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To estimate the prevalence of violent discipline at home against young children, and to explore the potential association between violent discipline at home and multifaceted health risks in children. A community-based cross-sectional survey was conducted in twenty rural counties of weight provinces in western China. The information about child neglect and socio-demographic factors, exposure to different forms of violent discipline at home and four health outcomes was collected by face-to-face interview. Before analysis, the included interviews were weighted by the double-weighted comprehensive weighting. The proportion of children reported by primary caregivers to have experienced different forms of violent discipline by gender were calculated. To adjust the clustering effect of the survey design, two-level univariate and multivariate logistic regression models were constructed to evaluate the potential association between a child’s exposure to violent discipline at home and risk of suffering from diarrhea, fever, cough and injury. A total of 3,682 weighted interviews were finally included in the analysis. The prevalence of any violent discipline, psychological aggression, any physical punishment and severe physical punishment were 76.4%, 57.5%, 68.3% and 14.1%, respectively. In multivariate analysis, after adjusting for clustering, there was still a positive association between a child’s exposure to psychological aggression and risk of diarrhea (adjusted OR: 1.47, 95%CI: 1.14-1.90) and injury (adjusted OR: 1.95, 95%CI: 1.36-2.80); a child’s exposure to any physical punishment and risk of diarrhea (adjusted OR: 1.36, 95%CI: 1.04-1.77), cough (adjusted OR: 1.37, 95%CI: 1.14-1.66), and injury (adjusted OR: 2.05, 95%CI: 1.37-3.06); and a child’s exposure to severe physical punishment and risk of injury (adjusted OR: 2.07, 95%CI: 1.41-3.05). Considering that using violent discipline at home is prevalent in rural western China, and it could threaten young children’s health, effective measures to prevent young children from violent discipline are urgently needed.
To estimate the prevalence of violent discipline at home against young children, and to explore the potential association between violent discipline at home and multifaceted health risks in children. A community-based cross-sectional survey was conducted in twenty rural counties of weight provinces in western China. The information about child neglect and socio-demographic factors, exposure to different forms of violent discipline at home and four health outcomes was collected by face-to-face interview. Before analysis, the included interviews were weighted by the double-weighted comprehensive weighting. The proportion of children reported by primary caregivers to have experienced different forms of violent discipline by gender were calculated. To adjust the clustering effect of the survey design, two-level univariate and multivariate logistic regression models were constructed to evaluate the potential association between a child’s exposure to violent discipline at home and risk of suffering from diarrhea, fever, cough and injury. A total of 3,682 weighted interviews were finally included in the analysis. The prevalence of any violent discipline, psychological aggression, any physical punishment and severe physical punishment were 76.4%, 57.5%, 68.3% and 14.1%, respectively. In multivariate analysis, after adjusting for clustering, there was still a positive association between a child’s exposure to psychological aggression and risk of diarrhea (adjusted OR: 1.47, 95%CI: 1.14-1.90) and injury (adjusted OR: 1.95, 95%CI: 1.36-2.80); a child’s exposure to any physical punishment and risk of diarrhea (adjusted OR: 1.36, 95%CI: 1.04-1.77), cough (adjusted OR: 1.37, 95%CI: 1.14-1.66), and injury (adjusted OR: 2.05, 95%CI: 1.37-3.06); and a child’s exposure to severe physical punishment and risk of injury (adjusted OR: 2.07, 95%CI: 1.41-3.05). Considering that using violent discipline at home is prevalent in rural western China, and it could threaten young children’s health, effective measures to prevent young children from violent discipline are urgently needed.
From 2019 to 2022, the For Our Children project gathered a team of Chinese and American pediatricians to explore the readiness of the pediatric workforce in each country to address pressing child health concerns. The teams compared existing data on child health outcomes, the pediatric workforce, and education and combined qualitative and quantitative comparisons centered on themes of effective health care delivery outlined in the World Health Organization Workforce 2030 Report. This article describes key findings about pediatric workload, career satisfaction, and systems to assure competency. We discuss pediatrician accessibility, including geographic distribution, practice locations, trends in pediatric hospitalizations, and payment mechanisms. Pediatric roles differed in the context of each country’s child health systems and varied teams. We identified strengths we could learn from one another, such as the US Medical Home Model with continuity of care and robust numbers of skilled clinicians working alongside pediatricians, as well as China’s Maternal Child Health system with broad community accessibility and health workers who provide preventive care. In both countries, notable inequities in child health outcomes, evolving epidemiology, and increasing complexity of care require new approaches to the pediatric workforce and education. Although child health systems in the United States and China have significant differences, in both countries, a way forward is to develop a more inclusive and broad view of the child health team to provide truly integrated care that reaches every child. Training competencies must evolve with changing epidemiology as well as changing health system structures and pediatrician roles.
BACKGROUND:Increasing rates of childhood trauma, poisoning, and sequelae of environmental exposure not only reduce the quality of life of children and their families but also lead to disability and death. Statistical analysis of childhood trauma data makes it possible to define risk age groups among children and adolescents, identify the causes of the decrease or increase in the rates, estimate the level of medical care, and make necessary management decisions. AIM:To assess the state of childhood trauma in St. Petersburg and its changes in 5 years (20162020) and the provision of inpatient trauma care. MATERIALS AND METHODS:Data on childhood trauma in St. Petersburg were analyzed based on the analysis of Federal statistical observation forms submitted by the St. Petersburg State Budgetary Institution Medical Center for Information and Analysis, collections of N.N. Priorov National Medical Research Center for Traumatology and Orthopedics of the Ministry of Health of the Russian Federation Trauma, orthopedic morbidity, the state of trauma and orthopedic care for the population, edited by Acad. S.P. Mironov, RAS, and data from the Federal State Statistics Service. RESULTS:From 2016 to 2019, the frequency of trauma, poisoning, and sequelae of environmental exposure in children of St. Petersburg slightly increased. In 2020, owing to the COVID-19 pandemic, childhood trauma rates decreased, and the most significant decrease in trauma rates was recorded at 32%36% in adolescents aged 1517 years. Despite the overall decrease in childhood trauma in 2020, the structure of trauma due to environmental exposure revealedan81% increase in transport accidents, compared with previous years, anda39% increase in trauma due to injuries with undetermined intentions. For 5 years, the number of beds was reduced, and by 2020, the provision of trauma, and orthopedic beds for children in St. Petersburg was 1.4 beds per 10 thousand children, which corresponds to the data for Russia. CONCLUSIONS:The incidence of traumatic injuries slightly increased in children in St. Petersburg, mostly in children aged 04 years, and mortality from environmental exposure also increased in adolescence.Acorrelation was found between the COVID-19 pandemic andadecrease in the number of visits and hospital admissions of children with trauma to medical institutions. Moreover, the incidence of severe, high-energy injuries that require more serious treatment approaches also increased, as evidenced by the annual increase in the number of surgical interventions in children with traumatic injuries. The new form of statistical reporting does not allow us to determine all causes of trauma. The provision of trauma care for children in St. Petersburg remains atanappropriate level.
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