This study evaluates the impact of Village Fund allocation for health on stunting reduction as an investment in human capital in Lamongan Regency. Using village-level data for 2023–2024, the study applies Propensity Score Matching (PSM) and Ordinary Least Squares (OLS) to examine supporting factors. The PSM results indicate that villages receiving the intervention experienced a statistically significant reduction in stunting prevalence of approximately 1.2 percentage points compared with non-treated villages. The OLS results show that the Village Fund intervention has a negative but marginally significant association with stunting prevalence, while posyandu activity, supplementary feeding, child immunization, and basic-service access are statistically insignificant. These findings highlight the importance of targeted and integrated village-level interventions.
The interconnections among food systems, poverty, and malnutrition remain central to Bangladesh’s development trajectory. Despite substantial agricultural growth and notable reductions in poverty over the past two decades, structural challenges continue to constrain equitable access to food and nutrition. This study analyzes agricultural production trends, food system drivers, and consumption behaviors, situating Bangladesh in a comparative South Asian context. Using national survey data and secondary statistics, it further examines poverty dynamics, both income-based and multidimensional and their implications for food insecurity and nutrition outcomes. The empirical evidence highlights persistent disparities in dietary diversity, caloric intake, and affordability of healthy diets across rural–urban and socio-economic groups. Moreover, the prevalence of child undernutrition and the double burden of malnutrition underscore the fragility of current nutrition gains. The findings suggest that external shocks, including climate variability, market volatility, and global food price fluctuations, exacerbate systemic vulnerabilities. Policy analysis indicates that while government interventions in agriculture, poverty alleviation, and nutrition have achieved incremental success, gaps remain in coordination, targeting, and long-term sustainability. The paper argues for integrated, multisectoral strategies that enhance agricultural productivity, strengthen social protection mechanisms, and promote resilient, nutrition-sensitive food systems. Such approaches are essential to achieving the Sustainable Development Goals (SDGs) on zero hunger, poverty reduction, and improved health outcomes in Bangladesh.
Introduction Disseminated Bacillus Calmette–Guérin (BCG) disease is a rare but life-threatening complication in children with primary immunodeficiency (PID). Linezolid (LZD) is effective but limited by myelosuppression. Contezolid (CZD), a novel oxazolidinone, has shown better hematological safety in adults, but pediatric data are scarce. This retrospective case series aims to provide real-world experience on CZD use in this challenging population. Case description We report three children (aged 3–9.5 months) with PID (Wiskott–Aldrich syndrome, X-linked severe combined immunodeficiency, and IL-12 receptor β1 deficiency) who developed clinically presumed or confirmed disseminated BCG disease after routine vaccination. All received CZD-containing regimens (12–20 mg/kg/dose, q12 h) alongside other antimycobacterial agents and hematopoietic stem cell transplantation (HSCT). Outcomes Over 11–12 months of CZD-containing multidrug therapy followed by 1 year of post-treatment telephone follow-up, all patients achieved satisfactory clinical resolution of infectious lesions and no clinical relapse was observed. No CZD-attributable hematological, hepatic, renal, or neurological adverse events occurred. However, because all patients received concurrent HSCT and multiple antimycobacterial agents, the independent contribution of CZD cannot be determined. Conclusion CZD-containing regimens were well tolerated and associated with clinical improvement in these complex cases. CZD may serve as a valuable alternative when LZD is poorly tolerated. However, definitive attribution of efficacy to CZD alone is precluded by concurrent HSCT and multi-drug therapy.
Child mortality is often framed narrowly as a health issue, yet it reflects deeper structural inequalities, institutional deficiencies, and societal factors. This qualitative study investigates the representations of child deaths in Turkey by analyzing media discourse and the professional experiences of those working with children. Utilizing content analysis of 278 news articles from Cumhuriyet newspaper (2000–2024) alongside in-depth interviews with 25 professionals from social work, psychology, law, midwifery, and education, the research reveals divergent narratives: media portrayals tend to individualize and dramatize incidents, whereas professionals emphasize systemic causes such as social determinants, policy gaps, and institutional failures. The findings underscore the critical role of media visibility in shaping public awareness and highlight the need for interdisciplinary, rights-based approaches to prevention. Ultimately, the study calls for integrated policy frameworks that address child mortality through social justice, legal accountability, and cross-sector collaboration, moving beyond health-centric paradigms to safeguard children’s rights and well-being.
Background Parent-administered massage-based interventions are increasingly used in family-centered care for preterm infants, but their effects across infant and parental outcomes remain uncertain. Objective To systematically evaluate the effects of parent-administered massage-based interventions on growth, feeding, hospitalization, neurodevelopmental, and parental psychological outcomes in preterm infants. Methods We conducted a PRISMA 2020-compliant systematic review and meta-analysis of randomized controlled trials. PubMed/MEDLINE, Scopus, and Web of Science were searched from inception to 26 May 2026. Eligible studies compared parent-administered massage alone or combined with tactile, kinesthetic, oral, or other developmental sensory components against routine care or non-massage controls. Random-effects models with restricted maximum-likelihood estimation were used. Parental psychological outcomes were synthesized narratively because of substantial heterogeneity. Risk of bias was assessed with RoB 2, and certainty of evidence with GRADE. Results Twenty-four randomized controlled trials were included. Moderate-certainty evidence indicated that massage-based interventions were associated with higher odds of breastfeeding or human-milk feeding at discharge (OR 5.42, 95% CI 2.44–11.94), shorter time to full oral feeding (MD −2.04 days, 95% CI −3.95 to −0.13), and shorter hospital length of stay (MD −4.68 days, 95% CI −7.79 to −1.57). Weight-gain velocity was greater in the primary meta-analysis (MD 5.55 g/day, 95% CI 1.71–9.38), but certainty was low, heterogeneity was very high (I 2 = 97.87%), significant small-study effects were detected, and the trim-and-fill adjusted estimate was attenuated and no longer statistically significant (MD 3.45 g/day, 95% CI −1.67 to 8.56). Parent-related psychological findings were generally favorable but were supported by low-certainty evidence. Effects on length growth, head-circumference growth, and motor development were not statistically significant; certainty for length and head-circumference growth was very low. Conclusion Moderate-certainty evidence suggests that parent-administered massage-based interventions may improve selected feeding outcomes and reduce hospital length of stay in preterm or low-birth-weight infants. The effect on weight-gain velocity remains uncertain because of very high heterogeneity, low certainty of evidence, and possible small-study effects. However, many interventions were multimodal and heterogeneity was substantial; therefore, the findings should be interpreted as effects of parent-delivered developmental-care interventions that include massage rather than massage alone, and the independent effect of massage requires confirmation. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420261435482 , identifier CRD420261435482.
Background School-based physical activity (PA) interventions are a population-level strategy for improving children’s health, yet evidence on their combined effects on physical fitness and psychosocial adaptation remains fragmented. This systematic review and meta-analysis synthesized evidence from controlled intervention trials (randomized and non-randomized) examining school-based PA interventions on physical fitness (cardiorespiratory fitness, muscular fitness, body composition) and psychosocial adaptation (self-esteem, psychological well-being, social functioning) in children aged 6–12 years. Methods Following PRISMA 2020 guidelines, we searched PubMed, Web of Science, Embase, SPORTDiscus, Cochrane Library, and PsycINFO from inception to 15 January 2026. Randomized controlled trials (RCTs) and non-randomized controlled trials with a minimum 8-week school-based PA intervention and at least one physical fitness or psychosocial outcome were eligible. Random-effects meta-analyses were performed using Hedges’ g. Heterogeneity was assessed with I2 and Cochran’s Q. Risk of bias was evaluated using the Cochrane Risk of Bias 2 tool for RCTs and ROBINS-I for non-randomized trials. Results Forty studies (39 randomized, 1 non-randomized) involving 21,793 participants met inclusion criteria. School-based PA interventions were associated with significant improvements in cardiorespiratory fitness (g = 0.36, 95% CI [0.25, 0.46], p < 0.001, I2 = 98%) and muscular fitness (g = 0.24, 95% CI [0.17, 0.31], p < 0.001, I2 = 93%); the small reduction in body mass index did not reach statistical significance (g = −0.11, 95% CI [−0.27, 0.04], p = 0.154, I2 = 98%). For psychosocial outcomes, significant small effects were found for self-esteem (g = 0.18, 95% CI [0.10, 0.27], p < 0.001), psychological well-being (g = 0.15, 95% CI [0.09, 0.21], p < 0.001), and social functioning (g = 0.21, 95% CI [0.04, 0.38], p = 0.018). Exploratory subgroup analyses suggested that larger effects were associated with multicomponent interventions, durations of ≥24 weeks, and ≥3 sessions per week. Conclusion School-based PA interventions were associated with small-to-moderate improvements in physical fitness and small improvements in psychosocial adaptation in children. The findings support integrating comprehensive PA programs into school curricula. However, the small effect sizes for psychosocial outcomes and substantial heterogeneity underscore the need for rigorous studies with standardized measurement protocols.
Objective To estimate the lifetime and cumulative direct medical burden associated with childhood overweight and obesity in Kazakhstan using a dynamic age-structured modeling approach. Methods A dynamic age-structured Markov cohort model was developed to simulate the progression of children aged 5–9 years through successive age groups and weight states (normal weight, exclusive overweight, and obesity). Transition probabilities were reconstructed using a synthetic cohort approach based on repeated cross-sectional prevalence data and were calibrated to reproduce observed epidemiological patterns. State-specific annual direct medical costs were estimated using a normative costing approach based on national clinical protocols and tariffs. Lifetime burden was calculated as the discounted sum of future medical costs (3% discount rate). Furthermore, cumulative short-term was estimated for the period 2024–2035. Deterministic sensitivity analysis and structural scenario analysis were conducted to assess model robustness. Policy scenarios examined the impact of reducing childhood obesity prevalence by 5 and 10%. Results The average discounted lifetime cost per child was 96,996.26 KZT (USD 206.37), resulting in a total national lifetime financial impact of 194 billion KZT (USD 413 million) for the 2024 cohort of children aged 5–9 years. Over the 2024–2035 horizon, cumulative discounted direct healthcare expenditure reached 128.72 billion KZT (USD 273.9 million), with approximately 71% attributable to obesity. Sensitivity analysis showed that model results were most responsive to parameters related to obesity prevalence and costs. Structural scenarios indicated that the base-case model likely underestimates cost, with age-varying adult costs increasing estimates by up to 13.6%. Policy scenarios demonstrated that a 5 and 10% reduction in childhood obesity prevalence could reduce lifetime burden by 4.8 and 9.4%, respectively. Conclusion Childhood obesity imposes a substantial and persistent economic impact on Kazakhstan's healthcare system. Preventive interventions targeting obesity in early life may yield significant long-term cost savings and should be prioritized in national health policy.
Berik Koichubekov, Khamida Abdikadirova, Nazgul Omarbekova et al.
Social criticism is an analytical approach used to examine social structures, institutions, and power relations in order to reveal inequalities and injustices within a society. This study investigates the forms of social criticism presented in Charlotte Brontë’s novel Jane Eyre using a Marxist theoretical framework developed by Karl Marx. The data were collected from the novel through a qualitative descriptive method focusing on narrative events, character interactions, and social settings. The analysis reveals the rigid class hierarchy of Victorian English society, in which the bourgeoisie controlled economic resources and social power, while the proletariat experienced dependency, exploitation, and alienation. The findings show that the novel portrays various forms of social inequality through the experiences of Jane Eyre as an impoverished orphan and governess navigating a stratified social structure. Furthermore, the social criticism expressed in the novel remains relevant to contemporary societal issues, including gender oppression, power imbalances in the workplace, and struggles for individual autonomy. Therefore, Jane Eyre can be understood as a significant literary work that not only reflects social realities of its time but also encourages readers to critically examine injustice and inequality in modern society.
Andi Nurul Mawaddah Malik, Burhanuddin Arafah, Herawaty Abbas et al.
Objectives This study investigated the effects of a nanocomposite comprising N-acyl -homoserine lactonase Est816 and silver nanoparticles (Ag-Est816) on the microbial community of an enriched in vitro biofilm model derived from supragingival plaque of children with early childhood caries (ECC). Materials and methods Supragingival plaque samples were collected from 30 children aged younger than 6 years (15 males and 15 females) diagnosed with ECC. These samples were cultured in vitro to form biofilms, which were then treated with or without the Ag-Est816 composite for two days. The composition of the biofilms was analyzed by 16S rRNA sequencing to assess changes in α - and β -diversity, taxonomic composition, and predicted microbial functions. Biofilm morphology and biomass were evaluated using scanning electron microscopy (SEM) and crystal violet assays. Results The Ag-Est816 composite significantly reduced microbial α -diversity, including species richness and phylogenetic diversity (Chao1, Observed species, Faith's PD, p < 0.05). It also significantly altered overall bacterial community composition, as demonstrated by principal coordinate analysis (PCoA) and paired permutational multivariate analysis of variance (PERMANOVA), although the effect size was modest ( R 2 = 0.0286, P = 0.002). At the genus level, the abundances of Actinomyces , Lactobacillus , and Moryella were markedly decreased, whereas Haemophilus and Granulicatella were enriched. LEfSe analysis revealed Actinomyces and Lactobacillus as characteristic taxa enriched in the Control group, while Enterococcus and Granulicatella were significantly enriched following treatment. Functional prediction revealed that Ag-Est816 influenced pathways related to carbohydrate metabolism, amino acid biosynthesis, nucleotide metabolism, and nucleotide sugar biosynthesis. SEM imaging and biomass quantification confirmed that the Ag-Est816 composite disrupted biofilm architecture and significantly reduced total biomass. Conclusion The Ag-Est816 composite suppressed several low-abundance cariogenic genera while reducing overall community richness, altered microbial metabolic functions, and compromised biofilm structural integrity. These findings indicated this non-invasive nanocomposite has potential as an adjunctive therapy for caries prevention in children.
Background Data exist on adolescents’ screen time behavior, but are lacking on urban–rural differences. We compared daily screen time exposures and associated anthropometric parameters, frequency of outdoor physical activity, and psychological parameters of urban and rural school-going adolescents. Methods This was a cross-sectional study. Using five districts of one of the administrative divisions of a western Indian state as the sampling frame, the first two urban and first two rural schools were selected from a randomly reordered list of schools. We included 627 students from 5th, 7th, and 9th standards as representatives of the adolescent age group (10–19 years). Self-reported outdoor physical activity, psychological assessment using the Strengths and Difficulties Questionnaire (SDQ) and daily time spent on each were recorded. We determined associations between area of residence, frequency of outdoor physical activity, and SDQ scores and screen time using the chi-square test or Fisher’s exact test. Multivariable regression analysis was used to determine the predictors of excessive screen time (>2 h/day). Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were calculated. Results There were 334 (53.3%) urban and 293 (46.7%) rural students. The mean age was 12.5 ± 1.4 years. Mean daily total screen time was 111.9 ± 71.7 min. Urban compared to rural [121.5 ± 75.9 min vs. 100.9 ± 65.0 min; p = 0.001] and boys compared to girls [122.9 ± 81.9 min vs. 100.9 ± 58.0 min; p < 0.000] had longer total screen time exposure. Being a rural resident was significantly associated with a >2 days/week of outdoor physical activity [78.8% (rural) vs. 35.9% (urban), respectively; OR 6.64, 95% CI 4.64–9.51, p < 0.000]. Students with daily screen time of >2 h had some/high needs on the SDQ hyperactivity scale [11.4% vs. 5.7%; p = 0.022]. Males had significantly higher odds of >2 h of total daily screen time than females (aOR = 1.51, 95% CI 1.05–2.17; p = 0.026). Conclusion The associations between longer screen time exposure and worse physical and psychological factors warrant interventions with special attention to urban–rural differences.
Gauri A. Oka, Ashish S Ranade, Mayur Kiran Shinde et al.
