On the decomposition of rank-dependent indicator of socio-economic inequalities in child malnutrition: Some empirical findings

The persistent socioeconomic disparities in child under-nutrition in developing countries raises an important health policy question - whether different nutrition base interventions are required for different areas? Addressing this question, the main objective of this study is to investigate the trends of socio-economic inequalities in child undernutrition in Pakistan and to assess the causes of these inequalities through decomposition analysis. Using Pakistan Demographic and Health Survey, round 2017–18, data this study examined inequalities in child undernutrition through different health inequality indices. Moreover, decomposition analysis is performed by applying generalized decomposition procedure under recentered influence function (RIF) regression to find the contribution of (i) differences in levels of different factors (composition effects) and (ii) differences in the intensity of association between socio-demographic factors and child undernutrition (coefficient effects) to the observed inequality. Study findings suggest substantial pro-educated inequalities in child under-nutrition. In addition, the decomposition analysis reveals the factors such as parental education and wealth status are significant contributors to the observed inequality. Moreover, different policy interventions, for rural and urban areas are suggested. There is the need to design public health, nutrition-based, interventions to overcome rural urban disparities through bridging gaps in educational endowments of rural and urban populations. Moreover, a balanced distribution of wealth might be helpful to reduce the rural-urban gap.     

非农就业、母亲照料与儿童健康——来自中国乡村的证据

中国农村女性参与非农就业的比例显著提高,对于增进家庭收入、减少贫困起到了积极的作用。但从女性在家庭中的双重身份——挣取收入者和照看孩子的主要人员出发,其劳动模式和供给行为的改变对于下一代福利的影响和人力资本的积累所起到的作用却是不确定的。本文通过将农村地区妇女的劳动供给状况进行区分,就其劳动参与行为对孩童健康状况的影响进行了探讨。在控制其他因素的情况下,母亲额外单位的劳动时间的增加对孩子的健康状况具有显著的负向影响,且同样的母亲非农劳动时间的增加对于孩童健康的负面影响大于农业劳动时间增加的影响程度,而母亲收入增加对孩子健康状况具有显著的正向影响;边际效果分析表明母亲收入增加对孩子健康的正向影响难以抵销劳动时间增加所带来的负面效果。孩子性别不同所受到的影响亦不同,女童相对而言处于健康的劣势地位。虽然母亲的劳动供给有助于缩小孩子营养状况的性别差距,但却是以所有儿童的健康状况下降为代价的。研究结果预期具有较强的政策含义。     

芪柏塌渍治疗小儿静脉炎的疗效及对TLR-4/核因子-κB信号通路的影响

目的观察芪柏塌渍对静脉炎的疗效,同时探讨其对TLR-4/核因子-κB信号通路上标志蛋白表达的影响。方法选取2018年1月至2019年6月大连市中心医院收治的40例静脉炎患儿作为研究对象,按随机数字表法分为常规组和试验组,各20例,另取20例健康儿童为对照组。对照组患儿取50%硫酸镁溶液浸湿的无菌纱布敷于发生静脉炎处,面积以超过静脉炎范围1~2 cm为宜,并用保鲜膜包裹于纱布外,每2小时换药1次,3 d为一个治疗周期。试验组用无菌棉签蘸取适量芪柏塌渍膏涂于发生静脉炎处,面积以大于静脉炎范围1~2 cm为宜,厚度0.2~0.5 cm,予以无菌纱布覆盖,最后用胶布固定,每4~6小时换药1次,3 d为一个治疗周期。于治疗前及治疗2个周期时,采用蛋白免疫印迹法检测外周血中TLR-4和核因子-κB水平变化,酶联免疫吸附试验(ELISA)检测患儿血清肿瘤坏死因子-α(TNF-α)、白细胞介素-11(IL-11)、白细胞介素-4(IL-4)、白细胞介素-33(IL-33)蛋白表达。结果治疗后两组患儿数字评分法(NRS)评分、红肿面积有所改善,且试验组改善程度优于常规组,差异有统计学意义(P<0.05);静脉炎患儿血清TLR-4、核因子-κB、TNF-α、IL-11、IL-4、IL-33水平明显高于健康对照组(P<0.05);治疗后,常规组和试验组患儿TLR-4、核因子-κB、TNF-α、IL-11、IL-4、IL-33水平明显下降(P<0.05),且试验组上述指标明显低于常规组(P<0.05)。结论静脉炎患儿存在TLR-4/核因子-κB信号通路表达紊乱,芪柏塌渍可明显调节TLR-4/核因子-κB信号通路上标志性蛋白的表达,该效应可能是芪柏塌渍从机体炎症方面改善静脉炎患儿的作用机制之一。     

失独父母的社会支持体系现状及优化策略

基于社会支持理论,探讨失独父母的社会支持现状及其影响因素。2018年3-4月以多阶段分层整群抽样的方法,在我国西部某地级市抽取失独父母样本量108,分析失独父母的社会人口学特征、欧洲五维健康量表(EQ-5D)和社会支持评定量表(SSRS)等。失独父母的主观支持分、客观支持分、对支持的利用度和社会支持总分的中位得分低于国内常模及普通老年人的分数,线性回归分析结果显示,是否有第三代,是失独父母主观支持分、对支持的利用度和社会支持总分的影响因素;婚姻状况和月收入是失独父母客观支持分的影响因素。对失独父母须建立长期、固定的帮扶机制;政府应加大对患有大病、有第三代、退休金较少甚或没有的失独父母的经济帮扶力度;应夯实家庭医生重点签约对象的服务内容;须构建多种形式的特殊养老政策,引导失独父母自励互勉,构建多元化的社会支持体系,帮助失独群体早日融入社会。     

CHILD CARE PRICES AND MATERNAL EMPLOYMENT: A META‐ANALYSIS

The literature estimates for labor force participation elasticity with regard to child care prices are extensive and varying. While some estimates imply substantial gains from child care subsidies, others find insignificant effects. To determine the causes of the variance, this paper reviews and analyzes the elasticity sizes using estimates from 36 peer‐reviewed articles and working papers in the literature. We start by reviewing the theoretical and empirical aspects related to participation elasticity with regard to child care costs, paying special attention to sample characteristics, methodological aspects, and macro level factors. We conclude by providing a meta‐regression using control variables based on our review of the literature to explain some of the differences between the estimates. As research builds on and improves the methods and assumptions in prior works, elasticity estimates have become smaller over time. This decline might also be partially explained by changes in labor market characteristics. In countries with high rates of part‐time work and very high or very low rates of female labor force participation, we find elasticity rates to be smaller.     

Healthy and tasty school snacks: suggestions from Brazilian children consumers

Children do not choose what to eat based on health issues alone, and the high availability of non‐nutritious food in the environment can be a barrier to the consumption of healthy foods. Brazilian children are consuming processed, savoury, rich in fat, sodium and refined carbohydrates rather than more nutrient‐dense foods. Foods offered in public school meals and those sold in private school canteens in Brazil are subject to regulation, but not the snacks brought from home. This study identified the suggestions of public and private school students about the characteristics that a snack should present in order to be considered both healthy and palatable. A qualitative exploratory study using focus groups was conducted with 128 primary school students aged 7–10 years old. Interviews were transcribed and content analysis was conducted, generating three categories: (1) foods actually consumed during snack breaks; (2) examples of foods considered healthy and/or tasty for consumption during snack breaks; and (3) desired characteristics of a healthy and tasty snack. Foods of high energy density and low nutritional value were mentioned as the most consumed snacks, usually brought from home or purchased within/near the schools. Consumption of meals offered by the National School Meal Program was reported by only one‐third of the public school students. Fruits, natural juices and vegetables were considered healthy foods; sweet‐tasting preparations containing fruits were considered tasty; while fruits and natural fruit juices were considered both healthy and tasty. Sweet‐tasting preparations containing fruits were mentioned as examples of snacks with the desired healthy/tasty characteristics. The disparity between what was actually consumed and what was reported as ideal leads us to question the availability in retail stores of healthy yet palatable foods that meet this population's desires.     

Childhood investments and skill formation

The skills needed to ensure good life chances are rising (and changing) and, despite decades of education reforms, there has been little progress in terms of equalizing opportunities. The impact of social origins on child outcomes persists, and may even strengthen. This suggests that the pursuit of more equality and future productivity come together. A major challenge is to minimize the dispersion of skills. The foundations of policy lie in the realization that learning abilities are formed during the first years of childhood. The pursuit of an optimal human capital policy needs to consider three issues: (1) the uneven capacity of parents to invest in children; (2) the impact of mothers’ employment on child outcomes; and, (3) the potential benefits of early pre-school programmes.     

Home-related injuries among under-five-year children and mothers' care regarding injury prevention in rural areas

This cross-sectional study was conducted in rural areas of Twiserkan (Toyserkan) County, in Iran, to assess factors associated with home-related injuries among under-five-year children and their mothers’ care regarding injury prevention. Mothers who had their under-five-year-old children injured within a 12-month period were identified from recorded information in Twiserkan Health Center. Then, data were gathered using pre-tested questionnaire and through interview with injured children's mothers. The questions were about characteristics of the children's injuries and their mothers’ care regarding injury prevention, using PRECEDE (Predisposing, Reinforcing, and Enabling Constructs in Educational/Environmental Diagnosis and Evaluation) model with focus on knowledge and attitude; enabling and reinforcing factors; and mothers' preventive behaviours. The study results showed that 197 out of 210 total identified mothers took part in the study. The reported injuries were 11.68%, 39.09%, and 49.24%, respectively, for severe, moderate, and mild cases. Fall was the most frequent injury with 35%. Among PRECEDE model constructs, there was a statistically significant correlation between mothers' knowledge and injury severity among children. Home-related injuries are an important health problem among study population and their prediction and prevention are necessary. Enhancement of mothers’ knowledge can be helpful to improve child injury prevention.     

CHILD LABOUR: A REVIEW OF RECENT THEORY AND EVIDENCE WITH POLICY IMPLICATIONS

In recent years, a growing number of authors have turned their attention to the question of why children work. The purpose of this paper is to review some of the more recent theoretical and empirical research into the topic of child labour, and to illustrate the fact that no one factor on its own can account for the phenomenon of child labour. Therefore, policies aimed at eradicating child labour will need to address the broad range of underlying factors that contribute to the incidence of child labour, such as poverty, market imperfections and access to education.     

How important is improving food availability for reducing child malnutrition in developing countries?

Do increases in the food supply per person in a country, i.e., national food availability, contribute substantially to reductions in malnutrition among its children? This paper sets out to answer this controversial question using panel data from 63 developing countries over 1970–1996. This paper gives evidence in support of a statistically significant and strong positive impact of national food availability on child nutrition, finding that increased food supplies have resulted in significant reductions in malnutrition since the 1970s despite population increases over the period. However, per‐capita food supplies have a declining marginal impact: their effect is quite strong for countries with very low food availability (e.g., most countries in sub‐Saharan Africa and South Asia), but weak or non‐existent for those with high levels (e.g., most countries in the Near East and North Africa). Further, non‐food factors, such as women's education and status and the quality of health environments, are also important determinants of children's nutritional status. Depending on the state of food availability in any particular geographic area and relative costs, these factors may merit greater priority in policies to reduce malnutrition.