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Wood C, Rosati P, Lynn T. #Putkids1st: Health Professionals Using Social Media for Public Policy Advocacy-From Collective Action to Connective Action. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1343. [PMID: 37628342 PMCID: PMC10453826 DOI: 10.3390/children10081343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 07/26/2023] [Accepted: 08/01/2023] [Indexed: 08/27/2023]
Abstract
This study examines public policy advocacy by pediatricians and other health professionals in the hashtag community: #putkids1st. The study explores 4321 tweets that feature the hashtag, generated by 1231 unique users largely drawn from the American Association of Pediatricians and its members. The data are used to explore the structural dynamics of the hashtag community, the role of homophily, and to test a source-message framework to predict and recommendations to help improve engagement and retransmission of professional health advocacy messages.
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Affiliation(s)
- Charles Wood
- Collins College of Business, The University of Tulsa, Tulsa, OK 74104, USA;
| | - Pierangelo Rosati
- J.E. Cairnes School of Business and Economics, University of Galway, H91 YK8V Galway, Ireland
| | - Theo Lynn
- Irish Institute of Digital Business, Dublin City University, D09 RFK0 Dublin, Ireland;
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Van T, Varadi D, Adams AC, Feldman-Winter L. Promotion, Protection, and Support of Breastfeeding as a Human Right: A Narrative Review. Breastfeed Med 2023; 18:561-570. [PMID: 37428560 DOI: 10.1089/bfm.2023.0061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Background: Despite the benefits of breastfeeding, there are significant disparities in rates among various racial, social, and economic groups. Society poses various barriers to breastfeeding, threatening the child's access to a basic human right. Exploring and understanding these issues can ensure that effective interventions are implemented. Objective: To present situations in which the mother's and child's basic human right to breastfeeding is threatened and to highlight opportunities to uphold their rights within social and health care systems. Methods: A literature search of relevant articles was performed via PubMed regarding (1) rights to optimal protections for breastfeeding, (2) situations in which the rights of breastfeeding parents are threatened, and (3) challenges in providing inclusive and equitable breastfeeding care along with strategies to uphold the human right to breastfeed. Results: Maternity leave of at least 12 weeks was associated with higher breastfeeding rates, whereas mandated breaks in the workplace resulted in either positive or inconclusive effects. Peer counseling, institutional initiatives, and mass media campaigns were among the most effective interventions; however, effects on breastfeeding varied among different racial groups. Conclusions: There are clear benefits of breastfeeding for mothers and infants, which highlight the importance of prioritizing breastfeeding as a basic human right. Regardless, there are numerous societal barriers to providing equitable breastfeeding care. Although there are interventions that have proven to be helpful in breastfeeding promotion, protection, and support, further standardized research will be beneficial in identifying effective and inclusive interventions.
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Affiliation(s)
- Trina Van
- Cooper Medical School of Rowan University, Camden, New Jersey, USA
| | - Daphna Varadi
- Cooper Medical School of Rowan University, Camden, New Jersey, USA
| | - Amanda C Adams
- Medical Library, Cooper Medical School of Rowan University, Camden, New Jersey, USA
| | - Lori Feldman-Winter
- Department of Pediatrics, Children's Regional Hospital at Cooper University Healthcare-Cooper Medical School of Rowan University, Camden, New Jersey, USA
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Georgousopoulou V, Voutetakis A, Galanis P, Kourti FE, Zartaloudi A, Koutelekos I, Dousis E, Kosmidis D, Koutsouki S, Pappa D, Igoumenidis M, Dafogianni C. Assessing the Respect of Children's Rights in Pediatric Hospitals. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59050955. [PMID: 37241187 DOI: 10.3390/medicina59050955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/10/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023]
Abstract
Background and Objectives: In 1989, the United Nations (UN) General Assembly adopted the United Nations Convention on the Rights of the Child (UNCRC), with a considerable number of the Articles of the Convention being related to the health status of children. Therefore, adhering to and assessing the implementation of the rights of children during hospitalization is a very important step towards child protection. Herein, we attempt to highlight the depth of knowledge of employees working in children's hospitals with regard to children's rights as well as the degree of adherence to the UNCRC with respect to hospitalized children. Material and Methods: The target group included all healthcare professionals working in the various general pediatric clinics of the three Children's Hospitals of the Athens metropolitan area in Greece. We conducted a cross-sectional study, with data collection carried out in February and March 2020, using a structured questionnaire consisting of 46 questions which was handed out to all personnel. For the analysis, we used the IBM SPSS 21.0. Results: A total of 251 individuals participated in the study (physicians 20%, nurses 72%, and other employees 8%). A total of 54.5% of health professionals did not know what the UNCRC is, and 59.6% of them were not even aware that their hospital had rules and a bioethical committee related to clinical research involving children. Lack of awareness or trust of health professionals is also observed for other procedures or supervisory measures such as abuse protocols, complaint control, admission control, etc. With regard to the health system, there are shortcomings or weaknesses in (a) procedures followed with regard to respect for gender and privacy, (b) information on basic services provided by pediatric hospitals (such as recreation, education and free meals during hospitalization), (c) the logistical infrastructure (such as recreational facilities and facilities for the disabled), (d) the possibility of recording complaints, and (e) hospitalizations that were not necessary. A difference emerged concerning the nurses' responses between the three hospitals, with nurses participating in relevant seminars held in one of the hospitals being significantly more informed. Conclusions: The majority of healthcare personnel seem unaware of basic principles with respect to children's rights during hospitalization as well as relevant procedures and supervisory measures. Moreover, obvious weaknesses of the health system exist with respect to procedures, services, infrastructure, and complaint recording. There is a need for improved education of health professionals with respect to the implementation of children's rights in pediatric hospitals.
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Affiliation(s)
- Vasiliki Georgousopoulou
- 1st Department of Pediatrics, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Department of Pediatrics, University General Hospital of Alexandroupolis, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Antonis Voutetakis
- Department of Pediatrics, University General Hospital of Alexandroupolis, Democritus University of Thrace, 68100 Alexandroupolis, Greece
| | - Petros Galanis
- Center for Health Services Management and Evaluation, Department of Nursing, School of Health Sciences, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | | | | | | | - Evangelos Dousis
- Department of Nursing, University of West Attica, 12243 Athens, Greece
| | - Dimitrios Kosmidis
- Department of Nursing, International Hellenic University, 68300 Didimoteixo, Greece
| | - Sotiria Koutsouki
- Department of Nursing, General Hospital of Kavala, 65500 Kavala, Greece
| | - Despoina Pappa
- Department of Nursing, University of West Attica, 12243 Athens, Greece
| | - Michael Igoumenidis
- Department of Nursing, School of Health Rehabilitation Sciences, University of Patras, 26334 Patras, Greece
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Rocha HAL. Introduction to the Special Issue on Improving Early Childhood Nurturing Care to Support Childhood Development and Adult Health. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050806. [PMID: 37238354 DOI: 10.3390/children10050806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 04/27/2023] [Indexed: 05/28/2023]
Abstract
Background: Child development is an ongoing process that occurs from birth to adolescence and is shaped by various factors, such as genetics, the environment, and experiences [...].
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Schultz ML, Winn M, Derse AR, Kaczor F, Levas MN. Interactions With Police in the Emergency Care of Children: Ethical and Legal Considerations. Pediatr Emerg Care 2023; 39:226-229. [PMID: 36727807 PMCID: PMC10082052 DOI: 10.1097/pec.0000000000002908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVES Emergency medicine providers may interface with law enforcement personnel (LEP) on behalf of their pediatric patients for a variety of reasons, from reporting child abuse to caring for children who are in police custody. Given the unique nature of caring for minors who may not have legal or medical autonomy, interactions with LEP can raise ethical concerns for emergency providers, specifically with regard to legal representation, developmental immaturity, and the civil rights of children and their parents/guardians. METHODS We review 4 patient scenarios, based on real cases experienced by the authors, to demonstrate the legal and ethical issues that may arise when LEP are involved in the emergency care of a child. These scenarios discuss parental/guardian visitation for children in police custody in the emergency department (ED), the practice of making arrests on hospital grounds, and police interviews of children in the ED. RESULTS Using the ethical principles of autonomy, beneficence, and justice, we offer recommendations for emergency providers on how to advocate for their pediatric patients in LEP custody within the constraints and protections of the law. We also suggest best practices for hospital systems to develop policies surrounding LEP activity in the ED. CONCLUSIONS These nuanced situations require careful advocacy for the child and a collaborative approach between medical providers and LEP to balance the child's well-being with public safety. We offer recommendations here, and we maintain that clear, widely adopted best practices for the care of minors in LEP custody are long overdue.
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Affiliation(s)
- Megan L. Schultz
- From the Department of Pediatrics, Section of Emergency Medicine, Medical College of Wisconsin
| | - Madeline Winn
- From the Department of Pediatrics, Section of Emergency Medicine, Medical College of Wisconsin
| | - Arthur R. Derse
- Department of Emergency Medicine, Medical College of Wisconsin
| | | | - Michael N. Levas
- From the Department of Pediatrics, Section of Emergency Medicine, Medical College of Wisconsin
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Shur N, Tigranyan A, Daymont C, Regier DS, Raturi S, Roshan Lal T, Cleary K, Summar M. The past, present, and future of child growth monitoring: A review and primer for clinical genetics. Am J Med Genet A 2023; 191:948-961. [PMID: 36708136 DOI: 10.1002/ajmg.a.63102] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/11/2022] [Accepted: 12/13/2022] [Indexed: 01/29/2023]
Abstract
Child growth measurements are critical vital signs to track, with every individual child growth curve potentially revealing a story about a child's health and well-being. Simply put, every baby born requires basic building blocks to grow and thrive: proper nutrition, love and care, and medical health. To ensure that every child who is missing one of these vital aspects is identified, growth is traditionally measured at birth and each well-child visit. While the blue and pink growth curves appear omnipresent in pediatric clinics, it is surprising to realize that their use only became standard of care in 1977 when the National Center for Health Statistics (NCHS) adopted the growth curve as a clinical tool for health. Behind this practice lies a socioeconomically, culturally, and politically complex interplay of individuals and institutions around the world. In this review, we highlight the often forgotten past, current state of practice, and future potential of this powerful clinical tool: the growth reference chart, with a particular focus on clinical genetics practice. The goal of this article is to understand ongoing work in the field of anthropometry (the scientific study of human measurements) and its direct impact on modern pediatric and genetic patient care.
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Affiliation(s)
- Natasha Shur
- Rare Disease Institute, Children's National Research and Innovation Campus, Washington, District of Columbia, USA.,The Sheikh Zayed Institute for Pediatric Surgical Innovation Children's National Hospital, Washington, District of Columbia, USA
| | - Annie Tigranyan
- The Sheikh Zayed Institute for Pediatric Surgical Innovation Children's National Hospital, Washington, District of Columbia, USA
| | - Carrie Daymont
- Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Debra S Regier
- Rare Disease Institute, Children's National Research and Innovation Campus, Washington, District of Columbia, USA
| | - Sumant Raturi
- The Sheikh Zayed Institute for Pediatric Surgical Innovation Children's National Hospital, Washington, District of Columbia, USA
| | - Tamanna Roshan Lal
- The Sheikh Zayed Institute for Pediatric Surgical Innovation Children's National Hospital, Washington, District of Columbia, USA
| | - Kevin Cleary
- The Sheikh Zayed Institute for Pediatric Surgical Innovation Children's National Hospital, Washington, District of Columbia, USA
| | - Marshall Summar
- The Sheikh Zayed Institute for Pediatric Surgical Innovation Children's National Hospital, Washington, District of Columbia, USA
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Ensuring Optimal Early Childhood Development Globally: Optimism about the Increasing Role of Pediatricians. J Dev Behav Pediatr 2023; 44:e70. [PMID: 36563348 DOI: 10.1097/dbp.0000000000001145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Kar A, Chutke A, Gokhale C, Phadnis S, Radhakrishnan B. A healthy future for children and adolescents. Lancet 2022; 400:1099. [PMID: 36183721 DOI: 10.1016/s0140-6736(22)01599-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 08/15/2022] [Indexed: 10/14/2022]
Affiliation(s)
- Anita Kar
- Birth Defects and Childhood Disability Research Centre, Pune 411020, India.
| | - Amruta Chutke
- Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, India
| | - Charuta Gokhale
- Saksham Programme, Tata Institute of Social Sciences, Mumbai, India
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Uchitel J, Alden E, Bhutta ZA, Cavallera V, Lucas J, Oberklaid F, Patterson J, Raghavan C, Richter L, Rikard B, Russell RR, Mikati MA. Role of Pediatricians, Pediatric Associations, and Academic Departments in Ensuring Optimal Early Childhood Development Globally: Position Paper of the International Pediatric Association. J Dev Behav Pediatr 2022; 43:e546-e558. [PMID: 35980036 DOI: 10.1097/dbp.0000000000001112] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Accepted: 04/15/2022] [Indexed: 02/04/2023]
Abstract
ABSTRACT Early childhood (birth-8 years), particularly the first 3 years, is the most critical time in development because of the highly sensitive developing brain. Providing appropriate developmental care (i.e., nurturing care, as defined by the World Health Organization [WHO]) during early childhood is key to ensuring a child's holistic development. Pediatricians are expected to play a critical role in supporting early childhood development (ECD) through providing developmental services such as developmental monitoring, anticipatory guidance, screening, and referral to medical and/or community-based services when delay is identified. Pediatricians are also expected to serve as advocates within their clinics and communities for improved delivery of ECD services, such as advocating for increasing funding for ECD initiatives, increasing insurance coverage of ECD services, and working to increase other pediatricians' awareness of the principles of ECD and how to deliver developmental services. However, this does not always occur. Typically, pediatricians' training and practice emphasizes treating disease rather than enhancing ECD. Pediatricians are further hindered by a lack of uniformity across nations in guidelines for developmental monitoring and screening. In this article, we present the vision of the International Pediatric Association (IPA) of the roles that pediatricians, academic departments, medical training programs, and pediatric associations should fulfill to help support ECD, including raising ECD to higher levels of priority in routine pediatric care. First, we present the challenges that face these goals in supporting ECD. We then propose, with supportive literature, strategies and resources to overcome these challenges in collaboration with local and international stakeholders, including the IPA, the WHO, UNICEF, and the World Bank.
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Affiliation(s)
- Julie Uchitel
- Department of Paediatrics, University of Cambridge, The Rosie Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
- Division of Pediatric Neurology and Developmental Medicine, Duke University Health System, Durham, NC
| | - Errol Alden
- International Pediatric Association, Uniformed Services of Health Sciences, Bethesda, MD
| | - Zulfiqar A Bhutta
- International Pediatric Association; Division of Women and Child Health, Aga Khan University, Karachi, Pakistan
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada
| | | | - Jane Lucas
- Consultant in International Health and Child Development to UNICEF and the World Health Organization, New York, NY
| | - Frank Oberklaid
- Centre for Community Child Health, The Royal Children's Hospital, Melbourne, Australia
| | - Janna Patterson
- Global Child Health and Life Support, American Academy of Pediatrics, Chicago, IL
| | - Chemba Raghavan
- Early Childhood Development Specialist/Acting Chief, UNICEF, New York, NY
| | - Linda Richter
- DSI-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
| | - Blaire Rikard
- Division of Pediatric Neurology and Developmental Medicine, Duke University Health System, Durham, NC
| | - Robert Ross Russell
- European Board of Paediatrics, European Academy of Paediatrics; Paediatric Respiratory Paediatrics, Addenbrooke's Hospital, Cambridge, United Kingdom
| | - Mohamad A Mikati
- Early Childhood Development Standing Advisory Group, International Pediatrics Association; Department of Pediatrics, Division of Pediatric Neurology and Developmental Medicine Duke University Medical Center, Durham, NC
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10
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Cruz ED, Rahim F, Lemmon M, Mikati MA. US Food and Drug Administration Facilitated Pediatric Approval Programs: Application to Pediatric Neurological Disorders. J Child Neurol 2022; 37:222-231. [PMID: 35135372 DOI: 10.1177/08830738211037470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Crucial time is often lost while waiting for approval of therapies for pediatric neurological disorders, many of which have aggressive manifestations with devastating effects. There are logistical, ethical, and financial impediments that face the studies needed to determine efficacy and safety of therapies in children. In this article, the authors present the Food and Drug Administration's programs aimed at facilitating the development of pediatric drugs, focusing on their application to pediatric neurological disorders. They also provide examples of drugs that received, or are currently enrolled in, these programs. Reflecting upon the commonalities of drugs receiving these designations, the authors highlight underlying ethical issues related to pediatric drug development and emphasize the need for structured incentives to stimulate approval and production of drug therapies for pediatric neurology patients. By consolidating information that applies to drug approval of pediatric neurological disorders, stakeholders in drug development can enhance treatment development for these disorders.
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Affiliation(s)
- Emily Da Cruz
- Division of Pediatric Neurology and Developmental Medicine, Department of Pediatrics, Duke University, Durham, NC, USA
| | - Faraan Rahim
- Division of Pediatric Neurology and Developmental Medicine, Department of Pediatrics, Duke University, Durham, NC, USA
| | - Monica Lemmon
- Division of Pediatric Neurology and Developmental Medicine, Department of Pediatrics, Duke University, Durham, NC, USA
| | - Mohamad A Mikati
- Division of Pediatric Neurology and Developmental Medicine, Department of Pediatrics, Duke University, Durham, NC, USA.,Department of Neurobiology, Duke University, Durham, NC, USA
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11
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Quality of the home, daycare and neighborhood environment and the cognitive development of economically disadvantaged children in early childhood: A mediation analysis. Infant Behav Dev 2021; 64:101619. [PMID: 34385051 DOI: 10.1016/j.infbeh.2021.101619] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 06/20/2021] [Accepted: 07/24/2021] [Indexed: 11/20/2022]
Abstract
The objective of this study was to investigate how socioeconomic factors and the quality of ecological environments affect motor and cognitive development of economically disadvantaged children. This is a cross-sectional, predictive and correlational study using structural equation modeling to analyze data on 147 economic disadvantage children of 24-36 months attending public daycare. The Bayley-III Scales, the Home Observation for Measurement of the Environment Inventory, the Infant/Toddler Environment Rating Scale-Revised Edition, a socioeconomic index and a specifically designed questionnaire on neighborhood quality were applied. The ecological environments did not affect motor development, but 25 % of variations in cognitive development were explained by socioeconomic differences and differences in the quality of the neighborhood, home and daycare. However, only the quality of the home and daycare had a direct impact, with the other factors affecting the outcome indirectly and to a lesser extent. In conclusion, this study investigated the association between the ecological contexts of economically disadvantaged children and their cognitive and motor development. The findings showed that the environmental context had effect on cognitive development. The home was the environment that exerted the most significant direct effect, followed by daycare and, indirectly and to a lesser extent, the neighborhood. Therefore, the coordination of public policies between health, education and social assistance sectors, aiming at the three ecological environments is important in order to promote the cognitive development of economically disadvantaged children.
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Ataullahjan A, Samara M, Betancourt TS, Bhutta ZA. Mitigating toxic stress in children affected by conflict and displacement. BMJ 2020; 371:m2876. [PMID: 33214156 PMCID: PMC7673909 DOI: 10.1136/bmj.m2876] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Anushka Ataullahjan
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
| | | | - Theresa S Betancourt
- Research Program on Children and Adversity, Boston College School of Social Work, Boston, USA
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, Hospital for Sick Children, Toronto, Ontario, Canada
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi, Pakistan
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