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Nutritional vitamin D supplements are often used in general pediatrics. Here, the aim is to address vitamin D supplementation and calcium nutritional intakes in newborns, infants, children, and adolescents to prevent vitamin D deficiency and rickets in general populations. We formulated clinical questions relating to the following categories: the Patient (or Population) to whom the recommendation will apply; the Intervention being considered; the Comparison (which may be "no action," placebo, or an alternative intervention); and the Outcomes affected by the intervention (PICO). These PICO elements were arranged into the questions to be addressed in the literature searches. Each PICO question then formed the basis for a statement. The population covered consisted of children aged between 0 and 18 years and premature babies hospitalized in neonatology. Two groups were assembled: a core working group and a voting panel from different scientific pediatric committees from the French Society of Pediatrics and national scientific societies. We present here 35 clinical practice points (CPPs) for the use of native vitamin D therapy (ergocalciferol, vitamin D 2 and cholecalciferol, vitamin D 3) and calcium nutritional intakes in general pediatric populations. This consensus document was developed to provide guidance to health care professionals on the use of nutritional vitamin D and dietary modalities to achieve the recommended calcium intakes in general pediatric populations. These CPPs will be revised periodically. Research recommendations to study key vitamin D outcome measures in children are also suggested. [ABSTRACT FROM AUTHOR]

Medical ethics and related topics such as data protection are often viewed as extraneous encumberments by researchers. However these fields provide guidelines for correct conduct and are mostly common sense. This Best Practice Guideline collection will focus on various related aspects pertaining to ethics in publication, and this paper will outline the key points in each of these papers in the collection. [ABSTRACT FROM AUTHOR]

There is now a growing interest in early-life influences on adult diseases in China. A number of birth cohorts have been established. This systematic review provided a better understanding of the development of mother–baby cohorts in China. Systematic review. We conducted a systematic review for research or profile papers in English/Chinese that reported data from mother–baby cohorts in mainland China, with ≥1y follow-up after birth. We identified 315 papers, corresponding to 31 cohorts from 19 provinces/megacities. All cohorts started in 1999–2017 (21 after 2010) and were set up with broad objectives or specific scientific focus. The baseline sample size varied, from <500 to >300,000 mothers. A majority of cohorts were initiated during pregnancy and followed children to <10y, only six to adolescence and none into adulthood. These cohorts mostly collected samples from mothers and babies, in addition to using interviews/questionnaires to collect information about pregnancy, birth and child health. Most cohorts were recruited from a single province/city. The large western region was understudied. Mother–baby cohorts have developed rapidly in China, but usually with a short follow-up duration. Extending the follow-up of children and developing cross-cohort collaboration will increase the diversity, size and coverage of the sample, allow studying early influences on life-course health and identify targets for early intervention in the Chinese population. [ABSTRACT FROM AUTHOR]

To examine profiles of distress of mothers of preterm infants in the neonatal intensive care unit (NICU) and relate profiles to maternal and child outcomes at child age 5 years. A racially and economically diverse sample of mothers (n = 94; 39% African American, 52% White) of preterm infants (≤30 weeks of gestation) completed validated questionnaires assessing depression, anxiety (state and trait), NICU stress, and life stress at NICU discharge of their infant. Mothers reported on their own and their children's symptomatology at child age 5. A latent profile analysis was conducted to categorize maternal symptomatology. Latent profile analysis yielded 4 distinct maternal profiles: low symptomatology, high NICU stress, high depression and anxiety, and high state anxiety. Social determinants of health factors including age, education, neighborhood deprivation, and infant clinical risk distinguished the profiles. Mothers in the high depression and anxiety profile reported more anxiety and life stress at follow-up and reported their children experienced more anxious/depressed symptoms. Existing literature has gaps related to examining multiple dimensions of NICU distress and understanding how patterns of mood/affective symptoms, life stressors, and related social determinants of health factors vary across mothers. In this study, one specific profile of maternal NICU distress demonstrated enduring risks for poorer maternal and child mental health outcomes. This new knowledge underscores sources of disparate health outcomes for mothers of preterm infants and the infants themselves. Universal screening is needed to identify at-risk dyads for poor health outcomes in need of individualized interventions that address both maternal and child well-being. We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented sexual and/or gender groups in science. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list. [ABSTRACT FROM AUTHOR]

This paper focuses on home smart voice devices to address the problems of traditional mental health diagnosis and evaluation (e.g., the inability to monitor, analyze and assess mental health in real-time and the heavy reliance on psychologists and counselors for judgment). It constructs a model for monitoring, examining, and evaluating children's mental health using interactive communication and voice recordings between children and intelligent voice devices. The model uses techniques such as natural language processing and data mining based on a random forest algorithm. Meanwhile, this paper explores and investigates the feasibility of implementing the model on the ground in terms of technology development and technology preference. [ABSTRACT FROM AUTHOR]

• Children sleep less on days with longer daylight duration. • Sleeping longer improves selected general developmental, behavioural and health outcomes in children and adolescents. • Sleeping more increases children's BMI scores, mainly by increasing the risk of being overweight. • The results indicate a null or relatively small positive impact of sleeping longer on cognitive skills. Children and adolescents spend more than one-third of their time sleeping. Yet, we know little about the causal impact of sleeping on their development. This paper is the first to exploit variation in local daily daylight duration measured on pre-determined diary dates across the same individuals through time as an instrument in an individual fixed effects regression model to draw causal estimates of sleep duration on a comprehensive set of child development indicators. Applying this model to about 50 thousand time use diaries from two cohorts of Australian children spanning over 16 years, we first document that children sleep substantially less on days with longer daylight duration. Our results show that sleeping longer improves selected general developmental, behavioural and health outcomes in children and adolescents. By contrast, sleeping more statistically significantly increases the BMI scores, mainly by increasing the risk of being overweight. Moreover, while the impact of sleep duration on general and behavioural outcomes is more pronounced for females or older individuals, the effect on BMI is largely driven by males. The results indicate a null or relatively small positive impact of sleeping longer on cognitive skills. [ABSTRACT FROM AUTHOR]

Institutional child abuse has several negative impacts, including effects on mental health, well-being and interpersonal relationships. There is a need to understand this complex form of abuse occurring in an out-of-home setting. The current review aims to understand the literature base regarding the impact of institutional child abuse and to identify areas where further research is needed. Consequently, a systematic review was conducted, which captured quantitative and qualitative methods. This resulted in 58 papers being included. The papers captured the impacts of institutional abuse, covering physical abuse, sexual abuse, emotional abuse and neglect (i.e., a failure to be adequately cared for). These were then analysed using a qualitative methodology, specifically Reflexive Thematic Analysis. Several factors, such as prior abuse, were reported to exacerbate the impact of institutional abuse, whereas secure attachment was noted as a protective feature. Responses to disclosure appear to have an important role in recovery. Areas important for further research included understanding the role of protective factors and how they impact future outcomes, but to do so alongside an acknowledgement and greater exploration of negative impacts. • Diversity in impact is clearly evidenced, alongside complexity in presentation. • Pre-existing factors, including availability of protective factors, appear as important correlates with later mental health challenges. • A role for disclosure as a unique feature is indicated. • An absence of longitudinal research into impacts is evidenced. • The research field uses considerable diversity in method, with resulting varied quality. [ABSTRACT FROM AUTHOR]

Early childhood education programs have been found to effectively promote children's social and cognitive development. However, the health impact of these programs is less understood. Using a quasi-experiment of the first universal child care reform in China from 2010, this paper aims to identify whether the preschool reform produces any short-term effects on health-related outcomes of preschoolers (3-6 years old). Specifically, this reform expands access to affordable preschools that provide full-day center-based education, with school meals and essential health services on campus. I exploit the variation in the number of newly established preschools across provinces and implement difference-in-differences and triple-difference strategies. Results confirm the effectiveness of this reform by showing a strong and positive impact on preschool attendance. This paper then documents the benefits to alleviating underweight among preschoolers. Estimates show a larger effect in rural areas, suggesting that the reform narrows rural-urban disparities in education access and undernutrition prevention. I also explore the impact on caregivers' health consciousness and find improved health-seeking behavior when children get sick. [ABSTRACT FROM AUTHOR]

Injury at living spaces accounts for over 70% of injuries among children under the age of 5 years and its prevention is essentially important in terms of children's health. This paper proposes an effective method of integrating knowledge graphs along with object recognition to determine the dangerous situations for infants and provide preventive measures to avoid such situations. This also leads to the proposal of a new system called "Empowering Reality (ER)" that enables a lecturer to educate parents on preventing childhood unintentional injuries at home while communicating with the parents using Augmented Reality (AR) technology. The proposed ER system consists of knowledge graphs for explaining dangerous situations, an online video capturing part, and a situation recognition part. This paper describes major advantages of knowledge graphs that takes into consideration of not only relation between objects and injuries but also dangerous layouts with the help of "inclusion" and "collocation" features. The feasibility and effectiveness of the system was evaluated through tests among 11 parents. The system allows the lecturer to conduct in-situ suggestion on specific preventive measures adapted to the home environment via online learning. [ABSTRACT FROM AUTHOR]

Presently, child-specific tools and instruments related to active school travel (AST) are lacking. This methodological shortcoming often contributes to suboptimal AST behaviour evaluations and intervention programming. The aim of this paper was to develop and validate a theoretically informed child-specific scale regarding multiple perceived barriers and enablers known to impact children's participation in AST. Mixed methods. A mixed-methods and multistudy scale development approach featuring the application of social-ecological theory, a validation pilot study (n = 80), and test-retest study (n = 96) was conducted in collaboration with children in Ontario, Canada. In tandem with completing cognitive interviews and online surveys, multiple analyses, including a qualitative thematic analysis, along with weighted Cohen's kappa, Cronbach's alpha, and confirmatory factor analysis were undertaken. Qualitative analyses of the developed tool addressed face validity concerns related to the response options and definitions of terms used. Following the reliability analyses of 40 items, two confirmatory factor analyses were run to assess the construct validation of perceived AST barriers and enablers, and resulted in the development of the 24-item Perceived Active School Travel Enablers and Barriers – Child (PASTEB-C) questionnaire. The developed PASTEB-C questionnaire may be used to inform the programming and development of AST interventions, as well as conduct child-specific AST research. [ABSTRACT FROM AUTHOR]

This paper investigates the nexus between women's empowerment and child health, in particular examining whether having more rights, and which rights, leads to improvements in the well-being of children, as reflected by child mortality rates. We distinguish between civil rights, political rights, and economic rights. In our sample of 134 countries over the period 1950–2018, and employing 27 separate rights-based measures of empowerment, women's empowerment commonly contributes to a reduction in child mortality in high-income countries, however, low- and middle-income countries reveal striking differences across some measures. For example, while women's participation in public administration or employment in the public sector is associated with reduced child mortality, the opposite is observed for the right to run a business and access to banking. Results suggest that strong institutions are needed to ensure rights are translated into better welfare. • Overarching study of rights-based measures of women's empowerment and their association with child mortality in 134 countries from 1950–2018. • Women's empowerment measures are commonly associated with a reduction in child mortality in high-income countries (HIC). • Association between women's empowerment and child health in low- and middle-income countries (LMIC) is less clearcut. • Women's participation in public sector and administration is associated with reduced child mortality in LMIC. • Results suggest strong institutions are needed to ensure rights are translated into better welfare. [ABSTRACT FROM AUTHOR]

This paper examines the influence of housing wealth on fertility outcomes through a regression discontinuity design based on a 2006 Chinese housing-market policy. Our analysis reveals that the positive impact of this policy on housing wealth significantly enhances the likelihood of fertility by 7.3 %. Our result implies that a 1 % increase in housing wealth can raise the fertility rate by 0.18 %. Furthermore, we observe that children born subsequent to the positive housing wealth shock exhibit improved health, not only at birth but also over the long term. Lastly, we present suggestive evidence suggesting that both parental pre-birth time allocation and parental health may help explain the documented positive effects of housing wealth on fertility rates. [ABSTRACT FROM AUTHOR]

Objective: Racism is a public health crisis that impacts on children's mental health, yet mental health service systems are insufficiently focused on addressing racism. Moreover, a focus on interpersonal racism and on individual coping with the impacts of racism has been prioritized over addressing structural racism at the level of the service system and associated institutions. In this paper, we examine strategies to address structural racism via policies affecting children's mental health services.Method: First, we identify and analyze federal and state policies focused on racism and mental health equity. Second, we evaluate areas of focus in these policies and discuss the evidence base informing their implementation. Finally, we provide recommendations for what states, counties, cities, and mental health systems can do to promote antiracist evidence-based practices in children's mental health.Results: Our analysis highlights gaps and opportunities in the evidence base for policy implementation strategies, including the following: mental health services for youth of color, interventions addressing interpersonal racism and bias in the mental health service system, interventions addressing structural racism, changes to provider licensure and license renewal, and development of the community health workforce.Conclusion: Recommendations are provided both within and across systems to catalyze broader systems transformation. [ABSTRACT FROM AUTHOR]

Abstract Child nutritional health has always been a research focus and an essential indicator reflecting children's health and living conditions in developing countries. This study investigates how household income and other individual and family factors influence child nutritional status. The Chinese Health and Nutrition Survey data are used to analyze changing patterns of child malnutrition status, and to compare the gap between genders, rural and urban areas etc., and the WHO new child growth standards are used in this paper as the reference for each specific age and gender. The findings in this paper include three aspects. First of all, the headcount ratio of undernourished children in both stunting and underweight has declined over years from 1991 to 2009 in China. Second, regional disparity in child nutritional status was significant, and the economic growth was a key driver to improve the nutritional conditions of the poor children. Furthermore, this paper also employs the stepwise logistic regression models to illustrate the influencing mechanisms of family income and other factors on child nutrition, and finds that household income affected child nutritional status significantly through the mechanisms of community, household, parental and individual factors. Highlights • This paper studies stunting and underweight rates of Chinese children and finds both malnutritional indicators have declined from 1991 to 2009. • This paper studies the regional and demographic differences in child nutrition and finds certain heterogeneity in malnutritional indicators. • This paper studies the relationship between family income and child nutrition and reveals significant and positive correlation between the two. • This paper finds significant impact mechanisms of individual, parental, family and community factors on child nutrition. [ABSTRACT FROM AUTHOR]

Highlights • Explores anecdotal evidence that grandparents could influence paediatric vaccine uptake. • Reviews articles that suggest grandparents influence parents' decision to vaccinate children. • Currently there is no direct evidence that grandparents influence parents' vaccination decisions. • Articles reviewed highlight indirect evidence of grandparental influence on parents' decisions. • Highlights grandparents' attitudes and beliefs are echoed in parents' decision to vaccinate. Abstract The global reduction in childhood infectious diseases since the 1960s is primarily due to the success of extensive worldwide immunisation campaigns. However, the universal vaccination coverage program appears to have lost momentum in the wake of negative, unfounded claims about the safety of vaccines. While parents of the 21st century have little first-hand knowledge of devastating childhood diseases, grandparents are more likely to remember family and community members who were afflicted. In the current age of vaccine hesitancy and science scepticism, where research-informed arguments are not always persuasive, grandparents, through their experience of the diseases, may positively influence paediatric vaccine uptake. This paper reviews the literature investigating potential direct or indirect influences of grandparents on parents' decisions to vaccinate their children. A database search using the keywords immunisation , vaccination , children and grandparents resulted in 1988 articles. Titles were screened for relevance and seventy-seven results were retained. After the abstracts were read, only five articles that either explored paediatric vaccines, factors promoting and/or inhibiting paediatric vaccine use and decision-making strategies were reviewed. One paper located through Google Scholar, which failed to show up on database searches, was also retained for a total of six papers. While none of the six papers set out to explore the impact of grandparents on vaccine uptake, they found that grandparents were involved to varying degrees in paediatric vaccine uptake within young families. The research clearly showing that grandparents, and older people more generally, promote vaccination uptake is not currently available. The dearth of literature shows the need for research exploring the perceived and real influences of grandparents on childhood vaccination. This will establish whether grandparents' memory and knowledge of preventable childhood infectious diseases could be harnessed as a public health measure to counteract the current, ill-informed, negative attention on paediatric vaccines. [ABSTRACT FROM AUTHOR]

Abstract This article examines a strategic area in the promotion of urban cycling, namely the drive to encourage this mode of transportation among children and adolescents. The findings of this paper are supported by a qualitative ethnographic study conducted in the Spanish region of Andalusia, where local and regional government interventions have promoted policies in recent years to foster cycling. Grounded in theories on corporality, this paper highlights the social perceptions of the agents involved in such interventions and stresses the need to combine approaches that promote infrastructure with those that focus on embodied enculturation. The conclusions reached offer proposals aimed at strengthening the promotion of cycling in this area, with a view to overcoming the limited and discontinuous character of training and education observed so far. [ABSTRACT FROM AUTHOR]

Background: Cardiac arrest, particularly in children, often has a poor outcome and international guidelines highlight significant gaps in the evidence base for effective resuscitation. Whilst randomised controlled trials for some interventions can be justified, they are not appropriate for many aspects of resuscitation. Therefore, guidelines must use other sources of data such as epidemiological evidence from cardiac arrest registries, to improve the efficacy of resuscitation. The aim of our study was to identify existing national cardiac arrest registries and document key information about the registries, including whether they contain data on paediatric arrests.Methods: Key bibliographic databases were searched for papers about or using data from cardiac arrest registries. Two reviewers independently screened the search results for relevant papers. A list of registers named in the papers was compiled and information obtained from the papers and the websites of registers where possible.Results: Twenty three active national or large regional cardiac arrest registries were identified. These included five international collaborations and 10 registries that cover a population of at least 10 million people. Twelve registries are based in Europe, five in North America, four in Asia and two in Australasia. The registries vary in their organisation, but the majority (20) defer to the Utstein reporting guidelines for cardiac arrest. Registries covered populations between 0.4 and 174.5 million and contained between 100 and 605,505 records. Sixteen collected data on out-of-hospital arrests only; three in-hospital arrests only; and four included both. For ten registers the number of paediatric arrests was available and ranged from 56 to 3900.Conclusions: To our knowledge this report contains the most complete list of active national and large regional cardiac arrest registries. Register data support current guidelines on effective resuscitation however, even the largest registries include relatively small numbers, particularly of paediatric events. A less fragmented approach has the potential to improve the utility of registration data for the benefit of patients. [ABSTRACT FROM AUTHOR]

Health as a common good is of paramount importance for the world, especially in developing countries. This paper contributes to the literature by analysing the effect of climate vulnerability on child health outcomes in a sample of 107 developing countries over the period 2000–2020. We also analyse the mediating role of women's political empowerment and women's education in the relationship between climate vulnerability and child health outcomes. Using the method of generalised moments in a two-stage system and linear regression absorbing several levels of fixed effects, we found robust evidence that climate vulnerability worsens child health outcomes. We also found that women's political empowerment (WPE) and women's education mitigate the negative effect of climate vulnerability on child health outcomes. These results remain robust against several alternative tests and therefore highlight the need to better examine how the health consequences of climate vulnerability are structured by gender in developing countries. Given the importance of women as agents of change, it would be more beneficial for policymakers to include them in the decision-making process. • We use a dataset covering 107 developing countries over 21 years. • Child health outcomes: IMR, NMR, under-5 mortality rate, and vaccination coverage. • Linear regression absorbing multi-levels of fixed effects, and S-GMM are used. • Climate vulnerability leads to worse child health outcomes. • WPE and female education mitigate the effects of vulnerability on child health. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Since its inception, the Pediatric Quality Measures Program has focused on the development and implementation of new and innovative pediatric quality measures (PQM) for both public and private use. Building the evidence base related to measure usability and feasibility is central to increasing measure uptake and, thereby, to increased performance monitoring and quality improvement (QI) for children in Medicaid or the Children's Health Insurance Program. This paper describes key stakeholder insights focused on measure implementation and increasing the uptake of PQM. METHODS: The PQMP Learning Collaborative conducted semistructured interviews with 9 key informants (KIs) representing states, health plans, and other potential end users of the measures. The interviews focused on gaining KIs' perspectives on 6 research questions focused on assessing the feasibility and usability of PQM and strengthening the connection between measurement and improvement. RESULTS: Our synthesis identified insights that highlight facilitators and barriers from the KIs' experience and the strategies they employ when using measures to drive improvement "on-the-ground." Importantly, while the KIs agreed on how essential the research questions are to measure implementation and uptake, they uniformly acknowledged the complexity of the issues raised and pinpointed multiple unresolved issues. DISCUSSION: The views expressed by these stakeholders point to several key issues - including incorporation of socio-economic status into quality measures and performance comparisons, use of benchmark data, and criteria for QI versus accountability - for developing a real-world research agenda to guide the future direction of quality measurement and implementation to improve children's health care. [ABSTRACT FROM AUTHOR]

Paediatric sepsis remains a leading cause of childhood death. Morbidity is high, with up to one third of children affected developing ongoing, sometimes lifelong sequelae. To address the major burden of sepsis on child health, there is need for a unified approach to care, as outlined in the Australian National Action Plan for sepsis. While the Surviving Sepsis Campaign 2020 guidelines provided evidence-based recommendations for sepsis management in hospital, additional emphasis on families, pre-hospital recognition and post-sepsis care incorporating the multidisciplinary team is paramount to achieve quality patient outcomes. The role of families, paramedics and nurses in recognising and managing paediatric sepsis remains an under-represented area in current literature. The aim of this paper is to critically discuss key challenges surrounding the journey of paediatric sepsis, drawing on contemporary literature to highlight key areas pertinent to recognition and management of sepsis in children. Application of a holistic, patient-centred focus will provide an overview of paediatric sepsis, aiming to inform future development for enhanced healthcare delivery and identify critical areas for further research. [ABSTRACT FROM AUTHOR]

Children are disproportionately vulnerable to the impacts of climate change because of physiological, developmental, behavioral, and social factors. In addition, they are likely to bear the consequences of these impacts over their life course. This paper reviews the health impacts of climate change on children's health, highlights specific vulnerabilities and offers recommendations to pediatric health care professionals for mitigation, adaptation, policy, and personal interventions to address our changing climate. Health care professionals can help families in mitigation and adaptation strategies to reduce their risk from climate change. [ABSTRACT FROM AUTHOR]

Last year, we wrote to you of our dedication and vision for this journal "to be antiracist at every level," outlining the following 6 initiatives "to reshape the Journal to pursue this vision:" (1) Issuing a Call for Papers "on racism and its impacts on child development and children's mental health;" (2) updating our Guide for Authors "to emphasize that we will evaluate articles submitted to the Journal on whether their study designs and discussions consider and address human diversity in the context of their research questions and hypotheses; (3) assembling a special collection of "Journal articles on bias, bigotry, racism, and mental health disparities;" (4) accelerating "our efforts to make our editorial board inclusive and representative of our community of scientists and practitioners as well as the communities we all serve;" (5) engaging in "continuing education and dialogue as an Editorial Board that will include antiracism training;" and (6) critically examining "our editorial and peer review process to ensure it is antiracist.1 In this Editors' Note, we write to update you on our progress. [ABSTRACT FROM AUTHOR]

Objective: This paper aimed to investigate whether distinct sleep quality subtypes predicted health-related quality of life in a nonclinical sample of children.Methods: This paper utilized data from two waves of the Longitudinal Study of Australian Children, a cohort study that follows a representative population of children in Australia. This paper examined data from Waves 4 and 5 of the LSAC (covering the period 2010-2012) and included 3974 children aged 10-11 years at Wave 4 (51.4% male). Multiple dimensions of sleep quality were assessed using a combination of child- and parent-reported measures. Health-related quality of life (HRQOL) was assessed through the Pediatric Quality of Life Inventory.Results: Latent class analysis indicated six distinct sleep quality classes in children, namely good sleep, moderate sleep quality, mild sleep disturbances, short sleep, long sleep, and disordered sleep. In general, the disordered sleep and minor sleep disturbance classes had poorer HRQOL, which worsened over time. The long sleep and moderate sleep quality classes also showed some decreases in HRQOL over time.Conclusions: This study demonstrates that there are distinct sleep quality subtypes in children that could have implications for HRQOL. These findings may inform future strategies to promote improved sleep and HRQOL in children. [ABSTRACT FROM AUTHOR]

Introduction: High maternal and child mortality continues in low- and middle-income countries (LMIC). Measurement of maternal, newborn and child health (MNCH) coverage indicators often involves an expensive, complex, and lengthy household data collection process that is especially difficult in less-resourced settings. Computer-assisted personal interviewing (CAPI) has been proposed as a cost-effective and efficient alternative to traditional paper-and-pencil interviewing (PAPI). However, the literature on respondent-level acceptance of CAPI in LMIC has reported mixed outcomes. This is the first study to prospectively examine female respondent acceptance of CAPI and its influencing factors for MNCH data collection in rural Southwest Uganda.Methods: Eighteen women aged 15-49 years were randomly selected from 3 rural villages to participate. Each respondent was administered a Women's Questionnaire with half of the survey questions asked using PAPI techniques and the other half using CAPI. Following this PAPI/CAPI exposure, semi-structured focus group discussions (FGDs) assessed respondent attitudes towards PAPI versus CAPI. FGD data analysis involved an immersion/crystallization method (thematic narrative analysis).Results: The sixteen FGD respondents had a median age of 27 (interquartile range: 24.8, 32.3) years old. The majority (62.5%) had only primary level education. Most respondents (68.8%) owned or regularly used a mobile phone or computer. Few respondents (31.3%) had previously seen but not used a tablet computer. Overall, FGDs revealed CAPI acceptance and the factors influencing CAPI acceptability were 'familiarity', 'data confidentiality and security', 'data accuracy', and 'modernization and development'.Discussion: Female survey respondents in our rural Southwest Ugandan setting found CAPI to be acceptable. Global health planners and implementers considering CAPI for health coverage survey data collection should accommodate influencing factors during survey planning in order to maximize and facilitate acceptance and support by local stakeholders and community participants. Further research is needed to generate best practices for CAPI implementation and LMIC; higher quality, timely, streamlined and budget-friendly collection of MNCH indicators could help direct and improve programming to save lives of mothers and children. [ABSTRACT FROM AUTHOR]

This paper investigates the thermal performance offour school buildings of different ages and characteristics, using current EU overheating criteria and ‘adjusted’ criteria based on children's lower comfort temperature found in recent research. Data collected in Southampton, UK, between 2011-2015 are used in the analysis, which consists of two parts: a) the development of an adaptive comfort model associating children's comfort temperature to outdoor climate based onapproximately 2,800 thermal comfort responses from children, and b) the thermal performance evaluation of four case study schools (built in 1894, 1929, 1978 and 2013)with the use of5-minute air temperature measurements during spring/summer from a total of 43 classrooms.The two models, current (adult-based) and adapted to pupils, are applied to the methodology for overheating assessment based on the European standard EN15251. Results show that there is no overheating in the schools when the classroom temperatures were assessed with the current adult-based model,while when using the children-based modeloverheating wasidentified in three out of the four schools. Interestingly, the school with the most acceptable summer performance is the oldest, an 1890smedium-weight building. The modern(2013) school had the most stable, yet high air temperatures amongst the studied schools. The study highlights the emerging issue of summer overheating in heating-dominated countries such as the UK,where this has not been traditionally a concern. The problem is exacerbated by a single-sided focus on reducing heating loads without taking appropriate measures for summer comfort, the global warming trends and children's sensitivity to high temperatures. This paper highlights the challenge of designing school buildings with acceptable year-round thermal and energy performance and the need to set higher standards in the school building design, using children-based criteria. [ABSTRACT FROM AUTHOR]

If ZIP code is more important than genetic code in determining one's health and opportunities, how can pediatricians enable healthy and opportunity-rich environments for all children? This paper introduces a broad network of organizations, policies, and financial resources that are working to improve ZIP codes by tackling poverty at the neighborhood level. The mission-driven US community development sector began with the War on Poverty in the 1960s and 70s and comprises a network of finance, real estate, and community-based organizations working together to overturn decades of racially motivated disinvestment, revitalize persistently marginalized, low-income communities, and enhance the lives of the people who live in them. Across the country, thousands of community development corporations, community development financial institutions, affordable housing developers, and regulated for-profit banks together invest over $300 billion annually in affordable housing, childcare and early learning facilities, recreation centers, community clinics, grocery stores, small businesses, and financial services for low-income families and neighborhoods. We present successful examples of community development efforts targeting child health and opportunity and highlight opportunities for pediatricians to advise, collaborate, and partner in order to accelerate and maximize the impact of billions of dollars invested in support of healthier neighborhoods where all children can grow and thrive. [ABSTRACT FROM AUTHOR]

Modern, reliable, and valid outcome measures are essential to understanding the health needs of young children with burn injuries. Burn-specific and age-appropriate legacy assessment tools exist for this population but are hindered by the limitations of existing paper-based instruments. The purpose of this study was to develop item pools comprised of questions appropriate for children aged 1-5 with burn injuries. Item development was based on a framework provided by previous work to develop the Preschool Life Impact Burn Recovery Evaluation (LIBRE) Conceptual Model. The Preschool LIBRE Conceptual Model work established four sub-domains of functioning for children with burns aged 1-5. Item development involved a systematic literature review, a qualitative item review process with clinical experts, and parent cognitive interviews. Four item pools were established: (1) communication and language development; (2) physical functioning; (3) psychological functioning and (4) social functioning for preschool-aged children with burn injuries. We selected and refined candidate items, recall periods, survey instructions, and response option choices through clinical and parental feedback during the qualitative review and cognitive interview processes. Item pools are currently being field-tested as part of the process to calibrate and validate the Preschool1-5 LIBRE Computer Adaptive Test (CAT) Profile. [ABSTRACT FROM AUTHOR]

To assess the national and state prevalence of being "Healthy and Ready to Learn" (HRL) and associated sociodemographic, health, family and neighborhood factors. Cross-sectional analysis of the 2016 National Survey of Children's Health, a nationally representative parent-reported survey administered by web and paper June 2016 to February 2017. Four domains were constructed from 18 items through confirmatory factor analyses: "Early Learning Skills", "Social-Emotional Development", "Self-Regulation", and "Physical Well-being and Motor Development." Each item and domain were scored according to age-specific standards as "On-Track", "Needs Support", and "At Risk" with overall HRL defined as "On-Track" in all domains for 7565 randomly selected children ages 3 to 5 years. In 2016, 42.2% of children ages 3 to 5 years were considered HRL with the proportion considered "On-Track" ranging from 58.4% for Early Learning Skills to 85.5% for Physical Well-being and Motor Development"; approximately 80% of children were considered "On-Track" in Social-Emotional Development and Self-Regulation, respectively. Sociodemographic differences were mostly non-significant in multivariable analyses. Health, family, and neighborhood factors (ie, special health care needs status/type, parental mental health, reading, singing and storytelling, screen time, adverse childhood experiences, and neighborhood amenities) were associated with HRL. HRL prevalence ranged from 25.5% (NV) to 58.7% (NY), but only 4 states were significantly different from the U.S. overall. Based on this pilot measure, only about 4 in 10 US children ages 3 to 5 years may be considered "Healthy and Ready to Learn." Improvement opportunities exist for multiple, modifiable factors to affect young children's readiness to start school. [ABSTRACT FROM AUTHOR]

Preference weights are widely used to score generic health states into utility indexes for estimation of quality adjusted life years (QALYs) and to aid health care funding decisions. To date, health state utilities are predominantly derived using stated preference methods based on decision utility. This paper tests an alternative and generates preference weights using experienced utility for children based on the Child Health Utility 9D (CHU9D) descriptive system. We estimate the relative values of the CHU9D health states with regard to experienced utility, where experienced utility is approximated by self-reported happiness. A nationally-representative longitudinal survey was used including 6090 Australian children aged 12–17 years surveyed over 2014–2018. The derived weights were then applied to calculate the utility decrements for a few common child health conditions. We found that the estimated utility decrements are largely similar to those estimated using the published CHU9D Australian adolescent weights based on decision utility, except for pain and depression. A smaller utility decrement for pain and a larger utility decrement for depression were indicated by experienced utility. We contribute to the literature by showing that using experienced utility methods to generate preference weights for health states is possible, and we discuss some important methodological challenges for future studies such as the impracticability of anchoring to 'dead' when utilizing experienced utility. • Established methods of valuing health states rely on decision utility. • We use experienced utility to generate preference weights for children. • The estimated decrements for health conditions are similar to published weights. • We see smaller impact for pain, larger for depression compared to published weights. • Feasibility is demonstrated using child experienced utility for preference weights. [ABSTRACT FROM AUTHOR]

Mobile apps for mental health and wellness (MH apps) have the potential to support youth mental health, expanding access to the large proportion of youth with mental health concerns who do not access formal treatment. Survey data suggest that young people are highly interested in MH apps, with minoritized youth (eg, LGBTQ individuals) and youth with elevated depressive symptoms reporting especially high rates of downloading MH apps.1 In addition, systematic reviews and meta-analyses suggest that MH apps can be effective.2 Although many popular MH apps do not have direct empirical evidence supporting their efficacy,3 they often include elements of empirically supported treatments for children and adolescents.4 The MH app space moves at a fast pace, making it difficult to stay up-to-date. More than 10,000 MH apps exist, with hundreds released each year.5 Even interested clinicians may, understandably, not have time to sort through the large number of apps, scientific papers, and app directories. Furthermore, these resources are rarely designed to offer clear, actionable advice for clinicians. Clinicians could benefit from information and guidance to help patients safely navigate MH apps and to best use MH apps in treatment. Here, we provide 3 key points about youth MH apps ("takeaways"), each with an actionable implication for clinicians ("action items"). We also provide examples of specific questions for clinicians to support their use of MH apps with children and adolescents (Table 1). More information regarding where we derived these recommendations is available in Supplement 1, available online. [ABSTRACT FROM AUTHOR]

Researchers and policymakers have identified adverse childhood experiences (ACEs) like abuse, neglect, and household dysfunction as a contributing factor to poor mental health outcomes for children. Positive childhood experiences (PCEs) like open family communication styles, having the ability to live and play in a safe, stable, and protective environment, having constructive opportunities for social engagement, and receiving mentorship from adults have been found to improve the mental health of children. This paper explores the role of ACEs and PCEs on the mental health outcomes of children. A sample of 22,628 children ages 6–17 from the National Survey of Children's Health (2017–2020) was used to explore the relationship between PCEs and ACEs and the mental health of children. Logistic regression analysis is used to model the effect of PCEs and ACEs on the odds of child mental health diagnoses. Findings indicate that with each additional ACE, there was a significant increase in the odds of reporting a MH condition (OR = 1.25, 95 % CI 1.09–1.43). Conversely, with each additional PCE, there is a significant decrease in the odds or reporting a MH condition (OR = 0.76, 95 % CI 0.68–0.84). There was also evidence that PCEs moderate the relationship between ACEs and reports of mental health conditions. When counts of ACEs are low, PCEs provide a protective effect on reports of mental health. But when the count of ACEs are high, children with higher numbers of PCEs have similar reports of mental health conditions. This study provides information about the moderating effect of PCEs on the relationship between ACEs and child mental health diagnosis with the goal of informing policies and interventions focused on ameliorating the growing crisis of children's negative mental health and well-being. Adverse childhood events (ACEs) like abuse, neglect and household dysfunction are known to negatively impact the mental health and well-being of children. Positive childhood experiences (PCEs), on the other hand, can positively influence the mental health and well-being of children. This study examines the association between adverse and positive childhood experiences to understand how they impact the mental health outcomes of children ages 6–17. Findings indicate that when ACEs are lower, the impact of PCEs are positive, but when ACEs are higher, PCEs do not make much difference in reports of mental health problems. [ABSTRACT FROM AUTHOR]

Social determinants of health influence child health behavior, development, and outcomes. This paper frames social capital, or the benefits that a child receives from social relationships, as a positive social determinant of health that helps children exposed to adversity achieve healthy outcomes across the life course. Children are uniquely dependent on their relationships with surrounding adults for material and nonmaterial resources. We identify and define three relevant aspects of social capital: 1) social support , which is embedded in a 2) social network , which is a structure through which 3) social cohesion can be observed. Social support is direct assistance available through social relationships and can be received indirectly through a caregiver or directly by a child. A child's social network describes the people in a child's life and the relationships between them. Social cohesion represents the strength of a group to which a child belongs (eg, family, community). Pediatric primary care practices play an important role in fostering social relationships between families, the health care system, and the community. Further research is needed to develop definitional and measurement rigor for social capital, to evaluate interventions (eg, peer health educators) that may improve health outcomes through social capital, and to broaden our understanding of how social relationships influence health outcomes. [ABSTRACT FROM AUTHOR]

This paper explores the effect of maternal education on child health and the channels in which education operates by exploiting a change in the compulsory schooling law (CSL) in Turkey. In order to account for the endogeneity of education, variation across cohorts induced by the timing of the CSL and variation across provinces by the intensity of additional classrooms constructed in the mother’s birth provinces is used as an instrumental variable. The results indicate that mother’s primary school completion improves infant health, as measured by very low birth weight, and child health, as measured by height-for-age and weight-for-age z -scores, even after controlling for many potential confounding factors. This paper also demonstrates that maternal education leads to earlier preventive care initiation, reduces smoking, reduces fertility, and increases age at first birth. [ABSTRACT FROM AUTHOR]

Good health is crucial for human and economic development. In particular poor health in childhood is of utmost concern since it causes irreversible damage and has implications later in life. Recent research suggests globalization is a strong force affecting adult and child health outcomes. Yet, there is much unexplained variation with respect to the globalization effect on child health, in particular in low- and middle-income countries. One factor that could explain such variation across countries is the quality of democracy. Using panel data for 70 developing countries between 1970 and 2009 this paper disentangles the relationship between globalization, democracy, and child health. Specifically the paper examines how globalization and a country's democratic status and historical experience with democracy, respectively, affect infant mortality. In line with previous research, results suggest that globalization reduces infant mortality and that the level of democracy in a country generally improves child health outcomes. Additionally, democracy matters for the size of the globalization effect on child health. If for example Côte d’Ivoire had been a democracy in the 2000–2009 period, this effect would translate into 1200 fewer infant deaths in an average year compared to the situation without democracy. We also find that nutrition is the most important mediator in the relationship. To conclude, globalization and democracy together associate with better child health in developing countries. [ABSTRACT FROM AUTHOR]

Hypertriglyceridemia (HTG) is a common metabolic disorder in which the concentration of very low density lipoproteins (VLDL) and of chylomicrons (CMs) is elevated in the plasma. HTG may be caused by primary and/or secondary causes and affected subjects may express HTG when children or in adulthood. In children and adults a genetic cause may underlie HTG which can be expressed as CMs a severe clinical picture known as Familial Hyperchylomicronemia due to lipoprotein lipase (LPL) or apolipoprotein (apo) CII deficiencies. Genetically determined HTG includes Familial Dysbetalipoproteinemia due to deficiency of apolipoprotein EIII of VLDL and Familial HTG. However, recent data suggest that classical Fredrickson phenotypes describing clinically HTG, which were once considered to be distinct based on biochemical features, have a shared genetic set up. The HTG has been classified according to a recent international paper: mild HTG: 2–10 mmol/L (176–882 mg/dL); severe HTG: > 10 mmol/L (>882 mg/dL) associated to CMs remnants, or Intermediate Density lipoprotein (IDL) like particles, and/or CMs. The treatment includes limitation of dietary content of saturated fat and alcohol, fibrates and omega3 fatty acids. When TG are severely elevated and associated to CMs the risk of acute pancreatitis suggests the use of more drastic therapeutic option such as therapeutic plasma exchange. This paper summarizes the experience with conventional plasmapheresis (Plasma-Exchange, PEX) and different Lipoprotein Apheresis methods with respect to acutely lowering TG levels in patients with normal TG, with mild and severe HTG. Upcoming promising therapies are gene therapy, novel apolipoprotein CIII inhibitors and lomitapide. [ABSTRACT FROM AUTHOR]

This paper explores the role of space–time constraints in determining the conditions under which people access to basic social services. To do so, the paper addresses two empirical questions: (i) how travel time impacts families’ strategies for choosing and using social services, and (ii) how service characteristics become part of the constraints families have to face when using services. Both questions refer to problems that are of “time nature” (e.g., long waiting hours or the imposition of additional tasks and travel to finally obtain access to the service). The use of a space–time approach introduces a theoretical innovation for studying access to urban public social services in the region, shedding light on the micro-processes underneath macro-aggregated indicators. This is performed by examining in a qualitative manner the way in which space–time constraints are distributed among different types of families and by looking at families’ strategies for accessing services in a city like Montevideo, the capital of Uruguay. The empirical evidence is a qualitative study with 13 households with at least one child between 0 and 3 years of age. These households were selected from a purposive sample that allowed the study of a group of cases from different socioeconomic strata living in different geographical locations. The paper results suggest that households use travel time as an input to manage total time investment (travel plus participation) when defining a strategy to reach better services. In addition, empirical evidence reflects the distorting effects that uncertainty about the time to be spent in using the services may have on the activities of households. [ABSTRACT FROM AUTHOR]

Background: Minimally adequate treatment (MAT) is intended to represent treatment minimally sufficient for common mental health problems. For children, MAT has been defined over a twelve-month period as either eight or more mental health visits, or four to seven visits plus relevant medication. MAT is used to identify those missing out on adequate care, but it is unknown whether MAT improves children's outcomes.Methods: This paper examines whether MAT is associated with improved outcomes for children. It uses survey data from the nationally representative Longitudinal Study of Australian children on 596 children with mental health problems based on the Strengths and Difficulties Questionnaire at ages 8-15 years, linked to health service administrative data from 2012 to 2016. Statistical analysis examines the association of MAT with later quality of life (Pediatric Quality of Life Inventory), using a lagged dependent variable model to account for time-varying unobserved confounding.Results: Compared to children with lower levels of treatment, those who received MAT between baseline and follow up had no statistically significant improvement in either quality of life or mental health symptoms.Limitations: The observational data provide insight into real-world practice but require statistical methods to account for selection into treatment.Conclusions: While clinical trials show mental health treatments can be efficacious, this study shows no evidence that children receiving MAT in routine practice have better outcomes. These findings demonstrate the need for better understanding of the nature and impact of children's mental health care as it is delivered and received in routine practice. [ABSTRACT FROM AUTHOR]

It is estimated that 20 million children are exposed to tuberculosis (TB) each year, making TB a global paediatric health emergency. TB preventative efforts have long been overlooked. With the view of achieving "TB elimination" in "our lifetime", this paper explores challenges and potential solutions in the TB prevention cascade, including identifying children who have been exposed to TB; detecting TB infection in these children; identifying those at highest risk of progressing to disease; implementing treatment of TB infection; and mobilizing multiple stakeholders support to successfully prevent TB. [ABSTRACT FROM AUTHOR]

Objective: Previous studies have offered mixed results regarding the link between digital screen engagement and the psychosocial functioning of young people. In this study, we aimed to determine the magnitude of this relation, to inform the discussion regarding whether amount of digital screen time has a subjectively significant impact on the psychosocial functioning of children and adolescents.Method: We analyzed data from primary caregivers participating in the National Survey of Children's Health (NSCH), an annual nationally representative survey fielded by the US Census Bureau between June 2016 and February 2017. NSCH uses an address-based sampling frame and both Web- and paper-based data collection instruments to measure psychosocial functioning and digital engagement, including a modified version of the Strengths and Difficulties questionnaire and caregiver estimates of daily television- and device-based engagement, respectively.Results: The expected parabolic inverted-U-shaped relationship linking digital screen engagement to psychosocial functioning was found. These results replicated past findings suggesting that moderate levels of screen time (1-2 hours a day) were associated with slightly higher levels of psychosocial functioning compared to lower or higher levels of engagement. Furthermore, it indicated that children and adolescents would require 4 hours 40 minutes of television-based engagement and 5 hours 8 minutes of daily device-based engagement before caregivers would be able to notice subjectively significant variations in psychosocial functioning.Conclusion: The possible influence of digital screen engagement is likely smaller and more nuanced than we might expect. These findings do not rule out the possibility that parents might only notice very high levels of screen time when their child manifests pronounced psychosocial difficulties. Future work should be guided by transparent and confirmatory programs of research. [ABSTRACT FROM AUTHOR]

Transition is the process of moving from a child focussed system to an adult orientated system. It is complicated for all children and a well-recognised point of weakness in health care. For looked after children transition is more complex with movements from social worker to personal advisor, from foster care (or children's home) to independent accommodation, from school to work, further or higher education or to none of these. It is also a time when the young person moves from children's health services to adult health services. Looked after children navigate these transition points with less support than many other children. Coincidentally, it occurs at an age when mental illness most commonly emerges. This paper describes the transitions in detail, considers the legislative framework, pathway plans and the mental health transition. [ABSTRACT FROM AUTHOR]

Adoption is a legal process by which a child becomes part of a new family with parental responsibility transferring from birth parents to adoptive parents. It is a major decision for all involved. Paediatricians can be involved in the process in a variety of ways seeing the child for a health assessment, reviewing the available medical information on birth parents and adoptive parents and in meeting with the prospective adoptive parents to discuss the health information. This paper describes my personal practice in these meetings. [ABSTRACT FROM AUTHOR]

Pediatric irritability is a functionally impairing transdiagnostic symptom underlying a substantial proportion of child mental health referrals. The past 20 years have witnessed a striking uptick in empirical work focused on pediatric irritability, with increasing recognition of its role across multiple internalizing and externalizing disorders. That said, it has only been in recent years that research has begun to make advances in understanding the natural course and neurobiological underpinnings of irritability across development; research directly informing effective clinical management of pediatric irritability has been limited. At this critical stage in the study of pediatric irritability, this special series brings together the latest work from leading experts across three interrelated domains: (a) progress in understanding the phenomenology and course of pediatric irritability; (b) advances in the assessment of pediatric irritability; and (c) innovations in the treatment of pediatric irritability. The papers in this special series collectively offer critical steps forward for better understanding pediatric irritability and improving proper assessment, classification, and clinical management. [ABSTRACT FROM AUTHOR]

• Maternal influenza vaccination protects the infant from influenza infection. • Maternal influenza vaccination reduces LCI in infants by approximately a third. • Maternal influenza vaccination reduces overall healthcare utilisation. • Raising awareness of the benefits of the vaccine to the infant may increase uptake. To determine the effectiveness of influenza vaccination during pregnancy on child health outcomes. Systematic review/meta-analysis. Clinical Trials.gov, Cochrane Library, EMBASE, Medline, Medline in process, PubMed and Web of Science, from 1st January 1996 to 29th June 2018. An updated Medline search was performed 30th June 2018 to 31st October 2019. Randomised controlled trials (RCTs) and observational studies reporting health outcomes of infants and children born to women who received inactivated influenza vaccine during pregnancy. The primary outcome was infant laboratory confirmed influenza (LCI). Secondary outcomes included influenza-like illness (ILI), other respiratory illnesses, primary care, clinic visit or hospitalisations due to influenza illness and long-term respiratory childhood outcomes. 19 studies were included; 15 observational studies and 4 primary RCTs with an additional 3 papers reporting secondary outcomes of these RCTs. In a random effects meta-analysis of 2 RCTs including 5742 participants, maternal influenza vaccination was associated with an overall reduction of LCI in infants of 34% (95% confidence interval 15–50%). However, there was no effect of maternal influenza vaccination on ILI in infants ≤6 months old. Two RCTs were excluded from the meta-analysis for the outcome of LCI in infants (different controls used). Both of these studies showed a protective effect for infants from LCI, with a vaccine efficacy of up to 70%. Overall observational studies showed an inverse (protective) association between maternal influenza vaccination and infant LCI, hospitalisation and clinic visits due to LCI or ILI in infants and other respiratory illness in infants ≤6 months old. This systematic review supports maternal influenza vaccination as a strategy to reduce LCI and influenza-related hospitalisations in young infants. Communicating these benefits to pregnant women may support their decision to accept influenza vaccination in pregnancy and increase vaccine coverage in pregnant women. PROSPERO CRD42018102776. [ABSTRACT FROM AUTHOR]

Despite being largely preventable, dental caries is one of the most common diseases both in the UK and worldwide. Unmanaged dental caries may adversely impact a child and their quality of life. All healthcare professionals who have contact with children have an important role to play in improving the oral health of their patients. This can be achieved by delivering consistent, structured and supportive preventive messages and signposting to dental professionals when required. This paper outlines evidence-based guidance that should be followed to prevent dental caries, both on an individual and population basis. [ABSTRACT FROM AUTHOR]

This paper explores the impact of school food policy from the perspective of school food workers to offer an alternative account of why school food may not be having the desired impact on child health or food choices. Drawing upon the findings from an institutional ethnography carried out in three UK primary schools, we argue that school food is being asked to perform an unrealistic task of luring children and families away from more unhealthy food options, without being given adequate resources or powers to do this job effectively. We theorise that the narrative depicting school food as a hero, combatting the harms of poor dietary choices and poor health outcomes, is inappropriate as a countermeasure to mitigate the effects of wider food industry forces. We revisit the narrative to consider the power imbalances within society that structure dietary choices, presenting our findings and the wider policy review in the form of a story about the evolution of school food set against a shifting food environment. We conclude with recommendations for policy makers who want to see school food have a greater impact in improving child health. • We report on an Institutional Ethnography of 3 UK schools to explore the issue of low meal uptake. • Semi-structured interviews with food workers, observations, and text analysis were used. • A significant barrier to meal uptake was an unfamiliarity with the healthy food offered in schools. • We discuss the evolution of the UK school meal service alongside changes in the wider food system. • We propose policy changes that would strengthen the protected food space offered by schools. [ABSTRACT FROM AUTHOR]

• The National Survey of Child and Adolescent Well-Being (NSCAW) is the only source of nationally representative, longitudinal data on the well-being of children and families involved with the child welfare system. • The baseline data collection for the third cohort (NSCAW III) was completed in March 2022 and data have been archived for researchers. • Methodological and operational challenges faced during the baseline wave of NSCAW III required the identification and implementation of creative solutions for sampling, child welfare agency recruitment, instrumentation, data collection, and weighting. • This paper shares lessons learned and solutions from NSCAW III that may be relevant to other studies utilizing similar methods and/or collecting data from child welfare-involved populations. The National Survey of Child and Adolescent Well-Being (NSCAW) is a national survey that follows children and families who have been the subjects of investigation by child protective services agencies. NSCAW is the only source of nationally representative, longitudinal data on the well-being of children and families involved with the child welfare system (CWS). The survey examines child and family well-being outcomes in detail and seeks to relate those outcomes to experience with the CWS and to family characteristics, service needs and receipt, community environments, and other factors. To date, there have been three cohorts of NSCAW. The design of NSCAW III was guided by three priorities: (1) keeping NSCAW III as comparable to the two previous cohorts as possible, (2) minimizing response burden for all participants, and (3) updating the NSCAW III sample and instruments as needed to reflect the composition and characteristics of children being served by the CWS in 2017. NSCAW III includes 3,298 children ranging in age from 0 to 17.5 years old at the time of sampling. Children were sampled from child welfare investigations closed between July 2017 and September 2021. We provide information about methodological and operational challenges faced during the enrollment of NSCAW III (e.g., COVID-19 pandemic, state-level refusals) that required a new level of persistence and creativity, a pivot from past approaches, and the identification of solutions to maintain the integrity of this nationally representative study. [ABSTRACT FROM AUTHOR]

• Teachers are an important source of information about individual child psychopathology. • Ratings of child symptoms should be collected using instruments that are practical and produce valid and reliable scores. • The Ontario Child Health Study Emotional Behavioural Scales (OCHS-EBS) parent/caregiver and youth versions meet these requirements. • This paper develops and evaluates a teacher version of these scales (OCHS-EBS-T), includes a copy of the instrument and Canadian general population normative data. • The OCHS-EBS-T meet the psychometric requirements of validity and reliability, although the conduct disorder subscale should be interpreted with caution. This paper describes the development and psychometric properties of a teacher version of the Ontario Child Health Study Emotional Behavioural Scales (OCHS-EBS-T) for dimensional measurement of six psychiatric disorders in elementary school-aged children based on DSM-5 criteria. Psychometric evaluation of the item and scale properties was conducted in a large, general population study of elementary teacher assessments of 3,072 children aged 4 to 13 years in 2,354 families in Ontario, Canada. Content validity, internal construct validity and internal consistency reliability of the six disorder subscales were assessed. Structural equation modelling was used to assess measurement invariance, internal and external convergent and discriminant validity. Confirmatory factor analyses confirmed unidimensionality of subscales and adequate item-fit to all scales. Measurement equivalence was demonstrated fully for four subscales and partially for two. Internal consistency reliability for all subscales exceeded 0.78, except for the conduct disorder scale in 12- to 13-year-olds. Evidence of internal convergent validity was demonstrated in all cases. Discriminant validity was demonstrated in 27 out of 30 correlation comparisons. External convergent and discriminant validity was demonstrated when comparing the OCHS-EBS-T to a parent/caregiver measure of disorders in 48 out of 60 correlation comparisons. All subscales independently predicted child mental health-related service contact. [ABSTRACT FROM AUTHOR]

A large body of literature has shown marked differences in the average levels of resources and child well-being across different family structures. Studies have examined cognitive, educational and behavioural outcomes; less is known about differentials in physical health, and about dynamics in early childhood. Furthermore, up to the present time, less emphasis has been placed on describing the underlying mechanisms relating childhood experiences of family structure to health. In this paper, we hypothesize that socio-economic characteristics and family structure trajectories will affect every-day, more proximal processes (material, behavioural and family stress pathways) directly experienced by the child, which will in turn affect child health. Using the UK Millennium Cohort Study, a nationally representative cohort of over 19 000 children born in 2001 and living in the UK shortly thereafter, we employ Graphical Chain Models to map the processes linking family structure trajectories to three physical health outcomes at age 5: overweight/obesity, respiratory health, and accidental injury. We construct family trajectories to highlight two components: status (distinguishing between married, cohabiting and single parents), and (in)stability. We show that both status, the (in)stability of that status, and their interplay, are important components of family structure trajectories which correlate to children's early physical health. Analyses highlight the relative importance of distinct pathways across different health outcomes. As well as some outcome-specific paths, we find that "family stress" variables appeared to underscore the relationship between family structure and child physical health, pointing to the importance of such variables in understanding how family structure relates to early child health. • Family structure trajectories are correlated to early child physical health. • Both status (married, cohabiting, single) and instability were important features. • We know little about the mechanisms relating family structure to early child health. • Family stress appeared to be an important mechanisms across all family trajectories. • Housing quality was important for cohabitors; daily routines for separating parents. [ABSTRACT FROM AUTHOR]

Case management is a frequently offered service to children and families receiving community based mental health care. However, despite its frequent use, child and adolescent mental health case management lacks formal structure leading to service ambiguity and poor outcomes, for both families being served, and the professionals serving them. This paper explores the implementation of the Strengths Model for Youth, a recovery oriented case management model, at a community mental health center and its relationship with case managers' professional quality of life. Researchers administered the Professional Quality of Life survey to child and adolescent mental health case managers implementing the Strengths Model for Youth at baseline and at six months into implementation. Results indicate the Strengths Model for Youth has positive impacts on case managers' feelings of compassion satisfaction and compassion fatigue after six months of using the model. • Strengths Model for Youth (SM-Y) is a youth-driven, goal-oriented approach to case management. • Results indicate SM-Y may lead to improved professional quality of life for case managers. • SM-Y case managers had improved compassion satisfaction and compassion fatigue. [ABSTRACT FROM AUTHOR]