The Lancet. Child & adolescent health最新文献

{"title":"Effect of a youth-led early childhood care and education programme on children's development and learning in rural Sindh, Pakistan (LEAPS): a stepped-wedge cluster-randomised implementation trial.","authors":"Aisha K Yousafzai, Saima Siyal, Emily E Franchett, Quanyi Dai, Karima Rehmani, Christopher R Sudfeld, Shelina Bhamani, Shahnaz Hakro, Chin R Reyes, Günther Fink, Liliana A Ponguta","doi":"10.1016/S2352-4642(24)00304-3","DOIUrl":"10.1016/S2352-4642(24)00304-3","url":null,"abstract":"<p><strong>Background: </strong>In low-income and middle-income countries, an estimated 181·9 million (74·6%) preschool-aged children do not receive adequate nurturing care in health, nutrition, protection, learning, and responsive care, thus jeopardising their healthy development across the life course. Working alongside the health sector, multisectoral actions including social protection and education are necessary to achieve child health and development outcomes. Innovations are needed to expand access to high-quality early childhood care and education (ECCE) for young children and opportunities for youth development. Youth Leaders for Early Childhood Assuring Children are Prepared for School (LEAPS) is a two-generation programme that trains female youth aged 18-24 years to deliver ECCE. We evaluated the effectiveness of LEAPS to improve children's school readiness when delivered at scale in rural Pakistan.</p><p><strong>Methods: </strong>We implemented a stepped-wedge cluster-randomised trial with three steps from Dec 3, 2018, to June 30, 2021. 99 villages (clusters) in four districts in rural Sindh, Pakistan, were randomly assigned (1:1:1) to introduce LEAPS across three steps. Eligible clusters were those that had a feeder primary school run by the National Commission for Human Development, a department of the Ministry of Federal Education and Professional Training; were safe; had space for a LEAPS preschool; could identify a female youth to deliver the ECCE service; and had not previously participated in the pilot study. Government partners trained female youth, aged 18-24 years, to provide community-based ECCE, enrolling up to 20 children, aged 3·5-5·0 years, per class. Population-based cross-sectional surveys were conducted at baseline and after each step for children who were eligible if they resided in the cluster, were aged 4·5-5·5 years at the time of the survey, and without any severe clinical health conditions or disability. The primary outcome was children's school readiness using the International Development and Early Learning Assessment (IDELA) composite score comprising emergent numeracy, emergent literacy, socio-emotional development, and motor skills. An intention-to-treat analysis was conducted, using linear mixed models accounting for clustering and the stepped-wedge design. The trial is registered with ClinicalTrials.gov (NCT03764436).</p><p><strong>Findings: </strong>LEAPS was implemented in 91 of 99 villages. In eight clusters, a LEAPS preschool could not be set up. For the intervention programme, the average enrolment of children in a LEAPS preschool was 19 (SD 3, range 12-20). A total of 3858 children (n=3852 with complete IDELA data) were assessed across the four survey rounds conducted between Jan 1, 2019, and March 31, 2021. LEAPS increased school readiness (standardised mean difference: 0·30 [95% CI 0·20-0·40]; p<0·0001) as compared with the control condition.</p><p><strong>Interpretation: </strong>LEAPS offers a ","PeriodicalId":94246,"journal":{"name":"The Lancet. Child & adolescent health","volume":" ","pages":"25-36"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142788346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Creating child-inclusive societies.","authors":"Helen Skouteris, Michael Marmot, Sharon Bessell","doi":"10.1016/S2352-4642(24)00254-2","DOIUrl":"10.1016/S2352-4642(24)00254-2","url":null,"abstract":"<p><p>In a global landscape defined by polycrisis, children are being failed. To address this failure, we ask an ambitious yet fundamental question: how do we create child-inclusive societies where every child thrives and has the best start in life, where intergenerational disadvantage is redressed, and where child poverty is ended? Building on the power of the social determinants of health in advancing equity and human wellbeing, we argue that child inclusiveness requires three foundational actions linked to the political, commercial, and social determinants of health: (1) prioritising implementation of transformative collaboration between policy makers, public bodies, and communities to improve outcomes for children; (2) reclaiming the public good through child-centred regulatory frameworks that aim to deliver health care and improve wellbeing; and (3) valuing the time to care for children and to build meaningful and responsive relationships with them. With innovative thinking about our societies and their core values, we can design child-inclusive interventions and derive relevant metrics and indicators to track progress.</p>","PeriodicalId":94246,"journal":{"name":"The Lancet. Child & adolescent health","volume":" ","pages":"71-76"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142690203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing multiple neurodivergent identities in clinical and research settings.","authors":"Sarah L Chellappa","doi":"10.1016/S2352-4642(24)00261-X","DOIUrl":"10.1016/S2352-4642(24)00261-X","url":null,"abstract":"","PeriodicalId":94246,"journal":{"name":"The Lancet. Child & adolescent health","volume":" ","pages":"5-6"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142690202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum GFAP and UCH-L1 for the identification of clinically important traumatic brain injury in children in France: a diagnostic accuracy substudy.","authors":"Antoine Puravet, Charlotte Oris, Bruno Pereira, Samy Kahouadji, Philippe Gonzalo, Damien Masson, Julie Durif, Catherine Sarret, Vincent Sapin, Damien Bouvier","doi":"10.1016/S2352-4642(24)00295-5","DOIUrl":"10.1016/S2352-4642(24)00295-5","url":null,"abstract":"<p><strong>Background: </strong>Many children with mild traumatic brain injury (mTBI), defined by a Glasgow Coma Scale (GCS) score between 13 and 15, undergo hospitalisation or cranial CT (CCT) scans despite the absence of clinically important traumatic brain injury (ciTBI; ie, hospitalisation >2 days associated with intracranial lesions on CCT, neurosurgical intervention, intensive care admission, or death). Clinical algorithms have reduced CCT scans and hospitalisations by 10%. We aimed to established age-appropriate reference values for GFAP and UCH-L1 and evaluate their diagnostic test performance in identifying ciTBI in children.</p><p><strong>Methods: </strong>This study was a diagnostic test accuracy substudy within the PROS100B stepped wedge cluster randomised trial that included children aged 16 years or younger, clinically managed within 3 h of mTBI, with a GCS score of 15 requiring hospitalisation or CCT scan according to French Pediatric Society guidelines (equivalent to the intermediate risk group of the PECARN algorithm). Enrolment for PROS100B occurred from Nov 1, 2016, to Oct 31, 2021, at 11 hospital emergency departments in France. Stored blood samples collected from March 1, 2015, to Oct 31, 2015, from children aged 16 years or younger who were outpatients for allergic conditions unrelated to mTBI and free of neurological disease were used as a control group to calculate reference values of GFAP and UCH-L1 across four age groups (<6 months, 6 months to <2 years, 2 years to <4 years, and 4 years to <16 years). The diagnostic test performance of GFAP and UCH-L1, both above the reference range to identify ciTBI, was evaluated in the children with mTBI. GFAP and UCH-L1 were measured with the Alinity analyser (Abbott, Chicago, IL, USA).</p><p><strong>Findings: </strong>Reference values were calculated from GFAP and UCH-L1 measured in samples from 718 control children (378 [53%] boys and 340 [47%] girls). 531 children (334 [63%] boys and 197 [37%] girls) aged 0-16 years with mTBI were included. By applying our reference values for GFAP and UCH-L1 across four age groups the biomarker combination (both biomarkers above reference ranges) had a sensitivity of 100% (95% CI 69-100), a negative predictive value of 100% (99-100), a specificity of 67% (63-71), a positive likelihood ratio of 3·01 (2·67-3·40), a negative likelihood ratio of 0, and an area under the curve of 0·83 (0·81-0·85) in identifying ciTBI.</p><p><strong>Interpretation: </strong>Serum GFAP and UCH-L1 identify ciTBI in children with 100% sensitivity and 67% specificity, which could potentially reduce unnecessary CCT scans and hospitalisations in children with mTBI if implemented.</p><p><strong>Funding: </strong>French Ministry of Health.</p>","PeriodicalId":94246,"journal":{"name":"The Lancet. Child & adolescent health","volume":" ","pages":"47-56"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142788350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developmental considerations in the quest for paediatric mTBI biomarkers.","authors":"Miriam Beauchamp","doi":"10.1016/S2352-4642(24)00326-2","DOIUrl":"10.1016/S2352-4642(24)00326-2","url":null,"abstract":"","PeriodicalId":94246,"journal":{"name":"The Lancet. Child & adolescent health","volume":" ","pages":"3-5"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142788340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"End violence against children and adolescents: integrate climate policy into the 2030 SDGs.","authors":"Ilan Cerna-Turoff, Karen M Devries","doi":"10.1016/S2352-4642(24)00301-8","DOIUrl":"10.1016/S2352-4642(24)00301-8","url":null,"abstract":"","PeriodicalId":94246,"journal":{"name":"The Lancet. Child & adolescent health","volume":" ","pages":"7-8"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building global collaborative research networks in paediatric critical care: a roadmap.","authors":"Luregn J Schlapbach, Padmanabhan Ramnarayan, Kristen S Gibbons, Brenda M Morrow, Natalie Napolitano, Lyvonne N Tume, Andrew C Argent, Akash Deep, Jan Hau Lee, Mark J Peters, Michael S D Agus, John Adabie Appiah, Jennifer Armstrong, Tigist Bacha, Warwick Butt, Daniela Carla de Souza, Jaime Fernández-Sarmiento, Heidi R Flori, Patricia Fontela, Ben Gelbart, Sebastián González-Dambrauskas, Takanari Ikeyama, Roberto Jabornisky, Muralidharan Jayashree, Yasser M Kazzaz, Martin C J Kneyber, Debbie Long, Jenala Njirimmadzi, Rujipat Samransamruajkit, Roelie M Wösten-van Asperen, Quan Wang, Katie O'Hearn, Kusum Menon","doi":"10.1016/S2352-4642(24)00303-1","DOIUrl":"https://doi.org/10.1016/S2352-4642(24)00303-1","url":null,"abstract":"<p><p>Paediatric critical care units are designed for children at a vulnerable stage of development, yet the evidence base for practice and policy in paediatric critical care remains scarce. In this Health Policy, we present a roadmap providing strategic guidance for international paediatric critical care trials. We convened a multidisciplinary group of 32 paediatric critical care experts from six continents representing paediatric critical care research networks and groups. The group identified key challenges to paediatric critical care research, including lower patient numbers than for adult critical care, heterogeneity related to cognitive development, comorbidities and illness or injury, consent challenges, disproportionately little research funding for paediatric critical care, and poor infrastructure in resource-limited settings. A seven-point roadmap was proposed: (1) formation of an international paediatric critical care research network; (2) development of a web-based toolkit library to support paediatric critical care trials; (3) establishment of a global paediatric critical care trial repository, including systematic prioritisation of topics and populations for interventional trials; (4) development of a harmonised trial minimum set of trial data elements and data dictionary; (5) building of infrastructure and capability to support platform trials; (6) funder advocacy; and (7) development of a collaborative implementation programme. Implementation of this roadmap will contribute to the successful design and conduct of trials that match the needs of globally diverse paediatric populations.</p>","PeriodicalId":94246,"journal":{"name":"The Lancet. Child & adolescent health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142884009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building policy around the built environment for adolescent mental health.","authors":"Amy Mizen, Richard Fry, Susan Williams, Ann John","doi":"10.1016/S2352-4642(24)00259-1","DOIUrl":"https://doi.org/10.1016/S2352-4642(24)00259-1","url":null,"abstract":"","PeriodicalId":94246,"journal":{"name":"The Lancet. Child & adolescent health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142752818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Children are not future producers and customers: a plea for the moral imperative of acting now.","authors":"Mark Tomlinson, James Radner","doi":"10.1016/S2352-4642(24)00312-2","DOIUrl":"https://doi.org/10.1016/S2352-4642(24)00312-2","url":null,"abstract":"","PeriodicalId":94246,"journal":{"name":"The Lancet. Child & adolescent health","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142694084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monitoring change from residential housing care to family-based care for children.","authors":"Marian J Bakermans-Kranenburg, Marinus H van IJzendoorn","doi":"10.1016/S2352-4642(24)00102-0","DOIUrl":"10.1016/S2352-4642(24)00102-0","url":null,"abstract":"","PeriodicalId":94246,"journal":{"name":"The Lancet. Child & adolescent health","volume":" ","pages":"549-550"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140961265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}