally, child prostitution is reported to be a common problem in Central and South America and Asia. Of all the south-east Asian nations, the problem is most prolific in Thailand. In Thailand, there appears to be a long history of child prostitution, and this article explores the factors that underpin the Thai child sex industry and the lessons and implications that can be drawn for health care and nursing around the world.

Community-Based Management of Child Malnutrition in Zambia: HIV/AIDS Infection and Other Risk Factors on Child Survival.

Science.gov (United States)

Moramarco, Stefania; Amerio, Giulia; Ciarlantini, Clarice; Chipoma, Jean Kasengele; Simpungwe, Matilda Kakungu; Nielsen-Saines, Karin; Palombi, Leonardo; Buonomo, Ersilia

2016-07-01

(1) BACKGROUND: Supplementary feeding programs (SFPs) are effective in the community-based treatment of moderate acute malnutrition (MAM) and prevention of severe acute malnutrition (SAM); (2) METHODS: A retrospective study was conducted on a sample of 1266 Zambian malnourished children assisted from 2012 to 2014 in the Rainbow Project SFPs. Nutritional status was evaluated according to WHO/Unicef methodology. We performed univariate and multivariate Cox proportional risk regression to identify the main predictors of mortality. In addition, a time-to event analysis was performed to identify predictors of failure and time to cure events; (3) RESULTS: The analysis included 858 malnourished children (19 months ± 9.4; 49.9% males). Program outcomes met international standards with a better performance for MAM compared to SAM. Cox regression identified SAM (3.8; 2.1-6.8), HIV infection (3.1; 1.7-5.5), and WAZ malnutrition, coupled to early detection of HIV/AIDS with adequate antiretroviral treatment, and extending the duration of feeding supplementation, could be crucial elements for ensuring full recovery and improve child survival in malnourished Zambian children.

Forecast factors for global survival in patients with sarcomas of soft parts treated with surgery and radiotherapy

International Nuclear Information System (INIS)

Vera Merino, V.; Winter, C.; Schnitman, F.; Caussa, L.; Brocca, C.; Basquiera, A.L.; Zunino, S.

2007-01-01

The task of this work is to study the characteristics of the patient (age, sex) and of the tumor (locating, histology, size, histological degree, deepness, margins commitment ) and the delay between surgery and radiotherapy relating to global survival [es

Effects of environmental factors on child survival in Bangladesh: a case control study.

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Hoque, B A; Chakraborty, J; Chowdhury, J T; Chowdhury, U K; Ali, M; el Arifeen, S; Sack, R B

1999-03-01

The need for further studies on relationships between deaths and environmental variables has been reported in the literature. This case-control study was, therefore, carried out to find out the associations between several social and environmental variables and deaths of children due to infectious diseases such as those leading to diarrhoea, acute respiratory infection, measles and other diseases. Six hundred and twenty-five deaths (cases) and an equal number of matched living children (controls) aged 1-59 months, were studied in rural Matlab. An analysis of crude and adjusted odds ratio showed differential associations. Sources of drinking water, amount of stored water, conditions of latrines, number of persons sleeping with the child and the type of cooking site were statistically significantly associated with deaths due to infectious diseases after controlling for breast feeding, immunization, and the family size. Significant associations were also observed between: (i) the sources of drinking water and deaths due to ARI, and (ii) conditions of latrines and deaths due to diarrhoeal diseases, after controlling for the confounding variables. Several other environmental factors also showed associations with these various death groups, but they were not statistically significant. The size of the samples in death groups (small) and the prevalence of more or less homogeneous environmental health conditions probably diminished the magnitude of the effects. The results of the study reconfirm the importance of environmental health intervention in child survival, irrespective of breast-feeding, immunization, and selected social variables.

Chemoembolization With Doxorubicin-Eluting Beads for Unresectable Hepatocellular Carcinoma: Five-Year Survival Analysis

Energy Technology Data Exchange (ETDEWEB)

Malagari, Katerina, E-mail: kmalag@otonet.gr [University of Athens, Second Department of Radiology (Greece); Pomoni, Mary [University of Athens, Imaging and Research Unit (Greece); Moschouris, Hippocrates, E-mail: hipmosch@gmail.com [Tzanion Hospital, Department of Radiology (Greece); Bouma, Evanthia [University of Athens, Imaging and Research Unit (Greece); Koskinas, John [Ippokration Hospital, University of Athens, Department of Internal Medicine and Hepatology (Greece); Stefaniotou, Aspasia [University of Athens, Imaging and Research Unit (Greece); Marinis, Athanasios [Tzanion Hospital, Department of Surgery (Greece); Kelekis, Alexios; Alexopoulou, Efthymia [University of Athens, Second Department of Radiology (Greece); Chatziioannou, Achilles [University of Athens, First Department of Radiology (Greece); Chatzimichael, Katerina [University of Athens, Second Department of Radiology (Greece); Dourakis, Spyridon [Ippokration Hospital, University of Athens, Department of Internal Medicine and Hepatology (Greece); Kelekis, Nikolaos [University of Athens, Second Department of Radiology (Greece); Rizos, Spyros [Tzanion Hospital, Department of Surgery (Greece); Kelekis, Dimitrios [University of Athens, Imaging and Research Unit (Greece)

2012-10-15

Purpose: The purpose of this study was to report on the 5-year survival of hepatocellular carcinoma (HCC) patients treated with DC Bead loaded with doxorubicin (DEB-DOX) in a scheduled scheme in up to three treatments and thereafter on demand. Materials and Methods: 173 HCC patients not suitable for curable treatments were prospectively enrolled (mean age 70.4 {+-} 7.4 years). Child-Pugh (Child) class was A/B (102/71 [59/41 %]), Okuda stage was 0/1/2 (91/61/19 [53.2/35.7/11.1 %]), and mean lesion diameter was 7.6 {+-} 2.1 cm. Lesion morphology was one dominant {<=}5 cm (22 %), one dominant >5 cm (41.6 %), multifocal {<=}5 (26 %), and multifocal >5 (10.4 %). Results: Overall survival at 1, 2, 3, 4, and 5 years was 93.6, 83.8, 62, 41.04, and 22.5 %, with higher rates achieved in Child class A compared with Child class B patients (95, 88.2, 61.7, 45, and 29.4 % vs. 91.5, 75, 50.7, 35.2, and 12.8 %). Mean overall survival was 43.8 months (range 1.2-64.8). Cumulative survival was better for Child class A compared with Child class B patients (p = 0.029). For patients with dominant lesions {<=}5 cm 1-, 2-, 3-, 4-, and 5-year survival rates were 100, 95.2, 71.4, 66.6, and 47.6 % for Child class A and 94.1, 88.2, 58.8, 41.2, 29.4, and 23.5 % for Child class B patients. Regarding DEB-DOX treatment, multivariate analysis identified number of lesions (p = 0.033), lesion vascularity (p < 0.0001), initially achieved complete response (p < 0.0001), and objective response (p = 0.046) as significant and independent determinants of 5-year survival. Conclusion: DEB-DOX results, with high rates of 5-year survival for patients, not amenable to curative treatments. Number of lesions, lesion vascularity, and local response were significant independent determinants of 5-year survival.

Chemoembolization With Doxorubicin-Eluting Beads for Unresectable Hepatocellular Carcinoma: Five-Year Survival Analysis

International Nuclear Information System (INIS)

Malagari, Katerina; Pomoni, Mary; Moschouris, Hippocrates; Bouma, Evanthia; Koskinas, John; Stefaniotou, Aspasia; Marinis, Athanasios; Kelekis, Alexios; Alexopoulou, Efthymia; Chatziioannou, Achilles; Chatzimichael, Katerina; Dourakis, Spyridon; Kelekis, Nikolaos; Rizos, Spyros; Kelekis, Dimitrios

2012-01-01

Purpose: The purpose of this study was to report on the 5-year survival of hepatocellular carcinoma (HCC) patients treated with DC Bead loaded with doxorubicin (DEB-DOX) in a scheduled scheme in up to three treatments and thereafter on demand. Materials and Methods: 173 HCC patients not suitable for curable treatments were prospectively enrolled (mean age 70.4 ± 7.4 years). Child-Pugh (Child) class was A/B (102/71 [59/41 %]), Okuda stage was 0/1/2 (91/61/19 [53.2/35.7/11.1 %]), and mean lesion diameter was 7.6 ± 2.1 cm. Lesion morphology was one dominant ≤5 cm (22 %), one dominant >5 cm (41.6 %), multifocal ≤5 (26 %), and multifocal >5 (10.4 %). Results: Overall survival at 1, 2, 3, 4, and 5 years was 93.6, 83.8, 62, 41.04, and 22.5 %, with higher rates achieved in Child class A compared with Child class B patients (95, 88.2, 61.7, 45, and 29.4 % vs. 91.5, 75, 50.7, 35.2, and 12.8 %). Mean overall survival was 43.8 months (range 1.2–64.8). Cumulative survival was better for Child class A compared with Child class B patients (p = 0.029). For patients with dominant lesions ≤5 cm 1-, 2-, 3-, 4-, and 5-year survival rates were 100, 95.2, 71.4, 66.6, and 47.6 % for Child class A and 94.1, 88.2, 58.8, 41.2, 29.4, and 23.5 % for Child class B patients. Regarding DEB-DOX treatment, multivariate analysis identified number of lesions (p = 0.033), lesion vascularity (p < 0.0001), initially achieved complete response (p < 0.0001), and objective response (p = 0.046) as significant and independent determinants of 5-year survival. Conclusion: DEB-DOX results, with high rates of 5-year survival for patients, not amenable to curative treatments. Number of lesions, lesion vascularity, and local response were significant independent determinants of 5-year survival.

Improvement of child survival in Mexico: the diagonal approach.

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Sepúlveda, Jaime; Bustreo, Flavia; Tapia, Roberto; Rivera, Juan; Lozano, Rafael; Oláiz, Gustavo; Partida, Virgilio; García-García, Lourdes; Valdespino, José Luis

2006-12-02

Public health interventions aimed at children in Mexico have placed the country among the seven countries on track to achieve the goal of child mortality reduction by 2015. We analysed census data, mortality registries, the nominal registry of children, national nutrition surveys, and explored temporal association and biological plausibility to explain the reduction of child, infant, and neonatal mortality rates. During the past 25 years, child mortality rates declined from 64 to 23 per 1000 livebirths. A dramatic decline in diarrhoea mortality rates was recorded. Polio, diphtheria, and measles were eliminated. Nutritional status of children improved significantly for wasting, stunting, and underweight. A selection of highly cost-effective interventions bridging clinics and homes, what we called the diagonal approach, were central to this progress. Although a causal link to the reduction of child mortality was not possible to establish, we saw evidence of temporal association and biological plausibility to the high level of coverage of public health interventions, as well as significant association to the investments in women education, social protection, water, and sanitation. Leadership and continuity of public health policies, along with investments on institutions and human resources strengthening, were also among the reasons for these achievements.

[Improvement of child survival in Mexico: the diagonal approach].

Science.gov (United States)

Sepúlveda, Jaime; Bustreo, Flavia; Tapia, Roberto; Rivera, Juan; Lozano, Rafael; Olaiz, Gustavo; Partida, Virgilio; García-García, Ma de Lourdes; Valdespino, José Luis

2007-01-01

Public health interventions aimed at children in Mexico have placed the country among the seven countries on track to achieve the goal of child mortality reduction by 2015. We analysed census data, mortality registries, the nominal registry of children, national nutrition surveys, and explored temporal association and biological plausibility to explain the reduction of child, infant, and neonatal mortality rates. During the past 25 years, child mortality rates declined from 64 to 23 per 1000 livebirths. A dramatic decline in diarrhoea mortality rates was recorded. Polio, diphtheria, and measles were eliminated. Nutritional status of children improved significantly for wasting, stunting, and underweight. A selection of highly cost-effective interventions bridging clinics and homes, what we called the diagonal approach, were central to this progress. Although a causal link to the reduction of child mortality was not possible to establish, we saw evidence of temporal association and biological plausibility to the high level of coverage of public health interventions, as well as significant association to the investments in women education, social protection, water, and sanitation. Leadership and continuity of public health policies, along with investments on institutions and human resources strengthening, were also among the reasons for these achievements.

The Influence Of Child Survival And Health Of The Previous Child ...

African Journals Online (AJOL)

The result indicated that significant relationship existed between birth order, sex of child, mother's age at birth, index of household wealth, and the length of the preceding birth interval, but not with rural/urban residence, mother's education and type of provider of prenatal care. The result further indicated that a combination of ...

Paediatricians’ perspectives on global health priorities for newborn care in a developing country: a national survey from Nigeria

Directory of Open Access Journals (Sweden)

Olusanya Bolajoko O

2012-07-01

Full Text Available Abstract Background An understanding of the perception of paediatricians as key stakeholders in child healthcare delivery and the degree of congruence with current investment priorities is crucial in accelerating progress towards the attainment of global targets for child survival and overall health in developing countries. This study therefore elicited the views of paediatricians on current global priorities for newborn health in Nigeria as possible guide for policy makers. Methods Paediatric consultants and residents in the country were surveyed nationally between February and March 2011 using a questionnaire requiring the ranking of nine prominent and other neonatal conditions based separately on hospital admissions, mortality, morbidity and disability as well as based on all health indices in order of importance or disease burden. Responses were analysed with Friedman test and differences between subgroups of respondents with Mann-Whitney U test. Results Valid responses were received from 152 (65.8% of 231 eligible physicians. Preterm birth/low birthweight ranked highest by all measures except for birth asphyxia which ranked highest for disability. Neonatal jaundice ranked next to sepsis by all measures except for disability and above tetanus except mortality. Preterm birth/low birthweight, birth asphyxia, sepsis, jaundice and meningitis ranked highest by composite measures while jaundice had comparable rating with sepsis. Birth trauma was most frequently cited under other unspecified conditions. There were no significant differences in ranking between consultants and residents except for birth asphyxia in relation to hospital admissions and morbidity as well as sepsis and tetanus in relation to mortality. Conclusions Current global priorities for neonatal survival in Nigeria largely accord with paediatricians’ views except for neonatal jaundice which is commonly subsumed under “other“ or "miscellaneous" neonatal conditions. While the

Community engagement to enhance child survival and early development in low- and middle-income countries: an evidence review.

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Farnsworth, S Katherine; Böse, Kirsten; Fajobi, Olaoluwa; Souza, Patricia Portela; Peniston, Anne; Davidson, Leslie L; Griffiths, Marcia; Hodgins, Stephen

2014-01-01

As part of a broader evidence summit, USAID and UNICEF convened a literature review of effective means to empower communities to achieve behavioral and social changes to accelerate reductions in under-5 mortality and optimize early child development. The authors conducted a systematic review of the effectiveness of community mobilization and participation that led to behavioral change and one or more of the following: child health, survival, and development. The level and nature of community engagement was categorized using two internationally recognized models and only studies where the methods of community participation could be categorized as collaborative or shared leadership were eligible for analysis. The authors identified 34 documents from 18 countries that met the eligibility criteria. Studies with shared leadership typically used a comprehensive community action cycle, whereas studies characterized as collaborative showed clear emphasis on collective action but did not undergo an initial process of community dialogue. The review concluded that programs working collaboratively or achieving shared leadership with a community can lead to behavior change and cost-effective sustained transformation to improve critical health behaviors and reduce poor health outcomes in low- and middle-income countries. Overall, community engagement is an understudied component of improving child outcomes.

Surviving global risks through the preservation of humanity's data on the Moon

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Turchin, Alexey; Denkenberger, David

2018-05-01

Many global catastrophic risks are threatening human civilization, and a number of ideas have been suggested for preventing or surviving them. However, if these interventions fail, society could preserve information about the human race and human DNA samples in the hopes that the next civilization on Earth will be able to reconstruct Homo sapiens and our culture. This requires information preservation of an order of magnitude of 100 million years, a little-explored topic thus far. It is important that a potential future civilization discovers this information as early as possible, thus a beacon should accompany the message in order to increase visibility. The message should ideally contain information about how humanity was destroyed, perhaps including a continuous recording until the end. This could help the potential future civilization to survive. The best place for long-term data storage is under the surface of the Moon, with the beacon constructed as a complex geometric figure drawn by small craters or trenches around a central point. There are several cost-effective options for sending the message as opportunistic payloads on different planned landers.

Children in Africa: Key Statistics on Child Survival, Protection and Development

Science.gov (United States)

UNICEF, 2014

2014-01-01

This report presents key statistics relating to: (1) child malnutrition in Africa; (2) HIV/AIDS and Malaria in Africa; (3) child marriage, birth registration and Female Genital Mutilation/Cutting (FGM/C); (4) education in Africa; (5) child mortality in Africa; (6) Drinking water and sanitation in Africa; and (7) maternal health in Africa.…

A general psychopathology factor (P factor) in children: Structural model analysis and external validation through familial risk and child global executive function.

Science.gov (United States)

Martel, Michelle M; Pan, Pedro M; Hoffmann, Maurício S; Gadelha, Ary; do Rosário, Maria C; Mari, Jair J; Manfro, Gisele G; Miguel, Eurípedes C; Paus, Tomás; Bressan, Rodrigo A; Rohde, Luis A; Salum, Giovanni A

2017-01-01

High rates of comorbidities and poor validity of disorder diagnostic criteria for mental disorders hamper advances in mental health research. Recent work has suggested the utility of continuous cross-cutting dimensions, including general psychopathology and specific factors of externalizing and internalizing (e.g., distress and fear) syndromes. The current study evaluated the reliability of competing structural models of psychopathology and examined external validity of the best fitting model on the basis of family risk and child global executive function (EF). A community sample of 8,012 families from Brazil with children ages 6-12 years completed structured interviews about the child and parental psychiatric syndromes, and a subsample of 2,395 children completed tasks assessing EF (i.e., working memory, inhibitory control, and time processing). Confirmatory factor analyses tested a series of structural models of psychopathology in both parents and children. The model with a general psychopathology factor ("P factor") with 3 specific factors (fear, distress, and externalizing) exhibited the best fit. The general P factor accounted for most of the variance in all models, with little residual variance explained by each of the 3 specific factors. In addition, associations between child and parental factors were mainly significant for the P factors and nonsignificant for the specific factors from the respective models. Likewise, the child P factor-but not the specific factors-was significantly associated with global child EF. Overall, our results provide support for a latent overarching P factor characterizing child psychopathology, supported by familial associations and child EF. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

The Emotional Child Witness Effect Survives Presentation Mode.

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Melinder, Annika; Burrell, Lisa; Eriksen, Maria Olaussen; Magnussen, Svein; Wessel, Ellen

2016-01-01

The emotional witness effect - the phenomenon whereby people are affected by the emotional manner in which a witness presents testimony - constitutes a possible source of wrongful decisions in legal contexts. One stereotypical view of abused children is that they should be sad when talking about their experiences of maltreatment, whereas children may in fact express a variety of emotional expressions when talking about abusive events. This raises the question as to whether there is an optimal mode in which to present child victim testimony that could reduce the possible influence of displayed emotions. In the present study, mock police interviews were carried out with female child actors, role-playing the victims of physical abuse by their stepfather, telling the same story with four emotional expressions (neutral, sad, angry, or positive). Laypersons (N = 465) were presented with the interviews as transcripts with the emotional reactions of the child witness noted, audio recordings, or videotaped recordings. Participants then rated the credibility of the victim witness. Replicating previous results, the "sad" expression elicited the highest credibility ratings across all modes of presentations. Presentation mode affected ratings of credibility, with the transcript versions resulting in the highest ratings. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Inmunofenotipaje y supervivencia global de pacientes pediátricos con leucemias agudas Immunophenotyping and global survival of pediatric patients with acute leukemia

Directory of Open Access Journals (Sweden)

Vianed Marsán Suárez

2002-04-01

Full Text Available El inmunofenotipaje celular (IFC permite identificar la línea específica de origen de las células leucémicas y su nivel de maduración. Se determinó la frecuencia de los distintos subtipos inmunológicos de leucemias agudas (LA y su posible relación con la supervivencia global de los pacientes. Se estudiaron 117 niños con LA entre 1983 y 1999. El IFC se realizó mediante el ultramicrométodo inmunocitoquímico y el de fosfatasa alcalina-antifosfatasa alcalina. Del total de LA, 77(65,8 % fueron linfoides agudas (LLA, 26 (22,2 % mieloides agudas, 9 (8 % LA indiferenciadas y 5 (4 % se clasificaron como LA híbridas. Del total de LLA, 59 (76,6 % fueron de fenotipo B y 18 (23,4 % de fenotipo T. Se observó una mayor sobrevida en los pacientes de linaje B en relación con los de linaje T y mieloide, con una diferencia muy significativa (p Cell immunophenotyping (CIP identifies the specific line of origin of leukemic cells and their maturing level. The frequency of the various immunological subtypes of acute leukemias (AL and their possible relationship with global survival rate of patients were determined. One hundred and seventeen children with AL were studied from 1983 to 1999. The CIP was conducted through the immunocytochemical ultramicromethod and the alkaline phosphatase - anti-alkaline phosphatase method. Seventy seven (65,8% of all AL were acute lymphoid leukemias (ALL, 26(22,2% acute myeloid (AML, 9 (8% undifferentiated AL, and 5 (4% were hybrid AL. Fifty-nine (76,6% ALL belonged to phenotype B and 18 (23,4% to phenotype T. A higher survival rate was observed in phenotype B ALL patients than in phenotype T ALL and myeloid anemia patients, with a very significant difference (p< 0,001. Survival was also analyzed among the various types of phenotype B acute leukemias; a lower survival rate was observed in patients with more immature phenotypes

Women's status and child survival in West Java, Indonesia.

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Widayatun

1991-03-01

This study is introduced by a literature review of the concept of women's status, and related factors that determine infant and child mortality. Women's status is primarily defined by education, occupation and economic activity, which affect women's decision-making in the home and their independence in larger society. Cluster analysis was used to identify geographical patterns of standardized women's status variables among 20 regencies and 4 municipalities in West Java. Euclidian distances were computed between pairs of regencies across the 13 indicators. Pearson's correlations and multiple regression were used to compare associations between women's status variables and infant and child mortality, after controlling for economic development. Using data from the 1980 census, the study demonstrated large regional variations in women's status in West Java, with higher status in both the household and in society in the south and central highlands than in the north and west. Women's status is closely related to infant and child mortality, independent of the level of development. There was 1 notable exception, the municipality of Bogor, where infant and child mortality were higher than average rates for the cluster of areas with higher women's status. The results suggest that improved education, and increase in age at 1st marriage are key elements for improving the status of women in West Java.

Treatment of hepatocellular carcinoma in Child-Pugh B patients.

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Piscaglia, Fabio; Terzi, Eleonora; Cucchetti, Alessandro; Trimarchi, Chiara; Granito, Alessandro; Leoni, Simona; Marinelli, Sara; Pini, Patrizia; Bolondi, Luigi

2013-10-01

The frequency with which patients in Child-Pugh B having hepatocellular carcinoma are treated following the international guidelines according to the Barcelona Clinic Liver Cancer stages is unknown. To investigate treatment allocation for Child-Pugh B patients in different tumour stages, with particular interest in the intermediate stage. Patients were retrospectively identified from a consecutively collected series. Treatment was carried out primarily according to the guidelines. Of 86 Child-Pugh B patients, 45 were Barcelona early stage, of which the Child-Pugh scores were 46.7% B7, 33.3% B8, 20.0% B9; 27 patients were intermediate stage (B7 59.3%, B8 37.0% and B9 3.7% respectively), 12 were advanced (41.7% B7, 25.0% B8 and 33.3% B9) and 2 were terminal (both B9). In the intermediate stage, transarterial chemoembolization (or ablation) was performed in 68.8% of the Child-Pugh B7 patients, 50% of the B8 patients and 0% of the B9 patients. Median survival of the intermediate patients was 8.0 months (9.0 in B7 vs. 6.0 in -B8/B9, P=0.048). Survival of the intermediate stage patients undergoing chemoembolisation was 22.0 months in Child-Pugh B7 and 6.0 in B8. Approximately half of the intermediate stage patients can undergo locoregional treatment with good survival when in the Child-Pugh B7. The Child-Pugh numeric score impacts survival, suggesting that this tumour stage be refined. Copyright © 2013 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Parents' perceptions of child abuse and child discipline in Bangkok, Thailand.

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Auemaneekul, Naruemon

2013-12-01

Violation of a child's right to protection is an issue for children all over the world. In Thailand, the greatest barrier to intervening in child abuse issues is the lack of awareness and the positive attitudes and beliefs on using violence as a way to discipline children. The incongruent definition used amongst Thai society and relevant sectors, causes incidences to be under reported and an obstacle to child survival and development. The present study is a qualitative study and aims to explore the perceptions of child abuse and child discipline definitions amongst parents in the Bangkok Metropolitan Area in order to extend broader knowledge for interpretation, definitions and to differentiate the line between child abuse and child discipline. Focus group discussions were used as the primary data collection method and content analysis was applied as the data analysis. The results produced two categories of parents' perceptions regarding child abuse and discipline. First, was the perception of the causes of child punishment and child discipline, and second was the meaning and difference between child abuse and child discipline. The study results would be beneficial for policy makers, health and related sectors to understand the meaning of the terms used amongst family members in order to apply and promote child protection strategies in culturally appropriate

Reducing stigma and discrimination to improve child health and survival in low- and middle-income countries: promising approaches and implications for future research.

Science.gov (United States)

Nayar, Usha S; Stangl, Anne L; De Zalduondo, Barbara; Brady, Laura M

2014-01-01

The social processes of stigmatization and discrimination can have complex and devastating effects on the health and welfare of families and communities, and thus on the environments in which children live and grow. The authors conducted a literature review to identify interventions for reducing the stigma and discrimination that impede child health and well-being in low- and middle-income countries, with a focus on nutrition, HIV/AIDS, neonatal survival and infant health, and early child development. Despite broad consensus on the importance of stigma and discrimination as barriers to access and uptake of health information and services, the authors found a dearth of research and program evaluations directly assessing effective interventions in the area of child health except in the area of reducing HIV-related stigma and discrimination. While the literature demonstrates that poverty and social exclusion are often stigma-laden and impede adult access to health information and services, and to education relevant to family planning, child rearing, nutrition, health promotion, and disease prevention, the child health literature does not document direct connections between these known mediators of child health and the stigmatization of either children or their caregivers. The child health field would greatly benefit from more research to understand and address stigma as it relates to child health and well-being. The authors suggest applying a framework, adapted from the HIV stigma field, to direct future research and the adaptation of existing strategies to reduce HIV-related stigma and discrimination to address social and health-related stigmas affecting children and their families.

Reducing Stigma and Discrimination to Improve Child Health and Survival in Low- and Middle-Income Countries: Promising Approaches and Implications for Future Research

Science.gov (United States)

Nayar, Usha S.; Stangl, Anne L.; De Zalduondo, Barbara; Brady, Laura M.

2014-01-01

The social processes of stigmatization and discrimination can have complex and devastating effects on the health and welfare of families and communities, and thus on the environments in which children live and grow. The authors conducted a literature review to identify interventions for reducing the stigma and discrimination that impede child health and well-being in low- and middle-income countries, with a focus on nutrition, HIV/AIDS, neonatal survival and infant health, and early child development. Despite broad consensus on the importance of stigma and discrimination as barriers to access and uptake of health information and services, the authors found a dearth of research and program evaluations directly assessing effective interventions in the area of child health except in the area of reducing HIV-related stigma and discrimination. While the literature demonstrates that poverty and social exclusion are often stigma-laden and impede adult access to health information and services, and to education relevant to family planning, child rearing, nutrition, health promotion, and disease prevention, the child health literature does not document direct connections between these known mediators of child health and the stigmatization of either children or their caregivers. The child health field would greatly benefit from more research to understand and address stigma as it relates to child health and well-being. The authors suggest applying a framework, adapted from the HIV stigma field, to direct future research and the adaptation of existing strategies to reduce HIV-related stigma and discrimination to address social and health-related stigmas affecting children and their families. PMID:25207451

“The child can remember your voice”: parent–child communication ...

African Journals Online (AJOL)

There is a wealth of research on parent–child communication about sexual and reproductive health and rights (SRHR) and its influence on young people's sexual behaviours. However, most of it is from the global North. The aim of this study was to explore parent–child communication in three South African provinces: ...

The emergence, growth and decline of political priority for newborn survival in Bolivia.

Science.gov (United States)

Smith, Stephanie L

2014-12-01

Bolivia is expected to achieve United Nations Millennium Development Goal Four, reducing under-five child mortality by two-thirds between 2021 and 2025. However, progress on child mortality reduction masks a disproportionately slow decline in newborn deaths during the 2000s. Bolivia's neonatal mortality problem emerged on the policy agenda in the mid-1990s and grew through 2004 in relationship to political commitments to international development goals and the support of a strong policy network. Network status declined later in the decade. This study draws upon a framework for analysing determinants of political priority for global health initiatives to understand the trajectory of newborn survival policy in Bolivia from the early 1990s. A process-tracing case study methodology is used, informed by interviews with 26 individuals with close knowledge of newborn survival policy in the country and extensive document analysis. The case of newborn survival in Bolivia highlights the significance of political commitments to international development goals, health policy network characteristics (cohesion, composition, status and key actor support) and political transitions and instability in shaping agenda status, especially decline-an understudied phenomenon considering the transitory nature of policy priorities. The study suggests that the sustainability of issue attention therefore become a focal point for health policy networks and analyses. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

Did Child Restraint Laws Globally Converge? Examining 40 Years of Policy Diffusion.

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Nazif-Muñoz, José Ignacio

2015-01-01

The objective of the current study is to determine what factors have been associated with the global adoption of mandatory child restraint laws (ChRLs) since 1975. In order to determine what factors explained the global adoption of mandatory ChRLs, Weibull models were analyzed. To carry out this analysis, 170 countries were considered and the time risk corresponded to 5,146 observations for the period 1957-2013. The dependent variable was first time to adopt a ChRL. Independent variables representing global factors were the World Health Organization (WHO) and World Bank's (WB) road safety global campaign; the Geneva Convention on Road Traffic; and the United Nation's (UN) 1958 Vehicle Agreement. Independent variables representing regional factors were the creation of the European Transport Safety Council and being a Commonwealth country. Independent variables representing national factors were population; gross domestic product (GDP) per capita; political violence; existence of road safety nongovernmental organizations (NGOs); and existence of road safety agencies. Urbanization served as a control variable. To examine regional dynamics, Weibull models for Africa, Asia, Europe, North America, Latin America, the Caribbean, and the Commonwealth were also carried out. Empirical estimates from full Weibull models suggest that 2 global factors and 2 national factors are significantly associated with the adoption of this measure. The global factors explaining adoption are the WHO and WB's road safety global campaign implemented after 2004 (P policy was global. Regional analysis showed that the UN's Convention on Road Traffic was significant in Asia, the creation of the European Transport Safety Council was significant in Europe and North America, and the global campaign was in Africa. In Commonwealth and European and North American countries, the existence of road safety agencies was also positively associated with ChRL adoption. Results of the world models suggest that

Global variations in cancer survival. Study Group on Cancer Survival in Developing Countries.

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Sankaranarayanan, R; Swaminathan, R; Black, R J

1996-12-15

Population-based cancer registries from Algeria, China, Costa Rica, Cuba, India, the Philippines, and Thailand are collaborating with the International Agency for Research on Cancer in a study of cancer survival in developing countries. Comparisons with the SEER program results of the National Cancer Institute in the United States, and the EUROCARE study of survival in European countries revealed considerable differences in the survival of patients with certain tumors associated with intensive chemotherapeutic treatment regimes (Hodgkin's disease and testicular tumors), more modest differences in the survival of patients with tumors for which early diagnosis and treatment confer an improved prognosis (carcinomas of the large bowel, breast, and cervix), and only slight differences for tumors associated with poor prognosis (carcinomas of the stomach, pancreas, and lung). With limited resources to meet the challenge of the increasing incidence of cancer expected in the next few decades, health authorities in developing countries should be aware of the importance of investing in a range of cancer control activities, including primary prevention and early detection programs as well as treatment.

Association between gender inequality index and child mortality rates: a cross-national study of 138 countries.

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Brinda, Ethel Mary; Rajkumar, Anto P; Enemark, Ulrika

2015-03-09

Gender inequality weakens maternal health and harms children through many direct and indirect pathways. Allied biological disadvantage and psychosocial adversities challenge the survival of children of both genders. United Nations Development Programme (UNDP) has recently developed a Gender Inequality Index to measure the multidimensional nature of gender inequality. The global impact of Gender Inequality Index on the child mortality rates remains uncertain. We employed an ecological study to investigate the association between child mortality rates and Gender Inequality Indices of 138 countries for which UNDP has published the Gender Inequality Index. Data on child mortality rates and on potential confounders, such as, per capita gross domestic product and immunization coverage, were obtained from the official World Health Organization and World Bank sources. We employed multivariate non-parametric robust regression models to study the relationship between these variables. Women in low and middle income countries (LMICs) suffer significantly more gender inequality (p Gender Inequality Index (GII) was positively associated with neonatal (β = 53.85; 95% CI 41.61-64.09), infant (β = 70.28; 95% CI 51.93-88.64) and under five mortality rates (β = 68.14; 95% CI 49.71-86.58), after adjusting for the effects of potential confounders (p gender inequality and child mortality. We present the socio-economic problems, which sustain higher gender inequality and child mortality in LMICs. We further discuss the potential solutions pertinent to LMICs. Dissipating gender barriers and focusing on social well-being of women may augment the survival of children of both genders.

Option A improved HIV-free infant survival and mother to child HIV transmission at 9-18 months in Zimbabwe.

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Buzdugan, Raluca; Kang Dufour, Mi-Suk; McCoy, Sandra I; Watadzaushe, Constancia; Dirawo, Jeffrey; Mushavi, Angela; Mujuru, Hilda Angela; Mahomva, Agnes; Kangwende, Rugare Abigail; Hakobyan, Anna; Mugurungi, Owen; Cowan, Frances M; Padian, Nancy S

2016-06-19

We evaluated the impact of Option A on HIV-free infant survival and mother-to-child transmission (MTCT) in Zimbabwe. Serial cross-sectional community-based serosurveys. We analyzed serosurvey data collected in 2012 and 2014 among mother-infant pairs from catchment areas of 132 health facilities from five of 10 provinces in Zimbabwe. Eligible infants (alive or deceased) were born 9-18 months before each survey to mothers at least 16 years old. We randomly selected mother-infant pairs and conducted questionnaires, verbal autopsies, and collected blood samples. We estimated the HIV-free infant survival and MTCT rate within each catchment area and compared the 2012 and 2014 estimates using a paired t test and number of HIV infections averted because of the intervention. We analyzed 7249 mother-infant pairs with viable maternal specimens collected in 2012 and 8551 in 2014. The mean difference in the catchment area level MTCT between 2014 and 2012 was -5.2 percentage points (95% confidence interval = -8.1, -2.3, P Option A regimen. The association between HIV-free infant survival and duration of Option A implementation was NS at the multivariate level (P = 0.093). We found a substantial and statistically significant increase in HIV-free survival and decrease in MTCT among infants aged 9-18 months following Option A rollout in Zimbabwe. This is the only evaluation of Option A and shows the effectiveness of Option A and Zimbabwe's remarkable progress toward eMTCT.

20 CFR 725.209 - Determination of dependency; child.

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Determination of dependency; child. 725.209... Determination of dependency; child. (a) For purposes of augmenting the benefits of a miner or surviving spouse... benefits (see § 725.202 and § 725.212). An individual who is the beneficiary's child (§ 725.208) will be...

20 CFR 725.208 - Determination of relationship; child.

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Determination of relationship; child. 725.208... Determination of relationship; child. As used in this section, the term “beneficiary” means only a surviving... considered to be the child of a beneficiary if: (a) The courts of the State in which the beneficiary is...

20 CFR 410.370 - Determination of dependency; child.

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Determination of dependency; child. 410.370... dependency; child. For purposes of augmenting the benefits of a miner or widow (see § 410.510 (c)), the term....210); or, for purposes of an individual's entitlement to benefits as a surviving child (see § 410.212...

Laboring Below the Line: The New Ethnography of Poverty, Low-Wage Work, and Survival in the Global Economy.

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Munger, Frank, Ed.

This document contains 15 papers on poverty, low-wage work, and survival in the global economy, with emphasis on the following topics: identity and the meaning of work; making decisions about work, family, and welfare; and paths toward change. The following papers are included: "Identity as a Weapon in the Moral Politics of Work and…

Agenda setting for maternal survival: the power of global health networks and norms.

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Smith, Stephanie L; Rodriguez, Mariela A

2016-04-01

Nearly 300,000 women--almost all poor women in low-income countries--died from pregnancy-related complications in 2010. This represents a decline since the 1980s, when an estimated half million women died each year, but is still far higher than the aims set in the United Nations Millennium Development Goals (MDGs) at the turn of the century. The 1970s, 1980s and 1990 s witnessed a shift from near complete neglect of the issue to emergence of a network of individuals and organizations with a shared concern for reducing maternal deaths and growth in the number of organizations and governments with maternal health strategies and programmes. Maternal health experienced a marked change in agenda status in the 2000s, attracting significantly higher level attention (e.g. from world leaders) and greater resource commitments (e.g. as one issue addressed by US$40 billion in pledges to the 2010 Global Strategy for Women's and Children's Health) than ever before. Several differences between network and actor features, issue characteristics and the policy environment pre- and post-2000 help to explain the change in agenda status for global maternal mortality reduction. Significantly, a strong poverty reduction norm emerged at the turn of the century; represented by the United Nations MDGs framework, the norm set unusually strong expectations for international development actors to advance included issues. As the norm grew, it drew policy attention to the maternal health goal (MDG 5). Seeking to advance the goals agenda, world leaders launched initiatives addressing maternal and child health. New network governance and framing strategies that closely linked maternal, newborn and child health shaped the initiatives. Diverse network composition--expanding beyond a relatively narrowly focused and technically oriented group to encompass allies and leaders that brought additional resources to bear on the problem--was crucial to maternal health's rise on the agenda in the 2000s

What Is the Association between Absolute Child Poverty, Poor Governance, and Natural Disasters? A Global Comparison of Some of the Realities of Climate Change.

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Daoud, Adel; Halleröd, Björn; Guha-Sapir, Debarati

2016-01-01

The paper explores the degree to which exposure to natural disasters and poor governance (quality of governance) is associated with absolute child poverty in sixty-seven middle- and low-income countries. The data is representative for about 2.8 billion of the world´s population. Institutionalist tend to argue that many of society's ills, including poverty, derive from fragile or inefficient institutions. However, our findings show that although increasing quality of government tends to be associated with less poverty, the negative effects of natural disasters on child poverty are independent of a country´s institutional efficiency. Increasing disaster victims (killed and affected) is associated with higher rates of child poverty. A child´s estimated odds ratio to be in a state of absolute poverty increases by about a factor of 5.7 [95% CI: 1.7 to 18.7] when the average yearly toll of disasters in the child´s country increases by one on a log-10 scale. Better governance correlates with less child poverty, but it does not modify the correlation between child poverty and natural disasters. The results are based on hierarchical regression models that partition the variance into three parts: child, household, and country. The models were cross-sectional and based on observational data from the Demographic Health Survey and the Multiple Indicator Cluster Survey, which were collected at the beginning of the twenty-first millennium. The Sustainable Development Goals are a principle declaration to halt climate change, but they lack a clear plan on how the burden of this change should be shared by the global community. Based on our results, we suggest that the development agencies should take this into account and to articulate more equitable global policies to protect the most vulnerable, specifically children.

What Is the Association between Absolute Child Poverty, Poor Governance, and Natural Disasters? A Global Comparison of Some of the Realities of Climate Change.

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Adel Daoud

Full Text Available The paper explores the degree to which exposure to natural disasters and poor governance (quality of governance is associated with absolute child poverty in sixty-seven middle- and low-income countries. The data is representative for about 2.8 billion of the world´s population. Institutionalist tend to argue that many of society's ills, including poverty, derive from fragile or inefficient institutions. However, our findings show that although increasing quality of government tends to be associated with less poverty, the negative effects of natural disasters on child poverty are independent of a country´s institutional efficiency. Increasing disaster victims (killed and affected is associated with higher rates of child poverty. A child´s estimated odds ratio to be in a state of absolute poverty increases by about a factor of 5.7 [95% CI: 1.7 to 18.7] when the average yearly toll of disasters in the child´s country increases by one on a log-10 scale. Better governance correlates with less child poverty, but it does not modify the correlation between child poverty and natural disasters. The results are based on hierarchical regression models that partition the variance into three parts: child, household, and country. The models were cross-sectional and based on observational data from the Demographic Health Survey and the Multiple Indicator Cluster Survey, which were collected at the beginning of the twenty-first millennium. The Sustainable Development Goals are a principle declaration to halt climate change, but they lack a clear plan on how the burden of this change should be shared by the global community. Based on our results, we suggest that the development agencies should take this into account and to articulate more equitable global policies to protect the most vulnerable, specifically children.

World Health Organization perspectives on the contribution of the Global Alliance for Vaccines and Immunization on reducing child mortality.

Science.gov (United States)

Bustreo, F; Okwo-Bele, J-M; Kamara, L

2015-02-01

Child mortality has decreased substantially globally-from 12.6 million in 1990 to 6.3 million in 2013-due, in large part to of governments' and organisations' work, to prevent pneumonia, diarrhoea and malaria, the main causes of death in the postneonatal period. In 2012, the World Health Assembly adopted the Decade of Vaccines Global Vaccine Action Plan 2011-2020 as the current framework aimed at preventing millions of deaths through more equitable access to existing vaccines for people in all communities. The Global Alliance for Vaccines and Immunization (GAVI) plays a critical role in this effort by financing and facilitating delivery platforms for vaccines, with focused support for the achievements of improved vaccination coverage and acceleration of the uptake of WHO-recommended lifesaving new vaccines in 73 low-income countries. The GAVI Alliance has contributed substantially towards the progress of Millennium Development Goal 4 and to improving women's lives. By 2013, the GAVI Alliance had immunised 440 million additional children and averted six million future deaths from vaccine-preventable diseases in the world's poorest countries. The GAVI Alliance is on track to reducing child mortality to 68 per 1000 live births by 2015 in supported countries. This paper discusses the GAVI Alliance achievements related to Millennium Development Goal 4 and its broader contribution to improving women's lives and health systems, as well as challenges and obstacles it has faced. Additionally, it looks at challenges for the future and how it will continue its work related to reducing child mortality and improving women's health. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Perpetrators or Preventers? The Double Role of Corporations in Child Trafficking in a Global Context

Directory of Open Access Journals (Sweden)

Silvia Rodríguez-López

2018-03-01

Full Text Available In recent years, the engagement of corporations in child trafficking has become a matter of growing importance. Many corporations have adopted global subcontracting systems and complex structures that boost their productivity and profits, but might also create more opportunities for trafficking and exploitation of both adults and children. Taking this context into account, the ways in which corporations can commit child trafficking will be explored and exemplified to highlight their diversity. This paper also offers a brief overview of the response given by international and European anti-trafficking instruments concerning corporate criminal liability for child trafficking. Moreover, the mechanisms adopted by some companies to prevent trafficking and promote transparency within their supply chains will also be addressed. Overall, this paper aims to illustrate the pivotal role of corporations from two perspectives: as potential perpetrators of this serious crime, and as necessary actors to prevent it.  El compromiso empresarial sobre el tráfico infantil es un asunto de creciente importancia. Muchas corporaciones han adoptado sistemas globales de subcontrataciones y complejas estructuras que incrementan su productividad y sus beneficios, pero que también podrían crear más oportunidades para la trata y la explotación de adultos y niños. Partiendo de este contexto, se exploran y ejemplifican las diversas formas en que las corporaciones pueden cometer tráfico infantil. El artículo repasa brevemente la respuesta de los instrumentos internacionales y europeos en lo tocante a la responsabilidad penal de las corporaciones por la trata infantil, y aborda los mecanismos adoptados por algunas empresas para prevenir la trata y promover la transparencia en sus cadenas de suministro. En suma, se pretende ilustrar el rol crucial de las corporaciones desde dos puntos de vista: como potenciales perpetradores de este grave crimen y como actores necesarios

Community-Based Management of Child Malnutrition in Zambia: HIV/AIDS Infection and Other Risk Factors on Child Survival

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Stefania Moramarco

2016-07-01

Full Text Available (1 Background: Supplementary feeding programs (SFPs are effective in the community-based treatment of moderate acute malnutrition (MAM and prevention of severe acute malnutrition (SAM; (2 Methods: A retrospective study was conducted on a sample of 1266 Zambian malnourished children assisted from 2012 to 2014 in the Rainbow Project SFPs. Nutritional status was evaluated according to WHO/Unicef methodology. We performed univariate and multivariate Cox proportional risk regression to identify the main predictors of mortality. In addition, a time-to event analysis was performed to identify predictors of failure and time to cure events; (3 Results: The analysis included 858 malnourished children (19 months ± 9.4; 49.9% males. Program outcomes met international standards with a better performance for MAM compared to SAM. Cox regression identified SAM (3.8; 2.1–6.8, HIV infection (3.1; 1.7–5.5, and WAZ <−3 (3.1; 1.6–5.7 as predictors of death. Time to event showed 80% of children recovered by SAM/MAM at 24 weeks. (4 Conclusions: Preventing deterioration of malnutrition, coupled to early detection of HIV/AIDS with adequate antiretroviral treatment, and extending the duration of feeding supplementation, could be crucial elements for ensuring full recovery and improve child survival in malnourished Zambian children.

Inequality of child mortality among ethnic groups in sub-Saharan Africa.

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Brockerhoff, M; Hewett, P

2000-01-01

Accounts by journalists of wars in several countries of sub-Saharan Africa in the 1990s have raised concern that ethnic cleavages and overlapping religious and racial affiliations may widen the inequalities in health and survival among ethnic groups throughout the region, particularly among children. Paradoxically, there has been no systematic examination of ethnic inequality in child survival chances across countries in the region. This paper uses survey data collected in the 1990s in 11 countries (Central African Republic, Côte d'Ivoire, Ghana, Kenya, Mali, Namibia, Niger, Rwanda, Senegal, Uganda, and Zambia) to examine whether ethnic inequality in child mortality has been present and spreading in sub-Saharan Africa since the 1980s. The focus was on one or two groups in each country which may have experienced distinct child health and survival chances, compared to the rest of the national population, as a result of their geographical location. The factors examined to explain potential child survival inequalities among ethnic groups included residence in the largest city, household economic conditions, educational attainment and nutritional status of the mothers, use of modern maternal and child health services including immunization, and patterns of fertility and migration. The results show remarkable consistency. In all 11 countries there were significant differentials between ethnic groups in the odds of dying during infancy or before the age of 5 years. Multivariate analysis shows that ethnic child mortality differences are closely linked with economic inequality in many countries, and perhaps with differential use of child health services in countries of the Sahel region. Strong and consistent results in this study support placing the notion of ethnicity at the forefront of theories and analyses of child mortality in Africa which incorporate social, and not purely epidemiological, considerations. Moreover, the typical advantage of relatively small, clearly

Care for Child Development: an intervention in support of responsive caregiving and early child development.

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Lucas, J E; Richter, L M; Daelmans, B

2018-01-01

An estimated 43% of children younger than 5 years of age are at elevated risk of failing to achieve their human potential. In response, the World Health Organization and UNICEF developed Care for Child Development (CCD), based on the science of child development, to improve sensitive and responsive caregiving and promote the psychosocial development of young children. In 2015, the World Health Organization and UNICEF identified sites where CCD has been implemented and sustained. The sites were surveyed, and responses were followed up by phone interviews. Project reports provided information on additional sites, and a review of published studies was undertaken to document the effectiveness of CCD for improving child and family outcomes, as well as its feasibility for implementation in resource-constrained communities. The inventory found that CCD had been integrated into existing services in diverse sectors in 19 countries and 23 sites, including child survival, health, nutrition, infant day care, early education, family and child protection and services for children with disabilities. Published and unpublished evaluations have found that CCD interventions can improve child development, growth and health, as well as responsive caregiving. It has also been reported to reduce maternal depression, a known risk factor for poor pregnancy outcomes and poor child health, growth and development. Although CCD has expanded beyond initial implementation sites, only three countries reported having national policy support for integrating CCD into health or other services. Strong interest exists in many countries to move beyond child survival to protect and support optimal child development. The United Nations Sustainable Development Goals depend on children realizing their potential to build healthy and emotionally, cognitively and socially competent future generations. More studies are needed to guide the integration of the CCD approach under different conditions. Nevertheless

School Nurses Avoid Addressing Child Sexual Abuse

Science.gov (United States)

Engh Kraft, Lisbet; Rahm, GullBritt; Eriksson, Ulla-Britt

2017-01-01

Child sexual abuse (CSA) is a global public health problem with major consequences for the individual child and society. An earlier Swedish study showed that the school nurses did not initially talk about nor mention CSA as one form of child abuse. For the child to receive adequate support, the disclosure is a precondition and is dependent on an…

The effectiveness of social marketing in global health: a systematic review.

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Firestone, Rebecca; Rowe, Cassandra J; Modi, Shilpa N; Sievers, Dana

2017-02-01

Social marketing is a commonly used strategy in global health. Social marketing programmes may sell subsidized products through commercial sector outlets, distribute appropriately priced products, deliver health services through social franchises and promote behaviours not dependent upon a product or service. We aimed to review evidence of the effectiveness of social marketing in low- and middle-income countries, focusing on major areas of investment in global health: HIV, reproductive health, child survival, malaria and tuberculosis. We searched PubMed, PsycInfo and ProQuest, using search terms linking social marketing and health outcomes for studies published from 1995 to 2013. Eligible studies used experimental or quasi-experimental designs to measure outcomes of behavioural factors, health behaviours and/or health outcomes in each health area. Studies were analysed by effect estimates and for application of social marketing benchmark criteria. After reviewing 18 974 records, 125 studies met inclusion criteria. Across health areas, 81 studies reported on changes in behavioural factors, 97 studies reported on changes in behaviour and 42 studies reported on health outcomes. The greatest number of studies focused on HIV outcomes (n = 45) and took place in sub-Saharan Africa (n = 67). Most studies used quasi-experimental designs and reported mixed results. Child survival had proportionately the greatest number of studies using experimental designs, reporting health outcomes, and reporting positive, statistically significant results. Most programmes used a range of methods to promote behaviour change. Programmes with positive, statistically significant findings were more likely to apply audience insights and cost-benefit analyses to motivate behaviour change. Key evidence gaps were found in voluntary medical male circumcision and childhood pneumonia. Social marketing can influence health behaviours and health outcomes in global health; however evaluations

A web of gaps: a discussion of research strands concerning Global South families with a disabled child.

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Hunt, Xanthe; Watermeyer, Brian

2017-01-01

In low- and middle-income countries (LMICs), limited access to a range of supports means that families often carry primary responsibility for the care of a disabled child. The impact of this responsibility is poorly understood. To present a selective review, critique, and comparison of the prominent areas of research aimed at understanding families with disabled children in the Global South. We compare and critically discuss prominent bodies of literature concerning the family-disability-poverty nexus in LMICs. Three prominent bodies of literature concerned with families with a disabled child in LMICs are reviewed. These were selected based on their relative prevalence in a large review of the literature, and comprise (1) work concerning quality of life (FQOL) of families with a disabled child; (2) interventions aimed at supporting families with a disabled child in LMICs; and (3) the ways in which culture mediates the families' experience of disability. FQOL research points to poverty as a primary source of family distress, and directs our focus towards families' own expertise in coping with their circumstances. Intervention literature from LMICs highlights the family as the unit of analysis and praxis concerning disabled children, and reminds us of the contextual factors which must be considered when working with their families. Culturally oriented research on poverty, disability, and the family nuances our understanding of the locally-determined priorities of families with a disabled child in LMICs. All three research strands carry benefits, limitations and gaps. The complexity of understanding families with a disabled child in LMICs comes to the fore, directing us away from narrow application of any single theoretical or research framework. Future researchers may draw on insights provided here in creating a more integrated approach.

Modern-Day Child Slavery

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van de Glind, Hans; Kooijmans, Joost

2008-01-01

Child slavery is a contemporary global problem existing since ancient times. The concept of slavery and practices similar to it are defined in a range of international instruments. Children are particularly vulnerable to slavery-like practices, and their special plight is addressed by the UN Convention on the Rights of the Child (CRC-in particular…

Newborn survival in Bangladesh: a decade of change and future implications.

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Rubayet, Sayed; Shahidullah, Mohammad; Hossain, Altaf; Corbett, Erica; Moran, Allisyn C; Mannan, Imteaz; Matin, Ziaul; Wall, Stephen N; Pfitzer, Anne; Mannan, Ishtiaq; Syed, Uzma

2012-07-01

Remarkable progress over the last decade has put Bangladesh on track for Millennium Development Goal (MDG) 4 for child survival and achieved a 40% decline in maternal mortality. However, since neonatal deaths make up 57% of under-five mortality in the country, increased scale up and equity in programmes for neonatal survival are critical to sustain progress. We examined change for newborn survival from 2000 to 2010 considering mortality, coverage and funding indicators, as well as contextual factors. The national neonatal mortality rate has undergone an annual decline of 4.0% since 2000, reflecting greater progress than both the regional and global averages, but the mortality reduction for children 1-59 months was double this rate, at 8.6%. Examining policy and programme change, and national and donor funding for health, we identified various factors which contributed to an environment favourable to newborn survival. Locally-generated evidence combined with re-packaged global evidence, notably The Lancet Neonatal Series, has played a role, although pathways between research and policies and programme change are often complex. Several high-profile champions have had major influence. Attention for community initiatives and considerable donor funding also appear to have contributed. There have been some increases in coverage of key interventions, such as skilled attendance at birth and postnatal care, however these are low and reach less than one-third of families. Major reductions in total fertility, some change in gross national income and other contextual factors are likely to also have had an influence in mortality reduction. However, other factors such as socio-economic and geographic inequalities, frequent changes in government and pluralistic implementation structures have provided challenges. As coverage of health services increases, a notable gap remains in quality of facility-based care. Future gains for newborn survival in Bangladesh rest upon increased

Survived infancy but still vulnerable: spatial-temporal trends and risk factors for child mortality in the Agincourt rural sub-district, South Africa, 1992-2007

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Benn Sartorius

2011-05-01

Full Text Available Targeting of health interventions to poor children at highest risk of mortality are promising approaches for enhancing equity. Methods have emerged to accurately quantify excess risk and identify space-time disparities. This provides useful and detailed information for guiding policy. A spatio-temporal analysis was performed to identify risk factors associated with child (1-4 years mortality in the Agincourt sub-district, South Africa, to assess temporal changes in child mortality patterns within the study site between 1992 and 2007, and to produce all-cause and cause-specific mortality maps to identify high risk areas. Demographic, maternal, paternal and fertility-related factors, household mortality experience, distance to health care facility and socio-economic status were among the examined risk factors. The analysis was carried out by fitting a Bayesian discrete time Bernoulli survival geostatistical model using Markov chain Monte Carlo simulation. Bayesian kriging was used to produce mortality risk maps. Significant temporal increase in child mortality was observed due to the HIV epidemic. A distinct spatial risk pattern was observed with higher risk areas being concentrated in poorer settlements on the eastern part of the study area, largely inhabited by former Mozambican refugees. The major risk factors for childhood mortality, following multivariate adjustment, were mother’s death (especially when due to HIV and tuberculosis, greater number of children under 5 years living in the same household and winter season. This study demonstrates the use of Bayesian geostatistical models for accurately quantifying risk factors and producing maps of child mortality risk in a health and demographic surveillance system. According to the space-time analysis, the southeast and upper central regions of the site appear to have the highest mortality risk. The results inform policies to address health inequalities in the Agincourt sub-district and to

The Potential Impact of Animal Science Research on Global Maternal and Child Nutrition and Health: A Landscape Review.

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Odle, Jack; Jacobi, Sheila K; Boyd, R Dean; Bauman, Dale E; Anthony, Russell V; Bazer, Fuller W; Lock, Adam L; Serazin, Andrew C

2017-03-01

High among the challenges facing mankind as the world population rapidly expands toward 9 billion people by 2050 is the technological development and implementation of sustainable agriculture and food systems to supply abundant and wholesome nutrition. In many low-income societies, women and children are the most vulnerable to food insecurity, and it is unequivocal that quality nutrition during the first 1000 d of life postconception can be transformative in establishing a robust, lifelong developmental trajectory. With the desire to catalyze disruptive advancements in global maternal and child health, this landscape review was commissioned by the Bill & Melinda Gates Foundation to examine the nutritional and managerial practices used within the food-animal agricultural system that may have relevance to the challenges faced by global human health. The landscape was categorized into a framework spanning 1 ) preconception, 2 ) gestation and pregnancy, 3 ) lactation and suckling, and 4 ) postweaning and toddler phases. Twelve key findings are outlined, wherein research within the discipline of animal sciences stands to inform the global health community and in some cases identifies gaps in knowledge in which further research is merited. Notable among the findings were 1 ) the quantitative importance of essential fatty acid and amino acid nutrition in reproductive health, 2 ) the suggested application of the ideal protein concept for improving the amino acid nutrition of mothers and children, 3 ) the prospect of using dietary phytase to improve the bioavailability of trace minerals in plant and vegetable-based diets, and 4 ) nutritional interventions to mitigate environmental enteropathy. The desired outcome of this review was to identify potential interventions that may be worthy of consideration. Better appreciation of the close linkage between human health, medicine, and agriculture will identify opportunities that will enable faster and more efficient innovations

Global Health Observatory (GHO)

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... global health estimates Health Equity Monitor 3.1 Maternal mortality Maternal health 3.2 Newborn and child mortality Child ... Programmes) Quick links Contact us Frequently asked questions Employment Feedback Privacy Email scams Regions Africa Americas South- ...

Option A Improved HIV-free Infant Survival and Mother to Child HIV Transmission at 9–18 Months in Zimbabwe

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BUZDUGAN, Raluca; KANG DUFOUR, Mi-Suk; MCCOY, Sandra I; WATADZAUSHE, Constancia; DIRAWO, Jeffrey; MUSHAVI, Angela; MUJURU, Hilda Angela; MAHOMVA, Agnes; KANGWENDE, Rugare Abigail; HAKOBYAN, Anna; MUGURUNGI, Owen; COWAN, Frances M; PADIAN, Nancy S

2016-01-01

Objective We evaluated the impact of Option A on HIV-free infant survival and mother-to-child transmission (MTCT) in Zimbabwe. Design Serial cross-sectional community-based serosurveys. Methods We analyzed serosurvey data collected in 2012 and 2014 among mother-infant pairs from catchment areas (CAs) of 132 health facilities from 5 of 10 provinces in Zimbabwe. Eligible infants (alive or deceased) were born 9–18 months before each survey to mothers ≥16 years old. We randomly selected mother-infant pairs and conducted questionnaires, verbal autopsies and collected blood samples. We estimated: 1) the HIV-free infant survival and MTCT rate within each CA and compared the 2012 and 2014 estimates using a paired t-test, 2) number of HIV infections averted due to the intervention. Results We analyzed 7,249 mother-infant pairs with viable maternal specimens collected in 2012 and 8,551 in 2014. The mean difference in the CA-level MTCT between 2014 and 2012 was −5.2 percentage points (95% confidence interval (CI)=−8.1, −2.3, pOption A regimen. The association between HIV-free infant survival and duration of Option A implementation was not significant at the multivariate level (p=0.093). Conclusions We found a substantial and statistically significant increase in HIV-free survival and decrease in MTCT among infants aged 9–18 months following Option A rollout in Zimbabwe. This is the only impact evaluation of Option A and shows the effectiveness of Option A and Zimbabwe’s remarkable progress towards eMTCT. PMID:27058354

'Mixed blessings': parental religiousness, parenting, and child adjustment in global perspective.

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Bornstein, Marc H; Putnick, Diane L; Lansford, Jennifer E; Al-Hassan, Suha M; Bacchini, Dario; Bombi, Anna Silvia; Chang, Lei; Deater-Deckard, Kirby; Di Giunta, Laura; Dodge, Kenneth A; Malone, Patrick S; Oburu, Paul; Pastorelli, Concetta; Skinner, Ann T; Sorbring, Emma; Steinberg, Laurence; Tapanya, Sombat; Tirado, Liliana Maria Uribe; Zelli, Arnaldo; Alampay, Liane Peña

2017-08-01

Most studies of the effects of parental religiousness on parenting and child development focus on a particular religion or cultural group, which limits generalizations that can be made about the effects of parental religiousness on family life. We assessed the associations among parental religiousness, parenting, and children's adjustment in a 3-year longitudinal investigation of 1,198 families from nine countries. We included four religions (Catholicism, Protestantism, Buddhism, and Islam) plus unaffiliated parents, two positive (efficacy and warmth) and two negative (control and rejection) parenting practices, and two positive (social competence and school performance) and two negative (internalizing and externalizing) child outcomes. Parents and children were informants. Greater parent religiousness had both positive and negative associations with parenting and child adjustment. Greater parent religiousness when children were age 8 was associated with higher parental efficacy at age 9 and, in turn, children's better social competence and school performance and fewer child internalizing and externalizing problems at age 10. However, greater parent religiousness at age 8 was also associated with more parental control at age 9, which in turn was associated with more child internalizing and externalizing problems at age 10. Parental warmth and rejection had inconsistent relations with parental religiousness and child outcomes depending on the informant. With a few exceptions, similar patterns of results held for all four religions and the unaffiliated, nine sites, mothers and fathers, girls and boys, and controlling for demographic covariates. Parents and children agree that parental religiousness is associated with more controlling parenting and, in turn, increased child problem behaviors. However, children see religiousness as related to parental rejection, whereas parents see religiousness as related to parental efficacy and warmth, which have different

The Potential Impact of Animal Science Research on Global Maternal and Child Nutrition and Health: A Landscape Review12

Science.gov (United States)

Jacobi, Sheila K; Boyd, R Dean; Bauman, Dale E; Anthony, Russell V; Bazer, Fuller W; Lock, Adam L; Serazin, Andrew C

2017-01-01

High among the challenges facing mankind as the world population rapidly expands toward 9 billion people by 2050 is the technological development and implementation of sustainable agriculture and food systems to supply abundant and wholesome nutrition. In many low-income societies, women and children are the most vulnerable to food insecurity, and it is unequivocal that quality nutrition during the first 1000 d of life postconception can be transformative in establishing a robust, lifelong developmental trajectory. With the desire to catalyze disruptive advancements in global maternal and child health, this landscape review was commissioned by the Bill & Melinda Gates Foundation to examine the nutritional and managerial practices used within the food-animal agricultural system that may have relevance to the challenges faced by global human health. The landscape was categorized into a framework spanning 1) preconception, 2) gestation and pregnancy, 3) lactation and suckling, and 4) postweaning and toddler phases. Twelve key findings are outlined, wherein research within the discipline of animal sciences stands to inform the global health community and in some cases identifies gaps in knowledge in which further research is merited. Notable among the findings were 1) the quantitative importance of essential fatty acid and amino acid nutrition in reproductive health, 2) the suggested application of the ideal protein concept for improving the amino acid nutrition of mothers and children, 3) the prospect of using dietary phytase to improve the bioavailability of trace minerals in plant and vegetable-based diets, and 4) nutritional interventions to mitigate environmental enteropathy. The desired outcome of this review was to identify potential interventions that may be worthy of consideration. Better appreciation of the close linkage between human health, medicine, and agriculture will identify opportunities that will enable faster and more efficient innovations in global

Discourse, ideas and power in global health policy networks: political attention for maternal and child health in the millennium development goal era.

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McDougall, Lori

2016-05-18

Maternal and child health issues have gained global political attention and resources in the past 10 years, due in part to their prominence on the Millennium Development Goal agenda and the use of evidence-based advocacy by policy networks. This paper identifies key factors for this achievement, and raises questions about prospective challenges for sustaining attention in the transition to the post-2015 Sustainable Development Goals, far broader in scope than the Millennium Development Goals. This paper relies on participant observation methods and document analysis to develop a case study of the behaviours of global maternal and child health advocacy networks during 2005-2015. The development of coordinated networks of heterogeneous actors facilitated the rise in attention to maternal and child health during the past 10 years. The strategic use of epidemiological and economic evidence by these networks enabled policy attention and promoted network cohesion. The time-bound opportunity of reaching the 2015 Millennium Development Goals created a window of opportunity for joint action. As the new post-2015 goals emerge, networks seek to sustain attention by repositioning their framing of issues, network structures, and external alliances, including with networks that lay both inside and outside of the health domain. Issues rise on global policy agendas because of how ideas are constructed, portrayed and positioned by actors within given contexts. Policy networks play a critical role by uniting stakeholders to promote persuasive ideas about policy problems and solutions. The behaviours of networks in issue-framing, member-alignment, and strategic outreach can force open windows of opportunity for political attention -- or prevent them from closing.

Measuring coverage in MNCH: challenges and opportunities in the selection of coverage indicators for global monitoring.

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Jennifer Harris Requejo

Full Text Available Global monitoring of intervention coverage is a cornerstone of international efforts to improve reproductive, maternal, newborn, and child health. In this review, we examine the process and implications of selecting a core set of coverage indicators for global monitoring, using as examples the processes used by the Countdown to 2015 for Maternal, Newborn and Child Survival and the Commission on Accountability for Women's and Children's Health. We describe how the generation of data for global monitoring involves five iterative steps: development of standard indicator definitions and measurement approaches to ensure comparability across countries; collection of high-quality data at the country level; compilation of country data at the global level; organization of global databases; and rounds of data quality checking. Regular and rigorous technical review processes that involve high-level decision makers and experts familiar with indicator measurement are needed to maximize uptake and to ensure that indicators used for global monitoring are selected on the basis of available evidence of intervention effectiveness, feasibility of measurement, and data availability as well as programmatic relevance. Experience from recent initiatives illustrates the challenges of striking this balance as well as strategies for reducing the tensions inherent in the indicator selection process. We conclude that more attention and continued investment need to be directed to global monitoring, to support both the process of global database development and the selection of sets of coverage indicators to promote accountability. The stakes are high, because these indicators can drive policy and program development at the country and global level, and ultimately impact the health of women and children and the communities where they live.

Transcatheter arterial Chemoembolization for infiltrative hepatocellular carcinoma: Clinical safety and efficacy and factors influencing patient survival

International Nuclear Information System (INIS)

Han, Kichang; Kim, Jin Hyoung; Yoon, Hee Mang; Kim, Eun Joung; Gwon, Dong Il; Ko, Gi Young; Yoon, Hyun Ki; Ko, Heung Kyu

2014-01-01

To evaluate the safety and efficacy of transcatheter arterial chemoembolization (TACE) in patients with infiltrative hepatocellular carcinoma (HCC) and to identify the prognostic factors associated with patient survival. Fifty two patients who underwent TACE for infiltrative HCC were evaluated between 2007 and 2010. The maximum diameter of the tumors ranged from 7 cm to 22 cm (median 15 cm). Of 46 infiltrative HCC patients with portal vein tumor thrombosis, 32 patients received adjuvant radiation therapy for portal vein tumor thrombosis after TACE. The tumor response by European Association for the Study of the Liver criteria was partial in 18%, stable in 47%, and progressive in 35% of the patients. The median survival time was 5.7 months (Kaplan-Meier analysis). The survival rates were 48% at six months, 25% at one year, and 12% at two years. In the multivariable Cox regression analysis, Child-Pugh class (p = 0.02), adjuvant radiotherapy (p 0.003) and tumor response after TACE (p = 0.004) were significant factors associated with patient survival. Major complications occurred in nine patients. The major complication rate was significantly higher in patients with Child-Pugh B than in patients with Child-Pugh A (p = 0.049, x 2 test). Transcatheter arterial chemoembolization can be a safe treatment option in infiltrative HCC patients with Child Pugh class A. Child Pugh class A, radiotherapy for portal vein tumor thrombosis after TACE and tumor response are good prognostic factors for an increased survival after TACE in patients with infiltrative HCCs.

Parental Incarceration and Child Mortality in Denmark

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Andersen, Signe Hald; Lee, Hedwig; Karlson, Kristian Bernt

2014-01-01

Objectives. We used Danish registry data to examine the association between parental incarceration and child mortality risk. Methods. We used a sample of all Danish children born in 1991 linked with parental information. We conducted discrete-time survival analysis separately for boys (n = 30 146) and girls (n = 28 702) to estimate the association of paternal and maternal incarceration with child mortality, controlling for parental sociodemographic characteristics. We followed the children until age 20 years or death, whichever came first. Results. Results indicated a positive association between paternal and maternal imprisonment and male child mortality. Paternal imprisonment was associated with lower child mortality risks for girls. The relationship between maternal imprisonment and female child mortality changed directions depending on the model, suggesting no clear association. Conclusions. These results indicate that the incarceration of a parent may influence child mortality but that it is important to consider the gender of both the child and the incarcerated parent. PMID:24432916

Child health, child education.

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Rao, A R

1989-06-01

Although child survival programs may help to increase the life span of poor children in developing countries such as India, the quality of life will remain unchanged unless the value of involving children in health education efforts is recognized. The primary health care strategy seeks to involve children and communities in making decisions and taking actions to improve their health. Children can be engaged in the learning process through activities such as helping to care for younger siblings, educating children of their own age who are not attending school, and spreading preventive health messages to their homes and communities. Numerous studies have confirmed that children are easily motivated to play such roles and have the desire to transfer their knowledge to others; however, it is essential that health education messages are appropriate for the level of the child. Specific messages with tested effectiveness in child-to-child programs include accident prevention, dental hygiene, neighborhood hygiene, use of oral rehydration in cases of diarrhea, recognition of signs of major illness, care of sick children, use of play and mental stimulation to enhance children's development, and the making of toys and games to aid growth. Children can further be instructed to identify peers with sight and hearing problems as well as those with nutritional deficiencies. In the Malvani Project in Bombay, children are given responsibility for the health care of 3-4 families in their neighborhood. In the NCERT Project in New Delhi, children are organizing artistic exhibitions and plays to convey health messages to their peers who are not in school. Also in New Delhi, the VHAI Project has enlisted children in campaigns to prevent diarrhea and dehydration, smoking, and drug use.

Relationship between birth spacing, child maltreatment, and child behavior and development outcomes among at-risk families.

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Crowne, Sarah Shea; Gonsalves, Kay; Burrell, Lori; McFarlane, Elizabeth; Duggan, Anne

2012-10-01

Prior research indicates that closely spaced births are associated with poor outcomes for the mother and subsequent child. Limited research has focused on outcomes for the index child (the child born immediately prior to a subsequent child in a birth interval). The objectives are to assess the association of short birth intervals in at-risk families with: (1) indicators of harsh and neglectful parenting behaviors towards the index child, including substantiated maltreatment reports across 6 years; and (2) the index child's behavior and development in first grade. This is a longitudinal study of 658 women screened to be at-risk for child maltreatment. Twenty percent of women had a rapid repeat birth (RRB), defined as the birth of a subsequent child within 24 months of the index child. Generalized estimating equations, survival analyses, and linear and logistic regression models were used to assess the associations between RRB and index child outcomes. Women with an RRB were more likely than those without an RRB to report neglectful parenting of the index child. Children of mothers with an RRB were more likely than children of mothers without an RRB to have more behavioral problems and lower cognitive functioning in first grade. This study is among the first to focus on the associations of birth spacing with maltreatment, behavior and development outcomes in the index child. Future work regarding the effects of birth spacing should include a focus on the index child.

Child Domestic Labour: A Modern Form of Slavery

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Blagbrough, Jonathan

2008-01-01

This article provides a global scene for the scope of child domestic labour and explores the inter-woven relationship between the practice and slavery, as well as the consequences for this uniquely vulnerable group of child workers. In doing so, it seeks to dispel the myths that child domestic work is a safe form of employment for girls…

Are stepparents always evil? Parental death, remarriage, and child survival in demographically saturated Krummhörn (1720-1859) and expanding Québec (1670-1750).

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Willführ, Kai P; Gagnon, Alain

2013-01-01

Parental death precipitates a cascade of events leading to more or less detrimental exposures, from the sudden and dramatic interruption of parental care to cohabitation with stepparents and siblings in a recomposed family. This article compares the effect of early parental loss on child survival in the past in the Krummhörn region of East Frisia (Germany) and among the French Canadian settlers of the Saint Lawrence Valley (Québec, Canada). The Krummhörn region was characterized by a saturated habitat, while the opportunities for establishing a new family were virtually unlimited for the French Canadian settlers. Early parental loss had quite different consequences in these dissimilar environments. Event history analyses with time-varying specification of family structure are used on a sample of 7,077 boys and 6,906 girls born between 1720 and 1859 in the Krummhörn region and 31,490 boys and 33,109 girls whose parents married between 1670 and 1750 in Québec. Results indicate that in both populations, parental loss is associated with increased infant and child mortality. Maternal loss has a universal and consistent effect for both sexes, while the impact of paternal loss is less easy to establish and interpret. On the other hand, the effect of the remarriage of the surviving spouse is population-specific: the mother's remarriage has no effect in Krummhörn, while it is beneficial in Québec. In contrast, the father's remarriage in Krummhörn dramatically reduces the survival chances of the children born from his former marriage, while such an effect is not seen for Québec. These population-specific effects appear to be driven by the availability of resources and call into question the universality of the "Cinderella" effect.

Child Protection, Care and Education in Vietnam from Now up to the Year 2000.

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Son, Ngo Quang

1994-01-01

Provides an overview of child welfare and early childhood education programs in Vietnam, including statistics on infant mortality, child survival, vaccination ratios, birth weight trends, and rates of disease and disability. Describes government programs to promote child welfare; early childhood (creche) education; kindergarten; programs for…

The history and development of NASA survival equipment.

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Radnofsky, M. I.

1972-01-01

A research and development program on survival equipment was begun in early 1960 with the Mercury Program. The Mercury survival kit is discussed together with Gemini survival equipment, and Apollo I survival equipment. A study program is conducted to assess potential survival problems that may be associated with future space flights landing in polar waters. Survival kit requirements for applications on the Skylab program are also considered. Other investigations are concerned with the design of a global survival kit in connection with Space Shuttle missions.

Measles Vaccination Supports Millennium Development Goal 4: Increasing Coverage and Increasing Child Survival in Northern Ghana, 1996–2012

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Paul Welaga

2018-02-01

Full Text Available BackgroundMeasles vaccine (MV administered as the last vaccine after the third dose of diphtheria-tetanus-pertussis (DTP may be associated with better child survival unrelated to prevention of measles infection. Other studies have shown that MV administered after DTP was more beneficial and was associated with lower mortality compared with DTP administered after MV or DTP administered simultaneously with MV. We compared the difference in mortality between measles vaccinated after DTP3 and measles-unvaccinated children in Navrongo, Ghana.MethodsThis was a follow-up study involving annual cohort of children aged 9–23 months from 1996 to 2012. We assessed survival in relation to the measles vaccination status within the first 12 months from interview date and until 5 years of age using Cox proportional hazards models.ResultsIn all, 38,333 children were included in the study. The proportion of children vaccinated with MV-after-DTP3 increased from 45% in 1996 to 95% in 2012. The adjusted hazard ratio (HR for measles unvaccinated compared with MV-after-DTP3 vaccinated children was 1.38 (1.15–1.66 in the first 12 months after assessment of vaccination status and 1.22 (1.05–1.41 with follow-up to 5 years of age. The national immunization days campaigns with oral polio vaccine or MV might have reduced the effect of being MV-after-DTP3 vaccinated vs MV-unvaccinated. For 12 months of follow-up, the HR before a campaign for MV-unvaccinated children was 1.63 (1.23–2.17 compared to those who received MV-after-DTP3. After the campaign, the HR reduced to 1.23 (0.97–1.54. Stratifying the analysis by sex, measles-unvaccinated boys had a HR of 1.69 (1.33–2.61 compared to measles-unvaccinated girls who had a HR 1.06 (0.79–1.40 during 1-year follow-up. In 1989, only 7% of children in the area had received MV-after-DTP3; the increase in MV-after-DTP3 coverage from 1989 to 2012 may have lowered mortality rate among children aged 9 months to

Factors During Pregnancy, Delivery and Birth Affecting Global Quality of Life of the Adult Child at Long-term Follow-up. Results from the Prospective Copenhagen Perinatal Birth Cohort 1959-61

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Søren Ventegodt

2005-01-01

Full Text Available This paper presents a prospective cohort study, where we explore associations between pregnancy, delivery and the global quality of life (QOL of the adult child 31-33 years later. The data is from the Copenhagen Perinatal Birth Cohort 1959-61 using two sets of questionnaires send to 7,222 persons: one filled out by physicians during pregnancy and delivery, while the follow-up questionnaire was completed by the adult children 31-33 years later. The main outcome measures were objective factors describing pregnancy and delivery along with global quality of life, including: Well-being, life satisfaction, happiness, fulfilment of needs, experience of life's temporal and spatial domains, expression of life's potentials and objective measures. Results showed two main factors in pregnancy that seemed to be associated with a reduced quality of life for the child 31-33 years later: the mother's smoking habits and the mother's medication–especially painkillers and different psychopharmacological drugs with the association being most prevalent early in pregnancy. Considering what can and do go wrong during the various stages of labour and delivery and considering how few connections we found between the factors examined and the later global QOL, it seems that the child is remarkably resilient to external influences during pregnancy and delivery concerned with global QOL, as an adult.

Mother and Child Health International Research Network | IDRC ...

International Development Research Centre (IDRC) Digital Library (Canada)

Building a virtual global research institute to support maternal and child health ... Learning Initiatives for Network Economies in Asia (LIRNEasia) : Building ... to information and communication technology (ICT) initiatives through its global ...

Kin and birth order effects on male child mortality: three East Asian populations, 1716-1945.

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Dong, Hao; Manfredini, Matteo; Kurosu, Satomi; Yang, Wenshan; Lee, James Z

2017-03-01

Human child survival depends on adult investment, typically from parents. However, in spite of recent research advances on kin influence and birth order effects on human infant and child mortality, studies that directly examine the interaction of kin context and birth order on sibling differences in child mortality are still rare. Our study supplements this literature with new findings from large-scale individual-level panel data for three East Asian historical populations from northeast China (1789-1909), northeast Japan (1716-1870), and north Taiwan (1906-1945), where preference for sons and first-borns is common. We examine and compare male child mortality risks by presence/absence of co-resident parents, grandparents, and other kin, as well as their interaction effects with birth order. We apply discrete-time event-history analysis on over 172,000 observations of 69,125 boys aged 1-9 years old. We find that in all three populations, while the presence of parents is important for child survival, it is more beneficial to first/early-borns than to later-borns. Effects of other co-resident kin are however null or inconsistent between populations. Our findings underscore the importance of birth order in understanding how differential parental investment may produce child survival differentials between siblings.

Infant and Child Mortality in India in the Last Two Decades: A Geospatial Analysis

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Singh, Abhishek; Pathak, Praveen Kumar; Chauhan, Rajesh Kumar; Pan, William

2011-01-01

Background Studies examining the intricate interplay between poverty, female literacy, child malnutrition, and child mortality are rare in demographic literature. Given the recent focus on Millennium Development Goals 4 (child survival) and 5 (maternal health), we explored whether the geographic regions that were underprivileged in terms of wealth, female literacy, child nutrition, or safe delivery were also grappling with the elevated risk of child mortality; whether there were any spatial outliers; whether these relationships have undergone any significant change over historical time periods. Methodology The present paper attempted to investigate these critical questions using data from household surveys like NFHS 1992–1993, NFHS 1998–1999 and DLHS 2002–2004. For the first time, we employed geo-spatial techniques like Moran's-I, univariate LISA, bivariate LISA, spatial error regression, and spatiotemporal regression to address the research problem. For carrying out the geospatial analysis, we classified India into 76 natural regions based on the agro-climatic scheme proposed by Bhat and Zavier (1999) following the Census of India Study and all estimates were generated for each of the geographic regions. Result/Conclusions This study brings out the stark intra-state and inter-regional disparities in infant and under-five mortality in India over the past two decades. It further reveals, for the first time, that geographic regions that were underprivileged in child nutrition or wealth or female literacy were also likely to be disadvantaged in terms of infant and child survival irrespective of the state to which they belong. While the role of economic status in explaining child malnutrition and child survival has weakened, the effect of mother's education has actually become stronger over time. PMID:22073208

Child labour: a public health issue.

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Gulzar, Saleema Aziz; Vertejee, Samina; Pirani, Laila

2009-11-01

Child labour is a global practice and has many negative outcomes. According to International Labour Organization, child labour is the important source of child exploitation and child abuse in the world today. The Human Rights Commission of Pakistan has estimated the number of Pakistani working children to be around 11-12 millions, out of which, at least, half the children are under the age of ten years. It portrays the society's attitude towards child care. It is therefore, essential to break this vicious cycle and hence, enable the society to produce healthy citizens. This article analyzes the determinants of child labour in the Pakistani context and its implications for child's life, in specific, and for the nation, in general, utilizing the model developed by Clemen-stone & McGuire (1991). Since this practice has complex web of causation, a multidisciplinary approach is required to combat this issue through proposed recommendations.

Child Health and Survival in a Changing World.

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Denno, Donna M; Paul, Shadae L

2017-08-01

Ninety-nine percent of the 5.9 million annual child deaths occur in low and middle-income countries. Undernutrition underlies 45% of deaths. Determinants include access to care, maternal education, and absolute and relative poverty. Socio-political-economic factors and policies tremendously influence health and their determinants. Most deaths can be prevented with interventions that are currently available and recommended for widespread implementation. Millennium Development Goal 4 was not achieved. Sustainable Development Goal 3.2 presents an even more ambitious target and opportunity to save millions of lives; and requires attention to scaling up interventions, especially among the poorest and most vulnerable children. Copyright © 2017 Elsevier Inc. All rights reserved.

Child and Adolescent Health From 1990 to 2015: Findings From the Global Burden of Diseases, Injuries, and Risk Factors 2015 Study.

Science.gov (United States)

Kassebaum, Nicholas; Kyu, Hmwe Hmwe; Zoeckler, Leo; Olsen, Helen Elizabeth; Thomas, Katie; Pinho, Christine; Bhutta, Zulfiqar A; Dandona, Lalit; Ferrari, Alize; Ghiwot, Tsegaye Tewelde; Hay, Simon I; Kinfu, Yohannes; Liang, Xiaofeng; Lopez, Alan; Malta, Deborah Carvalho; Mokdad, Ali H; Naghavi, Mohsen; Patton, George C; Salomon, Joshua; Sartorius, Benn; Topor-Madry, Roman; Vollset, Stein Emil; Werdecker, Andrea; Whiteford, Harvey A; Abate, Kalkidan Hasen; Abbas, Kaja; Damtew, Solomon Abrha; Ahmed, Muktar Beshir; Akseer, Nadia; Al-Raddadi, Rajaa; Alemayohu, Mulubirhan Assefa; Altirkawi, Khalid; Abajobir, Amanuel Alemu; Amare, Azmeraw T; Antonio, Carl A T; Arnlov, Johan; Artaman, Al; Asayesh, Hamid; Avokpaho, Euripide Frinel G Arthur; Awasthi, Ashish; Ayala Quintanilla, Beatriz Paulina; Bacha, Umar; Betsu, Balem Demtsu; Barac, Aleksandra; Bärnighausen, Till Winfried; Baye, Estifanos; Bedi, Neeraj; Bensenor, Isabela M; Berhane, Adugnaw; Bernabe, Eduardo; Bernal, Oscar Alberto; Beyene, Addisu Shunu; Biadgilign, Sibhatu; Bikbov, Boris; Boyce, Cheryl Anne; Brazinova, Alexandra; Hailu, Gessessew Bugssa; Carter, Austin; Castañeda-Orjuela, Carlos A; Catalá-López, Ferrán; Charlson, Fiona J; Chitheer, Abdulaal A; Choi, Jee-Young Jasmine; Ciobanu, Liliana G; Crump, John; Dandona, Rakhi; Dellavalle, Robert P; Deribew, Amare; deVeber, Gabrielle; Dicker, Daniel; Ding, Eric L; Dubey, Manisha; Endries, Amanuel Yesuf; Erskine, Holly E; Faraon, Emerito Jose Aquino; Faro, Andre; Farzadfar, Farshad; Fernandes, Joao C; Fijabi, Daniel Obadare; Fitzmaurice, Christina; Fleming, Thomas D; Flor, Luisa Sorio; Foreman, Kyle J; Franklin, Richard C; Fraser, Maya S; Frostad, Joseph J; Fullman, Nancy; Gebregergs, Gebremedhin Berhe; Gebru, Alemseged Aregay; Geleijnse, Johanna M; Gibney, Katherine B; Gidey Yihdego, Mahari; Ginawi, Ibrahim Abdelmageem Mohamed; Gishu, Melkamu Dedefo; Gizachew, Tessema Assefa; Glaser, Elizabeth; Gold, Audra L; Goldberg, Ellen; Gona, Philimon; Goto, Atsushi; Gugnani, Harish Chander; Jiang, Guohong; Gupta, Rajeev; Tesfay, Fisaha Haile; Hankey, Graeme J; Havmoeller, Rasmus; Hijar, Martha; Horino, Masako; Hosgood, H Dean; Hu, Guoqing; Jacobsen, Kathryn H; Jakovljevic, Mihajlo B; Jayaraman, Sudha P; Jha, Vivekanand; Jibat, Tariku; Johnson, Catherine O; Jonas, Jost; Kasaeian, Amir; Kawakami, Norito; Keiyoro, Peter N; Khalil, Ibrahim; Khang, Young-Ho; Khubchandani, Jagdish; Ahmad Kiadaliri, Aliasghar A; Kieling, Christian; Kim, Daniel; Kissoon, Niranjan; Knibbs, Luke D; Koyanagi, Ai; Krohn, Kristopher J; Kuate Defo, Barthelemy; Kucuk Bicer, Burcu; Kulikoff, Rachel; Kumar, G Anil; Lal, Dharmesh Kumar; Lam, Hilton Y; Larson, Heidi J; Larsson, Anders; Laryea, Dennis Odai; Leung, Janni; Lim, Stephen S; Lo, Loon-Tzian; Lo, Warren D; Looker, Katharine J; Lotufo, Paulo A; Magdy Abd El Razek, Hassan; Malekzadeh, Reza; Markos Shifti, Desalegn; Mazidi, Mohsen; Meaney, Peter A; Meles, Kidanu Gebremariam; Memiah, Peter; Mendoza, Walter; Abera Mengistie, Mubarek; Mengistu, Gebremichael Welday; Mensah, George A; Miller, Ted R; Mock, Charles; Mohammadi, Alireza; Mohammed, Shafiu; Monasta, Lorenzo; Mueller, Ulrich; Nagata, Chie; Naheed, Aliya; Nguyen, Grant; Nguyen, Quyen Le; Nsoesie, Elaine; Oh, In-Hwan; Okoro, Anselm; Olusanya, Jacob Olusegun; Olusanya, Bolajoko O; Ortiz, Alberto; Paudel, Deepak; Pereira, David M; Perico, Norberto; Petzold, Max; Phillips, Michael Robert; Polanczyk, Guilherme V; Pourmalek, Farshad; Qorbani, Mostafa; Rafay, Anwar; Rahimi-Movaghar, Vafa; Rahman, Mahfuzar; Rai, Rajesh Kumar; Ram, Usha; Rankin, Zane; Remuzzi, Giuseppe; Renzaho, Andre M N; Roba, Hirbo Shore; Rojas-Rueda, David; Ronfani, Luca; Sagar, Rajesh; Sanabria, Juan Ramon; Kedir Mohammed, Muktar Sano; Santos, Itamar S; Satpathy, Maheswar; Sawhney, Monika; Schöttker, Ben; Schwebel, David C; Scott, James G; Sepanlou, Sadaf G; Shaheen, Amira; Shaikh, Masood Ali; She, June; Shiri, Rahman; Shiue, Ivy; Sigfusdottir, Inga Dora; Singh, Jasvinder; Silpakit, Naris; Smith, Alison; Sreeramareddy, Chandrashekhar; Stanaway, Jeffrey D; Stein, Dan J; Steiner, Caitlyn; Sufiyan, Muawiyyah Babale; Swaminathan, Soumya; Tabarés-Seisdedos, Rafael; Tabb, Karen M; Tadese, Fentaw; Tavakkoli, Mohammad; Taye, Bineyam; Teeple, Stephanie; Tegegne, Teketo Kassaw; Temam Shifa, Girma; Terkawi, Abdullah Sulieman; Thomas, Bernadette; Thomson, Alan J; Tobe-Gai, Ruoyan; Tonelli, Marcello; Tran, Bach Xuan; Troeger, Christopher; Ukwaja, Kingsley N; Uthman, Olalekan; Vasankari, Tommi; Venketasubramanian, Narayanaswamy; Vlassov, Vasiliy Victorovich; Weiderpass, Elisabete; Weintraub, Robert; Gebrehiwot, Solomon Weldemariam; Westerman, Ronny; Williams, Hywel C; Wolfe, Charles D A; Woodbrook, Rachel; Yano, Yuichiro; Yonemoto, Naohiro; Yoon, Seok-Jun; Younis, Mustafa Z; Yu, Chuanhua; Zaki, Maysaa El Sayed; Zegeye, Elias Asfaw; Zuhlke, Liesl Joanna; Murray, Christopher J L; Vos, Theo

2017-06-01

Comprehensive and timely monitoring of disease burden in all age groups, including children and adolescents, is essential for improving population health. To quantify and describe levels and trends of mortality and nonfatal health outcomes among children and adolescents from 1990 to 2015 to provide a framework for policy discussion. Cause-specific mortality and nonfatal health outcomes were analyzed for 195 countries and territories by age group, sex, and year from 1990 to 2015 using standardized approaches for data processing and statistical modeling, with subsequent analysis of the findings to describe levels and trends across geography and time among children and adolescents 19 years or younger. A composite indicator of income, education, and fertility was developed (Socio-demographic Index [SDI]) for each geographic unit and year, which evaluates the historical association between SDI and health loss. Global child and adolescent mortality decreased from 14.18 million (95% uncertainty interval [UI], 14.09 million to 14.28 million) deaths in 1990 to 7.26 million (95% UI, 7.14 million to 7.39 million) deaths in 2015, but progress has been unevenly distributed. Countries with a lower SDI had a larger proportion of mortality burden (75%) in 2015 than was the case in 1990 (61%). Most deaths in 2015 occurred in South Asia and sub-Saharan Africa. Global trends were driven by reductions in mortality owing to infectious, nutritional, and neonatal disorders, which in the aggregate led to a relative increase in the importance of noncommunicable diseases and injuries in explaining global disease burden. The absolute burden of disability in children and adolescents increased 4.3% (95% UI, 3.1%-5.6%) from 1990 to 2015, with much of the increase owing to population growth and improved survival for children and adolescents to older ages. Other than infectious conditions, many top causes of disability are associated with long-term sequelae of conditions present at birth (eg

Credit where credit is due: Pakistan?s role in reducing the global burden of reproductive, maternal, newborn, and child health (RMNCH)

OpenAIRE

Ghaffar, Abdul; Qazi, Shamim; Shah, Iqbal

2015-01-01

Factors contributing to Pakistan?s poor progress in reducing reproductive, maternal, newborn, and child health (RMNCH) include its low level of female literacy, gender inequity, political challenges, and extremism along with its associated relentless violence; further, less than 1% of Pakistan?s GDP is allocated to the health sector. However, despite these disadvantages, Pakistani researchers have been able to achieve positive contributions towards RMNCH-related global knowledge and evidence ...

Percutaneous radiofrequency ablation for early hepatocellular carcinoma: Risk factors for survival

Science.gov (United States)

Kikuchi, Luciana; Menezes, Marcos; Chagas, Aline L; Tani, Claudia M; Alencar, Regiane SSM; Diniz, Marcio A; Alves, Venâncio AF; D’Albuquerque, Luiz Augusto Carneiro; Carrilho, Flair José

2014-01-01

AIM: To evaluate outcomes of radiofrequency ablation (RFA) therapy for early hepatocellular carcinoma (HCC) and identify survival- and recurrence-related factors. METHODS: Consecutive patients diagnosed with early HCC by computed tomography (CT) or magnetic resonance imaging (MRI) (single nodule of ≤ 5 cm, or multi- (up to 3) nodules of ≤ 3 cm each) and who underwent RFA treatment with curative intent between January 2010 and August 2011 at the Instituto do Câncer do Estado de São Paulo, Brazil were enrolled in the study. RFA of the liver tumors (with 1.0 cm ablative margin) was carried out under CT-fluoro scan and ultrasonic image guidance of the percutaneous ablation probes. Procedure-related complications were recorded. At 1-mo post-RFA and 3-mo intervals thereafter, CT and MRI were performed to assess outcomes of complete response (absence of enhancing tissue at the tumor site) or incomplete response (enhancing tissue remaining at the tumor site). Overall survival and disease-free survival rates were estimated by the Kaplan-Meier method and compared by the log rank test or simple Cox regression. The effect of risk factors on survival was assessed by the Cox proportional hazard model. RESULTS: A total of 38 RFA sessions were performed during the study period on 34 patients (age in years: mean, 63 and range, 49-84). The mean follow-up time was 22 mo (range, 1-33). The study population showed predominance of male sex (76%), less severe liver disease (Child-Pugh A, n = 26; Child-Pugh B, n = 8), and single tumor (65%). The maximum tumor diameters ranged from 10 to 50 mm (median, 26 mm). The initial (immediately post-procedure) rate of RFA-induced complete tumor necrosis was 90%. The probability of achieving complete response was significantly greater in patients with a single nodule (vs patients with multi-nodules, P = 0.04). Two patients experienced major complications, including acute pulmonary edema (resolved with intervention) and intestinal perforation

Infant and Young Child Feeding Behavior among Working Mothers in India: Implications for Global Health Policy and Practice

Directory of Open Access Journals (Sweden)

Vinay Kumar, MD, MPH

2014-12-01

Full Text Available Background: The National Guidelines on Infant and Young Child Feeding introduced in 2006 recommended the initiation of breastfeeding immediately after birth, preferably within one hour; exclusive breastfeeding for the first six months; appropriate and adequate complementary feeding from six months of age while continuing breastfeeding; and continued breastfeeding up to the age of two years or beyond. Working women in India constitute a dominant and expanding pool of mothers. There is paucity of research focused on feeding behavior within this group. Method: One hundred and fifty working women answered a structured questionnaire about their demographics, birth history, levels of awareness and practice of feeding guidelines, and perceptions about breastfeeding and counseling. Data analysis was carried out using Microsoft Excel and the Statistical Package for the Social Sciences. Results: Majority of participants belonged to 21-39 years age group, had nuclear families, received college education, and delivered in institutional setups. Gaps were observed between the mother’s levels of awareness and practice for different tenets of national guidelines. Higher education, longer maternity leave, higher income, and utilization of counseling services facilitated adoption of optimal feeding behavior. Most women perceived breast milk to be superior to any alternative and favored provision of counseling during last trimester. Conclusions and Global Health Implications: Counseling women on optimal feeding behavior is a potential intervention to convert its awareness into actual practice. The lessons learned from this study can help refine both national and global Mother and Child Health policies and programs.

"Who Cares for the Children?" Lessons from a Global Perspective of Child Care Policy

Science.gov (United States)

Lokteff, Maegan; Piercy, Kathleen W.

2012-01-01

We present the argument that the meaning of child care and the policies that address it are explicitly linked with national ideologies, work force participation, economic success, and child outcomes. The relationship between family and child care policies is cyclical in nature, with a nation's ideology and vision of family often driving child care…

Globalization

DEFF Research Database (Denmark)

Plum, Maja

Globalization is often referred to as external to education - a state of affair facing the modern curriculum with numerous challenges. In this paper it is examined as internal to curriculum; analysed as a problematization in a Foucaultian sense. That is, as a complex of attentions, worries, ways...... of reasoning, producing curricular variables. The analysis is made through an example of early childhood curriculum in Danish Pre-school, and the way the curricular variable of the pre-school child comes into being through globalization as a problematization, carried forth by the comparative practices of PISA...

Global health in conflict. Understanding opposition to vitamin A supplementation in India.

Science.gov (United States)

Wallace, Sarah K

2012-07-01

Vitamin A supplementation is a public health intervention that clinical trials have suggested can significantly improve child survival in the developing world. Yet, prominent scientists in India have questioned its scientific validity, opposed its implementation, and accused its advocates of corruption and greed. It is ironic that these opponents were among the pioneers of populationwide vitamin A supplementation for ocular health. Historically, complex interests have shaped vitamin A supplementation resistance in India. Local social and nutritional revolutions and shifting international paradigms of global health have played a role. Other resistance movements in Indian history, such as those in response to campaigns for bacillus Calmette-Guérin and novel vaccines, have been structured around similar themes. Public health resistance is shaped by the cultural and political context in which it develops. Armed with knowledge of the history of a region and patterns of past resistance, public health practitioners can better understand how to negotiate global health conflicts.

KINET: a social marketing programme of treated nets and net treatment for malaria control in Tanzania, with evaluation of child health and long-term survival.

Science.gov (United States)

Schellenberg, J R; Abdulla, S; Minja, H; Nathan, R; Mukasa, O; Marchant, T; Mponda, H; Kikumbih, N; Lyimo, E; Manchester, T; Tanner, M; Lengeler, C

1999-01-01

We present a large-scale social marketing programme of insecticide-treated nets in 2 rural districts in southwestern Tanzania (population 350,000) and describe how the long-term child health and survival impact will be assessed. Formative and market research were conducted in order to understand community perceptions, knowledge, attitudes and practice with respect to the products to be socially marketed. We identified Zuia Mbu (Kiswahili for 'prevent mosquitoes') as a suitable brand name for both treated nets and single-dose insecticide treatment sachets. A mix of public and private sales outlets is used for distribution. In the first stage of a stepped introduction 31 net agents were appointed and trained in 18 villages: 15 were shop owners, 14 were village leaders, 1 was a parish priest and 1 a health worker. For net treatment 37 young people were appointed in the same villages and trained as agents. Further institutions in both districts such as hospitals, development projects and employers were also involved in distribution. Promotion for both products was intense and used a variety of channels. A total of 22,410 nets and 8072 treatments were sold during the first year: 18 months after launching, 46% of 312 families with children aged under 5 years reported that their children were sleeping under treated nets. A strong evaluation component in over 50,000 people allows assessment of the long-term effects of insecticide-treated nets on child health and survival, anaemia in pregnancy, and the costs of the intervention. This evaluation is based on cross-sectional surveys, and case-control and cohort studies.

Moving from Survival to Healthy Survival through Child Health Screening and Early Intervention Services Under Rashtriya Bal Swasthya Karyakram (RBSK).

Science.gov (United States)

Singh, Arun K; Kumar, Rakesh; Mishra, C K; Khera, Ajay; Srivastava, Anubhav

2015-11-01

For negating the impact of early adversities on the development and ensuring a healthy, dynamic future for all children, Ministry of Health and Family Welfare in 2013 launched a programme for child health screening and early intervention services as Rashtriya Bal Swasthya Karyakram (RBSK) which aims to improve the quality of life with special focus on improving cognition and survival outcomes for "at risk" children. It has a systemic approach of prevention, early identification and management of 30 health conditions distributed under 4Ds: Defects at birth, Diseases, Deficiencies and Developmental delays including Disabilities spread over birth to 18 y of age in a holistic manner. There is a dedicated 4 member Mobile Health team for community screening and a dedicated 14 member team at District Early Intervention Center (DEIC) for comprehensive management. Existing health infrastructure and personnel are also integrated and utilized in this endeavor. Defects at birth are screened at Delivery points, home visits by accredited social health activist (ASHA), Anganwadi centers and at schools. Developmental delays are evaluated at DEIC through a multidisciplinary team with interdisciplinary approach. Five thousand four hundred eighteen dedicated Mobile Health teams have screened a total of 12.19 crore children till Dec.14. From April to Dec. 2014, 4.20 crore children were screened, of which birth to 6-y-old children were 2.13 crore while 2.07 crore were from 6 to 18 y. 17.7 lakh children were referred to tertiary centers and 6.2 lakh availed tertiary care. 50.7 lakhs were found positive for 4Ds; 1.35 lakhs were birth defects. RBSK is a step towards universal health care for free assured services.

Risk Assessment: How Crucial in Determining Child's Susceptibility ...

African Journals Online (AJOL)

There is a global concern to curtail the prevalence of child abuse. However, certain difficulties are posed in meeting this objective in Nigeria, because child social workers often lack the practical or theoretical skills for detecting those children that are susceptible to abuse and thus, in need of early protective measures.

Globalization, localization and food culture: perceived roles of social and cultural capitals in healthy child feeding practices in Japan.

Science.gov (United States)

Goto, Keiko; Ominami, Chihiro; Song, Chunyan; Murayama, Nobuko; Wolff, Cindy

2014-03-01

The current study examined parental perceptions of sociocultural factors associated with healthy child feeding practices among parents of preschool-age children in rural Japan. Fifteen Japanese mothers of preschool-age children participated in this qualitative study. These participants were aged 22-39 years and resided in a rural town in western Japan. We conducted semi-structured qualitative interviews to assess parental perceptions of healthy child feeding practices and their relationships with globalization and localization. These interviews were transcribed, translated into English and coded, based on the principles of grounded theory. A codebook was developed and pre-identified, and the newly-identified themes from this codebook were examined and compared. Overall, local and seasonal foods, along with traditional Japanese foods and simple foods (soshoku), were considered to be beneficial for children. Participants also noted that children were expected to be mindful and exhibit good table manners that reflect cultural values related to meal-time socializing or family bonding, and food appreciation. On the other hand, the majority of the participants stated that foods containing food additives and imported foods were unsuitable for children. Participants noted that strong social capital, especially social support from their mothers or mothers-in-law, as well as social networks for obtaining fresh local foods, contributed to healthy child feeding practices. Cultural capital (including the preservation of traditional Japanese dietary habits, eating rules and inter-generational commensality), was also identified as being key to healthy feeding practices. Identifying and promoting the social and cultural capital that positively support healthy child feeding practices may be an important component of nutrition education programs.

Quality of life in children surviving cancer: a personality and multi-informant perspective.

Science.gov (United States)

De Clercq, Barbara; De Fruyt, Filip; Koot, Hans M; Benoit, Yves

2004-12-01

To describe quality of life (QoL) of children surviving cancer in relation to their personality, using self- and maternal reports and examining differences with healthy referents. Sixty-seven children who survived childhood cancer were compared with eighty-one healthy children on QoL and personality characteristics. Children who survived cancer reported higher QoL than healthy children, whereas there were no differences for personality. Two main effects emerged for informant with children rating themselves as less neurotic and more conscientious than their mothers. The correspondence between mothers and children was substantially higher for survivors for QoL and personality ratings. QoL and trait measures share substantial variance, and personality traits significantly predict QoL. Parental personality ratings explained child QoL beyond children's personality ratings. Personality traits contribute to quality of life, indicating that personality significantly influences child's quality of life beyond the experience of a negative life event such as surviving cancer and its treatment. From a diagnostic perspective, parental trait ratings are informative in addition to children's ratings of personality to understand children's QoL.

Effect of investment in malaria control on child mortality in sub-Saharan Africa in 2002-2008.

Directory of Open Access Journals (Sweden)

Yoko Akachi

Full Text Available BACKGROUND: Around 8.8 million children under-five die each year, mostly due to infectious diseases, including malaria that accounts for 16% of deaths in Africa, but the impact of international financing of malaria control on under-five mortality in sub-Saharan Africa has not been examined. METHODS AND FINDINGS: We combined multiple data sources and used panel data regression analysis to study the relationship among investment, service delivery/intervention coverage, and impact on child health by observing changes in 34 sub-Saharan African countries over 2002-2008. We used Lives Saved Tool to estimate the number of lives saved from coverage increase of insecticide-treated nets (ITNs/indoor residual spraying (IRS. As an indicator of outcome, we also used under-five mortality rate. Global Fund investments comprised more than 70% of the Official Development Assistance (ODA for malaria control in 34 countries. Each $1 million ODA for malaria enabled distribution of 50,478 ITNs [95%CI: 37,774-63,182] in the disbursement year. 1,000 additional ITNs distributed saved 0.625 lives [95%CI: 0.369-0.881]. Cumulatively Global Fund investments that increased ITN/IRS coverage in 2002-2008 prevented an estimated 240,000 deaths. Countries with higher malaria burden received less ODA disbursement per person-at-risk compared to lower-burden countries ($3.90 vs. $7.05. Increased ITN/IRS coverage in high-burden countries led to 3,575 lives saved per 1 million children, as compared with 914 lives in lower-burden countries. Impact of ITN/IRS coverage on under-five mortality was significant among major child health interventions such as immunisation showing that 10% increase in households with ITN/IRS would reduce 1.5 [95%CI: 0.3-2.8] child deaths per 1000 live births. CONCLUSIONS: Along with other key child survival interventions, increased ITNs/IRS coverage has significantly contributed to child mortality reduction since 2002. ITN/IRS scale-up can be more efficiently

Child Sexual Abuse and the Media

OpenAIRE

Lee, J.

2016-01-01

This is the first book to explore child sexual abuse within global religious and media organisations. Termed here the dual narrative, there is, on the one hand, the view that everyone is a potential paedophile, and, on the other, the notion of a witch-hunt falsely accusing people. Beginning with a re-examination of historic claims of satanic ritual abuse, the author moves on to investigate global celebrity culture, the global religious context as well as an analysis of technology. The interna...

Child Odors and Parenting: A Survey Examination of the Role of Odor in Child-Rearing.

Science.gov (United States)

Okamoto, Masako; Shirasu, Mika; Fujita, Rei; Hirasawa, Yukei; Touhara, Kazushige

2016-01-01

Parental caregiving is critical for the survival of our young and continuation of our species. In humans, visual and auditory signals from offspring have been shown to be potent facilitators of parenting. However, whether odors emitted by our young also influence human parenting remains unclear. To explore this, we conducted a series of questionnaire surveys targeting parents with children under 6 years old. First, we collected episodes on experiencing odors/sniffing various parts of a child's body (n = 507). The prevalence of experiencing events described in those episodes was examined in a separate survey (n = 384). Based on those results, the Child Odor in Parenting scale (COPs) was developed, and subsequently used in the main survey (n = 888). We found COPs to have adequate content validity, concurrent validity, and reliability. Responses to the COPs demonstrated that parents, especially mothers with infants, are aware of odors from their offspring, and actively seek them in daily child-rearing. The factor structure and content of the COPs items indicated that child odors have both affective and instrumental roles. Affective experiences induce loving feeling and affectionate sniffing, while instrumental experiences pertain to specific hygienic needs. The head was the most frequent source of affective experiences, and the child's bottom of instrumental. Each was experienced by more than 90% of the mothers with a child below 1 year of age. Affective experiences significantly declined as the child grew older, possibly associated with the decline of physical proximity between parents and child. This age-related decline was not prominent for instrumental experiences, except for the bottom, which significantly declined after 3 years of age. The present findings suggest that child odors play roles in human parenting, and that their nature and significance change during the course of a child's development.

Child Odors and Parenting: A Survey Examination of the Role of Odor in Child-Rearing.

Directory of Open Access Journals (Sweden)

Masako Okamoto

Full Text Available Parental caregiving is critical for the survival of our young and continuation of our species. In humans, visual and auditory signals from offspring have been shown to be potent facilitators of parenting. However, whether odors emitted by our young also influence human parenting remains unclear. To explore this, we conducted a series of questionnaire surveys targeting parents with children under 6 years old. First, we collected episodes on experiencing odors/sniffing various parts of a child's body (n = 507. The prevalence of experiencing events described in those episodes was examined in a separate survey (n = 384. Based on those results, the Child Odor in Parenting scale (COPs was developed, and subsequently used in the main survey (n = 888. We found COPs to have adequate content validity, concurrent validity, and reliability. Responses to the COPs demonstrated that parents, especially mothers with infants, are aware of odors from their offspring, and actively seek them in daily child-rearing. The factor structure and content of the COPs items indicated that child odors have both affective and instrumental roles. Affective experiences induce loving feeling and affectionate sniffing, while instrumental experiences pertain to specific hygienic needs. The head was the most frequent source of affective experiences, and the child's bottom of instrumental. Each was experienced by more than 90% of the mothers with a child below 1 year of age. Affective experiences significantly declined as the child grew older, possibly associated with the decline of physical proximity between parents and child. This age-related decline was not prominent for instrumental experiences, except for the bottom, which significantly declined after 3 years of age. The present findings suggest that child odors play roles in human parenting, and that their nature and significance change during the course of a child's development.

Leadership for child health in the developing countries of the Western Pacific

OpenAIRE

Subhi, Rami; Duke, Trevor

2011-01-01

The content and landscape of global child health is increasingly complex. There is strong evidence for the effectiveness of local, national and institutional leadership in reducing child mortality, but this has not been a focus of global health initiatives. Interventions to strengthen health systems should include support for local leadership: building-up institutions of training, empowering national paediatric professional associations, creating opportunities for contribution and leadership ...

Contraceptive use, birth spacing, and child survival in Matlab, Bangladesh

NARCIS (Netherlands)

Saha, U.R.; van Soest, A.H.O.

To reduce infant mortality through improved family planning, a better understanding of the factors driving contraceptive use and how this decision affects infant survival is needed. Using dynamic panel-data models of infant deaths, birth intervals, and contraceptive use, this study analyzes the

CGH Celebrates Take Your Child To Work Day 2015

Science.gov (United States)

Shady Grove celebrated Take Your Child To Work Day this year with a variety of activities and sessions aimed at inspiring school-aged children to explore career paths in science and public service. CGH hosted its inaugural Take Your Child To Work Day session: An Introduction to Global Health.

Teaching the pre-primary child reading and writing: a challenge for ...

African Journals Online (AJOL)

Teaching the pre-primary child reading and writing: a challenge for pre-primary school teachers in rivers state, Nigeria. ... Global Journal of Educational Research ... of the child's interactive learning and emphasizes specific teaching methods ...

Systematic screening of child abuse in out-of-hours primary care

NARCIS (Netherlands)

Schouten, MCM

2017-01-01

Child abuse is a serious global health problem. This thesis focused on – improving – the detection of child abuse in the out-of-hours primary care (OOH-PC). The main aim was to assess the diagnostic value of the screening instrument SPUTOVAMO-R2 for child abuse. We found that the detection rate of

Global, regional, and national causes of under-5 mortality in 2000-15: an updated systematic analysis with implications for the Sustainable Development Goals.

Science.gov (United States)

Liu, Li; Oza, Shefali; Hogan, Dan; Chu, Yue; Perin, Jamie; Zhu, Jun; Lawn, Joy E; Cousens, Simon; Mathers, Colin; Black, Robert E

2016-12-17

Despite remarkable progress in the improvement of child survival between 1990 and 2015, the Millennium Development Goal (MDG) 4 target of a two-thirds reduction of under-5 mortality rate (U5MR) was not achieved globally. In this paper, we updated our annual estimates of child mortality by cause to 2000-15 to reflect on progress toward the MDG 4 and consider implications for the Sustainable Development Goals (SDG) target for child survival. We increased the estimation input data for causes of deaths by 43% among neonates and 23% among 1-59-month-olds, respectively. We used adequate vital registration (VR) data where available, and modelled cause-specific mortality fractions applying multinomial logistic regressions using adequate VR for low U5MR countries and verbal autopsy data for high U5MR countries. We updated the estimation to use Plasmodium falciparum parasite rate in place of malaria index in the modelling of malaria deaths; to use adjusted empirical estimates instead of modelled estimates for China; and to consider the effects of pneumococcal conjugate vaccine and rotavirus vaccine in the estimation. In 2015, among the 5·9 million under-5 deaths, 2·7 million occurred in the neonatal period. The leading under-5 causes were preterm birth complications (1·055 million [95% uncertainty range (UR) 0·935-1·179]), pneumonia (0·921 million [0·812 -1·117]), and intrapartum-related events (0·691 million [0·598 -0·778]). In the two MDG regions with the most under-5 deaths, the leading cause was pneumonia in sub-Saharan Africa and preterm birth complications in southern Asia. Reductions in mortality rates for pneumonia, diarrhoea, neonatal intrapartum-related events, malaria, and measles were responsible for 61% of the total reduction of 35 per 1000 livebirths in U5MR in 2000-15. Stratified by U5MR, pneumonia was the leading cause in countries with very high U5MR. Preterm birth complications and pneumonia were both important in high, medium high, and medium

Effect of Investment in Malaria Control on Child Mortality in Sub-Saharan Africa in 2002–2008

Science.gov (United States)

Akachi, Yoko; Atun, Rifat

2011-01-01

Background Around 8.8 million children under-five die each year, mostly due to infectious diseases, including malaria that accounts for 16% of deaths in Africa, but the impact of international financing of malaria control on under-five mortality in sub-Saharan Africa has not been examined. Methods and Findings We combined multiple data sources and used panel data regression analysis to study the relationship among investment, service delivery/intervention coverage, and impact on child health by observing changes in 34 sub-Saharan African countries over 2002–2008. We used Lives Saved Tool to estimate the number of lives saved from coverage increase of insecticide-treated nets (ITNs)/indoor residual spraying (IRS). As an indicator of outcome, we also used under-five mortality rate. Global Fund investments comprised more than 70% of the Official Development Assistance (ODA) for malaria control in 34 countries. Each $1 million ODA for malaria enabled distribution of 50,478 ITNs [95%CI: 37,774–63,182] in the disbursement year. 1,000 additional ITNs distributed saved 0.625 lives [95%CI: 0.369–0.881]. Cumulatively Global Fund investments that increased ITN/IRS coverage in 2002–2008 prevented an estimated 240,000 deaths. Countries with higher malaria burden received less ODA disbursement per person-at-risk compared to lower-burden countries ($3.90 vs. $7.05). Increased ITN/IRS coverage in high-burden countries led to 3,575 lives saved per 1 million children, as compared with 914 lives in lower-burden countries. Impact of ITN/IRS coverage on under-five mortality was significant among major child health interventions such as immunisation showing that 10% increase in households with ITN/IRS would reduce 1.5 [95%CI: 0.3–2.8] child deaths per 1000 live births. Conclusions Along with other key child survival interventions, increased ITNs/IRS coverage has significantly contributed to child mortality reduction since 2002. ITN/IRS scale-up can be more efficiently

[Global child health--interventions that work].

Science.gov (United States)

Wathne, K O; Bøhler, E

2001-09-20

Over the last decades, better drinking water and hygiene, improved nutrition and vaccines and antibiotics have greatly reduced child mortality and morbidity. Still, 11 million children under the age of five die every year, many of them from diseases that could have been prevented or treated, given existing knowledge and technology. On the basis of a review of recent literature, this paper discusses current strategies to reduce childhood morbidity and mortality. Sufficient knowledge and technology exist to further improve the health of the worlds' children. Poverty and its consequences--weak implementation and organisation of health services--is a major obstacle. In order to improve health services in developing countries, additional resources are needed. There is also a need for better quality of service. This will require increased efforts in the field of health policy and systems research.

Parenting a child at home with hypoplastic left heart syndrome: experiences of commitment, of stress, and of love.

Science.gov (United States)

Cantwell-Bartl, Annie M; Tibballs, James

2017-09-01

To evaluate the experiences of parenting a child with hypoplastic left heart syndrome after the child has been discharged home from hospital. A study of the parents' experiences using face-to-face interviews and psychometric measures with parents whose child had survived stage surgery. Parents were interviewed within the home environment or within the hospital if that was their choice. A total of 29 parents (16 mothers and 13 fathers) of surviving children. Intervention A semi-structured face-to-face interview plus psychometric tests (parent demographics, Maslach Burnout Inventory, Impact on Family Scale, and the Psychological Check List - Civilian). Measurements and main results The parents' experience in supporting a child with hypoplastic left heart syndrome is one of stress, of commitment, and of love. Although parents experienced joy in their child, they were also subjected to anxiety with four parents test positive to post-traumatic stress disorder and hypervigilance while monitoring their child's condition. Parents lived with many difficulties, and demands.

A Global Investigation of Child Labor: Case Studies from India, Uganda, and the United States.

Science.gov (United States)

Lai, Selena

This curriculum guide was developed to help students gain a broader perspective about child labor and become more familiar with the issues, controversies, and debates that surround it. Three case studies are highlighted: (1) a street child in India; (2) child soldiers in Uganda; and (3) a migrant farm worker child in the United States. Each case…

Characteristics of mother-child conflict and child sex predicting resolution.

Science.gov (United States)

Nelson, Jackie A; Boyer, Brittany P; Sang, Samantha A; Wilson, Elizabeth K

2014-04-01

Data from 190 mothers and their 5- to 7-year-old children were used to evaluate how characteristics of mother-child conflict discussions contribute to the likelihood of reaching a compromise, a win-loss resolution, or a standoff. Dyads discussed 2 topics they reported having disagreements about that were emotionally arousing. Coders rated global measurements of mothers' emotional responsiveness, intrusiveness, and negativity; children's negativity; and the frequency of mothers' and children's constructive and oppositional comments. Child sex was examined as a moderator of the relation between discussion characteristics and resolution reached. Results indicated that more constructive comments by mothers and children increased the likelihood of reaching a resolution versus a standoff, but only children's constructive comments differentiated between a compromise and a win-loss resolution favoring mothers. Dyads with more emotionally responsive mothers who made fewer oppositional comments were also more likely to reach a compromise versus a win-loss resolution. A significant interaction with child sex revealed that, for boys, the use of more child oppositional comments was associated with a higher likelihood of reaching a standoff versus a compromise. Girls' oppositional comments did not predict resolution type. These results are discussed in terms of the children's developmental level and parents' socialization goals. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Early Marriage, Rape, Child Prostitution, and Related Factors Determining the Psychosocial Effects Severity of Child Sexual Abuse in Ethiopia

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Wondie, Yemataw; Zemene, Workie; Reschke, Konrad; Schroder, Harry

2011-01-01

This study was aimed at identifying factors that determine the psychosocial effects severity of child sexual abuse. Data were collected from 318 female children in Ethiopia using the Children's Impact of Traumatic Events Scale-Revised and the Rosenberg Self-Esteem Scale. The results revealed that respondents who survived rape and child…

Impacts of Climate Change on Inequities in Child Health

Directory of Open Access Journals (Sweden)

Charmian M. Bennett

2014-12-01

Full Text Available This paper addresses an often overlooked aspect of climate change impacts on child health: the amplification of existing child health inequities by climate change. Although the effects of climate change on child health will likely be negative, the distribution of these impacts across populations will be uneven. The burden of climate change-related ill-health will fall heavily on the world’s poorest and socially-disadvantaged children, who already have poor survival rates and low life expectancies due to issues including poverty, endemic disease, undernutrition, inadequate living conditions and socio-economic disadvantage. Climate change will exacerbate these existing inequities to disproportionately affect disadvantaged children. We discuss heat stress, extreme weather events, vector-borne diseases and undernutrition as exemplars of the complex interactions between climate change and inequities in child health.

Corruption kills: estimating the global impact of corruption on children deaths.

Science.gov (United States)

Hanf, Matthieu; Van-Melle, Astrid; Fraisse, Florence; Roger, Amaury; Carme, Bernard; Nacher, Mathieu

2011-01-01

Information on the global risk factors of children mortality is crucial to guide global efforts to improve survival. Corruption has been previously shown to significantly impact on child mortality. However no recent quantification of its current impact is available. The impact of corruption was assessed through crude Pearson's correlation, univariate and multivariate linear models coupling national under-five mortality rates in 2008 to the national "perceived level of corruption" (CPI) and a large set of adjustment variables measured during the same period. The final multivariable model (adjusted R(2)= 0.89) included the following significant variables: percentage of people with improved sanitation (p.valueCorruption Perception Index (p.valuecorruption) was associated with an increase in the log of national under-five mortality rate of 0.0644. According to this result, it could be roughly hypothesized that more than 140000 annual children deaths could be indirectly attributed to corruption. Global response to children mortality must involve a necessary increase in funds available to develop water and sanitation access and purchase new methods for prevention, management, and treatment of major diseases drawing the global pattern of children deaths. However without paying regard to the anti-corruption mechanisms needed to ensure their proper use, it will also provide further opportunity for corruption. Policies and interventions supported by governments and donors must integrate initiatives that recognise how they are inter-related.

Updates in the genetic evaluation of the child with global developmental delay or intellectual disability.

Science.gov (United States)

Flore, Leigh Anne; Milunsky, Jeff M

2012-12-01

Global developmental delay (GDD) and intellectual disability (ID) occur in up to 3% of the general population and are even more commonly encountered in the setting of the pediatric neurology clinic. New advances in technology and in the understanding of genetic disorders have led to changes in the diagnostic approach to a child with unexplained GDD or ID. Chromosomal microarray has become a first-line test for evaluation of patients in this population and has both significantly increased diagnostic yield and introduced new challenges in the interpretation of copy number variants of uncertain significance. The G-banded karyotype is now frequently utilized as an adjunct to the microarray rather than as a first-line test in individuals with GDD or ID. Fragile X DNA testing continues to be recommended in the initial evaluation of the child with GDD or ID. The presence or absence of certain cardinal features (such as microcephaly or macrocephaly, seizures, autism, abnormal neurologic examination, and facial dysmorphism) can be utilized to direct single-gene molecular testing. The availability of next-generation and massively parallel sequencing technologies has enabled the use of genetic testing panels, in which dozens of genes associated with GDD or ID may be rapidly analyzed. Most recently, the clinical availability of whole-genome and whole-exome sequencing has opened new possibilities for the evaluation of individuals with GDD or ID who have previously eluded a genetic diagnosis. Consultation with a medical geneticist is recommended when progressing beyond first-tier analyses to most efficiently prioritize testing. Copyright © 2012 Elsevier Inc. All rights reserved.

Depression and Liver Transplant Survival.

Science.gov (United States)

Meller, William; Welle, Nicole; Sutley, Kristen; Thurber, Steven

Patients who underwent liver transplantation and experienced clinical depression have heretofore evinced lower survival rates when compared to nondepressed counterparts. To investigate the hypothesis that transplant patients who seek and obtain medical treatment for depression would circumvent the prior reduced survival findings. A total of 765 patients with liver transplants were scrutinized for complications following transplantation. Further, 104 patients experienced posttransplant depression as manifested by diagnosis and treatment by medical personnel. Survival analyses were conducted comparing hazard and survival curves for these selected individuals and the remainder of transplant patients. Contrary to prior data and consistent with the aforementioned hypothesis, median survival durations, survival curves, and hazard functions (controlling for age and prolonged posttransplant survival for the depressed patients were better. The improved survival for the depressed patients may simply be related to an amelioration of depressed symptoms via antidepressant medications. However, this interpretation would only be congruent with reduced hazard, not elevated survival, beyond the norm (median) for other transplant participants. Assuming the reliability and generalization of our findings, perhaps a reasonable and compelling interpretation is that combined with the effectiveness of antidepressant medications, the seeking and receiving treatment for depression is a type of proxy measure of a more global pattern of adherence to recommended posttransplant medical regimens. Copyright © 2017 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

Prognostic value of Child-Turcotte criteria in medically treated cirrhosis

DEFF Research Database (Denmark)

Christensen, E; Schlichting, P; Fauerholdt, L

1984-01-01

The Child- Turcotte criteria (CTC) (based on serum bilirubin and albumin, ascites, neurological disorder and nutrition) are established prognostic factors in patients with cirrhosis having portacaval shunt surgery. The objective of this study was to evaluate the prognostic value of CTC in conserv......The Child- Turcotte criteria (CTC) (based on serum bilirubin and albumin, ascites, neurological disorder and nutrition) are established prognostic factors in patients with cirrhosis having portacaval shunt surgery. The objective of this study was to evaluate the prognostic value of CTC...... compared using the log-rank test. Survival decreased significantly with increasing degree of abnormality (A----B----C) of albumin (p less than 0.001), ascites (p less than 0.001), bilirubin (p = 0.02) and nutritional status (p = 0.03). Survival was insignificantly influenced by neurological status (p = 0...

Child Sexual Abuse in Zimbabwe.

Science.gov (United States)

Mantula, Fennie; Saloojee, Haroon

2016-01-01

Although child sexual abuse is a significant public health problem globally, its incidence, prevention, and management is less well described in resource-poor settings. In poorer settings prevention initiatives assume even more importance since resources for managing abused children are severely limited. This article examines the current status of policy and practice related to the prevention of child sexual abuse in Zimbabwe. It identifies implementation challenges and highlights opportunities that could be embraced to reduce CSA in Zimbabwe, based on evidence synthesized from recent work. Although Zimbabwe has a well-established legal and regulatory framework to protect children from child sexual abuse, implementation of existing policies is weak. Financial, human, and material resource constraints are frequently cited to explain limited prevention activity. Effective strategies for the prevention of child sexual abuse should focus on implementing existing legislation, targeting schoolchildren, and getting community involvement. A dedicated budget would help entrench these strategies, but gains can be achieved even in the absence of this.

A surviving infant with sirenomelia (Mermaid syndrome) associated with absent bladder.

Science.gov (United States)

Stanton, Michael P; Penington, Elizabeth C; Hutson, John M

2003-08-01

The authors report a case of a surviving infant with sirenomelia (Mermaid syndrome). The child is now 4 years of age. The authors believe that this is only the fourth reported case of an infant with sirenomelia surviving beyond the neonatal period and the first associated with absent bladder. The abnormal distal aorta shown in this case supports the theory that sirenomelia is an extreme form of caudal dysgenesis rather than occurring secondary to vascular steal.

Evidence acquisition and evaluation for evidence summit on population-level behavior change to enhance child survival and development in low- and middle-income countries.

Science.gov (United States)

Balster, Robert L; Levy, Stephanie; Stammer, Emily

2014-01-01

Recognizing the need for evidence to inform public health officials and health care workers in the U.S. government and low- and middle-income country governments on efficient, effective behavior change policies, strategies, and programs for child health and development, the U.S. government convened the Evidence Summit on Enhancing Child Survival and Development in Lower- and Middle-Income Countries by Achieving Population-Level Behavior Change. This article summarizes the background and methods for the acquisition and evaluation of the evidence used to the achieve the goals of the summit that is reviewed in other articles in this special issue of the Journal of Health Communication. The process began by identifying focal questions intended to inform the U.S. and low- and middle-income governments about behavior change interventions that accelerate reductions in under-5 mortality and optimize healthy and protective child development to 5 years of age. Experts were selected representing the research and program communities, academia, relevant nongovernmental organizations, and government agencies and assembled into evidence review teams. This was followed by the systematic gathering of relevant peer-reviewed literature that would inform the focal questions. Members of the evidence review teams were invited to add relevant articles not identified in the initial literature review to complete the bibliographies. Details of the search processes and methods used for screening and quality reviews are described. The evidence review teams were asked to comply with a specific evaluation framework for recommendations on practice and policy on the basis of both expert opinion and the quality of the data reviewed.

Power and Politics in the Global Health Landscape: Beliefs, Competition and Negotiation Among Global Advocacy Coalitions in the Policy-Making Process

Science.gov (United States)

McDougall, Lori

2016-01-01

Background: Advocacy coalitions play an increasingly prominent role within the global health landscape, linking actors and institutions to attract political attention and resources. This paper examines how coalitions negotiate among themselves and exercise hidden forms of power to produce policy on the basis of their beliefs and strategic interests. Methods: This paper examines the beliefs and behaviours of health advocacy coalitions using Sabatier’s Advocacy Coalition Framework (ACF) as an informal theoretical lens. Coalitions are further explored in relation to the concept of transnational advocacy networks (Keck and Sikkink) and of productive power (Shiffman). The ACF focuses on explaining how policy change takes place when there is conflict concerning goals and technical approaches among different actors. This study uses participant observation methods, self-reported survey results and semi-structured qualitative interviews to trace how a major policy project of the Millennium Development Goal (MDG) era, the Global Strategy for Women’s and Children’s Health, was constructed through negotiations among maternal, newborn, and child health (MNCH) and sexual and reproductive health and rights (SRHR) advocacy coalitions. Results: The Global Strategy represented a new opportunity for high-level political attention. Despite differing policy beliefs, MNCH and SRHR actors collaborated to produce this strategy because of anticipated gains in political attention. While core beliefs did not shift fundamentally and collaboration was primarily a short-term tactical response to a time-bound opportunity, MNCH actors began to focus more on human rights perspectives and SRHR actors adopted greater use of quantifiable indicators and economic argumentation. This shift emphasises the inherent importance of SRHR to maternal and child health survival. Conclusion: As opportunities arise, coalitions respond based on principles and policy beliefs, as well as to perceptions of

Power and Politics in the Global Health Landscape: Beliefs, Competition and Negotiation Among Global Advocacy Coalitions in the Policy-Making Process

Directory of Open Access Journals (Sweden)

Lori McDougall

2016-05-01

Full Text Available Background Advocacy coalitions play an increasingly prominent role within the global health landscape, linking actors and institutions to attract political attention and resources. This paper examines how coalitions negotiate among themselves and exercise hidden forms of power to produce policy on the basis of their beliefs and strategic interests. Methods This paper examines the beliefs and behaviours of health advocacy coalitions using Sabatier’s Advocacy Coalition Framework (ACF as an informal theoretical lens. Coalitions are further explored in relation to the concept of transnational advocacy networks (Keck and Sikkink and of productive power (Shiffman. The ACF focuses on explaining how policy change takes place when there is conflict concerning goals and technical approaches among different actors. This study uses participant observation methods, self-reported survey results and semistructured qualitative interviews to trace how a major policy project of the Millennium Development Goal (MDG era, the Global Strategy for Women’s and Children’s Health, was constructed through negotiations among maternal, newborn, and child health (MNCH and sexual and reproductive health and rights (SRHR advocacy coalitions. Results The Global Strategy represented a new opportunity for high-level political attention. Despite differing policy beliefs, MNCH and SRHR actors collaborated to produce this strategy because of anticipated gains in political attention. While core beliefs did not shift fundamentally and collaboration was primarily a short-term tactical response to a time-bound opportunity, MNCH actors began to focus more on human rights perspectives and SRHR actors adopted greater use of quantifiable indicators and economic argumentation. This shift emphasises the inherent importance of SRHR to maternal and child health survival. Conclusion As opportunities arise, coalitions respond based on principles and policy beliefs, as well as to perceptions

Power and Politics in the Global Health Landscape: Beliefs, Competition and Negotiation Among Global Advocacy Coalitions in the Policy-Making Process.

Science.gov (United States)

McDougall, Lori

2016-01-30

Advocacy coalitions play an increasingly prominent role within the global health landscape, linking actors and institutions to attract political attention and resources. This paper examines how coalitions negotiate among themselves and exercise hidden forms of power to produce policy on the basis of their beliefs and strategic interests. This paper examines the beliefs and behaviours of health advocacy coalitions using Sabatier's Advocacy Coalition Framework (ACF) as an informal theoretical lens. Coalitions are further explored in relation to the concept of transnational advocacy networks (Keck and Sikkink) and of productive power (Shiffman). The ACF focuses on explaining how policy change takes place when there is conflict concerning goals and technical approaches among different actors. This study uses participant observation methods, self-reported survey results and semi-structured qualitative interviews to trace how a major policy project of the Millennium Development Goal (MDG) era, the Global Strategy for Women's and Children's Health, was constructed through negotiations among maternal, newborn, and child health (MNCH) and sexual and reproductive health and rights (SRHR) advocacy coalitions. The Global Strategy represented a new opportunity for high-level political attention. Despite differing policy beliefs, MNCH and SRHR actors collaborated to produce this strategy because of anticipated gains in political attention. While core beliefs did not shift fundamentally and collaboration was primarily a short-term tactical response to a time-bound opportunity, MNCH actors began to focus more on human rights perspectives and SRHR actors adopted greater use of quantifiable indicators and economic argumentation. This shift emphasises the inherent importance of SRHR to maternal and child health survival. As opportunities arise, coalitions respond based on principles and policy beliefs, as well as to perceptions of advantage. Global health policy-making is an arena of

Web-based child pornography: The global impact of deterrence efforts and its consumption on mobile platforms.

Science.gov (United States)

Steel, Chad M S

2015-06-01

Our study is the first to look at mobile device use for child sexual exploitation material (CSEM) consumption, and at the global impact of deterrence efforts by search providers. We used data from Google, Bing, and Yandex to assess how web searches for CSEM are being conducted, both at present and historically. Our findings show that the blocking efforts by Google and Microsoft have resulted in a 67% drop in the past year in web-based searches for CSEM. Additionally, our findings show that mobile devices are a substantial platform for web-based consumption of CSEM, with tablets and smartphones representing 32% of all queries associated with CSEM conducted on Bing. Further, our findings show that a major search engine not located in the United States, Yandex, did not undertake blocking efforts similar to those implemented by Google and Microsoft and has seen no commensurate drop in CSEM searches and continues to profit from ad revenue on these queries. While the efforts by Google and Microsoft have had a deterrence effect in the United States, searchers from Russia and other locations where child pornography possession is not criminalized have continued to use these services. Additionally, the same lax enforcement environment has allowed searchers from the United States to utilize Yandex with little fear of detection or referral to United States law enforcement from the Russian authorities. Copyright © 2015 Elsevier Ltd. All rights reserved.

Leadership for child health in the developing countries of the Western Pacific

Science.gov (United States)

Subhi, Rami; Duke, Trevor

2011-01-01

The content and landscape of global child health is increasingly complex. There is strong evidence for the effectiveness of local, national and institutional leadership in reducing child mortality, but this has not been a focus of global health initiatives. Interventions to strengthen health systems should include support for local leadership: building-up institutions of training, empowering national paediatric professional associations, creating opportunities for contribution and leadership at national, provincial and local level, and networks of support for staff working in child health in remote areas. In the poorer high mortality burden countries of the Pacific, to meet the clinical and public health gaps, there is a need for increases in the education of child health nurse practitioners, and development of systems of continuing professional development for paediatric doctors and nurses. Involvement in local research, especially that which contributes directly to critical issues in child health policy or strengthening national data systems builds capacity for leadership. PMID:23198107

Leadership for child health in the developing countries of the Western Pacific

Directory of Open Access Journals (Sweden)

Rami Subhi

2011-06-01

Full Text Available The content and landscape of global child health is increasingly complex. There is strong evidence for the effectiveness of local, national and institutional leadership in reducing child mortality, but this has not been a focus of global health initiatives. Interventions to strengthen health systems should include support for local leadership: building-up institutions of training, empowering national paediatric professional associations, creating opportunities for contribution and leadership at national, provincial and local level, and networks of support for staff working in child health in remote areas. In the poorer high mortality burden countries of the Pacific, to meet the clinical and public health gaps, there is a need for increases in the education of child health nurse practitioners, and development of systems of continuing professional development for paediatric doctors and nurses. Involvement in local research, especially that which contributes directly to critical issues in child health policy or strengthening national data systems builds capacity for leadership.

Factors Underlying the Relationship Between Parent and Child Grief.

Science.gov (United States)

Cipriano, David J; Cipriano, Madeline R

2017-01-01

The death of a parent in a child's life is a significant risk factor for later mental and physical health problems. While much has been written about the surviving parent's functioning and its effects on their bereaved children, little work has been done to look into factors underlying this effect such as how the parent copes. The present study recruited 38 parent-child dyads from a community-based grief support center. Parent and child, independently, completed various measures of emotional functioning, including grief symptoms and coping such as social support and locus of control. The results indicated that parental coping did have an impact on children's grief symptoms. This represents a unique view of adaptation in bereaved children: Parental coping strategies can have an impact on the child, independent of the child's coping strategies. By focusing on parent coping, we have highlighted another possible pathway through which parental functioning affects children's grief.

Global, regional, national, and selected subnational levels of stillbirths, neonatal, infant, and under-5 mortality, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015

DEFF Research Database (Denmark)

Moesgaard Iburg, Kim; Gyawali, Bishal

2016-01-01

in 2015. Unless these countries are able to accelerate reductions in child deaths at an extraordinary pace, their achievement of proposed SDG targets is unlikely. Improving the evidence base on drivers that might hasten the pace of progress for child survival, ranging from cost-effective intervention...

Credit where credit is due: Pakistan's role in reducing the global burden of reproductive, maternal, newborn, and child health (RMNCH).

Science.gov (United States)

Ghaffar, Abdul; Qazi, Shamim; Shah, Iqbal

2015-11-25

Factors contributing to Pakistan's poor progress in reducing reproductive, maternal, newborn, and child health (RMNCH) include its low level of female literacy, gender inequity, political challenges, and extremism along with its associated relentless violence; further, less than 1% of Pakistan's GDP is allocated to the health sector. However, despite these disadvantages, Pakistani researchers have been able to achieve positive contributions towards RMNCH-related global knowledge and evidence base, in some cases leading to the formulation of WHO guidelines, for which they should feel proud. Nevertheless, in order to improve the health of its own women and children, greater investments in human and health resources are required to facilitate the generation and use of policy-relevant knowledge. To accomplish this, fair incentives for research production need to be introduced, policy and decision-makers' capacity to demand and use evidence needs to be increased, and strong support from development partners and the global health community must be secured.

CHILD SEXUAL ABUSE IN ZIMBABWE: PREVENTION ...

African Journals Online (AJOL)

Jacob Mugumbate

that social workers in Zimbabwe have a role to play at all the three levels of intervention. KEY TERMS: Child sexual abuse (CSA), social work, prevention,. Meili's model. ..... network/2013/mar/19/world-social-work-day-fair-global- · economy1.

Diversity, globalization and the ways of nature

Energy Technology Data Exchange (ETDEWEB)

Anton, D.J.

1995-11-01

During the last few years, technological advances and the reorganization of the international framework of economies, societies, and states have brought about profound changes with widespread socioeconomic effects. This book reviews global trends and their effects on the environment and on reducing global diversity. These trends include the information revolution, development of global financial markets and of more efficient international transport, and international migration. Environmental consequences noted include global pollution, deforestation, water shortages, and destruction of large ecosystems. The author uses examples from Africa, Latin America, and the Caribbean to illustrate the history of environmental degradation and its relation to globalization. He also discusses the importance of clean energy for planetary survival, the urban environmental challenge, the importance of diversity for human survival, and strategies for the future.

Research priorities on ending child marriage and supporting married girls.

Science.gov (United States)

Svanemyr, Joar; Chandra-Mouli, Venkatraman; Raj, Anita; Travers, Ellen; Sundaram, Lakshmi

2015-09-03

Over the past few years the issue of child marriage has received growing political and programmatic attention. In spite of some progress in a number of countries, global rates have not declined over the past decade. Knowledge gaps remain in understanding trends, drivers and approaches to ending child marriage, especially to understand what is needed to achieve results on a large scale. This commentary summarizes the outcomes of an Expert Group Meeting organized by World Health Organization to discuss research priorities on Ending Child Marriage and Supporting Married Girls. It presents research gaps and recommends priorities for research in five key areas; (i) prevalence and trends of child marriage; (ii) causes of child marriage (iii) consequences of child marriage; (iv) efforts to prevent child marriage; (v) efforts to support married girls.

Is "treat your child normally" helpful advice for parents of survivors of treatment of hypoplastic left heart syndrome?

Science.gov (United States)

Rempel, Gwen R; Harrison, Margaret J; Williamson, Deanna L

2009-04-01

Developing technology affords children with complex congenitally malformed hearts a chance for survival. Parents gratefully pursue life-saving options on behalf of their children, despite the risks to the life of their child, and uncertainty about outcomes. Little is known about how mothers and fathers experience parenting a child whose new state as a survivor may include less than optimal developmental sequels. Our study involved multiple interactive interviews with 9 mothers and 7 fathers of infants and preschool children with hypoplastic left heart syndrome who had survived the Norwood surgical approach. Qualitative methodology included grounded theory methods of simultaneous collection and analysis of data, and we used open and selective coding of transcribed interviews. Parents used normalization in the context of uncertainty regarding the ongoing survival of their child. Parents described their underweight children as being on their own growth curve, and viewed their developmental progress, however delayed, as reason for celebration, as they had been prepared for their child to die. There is growing evidence that children with congenitally malformed hearts who require surgical intervention during the first year of life may experience developmental delay. The use of normalization by their parents may be effective in decreasing their worry regarding the uncertain future faced by their child, but may negatively affect the developmental progress of the child if they do not seek resources to assist development. Advice from paediatric specialists for parents to view their children as normal needs to be balanced with assistance for parents to access services to support optimal growth and development of their child.

Newborn survival in Pakistan: a decade of change and future implications.

Science.gov (United States)

Khan, Amanullah; Kinney, Mary V; Hazir, Tabish; Hafeez, Assad; Wall, Stephen N; Ali, Nabeela; Lawn, Joy E; Badar, Asma; Khan, Ali Asghar; Uzma, Qudsia; Bhutta, Zulfiqar A

2012-07-01

Pakistan has the world's third highest national number of newborn deaths (194 000 in 2010). Major national challenges over the past decade have affected health and development including several large humanitarian disasters, destabilizing political insurgency, high levels of poverty and an often hard-to-reach predominately rural population with diverse practices. As part of a multi-country analysis, we examined changes for newborn survival between 2000 and 2010 in terms of mortality, coverage and health system indicators as well as national and donor funding. Neonatal mortality declined by only 0.9% per annum between 2000 and 2010; less than the global average (2.1%) and less than national maternal and child mortality declines. Coverage of newborn care interventions increased marginally, with wide socio-economic variations. There was little focus on newborn health until 2000 when considerable policy change occurred, including integration of newborn care into existing community-based maternal and child packages delivered by the Lady Health Worker Programme and national behaviour change communications strategies and programmes. The National Maternal, Newborn and Child Health Programme catalyzed newborn services at both facility and community levels. Civil society and academics have linked with government and several research studies have been highly influential. Since 2005, donor funding mentioning the term 'newborn' has increased more for Pakistan than for other countries. The country faces ongoing challenges in reducing neonatal mortality, and in much of Pakistan, societal norms discourage care-seeking and many women are unable to access care for themselves or their children. The policy advances and existing delivery platforms offer the potential to substantially accelerate progress in reducing neonatal deaths. The recent decision to dismantle the national Ministry of Health and devolve responsibility for health sector management to the provincial level presents

South African Journal of Child Health - Vol 8, No 4 (2014)

African Journals Online (AJOL)

Maternal sociodemographic factors that influence full child immunisation uptake in ... Birth weight recovery among very low birth weight infants surviving to ... Short Report: Neonatal cleft lip repair in babies with breastfeeding difficulties at ...

Newborn survival in Nepal: a decade of change and future implications.

Science.gov (United States)

Pradhan, Y V; Upreti, Shyam Raj; Pratap K C, Naresh; K C, Ashish; Khadka, Neena; Syed, Uzma; Kinney, Mary V; Adhikari, Ramesh Kant; Shrestha, Parashu Ram; Thapa, Kusum; Bhandari, Amit; Grear, Kristina; Guenther, Tanya; Wall, Stephen N

2012-07-01

Nepal is on target to meet the Millennium Development Goals for maternal and child health despite high levels of poverty, poor infrastructure, difficult terrain and recent conflict. Each year, nearly 35,000 Nepali children die before their fifth birthday, with almost two-thirds of these deaths occurring in the first month of life, the neonatal period. As part of a multi-country analysis, we examined changes for newborn survival between 2000 and 2010 in terms of mortality, coverage and health system indicators as well as national and donor funding. Over the decade, Nepal's neonatal mortality rate reduced by 3.6% per year, which is faster than the regional average (2.0%) but slower than national annual progress for mortality of children aged 1-59 months (7.7%) and maternal mortality (7.5%). A dramatic reduction in the total fertility rate, improvements in female education and increasing change in skilled birth attendance, as well as increased coverage of community-based child health interventions, are likely to have contributed to these mortality declines. Political commitment and support for newborn survival has been generated through strategic use of global and national data and effective partnerships using primarily a selective newborn-focused approach for advocacy and planning. Nepal was the first low-income country to have a national newborn strategy, influencing similar strategies in other countries. The Community-Based Newborn Care Package is delivered through the nationally available Female Community Health Volunteers and was piloted in 10 of 75 districts, with plans to increase to 35 districts in mid-2013. Innovation and scale up, especially of community-based packages, and public health interventions and commodities appear to move relatively rapidly in Nepal compared with some other countries. Much remains to be done to achieve high rates of effective coverage of community care, and especially to improve the quality of facility-based care given the rapid

The health and social situation of the mother during pregnancy and global quality of life of the child as an adult. Results from the prospective Copenhagen Perinatal Cohort 1959-1961

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Søren Ventegodt

2005-01-01

Full Text Available A prospective cohort study (Copenhagen Perinatal Birth Cohort 1959-61 of 7,222 persons was used in order to explore the association between the social and health situation during pregnancy and the global quality of life (QOL of the adult child 31-33 years later. Two sets of questionnaires were used with one filled out by physicians during pregnancy and one filled out by the adult children 31-33 years later. The questionnaires included mother's situation during pregnancy and global QOL of the child at follow-up: Well-being, life satisfaction, happiness, fulfilment of needs, experience of life’s temporal and spatial domains, expression of life’s potentials and objective measures. The only indicators to have clear connections with a reduced quality of life were the cases of mother's with syphilis (8.5%, mother's congenital malformations (8.8%, low social group (6.9% and failing contraception (3.8%. The results obtained repudiate the common notion and hypothesis that the mother's situation during pregnancy is highly important for the quality of life that the child experience as an adult. This suggest that the aspects important for quality of life later on are not found solely in early conditions, but instead more dependent on later attitude towards life of that specific person.

WOMEN’S SUFFRAGE, POLITICAL RESPONSIVENESS, AND CHILD SURVIVAL IN AMERICAN HISTORY*

OpenAIRE

Miller, Grant

2008-01-01

Women’s choices appear to emphasize child welfare more than those of men. This paper presents new evidence on how suffrage rights for American women helped children to benefit from the scientific breakthroughs of the bacteriological revolution. Consistent with standard models of electoral competition, suffrage laws were followed by immediate shifts in legislative behavior and large, sudden increases in local public health spending. This growth in public health spending fueled large-scale door...

Parental hopes, interventions, and survival of neonates with trisomy 13 and trisomy 18.

Science.gov (United States)

Janvier, Annie; Farlow, Barbara; Barrington, Keith J

2016-09-01

Trisomy 13 and 18 are life-limiting conditions for which a palliative approach is frequently recommended. The objective of this study was to examine parental goals/decisions, the length of life of their child and factors associated with survival. Parents of children who lived with trisomy 13 or 18 that were part of English-speaking social networks were invited to participate in a questionnaire study. Participants answered questions about their hopes/goals, decisions regarding neonatal interventions, and the duration of their children's lives. The participants were 332 parents who answered questions about their 272 children (87% response rate based on site visits; 67% on invitations sent). When parents were asked about their hope after the diagnosis, the main themes invoked by parents were the following: meet their child alive (80% of parents with a prenatal diagnosis), spend some time as a family (72%), bring their child home (52%), and give their child a good life (66%). Parents wanted to give them a chance, but also reported their fears were medical complexity, pain and/or life in the hospital (61%). Healthcare providers recommended comfort care at birth to all parents. Life-sustaining interventions "as for any other child" was chosen as a plan of care by 25% of parents. Of the 216 children with full trisomy, 69% were discharged home after birth and 40% lived >1 y. The presence of a prenatal diagnosis was the strongest independent factor negatively associated with longevity: 36% of children with a prenatal diagnosis lived survival (P care at birth consisted of limited interventions, whereas after a postnatal diagnosis (median age of 6 days) it consisted of various interventions, including oxygen, ventilation, tube feeding and intravenous fluids, complicating the analysis. In conclusion, the goals of parents of children with trisomy 13 or 18 were to meet their child, be discharged home and be a family. Having a postnatal diagnosis was the independent factor

Infant and Young Child Feeding: a Key area to Improve Child Health

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Habibolah Taghizade Moghaddam

2015-11-01

Full Text Available Good nutrition is essential for survival, physical growth, mental development, performance, productivity, health and well-being across the entire life-span: from the earliest stages of fetal development, at birth, and through infancy, childhood, adolescence and on into adulthood. Poor nutrition in the first 1,000 days of children’s lives can have irreversible consequences. For millions of children, it means they are, forever, stunted. Every infant and child has the right to good nutrition according to the Convention on the Rights of the Child; so the World Health Assembly has adopted a new target of reducing the number of stunted children under the age of 5 by 40 percent by 2025. The first 2 years of a child’s life are particularly important, as optimal nutrition during this period lowers morbidity and mortality, reduces the risk of chronic disease, and fosters better development overall. Breastfeeding and complementary feeding are a critical aspect of caring for infants and young children.

The murdered child and his killers.

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Kaplun, D; Reich, R

1976-07-01

The authors studied 112 cases of child homicide in New York City in 1968-1969 to identify contributing social and psychiatric factors and to determine the fate of the surviving siblings and the degree of involvement of the city's social agencies with the families. There was a pattern of long-term familial child maltreatment extending to the siblings and continuing after the murders. The victims were usually illegitimate preschoolers; the assailants, usually the mothers or their paramours, had backgrounds of assaultiveness and social deviance and killed in impulsive rage. Reports of sexual abuse of victims or of suicide or psychosis among assailants were rare. The authors present case illustrations and offer guidelines for improved prevention by psychiatrists and social workers.

Beneficial effects of a woman-focused development programme on child survival: evidence from rural Bangladesh.

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Bhuiya, Abbas; Chowdhury, Mushtaque

2002-11-01

This paper reports results from a prospective study of the impact of a woman-focused development programme on child survival in Matlab, a rural area of Bangladesh. The programme was targeted to households owning less than 50 decimals of land and members selling more than 100 days of labour for living in a year. Programme components included formation of women's groups for saving and credit, training on skill development, functional literacy including legal and social awareness, and technical and marketing support to projects undertaken with the loan money from the organization. A total of 13,549 children born alive during 1988-97 in the study area were included in the study. Hazards of mortality during pre- and post-intervention periods were compared among the programme participants and non-participants controlling the effects of other relevant variables. There has been a substantial reduction in mortality during the post-intervention period; however, the reduction was much greater for infants whose mothers participated in the development programme compared to infants of non-participant mothers from similar socioeconomic background. In a relative sense, there has been a 52% reduction of the pre-intervention level hazard of death of children during infancy of participant mothers compared to 31% reduction for the infants of non-participant mothers from similar socioeconomic background. There had also been a substantial reduction in hazard of death during childhood (1-4 year age group), however, the reduction was statistically similar for all groups of children irrespective of their mothers' participation in the development programmes.

Child Mortality Levels and Trends by HIV Status in Blantyre, Malawi: 1989-2009

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Taha, Taha E.; Dadabhai, Sufia S.; Sun, Jin; Rahman, M. Hafizur; Kumwenda, Johnstone; Kumwenda, Newton

2012-01-01

Introduction Continuous evaluation of child survival is needed in sub-Saharan Africa where HIV prevalence among women of reproductive age continues to be high. We examined mortality levels and trends over a period of ~20 years among HIV-unexposed and exposed children in Blantyre, Malawi. Methods Data from five prospective cohort studies conducted at a single research site from 1989-2009 were analyzed. In these studies, children born to HIV-infected and uninfected mothers were enrolled at birth and followed longitudinally for at least two years. Information on socio-demographic, HIV infection status, survival and associated risk factors was collected in all studies. Mortality rates were estimated using birth-cohort analyses stratified by maternal and infant HIV status. Multivariate Cox regression models were used to determine risk factors associated with mortality. Results The analysis included 8,286 children. From 1989-1995, overall mortality rates (per 100 person-years) in these clinic-based cohorts remained comparable among HIV-uninfected children born to HIV-uninfected mothers (range 3.3-6.9) or to HIV-infected mothers (range 2.5-7.5). From 1989-2009, overall mortality remained high among all children born to HIV-infected mothers (range 6.3-19.3), and among children who themselves became infected (range 15.6-57.4, 1994-2009). Only lower birth weight was consistently and significantly (P<0.05) associated with higher child mortality. Conclusions HIV infection among mothers and children contributed to high levels of child mortality in the African setting in the pre-treatment era. In addition to services that prevent mother-to-child transmission of HIV, other programs are needed to improve child survival by lowering HIV-unrelated mortality through innovative interventions that strengthen health infrastructure. PMID:22692091

The influence of Australian eye banking practices on corneal graft survival.

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Keane, Miriam C; Lowe, Marie T; Coster, Douglas J; Pollock, Graeme A; Williams, Keryn A

2013-08-19

To identify eye banking practices that influence corneal graft survival. Prospective cohort study of records of 19,254 followed corneal grafts in 15160 patients, submitted to the Australian Corneal Graft Registry between May 1985 and July 2012. Influence of corneal preservation method (organ culture, moist pot, Optisol, other); death-to-enucleation, death-to-preservation and enucleation-to-graft times; transportation by air; graft era; and indication for graft on probability of graft survival at most recent follow-up. In multivariate analysis, 919 penetrating grafts performed using corneas transported interstate by air exhibited worse survival than 14,684 grafts performed using corneas retrieved and used locally (hazard ratio [HR], 1.44; 95% CI, 1.21-1.73; P = 0.001). This was also the case for traditional lamellar grafts (64 corneas transported by air and 813 used locally; HR, 1.69; 95% CI, 1.03-2.78; P = 0.038). Indication for graft influenced survival of penetrating grafts (4611 keratoconus, 727 emergency or high-risk, 10,265 other indication; global P < 0.001) and traditional lamellar grafts (65 keratoconus, 212 emergency or high-risk, 600 other indication; global P < 0.001). The preservation medium in which corneas used for traditional lamellar grafts were stored exerted a marginal influence on graft survival (global P = 0.047). Donor corneas transported interstate exhibited poorer survival after transplantation than those retrieved and grafted locally. Higher proportions of emergency procedures involving transported corneas did not account for this difference. Where possible, efforts to avoid transportation of corneal tissue by air freight within Australia may be warranted.

A children's nurse's role in the global development of a child with diabetes mellitus.

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Kenny, Jodie; Corkin, Doris

2013-11-01

The nursing care of a six year old with type 1 diabetes reveals the importance of accurate control of the condition for normal physical, emotional and cognitive development. Clearly the children's nurse can educate and support the child, parents and extended family towards achieving independence and self-care. Theoretical knowledge of normal child maturation can guide nurses to constantly adapt their modes of communication and nursing skills, so as to promote every aspect and stage of the child's growth. Prevalence of type 1 diabetes is increasing, and nurses should use their close professional involvement with patients to assist research at every opportunity.

Unusual long survival despite severe lung disease of a child with biallelic loss of function mutations in ABCA-3

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P. El Boustany

Full Text Available Homozygous or compound heterozygous for frameshift or nonsense mutations in the ATP–binding cassette transporter A3 (ABCA3 is associated with neonatal respiratory failure and death within the first year of life without lung transplantation. We report the case of a newborn baby girl who developed severe respiratory distress soon after birth. She was diagnosed with compound heterozygous frameshift mutation of the ABCA3 gene. Despite extensive treatment (intravenous corticosteroids pulse therapy, oral corticosteroids, azithromycin, and hydroxychloroquine, she developed chronic respiratory failure. As the parents refused cardio-pulmonary transplantation and couldn't resolve to an accompaniment of end of life, a tracheostomy was performed resulting in continuous mechanical ventilation. A neurodevelopmental delay and an overall muscular dystrophy were noted. At the age of 5 years, after 2 episodes of pneumothorax, the patient died from severe respiratory failure. To our knowledge, this was the first case of a child with compound heterozygous frameshift mutation who posed such an ethical dilemma with a patient surviving till the age of five years. Keywords: ABCA3 deficiency, Compound heterozygous frameshift mutation, Neonatal respiratory failure, Tracheostomy, Mechanical ventilation, Ethical dilemma

The status of adolescent medicine: Building a global adolescent workforce

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Lee, Lana; Upadhya, Krishna K; Matson, Pamela; Adger, Hoover; Trent, Maria E

2016-01-01

Remarkable public health achievements to reduce infant and child mortality and improve the health and well-being of children worldwide have successfully resulted in increased survival and a growing population of young people aged 10–24 years. Population trends indicate that the current generation of 1.8 billion young people is the largest in history, but there is a scarcity of dedicated resources available to effectively meet the health needs of adolescents and young adults worldwide. Growing recognition of the pivotal roles young people play in the cultures, societies, and countries in which they live has spurred an expanding global movement to address the needs of this special population. Building an effective global workforce of highly-skilled adolescent health professionals who understand the unique biological, psychological, behavioral, social, and environmental factors that impact the health of adolescents is a critical step in addressing the health needs of the growing cohort of young people. In this review, we aim to: 1) Define a global assessment of the health needs for adolescents around the world; 2) Describe examples of current training programs and requirements in Adolescent Medicine; 3) Identify existing gaps and barriers to develop an effective adolescent health workforce; and 4) Develop a call for targeted actions to build capacity of the adolescent health workforce, broaden culturally relevant research and evidence-based intervention strategies, and reinforce existing interdisciplinary global networks of youth advocates and adolescent health professionals to maximize the opportunities for training, research, and care delivery. PMID:26167974

FORECASTING OF SURVIVAL OF CHILDREN WITH THE PRENATALLY DIAGNOSED PATHOLOGY OF THE CARDIOVASCULAR SYSTEM

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Анна Валериевна Дубовая

2018-05-01

Full Text Available The development of effective methods for the analysis and prognosis of the survival of newborns with prenatally diagnosed congenital malformations of the cardiovascular system are the urgent task of modern medicine. Objective – a neural network model for predicting the survival of children with prenatally diagnosed congenital malformations of the cardiovascular system was developed. Materials and methods. To create the artificial neural networks, the method of constructing multifactor mathematical prediction models in the software package Statistica 6.0 was used. The significance level of the factors influencing the survival of children with prenatally diagnosed congenital malformations of the cardiovascular system was determined using Wald statistics. When checking statistical hypotheses, the critical level of significance was assumed to be 0,05. Results. A neural network model for the determination of the probability of survival of a child with prenatally diagnosed congenital malformations of the cardiovascular system, which has a high prognostic ability of 0,88, sensitivity of the model was 77,6 %, specificity 86,4 %. The value of prognostic survival probability is in the range from 0 to 100 %. With an indicator value of more than 80 %, the probability of survival of a child with prenatally diagnosed congenital malformations of the cardiovascular system is estimated as high, ranging from 20 % to 80 % – as an average and less than 20 % – as low. Conclusion. In the algorithm for predicting the survival of children with prenatally diagnosed congenital malformations of the cardiovascular system it is necessary to include a combination with other pathology of cardiovascular system, with other organs and systems, with chromosomal abnormalities, with microdeletion and monogenic syndromes.

"She Got Spoilt": Perceptions of Victims of Child Sexual Abuse in Ghana.

Science.gov (United States)

Böhm, Bettina

2017-10-01

International research has commented on social stigma as a key reason for nondisclosure of child sexual abuse. However, the actual components of this social stigma frequently remain unexplored. The present study deals with perceptions of consequences of child sexual abuse among professionals and laypeople in Ghana (N = 44), employing a bystander perspective. As a qualitative study using a grounded theory framework, it considers these consequences in light of their underlying beliefs about child and adolescent development, particularly in relation to gender-based expectations placed on girls and boys. Consequences of child sexual abuse could be divided into sexual health consequences, beliefs about "destroyed innocence" and beliefs about a "destroyed future," which were strongly related to the sexual nature of the violence perpetrated. These perceived consequences of child sexual abuse hold implications for what surviving child sexual abuse means on a social level. Implications for practice are discussed on the basis of the data analysis.

Partner testing, linkage to care, and HIV-free survival in a program to prevent parent-to-child transmission of HIV in the Highlands of Papua New Guinea

Science.gov (United States)

Carmone, Andy; Bomai, Korai; Bongi, Wayaki; Frank, Tarua Dale; Dalepa, Huleve; Loifa, Betty; Kiromat, Mobumo; Das, Sarthak; Franke, Molly F.

2014-01-01

Background To eliminate new pediatric HIV infections, interventions that facilitate adherence, including those that minimize stigma, enhance social support, and mitigate the influence of poverty, will likely be required in addition to combination antiretroviral therapy (ART). We examined the relationship between partner testing and infant outcome in a prevention of parent-to-child transmission of HIV program, which included a family-centered case management approach and a supportive environment for partner disclosure and testing. Design We analyzed routinely collected data for women and infants who enrolled in the parent-to-child transmission of HIV program at Goroka Family Clinic, Eastern Highlands Provincial Hospital, Papua New Guinea, from 2007 through 2011. Results Two hundred and sixty five women were included for analysis. Of these, 226 (85%) had a partner, 127 (56%) of whom had a documented HIV test. Of the 102 HIV-infected partners, 81 (79%) had been linked to care. In adjusted analyses, we found a significantly higher risk of infant death, infant HIV infection, or loss to follow-up among mother–infant pairs in which the mother reported having no partner or a partner who was not tested or had an unknown testing status. In a second multivariable analysis, infants born to women with more time on ART or who enrolled in the program in later years experienced greater HIV-free survival. Conclusions In a program with a patient-oriented and family-centered approach to prevent vertical HIV transmission, the majority of women's partners had a documented HIV test and, if positive, linkage to care. Having a tested partner was associated with program retention and HIV-free survival for infants. Programs aiming to facilitate diagnosis disclosure, partner testing, and linkage to care may contribute importantly to the elimination of pediatric HIV. PMID:25172429

The legacy of the Child Health and Nutrition Research Initiative (CHNRI).

Science.gov (United States)

Black, Robert E

2016-06-01

Under the Global Forum for Health Research, the Child Health and Nutrition Research Initiative (CHNRI) began its operations in 1999 and became a Swiss foundation in 2006. The vision of CHNRI was to improve child health and nutrition of all children in low- and middle-income countries (LMIC) through research that informs health policy and practice. Specific objectives included expanding global knowledge on childhood disease burden and cost-effectiveness of interventions, promoting priority setting in research, ensuring inclusion of institutions and scientists in LMIC in setting priorities, promoting capacity development in LMIC and stimulating donors and countries to increase resources for research. CHNRI created a knowledge network, funded research through multiple rounds of a global competitive process and published research papers and policy briefs. A signature effort was to develop a systematic methodology for prioritizing health and nutrition research investments. The "CHNRI method" has been extensively applied to global health problems and is now the most commonly used method for prioritizing health research questions.

Implementation and Evaluation of a Parenting Program to Prevent Child Maltreatment in Suriname

NARCIS (Netherlands)

van der Kooij, Inger W.; Bipat, Shandra; Boer, Frits; Lindauer, Ramón J. L.; Graafsma, Tobi L. G.

2017-01-01

The prevention of child maltreatment has become a global health concern because child maltreatment is a violation of children's rights. Across the world, a variety of parenting programs have been developed to address this problem. However, no such parenting program currently exists in Suriname. This

Early childhood holocaust survival and the influence on well-being in later life

NARCIS (Netherlands)

Hal-van Raalte, van der Elisabeth A.M.

2007-01-01

No specific, systematic research existed focusing exclusively on late effects of surviving the Holocaust and its aftermath on the youngest child Holocaust survivors. Born between 1935 and 1944, they had endured persecution and deprivation in their first and most formative years. From

The imbalanced surfing-life of humanity to survival in the global changes

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Kontar, V. A.

2013-12-01

We have written many times about the imbalance of Nature as the cause of the global change. Here, we offer some method for the humanity survival in the face of global change of the imbalanced anisotropic real Nature. There are two logics of understanding the real Nature: the traditional balanced, and the new imbalanced. The balanced logic presupposes that Nature is balanced, isotropic, etc. The imbalanced logic presupposes opposite that Nature is imbalanced, anisotropic, etc. Respectively can be two styles of the people life: balanced and imbalanced. The image of the flat earth corresponds well with the balanced lifestyle of people. On the balanced life people spend activities to achieve the balance by reducing the change, stabilization, leveling any level changes, etc. If there is a mountain on the road, it must be align the track or make the tunnel. If there is a ravine on the road, then it need backfilled or to build a bridge. If someone is in restless, it must be calm, etc. As example of the happiness in the balanced life is the stability, balance, and therefore the global changes of Nature are perceived as a catastrophe. In the balanced lifestyle people can easily decide to use force, especially if there is not enough knowledge. But Nature has power which in billions times greater than the forces of humanity. Therefore, humanity will beaten in struggle with Nature and disappear. The imbalanced lifestyle is the fundamentally different. The imbalanced lifestyle complies with the surface of the ocean, which always changes, but sometimes can be and flat. But the flat calm ocean surface is inconvenient for the imbalanced life. You need to pull boat yourself because is no wind in the sails. The anisotropic imbalanced Nature has gradients in all parameters. At a certain level of knowledge and experience, people can use this multi-dimensional gradient essence of the real Nature for human's discretion. The imbalanced life is like a surfing. If properly understood

An Observational Approach to Testing Bi-Directional Parent-Child Interactions as Influential to Child Eating and Weight

Science.gov (United States)

Demir, Defne; Skouteris, Helen; Dell'Aquila, Daniela; Aksan, Nazan; McCabe, Marita P.; Ricciardelli, Lina A.; Milgrom, Jeannette; Baur, Louise A.

2012-01-01

Obesity among children has been on the rise globally for the past few decades. Previous research has centred mainly on self/parent-reported measures examining only uni-directional parental feeding styles and practices. Recent discussions in the literature have raised the importance of bi-directional parent-child interactions in influencing…

Gaps in international nutrition and child feeding guidelines: a look at the nutrition and young child feeding education of Ghanaian nurses.

Science.gov (United States)

Davis, Jennie N; Brown, Helen; Ramsay, Samantha A

2017-08-01

To examine the nutrition and young child feeding (YCF) education and training of nurses in public health clinics of Ghana's Komenda-Edina-Eguafo-Abrem region (KEEA) in relation to global health guidelines, and how nurses served as educators for caregivers with children aged 0-5 years. A qualitative study of semi-structured one-on-one and group interviews (n 21) following a questionnaire of closed- and open-ended questions addressing child feeding, nutrition and global health recommendations. Interviews were conducted in English, audio-recorded, transcribed and coded. Descriptive data were tabulated. Content analysis identified themes from open-ended questions. KEEA public health clinics (n 12). Nurses (n 41) purposefully recruited from KEEA clinics. A model capturing nurses' nutrition and YCF education emerged with five major themes: (i) adequacy of nurses' basic knowledge in breast-feeding, complementary feeding, iron-deficiency anaemia, YCF and hygiene; (ii) nurses' delivery of nutrition and YCF information; (iii) nurses' evaluation of children's health status to measure education effectiveness; (iv) nurses' perceived barriers of caregivers' ability to implement nutrition and YCF education; and (v) a gap in global health recommendations on YCF practices for children aged 2-5 years. Nurses demonstrated adequate nutrition and YCF knowledge, but reported a lack of in-depth nutrition knowledge and YCF education for children 2-5 years of age, specifically education and knowledge of YCF beyond complementary feeding. To optimize child health outcomes, a greater depth of nutrition and YCF education is needed in international health guidelines.

Benefits of Child-Focused Anxiety Treatments for Parents and Family Functioning

Science.gov (United States)

Keeton, Courtney P.; Ginsburg, Golda S.; Drake, Kelly L.; Sakolsky, Dara; Kendall, Philip C.; Birmaher, Boris; Albano, Anne Marie; March, John S.; Rynn, Moira; Piacentini, John; Walkup, John T.

2014-01-01

Background To examine (1) changes in parent (global psychological distress, trait anxiety) and family (dysfunction, burden) functioning following 12 weeks of child-focused anxiety treatment, and (2) whether changes in these parent and family factors were associated with child's treatment condition and response. Methods Participants were 488 youth ages 7–17 years (50% female; mean age 10.7 years) who met DSM-IV-TR criteria for social phobia, separation anxiety, and/or generalized anxiety disorder, and their parents. Youth were randomly assigned to 12 weeks of “Coping Cat” individual cognitive-behavioral therapy (CBT), medication management with sertraline (SRT), their combination (COMB), or medication management with pill placebo (PBO) within the multisite Child/Adolescent Anxiety Multimodal Study (CAMS). At pre- and posttreatment, parents completed measures of trait anxiety, psychological distress, family functioning, and burden of child illness; children completed a measure of family functioning. Blinded independent evaluators rated child's response to treatment using the Clinical Global Impression-Improvement Scale at posttreatment. Results Analyses of covariance revealed that parental psychological distress and trait anxiety, and parent-reported family dysfunction improved only for parents of children who were rated as treatment responders, and these changes were unrelated to treatment condition. Family burden and child-reported family dysfunction improved significantly from pre- to posttreatment regardless of treatment condition or response. Conclusions Findings suggest that child-focused anxiety treatments, regardless of intervention condition, can result in improvements in nontargeted parent symptoms and family functioning particularly when children respond successfully to the treatment. PMID:23390005

Comparison of survival rates among different treatment methods of transcatheter hepatic arterial chemoembolization for hepatocellular carcinoma

Energy Technology Data Exchange (ETDEWEB)

Shim, Yong Woon; Lee, Jong Tae; Yoo, Hyung Sik; Lee, Do Yun; Jun, Pyoung Jun; Chang, So Yong [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

1996-06-01

To compare the survival rates of patients with hepatoma using different methods of transcatheter arterial chemoemblization(THAE). Four hundred and eighty three patients with hepatoma diagnosed by biopsy, serum alpha-fetoprotein, abdominal CT scan, abdominal ultrasonography or hepatic angiography were included, but not all had received surgical treatment. They were divided onto two groups according to Child's classification and into subgroups according to different methods of THAE. Five-tear survival rates among these groups were retrospectively compared. The patients were aged between 24 and 85(mean, 58) ; male to female ratio was 324 : 61 for those who received THAE (369 : 87 when only hepatic angiography was considered.). In the group with more than a single episode of chemoembolization, regardless of Child's classification, a better survival rate compared to the other groups with or without concommitant radiotherapy or without chemoembolization was noted. There was no difference in the survival rate of patients with multiple chemoembolization. moreover, no difference in this rate was observed no matter what chemotherapeutic agents, including Adriamycin, Cis-Diaminedichloroplatinum of I-131-Lipiodol, were used. Amortization by gelfoam in conjuction with Adriamycin resulted in no difference in survival rate regardless of frequency of chemoembolization. An improved survival rate was seen when multiple episodes of chemoembolization were applied, but no difference was seen when there was concomitant application of either gelfoam or radiotherapy. Two different chemotherapeutic agents, Adriamycin and Cis-Diaminedichloroplatinum, were used, but there was no difference between them in their effect on survival rates.

Influences of early child nutritional status and home learning environment on child development in Vietnam.

Science.gov (United States)

Nguyen, Phuong H; DiGirolamo, Ann M; Gonzalez-Casanova, Ines; Young, Melissa; Kim, Nicole; Nguyen, Son; Martorell, Reynaldo; Ramakrishnan, Usha

2018-01-01

Early childhood development plays a key role in a child's future health, educational success, and economic status. However, suboptimal early development remains a global challenge. This study examines the influences of quality of the home learning environment (HOME) and child stunting in the first year of life on child development. We used data collected from a randomized controlled trial of preconceptional micronutrient supplementation in Vietnam (n = 1,458). The Bayley Scales of Infant Development-III were used to assess cognition, language, and motor development domains at 2 years. At 1 year, 14% of children were stunted, and 15%, 58%, and 28% of children lived in poor, medium, and high HOME environments, respectively. In multivariate generalized linear regression models, living in a high HOME environment was significantly associated with higher scores (0.10 to 0.13 SD) in each of the developmental domains. Stunted children scored significantly lower for cognitive, language, and motor development (-0.11 to -0.18), compared to nonstunted children. The negative associations between stunting on development were modified by HOME; the associations were strong among children living in homes with a poor learning environment whereas they were nonsignificant for those living in high-quality learning environments. In conclusion, child stunting the first year of life was negatively associated with child development at 2 years among children in Vietnam, but a high-quality HOME appeared to attenuate these associations. Early interventions aimed at improving early child growth as well as providing a stimulating home environment are critical to ensure optimal child development. © 2017 John Wiley & Sons Ltd.

Child Abuse and its Implications for the Educational Sector in Nigeria

African Journals Online (AJOL)

Child abuse has become a global problem that needs to be tackled if children are to be given the right to education and freedom. The issue of child abuse has been given serious attention in many parts of the world and Nigeria is not left out. Given this serious effort, one would have thought that this menace will not persist.

Certifications, child labour and livelihood strategies: an analysis of cocoa production in Ghana

NARCIS (Netherlands)

Owusu-Amankwah, R.

2015-01-01

Abstract

There have been various innovative initiatives by global and local actors in response to pressure on cocoa value-chain actors to free cocoa production from child labour (CL) and especially the worst forms of child labour (WFCL) and also to improve the livelihoods

The social dimension of globalization : a review of the literature

OpenAIRE

Gunter, Bernhard G

2004-01-01

Reviews the key economic characteristics of the globalization process and examines its impact on employment, poverty, inequality, global insecurity, child labour, gender issues and migration. Explores national and international policy responses, highlighting the importance of trade negotiations and the financial architecture.

Survival and Neurodevelopmental Outcomes among Periviable Infants.

Science.gov (United States)

Younge, Noelle; Goldstein, Ricki F; Bann, Carla M; Hintz, Susan R; Patel, Ravi M; Smith, P Brian; Bell, Edward F; Rysavy, Matthew A; Duncan, Andrea F; Vohr, Betty R; Das, Abhik; Goldberg, Ronald N; Higgins, Rosemary D; Cotten, C Michael

2017-02-16

Data reported during the past 5 years indicate that rates of survival have increased among infants born at the borderline of viability, but less is known about how increased rates of survival among these infants relate to early childhood neurodevelopmental outcomes. We compared survival and neurodevelopmental outcomes among infants born at 22 to 24 weeks of gestation, as assessed at 18 to 22 months of corrected age, across three consecutive birth-year epochs (2000-2003 [epoch 1], 2004-2007 [epoch 2], and 2008-2011 [epoch 3]). The infants were born at 11 centers that participated in the National Institute of Child Health and Human Development Neonatal Research Network. The primary outcome measure was a three-level outcome - survival without neurodevelopmental impairment, survival with neurodevelopmental impairment, or death. After accounting for differences in infant characteristics, including birth center, we used multinomial generalized logit models to compare the relative risk of survival without neurodevelopmental impairment, survival with neurodevelopmental impairment, and death. Data on the primary outcome were available for 4274 of 4458 infants (96%) born at the 11 centers. The percentage of infants who survived increased from 30% (424 of 1391 infants) in epoch 1 to 36% (487 of 1348 infants) in epoch 3 (Pneurodevelopmental impairment increased from 16% (217 of 1391) in epoch 1 to 20% (276 of 1348) in epoch 3 (P=0.001), whereas the percentage of infants who survived with neurodevelopmental impairment did not change significantly (15% [207 of 1391] in epoch 1 and 16% [211 of 1348] in epoch 3, P=0.29). After adjustment for changes in the baseline characteristics of the infants over time, both the rate of survival with neurodevelopmental impairment (as compared with death) and the rate of survival without neurodevelopmental impairment (as compared with death) increased over time (adjusted relative risks, 1.27 [95% confidence interval {CI}, 1.01 to 1.59] and 1

SystEmatic review and meta-aNAlysis of infanT and young child feeding Practices (ENAT-P) in Ethiopia : Protocol

NARCIS (Netherlands)

Habtewold, Tesfa Dejenie; Islam, Md. Atiqul; Sharew, Nigussie Tadesse; Mohammed, Shimels Hussien; Birhanu, Mulugeta Molla; Tegegne, Balewgizie Sileshi

Introduction Infant and young child feeding (IYCF) is the cornerstone of infant and child survival, healthy growth and development, healthy future generations and national development. In spite of the importance of optimal nutrition in low- and middle-income countries, there has been no review

Comments on "Differentials on Child Mortality and Health Care in Pakistan".

Science.gov (United States)

Manzoor, K

1992-01-01

Critical comments are provided on M. Framurz Kiani's examination of differentials in child mortality by parents' education, urban/rural status, work status, availability of maternal and child health services, immunization status, and diarrheal treatment and age of the mother. The findings emphasize the importance of literacy, particularly maternal education, as a major influence in child survival. There were 5 areas of discussion. The first pertained to the absence of factors for fertility, which had been shown to be interactive with mortality. Higher fertility was associated with higher mortality, and higher mortality was associated with higher fertility, and both were influenced by poverty and literacy. The second comment pertained to the lack of control variables for income and socioeconomic status in order to separate out the effects of educational status. It may well be that educational status was capturing the affordability and accessibility of health care, and increased consciousness due to education, even in an urban setting. Work status of the mother, rather than mothers working in a family business of working as housewives, may be representing women's mobility. Salaried fathers may enjoy lower mortality because of full or partial medical benefits that are included in their salary package, that those in agriculture would not have. The third point focused on the lack of specification of what "clinic" referred to, in the findings that urban and rural mothers with postnatal care had lower child mortality. The fourth point noted that the findings (maternal education was important in maternal and child health care and paternal education was important in immunization) reflected women's lack of decision making. Other findings were that education differences influenced child survival, but child immunization was not a significant factor. The policy implications are that health services and outreach are needed in rural areas in order to increase the level of

Reproductive, maternal, newborn, child & adolescent health in ...

International Development Research Centre (IDRC) Digital Library (Canada)

This research project will contribute to evidence from four country case studies in Syria, South Sudan, Mali, and Colombia or the Democratic Republic of Congo as part of a global project to inform developing operational guidance on interventions related to reproductive, maternal, newborn, child, and adolescent health ...

Innovating for Maternal and Child Health in Africa: Strengthening ...

International Development Research Centre (IDRC) Digital Library (Canada)

The Innovating for Maternal and Child Health in Africa program aims to assist targeted developing ... The program is part of the Global Health Research Initiative, a collaboration between Foreign Affairs, Trade and Development Canada, the ...

The social dimension of globalization: A review of the literature

NARCIS (Netherlands)

B.G. Gunter (Bernard); R.E. van der Hoeven (Rolph)

2004-01-01

textabstractWith globalization affecting so many inter-connected areas, it is difficult to grasp its full impact. This literature review of over 120 sources considers the impact of globalization on wages and taxes, poverty, inequality, insecurity, child labour, gender, and migration. Opening with

The legacy of the Child Health and Nutrition Research Initiative (CHNRI

Directory of Open Access Journals (Sweden)

Robert E Black

2016-06-01

Full Text Available Under the Global Forum for Health Research, the Child Health and Nutrition Research Initiative (CHNRI began its operations in 1999 and became a Swiss foundation in 2006. The vision of CHNRI was to improve child health and nutrition of all children in low– and middle–income countries (LMIC through research that informs health policy and practice. Specific objectives included expanding global knowledge on childhood disease burden and cost-effectiveness of interventions, promoting priority setting in research, ensuring inclusion of institutions and scientists in LMIC in setting priorities, promoting capacity development in LMIC and stimulating donors and countries to increase resources for research. CHNRI created a knowledge network, funded research through multiple rounds of a global competitive process and published research papers and policy briefs. A signature effort was to develop a systematic methodology for prioritizing health and nutrition research investments. The “CHNRI method” has been extensively applied to global health problems and is now the most commonly used method for prioritizing health research questions.

"Mixed Blessings": Parental Religiousness, Parenting, and Child Adjustment in Global Perspective

Science.gov (United States)

Bornstein, Marc H.; Putnick, Diane L.; Lansford, Jennifer E.; Al-Hassan, Suha M.; Bacchini, Dario; Bombi, Anna Silvia; Chang, Lei; Deater-Deckard, Kirby; Di Giunta, Laura; Dodge, Kenneth A.; Malone, Patrick S.; Oburu, Paul; Pastorelli, Concetta; Skinner, Ann T.; Sorbring, Emma; Steinberg, Laurence; Tapanya, Sombat; Tirado, Liliana Maria Uribe; Zelli, Arnaldo; Alampay, Liane Peña

2017-01-01

Background: Most studies of the effects of parental religiousness on parenting and child development focus on a particular religion or cultural group, which limits generalizations that can be made about the effects of parental religiousness on family life. Methods: We assessed the associations among parental religiousness, parenting, and…

A review of child stunting determinants in Indonesia.

Science.gov (United States)

Beal, Ty; Tumilowicz, Alison; Sutrisna, Aang; Izwardy, Doddy; Neufeld, Lynnette M

2018-05-17

Child stunting reduction is the first of 6 goals in the Global Nutrition Targets for 2025 and a key indicator in the second Sustainable Development Goal of Zero Hunger. The prevalence of child stunting in Indonesia has remained high over the past decade, and at the national level is approximately 37%. It is unclear whether current approaches to reduce child stunting align with the scientific evidence in Indonesia. We use the World Health Organization conceptual framework on child stunting to review the available literature and identify what has been studied and can be concluded about the determinants of child stunting in Indonesia and where data gaps remain. Consistent evidence suggests nonexclusive breastfeeding for the first 6 months, low household socio-economic status, premature birth, short birth length, and low maternal height and education are particularly important child stunting determinants in Indonesia. Children from households with both unimproved latrines and untreated drinking water are also at increased risk. Community and societal factors-particularly, poor access to health care and living in rural areas-have been repeatedly associated with child stunting. Published studies are lacking on how education; society and culture; agriculture and food systems; and water, sanitation, and the environment contribute to child stunting. This comprehensive synthesis of the available evidence on child stunting determinants in Indonesia outlines who are the most vulnerable to stunting, which interventions have been most successful, and what new research is needed to fill knowledge gaps. © 2018 The Authors. Maternal and Child Nutrition Published by John Wiley & Sons, Ltd.

Infections of the Central Nervous System and Child Development in Sub-Saharan Africa

NARCIS (Netherlands)

Abubakar Ali, A.

2017-01-01

Infectious diseases contribute significantly to child mortality in Africa; however, mortality rates only represent part of the problem. Among those who survive, cognitive, educational, and behavioral impairments have been reported. In the current chapter, I highlight the neurocognitive deficits,

Preliminary evaluation of child self-rating using the Child Tourette Syndrome Impairment Scale.

Science.gov (United States)

Cloes, Kelly Isaacs; Barfell, Kara S Francis; Horn, Paul S; Wu, Steve W; Jacobson, Sarah E; Hart, Kathleen J; Gilbert, Donald L

2017-03-01

To evaluate and compare how children with Tourette syndrome and parents rate tic and non-tic behavioral related impairment in home, school, and social domains; to compare these with clinician tic ratings; and to identify factors that may predict greater impairment. In a sample of 85 Tourette syndrome and 92 healthy control families, the Child Tourette Syndrome Impairment Scale, designed for parent-report and which includes 37 items rated for tic and non-tic impairment, was administered to parents and, with the referent modified, to children ages 9 to 17 years. Tic severity was rated using the Yale Global Tic Severity Scale (YGTSS). Analyses utilized descriptive and multivariate statistics. Tourette syndrome children's and parents' impairment ratings were higher than HC (ptic impairment ratings correlated with YGTSS (r=0.36 to 0.37; ptic and all 37 non-tic impairment items. For 29 items, children self-rated impairment higher for tics than non-tics. Diagnoses of attention-deficit-hyperactivity disorder and obsessive-compulsive disorder had larger effects on parent impairment ratings. The Child Tourette Syndrome Impairment Scale appears informative for child self-rating in Tourette syndrome. © 2016 Mac Keith Press.

Globalization and the German model of capitalism--erosion or survival?

Science.gov (United States)

Lane, C

2000-06-01

The German business system has been regarded as a particularly tightly coupled system, with embeddedness of even multinational companies (MNCs) in their home base as particularly deep. A study of the impact of companies' changing internationalization, if not globalization, strategies is therefore especially suited to test competing claims about their effects on the German business system. Are we experiencing an erosion of this system, an adaptation in a largely path-dependent way, or even a greater specialization and stronger crystallization of the German business system? To investigate these questions, the paper examines a small number of German MNCs in their domestic and international context. More particularly, the work focuses on whether and how their emergent globalization activities affect the reproduction or erosion of the three institutional complexes which shape the factors of production: the financial system; the innovation system; and the industrial relations system. The paper concludes that a new type of transformation--hybridization--is emerging. It is regarded as a consequence of German companies' growing integration into a global economic system.

Factors Related to Sibling Removal after a Child Maltreatment Fatality

Science.gov (United States)

Damashek, Amy; Bonner, Barbara L.

2010-01-01

Objectives: Many children who die from abuse or neglect are survived by siblings. However, little data are available about what happens to these siblings after the victim's death, such as whether they are removed from their home. Even less is known about how decisions are made regarding sibling removal following a child fatality. This study…

Child development assessment tools in low-income and middle-income countries: how can we use them more appropriately?

Science.gov (United States)

Sabanathan, Saraswathy; Wills, Bridget; Gladstone, Melissa

2015-05-01

Global emphasis has shifted beyond reducing child survival rates to improving health and developmental trajectories in childhood. Optimum early childhood experience is believed to allow children to benefit fully from educational opportunities resulting in improved human capital. Investment in early childhood initiatives in low-income and middle-income countries (LMICs) is increasing. These initiatives use early childhood developmental assessment tools (CDATs) as outcome measures. CDATs are also key measures in the evaluation of programmatic health initiatives in LMICs, influencing public health policy. Interpretation of CDAT outcomes requires understanding of their structure and psychometric properties. This article reviews the structure and main methods of CDAT development with specific considerations when applied in LMICs. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Child maltreatment and adult psychopathology in an Irish context.

LENUS (Irish Health Repository)

Fitzhenry, Mark

2015-07-01

One-hundred-ninety-nine adult mental health service users were interviewed with a protocol that included the Childhood Trauma Questionnaire, the Structured Clinical Interviews for Axis I and II DSM-IV disorders, the Global Assessment of Functioning scale, the SCORE family assessment measure, the Camberwell Assessment of Need Short Appraisal Schedule, and the Readiness for Psychotherapy Index. Compared to a U.S. normative sample, Irish clinical cases had higher levels of maltreatment. Cases with comorbid axis I and II disorders reported more child maltreatment than those with axis I disorders only. There was no association between types of CM and types of psychopathology. Current family adjustment and service needs (but not global functioning and motivation for psychotherapy) were correlated with a CM history. It was concluded that child maltreatment may contribute to the development of adult psychopathology, and higher levels of trauma are associated with co-morbid personality disorder, greater service needs and poorer family adjustment. A history of child maltreatment should routinely be determined when assessing adult mental health service users, especially those with personality disorders and where appropriate evidence-based psychotherapy which addresses childhood trauma should be offered.

Increasing incidence and survival in oral cancer

DEFF Research Database (Denmark)

Karnov, Kirstine Kim Schmidt; Grønhøj, Christian; Jensen, David Hebbelstrup

2017-01-01

Background: Oral carcinomas (OCs) make up a significant proportion of head and neck carcinomas (HNCs) and are an important cause of morbidity and mortality globally. The purpose of this population-based study was to determine trends in incidence and survival in OC in the Danish population from 1980...... to 2014. Material and methods: This study covered all patients registered in the nationwide Danish cancer registry (DCR) in the period 1980–2014. Age-adjusted incidence rate (AAIR) per 100,000 and annual percentage change (APC) were evaluated. Also, 5-year overall survival (OS) was calculated with Cox......-standardized incidence of OC during the last 30 years in Denmark, and also an improvement in survival. The 5-year OS was significantly better in recent years even when we adjusted the analysis for relevant covariates....

The Fight against the Least Visible Form of Human Trafficking: Trafficking for Child Labour Exploitation

Directory of Open Access Journals (Sweden)

Luz María Puente Aba

2018-03-01

Full Text Available Child trafficking for the purpose of labour exploitation is a difficult phenomenon to detect. It is also not readily definable considering that this specific form of trafficking is closely linked with the phenomenon of forced child labour, and even with the broader occurrence of child labour. A lack of globally reliable data and the convergence of different concepts related to child trafficking for labour exploitation pose significant challenges when trying to regulate the circumstances concerning child work and the criminalisation of trafficking for labour exploitation. This article offers a clear overview of the available data related to all the phenomena, and aims to clarify all the situations involved, defining child work, child labour, forced child labour and child trafficking for the purposes of labour exploitation. Furthermore, this article discusses the possible loopholes and critical issues that could hinder global approaches to resolving these issues. La trata infantil con fines de explotación laboral es un fenómeno difícil de detectar, y tampoco es sencillo definirlo si se tiene en cuenta que esta forma específica de trata está estrechamente relacionada con el fenómeno del trabajo forzado infantil e, incluso, con el fenómeno más general de trabajo infantil. Todo ello supone un desafío a la hora de regular las circunstancias que definen el trabajo realizado por niños y la criminalización de la trata para la explotación laboral. Este artículo ofrece un repaso de los datos disponibles en esta materia y procura aclarar las situaciones que se pueden plantear, así como definir trabajo realizado por niños, trabajo infantil, trabajo infantil forzado y trata infantil con fines de explotación laboral. Por último, profundiza en las posibles deficiencias y en los aspectos críticos que podrían obstaculizar un acercamiento global a esta problemática. DOWNLOAD THIS PAPER FROM SSRN: http://ssrn.com/abstract=3088010

Adjuvant Medications That Improve Survival after Locoregional Therapy.

Science.gov (United States)

Boas, F Edward; Ziv, Etay; Yarmohammadi, Hooman; Brown, Karen T; Erinjeri, Joseph P; Sofocleous, Constantinos T; Harding, James J; Solomon, Stephen B

2017-07-01

To determine if outpatient medications taken at the time of liver tumor embolization or ablation affect survival. A retrospective review was done of 2,032 liver tumor embolization, radioembolization, and ablation procedures performed in 1,092 patients from June 2009 to April 2016. Pathology, hepatocellular carcinoma (HCC) stage (American Joint Committee on Cancer), neuroendocrine tumor (NET) grade, initial locoregional therapy, overall survival after initial locoregional therapy, Child-Pugh score, Eastern Cooperative Oncology Group performance status, Charlson Comorbidity Index, and outpatient medications taken at the time of locoregional therapy were analyzed for each patient. Kaplan-Meier survival curves were calculated for patients taking 29 medications or medication classes (including prescription and nonprescription medications) for reasons unrelated to their primary cancer diagnosis. Kaplan-Meier curves were compared using the log-rank test. For patients with HCC initially treated with embolization (n = 304 patients), the following medications were associated with improved survival when taken at the time of embolization: beta-blockers (P = .0007), aspirin (P = .0008) and other nonsteroidal antiinflammatory drugs (P = .009), proton pump inhibitors (P = .004), and antivirals for hepatitis B or C (P = .01). For colorectal liver metastases initially treated with ablation (n = 172 patients), beta-blockers were associated with improved survival when taken at the time of ablation (P = .02). Aspirin and beta-blockers are associated with significantly improved survival when taken at the time of embolization for HCC. Aspirin was not associated with survival differences after locoregional therapy for NET or colorectal liver metastases, suggesting an HCC-specific effect. Copyright © 2017 SIR. Published by Elsevier Inc. All rights reserved.

Child slavery and child labour

OpenAIRE

McKinney, Stephen J.; Hill, R.J.; Hania, Honor

2015-01-01

Child slavery and child labour deny children their God-given dignity and freedom, and their right to education. Catholic Social Teaching is unequivocal in resolute condemnation of child slavery and child labour, in all of their forms.

Genetic and Environmental Influences on Global Family Conflict

Science.gov (United States)

Horwitz, Briana N.; Neiderhiser, Jenae M.; Ganiban, Jody M.; Spotts, Erica L.; Lichtenstein, Paul; Reiss, David

2010-01-01

This study examined genetic and environmental influences on global family conflict. The sample comprised 872 same-sex pairs of twin parents, their spouses/partners and one adolescent child per twin from the Twin and Offspring Study in Sweden (TOSS). The twins, spouses and child each reported on the degree of family conflict, and there was significant agreement among the family members’ ratings. These shared perspectives were explained by one common factor, indexing global family conflict. Genetic influences explained 36% of the variance in this common factor, suggesting that twins’ heritable characteristics contribute to family conflict, via genotype-environment correlation. Nonshared environmental effects explained the remaining 64% of this variance, indicating that twins’ unique childhood and/or current family experiences also play an important role. PMID:20438198

Quality of life as predictor of survival: A prospective study on patients treated with combined surgery and radiotherapy for advanced oral and oropharyngeal cancer

International Nuclear Information System (INIS)

Oskam, Inge M.; Verdonck-de Leeuw, Irma M.; Aaronson, Neil K.; Kuik, Dirk J.; Bree, Remco de; Doornaert, Patricia; Langendijk, Johannes A.; Leemans, Rene C.

2010-01-01

Background and purpose: The relation between health-related quality of life (HRQOL) and survival was investigated at baseline and 6 months in 80 patients with advanced oral or oropharyngeal cancer after microvascular reconstructive surgery and (almost all) adjuvant radiotherapy. Materials and methods: Multivariate Cox regression analyses of overall and disease-specific survival were performed including sociodemographic (age, gender, marital status, comorbidity), and clinical (tumor stage and site, radical surgical, metastasis, radiotherapy) parameters, and HRQOL (EORTC QLQ-C30 global quality of life scale). Results: Before treatment, younger age and having a partner were predictors of disease-specific survival; younger age predicted overall survival. At 6 months post-treatment, disease-specific and overall survival was predicted by (deterioration of) global quality of life solely. Global health-related quality of life after treatment was mainly influenced by emotional functioning. Conclusion: Deterioration of global quality of life after treatment is an independent predictor of survival in patients with advanced oral or oropharyngeal cancer.

Street children turn to sex-work to survive.

Science.gov (United States)

1995-08-01

The Kenyan government currently deports tourists who are caught with child prostitutes and charges the children with prostitution. A harder treatment of foreigners caught with child prostitutes may soon emerge. The Undugu Society in Kenya, an organization working with street children, welcomes such changes. It teaches children practical skills, e.g., tailoring and carpentry. The Society has four schools and sponsors 1000 children to attend school or workshops. It sends social workers into the slums to counsel and gain the trust of street children as well as to encourage them to attend workshops. The Society has workshops on HIV transmission and emphasizes behavior change rather than condom use. Kenyan law prohibits adults from having sex with a child less than 18 years old. Juvenile courts deal with children caught engaging in solicitation of customers and/or prostitution. Children found guilty go to children's homes for rehabilitation into mainstream society. More and more countries of sex-tourists are punishing tourists who engage in sexual intercourse with minors in Kenya. Fear that high-profile cases will harm the multi-million-dollar tourist industry as well as lack of state resources makes Kenya reluctant to prosecute tourists. In 1994, most of Nairobi's 40,000 street children were engaged in prostitution. The leading centers of child prostitution are all tourist areas: Nairobi, Mombasa, Malindi, Lamu, and Diani. 80% of pornographic material in Kenya features children. Kenyan taxi drivers, tour guides, and hotel workers serve as middlemen in child prostitution. Urban poverty forces many children on to the streets. Rural children sent to urban areas to work as maids or servants in a rich house are often sexually abused. They then escape to the streets. Many child prostitutes come from poor families and have low literacy and no practical skills. AIDS orphans also become prostitutes to survive.

Median survival time of patients after transcatheter chemo-embolization for hepatocellular carcinoma

International Nuclear Information System (INIS)

Haider, Z.; Haq, T.; Munir, K.; Usman, M.U.; Azeemuddin, M.

2006-01-01

Objective: To determine the effect on survival after trans arterial chemo embolization (TACE) in patients with unresectable hepatocellular carcinoma (HCC). Design: Longitudinal cohort study. Place and Duration of Study: Radiology Department, The Aga Khan University Hospital, Stadium Road, Karachi, from December 1997 to September 2005. Patients and Methods: Patients undergoing TACE procedure for HCC were prospectively followed. Forty three patients were enrolled from December 1997 to March 2003 in the study and subjected to chemo embolization therapy. Eight out of 43 patients were excluded from the study, who lost to follow-up. All the patients were followed till their death. Median and mean survival were calculated. Results: The median survival of these 35 patients was 410 days (13.6 months), with 95% confidence interval (236 days lower bound and 536 days upper bound). Mean survival time was 603 days (20.1 months) with 95% confidence interval (394 days lower bound and 812 days upper bound). There was significant difference in mean survival time (in days) by Child's Pugh class (X2 = 12.384; df=2, p-value=0.002). Conclusion: The study showed that TACE is an effective palliative treatment. TACE increases the median survival time. (author)

Parents' mental health after the birth of an extremely preterm child: a comparison between bereaved and non-bereaved parents.

Science.gov (United States)

Jenewein, J; Moergeli, H; Fauchère, J-C; Bucher, H U; Kraemer, B; Wittmann, L; Schnyder, U; Büchi, S

2008-03-01

To assess the impact of extremely preterm birth (24-26 weeks of gestation) on the mental health of parents two to six years after delivery, and to examine potential differences in post-traumatic growth between parents whose newborn infant died and those whose child survived. A total of 54 parents who had lost their newborn and 38 parents whose preterm child survived were assessed by questionnaires with regard to depression and anxiety (HADS) and post-traumatic growth (PTGI). Neither group of parents had clinically relevant levels of depression and anxiety. Mothers showed higher levels of anxiety than fathers. Bereaved parents with no other, living child reported higher levels of depression than bereaved parents with one or more children. Mothers reported higher post-traumatic growth compared to fathers. In particular, bereaved mothers experienced the value and quality of their close social relationships more positively compared to the non-bereaved parents. In the long term, bereaved and non-bereaved parents cope reasonably well with an extremely preterm birth of a child. Post-traumatic growth appears to be positively related to bereavement, particularly in mothers.

Psychometrics of a Child Report Measure of Maternal Support following Disclosure of Sexual Abuse.

Science.gov (United States)

Smith, Daniel W; Sawyer, Genelle K; Heck, Nicholas C; Zajac, Kristyn; Solomon, David; Self-Brown, Shannon; Danielson, Carla K; Ralston, M Elizabeth

2017-04-01

The study examined a new child report measure of maternal support following child sexual abuse. One hundred and forty-six mother-child dyads presenting for a forensic evaluation completed assessments including standardized measures of adjustment. Child participants also responded to 32 items considered for inclusion in a new measure, the Maternal Support Questionnaire-Child Report (MSQ-CR). Exploratory factor analysis of the Maternal Support Questionnaire-Child Report resulted in a three factor, 20-item solution: Emotional Support (9 items), Skeptical Preoccupation (5 items), and Protection/Retaliation (6 items). Each factor demonstrated adequate internal consistency. Construct and concurrent validity of the new measure were supported in comparison to other trauma-specific measures. The Maternal Support Questionnaire-Child Report demonstrated sound psychometric properties. Future research is needed to determine whether the Maternal Support Questionnaire-Child Report provides a more sensitive approximation of maternal support following disclosure of sexual abuse, relative to measures of global parent-child relations and to contextualize discrepancies between mother and child ratings of maternal support.

"The child can remember your voice": parent-child communication about sexuality in the South African context.

Science.gov (United States)

Vilanculos, Esmeralda; Nduna, Mzikazi

2017-03-01

There is a wealth of research on parent-child communication about sexual and reproductive health and rights (SRHR) and its influence on young people's sexual behaviours. However, most of it is from the global North. The aim of this study was to explore parent-child communication in three South African provinces: Eastern Cape, KwaZulu-Natal (KZN) and Mpumalanga. Nine, peer, focus group discussions (FGDs) were conducted with young and adult black African men and women in their spoken languages. Data were analysed thematically. Findings revealed that cultural and religious constructions of taboo silenced direct communication and restricted the discussed topics. Parents' older age, low educational level, lack of knowledge, and discomfort in talking about sexuality matters were reported to restrict conversations with children about sex and sexuality. The influence of these factors differed for parents residing in an urban setting who were more liberal than their counterparts residing in more rural areas. The child's age and gender were also reported to be a consideration in approaching these conversations. There is a need for interventions to assist parents on how to communicate with their children about SRHR topics beyond pregnancy and HIV/AIDS. These interventions should take into account and address factors that seem to influence parent-child communication.

Parenting and globalization in western countries: explaining differences in parent-child interactions.

Science.gov (United States)

Prevoo, Mariëlle Jl; Tamis-LeMonda, Catherine S

2017-06-01

We review research on intra-cultural differences in parenting, and the sources of those differences. Ethnic-minority parents differ from majority parents in parenting values, childrearing goals and resources-differences that affect parenting practices and children's development. Within-country comparisons indicate less sensitivity, more authoritarian discipline, less child-focused communications, and less engagement in learning activities in ethnic-minority compared to ethnic-majority parents, which help account for disparities in children. Despite group differences in parenting, associations between parenting and child development generalize across cultures, with rare exceptions. However, a focus on intra-cultural differences is based on comparisons of group 'averages', which masks the enormous variation within ethnic-minority samples. Within-group variation can be partly explained by stressors associated with low socioeconomic status (SES), acculturation and discrimination. Copyright © 2017 Elsevier Ltd. All rights reserved.

An ethical approach to resolving value conflicts in child protection.

Science.gov (United States)

Webb, E; Moynihan, S

2010-01-01

Child protection professionals working in diverse societies are regularly faced with value conflicts. Recognising these, and resolving them in the best interests of children, is a task that requires child protection specialists to make complex judgements and decisions. In this paper the philosophical concepts of absolutism and relativism to child abuse are applied, and it explores how this approach has practical relevance to solving ethical dilemmas in child protection. Children's interests are best served by erring towards an absolutist approach to the diagnosis and recognition of maltreatment and towards a relativistic approach in determining how services respond to a harmful incident or situation. Absolutism and relativism are not alternatives, but part of a continuous process of recognising and negotiating ever-changing community, national and global norms. At the service level the dichotomy transpires into the need to be culturally competent in handling the conflicting needs, rights and values of children, families, communities and professionals, whilst retaining the skill of child advocacy.

Child sexual abuse and possible health consequences among ...

African Journals Online (AJOL)

Background: Child sexual abuse (CSA) is a global public health concern especially in developed countries and where legal measures take unprecedented time. The aim of this study was to estimate the prevalence of different forms of CSA, and the perceived health consequences among secondary school students in ...

Child homicide perpetrators worldwide: a systematic review.

Science.gov (United States)

Stöckl, Heidi; Dekel, Bianca; Morris-Gehring, Alison; Watts, Charlotte; Abrahams, Naeemah

2017-01-01

This study aims to describe child homicide perpetrators and estimate their global and regional proportion to inform prevention strategies to reduce child homicide mortality worldwide. A systematic review of 9431 studies derived from 18 databases led to the inclusion of 126 studies after double screening. All included studies reported a number or proportion of child homicides perpetrators. 169 countries and homicide experts were surveyed in addition. The median proportion for each perpetrator category was calculated by region and overall and by age groups and sex. Data were obtained for 44 countries. Overall, parents committed 56.5% (IQR 23.7-69.6) of child homicides, 58.4% (0.0-66.7) of female and 46.8% (14.1-63.8) of male child homicides. Acquaintances committed 12.6% (5.9-31.3) of child homicides. Almost a tenth (9.2% (IQR 0.0-21.9) of child homicides had missing information on the perpetrator. The largest proportion of parental homicides of children was found in high-income countries (64.2%; 44.7-71.8) and East Asia and Pacific Region (61.7%; 46.7-78.6). Parents committed the majority (77.8% (61.5-100.0)) of homicides of children under the age of 1 year. For adolescents, acquaintances were the main group of homicide perpetrators (36.9%, 6.6-51.8). There is a notable lack of studies from low-income and middle-income countries and children above the age of 1 year. Children face the highest risk of homicide by parents and someone they know. Increased investment into the compilation of routine data on child homicide, and the perpetrators of this homicide is imperative for understanding and ultimately reducing child homicide mortality worldwide. PROSPERO registration number: CRD42015030125.

Cra negatively regulates acid survival in Yersinia pseudotuberculosis.

Science.gov (United States)

Hu, Yangbo; Lu, Pei; Zhang, Yong; Li, Yunlong; Li, Lamei; Huang, Li; Chen, Shiyun

2011-04-01

Survival in acidic environments is important for successful infection of gastrointestinal pathogens. Many bacteria have evolved elaborate mechanisms by inducing or repressing gene expression, which subsequently provide pH homeostasis and enable acid survival. In this study, we employed comparative proteomic analysis to identify the acid-responsive proteins of a food-borne enteric bacterium, Yersinia pseudotuberculosis. The expression level of eight proteins involved in carbohydrate metabolism was up- or downregulated over twofold at pH 4.5 compared with pH 7.0. The role of a global transcriptional regulator catabolite repressor/activator Cra was further studied in this acid survival process. lacZ-fusion analysis showed that expression of cra was repressed under acidic pH. Deletion of the cra gene increased acid survival by 10-fold, whereas complementation restored the wild-type phenotype. These results lead us to propose that, in response to acidic pH, the expression of cra gene is downregulated to increase acid survival. This is the first study to demonstrate the regulatory role of Cra in acid survival in an enteric bacterium. © 2011 Federation of European Microbiological Societies. Published by Blackwell Publishing Ltd. All rights reserved.

Role of male partners in the prevention of mother-to-child HIV transmission

Directory of Open Access Journals (Sweden)

Osoti A

2014-07-01

Full Text Available Alfred Osoti,1–3 Hannah Han,4 John Kinuthia,1,5 Carey Farquhar3,4,6 1Department of Obstetrics and Gynecology, University of Nairobi, Nairobi, Kenya; 2Department of Obstetrics and Gynecology, AIC Kijabe Hospital, Kijabe, Kenya; 3Department of Epidemiology, 4Department of Global Health, University of Washington, Seattle, USA; 5Department of Obstetrics and Gynecology, Kenyatta National Hospital, Nairobi, Kenya; 6Department of Medicine, University of Washington, Seattle, USA Abstract: There is emerging evidence that in resource-limited settings with a high human immunodeficiency virus (HIV burden, male partner involvement in prevention of mother-to-child HIV transmission (PMTCT is associated with improved uptake of effective interventions and infant HIV-free survival. There is also increasing evidence that male partner involvement positively impacts non-HIV related outcomes, such as skilled attendance at delivery, exclusive breastfeeding, uptake of effective contraceptives, and infant immunizations. Despite these associations, male partner involvement remains low, especially when offered in the standard antenatal clinic setting. In this review we explore strategies for improving rates of antenatal male partner HIV testing and argue that the role of male partners in PMTCT must evolve from one of support for HIV-infected pregnant and breastfeeding women to one of comprehensive engagement in prevention of primary HIV acquisition, avoidance of unintended pregnancies, and improved HIV-related care and treatment for the HIV-infected and uninfected women, their partners, and children. Involving men in all components of PMTCT has potential to contribute substantially to achieving virtual elimination of mother-to-child HIV transmission; promoting partner-friendly programs and policies, as well as pursuing research into numerous gaps in knowledge identified in this review, will help drive this process. Keywords: male involvement, limited-resource settings

The burden of child maltreatment in the East Asia and Pacific region.

Science.gov (United States)

Fang, Xiangming; Fry, Deborah A; Brown, Derek S; Mercy, James A; Dunne, Michael P; Butchart, Alexander R; Corso, Phaedra S; Maynzyuk, Kateryna; Dzhygyr, Yuriy; Chen, Yu; McCoy, Amalee; Swales, Diane M

2015-04-01

This study estimated the health and economic burden of child maltreatment in the East Asia and Pacific region, addressing a significant gap in the current evidence base. Systematic reviews and meta-analyses were conducted to estimate the prevalence of child physical abuse, sexual abuse, emotional abuse, neglect, and witnessing parental violence. Population Attributable Fractions were calculated and Disability-Adjusted Life Years (DALYs) lost from physical and mental health outcomes and health risk behaviors attributable to child maltreatment were estimated using the most recent comparable Global Burden of Disease data. DALY losses were converted into monetary value by assuming that one DALY is equal to the sub-region's per capita GDP. The estimated economic value of DALYs lost to violence against children as a percentage of GDP ranged from 1.24% to 3.46% across sub-regions defined by the World Health Organization. The estimated economic value of DALYs (in constant 2000 US$) lost to child maltreatment in the EAP region totaled US $151 billion, accounting for 1.88% of the region's GDP. Updated to 2012 dollars, the estimated economic burden totaled US $194 billion. In sensitivity analysis, the aggregate costs as a percentage of GDP range from 1.36% to 2.52%. The economic burden of child maltreatment in the East Asia and Pacific region is substantial, indicating the importance of preventing and responding to child maltreatment in this region. More comprehensive research into the impact of multiple types of childhood adversity on a wider range of putative health outcomes is needed to guide policy and programs for child protection in the region, and globally. Copyright © 2015 Elsevier Ltd. All rights reserved.

The burden of child maltreatment in the East Asia and Pacific region☆

Science.gov (United States)

Fang, Xiangming; Fry, Deborah A.; Brown, Derek S.; Mercy, James A.; Dunne, Michael P.; Butchart, Alexander R.; Corso, Phaedra S.; Maynzyuk, Kateryna; Dzhygyr, Yuriy; Chen, Yu; McCoy, Amalee; Swales, Diane M.

2015-01-01

This study estimated the health and economic burden of child maltreatment in the East Asia and Pacific region, addressing a significant gap in the current evidence base. Systematic reviews and meta-analyses were conducted to estimate the prevalence of child physical abuse, sexual abuse, emotional abuse, neglect, and witnessing parental violence. Population Attributable Fractions were calculated and Disability-Adjusted Life Years (DALYs) lost from physical and mental health outcomes and health risk behaviors attributable to child maltreatment were estimated using the most recent comparable Global Burden of Disease data. DALY losses were converted into monetary value by assuming that one DALY is equal to the sub-region’s per capita GDP. The estimated economic value of DALYs lost to violence against children as a percentage of GDP ranged from 1.24% to 3.46% across sub-regions defined by the World Health Organization. The estimated economic value of DALYs (in constant 2000 US$) lost to child maltreatment in the EAP region totaled US $151 billion, accounting for 1.88% of the region’s GDP. Updated to 2012 dollars, the estimated economic burden totaled US $194 billion. In sensitivity analysis, the aggregate costs as a percentage of GDP range from 1.36% to 2.52%. The economic burden of child maltreatment in the East Asia and Pacific region is substantial, indicating the importance of preventing and responding to child maltreatment in this region. More comprehensive research into the impact of multiple types of childhood adversity on a wider range of putative health outcomes is needed to guide policy and programs for child protection in the region, and globally. PMID:25757367

Associations of gender inequality with child malnutrition and mortality across 96 countries.

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Marphatia, A A; Cole, T J; Grijalva-Eternod, C; Wells, J C K

2016-01-01

National efforts to reduce low birth weight (LBW) and child malnutrition and mortality prioritise economic growth. However, this may be ineffective, while rising gross domestic product (GDP) also imposes health costs, such as obesity and non-communicable disease. There is a need to identify other potential routes for improving child health. We investigated associations of the Gender Inequality Index (GII), a national marker of women's disadvantages in reproductive health, empowerment and labour market participation, with the prevalence of LBW, child malnutrition (stunting and wasting) and mortality under 5 years in 96 countries, adjusting for national GDP. The GII displaced GDP as a predictor of LBW, explaining 36% of the variance. Independent of GDP, the GII explained 10% of the variance in wasting and stunting and 41% of the variance in child mortality. Simulations indicated that reducing GII could lead to major reductions in LBW, child malnutrition and mortality in low- and middle-income countries. Independent of national wealth, reducing women's disempowerment relative to men may reduce LBW and promote child nutritional status and survival. Longitudinal studies are now needed to evaluate the impact of efforts to reduce societal gender inequality.

Newborn survival in Uganda: a decade of change and future implications.

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Mbonye, Anthony K; Sentongo, Miriam; Mukasa, Gelasius K; Byaruhanga, Romano; Sentumbwe-Mugisa, Olive; Waiswa, Peter; Naamala Sengendo, Hanifah; Aliganyira, Patrick; Nakakeeto, Margaret; Lawn, Joy E; Kerber, Kate

2012-07-01

Each year in Uganda 141 000 children die before reaching their fifth birthday; 26% of these children die in their first month of life. In a setting of persistently high fertility rates, a crisis in human resources for health and a recent history of civil unrest, Uganda has prioritized Millennium Development Goals 4 and 5 for child and maternal survival. As part of a multi-country analysis we examined change for newborn survival over the past decade through mortality and health system coverage indicators as well as national and donor funding for health, and policy and programme change. Between 2000 and 2010 Uganda's neonatal mortality rate reduced by 2.2% per year, which is greater than the regional average rate of decline but slower than national reductions in maternal mortality and under-five mortality after the neonatal period. While existing population-based data are insufficient to measure national changes in coverage and quality of services, national attention for maternal and child health has been clear and authorized from the highest levels. Attention and policy change for newborn health is comparatively recent. This recognized gap has led to a specific focus on newborn health through a national Newborn Steering Committee, which has been given a mandate from the Ministry of Health to advise on newborn survival issues since 2006. This multi-disciplinary and inter-agency network of stakeholders has been able to preside over a number of important policy changes at the level of facility care, education and training, community-based service delivery through Village Health Teams and changes to essential drugs and commodities. The committee's comprehensive reach has enabled rapid policy change and increased attention to newborn survival in a relatively short space of time. Translating this favourable policy environment into district-level implementation and high quality services is now the priority.

Achieving maternal and child health gains in Afghanistan: a Countdown to 2015 country case study.

Science.gov (United States)

Akseer, Nadia; Salehi, Ahmad S; Hossain, S M Moazzem; Mashal, M Taufiq; Rasooly, M Hafiz; Bhatti, Zaid; Rizvi, Arjumand; Bhutta, Zulfiqar A

2016-06-01

for nurses (738 to 5766), midwives (211 to 3333), general physicians (403 to 5990), and community health workers (2682 to 28 837). Multivariable analysis of factors contributing to overall changes in skilled birth attendance and facility births suggests independent contributions of maternal literacy, deployment of community midwives, and proximity to a facility. Despite conflict and poverty, Afghanistan has made reasonable progress in its reproductive, maternal, newborn, and child health indicators over the last decade based on contributions of factors within and outside the health sector. However, equitable access to health care remains a challenge and present delivery models have high transactional costs, affecting sustainability. To maintain and further accelerate health and development gains, future strategies in Afghanistan will need to focus on investments in improving social determinants of health and targeted cost-effective interventions to address major causes of maternal and newborn mortality. US Fund for UNICEF under the Countdown to 2015 for Maternal, Newborn, and Child Survival grant from the Bill & Melinda Gates Foundation, and from the Government of Canada, Foreign Affairs, Trade and Development Canada. Additional direct and in-kind support was received from the UNICEF Country Office Afghanistan, the Centre for Global Child Health, the Hospital for Sick Children, Toronto, the Aga Khan University, and Mother and Child Care Trust (Pakistan). Copyright © 2016 Akseer et al. Open Access article distributed under the terms of CC BY. Published by Elsevier Ltd.. All rights reserved.

Prognostic and Added Value of Two-Dimensional Global Longitudinal Strain for Prediction of Survival in Patients with Light Chain Amyloidosis Undergoing Autologous Hematopoietic Cell Transplantation.

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Pun, Shawn C; Landau, Heather J; Riedel, Elyn R; Jordan, Jonathan; Yu, Anthony F; Hassoun, Hani; Chen, Carol L; Steingart, Richard M; Liu, Jennifer E

2018-01-01

Autologous hematopoietic cell transplantation (HCT) is a first-line therapy for prolonging survival in patients with light-chain (AL) amyloidosis. Cardiac involvement is the most important determinant of survival. However, patients with advanced cardiac involvement have often been excluded from HCT because of high risk for transplantation-related mortality and poor overall survival. Whether baseline left ventricular global longitudinal strain (GLS) can provide additional risk stratification and predict survival after HCT in this high-risk population remains unclear. The aim of this study was to evaluate the prognostic implication of baseline GLS and the added value of GLS beyond circulating cardiac biomarkers for risk stratification in patients with AL amyloidosis undergoing HCT. Eighty-two patients with newly diagnosed AL amyloidosis who underwent upfront HCT between January 2007 and April 2014 were included in the study. Clinical, echocardiographic, and serum cardiac biomarker data were collected at baseline and 12 months following HCT. GLS measurements were performed using a vendor-independent offline system. The median follow-up time for survivors was 58 months. Sixty-four percent of patients were in biomarker-based Mayo stage II or III. GLS, brain natriuretic peptide, troponin, and mitral E/A ratio were identified as the strongest predictors of survival (P value that best discriminated survivors from nonsurvivors, and the application of this cutoff value provided further mortality risk stratification within each Mayo stage. GLS is a strong predictor of survival in patients with AL amyloidosis undergoing HCT, potentially providing incremental value over serum cardiac biomarkers for risk stratification. GLS should be considered as a standard parameter along with serum cardiac biomarkers when evaluating eligibility for HCT or other investigational therapies. Copyright © 2017 American Society of Echocardiography. Published by Elsevier Inc. All rights reserved.

Globalization, Imperialism and Christianity: The Nigerian ...

African Journals Online (AJOL)

FIRST LADY

Musical instruments which Nigerian Christian churches use most often are those that depict .... the entire world”. Ekiyor (2007:51) states: “Globalization has aided and abetted the movement .... child-kidnapping and the local slave trade. 5. Christianity ..... Education and national development: A critique of NEPAD. Philosophy ...

Challenges and opportunities for neonatal respiratory support in ...

African Journals Online (AJOL)

Background: Neonatal health appears not to have received the deserved attention in the context of the Child Survival Strategies and this must have contributed to the non-attainment of the MDG-4 in Nigeria. Neonatal mortality contributes 40% or more to the current rate of child deaths globally, with birth asphyxia, prematurity ...

Local Needs and Global Indicators : A Contextual Approach to Multidimensional Child Deprivation

NARCIS (Netherlands)

Yousefzadeh Faal Daghati, Sepideh; Gossmann, Franziska

2016-01-01

This article focuses on the socio-political construction of childhood in Iran after the 1979 revolution and its influence on multidimensional child deprivation. It presents evidence that suggests that the revolution, and the ideological and political forces that emerged in its aftermath, established

Mechanical ventilation for a child with quadriplegia.

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Novotny, William E; Perkin, Ronald M; Mukherjee, Debjani; Lantos, John D

2014-09-01

Parents generally have the right to make medical decisions for their children. This right can be challenged when the parents' decision seems to go against the child's interests. The toughest such decisions are for a child who will survive with physical and neurocognitive impairments. We discuss a case of a 5-year-old boy who suffered a spinal injury as a result of a motor vehicle accident and whose father requests discontinuation of life support. Many experts recommend a "trial of therapy" to clarify both prognosis and quality of life. The key ethical question, then, is not whether to postpone a decision to forego mechanical ventilation. Instead, the key question is how long to wait. Parents should be allowed time to see what life will be like for themselves and for their child. Most of the time, life turns out better than they might have imagined. Comments are provided by 2 pediatric intensivists, Drs William Novotny and Ronald Perkin of East Carolina University, and by a specialist in rehabilitation, Dr Debjani Mukherjee of the Rehabilitation Institute of Chicago. Copyright © 2014 by the American Academy of Pediatrics.

[Estimating child mortality using the previous child technique, with data from health centers and household surveys: methodological aspects].

Science.gov (United States)

Aguirre, A; Hill, A G

1988-01-01

2 trials of the previous child or preceding birth technique in Bamako, Mali, and Lima, Peru, gave very promising results for measurement of infant and early child mortality using data on survivorship of the 2 most recent births. In the Peruvian study, another technique was tested in which each woman was asked about her last 3 births. The preceding birth technique described by Brass and Macrae has rapidly been adopted as a simple means of estimating recent trends in early childhood mortality. The questions formulated and the analysis of results are direct when the mothers are visited at the time of birth or soon after. Several technical aspects of the method believed to introduce unforeseen biases have now been studied and found to be relatively unimportant. But the problems arising when the data come from a nonrepresentative fraction of the total fertile-aged population have not been resolved. The analysis based on data from 5 maternity centers including 1 hospital in Bamako, Mali, indicated some practical problems and the information obtained showed the kinds of subtle biases that can result from the effects of selection. The study in Lima tested 2 abbreviated methods for obtaining recent early childhood mortality estimates in countries with deficient vital registration. The basic idea was that a few simple questions added to household surveys on immunization or diarrheal disease control for example could produce improved child mortality estimates. The mortality estimates in Peru were based on 2 distinct sources of information in the questionnaire. All women were asked their total number of live born children and the number still alive at the time of the interview. The proportion of deaths was converted into a measure of child survival using a life table. Then each woman was asked for a brief history of the 3 most recent live births. Dates of birth and death were noted in month and year of occurrence. The interviews took only slightly longer than the basic survey

Journalism in the jaw of globalism

Directory of Open Access Journals (Sweden)

Đorđević Živorad

2009-01-01

Full Text Available Globalism has always been an important factor of both survival and development of human civilization. However, contemporary processes of globalization are founded upon accomplishment of interests of powerful states, powerful individuals and their domination. Journalism has made a great contribution to the accomplishment of goals of contemporary globalism. Instead of creative engagement in spreading of truth and objective informing, journalists are becoming transmission in publicity control and redirecting of its consciousness toward virtual. Hence the weaking of position and reputation of journalism.

A Transactional Model of Temperamental Development: Evidence of a Relationship between Child Temperament and Maternal Stress over Five Years

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Pesonen, Anu-Katriina; Raikkonen, Katri; Heinonen, Kati; Komsi, Niina; Jarvenpaa, Anna-Liisa; Strandberg, Timo

2008-01-01

Although there is growing consensus that parental stress is a risk factor in child development, longitudinal studies of its effects are few. This study tested a sample of 231 mother-child dyads in terms of whether the relations between the global experience of stress in mothers (perceived stress scale) and child temperamental characteristics…

Maternal and family factors and child eating pathology: risk and protective relationships

Science.gov (United States)

2014-01-01

Background Previous studies have found associations between maternal and family factors and child eating disorder symptoms. However, it is not clear whether family factors predict eating disorder symptoms specifically, or relate to more general child psychopathology, of which eating disorder symptoms may be one component. This study aimed to identify maternal and family factors that may predict increases or decreases in child eating disorder symptoms over time, accounting for children’s body mass index z-scores and levels of general psychological distress. Methods Participants were 221 mother-child dyads from the Childhood Growth and Development Study, a prospective cohort study in Western Australia. Participants were assessed at baseline, 1-year follow-up and 2-year follow-up using interview and self-report measures. Children had a mean age of 10 years at baseline and 46% were male. Linear mixed models and generalised estimating equations were used to identify predictors of children’s eating disorder symptoms, with outcome variables including a global index of eating disorder psychopathology, levels of dietary restraint, levels of emotional eating, and the presence of loss of control (‘binge’) eating. Results Children of mothers with a current or past eating disorder reported significantly higher levels of global eating disorder symptoms and emotional eating than other children, and mothers with a current or past eating disorder reported significantly more concern about their children’s weight than other mothers. Maternal concern about child weight, rather than maternal eating disorder symptoms, was significant in predicting child eating disorder symptoms over time. Family exposure to stress and low maternal education were additional risk factors for eating disorder symptoms, whilst child-reported family satisfaction was a protective factor. Conclusions After adjusting for relevant confounding variables, maternal concern about child weight, children�

Taking Exception. Reduced mortality leads to population growth: an inconvenient truth.

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Shelton, James D

2014-05-01

Reduced mortality has been the predominant cause of the marked global population growth over the last 3/4 of a century. While improved child survival increases motivation to reduce fertility, it comes too little and too late to forestall substantial population growth. And, beyond motivation, couples need effective means to control their fertility. It is an inconvenient truth that reducing child mortality contributes considerably to the population growth destined to compromise the quality of life of many, particularly in sub-Saharan Africa. Vigorous child survival programming is of course imperative. Wide access to voluntary family planning can help mitigate that growth and provide many other benefits.

Evaluating the Impact of Zimbabwe's Prevention of Mother-to-Child HIV Transmission Program: Population-Level Estimates of HIV-Free Infant Survival Pre-Option A.

Science.gov (United States)

Buzdugan, Raluca; McCoy, Sandra I; Watadzaushe, Constancia; Kang Dufour, Mi-Suk; Petersen, Maya; Dirawo, Jeffrey; Mushavi, Angela; Mujuru, Hilda Angela; Mahomva, Agnes; Musarandega, Reuben; Hakobyan, Anna; Mugurungi, Owen; Cowan, Frances M; Padian, Nancy S

2015-01-01

We estimated HIV-free infant survival and mother-to-child HIV transmission (MTCT) rates in Zimbabwe, some of the first community-based estimates from a UNAIDS priority country. In 2012 we surveyed mother-infant pairs residing in the catchment areas of 157 health facilities randomly selected from 5 of 10 provinces in Zimbabwe. Enrolled infants were born 9-18 months before the survey. We collected questionnaires, blood samples for HIV testing, and verbal autopsies for deceased mothers/infants. Estimates were assessed among i) all HIV-exposed infants, as part of an impact evaluation of Option A of the 2010 WHO guidelines (rolled out in Zimbabwe in 2011), and ii) the subgroup of infants unexposed to Option A. We compared province-level MTCT rates measured among women in the community with MTCT rates measured using program monitoring data from facilities serving those communities. Among 8568 women with known HIV serostatus, 1107 (12.9%) were HIV-infected. Among all HIV-exposed infants, HIV-free infant survival was 90.9% (95% confidence interval (CI): 88.7-92.7) and MTCT was 8.8% (95% CI: 6.9-11.1). Sixty-six percent of HIV-exposed infants were still breastfeeding. Among the 762 infants born before Option A was implemented, 90.5% (95% CI: 88.1-92.5) were alive and HIV-uninfected at 9-18 months of age, and 9.1% (95%CI: 7.1-11.7) were HIV-infected. In four provinces, the community-based MTCT rate was higher than the facility-based MTCT rate. In Harare, the community and facility-based rates were 6.0% and 9.1%, respectively. By 2012 Zimbabwe had made substantial progress towards the elimination of MTCT. Our HIV-free infant survival and MTCT estimates capture HIV transmissions during pregnancy, delivery and breastfeeding regardless of whether or not mothers accessed health services. These estimates also provide a baseline against which to measure the impact of Option A guidelines (and subsequently Option B+).

Rectal cancer survival in a Brazilian Cancer Reference Unit

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Romualdo da Silva Corrêa

2016-10-01

Full Text Available Colorectal cancer is one of the most common malign tumors in men and women all over the world. In spite of prevention advances in the last few years, worldwide incidence remains significant, about one million per year. Objectives: Evaluate rectal cancer survival in patients diagnosed and surgically treated at the Cancer Reference Unit at Rio Grande do Norte State, Brazil. Methods: Observational retrospective study composed by 135 patients assisted from 2007 to 2014 at Doctor Luiz Antonio Hospital, Natal, Brazil. Data were collected from the patient records revision and survival rates were calculated and analyzed by non-parametric Kaplan–Meier and Wilcoxon tests, respectively. All patients were submitted to surgical treatment, chemotherapy and/or radiotherapy. Results: Overall survival was 62% in seven years, while disease-free survival in one, three and five years was 91.7%, 75.5% and 72.1%, respectively. Conclusion: Overall survival and disease-free survival remained enhanced until the end of the study, suggesting that the treatment protocols used in the institution have shown to be effective. Resumo: O câncer colorretal é um dos tumores malignos mais comuns em homens e mulheres em todo o mundo. Apesar das melhorias na prevenção nos últimos anos, a incidência global ainda é expressiva, cerca de um milhão por ano. Objetivos: Avaliar a sobrevida do câncer de reto nos pacientes diagnosticados e tratados cirurgicamente na Unidade de Referência do Câncer no Rio Grande do Norte, Brasil. Métodos: Estudo observacional retrospectivo composto por 135 pacientes, compreendido no período de 2007 a 2014 no Hospital Dr. Luiz Antônio, Natal, Brasil. Os dados foram coletados através da revisão de prontuários e as sobrevidas foram calculadas e comparadas utilizando, respectivamente, os métodos não-paramétricos de Kaplan-Meier e teste de Wilcoxon. Todos os pacientes foram submetidos a tratamento cirúrgico, quimioterápico e radioter

Reproducing Life and Labor: Global Processes and Working Children in Tijuana, Mexico

Science.gov (United States)

Aitken, Stuart; Estrada, Silvia Lopez; Jennings, Joel; Aguirre, Lina Maria

2006-01-01

The issue of child labor continues to challenge thinking on the nature of work, play, schooling and apprenticeship. New wisdom from some contemporary academic writing places children closer to the center of our understanding of consumption, production and reproduction, and at the heart of inequities generated by globalization. Child labor comes in…

Uptake and outcomes of a prevention-of mother-to-child transmission (PMTCT program in Zomba district, Malawi

Directory of Open Access Journals (Sweden)

Gawa Lucy

2011-06-01

Full Text Available Abstract Background HIV prevalence among pregnant women in Malawi is 12.6%, and mother-to-child transmission is a major route of transmission. As PMTCT services have expanded in Malawi in recent years, we sought to determine uptake of services, HIV-relevant infant feeding practices and mother-child health outcomes. Methods A matched-cohort study of HIV-infected and HIV-uninfected mothers and their infants at 18-20 months post-partum in Zomba District, Malawi. 360 HIV-infected and 360 HIV-uninfected mothers were identified through registers. 387 mother-child pairs were included in the study. Results 10% of HIV-infected mothers were on HAART before delivery, 27% by 18-20 months post-partum. sd-NVP was taken by 75% of HIV-infected mothers not on HAART, and given to 66% of infants. 18% of HIV-infected mothers followed all current recommended PMTCT options. HIV-infected mothers breastfed fewer months than HIV-uninfected mothers (12 vs.18, respectively; p p Conclusion This study shows low PMTCT program efficiency and effectiveness under routine program conditions in Malawi. HIV-free infant survival may have been influenced by key factors, including underuse of HAART, underuse of sd-NVP, and suboptimal infant feeding practices. Maternal mortality among HIV-infected women demands attention; improved maternal survival is a means to improve infant survival.

The effect of an integrated multisector model for achieving the Millennium Development Goals and improving child survival in rural sub-Saharan Africa: a non-randomised controlled assessment.

Science.gov (United States)

Pronyk, Paul M; Muniz, Maria; Nemser, Ben; Somers, Marie-Andrée; McClellan, Lucy; Palm, Cheryl A; Huynh, Uyen Kim; Ben Amor, Yanis; Begashaw, Belay; McArthur, John W; Niang, Amadou; Sachs, Sonia Ehrlich; Singh, Prabhjot; Teklehaimanot, Awash; Sachs, Jeffrey D

2012-06-09

Simultaneously addressing multiple Millennium Development Goals (MDGs) has the potential to complement essential health interventions to accelerate gains in child survival. The Millennium Villages project is an integrated multisector approach to rural development operating across diverse sub-Saharan African sites. Our aim was to assess the effects of the project on MDG-related outcomes including child mortality 3 years after implementation and compare these changes to local comparison data. Village sites averaging 35,000 people were selected from rural areas across diverse agroecological zones with high baseline levels of poverty and undernutrition. Starting in 2006, simultaneous investments were made in agriculture, the environment, business development, education, infrastructure, and health in partnership with communities and local governments at an annual projected cost of US$120 per person. We assessed MDG-related progress by monitoring changes 3 years after implementation across Millenium Village sites in nine countries. The primary outcome was the mortality rate of children younger than 5 years of age. To assess plausibility and attribution, we compared changes to reference data gathered from matched randomly selected comparison sites for the mortality rate of children younger than 5 years of age. Analyses were done on a per-protocol basis. This trial is registered with ClinicalTrials.gov, number NCT01125618. Baseline levels of MDG-related spending averaged $27 per head, increasing to $116 by year 3 of which $25 was spent on health. After 3 years, reductions in poverty, food insecurity, stunting, and malaria parasitaemia were reported across nine Millennium Village sites. Access to improved water and sanitation increased, along with coverage for many maternal-child health interventions. Mortality rates in children younger than 5 years of age decreased by 22% in Millennium Village sites relative to baseline (absolute decrease 25 deaths per 1000 livebirths, p=0

Child and adolescent mental disorders: the magnitude of the problem across the globe.

Science.gov (United States)

Belfer, Myron L

2008-03-01

Describe objectively the global gaps in policy, data gathering capacity, and resources to develop and implement services to support child mental health. Report on the World health Organization (WHO) child and adolescent mental health resources Atlas project. The Atlas project utilized key informants and was supplemented by studies that focused on policy. This report also draws on current epidemiological studies to provide a context for understanding the magnitude of the clinical problem. Current global epidemiological data consistently reports that up to 20% of children and adolescents suffer from a disabling mental illness; that suicide is the third leading cause of death among adolescents; and that up to 50% of all adult mental disorders have their onset in adolescence. While epidemiological data appears relatively uniform globally, the same is not true for policy and resources for care. The gaps in resources for child mental health can be categorized as follows: economic, manpower, training, services and policy. Key findings from the Atlas project include: lack of program development in low income countries; lack of any policy in low income countries and absent specific comprehensive policy in both low and high income countries; lack of data gathering capacity including that for country-level epidemiology and services outcomes; failure to provide social services in low income countries; lack of a continuum of care; and universal barriers to access. Further, the Atlas findings underscored the need for a critical analysis of the 'burden of disease' as it relates to the context of child and adolescent mental disorders, and the importance of defining the degree of 'impairment' of specific disorders in different cultures. The recent finding of substantial gaps in resources for child mental health underscores the need for enhanced data gathering, refinement of the economic argument for care, and need for innovative training approaches.

Globalization, Local and Global Identities of Students (Case study: University of Tabriz

Directory of Open Access Journals (Sweden)

Akram Hobbi

2010-06-01

Full Text Available The process of globalization is both a disputable issue and an ambiguous one and it has been approached through various and sometimes contradictory views. One of the major topics related to the process of globalization is the subject of survival or persistence of local identities in the mainstream of global economy and culture. Different views have been presented in this respect. One of them claims that globalization has a negative influence on local identities, and eliminates the differences. Some others, however, state an opposite view. This paper has identified three fundamental but different approaches and examines them by the research’s data .This research which its subjects are Fars, Turk and Kurd students of Tabriz University, indicates that as the global identity among the students’ increases, their local identities decrease. In other words, with enhancement of globalization process, local identities starts to decrease and it means that second and third approach’s theories in the research is rejected and the first approach’s theories are confirmed.

Reaching the unreached with polio vaccine and other child survival interventions through partnership with military in Angola.

Science.gov (United States)

Fekadu, Lemma; Okeibunor, Joseph; Nsubuga, Peter; Kipela, Jean Marie; Mkanda, Pascal; Mihigo, Richard

2016-10-10

Growing conflict and insecurity played a major role in precipitating polio outbreaks in the Horn of Africa and the Middle East. In Angola, the early post-conflict situation was characterized by the presence of many inaccessible zones and districts due to insecurity and poor infrastructure. Partnership with the Angolan Army health service (AAHS) was one of the innovative strategies that the Polio Eradication Initiative (PEI) introduced into the country to support the polio vaccination campaigns in insecure and hard to reach zones. Before embarking on creating a partnership with Angolan military it was essential to make high-level advocacy with top military decision makers to engage the leadership in the process for better and sustainable support to the strategy. The principal supports provided by the AAHS were the administration of oral polio vaccine, vitamin A, deworming agents, social mobilization, monitoring campaign quality, and surveillance. Distribution of logistics using military vehicles and helicopters to hard to reach and insecure zones was also part of the support. Using this partnership it was possible to reach a significant number of children in insecure and hard to reach areas with polio vaccine and other child survival interventions. The military partnership also contributed in increasing the demand and addressing rejection for the polio vaccine. Military is a potentially productive force that can be used for any development activities in any country. The Angolan experience has demonstrated that it is possible to form a partnership with the military for basic health intervention activities with little training and investment. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Bumblebee family lineage survival is enhanced in high-quality landscapes.

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Carvell, Claire; Bourke, Andrew F G; Dreier, Stephanie; Freeman, Stephen N; Hulmes, Sarah; Jordan, William C; Redhead, John W; Sumner, Seirian; Wang, Jinliang; Heard, Matthew S

2017-03-23

Insect pollinators such as bumblebees (Bombus spp.) are in global decline. A major cause of this decline is habitat loss due to agricultural intensification. A range of global and national initiatives aimed at restoring pollinator habitats and populations have been developed. However, the success of these initiatives depends critically upon understanding how landscape change affects key population-level parameters, such as survival between lifecycle stages, in target species. This knowledge is lacking for bumblebees, because of the difficulty of systematically finding and monitoring colonies in the wild. We used a combination of habitat manipulation, land-use and habitat surveys, molecular genetics and demographic and spatial modelling to analyse between-year survival of family lineages in field populations of three bumblebee species. Here we show that the survival of family lineages from the summer worker to the spring queen stage in the following year increases significantly with the proportion of high-value foraging habitat, including spring floral resources, within 250-1,000 m of the natal colony. This provides evidence for a positive impact of habitat quality on survival and persistence between successive colony cycle stages in bumblebee populations. These findings also support the idea that conservation interventions that increase floral resources at a landscape scale and throughout the season have positive effects on wild pollinators in agricultural landscapes.

Norwegian honey bees surviving Varroa destructor mite infestations by means of natural selection.

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Oddie, Melissa A Y; Dahle, Bjørn; Neumann, Peter

2017-01-01

Managed, feral and wild populations of European honey bee subspecies, Apis mellifera , are currently facing severe colony losses globally. There is consensus that the ectoparasitic mite Varroa destructor , that switched hosts from the Eastern honey bee Apis cerana to the Western honey bee A. mellifera , is a key factor driving these losses. For >20 years, breeding efforts have not produced European honey bee colonies that can survive infestations without the need for mite control. However, at least three populations of European honey bees have developed this ability by means of natural selection and have been surviving for >10 years without mite treatments. Reduced mite reproductive success has been suggested as a key factor explaining this natural survival. Here, we report a managed A. mellifera population in Norway, that has been naturally surviving consistent V. destructor infestations for >17 years. Surviving colonies and local susceptible controls were evaluated for mite infestation levels, mite reproductive success and two potential mechanisms explaining colony survival: grooming of adult worker bees and Varroa Sensitive Hygiene (VSH): adult workers specifically detecting and removing mite-infested brood. Mite infestation levels were significantly lower in surviving colonies and mite reproductive success was reduced by 30% when compared to the controls. No significant differences were found between surviving and control colonies for either grooming or VSH. Our data confirm that reduced mite reproductive success seems to be a key factor for natural survival of infested A. mellifera colonies. However, neither grooming nor VSH seem to explain colony survival. Instead, other behaviors of the adult bees seem to be sufficient to hinder mite reproductive success, because brood for this experiment was taken from susceptible donor colonies only. To mitigate the global impact of V. destructor , we suggest learning more from nature, i.e., identifying the obviously

Norwegian honey bees surviving Varroa destructor mite infestations by means of natural selection

Directory of Open Access Journals (Sweden)

Melissa A.Y. Oddie

2017-10-01

Full Text Available Background Managed, feral and wild populations of European honey bee subspecies, Apis mellifera, are currently facing severe colony losses globally. There is consensus that the ectoparasitic mite Varroa destructor, that switched hosts from the Eastern honey bee Apis cerana to the Western honey bee A. mellifera, is a key factor driving these losses. For >20 years, breeding efforts have not produced European honey bee colonies that can survive infestations without the need for mite control. However, at least three populations of European honey bees have developed this ability by means of natural selection and have been surviving for >10 years without mite treatments. Reduced mite reproductive success has been suggested as a key factor explaining this natural survival. Here, we report a managed A. mellifera population in Norway, that has been naturally surviving consistent V. destructor infestations for >17 years. Methods Surviving colonies and local susceptible controls were evaluated for mite infestation levels, mite reproductive success and two potential mechanisms explaining colony survival: grooming of adult worker bees and Varroa Sensitive Hygiene (VSH: adult workers specifically detecting and removing mite-infested brood. Results Mite infestation levels were significantly lower in surviving colonies and mite reproductive success was reduced by 30% when compared to the controls. No significant differences were found between surviving and control colonies for either grooming or VSH. Discussion Our data confirm that reduced mite reproductive success seems to be a key factor for natural survival of infested A. mellifera colonies. However, neither grooming nor VSH seem to explain colony survival. Instead, other behaviors of the adult bees seem to be sufficient to hinder mite reproductive success, because brood for this experiment was taken from susceptible donor colonies only. To mitigate the global impact of V. destructor, we suggest learning

Improving Quality of the Child Care Environment through a Consultancy Programme for Centre Directors

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Helmerhorst, Katrien O. W.; Fukkink, Ruben G.; Riksen-Walraven, J. Marianne A.; Gevers Deynoot-Schaub, Mirjam J. J. M.; Tavecchio, Louis W. C.

2017-01-01

This study examined the effects of a newly developed on-site consultancy programme to improve global quality of the child care environment in non-parental child care centres for 0- to 4-year-old children as measured with the ITERS-R/ECERS-R. Using a randomised controlled trial with a pretest, posttest, and follow-up test, we compared 35…

Effects of the introduction of new vaccines in Guinea-Bissau on vaccine coverage, vaccine timeliness, and child survival: an observational study.

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Fisker, Ane B; Hornshøj, Linda; Rodrigues, Amabelia; Balde, Ibraima; Fernandes, Manuel; Benn, Christine S; Aaby, Peter

2014-08-01

In 2008, the GAVI Alliance funded the introduction of new vaccines (including pentavalent diphtheria-tetanus-pertussis [DTP] plus hepatitis B and Haemophilus influenzae type b antigens) in Guinea-Bissau. The introduction was accompanied by increased vaccination outreach services and a more restrictive wastage policy, including only vaccinating children younger than 12 months. We assessed coverage of all vaccines in the Expanded Program on Immunizations before and after the new vaccines' introduction, and the implications on child survival. This observational cohort study used data from the Bandim Health Project, which has monitored vaccination status and mortality in randomly selected village clusters in Guinea-Bissau since 1990. We assessed the change in vaccination coverage using cohort data from children born in 2007 and 2009; analysed the proportion of children who received measles vaccine after 12 months of age using data from 1999-2006; and compared child mortality after age 12 months in children who had received measles vaccine and those who had not using data from 1999 to 2006. The proportion of children who were fully vaccinated by 12 months of age was 53% (468 of 878) in the 2007 cohort and 53% (467 of 879) in the 2009 cohort (relative risk [RR] 1·00, 95% CI 0·89-1·11). Coverage of DTP-3 and pentavalent-3 increased from 73% (644 of 878) in 2007 to 81% (712 of 879) in 2009 (RR 1·10, 95% CI 1·04 -1·17); by contrast, the coverage of measles vaccination declined from 71% (620 of 878) to 66% (577 of 879; RR 0·93, 0·85-1·01). The effect of the changes was significantly different for DTP-3 coverage compared with measles vaccine coverage (p=0·002). After 12 months of age, the adjusted mortality rate ratio was 0·71 (95% CI 0·56-0·90) for children who had received measles vaccine compared with those who had not (0·59 [0·43-0·80] for girls and 0·87 [0·62-1·23] for boys). The introduction of the new vaccination programme in 2008 was associated with

Racial and ethnic disparities in the impact of obesity on breast cancer risk and survival: a global perspective.

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Bandera, Elisa V; Maskarinec, Gertraud; Romieu, Isabelle; John, Esther M

2015-11-01

Obesity is a global concern, affecting both developed and developing countries. Although there are large variations in obesity and breast cancer rates worldwide and across racial/ethnic groups, most studies evaluating the impact of obesity on breast cancer risk and survival have been conducted in non-Hispanic white women in the United States or Europe. Given the known racial/ethnic differences in tumor hormone receptor subtype distribution, obesity prevalence, and risk factor profiles, we reviewed published data for women of African, Hispanic, and Asian ancestry in the United States and their countries of origin. Although the data are limited, current evidence suggests a stronger adverse effect of obesity on breast cancer risk and survival in women of Asian ancestry. For African Americans and Hispanics, the strength of the associations appears to be more comparable to that of non-Hispanic whites, particularly when accounting for subtype and menopausal status. Central obesity seems to have a stronger impact in African-American women than general adiposity as measured by body mass index. International data from countries undergoing economic transition offer a unique opportunity to evaluate the impact of rapid weight gain on breast cancer. Such studies should take into account genetic ancestry, which may help elucidate differences in associations between ethnically admixed populations. Overall, additional large studies that use a variety of adiposity measures are needed, because the current evidence is based on few studies, most with limited statistical power. Future investigations of obesity biomarkers will be useful to understand possible racial/ethnic biological differences underlying the complex association between obesity and breast cancer development and progression. © 2015 American Society for Nutrition.

[Child health and international cooperation: A paediatric approach].

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Sobrino Toro, M; Riaño Galan, I; Bassat, Q; Perez-Lescure Picarzo, J; de Aranzabal Agudo, M; Krauel Vidal, X; Rivera Cuello, M

2015-05-01

The international development cooperation in child health arouses special interest in paediatric settings. In the last 10 10 years or so, new evidence has been presented on factors associated with morbidity and mortality in the first years of life in the least developed countries. This greater knowledge on the causes of health problems and possible responses in the form of interventions with impact, leads to the need to disseminate this information among concerned professional pediatricians. Serious efforts are needed to get a deeper insight into matters related to global child health and encourage pediatricians to be aware and participate in these processes. This article aims to provide a social pediatric approach towards international cooperation and child health-related matters. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

Cultivating Layered Literacies: Developing the Global Child to Become Tomorrow's Global Citizen

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Shulsky, Debra D.; Baker, Sheila F.; Chvala, Terry; Willis, Jana M.

2017-01-01

Disappearing cultural, political and physical boundaries push humanity beyond a one-community perspective. Global citizenry requires a set of literacies that affect the ability to communicate effectively, think critically and act conscientiously. This challenges educators to consider reframing instructional practices and curricular content. The…

Beyond Bioethics: A Child Rights-Based Approach to Complex Medical Decision-Making.

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Wade, Katherine; Melamed, Irene; Goldhagen, Jeffrey

2016-01-01

This analysis adopts a child rights approach-based on the principles, standards, and norms of child rights and the U.N. Convention on the Rights of the Child (CRC)-to explore how decisions could be made with regard to treatment of a severely impaired infant (Baby G). While a child rights approach does not provide neat answers to ethically complex issues, it does provide a framework for decision-making in which the infant is viewed as an independent rights-holder. The state has obligations to develop the capacity of those who make decisions for infants in such situations to meet their obligations to respect, protect, and fulfill their rights as delineated in the CRC. Furthermore, a child rights approach requires procedural clarity and transparency in decision-making processes. As all rights in the CRC are interdependent and indivisible, all must be considered in the process of ethical decision-making, and the reasons for decisions must be delineated by reference to how these rights were considered. It is also important that decisions that are made in this context be monitored and reviewed to ensure consistency. A rights-based framework ensures decision-making is child-centered and that there are transparent criteria and legitimate procedures for making decisions regarding the child's most basic human right: the right to life, survival, and development.

Setting Priorities in Global Child Health Research Investments: Guidelines for Implementation of the CHNRI Method

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Rudan, Igor; Gibson, Jennifer L.; Ameratunga, Shanthi; El Arifeen, Shams; Bhutta, Zulfiqar A.; Black, Maureen; Black, Robert E.; Brown, Kenneth H.; Campbell, Harry; Carneiro, Ilona; Chan, Kit Yee; Chandramohan, Daniel; Chopra, Mickey; Cousens, Simon; Darmstadt, Gary L.; Gardner, Julie Meeks; Hess, Sonja Y.; Hyder, Adnan A.; Kapiriri, Lydia; Kosek, Margaret; Lanata, Claudio F.; Lansang, Mary Ann; Lawn, Joy; Tomlinson, Mark; Tsai, Alexander C.; Webster, Jayne

2008-01-01

This article provides detailed guidelines for the implementation of systematic method for setting priorities in health research investments that was recently developed by Child Health and Nutrition Research Initiative (CHNRI). The target audience for the proposed method are international agencies, large research funding donors, and national governments and policy-makers. The process has the following steps: (i) selecting the managers of the process; (ii) specifying the context and risk management preferences; (iii) discussing criteria for setting health research priorities; (iv) choosing a limited set of the most useful and important criteria; (v) developing means to assess the likelihood that proposed health research options will satisfy the selected criteria; (vi) systematic listing of a large number of proposed health research options; (vii) pre-scoring check of all competing health research options; (viii) scoring of health research options using the chosen set of criteria; (ix) calculating intermediate scores for each health research option; (x) obtaining further input from the stakeholders; (xi) adjusting intermediate scores taking into account the values of stakeholders; (xii) calculating overall priority scores and assigning ranks; (xiii) performing an analysis of agreement between the scorers; (xiv) linking computed research priority scores with investment decisions; (xv) feedback and revision. The CHNRI method is a flexible process that enables prioritizing health research investments at any level: institutional, regional, national, international, or global. PMID:19090596

Chest compression rates and survival following out-of-hospital cardiac arrest.

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Idris, Ahamed H; Guffey, Danielle; Pepe, Paul E; Brown, Siobhan P; Brooks, Steven C; Callaway, Clifton W; Christenson, Jim; Davis, Daniel P; Daya, Mohamud R; Gray, Randal; Kudenchuk, Peter J; Larsen, Jonathan; Lin, Steve; Menegazzi, James J; Sheehan, Kellie; Sopko, George; Stiell, Ian; Nichol, Graham; Aufderheide, Tom P

2015-04-01

Guidelines for cardiopulmonary resuscitation recommend a chest compression rate of at least 100 compressions/min. A recent clinical study reported optimal return of spontaneous circulation with rates between 100 and 120/min during cardiopulmonary resuscitation for out-of-hospital cardiac arrest. However, the relationship between compression rate and survival is still undetermined. Prospective, observational study. Data is from the Resuscitation Outcomes Consortium Prehospital Resuscitation IMpedance threshold device and Early versus Delayed analysis clinical trial. Adults with out-of-hospital cardiac arrest treated by emergency medical service providers. None. Data were abstracted from monitor-defibrillator recordings for the first five minutes of emergency medical service cardiopulmonary resuscitation. Multiple logistic regression assessed odds ratio for survival by compression rate categories (compression fraction and depth, first rhythm, and study site. Compression rate data were available for 10,371 patients; 6,399 also had chest compression fraction and depth data. Age (mean±SD) was 67±16 years. Chest compression rate was 111±19 per minute, compression fraction was 0.70±0.17, and compression depth was 42±12 mm. Circulation was restored in 34%; 9% survived to hospital discharge. After adjustment for covariates without chest compression depth and fraction (n=10,371), a global test found no significant relationship between compression rate and survival (p=0.19). However, after adjustment for covariates including chest compression depth and fraction (n=6,399), the global test found a significant relationship between compression rate and survival (p=0.02), with the reference group (100-119 compressions/min) having the greatest likelihood for survival. After adjustment for chest compression fraction and depth, compression rates between 100 and 120 per minute were associated with greatest survival to hospital discharge.

Rethinking plant functional types in Earth System Models: pan-tropical analysis of tree survival across environmental gradients

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Johnson, D. J.; Needham, J.; Xu, C.; Davies, S. J.; Bunyavejchewin, S.; Giardina, C. P.; Condit, R.; Cordell, S.; Litton, C. M.; Hubbell, S.; Kassim, A. R. B.; Shawn, L. K. Y.; Nasardin, M. B.; Ong, P.; Ostertag, R.; Sack, L.; Tan, S. K. S.; Yap, S.; McDowell, N. G.; McMahon, S.

2016-12-01

Terrestrial carbon cycling is a function of the growth and survival of trees. Current model representations of tree growth and survival at a global scale rely on coarse plant functional traits that are parameterized very generally. In view of the large biodiversity in the tropical forests, it is important that we account for the functional diversity in order to better predict tropical forest responses to future climate changes. Several next generation Earth System Models are moving towards a size-structured, trait-based approach to modelling vegetation globally, but the challenge of which and how many traits are necessary to capture forest complexity remains. Additionally, the challenge of collecting sufficient trait data to describe the vast species richness of tropical forests is enormous. We propose a more fundamental approach to these problems by characterizing forests by their patterns of survival. We expect our approach to distill real-world tree survival into a reasonable number of functional types. Using 10 large-area tropical forest plots that span geographic, edaphic and climatic gradients, we model tree survival as a function of tree size for hundreds of species. We found surprisingly few categories of size-survival functions emerge. This indicates some fundamental strategies at play across diverse forests to constrain the range of possible size-survival functions. Initial cluster analysis indicates that four to eight functional forms are necessary to describe variation in size-survival relations. Temporal variation in size-survival functions can be related to local environmental variation, allowing us to parameterize how demographically similar groups of species respond to perturbations in the ecosystem. We believe this methodology will yield a synthetic approach to classifying forest systems that will greatly reduce uncertainty and complexity in global vegetation models.

Corruption kills: estimating the global impact of corruption on children deaths.

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Matthieu Hanf

Full Text Available BACKGROUND: Information on the global risk factors of children mortality is crucial to guide global efforts to improve survival. Corruption has been previously shown to significantly impact on child mortality. However no recent quantification of its current impact is available. METHODS: The impact of corruption was assessed through crude Pearson's correlation, univariate and multivariate linear models coupling national under-five mortality rates in 2008 to the national "perceived level of corruption" (CPI and a large set of adjustment variables measured during the same period. FINDINGS: The final multivariable model (adjusted R(2= 0.89 included the following significant variables: percentage of people with improved sanitation (p.value<0.001, logarithm of total health expenditure (p.value = 0.006, Corruption Perception Index (p.value<0.001, presence of an arid climate on the national territory (p = 0.006, and the dependency ratio (p.value<0.001. A decrease in CPI of one point (i.e. a more important perceived corruption was associated with an increase in the log of national under-five mortality rate of 0.0644. According to this result, it could be roughly hypothesized that more than 140000 annual children deaths could be indirectly attributed to corruption. INTERPRETATIONS: Global response to children mortality must involve a necessary increase in funds available to develop water and sanitation access and purchase new methods for prevention, management, and treatment of major diseases drawing the global pattern of children deaths. However without paying regard to the anti-corruption mechanisms needed to ensure their proper use, it will also provide further opportunity for corruption. Policies and interventions supported by governments and donors must integrate initiatives that recognise how they are inter-related.

Opinion, Dialogue, Review: The New ILO Report on Child Labour--A Success Story, or the ILO Still at a Loss?

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Liebel, Manfred

2007-01-01

With this year's Global Report on Child Labour, the International Labour Organization (ILO) adopts a stance of victory. With confidence and pride, it announces that "the worldwide movement against child labour" led by the ILO itself has brought "the end of child labour--within reach". However, no convincing proof is given for this surprising…

Setting global research priorities for integrated community case management (iCCM: Results from a CHNRI (Child Health and Nutrition Research Initiative exercise

Directory of Open Access Journals (Sweden)

Kerri Wazny

2014-11-01

Full Text Available Aims: to systematically identify global research gaps and resource priorities for integrated community case management (iCCM. Methods: an iCCM Child Health and Nutrition Research Initiative (CHNRI Advisory Group, in collaboration with the Community Case Management Operational Research Group (CCM ORG identified experts to participate in a CHNRI research priority setting exercise. These experts generated and systematically ranked research questions for iCCM. Research questions were ranked using a “Research Priority Score” (RPS and the “Average Expert Agreement” (AEA was calculated for every question. Our groups of experts were comprised of both individuals working in Ministries of Health or Non Governmental Organizations (NGOs in low– and middle–income countries (LMICs and individuals working in high–income countries (HICs in academia or NGO headquarters. A Spearman's Rho was calculated to determine the correlation between the two groups' research questions' ranks. Results: The overall RPS ranged from 64.58 to 89.31, with a median score of 81.43. AEA scores ranged from 0.54 to 0.86. Research questions involving increasing the uptake of iCCM services, research questions concerning the motivation, retention, training and supervision of Community Health Workers (CHWs and concerning adding additional responsibilities including counselling for infant and young child feeding (IYCF and treatment of severe acute malnutrition (SAM ranked highly. There was weak to moderate, statistically significant, correlation between scores by representatives of high–income countries and those working in–country or regionally (Spearman's ρ = 0.35034, P < 0.01. Conclusions: Operational research to determine optimal training, supervision and modes of motivation and retention for the CHW is vital for improving iCCM, globally, as is research to motivate caregivers to take advantage of iCCM services. Experts working in–country or regionally in

Global, regional, national, and selected subnational levels of stillbirths, neonatal, infant, and under-5 mortality, 1980-2015 : A systematic analysis for the Global Burden of Disease Study 2015

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Wang, Haidong; Bhutta, Zulfiqar A.; Coates, Matthew M.; Coggeshall, Megan; Dandona, Lalit; Diallo, Khassoum; Franca, Elisabeth Barboza; Fraser, Maya; Fullman, Nancy; Gething, Peter W.; Hay, Simon I.; Kinfu, Yohannes; Kita, Maaya; Kulikoff, Xie Rachel; Larson, Heidi J.; Liang, Juan; Liang, Xiaofeng; Lim, Stephen S.; Lind, Margaret; Lopez, Alan D.; Lozano, Rafael; Mensah, George A.; Mikesell, Joseph B.; Mokdad, Ali H.; Mooney, Meghan D.; Naghavi, Mohsen; Nguyen, Grant; Rakovac, Ivo; Salomon, Joshua A.; Silpakit, Naris; Sligar, Amber; Sorensen, Reed J. D.; Vos, Theo; Zhu, Jun; Abajobir, Amanuel Alemu; Abate, Kalkidan Hassen; Abbas, Kaja M.; Abd-Allah, Foad; Abdulle, Abdishakur M.; Abera, Semaw Ferede; Aboyans, Victor; Abraham, Biju; Abubakar, Ibrahim; Abu-Raddad, Laith J.; Abu-Rmeileh, Niveen M. E.; Abyu, Gebre Yitayih; Achoki, Tom; Adebiyi, Akindele Olupelumi; Adedeji, Isaac Akinkunmi; Adelekan, Ademola Lukman; Adou, Arsene Kouablan; Agarwal, Arnav; Ajala, Oluremi N.; Akinyemiju, Tomi F.; Akseer, Nadia; Alam, Khurshid; Alam, Noore K. M.; Alasfoor, Deena; Aldridge, Robert William; Alegretti, Miguel Angel; Alemu, Zewdie Aderaw; Ali, Raghib; Alkerwi, Ala'a; Alla, Francois; Al-Raddadi, Rajaa; Alsharif, Ubai; Altirkawi, Khalid A.; Martin, Elena Alvarez; Alvis-Guzman, Nelson; Amare, Azmeraw T.; Amberbir, Alemayehu; Amegah, Adeladza Kofi; Ameh, Emmanuel A.; Ammar, Walid; Amrock, Stephen Marc; Andersen, Hjalte H.; Anderson, Gregory M.; Antonio, Carl Abelardo T.; Arlov, Johan; Artaman, Al; Asayesh, Hamid; Asghar, Rana Jawad; Assadi, Reza; Atique, Suleman; Avokpaho, Euripide Frinel G. Arthur; Awasthi, Ashish; Quintanilla, Beatriz Paulina Ayala; Bacha, Umar; Badawi, Alaa; Balakrishnan, Kalpana; Banerjee, Amitava; Banigbe, Bolanle F.; Barac, Aleksandra; Barber, Ryan M.; Barker-Collo, Suzanne L.; Barnighausen, Till; Barrero, Lope H.; Bayou, Tigist Assefa; Bayou, Yibeltal Tebekaw; Bazargan-Hejazi, Shahrzad; Beardsley, Justin; Bedi, Neeraj; Bekele, Tolesa; Bell, Michelle L.; Bello, Aminu K.; Bennett, Derrick A.; Bensenor, Isabela M.; Berhane, Adugnaw; Bernabe, Eduardo; Betsu, Balem Demtsu; Beyene, Addisu Shunu; Bhatt, Samir; Biadgilign, Sibhatu; Bikbov, Boris; Birlik, Sait Mentes; Bisanzio, Donal; Bjertness, Espen; Blore, Jed D.; Bourne, Rupert R. A.; Brainin, Michael; Brazinova, Alexandra; Breitborde, Nicholas J. K.; Brown, Alexandria; Colin Buckle, Geoff Rey; Burch, Michael; Butt, Zahid A.; Ricardo Campos-Nonato, Ismael; Cesar Campuzano, Julio; Cardenas, Rosario; Carpenter, David O.; Jesus Carrero, Juan; Carter, Austin; Casey, Daniel C.; Castaneda-Orjuela, Carlos A.; Rivas, Jacqueline Castillo; Castro, Ruben Estanislao; Catala-Lopez, Ferran; Cercy, Kelly; Chang, Hsing-Yi; Chang, Jung-Chen; Chibueze, Chioma Ezinne; Chisumpa, Vesper Hichilombwe; Choi, Jee-Young Jasmine; Chowdhury, Rajiv; Christopher, Devasahayam Jesudas; Ciobanu, Liliana G.; Colquhoun, Samantha M.; Cooper, Cyrus; Cornaby, Leslie; Damtew, Solomon Abrha; Danawi, Hadi; Dandona, Rakhi; das Neves, Jose; Davis, Adrian C.; de Jager, Pieter; De Leo, Diego; Degenhardt, Louisa; Deribe, Kebede; Deribew, Amare; Jarlais, Don C. Des; deVeber, Gabrielle A.; Dharmaratne, Samath D.; Dhillon, Preet K.; Ding, Eric L.; Doshi, Pratik Pinal; Doyle, Kerrie E.; Duan, Leilei; Dubey, Manisha; Ebrahimi, Hedyeh; Ellingsen, Christian Lycke; Elyazar, Iqbal; Endries, Aman Yesuf; Ermakov, Sergey Petrovich; Eshrati, Babak; Esteghamati, Alireza; Faraon, Emerito Jose Aquino; Farid, Talha A.; Farinha, Carla Sofia e Sa; Faro, Andre; Farvid, Maryam S.; Farzadfar, Farshad; Fereshtehnejad, Seyed-Mohammad; Fernandes, Joao C.; Fischer, Florian; Fitchett, Joseph R. A.; Foigt, Nataliya; Franklin, Richard C.; Friedman, Joseph; Furst, Thomas; Gambashidze, Ketevan; Gamkrelidze, Amiran; Ganguly, Parthasarathi; Gebre, Teshome; Gebrehiwot, Tsegaye Tewelde; Gebremedhin, Amanuel Tesfay; Gebru, Alemseged Aregay; Geleijnse, Johanna M.; Gessner, Bradford D.; Ginawi, Ibrahim Abdelmageem Mohamed; Giref, Ababi Zergaw; Gishu, Melkamu Dedefo; Gomez-Dantes, Hector; Gona, Philimon; Goodridge, Amador; Gopalani, Sameer Vali; Goto, Atsushi; Gouda, Hebe N.; Gugnani, Harish Chander; Guo, Yuming; Gupta, Rahul; Gupta, Rajeev; Gupta, Vipin; Gyawali, Bishal; Haagsma, Juanita A.; Hafezi-Nejad, Nima; Haile, Demewoz; Hailu, Alemayehu Desalegne; Hailu, Gessessew Bugssa; Hamadeh, Randah Ribhi; Hamidi, Samer; Hancock, Jamie; Handal, Alexis J.; Hankey, Graeme J.; Harb, Hilda L.; Harikrishnan, Sivadasanpillai; Harun, Kimani M.; Havmoeller, Rasmus; Hay, Roderick J.; Heredia-Pi, Ileana Beatriz; Hoek, Hans W.; Horino, Masako; Horita, Nobuyuki; Hosgood, H. Dean; Hotez, Peter J.; Hoy, Damian G.; Hsairi, Mohamed; Hu, Guoqing; Huang, Cheng; Huang, John J.; Huang, Hsiang; Huiart, Laetitia; Huynh, Chantal; Iburg, Kim Moesgaard; Idrisov, Bulat T.; Innos, Kaire; Jacobsen, Kathryn H.; Jahanmehr, Nader; Javanbakht, Mehdi; Jayatilleke, Achala Upendra; Jee, Sun Ha; Jeemon, Panniyammakal; Jha, Vivekanand; Jiang, Guohong; Jiang, Ying; Jibat, Tariku; Jin, Ye; Jonas, Jost B.; Kabir, Zubair; Kalkonde, Yogeshwar; Kamal, Ritul; Kan, Haidong; Kang, Gagandeep; Karch, Andre; Karema, Corine Kakizi; Kasaeian, Amir; Kaul, Anil; Kawakami, Norito; Kayibanda, Jeanne Francoise; Kazanjan, Konstantin; Keiyoro, Peter Njenga; Kemp, Andrew Haddon; Kengne, Andre Pascal; Keren, Andre; Kereselidze, Maia; Kesavachandran, Chandrasekharan Nair; Khader, Yousef Saleh; Khalil, Ibrahim A.; Khan, Abdur Rahman; Khan, Ejaz Ahmad; Khang, Young-Ho; Khonelidze, Irma; Khubchandani, Jagdish; Kim, Cho-il; Kim, Daniel; Kim, Yun Jin; Kissoon, Niranjan; Kivipelto, Miia; Knibbs, Luke D.; Kokubo, Yoshihiro; Kosen, Soewarta; Koul, Parvaiz A.; Koyanagi, Ai; Defo, Barthelemy Kuate; Bicer, Burcu Kucuk; Kudom, Andreas A.; Kumar, G. Anil; Kutz, Michael J.; Kyu, Hmwe H.; Lal, Dharmesh Kumar; Lalloo, Ratilal; Lam, Hilton; Lam, Jennifer O.; Lansingh, Van C.; Larsson, Anders; Leigh, James; Leung, Ricky; Li, Yichong; Li, Yongmei; Lindsay, M. Patrice; Liu, Patrick Y.; Liu, Shiwei; Lloyd, Belinda K.; Lo, Warren D.; Logroscino, Giancarlo; Low, Nicola; Lunevicius, Raimundas; Lyons, Ronan A.; Ma, Stefan; Abd El Razek, Hassan Magdy; Abd El Razek, Mohammed Magdy; Mahdavi, Mahdi; Majdan, Marek; Majeed, Azeem; Malekzadeh, Reza; Mapoma, Chabila C.; Marcenes, Wagner; Martinez-Raga, Jose; Marzan, Melvin Barrientos; Masiye, Felix; McGrath, John J.; Meaney, Peter A.; Mehari, Alem; Mehndiratta, Man Mohan; Mekonnen, Alemayehu B.; Melaku, Yohannes Adama; Memiah, Peter; Memish, Ziad A.; Mendoza, Walter; Meretoja, Atte; Meretoja, Tuomo J.; Mhimbira, Francis Apolinary; Miller, Ted R.; Mills, Edward J.; Mirarefin, Mojde; Misganaw, Awoke; Mock, Charles N.; Mohammad, Karzan Abdulmuhsin; Mohammadi, Alireza; Mohammed, Shafi U.; Monasta, Lorenzo; Hernandez, Julio Cesar Montanez; Montico, Marcella; Moore, Ami R.; Moradi-Lakeh, Maziar; Morawska, Lidia; Mori, Rintaro; Mueller, Ulrich O.; Murphy, Georgina A. V.; Murthy, Srinivas; Nachega, Jean B.; Naheed, Aliya; Naidoo, Kovin S.; Naldi, Luigi; Nand, Devina; Nangia, Vinay; Neupane, Subas; Newton, Charles R.; Newton, John N.; Ng, Marie; Ngalesoni, Frida Namnyak; Nguhiu, Peter; Quyen Le Nguyen, [Unknown; Nisar, Muhammad Imran; Pete, Patrick Martial Nkamedjie; Norheim, Ole F.; Norman, Rosana E.; Ogbo, Felix Akpojene; Oh, In-Hwan; Ojelabi, Foluke Adetola; Olivares, Pedro R.; Olusanya, Bolajoko Olubukunola; Olusanya, Jacob Olusegun; Oren, Eyal; Ota, Erika; Mahesh, P. A.; Park, Eun-Kee; Park, Hye-Youn; Parsaeian, Mahboubeh; Caicedo, Angel J. Paternina; Patten, Scott B.; Pedro, Joao Mario; Pereira, David M.; Perico, Norberto; Pesudovs, Konrad; Petzold, Max; Phillips, Michael Robert; Pillay, Julian David; Pishgar, Farhad; Polinder, Suzanne; Pope, Daniel; Popova, Svetlana; Pourmalek, Farshad; Qorbani, Mostafa; Rabiee, Rynaz H. S.; Rafay, Anwar; Rahimi-Movaghar, Vafa; Rahman, Mahfuzar; Rahman, Mohammad Hifz Ur; Rahman, Sajjad Ur; Rai, Rajesh Kumar; Raju, Murugesan; Ram, Usha; Rana, Saleem M.; Ranabhat, Chhabi Lal; Rao, Puja; Refaat, Amany H.; Remuzzi, Giuseppe; Resnikoff, Serge; Reynolds, Alex; Rojas-Rueda, David; Ronfani, Luca; Roshandel, Gholamreza; Roth, Gregory A.; Roy, Ambuj; Ruhago, George Mugambage; Sagar, Rajesh; Saleh, Muhammad Muhammad; Sanabria, Juan R.; Sanchez-Nino, Maria Dolores; Santos, Itamar S.; Santos, Joao Vasco; Sarmiento-Suarez, Rodrigo; Sartorius, Benn; Satpathy, Maheswar; Savic, Miloje; Sawhney, Monika; Schneider, Ione J. C.; Schottker, Ben; Schwebel, David C.; Seedat, Soraya; Sepanlou, Sadaf G.; Servan-Mori, Edson E.; Setegn, Tesfaye; Shahraz, Saeid; Shaikh, Masood Ali; Shakh-Nazarova, Marina; Sharma, Rajesh; She, Jun; Sheikhbahaei, Sara; Shen, Jiabin; Sheth, Kevin N.; Shibuya, Kenji; Shin, Hwashin Hyun; Shin, Min-Jeong; Shiri, Rahman; Shuie, Ivy; Sigfusdottir, Inga Dora; Silva, Diego Augusto Santos; Silverberg, Jonathan; Simard, Edgar P.; Sindi, Shireen; Singh, Abhishek; Singh, Jasvinder A.; Singh, Om Prakash; Singh, Prashant Kumar; Singh, Virendra; Soriano, Joan B.; Soshnikov, Sergey; Sposato, Luciano A.; Sreeramareddy, Chandrashekhar T.; Stathopoulou, Vasiliki; Steel, Nicholas; Stroumpoulis, Konstantinos; Sturua, Lela; Sunguya, Bruno F.; Swaminathan, Soumya; Sykes, Bryan L.; Szoeke, Cassandra E. I.; Tabares-Seisdedos, Rafael; Tavakkoli, Mohammad; Taye, Bineyam; Tedla, Bemnet Amare; Tefera, Worku Mekonnen; Tekle, Tesfaye; Shifa, Girma Temam; Terkawi, Abdullah Sulieman; Tesfay, Fisaha Haile; Tessema, Gizachew Assefa; Thapa, Kiran; Thomson, Alan J.; Thorne-Lyman, Andrew L.; Tobe-Gai, Ruoyan; Tonelli, Marcello; Topor-Madry, Roman; Topouzis, Fotis; Tran, Bach Xuan; Troeger, Christopher; Truelsen, Thomas; Dimbuene, Zacharie Tsala; Tura, Abera Kenay; Tyrovolas, Stefanos; Ukwaja, Kingsley N.; Uneke, Chigozie Jesse; Uthman, Olalekan A.; Vaezghasemi, Masoud; Vasankari, Tommi; Vasconcelos, Ana Maria Nogales; Venketasubramanian, Narayanaswamy; Verma, Raj Kumar; Violante, Francesco S.; Vladimirov, Sergey K.; Vlassov, Vasiliy Victorovich; Vollset, Stein Emil; Wang, Linhong; Wang, Yanping; Weichenthal, Scott; Weiderpass, Elisabete; Weintraub, Robert G.; Weiss, Daniel J.; Werdecker, Andrea; Westerman, Ronny; Widdowson, Marc-Alain; Wijeratne, Tissa; Williams, Thomas Neil; Wiysonge, Charles Shey; Wolfe, Charles D. A.; Wolfe, Ingrid; Won, Sungho; Wubshet, Mamo; Xiao, Qingyang; Xu, Gelin; Yadav, Ajit Kumar; Yakob, Bereket; Yano, Yuichiro; Yaseri, Mehdi; Ye, Pengpeng; Yebyo, Henock Gebremedhin; Yip, Paul; Yonemoto, Naohiro; Yoon, Seok-Jun; Younis, Mustafa Z.; Yu, Chuanhua; Zaidi, Zoubida; Zaki, Maysaa El Sayed; Zeeb, Hajo; Zhang, Hao; Zhao, Yong; Zheng, Yingfeng; Zhou, Maigeng; Zodpey, Sanjay; Murray, Christopher J. L.

2016-01-01

Background Established in 2000, Millennium Development Goal 4 (MDG4) catalysed extraordinary political, financial, and social commitments to reduce under-5 mortality by two-thirds between 1990 and 2015. At the country level, the pace of progress in improving child survival has varied markedly,

The effects of water type on growth, survival and condition of ...

African Journals Online (AJOL)

STORAGESEVER

2010-02-01

Feb 1, 2010 ... Available online at http://www.academicjournals.org/AJB ... Feed conversion ratio did not differ significantly among groups. Survival ... industry holds an important place in the global fishery ... The largest market for aquarium.

Evaluating the Impact of Zimbabwe’s Prevention of Mother-to-Child HIV Transmission Program: Population-Level Estimates of HIV-Free Infant Survival Pre-Option A

Science.gov (United States)

Buzdugan, Raluca; McCoy, Sandra I.; Watadzaushe, Constancia; Kang Dufour, Mi-Suk; Petersen, Maya; Dirawo, Jeffrey; Mushavi, Angela; Mujuru, Hilda Angela; Mahomva, Agnes; Musarandega, Reuben; Hakobyan, Anna; Mugurungi, Owen; Cowan, Frances M.; Padian, Nancy S.

2015-01-01

Objective We estimated HIV-free infant survival and mother-to-child HIV transmission (MTCT) rates in Zimbabwe, some of the first community-based estimates from a UNAIDS priority country. Methods In 2012 we surveyed mother-infant pairs residing in the catchment areas of 157 health facilities randomly selected from 5 of 10 provinces in Zimbabwe. Enrolled infants were born 9–18 months before the survey. We collected questionnaires, blood samples for HIV testing, and verbal autopsies for deceased mothers/infants. Estimates were assessed among i) all HIV-exposed infants, as part of an impact evaluation of Option A of the 2010 WHO guidelines (rolled out in Zimbabwe in 2011), and ii) the subgroup of infants unexposed to Option A. We compared province-level MTCT rates measured among women in the community with MTCT rates measured using program monitoring data from facilities serving those communities. Findings Among 8568 women with known HIV serostatus, 1107 (12.9%) were HIV-infected. Among all HIV-exposed infants, HIV-free infant survival was 90.9% (95% confidence interval (CI): 88.7–92.7) and MTCT was 8.8% (95% CI: 6.9–11.1). Sixty-six percent of HIV-exposed infants were still breastfeeding. Among the 762 infants born before Option A was implemented, 90.5% (95% CI: 88.1–92.5) were alive and HIV-uninfected at 9–18 months of age, and 9.1% (95%CI: 7.1–11.7) were HIV-infected. In four provinces, the community-based MTCT rate was higher than the facility-based MTCT rate. In Harare, the community and facility-based rates were 6.0% and 9.1%, respectively. Conclusion By 2012 Zimbabwe had made substantial progress towards the elimination of MTCT. Our HIV-free infant survival and MTCT estimates capture HIV transmissions during pregnancy, delivery and breastfeeding regardless of whether or not mothers accessed health services. These estimates also provide a baseline against which to measure the impact of Option A guidelines (and subsequently Option B+). PMID:26248197

Factors Associated with Complicated Grief in Students Who Survived the Sewol Ferry Disaster in South Korea.

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Lee, So Hee; Nam, Hee Sun; Kim, Hak Beom; Kim, Eun Ji; Noh, Jin-Won; Chae, Jeong-Ho

2018-03-01

The Sewol ferry disaster caused shock and grief in South Korea. The aim of this study was to identify the factors associated with symptoms of complicated grief (CG) among the surviving students 20 months after that disaster. This study was conducted using a cross-sectional design and a sample of 57 students who survived the Sewol ferry disaster. Data were collected using the following instruments: Inventory of Complicated Grief (ICG), the Lifetime Incidence of Traumatic Events-Child, the Child Report of Post-Traumatic Symptoms (CROPS), KIDSCREEN-27, Family Adaptability and Cohesion Evaluation Scales-III, the Peri-traumatic Dissociation-Post-traumatic Negative Beliefs-Post-traumatic Social Support scale, and the Strengths and Difficulties Questionnaire. A generalized linear model using a log link and Poisson distribution was performed to identify factors associated with symptoms of CG. The mean score on the ICG was 15.57 (standard deviation: 12.72). Being born in 1999, a higher score on the CROPS and a lower score in autonomy and relationship with parents on the KIDSCREEN-27 were related to higher levels of CG. Twenty months after the Sewol ferry disaster, 24.5% of surviving students were suffering from CG. This study uncovered a vulnerable population of bereaved children at high risk for CG.

Parent-Child Agreement on Parent-to-Child Maltreatment.

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Compier-de Block, Laura H C G; Alink, Lenneke R A; Linting, Mariëlle; van den Berg, Lisa J M; Elzinga, Bernet M; Voorthuis, Alexandra; Tollenaar, Marieke S; Bakermans-Kranenburg, Marian J

2017-01-01

Parent-child agreement on child maltreatment was examined in a multigenerational study. Questionnaires on perpetrated and experienced child maltreatment were completed by 138 parent-child pairs. Multi-level analyses were conducted to explore whether parents and children agreed about levels of parent-to-child maltreatment (convergence), and to examine whether parents and children reported equal levels of child maltreatment (absolute differences). Direct and moderating effects of age and gender were examined as potential factors explaining differences between parent and child report. The associations between parent- and child-reported maltreatment were significant for all subtypes, but the strength of the associations was low to moderate. Moreover, children reported more parent-to-child neglect than parents did. Older participants reported more experienced maltreatment than younger participants, without evidence for differences in actual exposure. These findings support the value of multi-informant assessment of child maltreatment to improve accuracy, but also reveal the divergent perspectives of parents and children on child maltreatment.

Shared Principles of Ethics for Infant and Young Child Nutrition in the Developing World

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Daar Abdallah S

2010-06-01

Full Text Available Abstract Background The defining event in the area of infant feeding is the aggressive marketing of infant formula in the developing world by transnational companies in the 1970s. This practice shattered the trust of the global health community in the private sector, culminated in a global boycott of Nestle products and has extended to distrust of all commercial efforts to improve infant and young child nutrition. The lack of trust is a key barrier along the critical path to optimal infant and young child nutrition in the developing world. Discussion To begin to bridge this gap in trust, we developed a set of shared principles based on the following ideals: Integrity; Solidarity; Justice; Equality; Partnership, cooperation, coordination, and communication; Responsible Activity; Sustainability; Transparency; Private enterprise and scale-up; and Fair trading and consumer choice. We hope these principles can serve as a platform on which various parties in the in the infant and young child nutrition arena, can begin a process of authentic trust-building that will ultimately result in coordinated efforts amongst parties. Summary A set of shared principles of ethics for infant and young child nutrition in the developing world could catalyze the scale-up of low cost, high quality, complementary foods for infants and young children, and eventually contribute to the eradication of infant and child malnutrition in the developing world.

Appropriate food policies and investments could reduce child malnutrition by 43% in 2020.

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Rosegrant, Mark W; Meijer, Siet

2002-11-01

This report describes past trends in global child malnutrition and assesses future prospects for reducing child malnutrition. Most developing countries have significantly reduced the proportion of malnourished children during the past three decades. However, because of population growth, the absolute number of malnourished children has fallen much less sharply. Moreover, the number of malnourished children has increased in Sub-Saharan Africa. A global food supply-and-demand model is used to project child malnutrition to 2020 under alternative assumptions on policies and investments that influence food security outcomes in education, clean water, agricultural research, irrigation and rural infrastructure. The baseline "best-estimate" projection shows that the number of malnourished children will continue to decline slowly but that child malnutrition will continue to increase in Sub-Saharan Africa. The optimistic scenario shows that better policy and more rapid economic and agricultural growth can lead to substantial food security improvements, but the pessimistic scenario shows that significantly worse outcomes are also possible with relatively small declines in policy and investment efforts relative to the baseline. A concerted effort to eliminate childhood malnutrition would require policy reform and significant increases in public investment to produce long-term gains in income growth, agricultural productivity and social indicators.

Nutrition and the child with cancer: where do we stand and where do ...

African Journals Online (AJOL)

of nutrition in children and young adults with malignancies is still ... decrease energy expenditure to allow prolonged survival are either lost or inhibited in certain .... tools are available to estimate energy and nutrient needs of the child with cancer ... does not recommend their use in seriously or chronically ill children until the ...

FERTILITY, CHILD LABOUR AND MIGRATION OF AGRICULTURAL DAY LABORERS (AS OF COFFEE IN THECROSS-BORDER SPACE MEXICO-GUATEMALA

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Austreberta Nazar-Beutelspacher

2014-07-01

Full Text Available Chiapas as the border departments of Guatemala is characterized as an area of socio-economic backwardness. Since the twentieth century a significant flow of undocumented Guatemalan migrant families are temporarily employed in Mexican coffee plantations in the Soconusco region, mostly from the poorest and most marginalized rural sectors from the border Guatemalan departments. This paper estimates the marital Total Fertility Rate and explores the reproductive characteristics of Guatemalan agricultural laborers families. The Global marital fertility rate is high (5.65 children per woman on average at the end of their reproductive life with an increasing trend. It is argued that a high number of children in these families are functional for them, since they require the family labor for their survival. In this cross-border area are articulated by child labor, high fertility of Guatemalan rural migrants, due to the political and socioeconomic conditions of Guatemala, and the development needs of the agricultural export capital coffee in Mexico, permanently driven by the Mexican government.

Global health inequalities and the need for solidarity: a view from the Global South.

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Tosam, Mbih J; Chi, Primus Che; Munung, Nchangwi Syntia; Oukem-Boyer, Odile Ouwe Missi; Tangwa, Godfrey B

2017-12-20

Although the world has experienced remarkable progress in health care since the last half of the 20th century, global health inequalities still persist. In some poor countries life expectancy is between 37-40 years lower than in rich countries; furthermore, maternal and infant mortality is high and there is lack of access to basic preventive and life-saving medicines, as well a high prevalence of neglected diseases, HIV/AIDS, tuberculosis, and malaria. Moreover, globalization has made the world more connected than before such that health challenges today are no longer limited within national or regional boundaries, making all persons equally vulnerable. Because of this, diseases in the most affluent countries are closely connected with diseases in the poorest countries. In this paper, we argue that, because of global health inequalities, in a situation of equal vulnerability, there is need for global solidarity not only as a means of reducing health inequalities, but also as a way of putting up a united force against global health challenges. We argue for an African approach to solidarity in which the humanity of a person is not determined by his/her being human or rational capacity, but by his/her capacity to live a virtuous life. According to this view of solidarity, because no one is self-sufficient, no individual can survive alone. If we are to collectively flourish in a world where no individual, nation or region has all the health resources or protection needed for survival, we must engage in solidarity where we remain compassionate and available to one another at all times. © 2017 John Wiley & Sons Ltd.

Becoming a parent to a child with birth asphyxia—From a traumatic delivery to living with the experience at home

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Alina Heringhaus

2013-04-01

Full Text Available The aim of this study is to describe the experiences of becoming a parent to a child with birth asphyxia treated with hypothermia in the neonatal intensive care unit (NICU. In line with the medical advances, the survival of critically ill infants with increased risk of morbidity is increasing. Children who survive birth asphyxia are at a higher risk of functional impairments, cerebral palsy (CP, or impaired vision and hearing. Since 2006, hypothermia treatment following birth asphyxia is used in many of the Swedish neonatal units to reduce the risk of brain injury. To date, research on the experience of parenthood of the child with birth asphyxia is sparse. To improve today's neonatal care delivery, health-care providers need to better understand the experiences of becoming a parent to a child with birth asphyxia. A total of 26 parents of 16 children with birth asphyxia treated with hypothermia in a Swedish NICU were interviewed. The transcribed interview texts were analysed according to a qualitative latent content analysis. We found that the experience of becoming a parent to a child with birth asphyxia treated with hypothermia at the NICU was a strenuous journey of overriding an emotional rollercoaster, that is, from being thrown into a chaotic situation which started with a traumatic delivery to later processing the difficult situation of believing the child might not survive or was to be seriously affected by the asphyxia. The prolonged parent–infant separation due to the hypothermia treatment and parents’ fear of touching the infant because of the high-tech equipment seemed to hamper the parent–infant bonding. The adaption of the everyday life at home seemed to be facilitated by the follow-up information of the doctor after discharge. The results of this study underline the importance of family-centered support during and also after the NICU discharge.

Becoming a parent to a child with birth asphyxia-From a traumatic delivery to living with the experience at home.

Science.gov (United States)

Heringhaus, Alina; Blom, Michaela Dellenmark; Wigert, Helena

2013-04-30

The aim of this study is to describe the experiences of becoming a parent to a child with birth asphyxia treated with hypothermia in the neonatal intensive care unit (NICU). In line with the medical advances, the survival of critically ill infants with increased risk of morbidity is increasing. Children who survive birth asphyxia are at a higher risk of functional impairments, cerebral palsy (CP), or impaired vision and hearing. Since 2006, hypothermia treatment following birth asphyxia is used in many of the Swedish neonatal units to reduce the risk of brain injury. To date, research on the experience of parenthood of the child with birth asphyxia is sparse. To improve today's neonatal care delivery, health-care providers need to better understand the experiences of becoming a parent to a child with birth asphyxia. A total of 26 parents of 16 children with birth asphyxia treated with hypothermia in a Swedish NICU were interviewed. The transcribed interview texts were analysed according to a qualitative latent content analysis. We found that the experience of becoming a parent to a child with birth asphyxia treated with hypothermia at the NICU was a strenuous journey of overriding an emotional rollercoaster, that is, from being thrown into a chaotic situation which started with a traumatic delivery to later processing the difficult situation of believing the child might not survive or was to be seriously affected by the asphyxia. The prolonged parent-infant separation due to the hypothermia treatment and parents' fear of touching the infant because of the high-tech equipment seemed to hamper the parent-infant bonding. The adaption of the everyday life at home seemed to be facilitated by the follow-up information of the doctor after discharge. The results of this study underline the importance of family-centered support during and also after the NICU discharge.

Malicious Botnet Survivability Mechanism Evolution Forecasting by Means of a Genetic Algorithm

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Nikolaj Goranin

2012-04-01

Full Text Available Botnets are considered to be among the most dangerous modern malware types and the biggest current threats to global IT infrastructure. Botnets are rapidly evolving, and therefore forecasting their survivability strategies is important for the development of countermeasure techniques. The article propose the botnet-oriented genetic algorithm based model framework, which aimed at forecasting botnet survivability mechanisms. The model may be used as a framework for forecasting the evolution of other characteristics. The efficiency of different survivability mechanisms is evaluated by applying the proposed fitness function. The model application area also covers scientific botnet research and modelling tasks.

Nutrition and the child with cancer: where do we stand and where do ...

African Journals Online (AJOL)

As a result of ongoing research and better supportive care, the treatment of childhood malignancies has dramatically improved survival in developed countries. The same cannot be said about the all important nutritional care of the child with cancer as much still needs to be done to reach the ultimate goal, namely to provide ...

Survival rates and predictors of survival among colorectal cancer patients in a Malaysian tertiary hospital.

Science.gov (United States)

Magaji, Bello Arkilla; Moy, Foong Ming; Roslani, April Camilla; Law, Chee Wei

2017-05-18

Colorectal cancer is the third most commonly diagnosed malignancy and the fourth leading cause of cancer-related death globally. It is the second most common cancer among both males and females in Malaysia. The economic burden of colorectal cancer is likely to increase over time owing to its current trend and aging population. Cancer survival analysis is an essential indicator for early detection and improvement in cancer treatment. However, there was a scarcity of studies concerning survival of colorectal cancer patients as well as its predictors. Therefore, we aimed to determine the 1-, 3- and 5-year survival rates, compare survival rates among ethnic groups and determine the predictors of survival among colorectal cancer patients. This was an ambidirectional cohort study conducted at the University Malaya Medical Centre (UMMC) in Kuala Lumpur, Malaysia. All Malaysian citizens or permanent residents with histologically confirmed diagnosis of colorectal cancer seen at UMMC from 1 January 2001 to 31 December 2010 were included in the study. Demographic and clinical characteristics were extracted from the medical records. Patients were followed-up until death or censored at the end of the study (31st December 2010). Censored patients' vital status (whether alive or dead) were cross checked with the National Registration Department. Survival analyses at 1-, 3- and 5-year intervals were performed using the Kaplan-Meier method. Log-rank test was used to compare the survival rates, while Cox proportional hazard regression analysis was carried out to determine the predictors of 5-year colorectal cancer survival. Among 1212 patients, the median survival for colorectal, colon and rectal cancers were 42.0, 42.0 and 41.0 months respectively; while the 1-, 3-, and 5-year relative survival rates ranged from 73.8 to 76.0%, 52.1 to 53.7% and 40.4 to 45.4% respectively. The Chinese patients had the lowest 5-year survival compared to Malay and Indian patients. Based on the 814

Acceptability of child adoption as management option for infertility in ...

African Journals Online (AJOL)

Infertility remains a global health challenge with devastating psycho-social consequences in many African communities. Adoption that may serve as an alternative strategy for the affected couples is not widely practiced. This study was conceptualized to assess the acceptability of child adoption as a management option by ...

Scaling-up access to family planning may improve linear growth and child development in low and middle income countries.

Science.gov (United States)

Fink, Günther; Sudfeld, Christopher R; Danaei, Goodarz; Ezzati, Majid; Fawzi, Wafaie W

2014-01-01

A large literature has indicated a robust association between birth spacing and child survival, but evidence on the association of birth timing with physical growth in low and middle income countries (LMICs) remains limited. Data from 153 cross-sectional Demographic and Health Surveys (DHS) across 61 LMICs conducted between 1990 and 2011 were combined to assess the association of birth timing with child stunting (height-for-age z-score Middle East and North Africa sample. Postponing the age of first birth and increasing inter-pregnancy intervals has the potential to significantly reduce the prevalence of stunting and improve child development in LMICs.

Locations of Joint Physical Activity in Parent-Child Pairs Based on Accelerometer and GPS Monitoring

Science.gov (United States)

Dunton, Genevieve Fridlund; Liao, Yue; Almanza, Estela; Jerrett, Micheal; Spruijt-Metz, Donna; Pentz, Mary Ann

2012-01-01

Background Parental factors may play an important role in influencing children’s physical activity levels. Purpose This cross-sectional study sought to describe the locations of joint physical activity among parents and children. Methods Parent-child pairs (N = 291) wore an Actigraph GT2M accelerometer and GlobalSat BT-335 Global Positioning Systems (GPS) device over the same 7-day period. Children were ages 8–14 years. Joint behavior was defined by a linear separation distance of less than 50m between parent and child. Land use classifications were assigned to GPS data points. Results Joint physical activity was spread across residential locations (35%), and commercial venues (24%), and open spaces/parks (20%). Obese children and parents performed less joint physical activity in open spaces/parks than under/normal weight children and parents (p’s parent-child physical activity naturally occurs may inform location-based interventions to promote these behaviors. PMID:23011914

EXPLODING THE ROLE OF RELIGIOUS INSTITUTIONS IN COMBATING CHILD TRAFFICKING IN NIGERIA

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Alhaji Umar Alkali

2015-02-01

Full Text Available Human trafficking is a global challenge especially in the 21stCentury. Nigeria like most developing countries is doing its best in addressing the menace of child trafficking. In view of the fact that religious institutions are highly respected in Nigeria, this paper intends to adopt a doctrinal methodology in examining the menace of child trafficking in Nigeria, by using the perspective of Islam and Christianity. Moreover, also seeing the role that can be played by the Supreme Council of Islamic Affairs and the Christian Association of Nigeria in the crusade against child trafficking in Nigeria Perdagangan manusia merupakan sebuah tantangan global pada abad ke-21. Sebagaimana negara berkembang pada umumnya, Nigeria melakukan upaya yang terbaik guna menangani ancaman perdagangan anak. Mengingat bahwa institusi keagamaan sangat dihormati di Nigeria, artikel ini bermaksud untuk mengadopsi metodologi doktrin dalam mengkaji ancaman perdagangan anak di Nigeria, melalui perspektif agama Islam dan agama Kristen perihal perdagangan anak. Selain itu, juga melihat peran yang dipegang oleh Dewan Tinggi Urusan Islam dan Asosiasi Umat Kristen Nigeria dalam perjuangan melawan perdagangan anak di Nigeria.

EXPLODING THE ROLE OF RELIGIOUS INSTITUTIONS IN COMBATING CHILD TRAFFICKING IN NIGERIA

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Alhaji Umar Alkali

2015-02-01

Full Text Available Human trafficking is a global challenge especially in the 21stCentury. Nigeria like most developing countries is doing its best in addressing the menace of child trafficking. In view of the fact that religious institutions are highly respected in Nigeria, this paper intends to adopt a doctrinal methodology in examining the menace of child trafficking in Nigeria, by using the perspective of Islam and Christianity. Moreover, also seeing the role that can be played by the Supreme Council of Islamic Affairs and the Christian Association of Nigeria in the crusade against child trafficking in Nigeria   Perdagangan manusia merupakan sebuah tantangan global pada abad ke-21. Sebagaimana negara berkembang pada umumnya, Nigeria melakukan upaya yang terbaik guna menangani ancaman perdagangan anak. Mengingat bahwa institusi keagamaan sangat dihormati di Nigeria, artikel ini bermaksud untuk mengadopsi metodologi doktrin dalam mengkaji ancaman perdagangan anak di Nigeria, melalui perspektif agama Islam dan agama Kristen perihal perdagangan anak. Selain itu, juga melihat peran yang dipegang oleh Dewan Tinggi Urusan Islam dan Asosiasi Umat Kristen Nigeria dalam perjuangan melawan perdagangan anak di Nigeria.

Early exposure to media violence and later child adjustment.

Science.gov (United States)

Fitzpatrick, Caroline; Barnett, Tracie; Pagani, Linda S

2012-05-01

The extent to which early childhood exposure to violent media is associated with subsequent adverse child functioning remains disconcerting. In this study, we examine whether preschool child exposure to what parents generally characterize as violent television programming predicts a range of second-grade mental health outcomes. Participants are from the Quebec Longitudinal Study of Child Development (N = 1786). At 41 and 53 months, parents reported whether the child had viewed television shows and videos consisting of what they judged as violent content. According to parents, children watched on average 1.8 hours of mixed programming per day. Parent-reported child exposure to televised violence was associated with teacher-reported antisocial symptoms (β = 0.180, 95% confidence interval [CI]: 0.026-0.333), emotional distress (β = 0.224, 95% CI: 0.010-0.438), inattention (β = 0.349, 95% CI: 0.048-0.651), and lower global academic achievement (β = -0.127, 95% CI: -0.237-0.017) in second grade. Violent televiewing was also associated with less child-reported academic self-concept (β = -0.175, 95% CI: -0.296-0.053) and intrinsic motivation (β = -0.162, 95% CI: -0.016-0.307) in second grade. Effects remained significant after adjusting for preexisting child and family characteristics such as baseline child aggression. This prospective study suggests risks associated with early childhood violent media exposure for long-term mental health in children. These findings, suggesting diffusive relationships between early childhood violent media exposure and negative socioemotional and academic outcomes, empirically support the notion that access to early childhood violent television represents a threat to population health and should be discouraged by adult caregivers.

Contributions of Child Sexual Abuse, Self-Blame, Posttraumatic Stress Symptoms, and Alcohol Use to Women's Risk for Forcible and Substance-Facilitated Sexual Assault.

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Mokma, Taylor R; Eshelman, Lee R; Messman-Moore, Terri L

2016-01-01

Child sexual abuse and adult sexual assault have been linked to increased self-blame, posttraumatic stress symptoms, and alcohol use. The current study aims to examine (a) whether these constructs explain women's risk for later adult sexual assault and revictimization, (b) whether such factors differentially confer risk for specific types of adult sexual assault (i.e., substance-facilitated and forcible), and (c) if self-blame confers risk indirectly through other risk factors. Multiple types of self-blame, posttraumatic stress, and alcohol use were examined among 929 female college students as serial mediators of the relationship between child sexual abuse and adult sexual assault and as risk factors for sexual revictimization among child sexual abuse survivors. In the model predicting risk for substance-facilitated adult sexual assault, child sexual abuse indirectly predicted greater risk for substance-facilitated adult sexual assault mediated through two separate paths: global blame-to-posttraumatic-stress and global blame-to-alcohol use. In the model predicting risk for forcible adult sexual assault, child sexual abuse directly predicted greater risk for forcible adult sexual assault, and this relation was mediated by the global blame-to-posttraumatic-stress path. Among child sexual abuse survivors, child sexual abuse specific characterological and behavioral self-blame directly predicted greater risk for forcible and substance-facilitated revictimization, but the pathways were not mediated by posttraumatic stress or alcohol use. Results emphasize the importance of assessing different types of self-blame in predicting posttraumatic stress symptoms as well as examining risk for sexual victimization and revictimization. Findings did not support hypotheses that increased posttraumatic stress would predict increased alcohol use but did indicate that heightened self-blame is consistently associated with heightened posttraumatic stress and that heightened global self

Global surveillance of cancer survival 1995-2009: analysis of individual data for 25,676,887 patients from 279 population-based registries in 67 countries (CONCORD-2).

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Allemani, Claudia; Weir, Hannah K; Carreira, Helena; Harewood, Rhea; Spika, Devon; Wang, Xiao-Si; Bannon, Finian; Ahn, Jane V; Johnson, Christopher J; Bonaventure, Audrey; Marcos-Gragera, Rafael; Stiller, Charles; Azevedo e Silva, Gulnar; Chen, Wan-Qing; Ogunbiyi, Olufemi J; Rachet, Bernard; Soeberg, Matthew J; You, Hui; Matsuda, Tomohiro; Bielska-Lasota, Magdalena; Storm, Hans; Tucker, Thomas C; Coleman, Michel P

2015-03-14

Worldwide data for cancer survival are scarce. We aimed to initiate worldwide surveillance of cancer survival by central analysis of population-based registry data, as a metric of the effectiveness of health systems, and to inform global policy on cancer control. Individual tumour records were submitted by 279 population-based cancer registries in 67 countries for 25·7 million adults (age 15-99 years) and 75,000 children (age 0-14 years) diagnosed with cancer during 1995-2009 and followed up to Dec 31, 2009, or later. We looked at cancers of the stomach, colon, rectum, liver, lung, breast (women), cervix, ovary, and prostate in adults, and adult and childhood leukaemia. Standardised quality control procedures were applied; errors were corrected by the registry concerned. We estimated 5-year net survival, adjusted for background mortality in every country or region by age (single year), sex, and calendar year, and by race or ethnic origin in some countries. Estimates were age-standardised with the International Cancer Survival Standard weights. 5-year survival from colon, rectal, and breast cancers has increased steadily in most developed countries. For patients diagnosed during 2005-09, survival for colon and rectal cancer reached 60% or more in 22 countries around the world; for breast cancer, 5-year survival rose to 85% or higher in 17 countries worldwide. Liver and lung cancer remain lethal in all nations: for both cancers, 5-year survival is below 20% everywhere in Europe, in the range 15-19% in North America, and as low as 7-9% in Mongolia and Thailand. Striking rises in 5-year survival from prostate cancer have occurred in many countries: survival rose by 10-20% between 1995-99 and 2005-09 in 22 countries in South America, Asia, and Europe, but survival still varies widely around the world, from less than 60% in Bulgaria and Thailand to 95% or more in Brazil, Puerto Rico, and the USA. For cervical cancer, national estimates of 5-year survival range from less

Community health workers providing government community case management for child survival in sub-Saharan Africa: who are they and what are they expected to do?

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George, Asha; Young, Mark; Nefdt, Rory; Basu, Roshni; Sylla, Mariame; Clarysse, Guy; Bannicq, Marika Yip; de Sousa, Alexandra; Binkin, Nancy; Diaz, Theresa

2012-11-01

We describe community health workers (CHWs) in government community case management (CCM) programs for child survival across sub-Saharan Africa. In sub-Saharan Africa, 91% of 44 United Nations Children's Fund (UNICEF) offices responded to a cross-sectional survey in 2010. Frequencies describe CHW profiles and activities in government CCM programs (N = 29). Although a few programs paid CHWs a salary or conversely, rewarded CHWs purely on a non-financial basis, most programs combined financial and non-financial incentives and had training for 1 week. Not all programs allowed CHWs to provide zinc, use timers, dispense antibiotics, or use rapid diagnostic tests. Many CHWs undertake health promotion, but fewer CHWs provide soap, water treatment products, indoor residual spraying, or ready-to-use therapeutic foods. For newborn care, very few promote kangaroo care, and they do not provide antibiotics or resuscitation. Even if CHWs are as varied as the health systems in which they work, more work must be done in terms of the design and implementation of the CHW programs for them to realize their potential.

Temporal trends and gender differentials in causes of childhood deaths at Ballabgarh, India - Need for revisiting child survival strategies

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Krishnan Anand

2012-07-01

Full Text Available Abstract Background Relating Information on causes of deaths to implementation of health interventions provides vital information for program planning and evaluation. This paper from Ballabgarh Health and Demographic Surveillance System (HDSS site in north India looks at temporal trends and gender differentials in the causes of death among under-five children. Methods Data on causes of death for 1972-74, 1982-84, 1992-94, 2002-04 were taken from existing HDSS publications and database. Physicians’ assigned causes of death were based on narratives by lay health worker till 1994 and later by verbal autopsy. Cause Specific Mortality Fractions (CSMF and Cause Specific Mortality Rates (CSMR per 1000 live births were calculated for neonatal ( Results The CSMF of prematurity and sepsis was 32% and 17.6% during neonatal period in 2002-04. The share of infections in all childhood deaths decreased from 55.2% in 1972-74 to 43.6% in 2002-04. All major causes of mortality (malnutrition, diarrhea and acute lower respiratory infection except injuries showed a steep decline among children and seem to have plateued in last decade. Most of disease specific public health interventions were launched in mid eighties. . Girls reported significantly higher mortality rates for prematurity (RR 1.52; 95% CI 1.01-2.29; diarrhea (2.29; 1.59 – 3.29, and malnutrition (3.37; 2.05 – 5.53. Conclusions The findings of the study point out to the need to move away from disease-specific to a comprehensive approach and to address gender inequity in child survival through socio-behavioural approaches.

The prognostic significance of whole blood global and specific DNA methylation levels in gastric adenocarcinoma.

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Mansour S Al-Moundhri

Full Text Available BACKGROUND: Epigenetics, particularly DNA methylation, has recently been elucidated as important in gastric cancer (GC initiation and progression. We investigated the clinical and prognostic importance of whole blood global and site-specific DNA methylation in GC. METHODS: Genomic DNA was extracted from the peripheral blood of 105 Omani GC patients at diagnosis. DNA methylation was quantified by pyrosequencing of global DNA and specific gene promoter regions at 5 CpG sites for CDH1, 7 CpG sites for p16, 4 CpG sites for p53, and 3 CpG sites for RUNX3. DNA methylation levels in patients were categorized into low, medium, and high tertiles. Associations between methylation level category and clinicopathological features were evaluated using χ(2 tests. Survival analyses were carried out using the Kaplan-Meier method and log rank test. A backward conditional Cox proportional hazards regression model was used to identify independent predictors of survival. RESULTS: Older GC patients had increased methylation levels at specific CpG sites within the CDH1, p53, and RUNX-3 promoters. Male gender was significantly associated with reduced global and increased site-specific DNA methylation levels in CDH1, p16, and p53 promoters. Global DNA low methylation level was associated with better survival on univariate analysis. Patients with high and medium methylation vs. low methylation levels across p16 promoter CpG sites, site 2 in particular, had better survival. Multivariate analysis showed that global DNA hypermethylation was a significant independent predictor of worse survival (hazard ratio (HR = 2.0, 95% CI: 1.1-3.8; p = 0.02 and high methylation mean values across p16 promoter sites 1-7 were associated with better survival with HR of 0.3 (95% CI, 0.1-0.8; p = 0.02 respectively. CONCLUSIONS: Analysis of global and site-specific DNA methylation in peripheral blood by pyrosequencing provides quantitative DNA methylation values that may serve as important

Parent-Child Agreement on Parent-to-Child Maltreatment

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Compier-de Block, Laura H.C.G.; Alink, Lenneke R.A.; Linting, Mariëlle; van den Berg, Lisa J.M.; Elzinga, Bernet M.; Voorthuis, Alexandra; Tollenaar, Marieke S.; Bakermans-Kranenburg, Marian J.

2017-01-01

Parent-child agreement on child maltreatment was examined in a multigenerational study. Questionnaires on perpetrated and experienced child maltreatment were completed by 138 parent-child pairs. Multi-level analyses were conducted to explore whether parents and children agreed about levels of

Child poverty and changes in child poverty.

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Chen, Wen-Hao; Corak, Miles

2008-08-01

This article offers a cross-country overview of child poverty, changes in child poverty, and the impact of public policy in North America and Europe. Levels and changes in child poverty rates in 12 Organisation for Economic Co-operation and Development (OECD) countries during the 1990s are documented using data from the Luxembourg Income Study project, and a decomposition analysis is used to uncover the relative role of demographic factors, labor markets, and income transfers from the state in determining the magnitude and direction of the changes. Child poverty rates fell noticeably in only three countries and rose in three others. In no country were demographic factors a force for higher child poverty rates, but these factors were also limited in their ability to cushion children from adverse shocks originating in the labor market or the government sector. Increases in the labor market engagement of mothers consistently lowered child poverty rates, while decreases in the employment rates and earnings of fathers were a force for higher rates. Finally, there is no single road to lower child poverty rates. Reforms to income transfers intended to increase labor supply may or may not end up lowering the child poverty rate.

The life mission theory IV. Theory on child development.

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Ventegodt, Søren; Merrick, Joav

2003-12-11

We can identify five important needs that children have: the need for acknowledgment, acceptance, awareness or attention, respect, and care. If these needs are not met, children will modify themselves by denying central parts of their nature in order to adjust to their parents and the situation at large. When a child denies his or her talents, powers, and gender or aspects thereof, he or she loses quality of life, the ability to function, and physical or mental health. The loss of ability takes the form of diminished social ability, psychosexual potency, joy, energy, and fantasy while playing, as well as diminished ability to concentrate, focus, and learn. Many modifications result in a child with severely damaged self-confidence, self-worth, and poor performance. A child more or less deprived of self-worth cannot enjoy, give, or receive. A child deprived of emotions turns cold, rational, asocial, socially stiff, uncomfortable, and in the extreme case...intentionally "evil". When a child denies his or her own sex, it becomes invisible, uninteresting, and vague or becomes like the opposite sex in behavior and appearance. The general holistic solution to the vast diversity of symptoms in children with low quality of life is to improve the situation for the child and give the child the holding and support he or she needs. It is very important to realize that a negative belief often has survival value to the child as it helps the child to avoid taking responsibility for problems, which really belong to the parents or other adults. Children have a fine capability for spontaneous healing, and seem to enter this process more easily than adults, given sufficient holding. The symptoms of children with poor thriving ability are often difficult to understand, as they are caused by a complex combination of self-modification in five existential dimensions. This often leads to complex medical diagnosis, giving the idea that the child is sick and without therapeutic reach, while

The Life Mission Theory IV. Theory on Child Development

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Soren Ventegodt

2003-01-01

Full Text Available We can identify five important needs that children have: the need for acknowledgment, acceptance, awareness or attention, respect, and care. If these needs are not met, children will modify themselves by denying central parts of their nature in order to adjust to their parents and the situation at large. When a child denies his or her talents, powers, and gender or aspects thereof, he or she loses quality of life, the ability to function, and physical or mental health. The loss of ability takes the form of diminished social ability, psychosexual potency, joy, energy, and fantasy while playing, as well as diminished ability to concentrate, focus, and learn. Many modifications result in a child with severely damaged self-confidence, self-worth, and poor performance. A child more or less deprived of self-worth cannot enjoy, give, or receive. A child deprived of emotions turns cold, rational, asocial, socially stiff, uncomfortable, and in the extreme case…... intentionally “evil”. When a child denies his or her own sex, it becomes invisible, uninteresting, and vague or becomes like the opposite sex in behavior and appearance. The general holistic solution to the vast diversity of symptoms in children with low quality of life is to improve the situation for the child and give the child the holding and support he or she needs. It is very important to realize that a negative belief often has survival value to the child as it helps the child to avoid taking responsibility for problems, which really belong to the parents or other adults. Children have a fine capability for spontaneous healing, and seem to enter this process more easily than adults, given sufficient holding. The symptoms of children with poor thriving ability are often difficult to understand, as they are caused by a complex combination of self-modification in five existential dimensions. This often leads to complex medical diagnosis, giving the idea that the child is sick and

Survival of Bacillus anthracis spores in fruit juices and wine.

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Leishman, Oriana N; Johnson, Miranda J; Labuza, Theodore P; Diez-Gonzalez, Francisco

2010-09-01

Foods have been identified as a potential target for bioterrorism due to their essential nature and global distribution. Foods produced in bulk have the potential to have large batches of product intentionally contaminated, which could affect hundreds or thousands of individuals. Bacillus anthracis spores are one potential bioterrorism agent that may survive pasteurization and remain viable throughout the shelf life of fruit juices and cause disease if consumed. This project examined B. anthracis spore survival in orange, apple, and grape juices, as well as wine. Samples of beverages were inoculated with spores of two nonpathogenic B. anthracis strains at approximately 10(6) CFU/ml, and the spore count was determined periodically during storage for 30 days at 4°C. After this time, the counts of survival spores never declined more than 1 log CFU/ml in any of the beverage types. These results indicate that spores can survive, with little to no loss in viability, for at least a month in fruit juices and wine.

Psychotherapy with children in refugee families who have survived torture

DEFF Research Database (Denmark)

Grünbaum, Liselotte

1997-01-01

and recurring exposure to shocking violence. The traumatic experiences of the child in the country of origin take place in the broader context of chronic danger and persecution, often to be followed in the country of exile both by recurrent family strain and social estrangement. In the transference......Children of refugee families who have survived torture often have emotional, psychosomatic and behavioural problems as well as problems with learning. In order to understand the difficulties of these children, we have to recognize the complicated interaction of cumulative traumatic strain...

Paternal investment and status-related child outcomes: timing of father's death affects offspring success.

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Shenk, Mary K; Scelza, Brooke A

2012-09-01

Recent work in human behavioural ecology has suggested that analyses focusing on early childhood may underestimate the importance of paternal investment to child outcomes since such investment may not become crucial until adolescence or beyond. This may be especially important in societies with a heritable component to status, as later investment by fathers may be more strongly related to a child's adult status than early forms of parental investment that affect child survival and child health. In such circumstances, the death or absence of a father may have profoundly negative effects on the adult outcomes of his children that cannot be easily compensated for by the investment of mothers or other relatives. This proposition is tested using a multigenerational dataset from Bangalore, India, containing information on paternal mortality as well as several child outcomes dependent on parental investment during adolescence and young adulthood. The paper examines the effects of paternal death, and the timing of paternal death, on a child's education, adult income, age at marriage and the amount spent on his or her marriage, along with similar characteristics of spouses. Results indicate that a father's death has a negative impact on child outcomes, and that, in contrast to some findings in the literature on father absence, the effects of paternal death are strongest for children who lose their father in late childhood or adolescence.

Understanding the motivations and activities of transnational advocacy networks against child sex trafficking in the Mekong Subregion: The value of cosmopolitan globalisation theory

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Deanna Davy

2013-03-01

Full Text Available Child sex trafficking has become one of the most highly publicised social issues of our time and, due to its global nature, transnational anti-trafficking advocacy networks are well placed and central to lead campaigns against it. Whilst there is an abundance of literature on the subjects of child sex trafficking and transnational advocacy networks we lack an understanding of the motivations of these networks that act as buffers against trafficking. Cosmopolitan globalisation theory remains a compelling framework for examining the motivations of transnational anti-child sex trafficking networks in the Greater Mekong Subregion. Applying a cosmopolitan globalisation lens, this article discusses the social justice goals of transnational advocacy networks, their centrality in combating child sex trafficking, and their ability to perform cosmopolitan ‘globalisation from below’ to counter global social problems.

Teacher-Child Relationships: Contribution of Teacher and Child Characteristics

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Choi, Ji Young; Dobbs-Oates, Jennifer

2016-01-01

This study investigates potential predictors of teacher-child relationships (i.e., closeness and conflict) focusing on child gender, teacher-child ethnicity match, and teacher education. Additionally, the study explores the possible moderation effect of teacher education on the associations between teacher-child relationships and child gender or…

A Look at the Phenomenon of Child Marriage in Iran and the World

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Salman Khazaei

2016-09-01

Full Text Available The recent statistics indicates child marriage has been a global concern especially in low and medium countries, so that more than 700 million of women were married before 18 years of age and out of them more than a third were less than 15 years. There is gender inequality in child marriage, so that it is more observed in girls (1. Some causes are introduced for incidence of child marriage including poverty and financial debility, extension of social network, and protection of girls against rape and violence (2. The consequences of child marriage are often far wider than just their impact on the individual children affected. The marriage of children has negative effects on families and communities. The practice thrives on poverty and impacts adversely on a country’s health and educational sector (1-3. Indeed child marriage in girls resulted in early pregnancy, social isolation, school dropout, reducing employment opportunities and increasing of domestic violence (3. According to important role of child marriage as a pivotal barrier in social and economic development, we encouraged that to write present letter. The letter aimed to provide a comparison of child marriage statistics in Iran and other parts of world, in addition to suggest some well-established solutions for reducing child marriage.

Examining the global health arena: strengths and weaknesses of a convention approach to global health challenges.

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Haffeld, Just Balstad; Siem, Harald; Røttingen, John-Arne

2010-01-01

The article comprises a conceptual framework to analyze the strengths and weaknesses of a global health convention. The analyses are inspired by Lawrence Gostin's suggested Framework Convention on Global Health. The analytical model takes a starting-point in events tentatively following a logic sequence: Input (global health funding), Processes (coordination, cooperation, accountability, allocation of aid), Output (definition of basic survival needs), Outcome (access to health services), and Impact (health for all). It then examines to what degree binding international regulations can create order in such a sequence of events. We conclude that a global health convention could be an appropriate instrument to deal with some of the problems of global health. We also show that some of the tasks preceding a convention approach might be to muster international support for supra-national health regulations, negotiate compromises between existing stakeholders in the global health arena, and to utilize WHO as a platform for further discussions on a global health convention. © 2010 American Society of Law, Medicine & Ethics, Inc.

Surviving Armageddon - Solutions for a Threatened Planet

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McGuire, Bill

2005-07-01

What do earthquakes, magma, asteroid 1950DA, and global warming have in common? All are very real natural disasters, already under way; all are also the focus of intensive work by scientists, aimed at preventing, predicting, or at least limiting their impact on civilization. Using the latest chilling data and taking care to draw a clear line between scientific fact and fiction, McGuire discusses the various ways that scientists have already started to prepare for survival. Solutions on earth range from 'space reflectors' to prevent global warming, to pressure-relieving 'robot excavators' to stop volcanic eruptions. In space, NASA is developing rocket motors to gently nudge asteroids out of Earth's path, and plans to have all threatening asteroids larger than 1km detected by 2008, thereby enabling us to predict possible collisions up to 2880. The book provides the strategies to the problems we face, and concludes optimistically with ways in which we can use technology to protect our society and planet from global catastrophe.

Maternal emotion regulation during child distress, child anxiety accommodation, and links between maternal and child anxiety.

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Kerns, Caroline E; Pincus, Donna B; McLaughlin, Katie A; Comer, Jonathan S

2017-08-01

Environmental contributions are thought to play a primary role in the familial aggregation of anxiety, but parenting influences remain poorly understood. We examined dynamic relations between maternal anxiety, maternal emotion regulation (ER) during child distress, maternal accommodation of child distress, and child anxiety. Mothers (N=45) of youth ages 3-8 years (M=4.8) participated in an experimental task during which they listened to a standardized audio recording of a child in anxious distress pleading for parental intervention. Measures of maternal and child anxiety, mothers' affective states, mothers' ER strategies during the child distress, and maternal accommodation of child anxiety were collected. Mothers' resting respiratory sinus arrhythmia (RSA) reactivity during the recording was also acquired. Higher maternal negative affect and greater maternal ER switching (i.e., using multiple ER strategies in a short time without positive regulatory results) during child distress were associated with child anxiety. Sequential mediation modeling showed that maternal anxiety predicted ineffective maternal ER during child distress exposure, which in turn predicted greater maternal accommodation, which in turn predicted higher child anxiety. Findings support the mediating roles of maternal ER and accommodation in linking maternal and child anxiety, and suggest that ineffective maternal ER and subsequent attempts to accommodate child distress may act as mechanisms underlying the familial aggregation of anxiety. Copyright © 2017 Elsevier Ltd. All rights reserved.

Developmental Plasticity in Child Growth and Maturation

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Ze'ev eHochberg

2011-09-01

Full Text Available The ability of a given genotype to produce different phenotypes in response to different environments is termed "plasticity", and is part of the organism's "adaptability" to environmental cues. The expressions of suites of genes, particularly during development or life-history transitions, probably underlie the fundamental plasticity of an organism. Plasticity in developmental programming has evolved in order to provide the best chances of survival and reproductive success to organisms under changing environments. Environmental conditions that are experienced in early life can profoundly influence human biology, child growth and maturation, and long-term health and longevity. Developmental origins of health and disease and life history transitions are purported to use placental, nutritional, and endocrine cues for setting long-term biological, mental, and behavioral strategies for child growth and maturation in response to local ecological and/or social conditions. The window of developmental plasticity extends from conception to early childhood, and even beyond to the transition from juvenility to adoelscence, and could be transmitted transgenerationally. It involves epigenetic responses to environmental changes, which exert their effects during life history phase-transitions.

Perceptions of Child Body Size and Health Care Seeking for Undernourished Children in Southern Malawi.

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Flax, Valerie L; Thakwalakwa, Chrissie; Ashorn, Ulla

2016-12-01

Child undernutrition affects millions of children globally, but little is known about the ability of adults to detect different types of child undernutrition in low-income countries. We used focused ethnographic methods to understand how Malawian parents and grandparents describe the characteristics they use to identify good and poor child growth, their actual or preferred patterns of health seeking for undernourished children, and the perceived importance of child undernutrition symptoms in relation to other childhood illnesses. Malawians value adiposity rather than stature in assessing child growth. Symptoms of malnutrition, including wasting and edema, were considered the least severe childhood illness symptoms. Parents delayed health care seeking when a child was ill. When they sought care, it was for symptoms such as diarrhea or fever, and they did not recognize malnutrition as the underlying cause. These findings can be used to tailor strategies for preventing and treating growth faltering in Malawian children. © The Author(s) 2015.

Child and Adolescent Health From 1990 to 2015

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Kyu, Hmwe Hmwe; Zoeckler, Leo; Olsen, Helen Elizabeth; Thomas, Katie; Pinho, Christine; Bhutta, Zulfiqar A.; Dandona, Lalit; Ferrari, Alize; Ghiwot, Tsegaye Tewelde; Hay, Simon I.; Kinfu, Yohannes; Liang, Xiaofeng; Lopez, Alan; Malta, Deborah Carvalho; Mokdad, Ali H.; Naghavi, Mohsen; Patton, George C.; Salomon, Joshua; Sartorius, Benn; Topor-Madry, Roman; Vollset, Stein Emil; Werdecker, Andrea; Whiteford, Harvey A.; Abate, Kalkidan Hasen; Abbas, Kaja; Damtew, Solomon Abrha; Ahmed, Muktar Beshir; Akseer, Nadia; Al-Raddadi, Rajaa; Alemayohu, Mulubirhan Assefa; Altirkawi, Khalid; Abajobir, Amanuel Alemu; Amare, Azmeraw T.; Antonio, Carl A. T.; Arnlov, Johan; Artaman, Al; Asayesh, Hamid; Avokpaho, Euripide Frinel G. Arthur; Awasthi, Ashish; Ayala Quintanilla, Beatriz Paulina; Bacha, Umar; Betsu, Balem Demtsu; Barac, Aleksandra; Bärnighausen, Till Winfried; Baye, Estifanos; Bedi, Neeraj; Bensenor, Isabela M.; Berhane, Adugnaw; Bernabe, Eduardo; Bernal, Oscar Alberto; Beyene, Addisu Shunu; Biadgilign, Sibhatu; Bikbov, Boris; Boyce, Cheryl Anne; Brazinova, Alexandra; Hailu, Gessessew Bugssa; Carter, Austin; Castañeda-Orjuela, Carlos A.; Catalá-López, Ferrán; Charlson, Fiona J.; Chitheer, Abdulaal A.; Choi, Jee-Young Jasmine; Ciobanu, Liliana G.; Crump, John; Dandona, Rakhi; Dellavalle, Robert P.; Deribew, Amare; deVeber, Gabrielle; Dicker, Daniel; Ding, Eric L.; Dubey, Manisha; Endries, Amanuel Yesuf; Erskine, Holly E.; Faraon, Emerito Jose Aquino; Faro, Andre; Farzadfar, Farshad; Fernandes, Joao C.; Fijabi, Daniel Obadare; Fitzmaurice, Christina; Fleming, Thomas D.; Flor, Luisa Sorio; Foreman, Kyle J.; Franklin, Richard C.; Fraser, Maya S.; Frostad, Joseph J.; Fullman, Nancy; Gebregergs, Gebremedhin Berhe; Gebru, Alemseged Aregay; Geleijnse, Johanna M.; Gibney, Katherine B.; Gidey Yihdego, Mahari; Ginawi, Ibrahim Abdelmageem Mohamed; Gishu, Melkamu Dedefo; Gizachew, Tessema Assefa; Glaser, Elizabeth; Gold, Audra L.; Goldberg, Ellen; Gona, Philimon; Goto, Atsushi; Gugnani, Harish Chander; Jiang, Guohong; Gupta, Rajeev; Tesfay, Fisaha Haile; Hankey, Graeme J.; Havmoeller, Rasmus; Hijar, Martha; Horino, Masako; Hosgood, H. Dean; Hu, Guoqing; Jacobsen, Kathryn H.; Jakovljevic, Mihajlo B.; Jayaraman, Sudha P.; Jha, Vivekanand; Jibat, Tariku; Johnson, Catherine O.; Jonas, Jost; Kasaeian, Amir; Kawakami, Norito; Keiyoro, Peter N.; Khalil, Ibrahim; Khang, Young-Ho; Khubchandani, Jagdish; Ahmad Kiadaliri, Aliasghar A.; Kieling, Christian; Kim, Daniel; Kissoon, Niranjan; Knibbs, Luke D.; Koyanagi, Ai; Krohn, Kristopher J.; Kuate Defo, Barthelemy; Kucuk Bicer, Burcu; Kulikoff, Rachel; Kumar, G. Anil; Lal, Dharmesh Kumar; Lam, Hilton Y.; Larson, Heidi J.; Larsson, Anders; Laryea, Dennis Odai; Leung, Janni; Lim, Stephen S.; Lo, Loon-Tzian; Lo, Warren D.; Looker, Katharine J.; Lotufo, Paulo A.; Magdy Abd El Razek, Hassan; Malekzadeh, Reza; Markos Shifti, Desalegn; Mazidi, Mohsen; Meaney, Peter A.; Meles, Kidanu Gebremariam; Memiah, Peter; Mendoza, Walter; Abera Mengistie, Mubarek; Mengistu, Gebremichael Welday; Mensah, George A.; Miller, Ted R.; Mock, Charles; Mohammadi, Alireza; Mohammed, Shafiu; Monasta, Lorenzo; Mueller, Ulrich; Nagata, Chie; Naheed, Aliya; Nguyen, Grant; Nguyen, Quyen Le; Nsoesie, Elaine; Oh, In-Hwan; Okoro, Anselm; Olusanya, Jacob Olusegun; Olusanya, Bolajoko O.; Ortiz, Alberto; Paudel, Deepak; Pereira, David M.; Perico, Norberto; Petzold, Max; Phillips, Michael Robert; Polanczyk, Guilherme V.; Pourmalek, Farshad; Qorbani, Mostafa; Rafay, Anwar; Rahimi-Movaghar, Vafa; Rahman, Mahfuzar; Rai, Rajesh Kumar; Ram, Usha; Rankin, Zane; Remuzzi, Giuseppe; Renzaho, Andre M. N.; Roba, Hirbo Shore; Rojas-Rueda, David; Ronfani, Luca; Sagar, Rajesh; Sanabria, Juan Ramon; Kedir Mohammed, Muktar Sano; Santos, Itamar S.; Satpathy, Maheswar; Sawhney, Monika; Schöttker, Ben; Schwebel, David C.; Scott, James G.; Sepanlou, Sadaf G.; Shaheen, Amira; Shaikh, Masood Ali; She, June; Shiri, Rahman; Shiue, Ivy; Sigfusdottir, Inga Dora; Singh, Jasvinder; Silpakit, Naris; Smith, Alison; Sreeramareddy, Chandrashekhar; Stanaway, Jeffrey D.; Stein, Dan J.; Steiner, Caitlyn; Sufiyan, Muawiyyah Babale; Swaminathan, Soumya; Tabarés-Seisdedos, Rafael; Tabb, Karen M.; Tadese, Fentaw; Tavakkoli, Mohammad; Taye, Bineyam; Teeple, Stephanie; Tegegne, Teketo Kassaw; Temam Shifa, Girma; Terkawi, Abdullah Sulieman; Thomas, Bernadette; Thomson, Alan J.; Tobe-Gai, Ruoyan; Tonelli, Marcello; Tran, Bach Xuan; Troeger, Christopher; Ukwaja, Kingsley N.; Uthman, Olalekan; Vasankari, Tommi; Venketasubramanian, Narayanaswamy; Vlassov, Vasiliy Victorovich; Weiderpass, Elisabete; Weintraub, Robert; Gebrehiwot, Solomon Weldemariam; Westerman, Ronny; Williams, Hywel C.; Wolfe, Charles D. A.; Woodbrook, Rachel; Yano, Yuichiro; Yonemoto, Naohiro; Yoon, Seok-Jun; Younis, Mustafa Z.; Yu, Chuanhua; Zaki, Maysaa El Sayed; Zegeye, Elias Asfaw; Zuhlke, Liesl Joanna; Murray, Christopher J. L.; Vos, Theo

2017-01-01

Importance Comprehensive and timely monitoring of disease burden in all age groups, including children and adolescents, is essential for improving population health. Objective To quantify and describe levels and trends of mortality and nonfatal health outcomes among children and adolescents from 1990 to 2015 to provide a framework for policy discussion. Evidence Review Cause-specific mortality and nonfatal health outcomes were analyzed for 195 countries and territories by age group, sex, and year from 1990 to 2015 using standardized approaches for data processing and statistical modeling, with subsequent analysis of the findings to describe levels and trends across geography and time among children and adolescents 19 years or younger. A composite indicator of income, education, and fertility was developed (Socio-demographic Index [SDI]) for each geographic unit and year, which evaluates the historical association between SDI and health loss. Findings Global child and adolescent mortality decreased from 14.18 million (95% uncertainty interval [UI], 14.09 million to 14.28 million) deaths in 1990 to 7.26 million (95% UI, 7.14 million to 7.39 million) deaths in 2015, but progress has been unevenly distributed. Countries with a lower SDI had a larger proportion of mortality burden (75%) in 2015 than was the case in 1990 (61%). Most deaths in 2015 occurred in South Asia and sub-Saharan Africa. Global trends were driven by reductions in mortality owing to infectious, nutritional, and neonatal disorders, which in the aggregate led to a relative increase in the importance of noncommunicable diseases and injuries in explaining global disease burden. The absolute burden of disability in children and adolescents increased 4.3% (95% UI, 3.1%-5.6%) from 1990 to 2015, with much of the increase owing to population growth and improved survival for children and adolescents to older ages. Other than infectious conditions, many top causes of disability are associated with long

Promotion of children's rights and prevention of child maltreatment.

Science.gov (United States)

Reading, Richard; Bissell, Susan; Goldhagen, Jeffrey; Harwin, Judith; Masson, Judith; Moynihan, Sian; Parton, Nigel; Pais, Marta Santos; Thoburn, June; Webb, Elspeth

2009-01-24

In medical literature, child maltreatment is considered as a public-health problem or an issue of harm to individuals, but less frequently as a violation of children's human rights. Public-health approaches emphasise monitoring, prevention, cost-effectiveness, and population strategies; protective approaches concentrate on the legal and professional response to cases of maltreatment. Both approaches have been associated with improvement in outcomes for children, yet maltreatment remains a major global problem. We describe how children's rights provide a different perspective on child maltreatment, and contribute to both public-health and protective responses. Children's rights as laid out in the UN convention on the rights of the child (UNCRC) provide a framework for understanding child maltreatment as part of a range of violence, harm, and exploitation of children at the individual, institutional, and societal levels. Rights of participation and provision are as important as rights of protection. The principles embodied in the UNCRC are concordant with those of medical ethics. The greatest strength of an approach based on the UNCRC is that it provides a legal instrument for implementing policy, accountability, and social justice, all of which enhance public-health responses. Incorporation of the principles of the UNCRC into laws, research, public-health policy, and professional training and practice will result in further progress in the area of child maltreatment.

Mother's time allocation, child care and child cognitive development

OpenAIRE

BRILLI, Ylenia

2015-01-01

This paper analyzes the effects of maternal employment and non-parental child care on child cognitive development, taking into account the mother's time allocation between leisure and child-care time. I estimate a behavioral model, in which maternal labor supply, non-parental child care, goods expenditure and time allocation decisions are considered to be endogenous choices of the mother. The child cognitive development depends on maternal and non-parental child care and on the goods bought f...

INEQUITY ISSUES AND MOTHERS' PREGNANCY, DELIVERY AND EARLY-AGE SURVIVAL EXPERIENCES IN ENDE DISTRICT, INDONESIA.

Science.gov (United States)

Pardosi, Jerico Franciscus; Parr, Nick; Muhidin, Salut

2015-11-01

Indonesia's infant mortality rates are among the highest in South-East Asia, and there are substantial variations between its sub-national regions. This qualitative study aims to explore early mortality-related health service provision and gender inequity issues based on mothers' pregnancy, delivery and early-age survival experience in Ende district, Nusa Tenggara Timur province. Thirty-two mothers aged 18-45 years with at least one birth in the previous five years were interviewed in depth in May 2013. The results show most mothers have little knowledge about the danger signs for a child's illness. Mothers with early-age deaths generally did not know the cause of death. Very few mothers had received adequate information on maternal and child health during their antenatal and postnatal visits to the health facility. Some mothers expressed a preference for using a traditional birth attendant, because of their ready availability and the more extensive range of support services they provide, compared with local midwives. Unprofessional attitudes displayed by midwives were reported by several mothers. As elsewhere in Indonesia, the power of health decision-making lies with the husband. Policies aimed at elevating mothers' roles in health care decision-making are discussed as measures that would help to improve early-age survival outcomes. Widening the public health insurance distribution, especially among poorer mothers, and equalizing the geographical distribution of midwives and health facilities are recommended to tackle geographical inequities and to increase early-age survival in Ende district.

Control of iron deficiency in the first 1000 days in life: prevention of impaired child development

NARCIS (Netherlands)

Chang, S.

2012-01-01

Evidence indicates that the first 1000 days of life (the period from the woman’s pregnancy continuing into the child’s second year) is the most critical period. This is where nutritional deficiencies have a significant and often irreversible adverse impact on child survival and growth affecting

Global surveillance of cancer survival 1995–2009: analysis of individual data for 25 676 887 patients from 279 population-based registries in 67 countries (CONCORD-2)

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Allemani, Claudia; Weir, Hannah K; Carreira, Helena; Harewood, Rhea; Spika, Devon; Wang, Xiao-Si; Bannon, Finian; Ahn, Jane V; Johnson, Christopher J; Bonaventure, Audrey; Marcos-Gragera, Rafael; Stiller, Charles; Silva, Gulnar Azevedo e; Chen, Wan-Qing; Ogunbiyi, Olufemi J; Rachet, Bernard; Soeberg, Matthew J; You, Hui; Matsuda, Tomohiro; Bielska-Lasota, Magdalena; Storm, Hans; Tucker, Thomas C; Coleman, Michel P

2015-01-01

Summary Background Worldwide data for cancer survival are scarce. We aimed to initiate worldwide surveillance of cancer survival by central analysis of population-based registry data, as a metric of the effectiveness of health systems, and to inform global policy on cancer control. Methods Individual tumour records were submitted by 279 population-based cancer registries in 67 countries for 25·7 million adults (age 15–99 years) and 75 000 children (age 0–14 years) diagnosed with cancer during 1995–2009 and followed up to Dec 31, 2009, or later. We looked at cancers of the stomach, colon, rectum, liver, lung, breast (women), cervix, ovary, and prostate in adults, and adult and childhood leukaemia. Standardised quality control procedures were applied; errors were corrected by the registry concerned. We estimated 5-year net survival, adjusted for background mortality in every country or region by age (single year), sex, and calendar year, and by race or ethnic origin in some countries. Estimates were age-standardised with the International Cancer Survival Standard weights. Findings 5-year survival from colon, rectal, and breast cancers has increased steadily in most developed countries. For patients diagnosed during 2005–09, survival for colon and rectal cancer reached 60% or more in 22 countries around the world; for breast cancer, 5-year survival rose to 85% or higher in 17 countries worldwide. Liver and lung cancer remain lethal in all nations: for both cancers, 5-year survival is below 20% everywhere in Europe, in the range 15–19% in North America, and as low as 7–9% in Mongolia and Thailand. Striking rises in 5-year survival from prostate cancer have occurred in many countries: survival rose by 10–20% between 1995–99 and 2005–09 in 22 countries in South America, Asia, and Europe, but survival still varies widely around the world, from less than 60% in Bulgaria and Thailand to 95% or more in Brazil, Puerto Rico, and the USA. For cervical cancer

The epidemiology of child homicides in South Africa.

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Mathews, Shanaaz; Abrahams, Naeemah; Jewkes, Rachel; Martin, Lorna J; Lombard, Carl

2013-08-01

To describe age- and sex-specific rates of child homicide in South Africa. A cross-sectional mortuary-based study was conducted in a national sample of 38 medicolegal laboratories operating in 2009. These were sampled in inverse proportion to the number that were operational in each of three strata defined by autopsy volume:  1499 annual autopsies. Child homicide data were collected from mortuary files, autopsy reports and police interviews. Cause of death, evidence of abuse and neglect or of sexual assault, perpetrator characteristics and circumstances surrounding the death were investigated. An estimated 1018 (95% confidence interval, CI: 843-1187) child homicides occurred in 2009, for a rate of 5.5 (95% CI: 4.6-6.4) homicides per 100 000 children younger than 18 years. The homicide rate was much higher in boys (6.9 per 100 000; 95% CI: 5.6-8.3) than in girls (3.9 per 100 000; 95% CI: 3.2-4.7). Child abuse and neglect had preceded nearly half (44.5%) of all homicides, but three times more often among girls than among boys. In children aged 15 to 17 years, the homicide rate among boys (21.7 per 100 000; 95% CI: 14.2-29.2) was nearly five times higher than the homicide rate among girls (4.6 per 100 000; 95% CI: 2.4-6.8). South Africa's child homicide rate is more than twice the global estimate. Since a background of child abuse and neglect is common, improvement of parenting skills should be part of primary prevention efforts.

Young Children's Self-Concepts Include Representations of Abstract Traits and the Global Self.

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Cimpian, Andrei; Hammond, Matthew D; Mazza, Giulia; Corry, Grace

2017-11-01

There is debate about the abstractness of young children's self-concepts-specifically, whether they include representations of (a) general traits and abilities and (b) the global self. Four studies (N = 176 children aged 4-7) suggested these representations are indeed part of early self-concepts. Studies 1 and 2 reexamined prior evidence that young children cannot represent traits and abilities. The results suggested that children's seemingly immature judgments in previous studies were due to peculiarities of the task context not the inadequacy of children's self-concepts. Similarly, Studies 3 and 4 revealed that, contrary to claims of immaturity in reasoning about the global self, young children update their global self-evaluations in flexible, context-sensitive ways. This evidence suggests continuity in the structure of self-concepts across childhood. © 2017 The Authors. Child Development © 2017 Society for Research in Child Development, Inc.

Can environmental variation affect seedling survival of plants in northeastern Mexico?

Directory of Open Access Journals (Sweden)

García Jaime F.

2011-01-01

Full Text Available The effects of global warming increase the frequency and intensity of many climate events such as rainfall. We evaluated the effects of environmental conditions on early stage seedling survival of the native thorn scrub species Caesalpinia mexicana A. Gray, Celtis pallida Torr., Cordia boissieri A. DC., and Ebenopsis ebano (Berland. Barneby and J.W. Grimes, during the summer of 2009 and 2010. The experimental design had two factors, two levels of rainfall and three microhabitats of thorn scrub: (i open interspace, (ii thorn scrub edge and (iii under the canopy of dense thorn scrub. In dense thorn scrub, seedling survival was higher for Caesalpinia mexicana and Celtis pallida, and for Cordia boissieri and Ebenopsis ebano seedling survival was higher in dense thorn scrub and thorn scrub edge. The effect of rainfall on seedling survival depended on the year. Rainfall in 2010 and dense thorn scrub increased seedling survival of native species. For survival, the limiting factors of microhabitats appear to change across the years. Besides rainfall events, biological aspects like competition and mycorrhiza effects would need to be considered in models of plant establishment.

Teacher-Child Interactions: Relations with Children's Self-Concept in Second Grade

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Leflot, Geertje; Onghena, Patrick; Colpin, Hilde

2010-01-01

This study examined whether teacher-child interactions characterized by teacher involvement, structure, and autonomy support at the beginning of second grade predicted children's global, academic, social, and behavioural self-concept at the end of second grade. The study was conducted in 30 second grade classrooms with 570 children and their…

Perception of child obesity among the elites in Bodija, Ibadan, Nigeria

African Journals Online (AJOL)

Child obesity is on the rise globally and evidence suggests that this upward trend has continued into the 21st century. Genetic, dietary and/or physical activity patterns are important factors explaining why increasing number of children and adolescents are becoming obese. Evidence also suggests that social class position ...

Determinants of performance of health systems concerning maternal and child health: a global approach.

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Pinzón-Flórez, Carlos Eduardo; Fernández-Niño, Julián Alfredo; Ruiz-Rodríguez, Myriam; Idrovo, Álvaro J; Arredondo López, Abel Armando

2015-01-01

To assess the association of social determinants on the performance of health systems around the world. A transnational ecological study was conducted with an observation level focused on the country. In order to research on the strength of the association between the annual maternal and child mortality in 154 countries and social determinants: corruption, democratization, income inequality and cultural fragmentation, we used a mixed linear regression model for repeated measures with random intercepts and a conglomerate-based geographical analysis, between 2000 and 2010. Health determinants with a significant association on child mortality(corrupt government (Q3 vs Q1 = 83,05; 95%CI: 33,10 to 133). Improving access to water and sanitation systems, decreasing corruption in the health sector must become priorities in health systems. The ethno-linguistic cultural fragmentation and the detriment of democracy turn out to be two factors related to health results.

Surviving Sengstaken.

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Jayakumar, S; Odulaja, A; Patel, S; Davenport, M; Ade-Ajayi, N

2015-07-01

To report the outcomes of children who underwent Sengstaken-Blakemore tube (SBT) insertion for life-threatening haemetemesis. Single institution retrospective review (1997-2012) of children managed with SBT insertion. Patient demographics, diagnosis and outcomes were noted. Data are expressed as median (range). 19 children [10 male, age 1 (0.4-16) yr] were identified; 18 had gastro-oesophageal varices and 1 aorto-oesophageal fistula. Varices were secondary to: biliary atresia (n=8), portal vein thrombosis (n=5), alpha-1-anti-trypsin deficiency (n=1), cystic fibrosis (n=1), intrahepatic cholestasis (n=1), sclerosing cholangitis (n=1) and nodular hyperplasia with arterio-portal shunt (n=1). Three children deteriorated rapidly and did not survive to have post-SBT endoscopy. The child with an aortooesophageal fistula underwent aortic stent insertion and subsequently oesophageal replacement. Complications included gastric mucosal ulceration (n=3, 16%), pressure necrosis at lips and cheeks (n=6, 31%) and SBT dislodgment (n=1, 6%). Six (31%) children died. The remaining 13 have been followed up for 62 (2-165) months; five required liver transplantation, two underwent a mesocaval shunt procedure and 6 have completed endoscopic variceal obliteration and are under surveillance. SBT can be an effective, albeit temporary, life-saving manoeuvre in children with catastrophic haematemesis. Copyright © 2015 Elsevier Inc. All rights reserved.

The Right to Education in a Globalized World

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Lindahl, Ronald

2006-01-01

This article explores the fundamental issues related to education as a human right, particularly in the context of rapid globalization. The 1948 Universal Declaration of Human Rights, the United Nations' 1959 Convention on the Rights of the Child, and the UN International Covenant on Economic, Social, and Cultural Rights all declare education to…

Knowledge Management and Global Information Dissemination

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Umunadi, Ejiwoke Kennedy

2014-01-01

The paper looked at knowledge management and global information dissemination. Knowledge is a very powerful tool for survival, growth and development. It can be seen as the information, understanding and skills that you gain through education or experience. The paper was addressed under the following sub-headings: Knowledge management knowledge…

Child labor. A matter of health and human rights.

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Mathews, Rahel; Reis, Chen; Iacopino, Vincent

2003-01-01

Despite the existence of laws in India that prohibit the labor of children under age 14, 70 to 115 million children between the ages of 5 and 14 are estimated to be part of India's labor force. Child labor in the agriculture sector accounts for 80% of child laborers in India and 70% of working children globally. From May 2001 to July 2001, Physicians for Human Rights (PHR) investigated the health experiences of 100 children in hybrid cottonseed production in rural Andhra Pradesh. Eighty-eight percent of the survey participants were girls, ages 7 to 14. PHR found that children worked on average 12 hours a day, were frequently exposed to pesticides, and were not provided with safety equipment, not even shoes or water to wash their hands and clothes. Children reported having frequent headaches and dizziness and skin and eye irritations after pesticide spraying. All 100 children reported that they were unable to go to school during the hybrid cottonseed season due to work demands. Ninety-four children reported to PHR that they would rather be in school. In addition, a majority of child workers interviewed by PHR reported physical and/or verbal abuse by their employers. Moreover, PHR interviews with representatives of multinational and national companies revealed knowledge of child labor practices for up to 10 years. Child labor is a significant health and human rights problem for children in India. The progressive elimination of child labor practices will require the support of a wide cross-section of civil society.

Cumulative risk effect of household dysfunction for child maltreatment after intensive intervention of the child protection system in Japan: a longitudinal analysis.

Science.gov (United States)

Ohashi, Hirotsuna; Wada, Ichiro; Yamaoka, Yui; Nakajima-Yamaguchi, Ryoko; Ogai, Yasukazu; Morita, Nobuaki

2018-04-20

Building an effective casework system for child maltreatment is a global issue. We estimated the effect of household dysfunction (i.e., interparental violence, caregiver mental health problems, and caregiver substance abuse) on child maltreatment to understand how to advance the current framework of child welfare. The sample comprised 759 children (1- to 17-year-old; mean age was 10.6; 404 boys and 355 girls) placed in temporary custody units (one of the strongest intervention of the Japanese child protection system). Caseworkers from 180 units across 43 prefectures completed questionnaires on children and their family and were asked whether a child maltreatment report had been made after cancelation of custody in a 15-month follow-up period. The relations of household dysfunction and maltreatment reports were assessed using the Cox proportional hazard model. About half (48.4%) of the children had been placed in the unit because of maltreatment, and 88.3% had a history of victimization. Seventy-six cases had maltreatment reports after cancelation. We entered household dysfunction variables individually into the model, and each had a significant relationship with maltreatment reports (hazard ratios for interparental violence, caregiver mental health problem, and substance abuse were 1.69, 1.69, and 2.19, respectively) after covariate adjustment. When treating these three variables as cumulative risk score model of household dysfunction, the hazard ratio increased with increasing number of score (1.96 for score two; 2.35 for score three; score 0 as reference). Greater household dysfunction score is a risk of maltreatment after intensive intervention. It is imperative to construct systems facilitating cooperation between child and adult service sectors and to deliver seamless services to children and families. Our findings provide child protect services with risk-stratified interventions for children at victimization risk and promote adult-focused services to be

The Impact of Chemoembolization Endpoints on Survival in Hepatocellular Carcinoma Patients

Science.gov (United States)

Jin, Brian; Wang, Dingxin; Lewandowski, Robert J.; Riaz, Ahsun; Ryu, Robert K.; Sato, Kent T.; Larson, Andrew C.; Salem, Riad; Omary, Reed A.

2010-01-01

OBJECTIVE To investigate the relationship between angiographic embolic endpoints of transarterial chemoembolization (TACE) and survival in patients with hepatocellular carcinoma (HCC). MATERIALS AND METHODS This study retrospectively assessed 105 patients with surgically unresectable HCC who underwent TACE. Patients were classified according to a previously established subjective angiographic chemoembolization endpoint (SACE) scale. Only one patient was classified as SACE level 1 and thus excluded from all subsequent analysis. Survival was evaluated with Kaplan-Meier analysis. Multivariate analysis with Cox’s proportional hazard regression model was used to determine independent prognostic risk factors of survival. RESULTS Overall median survival was 21.1 months (95% confidence interval [CI], 15.9–26.4). Patients embolized to SACE levels 2 and 3 were aggregated and had a significantly higher median survival (25.6 months; 95% CI, 16.2–35.0) than patients embolized to SACE level 4 (17.1 months; 95% CI, 13.3–20.9) (p = 0.035). Multivariate analysis indicated that SACE level 4 (Hazard ratio [HR], 2.49; 95% CI, 1.41–4.42; p = 0.002), European Cooperative Oncology Group performance status > 0 (HR, 1.97; 95% CI, 1.15–3.37; p = 0.013), American Joint Committee on Cancer stage 3 or 4 (HR, 2.42; 95% CI, 1.27–4.60; p = 0.007), and Child-Pugh class B (HR, 1.94; 95% CI, 1.09–3.46; p = 0.025) were all independent negative prognostic indicators of survival. CONCLUSION Embolization to an intermediate, sub-stasis endpoint (SACE levels 2 and 3) during TACE improves survival compared to embolization to a higher, stasis endpoint (SACE level 4). Interventional oncologists should consider targeting these intermediate, sub-stasis angiographic endpoints during TACE. PMID:21427346

Child abuse and neglect experts' determination of when a child being left home alone constitutes child neglect.

Science.gov (United States)

Jennissen, Charles A; Evans, Erin; Oral, Resmiye; Denning, Gerene

2018-04-10

Only 14 states have laws or guidelines regarding the minimum age a child may be left home alone. These ages range from 6 to 14 years. Our objective was to identify factors that influence child neglect determination by experts with regards to parents leaving children home alone. American Academy of Pediatrics Section on Child Abuse and Neglect members (N = 523) were surveyed from July-August, 2015. Respondents were asked whether scenarios involving a child of varying age knowingly left home alone for 4 h were neglect in the presence or absence of injury to the child and the legality of the situation. Comparisons were performed using the chi-square test. One hundred ninety-three members responded (36.9%). In the scenario where there were no relevant laws and the child was uninjured, nearly 100% of the child experts determined this as being child neglect when the child was 6 years old. For 8, 10, 12, and 14 year olds, this was 88, 48, 4, and 1%, respectively. However, a significantly higher percentage of experts considered it child neglect for most ages when there was a law making the scenario illegal as compared when there was no law, and when the child was injured versus when they were not. The only demographic variable that showed a difference in child neglect determination was that females were more likely to consider higher aged children as having been neglected when there were no laws but the child was injured. The vast majority of experts (85%) stated that leaving a child home alone for 4 h should be illegal if the child is < 9 years old, and nearly one-half (44%) said it should be illegal for children < 11 years old. A number of factors affect how experts view children being left home alone as potential child neglect. Our data suggests that such cases may be evaluated differently due to variations in state laws, even though the risk to the child is the same. These results call for child safety law reform to provide greater uniformity in the

Welcoming expertise: Bereaved parents' perceptions of the parent-healthcare provider relationship when a critically ill child is admitted to the paediatric intensive care unit.

Science.gov (United States)

Butler, Ashleigh E; Copnell, Beverley; Hall, Helen

2017-11-15

Entering the paediatric intensive care unit with a critically ill child is a stressful experience for parents. In addition to fearing for their child's well-being, parents must navigate both a challenging environment and numerous new relationships with healthcare staff. How parents form relationships with staff and how they perceive both their own and the healthcare providers' roles in this early stage of their paediatric intensive care journey is currently unknown. This paper explores bereaved parents' perceptions of their role and their relationships with healthcare providers when their child is admitted to the intensive care unit, as part of a larger study exploring their experiences when their child dies in intensive care. A constructivist grounded theory approach was utilised to recruit 26 bereaved parents from 4 Australian intensive care units. Parents participated in audio-recorded, semi-structured interviews lasting 90-150min. All data were analysed using the constant comparative analysis processes, supported by theoretical memos. Upon admission, parents viewed healthcare providers as experts, both of their child's medical care and of the hospital system. This expertise was welcomed, with the parent-healthcare provider relationship developing around the child's need for medical care. Parents engaged in 2 key behaviours in their relationships with staff: prioritising survival, and learning 'the system'. Within each of these behaviours are several subcategories, including 'Stepping back', 'Accepting restrictions' and 'Deferring to medical advice'. The relationships between parents and staff shift and change across the child's admission and subsequent death in the paediatric intensive care unit. However, upon admission, this relationship centres around the child's potential survival and their need for medical care, and the parent's recognition of the healthcare staff as experts of both the child's care and the hospital system. Copyright © 2017 Australian

Health-related quality of life of child and adolescent retinoblastoma survivors in the Netherlands

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Bezemer Pieter D

2007-12-01

Full Text Available Abstract Background To assess health-related quality of life (HRQoL in children (8–11 years and adolescents (12–18 years who survived retinoblastoma (RB, by means of the KIDSCREEN self-report questionnaire and the proxy-report version. Methods This population-based cross-sectional study (participation rate 70% involved 65 RB survivors (8–18 years and their parents. Child/adolescents' and parents' perception of their youth's HRQoL was assessed using the KIDSCREEN, and the results were compared with Dutch reference data. Relations with gender, age, marital status of the parents, and visual acuity were analyzed. Results RB survivors reported better HRQoL than did the Dutch reference group on the dimensions "moods and emotions" and "autonomy". Increased ratings of HRQoL in RB survivors were mainly seen in perceptions of the younger children and adolescent girls. RB survivors with normal visual acuity scored higher on "physical well-being" than visually impaired survivors. Age was negatively associated with the dimensions "psychological well-being", "self-perception" (according to the child and parent reports and "parent relations and home life" (according to the child. "Self-perception" was also negatively associated with visual acuity (according to the child. Only parents of young boys surviving RB reported lower on "autonomy" than the reference group, and parents of low visual acuity and blind RB survivors reported higher on "autonomy" than parents of visually unimpaired survivors. Survivors' perceptions and parents' perceptions correlated poorly on all HRQoL dimensions. Conclusion RB survivors reported a very good HRQoL compared with the Dutch reference group. The perceptions related to HRQoL differ substantially between parents and their children, i.e. parents judge the HRQoL of their child to be relatively poorer. Although the results are reassuring, additional factors of HRQoL that may have more specific relevance, such as psychological

Achieving MDG 4 in sub-Saharan Africa: what has contributed to the accelerated child mortality decline in Ghana?

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Haruyo Nakamura

Full Text Available BACKGROUND: Recent analyses have suggested an accelerated decline in child mortality in Ghana since 2000. This study examines the long-term child mortality trends in the country, relates them to changes in the key drivers of mortality decline, and assesses the feasibility of the country's MDG 4 attainment. METHODOLOGY: Data from five Demographic and Health Surveys (DHS between 1988 and 2008 and the Maternal Health Survey 2007 were used to generate two-year estimates of under-five mortality rates back to 1967. Lowess regression fitted past and future trends towards 2015. A modified Poisson approach was applied on the person-period data created from the DHS 2003 and 2008 to examine determinants of under-five mortality and their contributions to the change in mortality. A policy-modelling system assessed the feasibility of the country's MDG 4 attainment. FINDINGS: The under-five mortality rate has steadily declined over the past 40 years with acceleration since 2000, and is projected to reach between 45 and 69 per 1000 live births in 2015. Preceding birth interval (reference: 36+ months, relative risk [RR] increased as the interval shortened, bed net use (RR 0.71, 95% confidence interval [CI]: 0.52-0.95, maternal education (reference: secondary/higher, RR 1.71, 95% CI: 1.18-2.47 for primary, and maternal age at birth (reference: 17+ years, RR 2.13, 95% CI: 1.12-4.05 were primarily associated with under-five mortality. Increased bed-net use made a substantial contribution to the mortality decline. The scale-up of key interventions will allow the possibility of Ghana's MDG 4 attainment. CONCLUSIONS: National and global efforts for scaling up key child survival interventions in Ghana are paying off--these concerted efforts need to be sustained in order to achieve MDG 4.

Additive negative effects of anthropogenic sedimentation and warming on the survival of coral recruits.

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Fourney, Francesca; Figueiredo, Joana

2017-09-28

Corals worldwide are facing population declines due to global climate change and local anthropogenic impacts. Global climate change effects are hard to tackle but recent studies show that some coral species can better handle climate change stress when provided with additional energy resources. The local stressor that most undermines energy acquisition is sedimentation because it impedes coral heterotrophic feeding and their ability to photosynthesize. To investigate if reducing local sedimentation will enable corals to better endure ocean warming, we quantitatively assessed the combined effects of increased temperature and sedimentation (concentration and turbidity) on the survival of coral recruits of the species, Porites astreoides. We used sediment from a reef and a boat basin to mimic natural sediment (coarse) and anthropogenic (fine) sediment (common in dredging), respectively. Natural sediment did not negatively impact coral survival, but anthropogenic sediment did. We found that the capacity of coral recruits to survive under warmer temperatures is less compromised when anthropogenic sedimentation is maintained at the lowest level (30 mg.cm -2 ). Our study suggests that a reduction of US-EPA allowable turbidity from 29 Nephelometric Turbidity Units (NTU) above background to less than 7 NTU near coral reefs would facilitate coral recruit survival under current and higher temperatures.

The New UN CRC General Comment 13: "The Right of the Child to Freedom from All Forms of Violence"--Changing How the World Conceptualizes Child Protection

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Svevo-Cianci, Kimberly A.; Herczog, Maria; Krappmann, Lothar; Cook, Philip

2011-01-01

The UN Committee on the Rights of the Child established CRC General Comment 13 (April 2011) to address today's unabating high rates of violence against children globally despite CRC advances. GC13 provides clear interpretations and stronger detail to supplement the legal language of CRC Article 19, intended to establish protection of children from…

Testing the hypothesis that diphtheria-tetanus-pertussis vaccine has negative non-specific and sex-differential effects on child survival in high-mortality countries.

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Aaby, Peter; Benn, Christine; Nielsen, Jens; Lisse, Ida Maria; Rodrigues, Amabelia; Ravn, Henrik

2012-01-01

Measles vaccines (MV) have sex-differential effects on mortality not explained by protection against measles infection. The authors examined whether whole-cell diphtheria-tetanus-pertussis (DTP) vaccine has sex-differential and non-specific effects. Following previous reviews and a new search, the effect of DTP on mortality up to the next vaccination was assessed in all studies where DTP was given after BCG or DTP was given after MV and there was prospective follow-up after ascertainment of vaccination status. High-mortality countries in Africa and Asia. The initial observation of negative effect of DTP generated six hypotheses, which were examined in all available studies and two randomised trials reducing the time of exposure to DTP. Consistency between studies. In the first study, DTP had negative effects on survival in contrast to the beneficial effects of BCG and MV. This pattern was repeated in the six other studies available. Second, the two 'natural experiments' found significantly higher mortality for DTP-vaccinated compared with DTP-unvaccinated children. Third, the female-male mortality ratio was increased after DTP in all nine studies; in contrast, the ratio was decreased after BCG and MV in all studies. Fourth, the increased female mortality associated with high-titre measles vaccine was found only among children who had received DTP after high-titre measles vaccine. Fifth, in six randomised trials of early MV, female but not male mortality was increased if DTP was likely to be given after MV. Sixth, the mortality rate declined markedly for girls but not for boys when DTP-vaccinated children received MV. The authors reduced exposure to DTP as most recent vaccination by administering a live vaccine (MV and BCG) shortly after DTP. Both trials reduced child mortality. These observations are incompatible with DTP merely protecting against the targeted diseases. With herd immunity to whooping cough, DTP is associated with higher mortality for girls

Substantiated Reports of Child Maltreatment From the Canadian Incidence Study of Reported Child Abuse and Neglect 2008: Examining Child and Household Characteristics and Child Functional Impairment.

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Afifi, Tracie O; Taillieu, Tamara; Cheung, Kristene; Katz, Laurence Y; Tonmyr, Lil; Sareen, Jitender

2015-07-01

Identifying child and household characteristics that are associated with specific child maltreatment types and child functional impairment are important for informing prevention and intervention efforts. Our objectives were to examine the distribution of several child and household characteristics among substantiated child maltreatment types in Canada; to determine if a specific child maltreatment type relative to all other types was associated with increased odds of child functional impairment; and to determine which child and household characteristics were associated with child functional impairment. Data were from the Canadian Incidence Study of Reported Child Abuse and Neglect (collection 2008) from 112 child welfare sites across Canada (n = 6163 children). Physical abuse, sexual abuse, and emotional maltreatment were highly prevalent among children aged 10 to 15 years. For single types of child maltreatment, the highest prevalence of single-parent homes (50.6%), social assistance (43.0%), running out of money regularly (30.7%), and unsafe housing (30.9%) were reported for substantiated cases of neglect. Being male, older age, living in a single-parent home, household running out of money, moving 2 or more times in the past year, and household overcrowding were associated with increased odds of child functional impairment. More work is warranted to determine if providing particular resources for single-parent families, financial counselling, and facilitating adequate and stable housing for families with child maltreatment histories or at risk for child maltreatment could be effective for improving child functional outcomes.

Substantiated Reports of Child Maltreatment From the Canadian Incidence Study of Reported Child Abuse and Neglect 2008: Examining Child and Household Characteristics and Child Functional Impairment

Science.gov (United States)

Afifi, Tracie O; Taillieu, Tamara; Cheung, Kristene; Katz, Laurence Y; Tonmyr, Lil; Sareen, Jitender

2015-01-01

Objective: Identifying child and household characteristics that are associated with specific child maltreatment types and child functional impairment are important for informing prevention and intervention efforts. Our objectives were to examine the distribution of several child and household characteristics among substantiated child maltreatment types in Canada; to determine if a specific child maltreatment type relative to all other types was associated with increased odds of child functional impairment; and to determine which child and household characteristics were associated with child functional impairment. Method: Data were from the Canadian Incidence Study of Reported Child Abuse and Neglect (collection 2008) from 112 child welfare sites across Canada (n = 6163 children). Results: Physical abuse, sexual abuse, and emotional maltreatment were highly prevalent among children aged 10 to 15 years. For single types of child maltreatment, the highest prevalence of single-parent homes (50.6%), social assistance (43.0%), running out of money regularly (30.7%), and unsafe housing (30.9%) were reported for substantiated cases of neglect. Being male, older age, living in a single-parent home, household running out of money, moving 2 or more times in the past year, and household overcrowding were associated with increased odds of child functional impairment. Conclusions: More work is warranted to determine if providing particular resources for single-parent families, financial counselling, and facilitating adequate and stable housing for families with child maltreatment histories or at risk for child maltreatment could be effective for improving child functional outcomes. PMID:26175390

The role of the father in child sleep disturbance: child, parent, and parent-child relationship.

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Millikovsky-Ayalon, Maaian; Atzaba-Poria, Naama; Meiri, Gal

2015-01-01

The majority of studies on child sleep problems focus primarily on mothers, neglecting paternal influences. Guided by the transactional framework, we explored how child temperament, paternal and maternal stress, and the parent-child interactions differ between families having children with sleep disturbances and a selected comparison group. The role of paternal involvement in child caregiving as a moderator of these differences was assessed. The sample consisted of 51 children (1-3 years old) and their mothers and fathers. Data were collected during home visits, when mothers and fathers completed questionnaires and were interviewed. In addition, mother-child and father-child interactions were videotaped. Results indicate that compared to the comparison group, fathers rated children with sleep disturbances as fussier, both their mothers and fathers experienced higher levels of stress, and reported using more bedtime interactions that interfere with child's sleep-wake self-regulation. In addition, their fathers were less sensitive during father-child interaction and less involved in child caregiving. Finally, paternal involvement moderated the group differences seen in maternal stress, suggesting that high paternal involvement acted as a buffer to protect parents of children with sleep disturbances from experiencing parental stress. The important role of fathers in families having children with sleep disturbances is discussed. © 2014 Michigan Association for Infant Mental Health.

Synchronization and survival of connected bacterial populations

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Gokhale, Shreyas; Conwill, Arolyn; Ranjan, Tanvi; Gore, Jeff

Migration plays a vital role in controlling population dynamics of species occupying distinct habitat patches. While local populations are vulnerable to extinction due to demographic or environmental stochasticity, migration from neighboring habitat patches can rescue these populations through colonization of uninhabited regions. However, a large migratory flux can synchronize the population dynamics in connected patches, thereby enhancing the risk of global extinction during periods of depression in population size. Here, we investigate this trade-off between local rescue and global extinction experimentally using laboratory populations of E. coli bacteria. Our model system consists of co-cultures of ampicillin resistant and chloramphenicol resistant strains that form a cross-protection mutualism and exhibit period-3 oscillations in the relative population density in the presence of both antibiotics. We quantify the onset of synchronization of oscillations in a pair of co-cultures connected by migration and demonstrate that period-3 oscillations can be disturbed for moderate rates of migration. These features are consistent with simulations of a mechanistic model of antibiotic deactivation in our system. The simulations further predict that the probability of survival of connected populations in high concentrations of antibiotics is maximized at intermediate migration rates. We verify this prediction experimentally and show that survival is enhanced through a combination of disturbance of period-3 oscillations and stochastic re-colonization events.

Corporate social responsibility in the new global economy

OpenAIRE

Lindfelt, Lise-Lotte

2002-01-01

This paper is a discussion of the rights and responsibilities of global corporations. Multinational and transnational corporations of the new economy face a serious difficulty in being ethical today. The environment is subject to the enormous influence of material monism and ethics becomes at times a question of profits. This paper discusses a few aspects on ethical marketing strategies, the use of ethical codes and corporate survival under the pressures of increasing globalization. The purpo...

Prevalence of child abuse in Khorramabad junior high school students, 2012

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farideh Malekshahi

2014-03-01

Full Text Available Background: Child abuse is a global problem and occurs in a variety of forms and is deeply rooted in cultural, economic and social practices. Child abuse is a behaviour which causes physical, psychological, emotional or sexual abuses, consequentlylead to damage of children,s health, peace of mind and education. Based on these considerations, the present study was conducted to investigate the prevalence of child abuse among junior high school students of Khoramabad in 2012. Materials and Methods: In this cross sectional study, 907 junior high school students randomly selected .Data collection tool was a multiple questionnaire incloding child and parents’ demographic information, and a physical emotional abuse and neglect questionnaire. It,s validity and reliability was done by content validity and Test re test. Data were analysed using SPSS v. 19. Results: The findings of this study showed that average age of the cases was 13.36±1.04 and 5.4% of them were always under physical abuse and the most physical abuse was slap on the face , 7.3% emotional abuse and 5.5% neglect. Statistical test showed a significant relation between abuses and parents, educational level, job, addiction and divorce. Conclusion: Results showed that child abuse is common among families, therefore, monitoring of children, ratification of rules supporting children, planing and administration of preventive educational programs can be effective to reduce child abuse.

Boundaries of confidentiality in nursing care for mother and child in HIV programmes.

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Våga, Bodil Bø; Moland, Karen Marie; Blystad, Astrid

2016-08-01

Confidentiality lies at the core of medical ethics and is the cornerstone for developing and keeping a trusting relationship between nurses and patients. In the wake of the HIV epidemic, there has been a heightened focus on confidentiality in healthcare contexts. Nurses' follow-up of HIV-positive women and their susceptible HIV-exposed children has proved to be challenging in this regard, but the ethical dilemmas concerning confidentiality that emerge in the process of ensuring HIV-free survival of the third party - the child - have attracted limited attention. The study explores challenges of confidentiality linked to a third party in nurse-patient relationships in a rural Tanzanian HIV/AIDS context. The study was carried out in rural and semi-urban settings of Tanzania where the population is largely agro-pastoral, the formal educational level is low and poverty is rife. The HIV prevalence of 1.5% is low compared to the national prevalence of 5.1%. Data were collected during 9 months of ethnographic fieldwork and consisted of participant observation in clinical settings and during home visits combined with in-depth interviews. The main categories of informants were nurses employed in prevention of mother-to-child transmission of HIV programmes and HIV-positive women enrolled in these programmes. Based on information about the study aims, all informants consented to participate. Ethical approval was granted by ethics review boards in Tanzania and Norway. The material indicates a delicate balance between the nurses' attempt to secure the HIV-free survival of the babies and the mothers' desire to preserve confidentiality. Profound confidentiality-related dilemmas emerged in actual practice, and indications of a lack of thorough consideration of the implication of a patient's restricted disclosure came to light during follow-up of the HIV-positive women and the third party - the child who is at risk of HIV infection through mother's milk. World Health Organization

Public health surveillance of cancer survival in the United States and worldwide: The contribution of the CONCORD programme.

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Allemani, Claudia; Coleman, Michel P

2017-12-15

CONCORD is a programme for the global surveillance of cancer survival. In 2015, the second cycle of the program (CONCORD-2) established long-term surveillance of cancer survival worldwide, for the first time, in the largest cancer survival study published to date. CONCORD-2 provided cancer survival trends for 25,676,887 patients diagnosed during the 15-year period between 1995 and 2009 with 1 of 10 common cancers that collectively represented 63% of the global cancer burden in 2009. Herein, the authors summarize the past, describe the present, and outline the future of the CONCORD programme. They discuss the difference between population-based studies and clinical trials, and review the importance of international comparisons of population-based cancer survival. This study will focus on the United States. The authors explain why population-based survival estimates are crucial for driving effective cancer control strategies to reduce the wide and persistent disparities in cancer survival between white and black patients, which are likely to be attributable to differences in access to early diagnosis and optimal treatment. Cancer 2017;123:4977-81. Published 2017. This article is a U.S. Government work and is in the public domain in the USA. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

Journal of Child and Adolescent Mental Health - Vol 25, No 1 (2013)

African Journals Online (AJOL)

Journal of Child and Adolescent Mental Health - Vol 25, No 1 (2013) ... Autism spectrum disorders—Global challenges and local opportunities · EMAIL ... Peer education training for sexual health and well-being in public high schools in ... Evaluation of a school-based intervention programme for South African children of ...

Pretension Strategy in the Surviving Game

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Andrejs JAUNZEMS

2014-07-01

Full Text Available Till the nowadays we cannot find the scientific analysis that clearly explains the deepest roots of global economical and moral crisis. Because of that many famous politicians, economists, sociologists denote the understanding of current situation as the most valuable attainment. Under traditional influence of the doctrine of spontaneous harmony of egoistic individual behavior many economists believe that competition and private property rights through the markets' price mechanism leads in the long run to the Pareto efficient equilibrium. In the same time the social and economic reality categorically asks for ascertain the market failure and for revision the classical statements of microeconomics. The perfect competition market has lost its attributes due to dialectics of interactions of agents. The investigation of the strategies interactions of the individuals are based on the game theory, what helps to understand also the role of asymmetric information as specific market failure factor. In present paper the Martin Shubik classical surviving game is analyzed and some statements of Herbert Gintis concerning this game are critically appraised. The solution of Martin Shubik game in the original geometrical form is offered. The problem of Martin Shubik "does the fittest necessary survive?" is transformed according the case of asymmetric information in problem "does the pretender survive?", for which the answer "if the agent is not the weakest, but he pretends to be the weakest, than this agent survives with high probability" is offered. The results of the present paper appear to be innovative, not discussed in literature available to the author of the present paper.

Globalization and Aggregate Employment Nexus: A Recent ...

African Journals Online (AJOL)

Since Nigeria is monotonically dependent on external trade for survival, globalization measured by the ratio of export plus import to GDP soared for the period. Coincidentally, aggregate employment in the industrial sector also rose, at least from liturgical observation. This paper therefore examined this relationship using ...

New Findings on Child Marriage in Sub-Saharan Africa.

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Petroni, Suzanne; Steinhaus, Mara; Fenn, Natacha Stevanovic; Stoebenau, Kirsten; Gregowski, Amy

Despite increasing global attention and commitments by countries to end the harmful practice of child marriage, each year some 15 million girls marry before the age of 18. The preponderance of the evidence produced historically on child marriage comes from South Asia, where the vast majority of child brides live. Far less attention has been paid to child marriage in sub-Saharan Africa, where prevalence rates remain high. The International Center for Research on Women (ICRW) recently conducted research in Kenya, Senegal, Uganda, and Zambia to contribute to greater understanding of the drivers of child marriage in each of these contexts. Synthesizing findings from 4 diverse countries provides a useful opportunity to identify similarities and differences, as well as understandings that may be applicable to and helpful for preventing child marriage across these and other settings. Across the 4 countries, ICRW's research echoes the existing literature base in affirming that child marriage is rooted in inequitable gender norms that prioritize women's roles as wives, mothers, and household caretakers, resulting in inadequate investments by families in girls' education. These discriminatory norms interact closely with poverty and a lack of employment opportunities for girls and young women to perpetuate marriage as a seemingly viable alternative for girls. We found in the African study sites that sexual relations, unplanned pregnancy, and school dropout often precede child marriage, which differs from much of the existing evidence on child marriage from South Asia. Further, unlike in South Asia, where family members typically determine the spouse a girl will marry, most girls in the Africa study settings have greater autonomy in partner choice selection. In Senegal, increasing educational attainment and labor migration, particularly by young women, has contributed to reduced rates of child marriage for girls. Our findings suggest that improving gender equitable norms and

Child Labor in the World Polity: Decline and Persistence, 1980-2000

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Clark, Rob

2011-01-01

From 1980 to 2000, child labor rates across the world fell by more than a quarter. Much of the explanation for this decrease resides in development processes broadly associated with the demographic transition. Net of these internal dynamics, however, globalization may also have played a role. Previous studies have examined the effect of trade and…

Factors Predicting Survival after Transarterial Chemoembolization of Unresectable Hepatocellular Carcinoma

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Farina M. Hanif

2014-10-01

Full Text Available Background: Transarterial chemoembolization is the preferred treatment for unresectable, intermediate-stage hepatocellular carcinoma. Survival after transarterial chemoembolization can be highly variable. The purpose of this study is to identify the factors that predict overall survival of patients with unresectable hepatocellular carcinoma who undergo transarterial chemoembolization as the initial therapy. Methods:We included patients who underwent transarterial chemoembolization from 2007 to 2012 in this study. Patient’s age, gender, cause of cirrhosis, Child-Turcotte-Pugh score, model of end-stage liver disease score, Cancer of the Liver Italian Program score, Okuda stage, alpha- fetoprotein level, site, size and number of tumors were recorded. Radiological response to transarterial chemoembolization was assessed by computerized tomography scan at 1 and 3 months after the procedure. Repeat sessions of transarterial chemoembolization were performed according to the response. We performed survival assessment and all patients were assessed for survival at the last follow-up. Results: Included in this study were 71 patients of whom there were 57 (80.3 % males, with a mean age of 51.9±12.1 years (range: 18-76 years. The mean follow-up period was 12.5±10.7 months. A total of 31 (43.7% patients had only one session of transarterial chemoembolization, 17 (23.9% underwent 2 and 11 (15.5% had 3 or more sessions. On univariate analysis, significant factors that predicted survival included serum bilirubin (P=0.02, esophageal varices (P=0.002, Cancer of the Liver Italian Program score (P=0.003, tumor size (P=0.005, >3 sessions of transarterial chemoembolization (P=0.006 and patient's age (P=0.001. Cox regression analysis showed that tumor size of 1 transarterial chemoembolization session (P=0.004 were associated with better survival. Conclusion: Our study demonstrates that survival after transarterial chemoem- bolization is predicted by tumor size

Review shows that Icelandic society is taking firmer steps to tackle the diverse forms of child abuse and neglect that its children are exposed to.

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Gunnlaugsson, Geir; Einarsdóttir, Jónína

2018-04-04

This review examined and summarised the research published on child abuse in Iceland, which was mainly in the country's native language, to make the findings more accessible to English speakers. It specifically focused on child rearing and the physical, emotional and sexual abuse, neglect and intrafamilial conflicts suffered by children at the hands of their parents and other carers. The review drew on published research, books and reports and compared the findings with Nordic research and global estimates of child abuse. Qualitative and quantitative research revealed that the prevalence of different forms of child abuse, child neglect and intra-familial conflicts in Iceland was similar to, or higher than, global and Nordic estimates. Younger respondents reported less physical abuse than older respondents, but higher levels of emotional abuse. Legislation, greater awareness, public debates and research on child abuse in Iceland have contributed to the growing recognition of the negative consequences of child abuse and strengthened support for prevention strategies. Icelandic children have reportedly experienced diverse forms of child abuse and neglect from their parents and other carers. Diverse initiatives have been put in place that underline the urgent need to tackle such behaviour. ©2018 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.

GLOBALIZATION AND THE POTENTIAL FOR FROZEN POTATO PROCESSING IN MEXICO

OpenAIRE

Phillips, Jon C.

1998-01-01

An analysis of the potential for the establishment and survival of frozen potato processing in Mexico is provided. Tools used include demand analysis (including demographic data and elasticities) and Porter's competitive forces model. The process of globalization is reviewed, from an agribusiness perspective. Prepared for the "Globalization and Its (Dis) Contents: Multiple Perspectives" Conference held April 3-4, 1998, East Lansing, Michigan.

Educating the girl child in rural areas.

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Tandon, S

1995-01-01

This article discusses the importance of educating female children in India. There is ample evidence worldwide that improvements in girls' education benefit the status of the family and empower women. The World Declaration of Education for All was adopted in Jomtein, Thailand in 1990. It urged access to and improvement in the quality of education of girls and women to remove obstacles that hamper active participation. 1990 was the Year of Literacy and the Year of the Girl Child. Girls lag in education worldwide. The gender gap is widest in India in levels of literacy, school enrollment, school dropouts, and opportunities for vocational training. There is a need to educate the public, particularly mothers, about the value of girls. In rural and backward areas of India, there is fear of educating girls that is related to prevalent practices of exploitation and violence against women. Education and vocational training should be linked with anti-poverty programs. Adult literacy should be linked with girls' education. The National Policy on Education in 1986 targeted removal of sex stereotyping from school curricula and promoted diversified curricula and access of girls to vocational and professional training programs. The policy recommended integrated child care services and primary education. The national action plan for the 1990s focuses on protection, survival, and development of the girl child in India. Special schools for developing skills in nutrition, cooking, sewing, home economics, and child development should be set up in villages for girls 12-20 years old. The gap in girls' education is attributed to apathy and resistance of parents, unfavorable attitudes toward coeducation, poverty of parents, shortages of schools, and poor quality instruction. Girls' continuing education should be ensured by incentives, such as free books and clothes; time tables conducive to work; support systems; and work schemes.

Synchronous glioblastoma and medulloblastoma in a child with mismatch repair mutation.

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Amayiri, Nisreen; Al-Hussaini, Maysa; Swaidan, Maisa; Jaradat, Imad; Qandeel, Monther; Tabori, Uri; Hawkins, Cynthia; Musharbash, Awni; Alsaad, Khulood; Bouffet, Eric

2016-03-01

Synchronous primary malignant brain tumors are rare. We present a 5-year-old boy with synchronous glioblastoma and medulloblastoma. Both tumor samples had positive p53 stain and loss of PMS2 and MLH1 stains. The child had multiple café au lait spots and a significant family history of cancer. After subtotal resection of both tumors, he received craniospinal radiation with concomitant temozolomide followed by chemotherapy, alternating cycles of cisplatin/lomustine/vincristine with temozolomide. Then, he started maintenance treatment with cis-retinoic acid (100 mg/m(2)/day for 21 days). He remained asymptomatic for 34 months despite a follow-up brain MRI consistent with glioblastoma relapse 9 months before his death. Cis-retinoic acid may have contributed to prolong survival in this child with a probable biallelic mismatch repair syndrome.

ABC of child abuse. Role of the child psychiatry team.

OpenAIRE

Nicol, A. R.

1989-01-01

In summary, a child psychiatrist can make an important contribution to the management of child abuse. At least one child psychiatrist in each district should take an interest in this work and should be given the time to do so. As for other professionals, child abuse is an aspect of the work of child psychiatrists that is particularly harrowing and time consuming.

Parental practice of child car safety in Enugu, Southeast Nigeria

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Ndu KI

2016-11-01

Full Text Available KI Ndu,1,* U Ekwochi,1,* DC Osuorah,2,* OC Ifediora,3 FO Amadi,1 IN Asinobi,1 OW Okenwa,1 JC Orjioke,1 FN Ogbuka,1 TO Ulasi4 1Department of Paediatrics, Enugu State University of Science and Technology, Enugu State, Engu, Nigeria; 2Child Survival Unit, Medical Research Council UK, The Gambia Unit, Fajara, Gambia; 3Griffiths University Medical School, Gold Coast, QLD, Australia; 4Department of Paediatrics, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria *These authors contributed equally to this work Abstract: Child safety restraints and seat belts are regarded as the most successful safety and cost-effective protective devices available to vehicle occupants, which have saved millions of lives. This cross-sectional descriptive study evaluated the practice and use of child car restraints (CCRs among 458 purposively selected respondents resident in two local government areas in Enugu State, Nigeria. Self-administered questionnaires were sent to parents of children attending private schools who owned a car. Chi-square and multivariate analyses were used to assess the determinants of the use of car restraints in children among respondents. In all, 56% and 45% of adults and children, respectively, used car restraints regularly. The awareness of child safety laws and actual use of age-appropriate CCRs among respondents was negatively and weakly correlated (r=–0.121, P=0.310. Only respondent’s use of seat belt during driving (P=0.001 and having being cautioned for non-use of CCRs (P=0.005 maintained significance as determinants of the use of CCRs in cars on multivariate analysis. The most frequent reasons given for the non-use of CCRs included the child being uncomfortable, 64 (31%; restraints not being important, 53 (26%, and restraints being too expensive, 32 (15%. Similarly, for irregular users, exceptions for non-use included the child being asleep (29%, inadequate number of CCRs (22%, and the child being sick (18

Effect of political decentralization and female leadership on institutional births and child mortality in rural Bihar, India.

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Kumar, Santosh; Prakash, Nishith

2017-07-01

In this paper, we investigate the impacts of political decentralization and women reservation in local governance on institutional births and child mortality in the state of Bihar, India. Using the difference-in-differences methodology, we find a significant positive association between political decentralization and institutional births. We also find that the increased participation of women at local governance led to an increased survival rate of children belonging to richer households. We argue that our results are consistent with female leaders having policy preference for women and child well-being. Copyright © 2017 Elsevier Ltd. All rights reserved.

PACKAGING ARTISTIC PRODUCTS FOR THE GLOBAL VILLAGE ...

African Journals Online (AJOL)

Since its inauguration through the electronic connectedness of the whole world, Globalism has miniaturized the spatial immensity of the world by the conquest and ... our artistic products (just as our industrial manufactures) endure or survive this arena of sophisticated competition overhauled by the trade punditry and politics ...

Mozambique child soldier life outcome study: lessons learned in rehabilitation and reintegration efforts.

Science.gov (United States)

Boothby, N; Crawford, J; Halperin, J

2006-01-01

As the use of child soldiers continues to proliferate throughout the world, effective psychosocial interventions must be developed and evaluated. Our research shows that former child soldiers who are provided rehabilitative services and accepted back into their families and communities are able to become productive, responsible and caring adults. In 1988, 39 captured or escaped child soldiers were brought by the Mozambican government to the Lhanguene Rehabilitation Center in Maputo, Mozambique's capital city. Interventions that focused on rehabilitating the children both psychologically and physically were initiated during their 6-month stay at the Lhanguene centre, and reintegration assistance was provided for 2 years thereafter to support their return to families and communities. Our research continued to follow these former child soldiers for 16 years, and focused on their psychological, social and economic functioning. The study included qualitative and quantitative data collection methods to obtain adult well-being outcomes and was also designed to identify interventions that enabled these child soldiers to re-enter civilian life and lead relatively productive lives. Efficacious rehabilitation activities included those that strengthened individuals' coping skills for anticipated trauma and grief, instilled a sense of social responsibility and promoted self-regulation and security (versus survival) seeking behaviour. Activities that supported long term reintegration and self-sufficiency included community acceptance and forgiveness, traditional cleansing and healing rituals, livelihoods and apprenticeships.

Volume 9 No. 9 December 2009 1797 REVIEW ARTICLE GLOBAL ...

African Journals Online (AJOL)

2009-12-09

Dec 9, 2009 ... GLOBAL ECONOMIC CRISIS AND NUTRITION SECURITY IN AFRICA ... lack of access to capital, among other obstacles, leave African farmers with a ... a leading researcher in child health and development at the Federal University of .... production more than doubled within one year's time, exceeding ...

Trends and social differentials in child mortality in Rwanda 1990-2010: results from three demographic and health surveys.

Science.gov (United States)

Musafili, Aimable; Essén, Birgitta; Baribwira, Cyprien; Binagwaho, Agnes; Persson, Lars-Åke; Selling, Katarina Ekholm

2015-09-01

Rwanda has embarked on ambitious programmes to provide equitable health services and reduce mortality in childhood. Evidence from other countries indicates that advances in child survival often have come at the expense of increasing inequity. Our aims were to analyse trends and social differentials in mortality before the age of 5 years in Rwanda from 1990 to 2010. We performed secondary analyses of data from three Demographic and Health Surveys conducted in 2000, 2005 and 2010 in Rwanda. These surveys included 34 790 children born between 1990 and 2010 to women aged 15-49 years. The main outcome measures were neonatal mortality rates (NMR) and under-5 mortality rates (U5MR) over time, and in relation to mother's educational level, urban or rural residence and household wealth. Generalised linear mixed effects models and a mixed effects Cox model (frailty model) were used, with adjustments for confounders and cluster sampling method. Mortality rates in Rwanda peaked in 1994 at the time of the genocide (NMR 60/1000 live births, 95% CI 51 to 65; U5MR 238/1000 live births, 95% CI 226 to 251). The 1990s and the first half of the 2000s were characterised by a marked rural/urban divide and inequity in child survival between maternal groups with different levels of education. Towards the end of the study period (2005-2010) NMR had been reduced to 26/1000 (95% CI 23 to 29) and U5MR to 65/1000 (95% CI 61 to 70), with little or no difference between urban and rural areas, and household wealth groups, while children of women with no education still had significantly higher U5MR. Recent reductions in child mortality in Rwanda have concurred with improved social equity in child survival. Current challenges include the prevention of newborn deaths. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Culture and context in understanding child maltreatment: Contributions of intersectionality and neighborhood-based research.

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Nadan, Yochay; Spilsbury, James C; Korbin, Jill E

2015-03-01

In the early 1990s, the U.S. Advisory Board on Child Abuse and Neglect commissioned a series of reviews that appeared as the edited volume, Protecting Children from Abuse and Neglect (Melton & Barry, 1994). Using the 1994 review "Sociocultural Factors in Child Maltreatment" (Korbin, 1994) as a background, this article reconsiders culture and context in child maltreatment work. Since 1994, conditions promoting research and practice attention in this area include immigration-driven global increases in diverse, multicultural societies where different beliefs and practices meet (and clash); expanding purview of the human rights discourse to children; and the disproportionate and disparate representation of cultural, ethnic, and racial groups in child-welfare systems. Although research on child maltreatment has advanced in many ways over 20 years, the complexity of child maltreatment leaves many critical questions demanding further attention, culture and context among them. To help address these questions, we propose two approaches for future maltreatment research: intersectionality - the simultaneous examination of multiple identities (such as gender, race, and socioeconomic status) - as a framework for understanding the complexity of cultural factors; and neighborhood-based research as a means for understanding the context of child maltreatment from the perspective of an ecological framework. Copyright © 2014 Elsevier Ltd. All rights reserved.

Aspects of abuse: recognizing and responding to child maltreatment.

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Jackson, Allison M; Kissoon, Natalie; Greene, Christian

2015-03-01

Child maltreatment is a public health problem and toxic stress impacting at least 1 in 8 children by the age of 18 years. Maltreatment can take the form of physical and sexual abuse, neglect, and emotional maltreatment. While some children may experience only one form of maltreatment, others may survive multiple forms, and in some cases particularly complex forms of maltreatment such as torture and medical child abuse. When considering maltreatment, providers should be adept at obtaining a thorough history not only from the parent but when appropriate also from the patient. The most common form of child maltreatment is neglect, which encompasses nutritional and medical neglect, as well as other forms such as physical and emotional neglect. Talking with caregivers about stressors and barriers to care may give insight into the etiology for neglect and is an opportunity for the provider to offer or refer for needed assistance. Familiarity with injury patterns and distribution in the context of developmental milestones and injury mechanisms is critical to the recognition of physical abuse. While most anogenital exam results of child victims of sexual abuse are normal, knowing the normal variations for the female genitalia, and thereby recognizing abnormal findings, is important not only forensically but also more importantly for patient care. Pattern recognition does not only apply to specific injuries or constellation of injuries but also applies to patterns of behavior. Harmful patterns of behavior include psychological maltreatment and medical child abuse, both of which cause significant harm to patients. As health professionals serving children and families, pediatric providers are in a unique position to identify suspected maltreatment and intervene through the health care system in order to manage the physical and psychological consequences of maltreatment and to promote the safety and well-being of children and youth by making referrals to child protective

One year Survival Rate of Ketac Molar versus Vitro Molar for Occlusoproximal ART Restorations: a RCT

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PACHECO Anna Luisa de Brito

2017-11-01

Full Text Available Abstract Good survival rates for single-surface Atraumatic Restorative Treatment (ART restorations have been reported, while multi-surface ART restorations have not shown similar results. The aim of this study was to evaluate the survival rate of occluso-proximal ART restorations using two different filling materials: Ketac Molar EasyMix (3M ESPE and Vitro Molar (DFL. A total of 117 primary molars with occluso-proximal caries lesions were selected in 4 to 8 years old children in Barueri city, Brazil. Only one tooth was selected per child. The subjetcs were randomly allocated in two groups according to the filling material. All treatments were performed following the ART premises and all restorations were evaluated after 2, 6 and 12 months. Restoration survival was evaluated using Kaplan-Meier survival analysis and Log-rank test, while Cox regression analysis was used for testing association with clinical factors (α = 5%. There was no difference in survival rate between the materials tested, (HR = 1.60, CI = 0.98–2.62, p = 0.058. The overall survival rate of restorations was 42.74% and the survival rate per group was Ketac Molar = 50,8% and Vitro Molar G2 = 34.5%. Cox regression test showed no association between the analyzed clinical variables and the success of the restorations. After 12 months evaluation, no difference in the survival rate of ART occluso-proximal restorations was found between tested materials.

Microanalytic Coding versus Global Rating of Maternal Parenting Behaviour

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Morawska, Alina; Basha, Allison; Adamson, Michelle; Winter, Leanne

2015-01-01

This study examined the relationship between microanalytic coding and global rating systems when coding maternal parenting behaviour in two contexts. Observational data from 55 mother--child interactions with two- to four-year-old children, in either a mealtime (clinic; N?=?20 or control; N?=?20) or a playtime context (community; N?=?15), were…

Community Context and Child Health: A Human Capital Perspective.

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Smith-Greenaway, Emily

2017-09-01

Human capital theory suggests that education benefits individuals' and their children's health through the educational skills people acquire in school. This perspective may also be relevant at the community level: the greater presence of adults with educational skills in a community may be a reason why living in a more highly educated setting benefits health. I use Demographic and Health Survey data for 30 sub-Saharan African countries to investigate whether the percentage of literate adults-specifically women-in a community is associated with children's likelihood of survival. I characterize 13,785 African communities according to the prevalence of women who are literate. Multilevel discrete-time hazard models ( N = 536,781 children) confirm that living in a community where more women are literate is positively associated with child survival. The study supports the conceptualization of literacy, and potentially other educational skills, as forms of human capital that can spill over to benefit others.

Forced migration and child health and mortality in Angola.

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Avogo, Winfred Aweyire; Agadjanian, Victor

2010-01-01

This study investigates the effects of forced migration on child survival and health in Angola. Using survey data collected in Luanda, Angola, in 2004, just two years after the end of that country's prolonged civil war, we compare three groups: migrants who moved primarily due to war, migrants whose moves were not directly related to war, and non-migrants. First, we examine the differences among the three groups in under-five mortality. Using an event-history approach, we find that hazards of child death in any given year were higher in families that experienced war-related migration in the same year or in the previous year, net of other factors. To assess longer-term effects of forced migration, we examine hazards of death of children who were born in Luanda, i.e., after migrants had reached their destinations. We again observe a disadvantage of forced migrants, but this disadvantage is explained by other characteristics. When looking at the place of delivery, number of antenatal consultations, and age-adequate immunization of children born in Luanda, we again detect a disadvantage of forced migrants relative to non-migrants, but now this disadvantage also extends to migrants who came to Luanda for reasons other than war. Finally, no differences across the three groups in child morbidity and related health care seeking behavior in the two weeks preceding the survey are found. We interpret these results within the context of the literature on short- and long-term effects of forced migration on child health.

War, famine and excess child mortality in Africa: the role of parental education.

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Kiros, G E; Hogan, D P

2001-06-01

Civilian-targeted warfare and famine constitute two of the greatest public health challenges of our time. Both have devastated many countries in Africa. Social services, and in particular, health services, have been destroyed. Dictatorial and military governments have used the withholding of food as a political weapon to exacerbate human suffering. Under such circumstances, war and famine are expected to have catastrophic impacts on child survival. This study examines the role of parental education in reducing excess child mortality in Africa by considering Tigrai-Ethiopia, which was severely affected by famine and civil war during 1973--1991. This study uses data from the 1994 Housing and Population Census of Ethiopia and on communities' vulnerability to food crises. Child mortality levels and trends by various subgroups are estimated using indirect methods of mortality estimation techniques. A Poisson regression model is used to examine the relationship between number of children dead and parental education. Although child mortality is excessively high (about 200 deaths per 1000 births), our results show enormous variations in child mortality by parental education. Child mortality is highest among children born to illiterate mothers and illiterate fathers. Our results also show that the role of parental education in reducing child mortality is great during famine periods. In the communities devastated by war, however, its impact was significant only when the father has above primary education. CONCLUSIONS Our findings suggest that both mother's and father's education are significantly and negatively associated with child mortality, although this effect diminishes over time if the crisis is severe and prolonged. The policy implications of our study include, obviously, reducing armed conflict, addressing food security in a timely manner, and expansion of educational opportunities.

Global mapping of binding sites for Nrf2 identifies novel targets in cell survival response through ChIP-Seq profiling and network analysis

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Malhotra, Deepti; Portales-Casamar, Elodie; Singh, Anju; Srivastava, Siddhartha; Arenillas, David; Happel, Christine; Shyr, Casper; Wakabayashi, Nobunao; Kensler, Thomas W.; Wasserman, Wyeth W.; Biswal, Shyam

2010-01-01

The Nrf2 (nuclear factor E2 p45-related factor 2) transcription factor responds to diverse oxidative and electrophilic environmental stresses by circumventing repression by Keap1, translocating to the nucleus, and activating cytoprotective genes. Nrf2 responses provide protection against chemical carcinogenesis, chronic inflammation, neurodegeneration, emphysema, asthma and sepsis in murine models. Nrf2 regulates the expression of a plethora of genes that detoxify oxidants and electrophiles and repair or remove damaged macromolecules, such as through proteasomal processing. However, many direct targets of Nrf2 remain undefined. Here, mouse embryonic fibroblasts (MEF) with either constitutive nuclear accumulation (Keap1−/−) or depletion (Nrf2−/−) of Nrf2 were utilized to perform chromatin-immunoprecipitation with parallel sequencing (ChIP-Seq) and global transcription profiling. This unique Nrf2 ChIP-Seq dataset is highly enriched for Nrf2-binding motifs. Integrating ChIP-Seq and microarray analyses, we identified 645 basal and 654 inducible direct targets of Nrf2, with 244 genes at the intersection. Modulated pathways in stress response and cell proliferation distinguish the inducible and basal programs. Results were confirmed in an in vivo stress model of cigarette smoke-exposed mice. This study reveals global circuitry of the Nrf2 stress response emphasizing Nrf2 as a central node in cell survival response. PMID:20460467

Child-Mother and Child-Father Play Interaction Patterns with Preschoolers

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John, Aesha; Halliburton, Amy; Humphrey, Jeremy

2013-01-01

The study focused on qualitative and quantitative differences between maternal and paternal play interaction behaviours with their preschool children. Home observations of 18 child-mother and child-father play interactions were qualitatively analysed to derive interaction themes. In addition, the quality of child-mother and child-father…

Motorboat noise impacts parental behaviour and offspring survival in a reef fish.

Science.gov (United States)

Nedelec, Sophie L; Radford, Andrew N; Pearl, Leanne; Nedelec, Brendan; McCormick, Mark I; Meekan, Mark G; Simpson, Stephen D

2017-06-14

Anthropogenic noise is a pollutant of international concern, with mounting evidence of disturbance and impacts on animal behaviour and physiology. However, empirical studies measuring survival consequences are rare. We use a field experiment to investigate how repeated motorboat-noise playback affects parental behaviour and offspring survival in the spiny chromis ( Acanthochromis polyacanthus ), a brooding coral reef fish. Repeated observations were made for 12 days at 38 natural nests with broods of young. Exposure to motorboat-noise playback compared to ambient-sound playback increased defensive acts, and reduced both feeding and offspring interactions by brood-guarding males. Anthropogenic noise did not affect the growth of developing offspring, but reduced the likelihood of offspring survival; while offspring survived at all 19 nests exposed to ambient-sound playback, six of the 19 nests exposed to motorboat-noise playback suffered complete brood mortality. Our study, providing field-based experimental evidence of the consequences of anthropogenic noise, suggests potential fitness consequences of this global pollutant. © 2017 The Authors.

The Impact of IT Outsourcing on Surviving Employees: Managing Survivor Syndrome Symptoms

Science.gov (United States)

Lyons, Tony R.

2010-01-01

Global outsourcing of information technology functions has become a major tool used by organizations to increase or maintain competitive market positioning. One often overlooked in determining an organization's level of success from outsourcing is the negative impact on the behavioral and emotional well-being of surviving employees, often referred…

HIV-1 Disease Progression and Survival in an Adult Population in Zimbabwe

DEFF Research Database (Denmark)

Zinyama-Gutsire, Rutendo B L; Chasela, Charles; Kallestrup, Per

2015-01-01

HIV infection remains a major global health burden since its discovery in 1983. Sub-Saharan Africa is the region hardest hit by the HIV/AIDS pandemic where 63% of the 33 million infected people live. While there is marked person-to-person variability in susceptibility, progression, and survival...

Survival of the Fittest: Why Terrorist Groups Endure

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Joseph K. Young

2014-04-01

Full Text Available Why do terrorist groups endure? This question is relevant to scholars and policy makers alike. In the past, this issue was not been addressed in a systematic fashion. Recent work investigates this question using data on transnational groups and finds that factors associated with the home country can influence the duration the group endures. Applying the theory of outbidding to terrorist group survival, we argue that strategic competition among groups predicts group duration. Using the Global Terrorism Database, we develop a dataset using the terrorist group as the unit of analysis to model the duration of group activity and thus include the largest sample of groups yet. Controlling for previous explanations of both group duration and terrorism, we find a robust effect for the impact that group competition has on terrorist group survival.

“Culture Is So Interspersed”: Child-Minders’ and Health Workers’ Perceptions of Childhood Obesity in South Africa

OpenAIRE

Figueroa, Roger; Saltzman, Jaclyn; Jarick Metcalfe, Jessica; Wiley, Angela

2017-01-01

Introduction. Forty-one million children globally are overweight or obese, with most rapid rate increases among low- and middle-income nations. Child-minders and health workers play a crucial role in obesity prevention efforts, but their perceptions of childhood obesity in low- and middle-income countries are poorly understood. This study aims to (1) explore child-minders and health workers’ perceptions of the causes, consequences, potential strategies, and barriers for childhood obesity prev...

Energy globalization

International Nuclear Information System (INIS)

Tierno Andres

1997-01-01

Toward the future, the petroleum could stop to be the main energy source in the world and the oil companies will only survive if they are adjusted to the new winds that blow in the general energy sector. It will no longer be enough to be the owner of the resource (petroleum or gas) so that a company subsists and be profitable in the long term. The future, it will depend in great measure of the vision with which the oil companies face the globalization concept that begins to experience the world in the energy sector. Concepts like globalization, competition, integration and diversification is something that the companies of the hydrocarbons sector will have very present. Globalization means that it should be been attentive to what happens in the world, beyond of the limits of its territory, or to be caught by competitive surprises that can originate in very distant places. The search of cleaner and friendlier energy sources with the means it is not the only threat that it should fear the petroleum. Their substitution for electricity in the big projects of massive transport, the technology of the communications, the optic fiber and the same relationships with the aboriginal communities are aspects that also compete with the future of the petroleum

Child Labor: A Forgotten Focus for Child Welfare.

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Otis, Jack; Pasztor, Eileen Mayers; McFadden, Emily Jean

2001-01-01

Discusses the worldwide problem of child labor and efforts to advocate for the welfare of these impoverished children. Considers factors that contribute to the continued use of child labor and the resistance of these labor practices to reform. Discusses child labor in the United States, and urges public advocacy for labor reform within child…

Sanctification and spiritual disclosure in parent-child relationships: implications for family relationship quality.

Science.gov (United States)

Brelsford, Gina M

2013-08-01

Social scientific research on family life, religion, and spirituality tends to focus on global religiousness and spirituality with few studies seeking to understand interpersonal religious and spiritual contributors, namely sanctification and spiritual disclosure, from multiple family members' perspectives. This study explored 91 mother-college student and 64 father-college student dyads who rated their use of spiritual disclosure and theistic and nontheistic sanctification of the parent-child dyad in relation to parent-child relationship quality (e.g., parent-child relationship satisfaction and open communication). Results indicate significant positive links between higher levels of spiritual disclosure and greater theistic and nontheistic sanctification, for mothers, fathers, and their children. However, only greater nontheistic sanctification and higher levels spiritual disclosure were significantly related to increased parent-child relationship quality. Through use of Actor-Partner Interdependence Models (APIMs) results indicated unique contributions of spiritual disclosure to parent-child relationship quality above nontheistic sanctification for open communication in the family. However, full models, which included nontheistic sanctification and spiritual disclosure, predict college students' relationship satisfaction with their mothers and fathers. Implications for interpersonal religiousness and spirituality as contributors to familial relationship quality in research and practice are discussed. © 2013 American Psychological Association

Child Bride and Child Sex: Combating Child Marriages in Nigeria ...

African Journals Online (AJOL)

This paper considers the basis of child marriages in Northern Nigeria. It is an Islamic practice rooted in the interpretation of the Quran. Significantly, the caveat that copulation should be delayed until such girls are mature is often ignored as these child brides are engaged in sex. This paper analyzes the report of a Senator in ...

Early and Forced Child Marriages in Rural Western Nepal

OpenAIRE

Pitambar Acharya; Benjamin Welsh

2017-01-01

After reviewing the state of early and forced child marriage (ECM) globally and nationally within Nepal, this research assessed the determinants, consequences and preventive measures of ECM in rural municipalities in Nepal today. This mixed method surveyed 167 households taking 15 % sample from the clusters of three wards of Badhaiyatal Rural Municipality in Bardiya and Dullu Municipality in Dailekh of Western Nepal. Besides household survey, six Focus Group Discussions (FGDs), 16 Key Informa...

Adult survival and population growth rate in Colorado big brown bats (Eptesicus fuscus)

Science.gov (United States)

O'Shea, T.J.; Ellison, L.E.; Stanley, T.R.

2011-01-01

We studied adult survival and population growth at multiple maternity colonies of big brown bats (Eptesicus fuscus) in Fort Collins, Colorado. We investigated hypotheses about survival using information-theoretic methods and mark-recapture analyses based on passive detection of adult females tagged with passive integrated transponders. We constructed a 3-stage life-history matrix model to estimate population growth rate (??) and assessed the relative importance of adult survival and other life-history parameters to population growth through elasticity and sensitivity analysis. Annual adult survival at 5 maternity colonies monitored from 2001 to 2005 was estimated at 0.79 (95% confidence interval [95% CI] = 0.77-0.82). Adult survival varied by year and roost, with low survival during an extreme drought year, a finding with negative implications for bat populations because of the likelihood of increasing drought in western North America due to global climate change. Adult survival during winter was higher than in summer, and mean life expectancies calculated from survival estimates were lower than maximum longevity records. We modeled adult survival with recruitment parameter estimates from the same population. The study population was growing (?? = 1.096; 95% CI = 1.057-1.135). Adult survival was the most important demographic parameter for population growth. Growth clearly had the highest elasticity to adult survival, followed by juvenile survival and adult fecundity (approximately equivalent in rank). Elasticity was lowest for fecundity of yearlings. The relative importances of the various life-history parameters for population growth rate are similar to those of large mammals. ?? 2011 American Society of Mammalogists.

Hepatorenal Syndrome: Outcome of Response to Therapy and Predictors of Survival

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Jan Heidemann

2015-01-01

Full Text Available Aim. Treatment of hepatorenal syndrome (HRS in patients with liver cirrhosis is still challenging and characterized by a very high mortality. This study aimed to delineate treatment patterns and clinical outcomes of patients with HRS intravenously treated with terlipressin. Methods. In this retrospective single-center cohort study, 119 patients (median [IQR]; 56.50 [50.75–63.00] years of age with HRS were included. All patients were treated with terlipressin and human albumin intravenously. Those with response to treatment (n=65 were compared to the patient cohort without improvement (n=54. Patient characteristics and clinical parameters (Child stage, ascites, hepatic encephalopathy, HRS type I/II, and initial MELD score were retrieved. Univariate analysis of factors influencing the success of terlipressin therapy and Cox regression analysis of factors influencing survival was carried out. Results. One-month survival was significantly longer in the group of responders (p=0.048. Cox regression analysis identified age [Hazard ratio, 95% confidence interval (CI; 1.05, 1.01–1.09, resp.], alcohol abuse [HR 3.05, 95% CI 1.11–8.38], duration of treatment [HR 0.92, 95% CI 0.88–0.96], and MELD score [HR 1.08, 95% CI 1.02–1.14] to be independent predictors of survival. Conclusions. Survival of HRS patients after treatment depends on age, etiology of liver disease, and the duration of treatment.

Priorities for research in child maltreatment, intimate partner violence and resilience to violence exposures

DEFF Research Database (Denmark)

Wathen, C Nadine; MacGregor, Jennifer C D; Hammerton, Joanne

2012-01-01

Intimate partner violence (IPV) and child maltreatment (CM) are major global public health problems. The Preventing Violence Across the Lifespan (PreVAiL) Research Network, an international group of over 60 researchers and national and international knowledge-user partners in CM and IPV, sought...

Differentiation of homicidal child molesters, nonhomicidal child molesters, and nonoffenders by phallometry.

Science.gov (United States)

Firestone, P; Bradford, J M; Greenberg, D M; Nunes, K L

2000-11-01

The purpose of this study was to examine the ability of phallometry to discriminate among homicidal child molesters, nonhomicidal child molesters, and a comparison group of nonoffenders. Twenty-seven child molesters who had committed or had attempted a sexually motivated homicide, 189 nonhomicidal child molesters, and 47 nonoffenders were compared on demographic variables and psychometrically determined responses to aural descriptions of sexual vignettes. Two phallometric indexes were used: the pedophile index and the pedophile assault index. The pedophile index was computed by dividing the subject's highest response to an aural description of sex with a "consenting" child by his highest response to description of sex with a consenting adult. The pedophile assault index was computed by dividing the subject's highest response to an aural description of assault involving a child victim by his highest response to description of sex with a "consenting" child. Homicidal child molesters, nonhomicidal child molesters, and nonoffenders were not significantly different in age or IQ. Homicidal and nonhomicidal child molesters had significantly higher pedophile index scores than nonoffenders. Significantly more homicidal child molesters (14 [52%] of 27) and nonhomicidal child molesters (82 [46%] of 180) than nonoffenders (13 [28%] of 47) had pedophile index scores equal to or greater than 1.0, but homicidal and nonhomicidal child molesters did not differ from each other. Significantly more homicidal child molesters (17 [63%] of 27) than either nonhomicidal child molesters (71 [40%] of 178) or nonoffenders (17 [36%] of 47) had pedophile assault index scores equal to or greater than 1.0, and nonhomicidal child molesters and nonoffenders were not significantly different from each other. Within-group analyses revealed that of the three groups, only the nonhomicidal child molesters exhibited a significant difference between their pedophile index scores and their pedophile assault

Promoting equity through integrated early child development and nutrition interventions.

Science.gov (United States)

Black, Maureen M; Dewey, Kathryn G

2014-01-01

Sustainable development, a foundation of the post-2015 global agenda, depends on healthy and productive citizens. The origins of adult health begin early in life, stemming from genetic-environmental interactions that include adequate nutrition and opportunities for responsive learning. Inequities associated with inadequate nutrition and early learning opportunities can undermine children's health and development, thereby compromising their productivity and societal contributions. Transactional theory serves as a useful framework for examining the associations that link early child development and nutrition because it emphasizes the interplay that occurs between children and the environment, mediated through caregiver interactions. Although single interventions targeting early child development or nutrition can be effective, there is limited evidence on the development, implementation, evaluation, and scaling up of integrated interventions. This manuscript introduces a special edition of papers on six topics central to integrated child development/nutrition interventions: (1) review of integrated interventions; (2) methods and topics in designing integrated interventions; (3) economic considerations related to integrated interventions; (4) capacity-building considerations; (5) examples of integrated interventions; and (6) policy implications of integrated interventions. Ensuring the health and development of infants and young children through integrated child development/nutrition interventions promotes equity, a critical component of sustainable development. © 2014 New York Academy of Sciences.

Stressful Life Events and Child Anxiety: Examining Parent and Child Mediators

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Platt, Rheanna; Williams, Sarah R.; Ginsburg, Golda S.

2015-01-01

While a number of factors have been linked with excessive anxiety (e.g., parenting, child temperament), the impact of stressful life events remains under-studied. Moreover, much of this literature has examined bivariate associations rather than testing more complex theoretical models. The current study extends the literature on life events and child anxiety by testing a theory-driven meditational model. Specifically, one child factor (child cognitions/locus of control), two parent factors (parent psychopathology and parenting stress), and two parent-child relationship factors (parent-child dysfunctional interaction and parenting style) were examined as mediators in the relationship between stressful life events and severity of child anxiety. One hundred and thirty anxious parents and their nonanxious, high-risk children (ages ranged from 7 to 13 years) participated in this study. Results indicated that levels of parenting stress, parental anxious rearing, and dysfunctional parent-child interaction mediated the association between stressful life events and severity of anxiety symptoms. Child cognition and parent psychopathology factors failed to emerge as mediators. Findings provide support for more complex theoretical models linking life events and child anxiety and suggest potential targets of intervention. PMID:25772523

Interrelatedness of child health, protection and well-being: an application of the SAFE model in Rwanda.

Science.gov (United States)

Betancourt, Theresa S; Williams, Timothy P; Kellner, Sarah E; Gebre-Medhin, Joy; Hann, Katrina; Kayiteshonga, Yvonne

2012-05-01

This study examines the core components of children's basic security and well-being in order to examine issues central to improving child protection in Rwanda. Sources of data included 15 focus groups with adults, 7 focus groups with children ages 10-17, and 11 key informant interviews with child protection stakeholders, including representatives from international NGOs, community-based groups, and the Rwandan Government, all of which took place in April and May of 2010. Participants painted a complex picture of threats to children's basic security in Rwanda. Three key themes were pervasive across all interviews: (1) deterioration of social and community cohesion in post-genocide Rwanda; (2) the cascading effects of poverty; and (3) the impact of caregiver illness and death on the caregiving environment. Consistent with the SAFE (Safety/freedom from harm; Access to basic physiological needs and healthcare; Family and connection to others; Education and economic security) model of child protection, participants rarely elaborated on a child protection threat independent of other basic security needs and rights. Findings suggest a need for integrated approaches to child protection that recognize this interrelatedness and extend beyond issue-specific child protection responses. This study contributes to a growing body of work highlighting the interrelated nature of child protection threats and the implications of adaptive and dangerous survival strategies that children and families engage in to meet their basic security needs. Analysis of this interrelatedness provides a roadmap for improving policies and implementing integrated and robust child protection strategies in Rwanda and other settings. Copyright © 2012 Elsevier Ltd. All rights reserved.