Adherence to 24-hour movement guidelines in children with mental,behavioral,and developmental disorders:Data from the 2016-2020 National Survey of Children's Health

Background:Adopting a healthy lifestyle during childhood could improve physical and mental health outcomes in adulthood and reduce relevant disease burdens.However,the lifestyles of children with mental,behavioral,and developmental disorders(MBDDs)remains under-described within the literature of public health field.This study aimed to examine adherence to 24-hour movement guidelines among children with MBDDs compared to population norms and whether these differences are affected by demographic characteristics.Methods:Data were from the 2016-2020 National Survey of Children’s Health—A national,population-based,cross-sectional study.We used the data of 119,406 children aged 6-17 years,which included 38,571 participants with at least 1 MBDD and 80,835 without.Adherence to the 24-hour movement guidelines was measured using parent-reported physical activity,screen time,and sleep duration.Results:Among children with MBDDs,20.3%,37.0%,60.7%,and 77.3%met the physical activity,screen time,sleep,and at least 1 of the 24-hour movement guidelines.These rates were lower than those in children without MBDDs(22.8%,46.2%,66.7%,and 83.4%,respectively;all p<0.001).Children with MBDDs were less likely to meet these guidelines(odds ratio(OR)=1.21,95%confidence interval(95%CI):1.13-1.30;OR=1.37,95%CI:1.29-1.45;OR=1.29,95%CI:1.21-1.37;OR=1.45,95%CI:1.35-1.56)than children without MBDDs.Children with emotional disorders had the highest odds of not meeting these guidelines(OR=1.43,95%CI:1.29-1.57;OR=1.48,95%CI:1.37-1.60;OR=1.49,95%CI:1.39-1.61;OR=1.72,95%CI:1.57-1.88)in comparison to children with other MBDDs.Among children aged12-17 years,the difference in proportion of meeting physical activity and screen time guidelines for children with vs.children without MBDD was larger than that among children aged 6-11 years.Furthermore,the above difference of meeting physical activity guidelines in ethnic minority children was smaller than that in white children.Conclusion:Children with MBDDs were less likely to meet individual or combined 24-hour movement guidelines than children without MBDDs.In educational and clinical settings,the primary focus should be on increasing physical activity and limiting screen time in children aged 12-17 years who have MBDDs;and specifically for white children who have MBDDs,increasing physical activity may help.

Launch of “Maternal and Child Health in China” Campaign

On the morning of June 28,2014,under the joint guidance of National Health and Family Planning Commission(NHFPC)and All-China Women's Federation,the launching ceremony of "Maternal and Child Health in China"campaign was held in Beijing.It was jointly organized by Maternal and Child Health Center of Chinese Center for Disease Control and Prevention,China Women Activity Center and

The Uptake and Distribution Evidence of Nano-and Microplastics in vivo after a Single High Dose of Oral Exposure

Objective Tissue uptake and distribution of nano-/microplastics was studied at a single high dose by gavage in vivo.Methods Fluorescent microspheres(100 nm,3μm,and 10μm)were given once at a dose of 200 mg/(kg∙body weight).The fluorescence intensity(FI)in observed organs was measured using the IVIS Spectrum at 0.5,1,2,and 4 h after administration.Histopathology was performed to corroborate these findings.Results In the 100 nm group,the FI of the stomach and small intestine were highest at 0.5 h,and the FI of the large intestine,excrement,lung,kidney,liver,and skeletal muscles were highest at 4 h compared with the control group(P<0.05).In the 3μm group,the FI only increased in the lung at 2 h(P<0.05).In the 10μm group,the FI increased in the large intestine and excrement at 2 h,and in the kidney at 4 h(P<0.05).The presence of nano-/microplastics in tissues was further verified by histopathology.The peak time of nanoplastic absorption in blood was confirmed.Conclusion Nanoplastics translocated rapidly to observed organs/tissues through blood circulation;however,only small amounts of MPs could penetrate the organs.

Health related quality of life in paediatric chronic health conditions: A comparative study among children and adolescents in Jordan

The major aim of the current study is to understand health related quality of life (HRQoL) domains from children’s own perspective. Specifically, we aim to determine the HRQoL in childhood chronic illnesses and to compare scores with healthy children. A cross-sectional study design with a total of 149 chronically ill children and 162 healthy participants was consecutively enrolled in this study. The Arabic-PedsQLTM-Version 0.4 Scales were used to assess HRQoL in both groups. Results showed that the chronically ill children reported more problems with physical, emotional and school functioning (all significant at

Association of the Common Genetic Variant Upstream of INSIG2 Gene with Obesity Related Phenotypes in Chinese Children and Adolescents

Objective To study the association between the rs7566605 variant of INSIG2 and obesity-related phenotypes in Chinese children and adolescents. Methods The study sample consisted of two independent cohorts of Chinese children and adolescents. Anthropometric indices, lipids, blood pressure, fasting glucose, insulin and percentage of fat mass were determined. PCR with restriction fragment length polymorphism analysis was performed for genotyping the rs7566605 variant. Results In each of the two independent cohorts, no significant association was observed between rs7566605 and obesity under additive, dominant or recessive model. We also did not detect any difference in the genotype frequency between all the obese children and controls. Furthermore, we did not find evidence of an association between body composition indices and metabolic phenotypes in all children. However, the triglyceride level of CC homozygotes was significantly higher than that of GG＋GC genotypes in obese children （P=0.022）. Additionally, we observed a non-significant trend of severe obesity in a post-hoc test. Conclusion INSIG2 rs7566605 variant is not associated Chinese childhood obesity in two independent cohorts. Further study is needed to verify the effect of rs7566605 on triglyceride in obese children.

Determining Optimal Strategies to Reduce Maternal and Child Mortality in Rural Areas in Western China: an Assessment Using the Lives Saved Tool

China, as a whole, is about to meet the Millennium Development Goals for reducing the maternal mortality ratio (MMR) and infant mortality rate (IMR), but the disparities between rural area and urban area still exists. This study estimated the potential effectiveness of expanding coverage with high impact interventions using the Lives Saved Tool (LiST). It was found that gestational hypertension, antepartum and postpartum hemorrhage, preterm birth, neonatal asphyxia, and neonatal childhood pneumonia and diarrhea are still the major killers of mothers and children in rural area in China. It was estimated that 30% of deaths among 0-59 month old children and 25% of maternal deaths in 2008 could be prevented in 2015 if primary health care intervention coverage expanded to a feasible level. The LiST death cause framework, compared to data from the Maternal and Child Mortality Surveillance System, represents 60%-80% of neonatal deaths, 40%-50% of deaths in 1-59 month old children and 40%-60% of maternal deaths in rural areas of western China.

Trends of incidence rate and age at diagnosis for cervical cancer in China,from 2000 to 2014

Objective： To analyze the trends of incidence rate and age at diagnosis for cervical cancer incidence in China using population-based cancer registration data from 2000 to 2014. Methods： Data were from National Central Cancer Registry of China. Crude incidence rates （CIRs）, age-specific incidence rate, age-standardized incidence rates （ASIRs）, age percentage distribution, standardized age percentage distribution, mean age at diagnosis and standardized mean age at diagnosis for cervical cancer in all areas of China, urban China and rural China were calculated separately. The world Segi＇s population was applied to remove the age structure influence. Joinpoint regression was performed to obtain average annual percent change （AAPC） and age- period-cohort analysis was used to examine the incidence trends. Results： CIRs and ASIRs for cervical cancer increased in China from 2000 to 2014. The AAPC of ASIRs in China was at 9.2% [95% confidence interval （95% CI）： 7.0%-I 1.5%, P〈0.05], and the AAPC in rural areas was relatively high. The age-specific incidence rate in groups aged 0-69 years have significantly increased over time. Groups aged 40-69 years showed the highest incidence risk, and the annual percent changes （APCs） of incidence rate in groups aged 40-59 years in urban China and groups aged 0-49 years in rural China were more than 10%. For each age group, the urban-to-rural incidence rate ratios （IRRs） got close to 1 over time. There were clear birth cohort effects in successive generations born from 1940 to 1970 in China. In rural China, the standardized mean age at diagnosis had significantly declined by 5.18 years. In China, the main peak and secondary peak of standardized age percentages appeared in the groups aged 45-49 and 40-44 years, respectively. In rural China, the main peak of standardized age percentage moved from the group aged 55-59 years to the group aged 45-49 years, and the standardized age percentages of groups aged 25-34 years also increased. In China, the standardized age percentages has significantly increased in groups aged 35-64 and 30-64 years over time, and accounted for about 80% and 85% in 2014, respectively. Conclusions： The cervical cancer incidence increased in China and the gap of incidence between urban and rural China was narrowed. The trends of increasing cervical cancer incidence among younger women existed in China, especially in rural China. A more appropriate screening, vaccination and health education strategies should be established.

Effects of Chronic Administration of Melatonin on Spatial Learning Ability and Long-term Potentiation in Lead-exposed and Control Rats

Objective To explore the changes in spatial learning performance and long-term potentiation （LTP） which is recognized as a component of the cellular basis of learning and memory in normal and lead-exposed rats after administration of melatonin （MT） for two months. Methods Experiment was performed in adult male Wistar rats （12 controls, 12 exposed to melatonin treatment, 10 exposed to lead and 10 exposed to lead and melatonin treatment）. The lead-exposed rats received 0.2% lead acetate solution from their birth day while the control rats drank tap water. Melatonin （3 mg/kg） or vehicle was administered to the control and lead-exposed rats from the time of their weaning by gastric gavage each day for 60 days, depending on their groups. At the age of 81-90 days, all the animals were subjected to Morris water maze test and then used for extracellular recording of LTP in the dentate gyrus （DG） area of the hippocampus in vivo. Results Low dose of melatonin given from weaning for two months impaired LTP in the DG area of hippocampus and induced learning and memory deficit in the control rats. When melatonin was administered over a prolonged period to the lead-exposed rats, it exacerbated LTP impairment, learning and memory deficit induced by lead. Conclusion Melatonin is not suitable for normal and lead-exposed children.

Eye-movement Patterns of Chinese Children with Developmental Dyslexia during the Stroop Test

Objective To compare the eye-movement patterns of Chinese children with developmental dyslexia（DD children） with those of non-dyslexic children as they perform the Stroop Color and Word Test（SCWT）, and to explore the relationship between their eye-movement patterns and interference effect. Methods An EyeLink II was used to record the eye-movement parameters of 32 DD children and 37 non-dyslexic children as they performed the SCWT. The independent samples t-test and repeated measures were used to analyze behavioral and eye-movement parameters. Results Compared to the control group, Chinese DD children presented lower accuracy（F = 8.488）, slower response time（F = 25.306）, and larger interference effect（t = 2.29）; Chinese DD children also exhibited lower frequency of fixations（F = 6.069）, greater numbers of saccades（F = 7.914） and fixations（F = 5.272）, and shorter mean saccade distance（F = 4.03）. All behavioral and eye-movement parameters differed significantly among the three tasks in the SCWT. There was significant interaction between groups and tasks in accuracy（F = 5.844）, and marginally significant interaction in response time（F = 3.040）. Chinese DD children tended to have lower accuracy and longer response time than the control group in the ＇color-word naming＇ task. Conclusion Compared to non-dyslexic children, Chinese DD children are subject to a stronger interference effect. When performing the SCWT, Chinese DD children exhibit abnormal eye-movement patterns, namely shorter mean saccade distance, lower frequency of fixations, and more fixations and saccades. These abnormal eye movements may be relatively stable oculomotor patterns of DD children performing visual processing, and not influenced by impaired interference effect.

Evidence on Invasion of Blood,Adipose Tissues,Nervous System and Reproductive System of Mice After a Single Oral Exposure:Nanoplastics versus Microplastics

Objective This study was designed to provide the evidences on the toxicokinetics of microplastics(MPs)and nanoplastics(NPs)in the bodies of mammals.Methods 100 nm,3μm,and 10μm fluorescent polystyrene(PS)beads were administered to mice once by gavage at a dose of 200 mg/kg body weight.The levels and change of fluorescence intensity in samples of blood,subcutaneous fat,perirenal fat,peritesticular fat,cerebrum,cerebellum,testis,and epididymis were measured at 0.5,1,2,and 4 h after administration using an IVIS Spectrum small-animal imaging system.Histological examination,confocal laser scanning,and transmission electron microscope were performed to corroborate the findings.Results After confirming fluorescent dye leaching and impact of pH value,increased levels of fluorescence intensity in blood,all adipose tissues examined,cerebrum,cerebellum,and testis were measured in the 100 nm group,but not in the 3 and 10μm groups except in the cerebellum and testis at 4 h for the 3μm PS beads.The presence of PS beads was further corroborated.Conclusion After a single oral exposure,NPs are absorbed rapidly in the blood,accumulate in adipose tissues,and penetrate the blood-brain/testis barriers.As expected,the toxicokinetics of MPs is significantly size-dependent in mammals.

Development of Orthographic Awareness, Morphological Awareness and Rapid Automatized Naming of Elementary-level Students in China： A Longitudinal Analysis from Grades 1 to 4

The longitudinal study sought to examine the dynamic development of cognitive skills for reading among elementary-level students in China's Mainland. Two groups of students in first （n=164, mean age=6.65 years at first test） and second grade （n=202, mean age=7.73 years at first test） were followed on orthographic awareness, morphological awareness and rapid automatized naming （RAN） for two years. The children exhibited significant improvement in orthographic awareness, morphological awareness and RAN from grades 1 to 4. More importantly, to the orthographic and morphological awareness, while the children took a leap from grade 1 to 2 and grade 3 to 4, the progress developed at relatively slow rates from grade 2 to 3. In order to assure children＇s development of orthographic and morphological awareness, evidence-based orthographically and morphologically enhanced instruction is needed for Chinese children in the early elementary years, especially for those at the stage from grade 2 to 3.

A Controlled Study of the Effectiveness of EEG Biofeedback Training on Children with Attention Deficit Hyperactivity Disorder

In order to study the treatment of the children with attention deficit hyperactivity disorder (ADHD), the integrated visual and auditory continuous performance test (IVA-CPT) was clinically applied to evaluate the effectiveness of electroencephalogram (EEG) biofeedback training. Of all the 60 children with ADHD aged more than 6 years, the effective rate of EEG biofeedback training was 91.6 % after 40 sessions of EEG biofeedback training. Before and after treatment by EEG biofeedback training, the overall indexes of IVA were significantly improved among predominately inattentive, hyperactive, and combined subtype of children with ADHD (P<0.001). It was suggested that EEG biofeedback training was an effective and vital treatment on children with ADHD.

Influencing Factors of Mental Health of Medical Students in China

Summary： This study investigated the mental health status of medical students in China, and analyzed the influencing factors in order to provide evidence for mental health education for medical students. A stratified cluster sampling method was used to recruit medical students from Huazhong University of Science and Technology, China. The questionnaire survey on general information and Symptom Checklist 90 （SCL-90） were used for investigation and analysis. The results showed among the 1137 valid questionnaires, 278 （24.45%） participants had SCL-90 score ≥ 160. The top three mental problems of medical students were obsessive-compulsive disorder, interpersonal sensitivity and depression in terms of the factor score ≥ 2.5 and the number of participants who reflected on the diseases. The third-year medical students had the worst mental health status, and fifth-year medical students had the best mental health status. Students from rural area had more psychological problems than those from urban area; furthermore, students with high professional satisfaction, those who were the single child of the family, non-poor students, and those whose parents had high education level had better mental health status. It was concluded that the mental health of medical students is not optimistic in China. Medical students have some mental health problems of different degrees. Factors that influence the mental health of medical students include academic pressure, professional satisfaction level and family environment.

Role of urocortin in pregnancy: An update and future perspectives

The activities of corticotropin-releasing factor(CRF) and related peptides are mediated a number of receptors with seven transmembrane domains that are coupled to the Gs and Gq proteins. These receptors are known as CRF-Rs. In vitro studies have evidenced that urocortin(UCN) and CRF provoke an increase in the contractility of the uterus which is induced by endometrial prostaglandin F2 a. Furthermore, through trophoblasts, it stimulates the secretion of adrenocorticotropic hormone(ACTH) and prostaglandin PGE2 and has a vasodilatory effect on the placenta. While it is well known that the placenta produces considerable quantities of CRF, several studies have, however, excluded that the placenta can generate significant quantities of UCN. In the short term, the human fetal adrenal gland produces more cortisol and dehydroepiandrosterone sulfate. The gestational tissues express UCN3 and UCN2 m RNA in cytotrophoblast and syncytiotrophoblast cells, while UCN2 is only to be found in the maternal and fetal vessels and amniotic cells. Nevertheless, gestational tissues express UCN2 and UCN3 differentially and do not stimulate placental ACTH secretion. In term pregnancies, maternal plasma levels of CRF and UCN are lower than at the beginning of pregnancy and are correlated to labor onset. Conversely,they do not decrease in post-term pregnancies. This evidence would seem to indicate that the fine-regulated expression of these neuropeptides is important in determining the duration of human gestation. In this scenario, low concentrations of UCN in the amniotic fluid at mid-term may be considered a sign of predisposition to preterm birth.

Experiences of women with the support they received from their birth companions during labour and delivery in Malawi

A study was conducted to describe the experiences of primiparous women with the support they received from their birth companions during labour and delivery in Malawi. The study design was descriptive and utilized qualitative data collection and analysis method on a sample of 20 primiparous women. The women were recruited from the postnatal ward of Bwaila hospital and were interviewed regarding their experiences on the support they received from their birth companions during labour and delivery using an open ended interview guide. Data was manually analyzed using content analysis. Primiparous women described the support they received from their birth companions as useful and beneficial. Birth companions provided advice, physical, emotional and spiritual support to the women during their labour and delivery. In addition, the birth companions were viewed as guardians of the women during labour and delivery. Results however, show that some women were not properly assisted by their companions because both the mothers and companions lacked knowledge on birth companionship. The results further show that birth companions play important roles during the birth and delivery of primiparous women and thereby improving birth outcomes. Therefore, there is a need to train the companions regarding support to a woman during labour and delivery. Primiparous women also need to be trained during antenatal care education so that they properly understand the roles of a birth companion as opposed to those of the midwives.

Parity and Risk of Ovarian Cysts： Cross-Sectional Evidence from the Dongfeng-Tongji Cohort Study

Little is known about the association between parity and the risk of ovarian cysts. The aim of this study was to examine the association between parity and the risk of ovarian cysts among a population of Chinese women. A total of 20 502 women aged 45–86 years from the Dongfeng-Tongji Cohort study completed baseline questionnaires, medical examination and provided baseline blood samples. Participants were categorized into four groups according to parity（one, two, three, and four or more live births）. Logistic regression models were used to investigate the association between parity and the risk of ovarian cysts. The prevalence of ovarian cysts in the study population was 4.0%（816/20 502）. Increasing parity was associated with decreasing risk of ovarian cysts without adjustment for any covariates and after age-adjusted model（P〈0.001）. After adjusting for potential confounders, women who had had four or more live births had lower risk of ovarian cysts（OR： 0.51; 95% CI： 0.27–0.96） compared with women who had had one live birth. There was a consistent but non-significant decreased risk of ovarian cysts for women who had had two, and three live births（OR： 0.85; 95% CI： 0.68–1.05） and（OR： 0.84; 95% CI： 0.59–1.20） respectively compared with women who had had one live birth. It was concluded that higher parity was associated with decreasing risk of ovarian cysts in this population of Chinese women. These findings could be helpful in decision making in clinical practice for gynecologists when evaluating women suspected to have ovarian cysts.

Genome-wide Association Studies of Common Obesity: Now and Future

Obesity has become a major public health concern worldwide. Obesity is a complex disease influenced by both genetic and environmental factors. Epidemiological studies have indicated that environmental factors, such as excessive energy intake and lack of physical activity, might contribute to the development of obesity. Genetic factors also play an important role in the pathogenesis of obesity Indeed, approximately 40%-70% of the variation in body mass index （BMI） can be attributed to genetic factors.

Postcoital Administration of Asoprisnil Inhibited Embryo Implantation and Disturbed Ultrastructure of Endometrium in Implantation Window in Mice

Asoprisnil, a member of the selective progesterone receptor modulators, exerts high proges- terone receptor selectivity, endometrial targeted advantages and significant anti-implantation effect in rats. The purpose of this study was to confirm the anti-implantation effect of asoprisil, investigate the ultrastructural changes of the peri-implantation endometrium in mice and explore the effect of asoprisnil on endometrial receptivity and its targeted contraceptive proficiency. Post-coitus mice were adminis- tered with different dosages （0.2, 0.1, 0.05 mg·g^-1·day^-1） of asoprisnil from day 1 of pregnancy to day 3. Then 3 animals in each group were killed on day 5 of pregnancy, and uteri were collected to examine the ultrastructural changes of endometria under a transmission electron microscope （TEM）. A total of 80 animals were sacrificed on day 8 of pregnancy, and the uterine horns were examined for the presence or absence of nidation sites and the number of implantation embryos. The results showed that the implan- tation rate and the average number of implantation embryos in asoprisnil groups were statistically sig- nificantly decreased as compared with the vehicle control group （P〈0.05）. The TEM results revealed that, in vehicle control group, the tight junction between the luminal epithelia cells was short and straight, the gap was wide; the luminal epithelia cells were covered with plenty of short, clavate and neatly arranged microvilli; the endometril stromal cells were large with plenty of cytoplasm, and showed significant decidual change; there was more than one nucleus in stromal cells, and the karyotheca was integrity. In low dosage and high dosage asoprisnil groups, the tight junction was longer and more curve than in the vehicle control group; microvilli were uneven and asymmetrically distrib- uted in luminal epithelia; the stromal cells were small and the decidual change was not significant; there were karyopyknosis and karyolysis in stromal cells; there were abnormal thick-wall vessels in the en- dometrium. It was suggested that asoprisnil changed the ultrastructure of the endometrium in implantation window, disturbed the endometrial receptivity and finally resulted in embryo implantation failure.

Service Functions of Private Community Health Stations in China: A Comparison Analysis with Government-sponsored Community Health Stations

In China, with the restructuring of health care system moving forward, private community health facilities have been playing a complementary but increasingly important role in providing public health and basic medical care services in urban areas. However, only limited evidence is available con-cerning the service functions of private community health facilities in China. The aim of this study was to explore the functions of private community health stations (PCHSs) to provide evidence-based rec-ommendations for policy-making and practice in the development of urban community health services systems. A total of 818 PCHSs and 4320 government-sponsored community health stations (GCHSs) located in 28 cities of China were investigated in 2008. The percentages of stations that provided health services and the annual workload per community health worker (CHW) were compared between the two types of institutions. The results showed that the percentages of PCHSs providing public health services were significantly higher than those of GCHSs (P<0.05); but no significant differences were found in the percentages of basic medical services providing between PCHSs and GCHSs (P>0.05). The annual workloads of all the public health services and basic medical services per CHW in PCHSs were lighter than those in GCHSs (P<0.05), except for resident health records establishment and health education materials distribution (P>0.05). At present, the GCHSs are still the mainstream in urban China, which will last for a long period in future. However, our findings showed that the annual workloads of CHWs in PCHSs were no heavier than those in GCHSs, and the PCHSs were willing to provide public health services. In view of current inadequacy of health resources in China, it is feasible to further develop PCHSs under the guidance of the government, given that PCHSs can perform the basic functions of community health services, which is useful for the formation of public-private partnerships (PPP) and the improvement of community health services.

Non-inclusion of certified herbal medicines in the National Health Insurance Scheme affects patient utilization of the integrated herbal medicine services in Ghana

Background:In 2011,Ghana piloted the integration of herbal medicine services into mainstream health care delivery in selected government hospitals across the country.To date,however,no single certified herbal drug is generally covered by the national health insurance scheme.This study evaluated the implications of out-of-pocket payment for prescriptions on the patronage of herbal medicine units in 3 selected government hospitals within Kumasi Metropolis.Methods:A cross-sectional study on 413 participants was performed using a semi-structured questionnaire.Results:The majority of study respondents were female(54%),and the median age was 35 years.Most participants(83.1%)were aware that herbal medicine was integrated in the mainstream health care system of the country.Regarding the costs of certified herbal drugs,51.5%of respondents considered them very expensive;72.1%of the respondents believed that the costs of certified herbal drugs adversely affected the utilization of herbal units at government hospitals,which produced a positive correlation(r=0.5498).A total of 99.5%of the respondents recommended the inclusion of certified herbal drugs on the national health insurance drug list.Conclusion:This study revealed that the costs of certified herbal medicines negatively affect utilization of herbal units at government hospitals.To improve the utilization of herbal units,certified herbal drugs dispensed at these units must thus be included in the national health insurance drug list.