The evolutionary biology of child health

I apply evolutionary perspectives and conceptual tools to analyse central issues underlying child health, with emphases on the roles of human-specific adaptations and genomic conflicts in physical growth and development. Evidence from comparative primatology, anthropology, physiology and human disorders indicates that child health risks have evolved in the context of evolutionary changes, along the human lineage, affecting the timing, growth-differentiation phenotypes and adaptive significance of prenatal stages, infancy, childhood, juvenility and adolescence. The most striking evolutionary changes in humans are earlier weaning and prolonged subsequent pre-adult stages, which have structured and potentiated maladaptations related to growth and development. Data from human genetic and epigenetic studies, and mouse models, indicate that growth, development and behaviour during pre-adult stages are mediated to a notable degree by effects from genomic conflicts and imprinted genes. The incidence of cancer, the primary cause of non-infectious childhood mortality, mirrors child growth rates from birth to adolescence, with paediatric cancer development impacted by imprinted genes that control aspects of growth. Understanding the adaptive significance of child growth and development phenotypes, in the context of human-evolutionary changes and genomic conflicts, provides novel insights into the causes of disease in childhood.     

儿童保健对早产儿生长和智力发育的影响及相关性研究

为了探究正常的儿童保健对早产儿生长和智力发育的影响,并明确早产儿的生长和智力发育分别与儿童保健的影响,本研究选取40例早产儿,随机分为对照组和观察组,每组20例。对照组进行常规育儿管理,观察组采用儿童保健管理。统计分析两组早产儿在0.5岁、1岁、1.5岁和2岁的生长(头围,体重和身高)和智力(智力和心理活动)发育情况及相关性。研究发现,儿童保健可明显促进早产儿的生长和智力发育,且正规儿童保健与早产儿的生长和智力发育呈正相关关系,均具有显著性差异。本研究结果说明,儿童保健可明显促进早产儿的生长和智力发育,具有重要的临床应用价值。     

Rural Livelihood Variation and its Effects on Child Growth in Timor-Leste

Economic development introduces opportunities for subsistence households to diversify income sources. Timor-Leste is undergoing this transition; however, little is known about the patterns of household strategies and the effects of rural development on child wellbeing. We derive strategies from 190 households in two rural Timor-Leste communities and examine the links between resource strategies and child growth using linear mixed modeling. Children’s z-height, z-weight, and z-BMI are well below international standards. We find agriculture remains predominantly subsistence-based, with some reliance on cash flow from government pensions and salaries. Households with stable income sources are better able to accumulate wealth, and children living in salaried households have better z-height. However, child growth is best predicted by individual-level factors rather than household ecology. Substantial variation in household strategy and little association of strategy with growth indicates there is no ‘best’ strategy in this transitioning environment.     

A 7-year-old boy with 49,XYYYY syndrome

The growth and development of a child with a 49,XYYYY karyotype is reported. The main features are a large stature, speech delay, and sensorimotor dysfunction.     

The determination of age and growth from the scales in Barbus liberiensis (Pisces, Cyprinidae)

The predictability of scale check formation in Barbus liberiensis has been investigated. Scale length is shown to be linearly related to body length. The formation of the check can be interpreted in terms of the reproductive cycle and changes in somatic condition. Throughout the population check formation takes place in two phases, resorption of material from the scale edges coinciding with the early and middle phases of gonad maturation, and the formation of the check itself as a result of repair as maturation is completed. Check formation is not correlated with actual spawning activity and fluctuations in food intake and temperature are insignificant.
The first scale check is formed at the end of the first year and from analysis of check frequency the mean body lengths at the end of the first, second and third years were 6·9 cm, 8·3 cm and 9·3 cm. There was no significant difference in the growth rate of males and females although the females tend to live longer and therefore attain a greater maximum size. Some individuals may not have formed a check at the end of the first year.
The difference between check formation in tropical and temperate fish and also between forest and savanna types are discussed. The predictability and the factors affecting check formation in tropical freshwater fish are considered.     

Diversity in auxology: between theory and practice. Proceedings of the 18th Aschauer Soiree, 13th November 2010

Auxology has developed from mere describing child and adolescent growth into a vivid and interdisciplinary research area encompassing human biologists, physicians, social scientists, economists and biostatisticians. The meeting illustrated the diversity in auxology, with the various social, medical, biological and biostatistical aspects in studies on child growth and development.     

Associations between women’s empowerment and child development,growth, and nurturing care practices in sub-Saharan Africa: A cross-sectional analysis of demographic and health survey data

BackgroundApproximately 40% of children 3 to 4 years of age in low- and middle-income countries have suboptimal development and growth. Women’s empowerment may help provide inputs of nurturing care for early development and growth by building caregiver capacity and family support. We examined the associations between women’s empowerment and child development, growth, early learning, and nutrition in sub-Saharan Africa (SSA).Methods and findingsWe pooled data on married women (15 to 49 years) and their children (36 to 59 months) from Demographic and Health Surveys that collected data on child development (2011 to 2018) in 9 SSA countries (N = 21,434): Benin, Burundi, Cameroon, Chad, Congo, Rwanda, Senegal, Togo, and Uganda. We constructed a women’s empowerment score using factor analysis and assigned women to country-specific quintile categories. The child outcomes included cognitive, socioemotional, literacy–numeracy, and physical development (Early Childhood Development Index), linear growth (height-for-age Z-score (HAZ) and stunting (HAZ <−2). Early learning outcomes were number of parental stimulation activities (range 0 to 6) and learning resources (range 0 to 4). The nutrition outcome was child dietary diversity score (DDS, range 0 to 7). We assessed the relationship between women’s empowerment and child development, growth, early learning, and nutrition using multivariate generalized linear models.On average, households in our sample were large (8.5 ± 5.7 members) and primarily living in rural areas (71%). Women were 31 ± 6.6 years on average, 54% had no education, and 31% had completed primary education. Children were 47 ± 7 months old and 49% were female. About 23% of children had suboptimal cognitive development, 31% had suboptimal socioemotional development, and 90% had suboptimal literacy–numeracy development. Only 9% of children had suboptimal physical development, but 35% were stunted. Approximately 14% of mothers and 3% of fathers provided ≥4 stimulation activities. Relative to the lowest quintile category, children of women in the highest empowerment quintile category were less likely to have suboptimal cognitive development (relative risk (RR) 0.89; 95% confidence interval (CI) 0.80, 0.99), had higher HAZ (mean difference (MD) 0.09; 95% CI 0.02, 0.16), lower risk of stunting (RR 0.93; 95% CI 0.87, 1.00), higher DDS (MD 0.17; 95% CI 0.06, 0.29), had 0.07 (95% CI 0.01, 0.13) additional learning resources, and received 0.16 (95% CI 0.06, 0.25) additional stimulation activities from their mothers and 0.23 (95% CI 0.17 to 0.29) additional activities from their fathers. We found no evidence that women’s empowerment was associated with socioemotional, literacy–numeracy, or physical development. Study limitations include the possibility of reverse causality and suboptimal assessments of the outcomes and exposure.ConclusionsWomen’s empowerment was positively associated with early child cognitive development, child growth, early learning, and nutrition outcomes in SSA. Efforts to improve child development and growth should consider women’s empowerment as a potential strategy.

Lilia Bliznashka and co-workers study empowerment of women and associated child health outcomes in sub-Saharan Africa.     

Measure twice, think three times, cut once

When I was a child, my father taught me how to fix a punctured tyre. He stressed the importance of checking the whole tyre, even if I had already found a puncture, because there could always be more. In addition, he made me check the outer tyre for sharp pieces that could again damage the inside tyre.     

Parent development

Today's parents tend to be overwhelmed with advice from many sources. In his role as family counselor, the pediatrician must understand and consider the emotional development of parents in relation to their child's development; otherwise, his advice and counsel do not "take" and he becomes tired and frustrated and angry. PARENTS PROGRESS THROUGH DEFINITE STAGES OF DEVELOPMENT: Stage 1: Learning the cues-the struggle of the parents to interpret the infant's needs. Stage 2: Learning to accept growth and development-the parent learning to accept some loss of control of the toddler. Stage 3: Learning to separate-the parent learning to allow the child to develop independently. Stage 4: Learning to accept rejection, without deserting-the struggle of the parents not to intrude and yet to be there when needed. Stage 5: Learning to build a new life having been thoroughly discredited by one's teenager-the parent learning to live independently while the teenager struggles to develop his own identity.The pediatrician who is accepting, sensitive and a good listener and who keeps in mind that parents as well as children have capacities for growth and development, will be a potent factor in promoting good parent-child relationships and many times more effective in dealing with the child in health and disease.     

Tertiary trisomy 14q-, due to paternal balanced translocation 46,XY,t(1;14)(q44;q22)

Summary Retardation of growth and mental development, craniofacial dysmorphy, limb anomalies, cryptorchidism and repeated infections are observed in a child with 47,XY,+der(14),t(1;14)(q44;q22)pat.     

The Practitioner and School Age Child Problems

The extraordinary plasticity of the growing child offers the general practitioner an unusual opportunity to intervene either in a preventative or therapeutic manner. Such intervention, properly the task of any informed physician dealing with families, can alter unhealthy growth to healthier development. The whole child is just as important as his medical illnesses; the whole family usually needs help when there is an emotional disturbance in any child.Common problems that lend themselves readily to physician intervention are behavior disorders accompanying a neurological deficit, conduct disorders, enuresis and school phobias. Knowing how to elicit information, to evaluate clinical data and to utilize the findings of a skilled psychologist, and when to refer to a psychiatrist, plus a thorough knowledge of community resources are part and parcel of a physician''s equipment for dealing with children and families.     

Physical growth in a transitional economy: the aftermath of South African apartheid

The economic transition in developing countries is not always the result of the change from a centrally-planned to a free-market economy, but may be found within an already existing free-market economy as a result of profound political change, as in South Africa. The release of Nelson Mandela in February 1990 heralded an end both to the political system of apartheid and to the concomitant social, political, and economic disenfranchisement of 30 million non-White people in South Africa. The first freely elected non-White government came to power in 1994 and initiated a number of social and economic reforms aimed at alleviating the worst consequences of apartheid. This paper examines the effect of post-apartheid economic and social transition on the growth and development of urban children. Over 4000 children born in Soweto and Johannesburg were enrolled in the Birth to Ten (BTT) birth-cohort study in 1990. Whilst these children were born with lower birth weights than in developed countries, they did grow strongly in infancy, particularly in weight, to reflect normal reference values for body mass index (BMI) by 1 year of age. While post-apartheid social and economic changes were expected to take some time to affect child growth and development, the rate of change has been slower than expected. Data from the BTT study demonstrate that the growth of White children continues to be superior to that of their non-White peers and differences that existed at birth and during infancy have not diminished during childhood and early adolescence. Whatever factors are changed at the national or community levels during economic (and social) transition in South Africa appear not yet to have resulted in improved child physical growth.     

International Medical Aid

Knowledge of the intricacies of child growth and development and the complexities of family and community dynamics are invaluable for an adequate appraisal of the health needs of the child and for a responsible discharge of professional service. An attempt to incorporate these principles into a medical curriculum is illustrated by a specific method of teaching preventive pediatrics successfully employed over the past five years at the University of British Columbia. First-year students are assigned families and instructed and supervised in observation, examination and interviewing techniques relevant to the normal child. The second-year program is focused on specific individual and family problems of interpersonal relations and elaborates on counselling and other preventive techniques. Research projects are undertaken by the students. By the third year the program is integrated into the tradetional hospital setting, with additive exposure to the functioning of community health and welfare services.     

Characterisation of Pythium paroecandrum and its antagonism towards Botrytis cinerea, the causative agent of grey mould disease of grape

Pythium paroecandrum (B-30), an oomycete, was isolated from soil samples taken from a wheat field in Genlis in the Burgundy region of France and was found to check the growth and development of Botrytis cinerea, a serious grapevine pathogen. The oomycete is a fast-growing organism, living on vegetable debris, and can be recognised by its catenulate hyphal swellings, catenulate oogonia, and monoclinous antheridia. When grown together with B. cinerea, the causal agent of the grey mould disease of the grapevine, P. paroecandrum shows a pronounced antagonism and suppresses its growth and its aptitude to provoke the grey mould symptoms. Morphological features of this oomycete, its antagonism to B. cinerea, the sequences of the internal transcribed spacer region of its nuclear ribosomal DNA, and its comparison with related species are discussed in this article.     

Life history and the evolution of human maturation

The Taung child, like fossils of other individuals who died before reaching adulthood, is a piece of the puzzle of the evolution of human growth and development, the puzzle of when, how, and why human “life history” evolved into its modern form. With regard to Taung, interest focuses on both its rate of growth (maturation of the child in relation to its age) and its pattern of growth (synchrony of the elements of maturation). The meaning of rates and patterns of growth, as well as the interpretation of maturation of Taung or any other fossil mammal, are best understood through the broad perspectives provided by comparative study of mammalian life history and the techniques of allometry.     

Growth acceleration,behaviour and otolith check marks associated with sex change in the wrasse <Emphasis Type="Italic">Halichoeres miniatus</Emphasis>

In protogynous sex-changing fishes, females are expected to compete for the opportunity to change sex following the loss of a dominant male and may exhibit growth and behavioural traits that help them maintain their dominant status after sex change. A male removal experiment was used to examine changes in female growth and behaviour associated with sex change in the haremic wrasse Halichoeres miniatus and to test whether any changes in growth associated with sex change were recorded in otolith microstructure. Dominant females began displaying male-characteristic behaviour almost immediately after the harem male was removed. The frequency of interactions between females increased following male removal. In contrast, feeding frequency of females decreased. The largest one to three females in each social group changed sex following male removal and exhibited an increase in growth associated with sex change. Sex changers grew more than twice as fast as non-sex changers during the experimental period. This growth acceleration may enable new sex-changed males to rapidly reach a size where they can defend the remaining harem from other males. An optical discontinuity (check mark) was present in the otoliths of sex-changed fish, and otolith accretion rate increased significantly after the check mark, corresponding with the increased growth rate of sex-changing females. Wild caught males, but not females, exhibited an analogous check mark in their otoliths and similar increases in otolith increment widths after the check. This indicates that an increase in growth rate is a regular feature of sex-change dynamics of H. miniatus. Communicated by Environment Editor Prof. Rob van Woesik     

Child growth and the economic value of children in rural Bolivia

Previous investigations have yielded contradictory conclusions concerning the importance of the economic contribution of children to households in agricultural societies. The present study evaluates the significance of children 's economic input in rural Ancoraimes, Bolivia by using child growth as an indirect indicator of the economic value of children. Children whose households differed in size and age composition were compared on the basis of five anthropometric measurements. Children from households with many young, nonproducing children were found to be significantly smaller for their age than children from households with few nonproducing children. Absolute household size had no major effect on child growth. While young children have a negative effect on the growth of children in the household, the positive effect of children as they grow older appears to make up for this loss. In terms of child growth, children are neither a net liability nor a net asset to agricultural households in Ancoraimes.     

Precocious Puberty Due to Rathke Cleft Cyst in a Child

ObjectiveTo report a case of a child with precocious puberty attributable to Rathke cleft cyst (RCC).MethodsThe clinical features, laboratory results, and findings on ultrasonography of the pelvis and magnetic resonance imaging of the pituitary gland are presented.ResultsA 16-month-old child had breast enlargement, height increase, and an increase in growth velocity. On examination, she was found to have Tanner stage 3 breast development, and her vaginal mucosa was estrogenized. Her height was above the 97th percentile. Biochemically, she was diagnosed as having central precocious puberty, and magnetic resonance imaging of her pituitary gland disclosed RCC. Treatment with leuprolide resulted in normalization of her growth rate and regression of the breast development; the vaginal mucosa also became unestrogenized.ConclusionAlthough RCC is a relatively common finding, it is a rare cause of precocious puberty. Magnetic resonance imaging of the pituitary gland should be performed in all children younger than 6 years of age who have precocious puberty, in an effort to detect any organic lesions. (Endocr Pract. 2009;15:134-137)     

Designing water-saving-ecological check dam sites by a system optimization model in a region of the loess plateau,Northwest China

Check dams are the most widespread structures for successfully retaining water and checking erosion on the semiarid portions of China's Loess Plateau. However, in the process of check dam planning and construction, difficulties in identifying the weights of influential factors, balancing all factors and making decisions are common problems that seriously restrict rapid socioeconomic development. With the goals of determining potential check dam construction sites and holistically maximizing a projected check dam array's water resource, ecosystem and socioeconomic benefits (taking into account the water shortage and ecological fragility in semiarid areas), a water-saving-ecological check dam site optimization model (WCSOM) was developed. The WCSOM, with newly added water-saving factors, was applied to the selection of check dam sites in the Sijiagou Basin. The model showed that the ecological and the water-saving factors were the top two weights, accounting for 59.88% of the total weight. The top three influencing elements were conservation of water sources, flood prevention capacity and check dam control area, which were part of the ecological, socioeconomic and economic factors, respectively, accounting for 37.77% of the total weight. The scores of larger-scale check dam sites in the basin were generally higher, while the scores of smaller-scale sites were generally lower. The use of the WCSOM in watershed planning will allow a more efficient use of water and soil resources and greatly alleviate water crises in this semiarid area. The WCSOM can be further applied in other regions by adjusting the criterion and index hierarchies, and it can provide technical support for both the planning and rapid development of a check dam system.