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A new approach to dose reference levels in pediatric CT: Age and size-specific dose estimation. Radiat Phys Chem Oxf Engl 1993 2023. [DOI: 10.1016/j.radphyschem.2022.110698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Sex differences in the application of WHO standards to Shanghai infants from birth to 18 months. Early Hum Dev 2019; 140:104907. [PMID: 31707262 DOI: 10.1016/j.earlhumdev.2019.104907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 09/25/2019] [Accepted: 10/14/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND The number of obese children in Shanghai has increased annually. Shanghai growth standards are higher than the World Health Organization's (WHO's) growth standards, which may influence caregiver feeding practices and enhance the risk of overweight in infants. METHOD A cluster-randomized controlled trial analysed 15,019 infants (healthy newborns, ≥3 clinical consultations in one year) from 19 community health service centers in two urban areas in Shanghai. Randomization was performed at the community level. A total of 8510 infants in the S-group were assessed with the Shanghai growth standards, and 6509 infants in the W-group were assessed by the WHO growth standards. Follow-up data were collected at 1, 2, 4, 6, 9, 12 and 18 months. Changes in the weight-for-age z score (WAZ), length-for-age z score (LAZ), and weight-for length z score (WLZ) were assessed using mixed regression models. Sex differences were compared between groups at all follow-up periods. RESULTS Compared to the S-group, the percent of overweight in boys in the W-group significantly decreased starting at 9 months (4.9% vs 3.3%, P = 0.011 at 9 months, 4.5% vs 2.5%, P < 0.001 at 12 months and 3.1% vs 0.8%, P < 0.001 at 18 months), and the percent of overweight in girls in the W-group significantly decreased starting at 12 months (3.0% vs 1.8%, P = 0.009 at 12 months and 1.7% vs 0.6%, P = 0.039 at 18 months). A decreased weight in boys (from 4 months to 18 months, P < 0.05) and an increased length in girls (from 6 months to 18 months, P < 0.05) were the key reasons for the decreased overweight percentage in the W-group. CONCLUSION The adoption of the WHO growth standards could result in markedly decreased weight gain in boys and increased length gain in girls beyond the age of 18 months among urban Shanghai infants. TRIAL REGISTRATION NUMBER ChiCTR1800015371.
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Wang P, Hao M, Han W, Yamauchi T. Factors associated with nutritional status and motor development among young children. Nurs Health Sci 2019; 21:323-329. [PMID: 30989749 DOI: 10.1111/nhs.12604] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 11/27/2018] [Accepted: 12/30/2018] [Indexed: 12/19/2022]
Abstract
This study was conducted to investigate the nutritional status and gross motor development of children in a suburban area of northeast China and the factors influencing these issues. A total of 189 children aged 1-3 years and their mothers participated. Child and maternal length/height and weight were measured. Information was collected on basic characteristics, household monthly income, child's age at achievement of six gross motor milestones, and feeding practices by interviewing the mothers/caregivers. The prevalence of overweight (using World Health Organization growth standards) and delayed achievement of walking alone among the children was 27% and 12.7%, respectively. The independent predictors of increased odds for being overweight were middle household income and high dietary diversity score. Exclusive breastfeeding was associated with lower odds of children being overweight. Delayed solid feeding initiation was associated with increased odds of delay in walking alone for the children. Breastfeeding predicted reduced odds of this issue. These findings suggest that nutritional intervention and childcare education, such as breastfeeding promotion, improved diet quality, and the timely introduction of solid food, could improve growth and development among young children in suburban northeast China.
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Affiliation(s)
- Peipei Wang
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Ming Hao
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan
| | - Wei Han
- Community Health Service Center, Wolong Hospital, Benxi City, Liaoning, China
| | - Taro Yamauchi
- Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan
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Sorrie MB, Yesuf ME, GebreMichael TG. Overweight/Obesity and associated factors among preschool children in Gondar City, Northwest Ethiopia: A cross-sectional study. PLoS One 2017; 12:e0182511. [PMID: 28787013 PMCID: PMC5546603 DOI: 10.1371/journal.pone.0182511] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 07/12/2017] [Indexed: 11/25/2022] Open
Abstract
Background Overweight and obesity among children has emerged as one of the most serious public health concerns in the 21st century, which is a predictor of adulthood obesity, morbidity and mortality. The objective of this study was to assess the prevalence of overweight /obesity and associated factors among preschool children. Methods A community based cross-sectional study was conducted in Gondar City from February 14 to March 4, 2016. Multi stage sampling technique was used to select a total of 504 preschool children. Data were collected using structured interviewer administered questionnaire and anthropometric measurements. Data were entered using Epidata version 3.1 and analyzed using SPSS version 20 and WHO 2007 Anthro version 2.0.4 software. Both bivariate and multivariate logistic regression analysis were performed to identify associated factors. P values <0.05 with 95% confidence level were used to declare statistical significance. Results A total of 500 study participants were included with 99.2% response rate and 51.6% were girls while 48.4% were boys. The mean (±SD) age of participants was 47.68 ±7.19 months. The combined prevalence of overweight /obesity was 13.8% (95%CI; 10.6, 17.2) the specific being 9.6% for overweight and 4.2% for obesity. The multivariable analysis indicated that the age group between 36–47 months [AOR = 2.38 (95%CI; 1.27,4.46)],high dietary diversity[AOR = 3.73(95%CI;1.15,12.54),consumption of sweet food[AOR = 2.69 (95%CI,1.21, 5.98)],time spent in watching television>2hr/day [AOR = 4.01 (95%CI;2.22, 7.26)] and mother’s education at secondary level [AOR = 0.35 (95% CI; 0.12, 0.96)] were associated with overweight/obesity among preschool children. Conclusions Once considered a high income country problem, result of this study in urban city like Gondar reveals that overweight/obesity is on the rise in urban Ethiopia, which indicates the need for formulating preventive programs and policies during a child’s early years.
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Affiliation(s)
- Muluken Bekele Sorrie
- Arbaminch University College of Medicine and Health Sciences Department of Midwifery, Arbaminch, Ethiopia
| | - Melkie Edris Yesuf
- University of Gondar College of Medicine and Health Sciences Institute of Public Health, Gondar, Ethiopia
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Wu Y, Qi D. Regional Disparities in China in the Prevalence of Children Who Are Obese or Overweight. SOCIAL WORK IN PUBLIC HEALTH 2017; 32:1-10. [PMID: 27559769 DOI: 10.1080/19371918.2016.1160350] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
China has experienced rapid socioeconomic transitions during the last three decades, which may result in a rising prevalence of overweight and obese children in China. This article aims to fill in the existing knowledge gap by an analysis of the China Health and Nutrition Survey data to study the national prevalence of children who are overweight and obese as well as how the regional disparities and age differences in prevalence have changed between 1989 and 2009.
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Affiliation(s)
- Yichao Wu
- a School of Economics and Management, Southeast University , Nanjing , China
| | - Di Qi
- b Department of Sociology, Hohai University , Nanjing , China
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Feng A, Wang L, Chen X, Liu X, Li L, Wang B, Luo H, Mo X, Tobe RG. Developmental Origins of Health and Disease (DOHaD): Implications for health and nutritional issues among rural children in China. Biosci Trends 2016; 9:82-7. [PMID: 26173293 DOI: 10.5582/bst.2015.01008] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
In China, with fast economic growth, health and nutrition status among the rural population has shown significant improvement in the past decades. On the other hand, burden of non-communicable diseases and prevalence of related risk factors such as overweight and obesity has also increased. Among rural children, the double burden of malnutrition and emerging overweight and obesity has been neglected so far. According to the theory of Developmental Origin of Health and Diseases (DOHaD), malnutrition, including both undernutrition (stunting and wasting) and over-nutrition (overweight and obesity) during childhood is closely related to worsened health outcomes during adulthood. Such a neglected problem is attributable to a complicated synergy of social and environmental factors such as parental migration, financial situation of the household, child-rearing knowledge and practices of the primary caregivers, and has implications for public health. Based on literature review of lessons from the field, intervention to address malnutrition among rural children should be a comprehensive package, with consideration of their developmental environment and geographical and socioeconomic diversity. The scientific evidence on DOHaD indicates the probability and necessity of prevention of adult disease by promotion of maternal and child health and reducing malnutrition by provision of high-quality complementary foods, promotion of a well-balanced dietary pattern, and promotion of health literacy in the public would bring a potential benefit to reduce potential risk of diseases.
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A multilevel analysis of the relationship between parental migration and left-behind children's macronutrient intakes in rural China. Public Health Nutr 2015; 19:1913-27. [PMID: 26641518 PMCID: PMC4974629 DOI: 10.1017/s1368980015003341] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE China's internal migration has left 61 million children living apart from their parent(s) in rural areas. The present study aimed to examine whether the relative contributions of macronutrients (protein, fat and carbohydrate) to total energy intake differ between children left behind by the father or mother, compared with children from intact families. DESIGN Drawing on a longitudinal study, the China Health and Nutrition Survey (1997-2009), multilevel modelling analyses (level 1: occasions; level 2: children; level 3: villages) were performed. SETTING Data from rural communities in nine provinces in China. SUBJECTS Rural children (n 975; 555 boys and 420 girls) from 140 villages. RESULTS Among boys of school age, being left behind by the father tended to reduce the relative protein intake by 0·70 % (P<0·01) compared with boys from intact families. Being left behind by at least the mother was more detrimental for young boys under the age of 6 years than paternal migration, reducing relative protein intake by 1·14 % (P<0·05). Parental migration was associated with a significant increase in young boys' relative fat intake by 2·60 % (P<0·05). No significant associations were found for girls. Results suggest left-behind boys, especially in early life, are subject to a higher-fat and lower-protein diet compared with non-left-behind boys. This may put them at increased risk of being overweight or obese, or of suffering from stunted growth, when they grow up. CONCLUSIONS Public health policies should recognise the influences of parental migration on boys, especially maternal migration, and encourage a more balanced diet for children in rural China.
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Zhang N, Bécares L, Chandola T, Callery P. Intergenerational differences in beliefs about healthy eating among carers of left-behind children in rural China: A qualitative study. Appetite 2015; 95:484-91. [DOI: 10.1016/j.appet.2015.08.024] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 08/11/2015] [Accepted: 08/18/2015] [Indexed: 10/23/2022]
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Xiao Y, Qiao Y, Pan L, Liu J, Zhang T, Li N, Liu E, Wang Y, Liu H, Liu G, Huang G, Hu G. Trends in the Prevalence of Overweight and Obesity among Chinese Preschool Children from 2006 to 2014. PLoS One 2015; 10:e0134466. [PMID: 26267264 PMCID: PMC4534378 DOI: 10.1371/journal.pone.0134466] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 07/10/2015] [Indexed: 01/21/2023] Open
Abstract
Objective To examine the trends in the prevalence of overweight and obesity among preschool children from 2006 to 2014. Methods A total of 145,078 children aged 3–6 years from 46 kindergartens finished the annual health examination in Tianjin, China. Height, weight and other information were obtained using standardized methods. Z-scores for weight, height, and BMI were calculated based on the standards for the World Health Organization (WHO) child growth standards. Results From 2006 to 2014, mean values of height z-scores significantly increased from 0.34 to 0.54, mean values of weight z-scores kept constant, and mean values of BMI z-scores significantly decreased from 0.40 to 0.23. Mean values of height z-scores, weight z-scores, and BMI z-scores slightly decreased among children from 3 to 4 years old, and then increased among children from 4 to 6 years old. Between 2006 and 2014, there were no significant changes in prevalence of overweight (BMI z-scores >2 SD) and obesity (BMI z-scores >3 SD) among 3–4 years children. However, prevalence of obesity (BMI z-scores >2 SD) increased from 8.8% in 2006 to 10.1% in 2010, and then kept stable until 2014 among 5–6 years children. Boys had higher prevalence of obesity than girls. Conclusions Mean values of BMI z-scores decreased from 2006 to 2014 among Chinese children aged 3–6 years old due to the significant increase of height z-scores. Prevalence of obesity increased from 2006 to 2010, and then kept stable until 2014 among children aged 5–6 years. The prevalence of obesity was higher in boys than in girls.
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Affiliation(s)
- Yanyu Xiao
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yijuan Qiao
- Tianjin Women’s and Children’s Health Center, Tianjin, China
- Chronic Disease Epidemiology Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, United States of America
| | - Lei Pan
- Tianjin Women’s and Children’s Health Center, Tianjin, China
| | - Jin Liu
- Tianjin Women’s and Children’s Health Center, Tianjin, China
| | - Tao Zhang
- Tianjin Women’s and Children’s Health Center, Tianjin, China
| | - Nan Li
- Tianjin Women’s and Children’s Health Center, Tianjin, China
| | - Enqing Liu
- Tianjin Women’s and Children’s Health Center, Tianjin, China
| | - Yue Wang
- Tianjin Women’s and Children’s Health Center, Tianjin, China
| | - Hongyan Liu
- Tianjin Women’s and Children’s Health Center, Tianjin, China
| | - Gongshu Liu
- Tianjin Women’s and Children’s Health Center, Tianjin, China
| | - Guowei Huang
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China
- * E-mail: (GH); (GWH)
| | - Gang Hu
- Chronic Disease Epidemiology Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, United States of America
- * E-mail: (GH); (GWH)
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Al Mahrooqi KMS, Ng CKC, Sun Z. Pediatric Computed Tomography Dose Optimization Strategies: A Literature Review. J Med Imaging Radiat Sci 2015; 46:241-249. [PMID: 31052099 DOI: 10.1016/j.jmir.2015.03.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2014] [Revised: 02/20/2015] [Accepted: 03/23/2015] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Computed tomography (CT) dose optimization is an important issue in radiography because CT is the largest contributor to medical radiation dose and its use is increasing. However, CT dose optimization for pediatric patients could be more challenging than their adult counterparts. The purpose of this literature review was to identify and discuss the current pediatric CT dose saving techniques. Optimized pediatric protocols were also proposed. METHODS A comprehensive literature search was conducted using the Medline, ProQuest Health and Medical Complete, PubMed, ScienceDirect, Scopus, Springer Link, and Web of Science databases and the keywords CT, pediatric, optimization, protocol, and radiation dose to identify articles focusing on pediatric CT dose optimization strategies published between 2004 and 2014. RESULTS AND SUMMARY Seventy-seven articles were identified in the literature search. Strategies for optimizing a range of scan parameters and technical considerations including tube voltage and current, iterative reconstruction, diagnostic reference levels, bowtie filters, scout view, pitch, scan collimation and time, overscanning, and overbeaming for pediatric patients with different ages and body sizes and compositions were discussed. An example of optimized pediatric protocols specific to age and body size for the 64-slice CT scanners was devised. It is expected that this example could provide medical radiation technologists, radiologists, and medical physicists with ideas to optimize their pediatric protocols.
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Affiliation(s)
| | - Curtise Kin Cheung Ng
- Department of Medical Radiation Sciences, Curtin University, Perth, Western Australia, Australia.
| | - Zhonghua Sun
- Department of Medical Radiation Sciences, Curtin University, Perth, Western Australia, Australia
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