Search Results (345)

Background: Asthma is one of the leading chronic inflammatory respiratory conditions affecting children under 5 years of age, especially those who reside in socio-economically disadvantaged and densely populated low- and middle-income communities. Methods: A cross-sectional analytical study was conducted to ascertain the prevalence of factors influencing asthma and wheeze among young children attending early childhood development centres in Alexandra Township. Data were collected using a self-administered modified International Study of Asthma and Allergies in Childhood questionnaire. The analysis was performed utilising STATA version 19. The study sample comprised 3265 young children and their parents or guardians. Results: The findings reveal that the prevalence of asthma and current wheeze was 17.52% and 35.56%, respectively, while the prevalence of a history of wheeze was 64.36%. In the multivariate analysis, a family history of asthma was identified as a risk factor for asthma (p < 0.001) and for current wheeze (p < 0.001) and historical wheeze (p < 0.001). Additionally, the use of pain medication and passing of public transport were seldom identified as risk factors for both asthma and wheeze. Furthermore, exposure to second-hand tobacco smoke (p = 0.025) was found to influence the occurrence of asthma. Conclusions: This study highlights the impact of individual, household, and environmental factors on asthma. The findings are critical for the implementation of preventive environmental health measures to address this issue, particularly in low- and middle-income countries with limited curative resources. Full article

Using a sample of Chinese junior high school students (N = 1133), this study examined the latent heterogeneity and structural characteristics of mobile phone addiction risk. Latent profile analysis was conducted to identify subgroups with varying levels of risk. Network analysis was then used to model the relationships among smartphone addiction, materialism, and childhood neglect and compare structural differences across subgroups. Finally, five machine learning models were applied to model smartphone addiction scores and compare model performance across different combinations of variables. Results revealed three distinct risk groups of smartphone addiction. Network analysis indicated that loneliness-related nodes exhibited the highest expected influence in the overall network. Across latent profiles, childhood neglect-related nodes consistently occupied central positions, whereas materialism-related nodes showed relatively stable centrality. Network comparison tests further demonstrated significant structural differences across risk groups. In addition, incorporating latent profile information and centrality indices improved model performance, suggesting that these features capture individual differences in smartphone addiction. These findings provide structural evidence for the heterogeneity of mobile phone addiction risk and offer implications for subgroup-specific intervention strategies. Full article

In his swan song A Tale of the Wind (1988), Joris Ivens undertakes the seemingly impossible task of capturing the invisible—the wind—on film. At the same time, the film looks back over the director’s own career, in a spirit that is at once self-reflective and youthful. Set mainly in China, it functions both as an allegory of the wind and as a search for a middle ground between realism and more poetic approaches to cinema. This article examines the film through the lenses of self-reflexivity, the cinematic portrayal of old age, and the relation between life and death. It first delves into Stanley Cavell’s ontological understanding of self-reflexivity, before examining how this self-reflexivity unfolds in A Tale of the Wind. In this regard, it analyses the relationship between technique and magic, the search for a “theory of cinema”, and the importance of imagination and childhood. Taking into consideration the Deleuzian correlation between face and landscape and the notion of “any space whatever”, the article concludes by analysing old age through its marks and gestures: wrinkles, laughter, waiting, and searching—elements that contribute decisively to the film’s self-reflexivity. Full article

Background: The rising prevalence of childhood overweight/obesity (OWOB) and elevated blood pressure (EBP) parallels a global decline in muscular fitness. However, evidence linking whole-body muscular strength to the comorbidity of these cardiometabolic risks remains scarce. Methods: Data were obtained from five nationally representative waves of the Chinese National Survey on Students’ Constitution and Health (CNSSCH, 2000–2019), including 1,072,404 children and adolescents aged 7–18 years. A novel Muscle Strength Index (MSI) was developed by integrating handgrip strength (HGS) and standing broad jump (SBJ), standardized for body weight and height, respectively. Generalized linear mixed-effects models (GLMMs) with restricted cubic splines (RCS) were first applied to characterize dose–response associations. Subsequently, categorical analyses and forest plots were conducted to quantify risks of OWOB, EBP, and their comorbidity across five waves and subgroups. Sex-specific normative reference curves were established using the LMS method, and population-attributable fractions (PAFs) were estimated to assess the potential public health benefits of improving muscular strength. Results: Between 2000 and 2019, the prevalence of OWOB, EBP, and comorbidity increased markedly, reaching 25.80%, 12.23%, and 4.83% in 2019, and are projected to rise further to 37.88%, 20.16%, and 10.01% by 2030. Over the same period, mean MSI increased from 2000, peaked in 2005, and subsequently declined by 2019 with the values for boys and girls, being 1.73, 1.75, 1.63 and 1.46, 1.49, 1.41, respectively. Dose–response analyses revealed consistent L-shaped associations, with the greatest risk reductions observed when moving from low to moderate MSI levels. In 2019, participants with low MSI had higher odds of OWOB (OR 4.81, 95% CI 4.65–4.97), EBP (OR 1.42, 95% CI 1.36–1.49), and comorbidity (OR 3.49 95% CI 3.26–3.73) compared with those at middle levels. PAF analyses indicated that improving MSI to at least the 40th percentile could potentially avert 43.5% of OWOB cases, 12.3% of EBP cases, and 48.2% of comorbidity cases. The highest potential benefits were observed in northern and northeastern provinces, particularly Tianjin and Heilongjiang. Conclusions: Chinese children and adolescents face a dual burden of rising cardiometabolic comorbidity and declining muscular strength. Muscular strength demonstrates a strong nonlinear protective association with OWOB, EBP, and their co-occurrence. Targeted improvement among those with low muscular strength may substantially reduce future cardiometabolic burden. Full article

This research examined the component structure of two child measures, the Trait Emotional Intelligence Questionnaire–Child Form (TEIQue-CF; 75 items) and its short form (TEIQue-CSF; 36 items), developed specifically for children aged 8 to 12 years. Study 1 analysed TEIQue-CF data using the nine facet scores from 720 UK primary school pupils in Years 3 through 6 using principal component analysis with parallel analysis for factor retention. Results supported a unifactorial solution in the total sample, with a single factor explaining 43.48% of the variance. Exploratory subgroup factor analyses (in boys and older children in Years 5 to 6) in Study 1 suggested a potentially interpretable bifactorial pattern, though parallel analysis did not support retaining the second factor. Study 2 examined the TEIQue-CSF in 1582 Year 6 pupils using parcel-level analysis. A clearer two-factor structure emerged, with Socioemotionality (Adaptability, Peer relations, Self-esteem, Emotion expression, Affective disposition, Emotion perception) and Emotion control (Impulse control, Emotion regulation, Self-motivation) explaining 53.7% of the variance. This structure replicated across gender subgroups. Taken together, the findings suggest a developmental trend in which trait EI shifts from a largely undifferentiated structure in middle childhood to a more differentiated two-factor organisation by the end of primary school. They support the use of global trait EI scores in younger children while indicating that differentiated assessment becomes appropriate as children approach adolescence. Full article

Background/Objectives: Sizeable between- and within-country inequalities in childhood immunization impair progress towards the goals set by the global Immunization Agenda 2030 (IA2030) of achieving universal coverage of all persons with essential life-saving vaccines. Monitoring global trends in immunization inequalities helps to identify population subgroups that are less likely to benefit from vaccines and provides evidence for tracking progress on regional and global goals and informing equity-oriented interventions. This paper assesses the state of within-country inequality in childhood immunization across low- and middle-income study countries. Methods: Using data from household health surveys, the analysis quantifies within-country inequality across up to 92 countries, areas and territories, for nine childhood immunization indicators (seven coverage indicators and two indicators of non-receipt of vaccines) by five dimensions of inequality (child sex, mother’s age, mother’s education, household economic status and place of residence). Absolute and relative summary measures of inequality (difference, ratio, slope index of inequality, relative index of inequality and population attributable risk) were calculated to assess the latest situation of inequality (i.e., using the most recent survey from 2014 to 2023) and change over time (i.e., comparisons with data from 2004 to 2013). Results: The latest situation of inequality revealed overall low or no inequality by child sex, mother’s age and place of residence, with more pronounced inequality related to mother’s education and household economic status. The median differences between the most and least educated subgroups ranged between 9 and 14 percentage points for immunization coverage indicators, and between 6 and 9 percentage points for non-receipt of vaccines indicators. The extent of inequality in childhood immunization tended to remain about the same as the previous decade, with modest reductions in absolute economic-related and place of residence inequality in DTP3 immunization, as well as place of residence inequality in full immunization (declining by 3.25, 2.42, and 2.16 percentage points over 10 years, respectively). Distinct patterns of economic-related inequality were evident across country income groups, with low-income countries reporting larger inequality than lower- and upper-middle-income countries; there was substantial variation at the country level. Conclusions: Economic- and education-related inequalities in childhood immunization within low- and middle-income countries have persisted over the past decade. Full article

Background: Parents are children’s primary role models, are food and physical activity gatekeepers, and create the home structure/lifestyle environment. Thus, parents strongly influence children’s weight-related behaviors and have the opportunity to cultivate a “culture of health” within the home. Methods: The aim of the HomeStyles-2 (also called HomeStyles-Child) RCT was to determine whether this online, novel, age-appropriate, family intervention enabled and motivated the 131 systematically randomly assigned by computer parents of children in middle childhood (ages 6 to 11) in the experimental condition to shape home environments and healthy weight-related lifestyle practices to be more supportive of optimal health and reduced obesity risk in middle childhood youth more than the 134 counterparts assigned to the attention control condition. Results: This RCT demonstrated the feasibility of online delivery of a health promotion intervention to parents of children in middle childhood, which may inform the development of interventions targeting other age groups and health outcomes. Results indicate the HomeStyles-Child intervention improved healthy-weight-related behavior cognitions, which are predictors of behavior change, of the experimental group. Additionally, improvements in experimental parent and child health-related behaviors were observed. These improvements occurred during a time when families faced unprecedented and extraordinary economic and social stresses associated with the COVID-19 pandemic. Conclusions: HomeStyles-Child is one of the few interventions for families with middle childhood youth. It has the potential to help ameliorate obesity in middle childhood youth and, by extension, other family members. Full article

Background/Objectives: Sleep problems and physical activity are key lifestyle behaviors associated with children’s socioemotional development. However, their relative contribution to emotional regulation and emotional instability during middle childhood remains insufficiently clarified. This study aimed to examine the associations between sleep problems, habitual physical activity, and emotional regulation in elementary school children, while controlling for sociodemographic and lifestyle confounding variables. Methods: A cross-sectional study was conducted with 386 elementary school children (mean age = 11.15 ± 0.66 years; 45.6% boys) from southern Spain. Emotional regulation was assessed using the Emotion Regulation Checklist (ERC), sleep problems were measured with the Children’s Sleep Habits Questionnaire (CSHQ), and habitual physical activity was evaluated using the Physical Activity Questionnaire for Children (PAQ-C). Age, sex, socioeconomic status, and daily screen time were included as covariates. Pearson correlations and multiple linear regression analyses were performed. Results: Sleep problems were strongly associated with lower adaptive emotional regulation and higher emotional lability. In adjusted regression models, sleep problems emerged as the most robust independent predictor of both emotional regulation and lability. Although habitual physical activity was significantly associated with emotional outcomes at the bivariate level, its predictive strength decreased after adjustment for covariates and did not independently predict adaptive emotional regulation. Conclusions: Sleep problems appear to play a central role in children’s emotional functioning during middle childhood. Interventions aimed at promoting socioemotional well-being may benefit from prioritizing sleep health alongside physical activity within a comprehensive 24 h movement behavior framework. Full article

Background/Objectives: This study examined associations between maternal misperception and information-seeking opportunities, behaviors, and sources among Japanese mothers of preschool children. Methods: A cross-sectional online survey was conducted among mothers registered with a nationwide research panel. Mothers of children aged 3–5 years were included because, in Japan, this period follows the last early-childhood health checkup at age 3, after which caregivers are required to monitor child growth independently. In total, 1358 mothers were analyzed. Child anthropometric data were reported by mothers with reference to the Maternal and Child Health Handbook or childcare records. These measurements were originally obtained during routine health checkups conducted by healthcare professionals or childcare staff. Body mass index z-scores were categorized as high, middle, or low, and maternal perception as accurate, overestimated, or underestimated. Information-seeking behaviors were assessed using study-specific items informed by prior literature and reviewed by experts to ensure content and face validity. Health literacy was measured using the validated 12-item Japanese Health Literacy Scale, which has demonstrated reliability and validity in previous studies. Multinomial logistic regression was used. Results: Among children with high body size, 150/188 (80.8%) of mothers underestimated body size; among those with low body size, 20/35 (57.1%) overestimated it. In multivariable analyses, use of healthcare providers as an information source was statistically associated with maternal overestimation of child body size. Conclusions: Maternal misperception was common across body size categories. Further research is needed to determine whether support in interpreting objective growth indicators is associated with improved perception accuracy. Full article

Peer action coordination in middle childhood is thought to benefit from socio-cognitive abilities such as emotion understanding and inhibitory control, but empirical evidence for their role is limited. This study replicates and extends a previous study by examining whether emotion understanding and inhibitory control correlate with children’s peer action coordination in a cooperative sensorimotor problem-solving task. To test this hypothesis, 6- to 10-year-old children (N = 108, M = 8 years, 8 months, 46.3% girls, 53.7% boys) completed the Test of Emotion Comprehension and the Attention Network Task. To assess children’s performance in coordinating their actions with a peer, they were asked to complete the Labyrinth Ball Game—a sensorimotor task that they first performed individually and then together with a peer. Contrary to expectations, there was no direct association between emotion understanding or inhibitory control and children’s peer action coordination after controlling for age, gender, and individual sensorimotor skills. However, a significant interaction between age and gender revealed that older boys showed greater cooperative action coordination performance than younger boys, whereas girls’ performance remained stable across age. These findings challenge the view that individual socio-cognitive abilities straightforwardly support cooperative success, suggesting that peer action coordination in middle childhood may rely on more complex mechanisms, such as gender-specific communicative strategies or social play, rather than on emotion understanding and inhibitory control. Full article

Access to safe drinking water is critical for child growth and development. However, microbial contamination is a constant threat in many low- and middle-income countries. The current systematic review sets out to examine the evidence of drinking water quality and the physical and cognitive development of children aged 0 to 5 years. The review authors conducted a comprehensive search of SCOPUS, EBSCO, PubMed, the Cochrane Library, and Google Search for cohort studies and clinical trials conducted in English between the years 2010 and 2025. Of 222 studies, 15 were included in the review and the majority were conducted in low- and middle-income countries The findings consistently demonstrate that microbiological contamination, predominantly by Escherichia coli (the primary water quality indicator examined across studies), is associated with an increased risk of stunting (odds ratio up to 4.14) and reductions in height-for-age Z-scores (HAZ) (by 0.29–0.57). There is currently limited evidence in the studies reviewed that suggests a correlation between the presence of unsafe drinking water and a decrease in cognitive development; however, the evidence is insufficient and warrants further study. Integrated water, sanitation and hygiene (WASH) and nutrition programs had promising growth results, which varied depending on the initial sanitation coverage of the target population, adherence to the intervention, and the overall design of the program. To sum up, contaminated drinking water negatively affects physical and cognitive development during early childhood. Comprehensive WASH–nutrition strategies need to be implemented to reduce this impact and further progress towards Sustainable Development Goal (SDG) 6. Full article

Background/Objectives: Human milk (HM) is recognized as the optimal source of infant nutrition, particularly during the first six months of life. While its nutritional aspects and bioactive components are well studied, the HM metabolome remains less understood, particularly in low- and middle-income countries. This study utilized targeted metabolomics for HM profiling and investigated associations of the HM metabolome with maternal and infant characteristics. Methods: In total, 267 HM samples and demographic data from mothers participating in the Maternal and environmental Impact assessment on Neurodevelopment in Early childhood years (MINE) study were collected during enrolment (up to 6-months postpartum) and analyzed using the MxP^® Quant 500 targeted metabolomics kit from Biocrates. Results: A total of 440 metabolites were quantified, mostly lipids such as triglycerides (59.73%), phosphatidylcholines (14.25%), and diglycerides (8.49%), and small molecules including amino acids (26.67%), amino acid-related compounds (21.33%), hexosylceramides (17.33%), and fatty acids (14.67%). Maternal age was positively correlated with a wide range of metabolites, mainly cholesteryl esters, sphingomyelins, triglycerides, and acylcarnitines, while child age was associated with metabolites belonging to acylcarnitine, phosphatidyl-choline, ceramide, diacylglycerol, sphingomyelin, and triglyceride classes. Child’s gender was associated with metabolites, including ceramides, phosphatidylcholines, and sphingomyelins. Pathway enrichment analysis revealed that the metabolites were significantly enriched in valine, leucine, and isoleucine biosynthesis; arginine biosynthesis; phenylalanine, tyrosine, and tryptophan biosynthesis; and glutathione metabolism; however, these reflect annotation-based clustering rather than evidence of active metabolic processes in HM. Conclusions: The HM metabolome varies with maternal and infant characteristics, particularly infant age, reflecting cross-sectional differences in milk composition among mother–infant dyads. Enrichment of metabolites annotated to amino acid and antioxidant-related pathways highlights coordinated representation of nutritionally relevant compounds. These findings provide new insight into the factors shaping HM composition in a low- and middle-income populations. Full article

Background/Objectives: Being overweight in childhood is a strong predictor of later obesity and related health disorders, underscoring the importance of the early identification of at-risk children. The aim of this study was to develop a prediction model for being overweight across childhood and adolescence using routine life-course health records available up to 18–23 months of age. Methods: We analyzed 1581 participants from the Tohoku Medical Megabank Birth and Three-Generation Cohort Study and constructed multivariable logistic regression models to predict being overweight at 36–47 months, 6 years, 11 years, and 14 years. Predictors included being overweight at 18–23 months, maternal characteristics, birth weight, and body mass index changes from birth to 18–23 months. Model performance was evaluated using the area under the curve (AUC), calibration, Brier scores, risk by score range, and stratified 10-fold cross-validation to assess the stability and robustness of predictive performance. Results: Being overweight at 18–23 months consistently showed strong associations with later overweight status. Model discrimination was moderate to high for early and middle childhood (AUC 0.873 at 36–47 months; 0.772 at 6 years) but modest for adolescence (AUC 0.720 and 0.692 at 11 and 14 years). Cross-validation demonstrated stable predictive performance across all age groups. Calibration and overall predictive accuracies were acceptable across all age groups. Conclusions: These results indicate that routine early life-course health records moderately predict the risk of being overweight, supporting their practical potential for early preventive interventions. Full article

Micronutrient deficiencies remain a persistent challenge to global health and food security, particularly in low- and middle-income countries where evidence-based strategies are urgently needed. Biofortification of staple crops has been promoted as a complementary intervention to supplementation and food fortification, but its effective implementation requires locally relevant studies. Such evidence is essential because the performance and adoption of biofortified crops depend on context-specific factors, including crop varieties, soil micronutrient dynamics, dietary patterns, cultural acceptability, and bioavailability, which limit the transferability of findings across settings. This perspective examines whether countries with the highest micronutrient burdens generate sufficient local research to inform biofortification policy decisions. We conducted a bibliometric mapping of peer-reviewed literature indexed in Scopus and compared country-level publication counts with indicators of iodized salt coverage, zinc deficiency, and childhood anemia, which were selected because they are prioritized metrics in global health and food security. From 776 eligible articles, most publications originated from a small group of high- and middle-income countries, whereas regions facing the greatest nutritional burdens, including parts of Sub-Saharan Africa and South Asia, contributed little to the scientific output. Countries with low iodized-salt coverage, high zinc deficiency, or childhood anemia above 40% frequently showed zero or minimal publications. This misalignment suggests that countries facing the greatest nutritional vulnerabilities may be underrepresented in the indexed scientific literature. These findings highlight the value of further strengthening research participation and visibility in high-burden settings to ensure that the evidence base more accurately reflects global needs. Full article

Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) is one of the most common chronic liver diseases across all age groups. Methods: This review synthesizes the current evidence from landmark studies on the risk factors, diagnosis, and management of MASLD in pediatric, adult, and particularly elderly patients. Results: Based on the current data, we demonstrated that the prevalence of MASLD increases with age from childhood to middle adulthood, whereas, in elderly individuals, there is no further age-related increase observed. In the pathogenesis of the disease, familial and prenatal factors predominate in the youngest patients, while metabolic factors are the main contributors in adults. However, obesity remains the most significant risk factor for MASLD across all age groups. Therefore, systematic screening for MASLD should be strongly recommended in individuals with obesity. Laboratory parameters indicating an increased risk of MASLD are primarily recommended in screening regimens for children and adults; however, in elderly patients, these parameters may remain within normal ranges due to the long-standing disease course and progression toward fibrosis. On the basis of current studies and guidelines, we showed that lifestyle modification, including dietary changes and increased physical activity, is the cornerstone of treatment across all age groups. Nevertheless, non-pharmacological interventions have limitations in pediatric and elderly populations and are implemented less effectively in these groups than in middle-aged patients. Conclusions: The early identification of high-risk patients and implementation of multidisciplinary, age-targeted metabolic prevention strategies are essential to prevent MASLD progression and its non-liver complications. Full article