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Exposure to certain chemicals prenatally and in childhood can impact development and may increase risk for attention-deficit/hyperactivity disorder (ADHD). Leveraging a larger set of literature searches conducted to synthesize results from longitudinal studies of potentially modifiable risk factors for childhood ADHD, we present meta-analytic results from 66 studies that examined the associations between early chemical exposures and later ADHD diagnosis or symptoms. Studies were eligible for inclusion if the chemical exposure occurred at least 6 months prior to measurement of ADHD diagnosis or symptomatology. Included papers were published between 1975 and 2019 on exposure to anesthetics (n = 5), cadmium (n = 3), hexachlorobenzene (n = 4), lead (n = 22), mercury (n = 12), organophosphates (n = 7), and polychlorinated biphenyls (n = 13). Analyses are presented for each chemical exposure by type of ADHD outcome reported (categorical vs. continuous), type of ADHD measurement (overall measures of ADHD, ADHD symptoms only, ADHD diagnosis only, inattention only, hyperactivity/impulsivity only), and timing of exposure (prenatal vs. childhood vs. cumulative), whenever at least 3 relevant effect sizes were available. Childhood lead exposure was positively associated with ADHD diagnosis and symptoms in all analyses except for the prenatal analyses (odds ratios (ORs) ranging from 1.60 to 2.62, correlation coefficients (CCs) ranging from 0.14 to 0.16). Other statistically significant associations were limited to organophosphates (CC = 0.11, 95% confidence interval (CI): 0.03–0.19 for continuous measures of ADHD outcomes overall), polychlorinated biphenyls (CC = 0.08, 95% CI: 0.02–0.14 for continuous measures of inattention as the outcome), and both prenatal and childhood mercury exposure (CC = 0.02, 95% CI: 0.00–0.04 for continuous measures of ADHD outcomes overall for either exposure window). Our findings provide further support for negative impacts of prenatal and/or childhood exposure to certain chemicals and raise the possibility that primary prevention and targeted screening could prevent or mitigate ADHD symptomatology. Furthermore, these findings support the need for regular review of regulations as our scientific understanding of the risks posed by these chemicals evolves. [ABSTRACT FROM AUTHOR]

According to the World Health Organization’s guidelines, a two-year mandatory breastfeeding period is strongly recommended, supported by research demonstrating its significant benefits in reducing childhood illnesses and mortality rates. The present study is designed to address this recommendation by focusing on a specific infection, namely rotavirus. Acknowledging this evidence, researchers recognize the need for a deeper understanding of the dynamics of rotavirus disease. In response, our study focuses on constructing and analyzing an SIR epidemic model uniquely designed for transmitting rotavirus in children. The model partitions the children population into three compartments: susceptible, infected, and recovered. To enhance precision, we further categorize susceptible children based on breastfeeding status and infected individuals based on infectious or non-infectious nature. This detailed categorization enables a thorough examination of rotavirus transmission dynamics. The proposed model analyzes two equilibria, disease-free and endemic, revealing local and global stability conditions determined by the basic reproduction number (R0). Our exploration extends to local stability analysis for the endemic equilibrium when R0>1 and global stability assessment using the Lyapunov theory under specific conditions. Subsequently, we employ optimal control theory through Pontryagin’s maximum principle to minimize the cost burden associated with disease control in children. Then, our work provides a sensitivity analysis of different parameters for the basic reproduction number to enhance our understanding of model dynamics. Finally, numerical simulations conducted with MATLAB and Python software validate our analytical findings, offering a comprehensive and practical assessment of the proposed model’s implications for controlling rotavirus transmission in children.

Abstract Background Childhood adverse experience has been linked with poor health outcomes across the life course. Nevertheless, whether such an association or direction could be projected to older people’s life remains still unclear and needs to generate more evidence, particularly in India. Therefore, this study was conducted to examine the association of childhood socio-economic status and health with depressive symptoms amongst middle- aged and older adults in India. Methods The data for the study was drawn from national representative survey “Longitudinal Ageing Study in India (LASI)” Wave I, 2017–2018 in order to conduct cross-sectional study. Multivariable regression analysis was used to examine the association of childhood socioeconomic status and health with depressive symptoms in the older population. Results Poor childhood health was significantly and positively associated with depressive symptoms (AoR: 1.56, CI: 1.19, 2.04). Likewise, respondents who were bedridden for a month during their childhood had high odds of developing depressive symptoms (AoR: 1.16 CI: 1.01, 1.34). In addition to this, the odds of having depressive symptoms increased significantly among the average (AoR: 1.28 CI: 1.08, 1.51) and poor childhood socioeconomic status group (AoR: 1.31 CI: 1.11, 1.55) as compared to the higher socioeconomic category. Conclusions Childhood socioeconomic status and health have a significant role in determining mental health in later life. Results suggest that considering childhood socioeconomic status and health is important while diagnosing depression in older population in order to identify the significant associated factors in early childhood and thus help in preventing depressive symptoms in later life.

ABSTRACTImmunization programs worldwide have been facing challenges in keeping vaccination coverage high. Even though universally known for its robust National Immunization Program, Brazil has also faced significant challenges regarding vaccination coverage. One of the reasons for this is vaccine hesitancy, a complex, multi-causal, and context-specific phenomenon. This qualitative study aims to understand the factors associated with decision-making and the drivers of vaccine hesitancy in Florianopolis, Santa Catarina state capital, regarding caregivers’ perceptions of routine childhood vaccination. In-depth interviews were conducted in the Capital city of Santa Catarina State. Families with children up to 6 years old were included. Data were analyzed based on thematic content analysis. Twenty-nine caregivers in 18 families were interviewed. These caregivers were mainly mothers and fathers. Three themes emerged: 1. Access to information and the decision-making process, where we discuss the role of social circles, healthcare workers, and the internet; 2. Individual-institutions power relationships: Perceptions about the State’s role and the Health institutions: 3. Reasons and motivations: The senses and meanings behind non-vaccination, where we discuss the drivers of vaccine hesitancy related to risk perception, caregivers’ opinions on the medical-pharmaceutical industry, vaccines’ composition and their side effects, families’ lifestyles and worldviews, and the childhood routine vaccination schedule. The results of this study reaffirm the complexity of the decision-making process in childhood vaccination and further enable a better contextual understanding of the complex and challenging phenomenon of vaccine hesitancy.

Background: Childhood adverse experience has been linked with poor health outcomes across the life course. Nevertheless, whether such an association or direction could be projected to older people's life remains still unclear and needs to generate more evidence, particularly in India. Therefore, this study was conducted to examine the association of childhood socio-economic status and health with depressive symptoms amongst middle- aged and older adults in India. Methods: The data for the study was drawn from national representative survey "Longitudinal Ageing Study in India (LASI)" Wave I, 2017–2018 in order to conduct cross-sectional study. Multivariable regression analysis was used to examine the association of childhood socioeconomic status and health with depressive symptoms in the older population. Results: Poor childhood health was significantly and positively associated with depressive symptoms (AoR: 1.56, CI: 1.19, 2.04). Likewise, respondents who were bedridden for a month during their childhood had high odds of developing depressive symptoms (AoR: 1.16 CI: 1.01, 1.34). In addition to this, the odds of having depressive symptoms increased significantly among the average (AoR: 1.28 CI: 1.08, 1.51) and poor childhood socioeconomic status group (AoR: 1.31 CI: 1.11, 1.55) as compared to the higher socioeconomic category. Conclusions: Childhood socioeconomic status and health have a significant role in determining mental health in later life. Results suggest that considering childhood socioeconomic status and health is important while diagnosing depression in older population in order to identify the significant associated factors in early childhood and thus help in preventing depressive symptoms in later life. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Childhood obesity remains a major public health issue. This study assessed the association between school-sourced lunches and cardiometabolic risk factors in middle-school students. METHODS: Data from health behavior surveys and physiologic screenings in a Michigan middle-school wellness program between 2005 and 2019 were used to analyze the association of school lunch consumption with cardiometabolic risk factors (overweight/obesity, non-fasting lipids/glucose, blood pressure) and dietary behaviors (fruit/vegetable consumption, intake of sugar-sweetened beverages/foods). Students were divided into three groups based on their responses to the survey item if they 1) always, 2) sometimes, or 3) never consumed school-sourced lunches. Groups were compared using descriptive statistics and chi-squared tests. RESULTS: Students consuming school-sourced lunches were more likely to have overweight or obesity, without significant differences in total, HDL, or LDL cholesterol. There was no difference in non-fasting glucose levels, blood pressure, or resting heart rate. Students consuming school sourced lunch were more likely to have increased sugary and fatty food or beverage consumption. Students consuming school sourced lunch were more likely to attend school in a low or middle socioeconomic status region. CONCLUSIONS: In this large cohort of middle-school children, consuming school-sourced lunches was associated with a greater prevalence of overweight and obesity and consumption of fatty foods and sugary beverages. School-based interventions should target methods to reduce consumption of sugary beverages and unhealthy snacks and promote consumption of fruits and vegetables, particularly among high-risk individuals. [ABSTRACT FROM AUTHOR]

Natural disasters, pandemics, and epidemics have devastating impacts on communities. Poverty, famine, ill health, social isolation, and death are some of the consequences of such events. Transformations in culture, religion, political and economic stability, and other social aspects can also be attributed to catastrophic incidents. Whilst such events have been well documented and studied, little attention has been given to their effect on children. Using osteoarchaeological and historical evidence, this review article explores how children appear to have been affected during, and in the aftermath of, natural disasters and epidemics. A range of cases from Antiquity to the modern day is provided, alongside three focal case studies. This research demonstrates analogies with the present-day where countries face disease outbreaks, droughts, floods, and earthquakes. Ultimately, the findings presented in this paper illustrate the extent to which these events shaped the lives and deaths of children in the past. [ABSTRACT FROM AUTHOR]

Abstract Background Behavioural and mental disorders have become a public health crisis; averting mental ill-health in early years can achieve significant longer-term health benefits and cost savings. This study assesses whether the Enhancing Social-Emotional Health and Wellbeing in the Early Years (E-SEE-Steps)—a proportionate universal delivery model comprising the Incredible Babies book (IY-B) and the Incredible Years Infant (IY-I) and Toddler (IY-T) parenting programmes is cost-effective compared to services as usual (SAU) for the primary caregiver, child and dyad. Methods Using UK data for 339 primary caregivers from the E-SEE trial, we conducted a within-trial economic evaluation assessing the cost-effectiveness of E-SEE Steps. Health outcomes were expressed in quality-adjusted life-years (QALY) and costs in UK pounds sterling (2018–19). Missing data were populated via multiple imputation and costs and QALYs discounted at 3.5% per annum. Cost-effectiveness results were conducted for primary caregivers, children and dyad using econometric modelling to control for patient co-variables. Uncertainty was explored through scenario and sensitivity analyses. Results The average cost of E-SEE Steps intervention was £458.50 per dyad. E-SEE Steps was associated with modest gains in primary caregiver HRQoL but minor decrements in child HRQoL compared to SAU. For primary caregivers, E-SEE Steps was more effective (0.034 QALYs) and more costly (£446) compared to SAU, with a corresponding incremental cost-effectiveness ratio (ICER) of £13,011 per QALY. In children, E-SEE Steps was strictly dominated with poorer outcomes (-0.005 QALYs) and greater costs (£178) relative to SAU. QALY gains in primary caregivers exceeded those QALY losses found in children, meaning E-SEE Steps was more effective (0.031 QALYs) and costly (£621) for the dyad (ICER: £20,062 per QALY). All scenario analyses found E-SEE Steps cost-effective for the dyad at a £30,000 per QALY threshold. Sensitivity analyses found significant cost reductions from expansions in programme delivery and attendance. Conclusions E-SEE Steps achieved modest health gains in primary caregivers but small negative effects on children and was more costly than SAU. E-SEE Steps appears cost-effective for the dyad, but the results should be interpreted with caution given the potential detrimental impact on children. Trial registration ISRCTN11079129 ; Pre participant trial enrolment, 11/05/2015

Abstract In early childhood, air pollution leads to an increased risk of disease, premature death, and development of disruptions. Fine particulate matter (PM2.5) is considered the classical pollutant of major concern. However, in Brazil, fine particulate monitoring is still limited and restricted to a few cities. Particularly, in the city of Rio de Janeiro, only one automatic station obtains PM2.5 concentrations and publishes the air quality indexes daily. This study is part of the project “Clean air for a good start” managed by the Horizon Citizen Foundation, with the goal of obtaining evidence to set a plan to reduce children exposition to air pollution. Data is shared on a global web platform. Results showed that PM2.5 levels are high when compared with WHO guidelines and coordinated actions would be needed to decrease emissions of primary pollutants and secondary aerosol’s precursors.

This study investigated the relationship between children's mathematics performance and physical health using data from the Early Childhood Longitudinal Study Kindergarten Class of 2010–2011 (ECLS-K 2011). A two-level hierarchical growth curve model was used to explore the relationships between childhood mathematics performance and childhood health taking moderator effects into consideration. The study results indicate that higher body mass index relates to higher kindergarten mathematics performance, holding all else constant. The results of this study have implications for educators, parents, and health providers in understanding the relationship between mathematics performance and health indicators. [ABSTRACT FROM AUTHOR]

Background: Improving childhood health is complex due to the multifactorial nature and interaction of determinants. Complex problems call for complex intervention thinking, and simple one-size-fits-all solutions do not work to improve childhood health. Early awareness is important, as behavior in childhood often is manifested across adolescence and into adulthood. To facilitate shared understanding of the complex structures and relationships that determine children's health behavior, participatory system approaches in, for example, local communities have shown promising potential. However, such approaches are not used systematically within public health in Denmark, and before being rolled out, they should be tested for their feasibility within this context. Objective: This paper describes the study design for Children's Cooperation Denmark (Child-COOP) feasibility study that is aiming to examine the feasibility and acceptability of the participatory system approach and the study procedures for a future scale-up controlled trial. Methods: The feasibility study is designed as a process evaluation of the intervention with the use of both qualitative and quantitative methods. A local childhood health profile will provide data for childhood health issues, for example, daily physical activity behavior, sleep patterns, anthropometry, mental health, screen use, parental support, and leisure-time activities. Data at system level are collected to assess development in the community, for example, readiness to change, analysis of social networks with stakeholders, rippled effects mapping, and changes in system map. The setting is a small rural town in Denmark, Havndal, with children as the primary target group. Group model building, a participatory system dynamics method, will be used to engage the community, create consensus on the drivers of childhood health, identify local opportunities, and develop context-specific actions. Results: The Child-COOP feasibility study will test the participatory system dynamics approach for intervention and evaluation design and survey objective measures of childhood health behavior and well-being among the ~100 children (6-13 years) attending the local primary school. Community-level data will also be collected. We will assess the contextual factors, implementation of interventions, and mechanisms of impact as part of a process evaluation. Data will be collected at baseline, at 2 years, and 4 years of follow-up. Ethical approval for this study was sought and granted from the Danish Scientific Ethical Committee (1-10-72-283-21). Conclusions: s: The potential of this participatory system dynamics approach includes opportunities for community engagement and local capacity building to improve children's health and health behavior, and this feasibility study holds the potential to prepare an upscaling of the intervention for effectiveness testing. [ABSTRACT FROM AUTHOR]

Introduction: The study aims to investigate and evaluate the impacts of physical education on children's healthy physical and social development. Materials-Methods: In the search for scientific literature related to this review the US National Library of Medicine (PubMed) used MEDLINE and Sport Discus data and the terms "physical education", and "childhood health", and "physical activity" were used. The relevant literature has also taken its source from the research of relevant articles from reference lists derived from data studies. Results: Exercise is essential for children's development and is the main foundation for a physically active and healthy lifestyle. Physically active children have a bigger possibility to adopt all the other healthy lifestyles. Physical education will present a unique opportunity for school-age children to practice health-enhancing physical activities. Conclusion: To maintain the good healthy development of children's performance, physical activity is a crucial factor. It is without a doubt that physical education in schools will reduce the risk factors of health issues prevalent in children. [ABSTRACT FROM AUTHOR]

To investigate the potential associations between household renovation and allergic diseases among preschool children in Wuhan, we conducted a large cross-sectional questionnaire survey among 9455 preschool children aged 3–6 years in Wuhan during November to December 2019. Data on demographics, health status, and home decoration conditions were analysed based on a questionnaire. Compared with tiles/stone/cement floor covering, the use of composite floor significantly increased the risk of diagnosed rhinitis and eczema among children (rhinitis: AOR, 95% CI: 1.36, 1.06–1.73; eczema: AOR, 95% CI: 1.47, 1.17–1.85). Household renovation had significant associations with diagnosed eczema (within 1 year before pregnancy: AOR, 95% CI: 1.34, 1.20–1.50; during pregnancy: AOR, 95% CI: 1.25, 1.08–1.44). This study suggests that use of artificial synthetic materials in home renovation during early childhood and pregnancy may be potential risk factors for childhood asthma, allergic rhinitis, and eczema. [ABSTRACT FROM AUTHOR]

There is evidence that PM2.5 could be obesogenic. Lima is one of the most polluted cities in South America, with an increasing prevalence of childhood obesity. This study aimed to determine the association between PM2.5 exposure of children aged 6 to 59 months and being overweight or obese (O/O) in a significant dataset survey. Cases were defined when weight for height Z-score (WHZ) was >2 standard deviations (SD) from the mean, for each sex. A control was defined when WHZ was between ±2 SD. We used a conditional logistic regression model to calculate the odds ratio (OR) between extrauterine and intrauterine PM2.5 exposure and O/O. Extrauterine PM2.5 exposure was evaluated as a 6-month PM2.5 mean prior to the survey. We found a significant association between O/O and extrauterine (OR: 1.57, 1.51–1.63) and intrauterine (OR: 1.99, 1.88–2.12) PM2.5 exposure for an increment of 10 μg/m3. The ORs increased as the quartile increased in both exposures. We observed a higher association in children aged 6–11 months (OR: 3.07, 2.84–3.31). In conclusion, higher levels of PM2.5 in Lima and Callao were associated with cases of O/O in children from 6 to 59 months, with the association higher for prenatal exposure. [ABSTRACT FROM AUTHOR]

Abstract In previous studies on social stratification and mobility in China, education is considered as the core mediatory factor in social reproduction and mobility. This paper, however, investigates how childhood health affects social stratification. Using data from Urbanization and Labor Migrant National Survey (2012), this study examines the effects of nutrition, hygiene, and health before age 14 on adult socioeconomic status attainment, including education, the international socioeconomic indexes of first job and current job, and family income per head. The structural equation model results show that the nutrition intake (whether one experienced starvation and the frequency of fish and meat intake) and hygiene (indicated by the source of drinking water and the toilet type) have significant effect on adult socioeconomic status attainment. However, the effects change at different life course stages. Moreover, childhood health (indicated by adult height) has significant impact on adult socioeconomic status attainment, but no significant impact on the international socioeconomic indexes of first job and current job. We conclude that investment in childhood health is an important mechanism affecting social class reproduction and mobility. Therefore, health intervention for children from poor and disadvantaged families are necessary. It will benefit children’s education and encourage upward mobility.

Background: Behavioural and mental disorders have become a public health crisis; averting mental ill-health in early years can achieve significant longer-term health benefits and cost savings. This study assesses whether the Enhancing Social-Emotional Health and Wellbeing in the Early Years (E-SEE-Steps)-a proportionate universal delivery model comprising the Incredible Babies book (IY-B) and the Incredible Years Infant (IY-I) and Toddler (IY-T) parenting programmes is cost-effective compared to services as usual (SAU) for the primary caregiver, child and dyad.Methods: Using UK data for 339 primary caregivers from the E-SEE trial, we conducted a within-trial economic evaluation assessing the cost-effectiveness of E-SEE Steps. Health outcomes were expressed in quality-adjusted life-years (QALY) and costs in UK pounds sterling (2018-19). Missing data were populated via multiple imputation and costs and QALYs discounted at 3.5% per annum. Cost-effectiveness results were conducted for primary caregivers, children and dyad using econometric modelling to control for patient co-variables. Uncertainty was explored through scenario and sensitivity analyses.Results: The average cost of E-SEE Steps intervention was £458.50 per dyad. E-SEE Steps was associated with modest gains in primary caregiver HRQoL but minor decrements in child HRQoL compared to SAU. For primary caregivers, E-SEE Steps was more effective (0.034 QALYs) and more costly (£446) compared to SAU, with a corresponding incremental cost-effectiveness ratio (ICER) of £13,011 per QALY. In children, E-SEE Steps was strictly dominated with poorer outcomes (-0.005 QALYs) and greater costs (£178) relative to SAU. QALY gains in primary caregivers exceeded those QALY losses found in children, meaning E-SEE Steps was more effective (0.031 QALYs) and costly (£621) for the dyad (ICER: £20,062 per QALY). All scenario analyses found E-SEE Steps cost-effective for the dyad at a £30,000 per QALY threshold. Sensitivity analyses found significant cost reductions from expansions in programme delivery and attendance.Conclusions: E-SEE Steps achieved modest health gains in primary caregivers but small negative effects on children and was more costly than SAU. E-SEE Steps appears cost-effective for the dyad, but the results should be interpreted with caution given the potential detrimental impact on children.Trial Registration: ISRCTN11079129 ; Pre participant trial enrolment, 11/05/2015. [ABSTRACT FROM AUTHOR]

Our article aims to find the risk factors that may be proven related to childhood overweight and obesity that may allow for public policy design towards prevention. Based upon risk factors that have been already identified in literature at the international level, and a few factors that we assumed may be relevant, we have designed a simple survey. Survey data was collected and processed directly. Survey results have been processed using OR and p value. The results indicate that parent’s education especially for mono-parental families may provide the most effective target group for public policies. [ABSTRACT FROM AUTHOR]

Background: Growing evidence suggests that exposure to green space is associated with improved childhood health and development, but the influence of different green space types remains relatively unexplored. In the present study, we investigated the association between early-life residential exposure to vegetation and early childhood development and evaluated whether associations differed according to land cover types, including paved land. Methods: Early childhood development was assessed via kindergarten teacher-ratings on the Early Development Instrument (EDI) in a large population-based birth cohort (n = 27,539) in Metro Vancouver, Canada. The residential surrounding environment was characterized using a high spatial resolution land cover map that was linked to children by six-digit residential postal codes. Early-life residential exposure (from birth to time of EDI assessment, mean age = 5.6 years) was calculated as the mean of annual percentage values of different land cover classes (i.e., total vegetation, tree cover, grass cover, paved surfaces) within a 250 m buffer zone of postal code centroids. Multilevel models were used to analyze associations between respective land cover classes and early childhood development. Results: In adjusted models, one interquartile range increase in total vegetation percentage was associated with a 0.33 increase in total EDI score (95% CI: 0.21, 0.45). Similar positive associations were observed for tree cover (β-coefficient: 0.26, 95% CI: 0.15, 0.37) and grass cover (β-coefficient: 0.12, 95% CI: 0.02, 0.22), while negative associations were observed for paved surfaces (β-coefficient: −0.35, 95% CI: −0.47, −0.23). Conclusions: Our findings indicate that increased early-life residential exposure to vegetation is positively associated with early childhood developmental outcomes, and that associations may be stronger for residential exposure to tree cover relative to grass cover. Our results further indicate that childhood development may be negatively associated with residential exposure to paved surfaces. These findings can inform urban planning to support early childhood developmental health.

Low rates of blood lead level screening among young children persist as a public health issue in the United States, including in Texas where levels remain below the national average. This article describes a multiyear, multipartner initiative aimed at increasing screening rates through a creative, community-informed social media campaign. Interviews with parents, providers, and state health department staff revealed a common perception that lead poisoning was a relic of the past. Using these insights, the team developed humorous social media messaging comparing extinct animals to lead poisoning to capture attention and change attitudes about lead’s current relevance. The “#GetLeadCheckedTexas” campaign ran on state health department channels during National Lead Poisoning Prevention Week in October 2020. Colorful graphics depicted extinct creatures like dinosaurs along with their babies, playing on childhood enthusiasm for such animals while evoking protective feelings in parents. Messaging highlighted lead’s dangers for young children and encouraged viewers to discuss testing with providers. Website analytics showed the campaign drove substantial increases in page views for lead screening resources, particularly among providers. While originally designed with a parent audience in mind, the campaign seemed to resonate more with providers, likely due to timing during an awareness week and use of official health department channels. The initiative demonstrates the value of creative communications approaches employed in traditional advertising to raise awareness and promote public health priorities. Audience research, thoughtful use of humor, and designing human-focused messaging helped cut through information clutter and drive engagement with an important childhood health issue. [ABSTRACT FROM AUTHOR]

It is unknown if vitamin D (vitD) sufficiency in breastfeeding mothers can lead to physiological outcomes for their children that are discernible from infant vitD sufficiency per se. In a 3-month, randomized vitD supplementation study of mothers and their exclusively breastfeeding infants, the effects of maternal vitD sufficiency were determined on infant plasma concentrations of 25-hydroxyvitamin D (i.e., vitD status) and 11 cytokines. An inverse correlation was seen between maternal vitD status and infant plasma TNF concentration (r = −0.27; p < 0.05). Infant whole blood was also subjected to in vitro antigenic stimulation. TNF, IFNγ, IL-4, IL-13, and TGFβ1 responses by infant leukocytes were significantly higher if mothers were vitD sufficient but were not as closely correlated to infants' own vitD status. Conversely, IL-10 and IL-12 responses after antigenic challenge were more correlated to infant vitD status. These data are consistent with vitD-mediated changes in breast milk composition providing immunological signaling to breastfeeding infants and indicate differential physiological effects of direct-infant versus maternal vitD supplementation. Thus, consistent with many previous studies that focused on the importance of vitD sufficiency during pregnancy, maintenance of maternal sufficiency likely continues to affect the health of breastfed infants. [ABSTRACT FROM AUTHOR]

Immunization programs worldwide have been facing challenges in keeping vaccination coverage high. Even though universally known for its robust National Immunization Program, Brazil has also faced significant challenges regarding vaccination coverage. One of the reasons for this is vaccine hesitancy, a complex, multi-causal, and context-specific phenomenon. This qualitative study aims to understand the factors associated with decision-making and the drivers of vaccine hesitancy in Florianopolis, Santa Catarina state capital, regarding caregivers' perceptions of routine childhood vaccination. In-depth interviews were conducted in the Capital city of Santa Catarina State. Families with children up to 6 years old were included. Data were analyzed based on thematic content analysis. Twenty-nine caregivers in 18 families were interviewed. These caregivers were mainly mothers and fathers. Three themes emerged: 1. Access to information and the decision-making process, where we discuss the role of social circles, healthcare workers, and the internet; 2. Individual-institutions power relationships: Perceptions about the State's role and the Health institutions: 3. Reasons and motivations: The senses and meanings behind non-vaccination, where we discuss the drivers of vaccine hesitancy related to risk perception, caregivers' opinions on the medical-pharmaceutical industry, vaccines' composition and their side effects, families' lifestyles and worldviews, and the childhood routine vaccination schedule. The results of this study reaffirm the complexity of the decision-making process in childhood vaccination and further enable a better contextual understanding of the complex and challenging phenomenon of vaccine hesitancy.

This project sought to investigate whether an association may be observed between isotopic stress indicators and skeletal evidence of pathological conditions. Deciduous and permanent teeth of 15 non-adults from two contemporaneous mid-19th century London burial grounds (City Bunhill, Lukin Street). δ13C and δ15N was measured in the incrementally sectioned dentine collagen. Isotopic profiles for each individual included death during tooth development. Individuals with skeletal evidence of chronic pathological conditions (e.g., rickets, tuberculosis) exhibited raised δ15N values of 0.5–1.7‰ in the months prior to death. Isotopic change consistent with chronic physiological stress prior to death was also recorded in two individuals with no skeletal evidence of disease. An offset was observed between co-forming bone and dentine δ15N values in both populations, indicating that bone and dentine are not recording the same isotopic changes. Isotopic change consistent with chronic physiological stress was observed in both those with and without skeletal evidence of disease, suggesting that adaptation to chronic stress in childhood was not uncommon within these 19th century London populations. Chronic physiological stress prior to death may be seen in the incrementally sampled dentine of non-adults who die during tooth formation. The temporal resolution of current dentine micro-sampling methods may mask or minimise visibility of shorter-term periods of stress or dietary change. Future research should further explore the relationship between specific skeletal pathologies and isotopic evidence for stress. [ABSTRACT FROM AUTHOR]

In previous studies on social stratification and mobility in China, education is considered as the core mediatory factor in social reproduction and mobility. This paper, however, investigates how childhood health affects social stratification. Using data from Urbanization and Labor Migrant National Survey (2012), this study examines the effects of nutrition, hygiene, and health before age 14 on adult socioeconomic status attainment, including education, the international socioeconomic indexes of first job and current job, and family income per head. The structural equation model results show that the nutrition intake (whether one experienced starvation and the frequency of fish and meat intake) and hygiene (indicated by the source of drinking water and the toilet type) have significant effect on adult socioeconomic status attainment. However, the effects change at different life course stages. Moreover, childhood health (indicated by adult height) has significant impact on adult socioeconomic status attainment, but no significant impact on the international socioeconomic indexes of first job and current job. We conclude that investment in childhood health is an important mechanism affecting social class reproduction and mobility. Therefore, health intervention for children from poor and disadvantaged families are necessary. It will benefit children's education and encourage upward mobility. [ABSTRACT FROM AUTHOR]

There is evidence that PM2.5 could be obesogenic. Lima is one of the most polluted cities in South America, with an increasing prevalence of childhood obesity. This study aimed to determine the association between PM2.5 exposure of children aged 6 to 59 months and being overweight or obese (O/O) in a significant dataset survey. Cases were defined when weight for height Z-score (WHZ) was >2 standard deviations (SD) from the mean, for each sex. A control was defined when WHZ was between ±2 SD. We used a conditional logistic regression model to calculate the odds ratio (OR) between extrauterine and intrauterine PM2.5 exposure and O/O. Extrauterine PM2.5 exposure was evaluated as a 6-month PM2.5 mean prior to the survey. We found a significant association between O/O and extrauterine (OR: 1.57, 1.51–1.63) and intrauterine (OR: 1.99, 1.88–2.12) PM2.5 exposure for an increment of 10 μg/m3. The ORs increased as the quartile increased in both exposures. We observed a higher association in children aged 6–11 months (OR: 3.07, 2.84–3.31). In conclusion, higher levels of PM2.5 in Lima and Callao were associated with cases of O/O in children from 6 to 59 months, with the association higher for prenatal exposure.

Objectives: Socioeconomic status and health in childhood are linked to health outcomes in later life. Health outcomes may also be shaped by socioeconomic circumstances in adulthood and later life. This paper examined the relationship between childhood conditions and later life health and tested whether this relationship was mediated by later life economic living standards. Methods: Data from a longitudinal study of aging was combined with retrospective life history data from 787 participants from the New Zealand Health, Work and Retirement Study. Results: Significant relationships were found between childhood conditions and later life health. These relationships were mediated by economic living standards in older age, but the partial direct effect of childhood conditions on health found in early older age became fully meditated 10 years later. Conclusion: While childhood circumstances are part of this complex relationship, socioeconomic conditions in later life are vital to ensuring ongoing health into older age. [ABSTRACT FROM AUTHOR]

Objectives Age stereotypes and expectations about one's own aging commence in childhood but most research focuses on predictive associations with midlife health behaviors, later-life chronic conditions, biomarkers, and longevity. Surprisingly little is known about the role of poor childhood health in these associations. This study aims to fill this gap. Methods Using data from the Health and Retirement Study (HRS: N = 5,773, aged 50–98), we investigated whether diagnosed chronic illness before age 16 and self-rated childhood health predict late-life self-perceptions of aging (SPA) and proportional subjective age discrepancy (PSAD). We conducted multivariate multiple regression analysis (MMRA) to determine the joint and partial effects of the two indicators of childhood health. Models included controls for childhood family financial status as well as late-life self-rated health, chronic illnesses, memory status, and demographic covariates (age, gender, race/ethnicity, marital status, socioeconomic status) in 2016. Results Over and above all covariates and the covariation of the two views of one's own aging, the MMRA models revealed that the number of childhood chronic illnesses predicted SPA but not for PSAD. Self-rated childhood health predicted both SPA and PSAD in the unadjusted models, but not in the adjusted models. Discussion This study provides new insight into potential early-life precursors of self-evaluations of aging. In particular, childhood diagnoses of chronic illness enhance negative SPA up to 50 years later. Non-normative experiences related to poor health in childhood are lifelong foundations for socioeconomic status, health, and for self-related beliefs about age and aging. [ABSTRACT FROM AUTHOR]

Abstract Background The National Child Measurement Programme (NCMP) is a child weight monitoring system in England, taking place in the first and final years of primary school. Many local authorities consider it important to inform parents if their child is overweight, and do so by letter alongside the offer of support and advice. Such letters have been met with mixed reactions from parents, but research seeking to better understand parents’ responses is often limited by reliance on survey data and low participation rates. This study aimed to collect a broad variety of perspectives on the programme by analyzing views expressed in parent-to-parent discussions posted online. Methods UK-based online parenting fora were used to identify discussion threads based around the NCMP between 2010 and 2017. Thirty-one discussion threads from two parent fora were identified. Thematic analysis was used to identify themes in these data. Results The primary themes identified related to (1) the legitimacy of feedback and judgement from health professionals, (2) the relative importance of collecting population level data above individual preferences, and (3) risks versus benefits of having conversations with children about weight. Most threads adopted an ‘argument, counter-argument’ format, providing two sides to each issue raised. Information and opinions consistent with public health messages were frequently provided, such as how data are used, that feedback is intended to be helpful, and the importance of collecting national data. There was little evidence of individual parents shifting their views in response to others’ arguments. Conclusions This study provides novel insight into peer-to-peer debates about the NCMP, including the arguments parents find convincing and acceptable for and against a national programme to weigh children and provide feedback to parents about their weight. Online fora were used as an opportunity to express criticism or distress, but also to seek advice from peers regarding concerns about whether or not to opt-out. Thus, both general issues related to the legitimacy of population screening and outcomes for individual children were of concern to parents.

BackgroundAtherosclerotic remodeling starts early in life and can accelerate in the presence of cardiovascular risk (CV) factors. Regular physical activity (PA) can mitigate development of large and small artery disease during lifespan. We aimed to investigate the association of changes in body mass index (BMI), blood pressure (BP), PA behavior and retinal microvascular diameters with large artery pulse wave velocity (PWV) in prepubertal children over 4 years.MethodsThe school-based prospective cohort study included 262 children initially aged 6–8 years, assessing the above CV risk factors and retinal vessels by standardized procedures at baseline (2014) and follow-up (2018). PWV was assessed by an oscillometric device at follow-up.ResultsChildren with increased systolic BP over 4 years showed higher PWV at follow-up (β [95% CI] 0.006 [0.002 to 0.011] mmHg per unit, P = 0.002). In contrast, increased vigorous PA corresponded to a lower PWV at follow-up (β [95% CI] −0.009 [−0.018 to

It is unknown if vitamin D (vitD) sufficiency in breastfeeding mothers can lead to physiological outcomes for their children that are discernible from infant vitD sufficiency per se. In a 3-month, randomized vitD supplementation study of mothers and their exclusively breastfeeding infants, the effects of maternal vitD sufficiency were determined on infant plasma concentrations of 25-hydroxyvitamin D (i.e., vitD status) and 11 cytokines. An inverse correlation was seen between maternal vitD status and infant plasma TNF concentration (r = −0.27; p < 0.05). Infant whole blood was also subjected to in vitro antigenic stimulation. TNF, IFNγ, IL-4, IL-13, and TGFβ1 responses by infant leukocytes were significantly higher if mothers were vitD sufficient but were not as closely correlated to infants’ own vitD status. Conversely, IL-10 and IL-12 responses after antigenic challenge were more correlated to infant vitD status. These data are consistent with vitD-mediated changes in breast milk composition providing immunological signaling to breastfeeding infants and indicate differential physiological effects of direct-infant versus maternal vitD supplementation. Thus, consistent with many previous studies that focused on the importance of vitD sufficiency during pregnancy, maintenance of maternal sufficiency likely continues to affect the health of breastfed infants.

Background: Atherosclerotic remodeling starts early in life and can accelerate in the presence of cardiovascular risk (CV) factors. Regular physical activity (PA) can mitigate development of large and small artery disease during lifespan. We aimed to investigate the association of changes in body mass index (BMI), blood pressure (BP), PA behavior and retinal microvascular diameters with large artery pulse wave velocity (PWV) in prepubertal children over 4 years. Methods: The school-based prospective cohort study included 262 children initially aged 6–8 years, assessing the above CV risk factors and retinal vessels by standardized procedures at baseline (2014) and follow-up (2018). PWV was assessed by an oscillometric device at follow-up. Results: Children with increased systolic BP over 4 years showed higher PWV at follow-up (β [95% CI] 0.006 [0.002 to 0.011] mmHg per unit, P = 0.002). In contrast, increased vigorous PA corresponded to a lower PWV at follow-up (β [95% CI] −0.009 [−0.018 to <0−0.001] 10 min/day per unit, P = 0.047). Progression of retinal arteriolar narrowing and venular widening were linked to a higher PWV after 4 years (β [95% CI] −0.014 [−0.023 to −0.004] 0.01 changes per unit, P = 0.003). Conclusion: Increase in systolic BP and progression of microvascular dysfunction were associated with higher PWV after 4 years. Children with increasing levels of vigorous PA were found to have lower PWV at follow-up. Habitual vigorous PA has the potential to decelerate the process of early vascular aging in children and may thus help counteract CV disease development later in life. Clinical Trial Registration: ClinicalTrials.gov, Identifier: NCT03085498. [ABSTRACT FROM AUTHOR]

Abstract Background While regular handwashing effectively reduces communicable disease incidence and related child mortality, instilling a habit of regular handwashing in young children continues to be a challenging task, especially in developing country contexts. This randomised controlled pilot study assessed the effect of a novel handwashing intervention – a bi-monthly delivery of a colourful, translucent bar of soap with a toy embedded in its centre (HOPE SOAP©) – on children’s handwashing behaviour and health outcomes. Methods Between September and December 2014, 203 households in an impoverished community in Cape Town, South Africa, were randomised (1:1) to the control group or to receive HOPE SOAP©. Of all children (N = 287) aged 3–9 years and not enrolled in early childhood development programmes, 153 residing in intervention households received a bar of HOPE SOAP© every two weeks (total of 4 bars). Children in control households received a colourful, translucent bar of soap of equal size to HOPE SOAP©, with a toy alongside it. Two ‘snack tests’ (children were offered crackers and jam) were used to provide objective observational measures of handwashing. Through baseline and endline surveys, data were collected from caregivers on the frequency (scale of 1–10) of handwashing by children after using the toilet and before meals, and on soap-use during handwashing. Data on 14 illnesses/symptoms of illness experienced by children in the two weeks preceding the surveys were collected. Multivariable Ordinary Least Squares regression analyses were used to assess the intervention effect on handwashing behaviours and health outcomes. Results At endline, HOPE SOAP© children were directly observed as being more likely to wash their hands unprompted at both snack tests (49% vs 39%, β: 0.10, p = 0.27). They were more likely to score ≥8/10 for using soap when washing their hands (β: 0.14, p = 0.011). HOPE SOAP© children, in general, had better health outcomes, and those who used the soap as intended, and did not cheat to remove the toy from the soap, were less likely to have been ill (β: − 0.15, p = 0.049). Conclusions Results point towards HOPE SOAP© being an effective intervention to improve handwashing among children. Further research on this novel handwashing intervention is warranted. Trial registration NCT03280771 (www.clinicaltrials.gov) retrospectively registered on 8 September 2017.

Objectives Prior research on cumulative disadvantage has primarily focused on individuals' own childhood adversity for their later-life outcomes. Nevertheless, partner's childhood disadvantage may also shape respondent's later-life well-being. Methods Drawing on a household-level dataset, I examine respondent's own childhood adversity as well as their partner's childhood adversity (poor childhood health, parental divorce, or father's long-term unemployment) on respondent's subjective well-being, at aged 50 and older. Results Findings from the actor-partner interdependence model (APIM) show poor childhood health of the male partner as associated with worse mental health and self-rated health of the female partner in later life. For both outcome measures, the partner effects were attenuated after adjusting for the female partner's report of perceived social support. For self-rated health, adjusting for variation in the presence of a chronic illness and household income also attenuated the association. Discussion Partnered individuals are nested within a specific context, whereby stress and implications of early life disadvantage may be conceptualized at the couple-level. Future research that assesses how early life experiences of individuals may have implications for family members' later-life well-being may be valuable. [ABSTRACT FROM AUTHOR]

This paper extends previous measurements of the children's income-health gradient through 2015. We first replicate findings about the steepness of the gradient from 1986 to 2005. We then find that since 2005, the health gradient between children in low-income families and high-income families has flattened, but it still steepens with age. We also show that overall children's health has improved since 2005. [ABSTRACT FROM AUTHOR]

Malignancy is a big and serious childhood health problem in Iraq especially under 14 years. Childhood malignancy is the second major death-causing, which increasing by growing industrial revolution in third world country and the exposure to polluted environmental, so that this increase affect the distribution of the malignancy subtypes in age group, male-female ratio, residence and et, which at the end influence the incidence, survival rates and geographical variation. This retrospective study evaluated a numbers of childhood’s malignant cases that registered in oncology Department of Iraqi Child’s Central Teaching Hospital between the periods 14 January 2004 to26 December 2017, concerning their general characteristic and the type of malignancy, as well as a comprehensive overview the frequency of subtype malignancy, occurrence, demographics and geographic distribution. The aim of these study findings: depicting the happening of malignancy subtypes in children less than 14 years, recognizing the epidemiological and geographical divergence among child’s patients, compare the result with the United States of America study in 2014 and may bepointed out the future childhood malignant research needs. [ABSTRACT FROM AUTHOR]

China’s unprecedented population aging and social and economic change raise important issues concerning life course determinants of advantage or disadvantage into later life. Data from the China Health and Retirement Longitudinal Study (CHARLS) 2013 were analysed to identify the influence of childhood health on later life health as indicated by self-rated health and how this influence could be mediated by social and economic positions (SEP) and resources later in the life span. CHARLS provides nationally representative data on 18, 000 individuals aged 45 years and above in approximately 150 districts and 450 villages. Both multivariate logit regression model and KHB method (Karlson/Holm/Breen method) were applied to examine and decompose the life span influences on later life health. The results show that the childhood health, accounts for approximately half of the effect directly and another half of the effect indirectly through social and economic variations during adulthood. Relative living standard, marital status and urban residence are the most significant and important social and economic mediators for men; For women, living standard and secondary schooling are most influential while marital status is not significant. Implications for social and economic policies to improve later life health are discussed.

The societal costs of air pollution have historically been measured in terms of premature deaths (including the corresponding values of statistical lives lost), disability-adjusted life years, and medical costs. Emerging research, however, demonstrated potential impacts of air pollution on human capital formation. Extended contact with pollutants such as airborne particulate matter among young persons whose biological systems are still developing can result in pulmonary, neurobehavioral, and birth complications, hindering academic performance as well as skills and knowledge acquisition. Using a dataset that tracks 2014–2015 incomes for 96.2% of Americans born between 1979 and 1983, we assessed the association between childhood exposure to fine particulate matter (PM 2.5) and adult earnings outcomes across U.S. Census tracts. After accounting for pertinent economic covariates and regional random effects, our regression models indicate that early-life exposure to PM 2.5 is associated with lower predicted income percentiles by mid-adulthood; all else equal, children raised in high pollution tracts (at the 75th percentile of PM 2.5) are estimated to have approximately a 0.51 decrease in income percentile relative to children raised in low pollution tracts (at the 25th percentile of PM 2.5). For a person earning the median income, this difference corresponds to a $436 lower annual income (in 2015 USD). We estimate that 2014–2015 earnings for the 1978–1983 birth cohort would have been ∼$7.18 billion higher had their childhood exposure met U.S. air quality standards for PM 2.5. Stratified models show that the relationship between PM 2.5 and diminished earnings is more pronounced for low-income children and for children living in rural environments. These findings raise concerns about long-term environmental and economic justice for children living in areas with poor air quality where air pollution could act as a barrier to intergenerational class equity. • Childhood exposure to air pollution is associated with diminished adult earnings. • The association is most pronounced for children of low-income and rural families. • Improving air quality could improve earnings and intergenerational class equity. [ABSTRACT FROM AUTHOR]

We analyze how childhood hunger affects human aging for a panel of European individuals. For this purpose, we use six waves of the Survey of Health, Aging, and Retirement in Europe (SHARE) dataset and construct a health deficit index. Results from log-linear regressions suggest that, on average, elderly European men and women developed about 20 percent more health deficits when they experienced a hunger episode in their childhood. The effect becomes larger when the hunger episode is experienced earlier in childhood. In non-linear regressions (akin to the Gompertz-Makeham law), we obtain greater effects suggesting that health deficits in old age are up to 40 percent higher for children suffering from hunger. The difference of health deficits between hungry and non-hungry individuals increases absolutely and relatively with age. This implies that individuals who suffered from hunger as children age faster. [ABSTRACT FROM AUTHOR]

This essay uses Afrocentric and womanist perspectives for interrogating former First Lady Michelle Obama's intersecting gendered and raced roles as mother and First Lady, and the effects these simultaneous positions of power had on the meanings and functions of the White House Kitchen Garden (WHKG). Using leisure scholars Francis and Hestor, Jr.'s (1990) three dimensions for analyzing a garden, I consider how Michelle Obama as "Black" First Lady and "Black" mother gave meaning to the WHKG as idea, place, and action in her book American Grown: The White House Kitchen Garden and Gardens across America (2012). Specifically, I interrogate how First Lady of the United States (FLOTUS) Obama presents the WHKG as an idea for addressing health issues affecting American youth, a place for learning about food, nutrition, and America's diverse and complex histories, and a site for inspiring individual and community action towards fighting childhood obesity in the United States. I argue that the WHKG is a significant part of former First Lady Obama's continued legacy, and its rhetorical meanings and functions extended beyond the realms of the mundane to change a plot of land into a nationwide health movement. [ABSTRACT FROM AUTHOR]

We study the effect of in utero exposure to treated tap water on childhood health in rural China, where boiling water to inactivate disease-causing microorganisms before drinking is common. We exploit the gradual rollout of a rural drinking water program that supplies treated tap water to households. Besides microorganisms, the treatment removes chemical pollutants. We find that exposure to treated tap water in utero increases height at ages 1–11 by 0.3 standard deviations. We also document improvements in other health outcomes at different stages of childhood, as well as a reduction in the incidence of non-waterborne digestive diseases. Improving health by age one and inducing more health investments from parents are two possible channels. Results highlight the importance of removing chemical pollutants from drinking water to protect fetuses from environmental insults. [ABSTRACT FROM AUTHOR]

This paper examines the effect of the onset of Type 1 Diabetes Mellitus (T1DM) before 15 years of age on labor market outcomes and contributes to the literature on effects of childhood health on adult socioeconomic status. Using national Swedish socioeconomic register data 1991–2010 for 2485 individuals born 1972–1978 with onset of T1DM in 1977–1993, we find that T1DM in childhood has a negative effect on labor market outcomes later in life. Part of the T1DM effect is channeled through occupational field which may be related to both choice and opportunities. Although the magnitude of the effect is only directly generalizable to illnesses with similar attributes as T1DM, the results suggest that causality in the often observed correlation between health and socioeconomic status, at least partly, is explained by an effect running from health to earnings. This has implications for research and policy on strategies to reduce socioeconomic-related health inequality. Our findings also shed light on productivity losses, measured by employment status and earnings due to childhood onset T1DM, which have implications for both the individual and society. [ABSTRACT FROM AUTHOR]