Measuring Coverage in MNCH:A Validation Study Linking Population Survey Derived Coverage to Maternal, Newborn, and Child Health Care Records in Rural China

Accurate data on coverage of key maternal, newborn, and child health (MNCH) interventions are crucial for monitoring progress toward the Millennium Development Goals 4 and 5. Coverage estimates are primarily obtained from routine population surveys through self-reporting, the validity of which is not well understood. We aimed to examine the validity of the coverage of selected MNCH interventions in Gongcheng County, China.We conducted a validation study by comparing women's self-reported coverage of MNCH interventions relating to antenatal and postnatal care, mode of delivery, and child vaccinations in a community survey with their paper- and electronic-based health care records, treating the health care records as the reference standard. Of 936 women recruited, 914 (97.6%) completed the survey. Results show that self-reported coverage of these interventions had moderate to high sensitivity (0.57 [95% confidence interval (CI): 0.50-0.63] to 0.99 [95% CI: 0.98-1.00]) and low to high specificity (0 to 0.83 [95% CI: 0.80-0.86]). Despite varying overall validity, with the area under the receiver operating characteristic curve (AUC) ranging between 0.49 [95% CI: 0.39-0.57] and 0.90 [95% CI: 0.88-0.92], bias in the coverage estimates at the population level was small to moderate, with the test to actual positive (TAP) ratio ranging between 0.8 and 1.5 for 24 of the 28 indicators examined. Our ability to accurately estimate validity was affected by several caveats associated with the reference standard. Caution should be exercised when generalizing the results to other settings.The overall validity of self-reported coverage was moderate across selected MNCH indicators. However, at the population level, self-reported coverage appears to have small to moderate degree of bias. Accuracy of the coverage was particularly high for indicators with high recorded coverage or low recorded coverage but high specificity. The study provides insights into the accuracy of self-reports based on a population survey in low- and middle-income countries. Similar studies applying an improved reference standard are warranted in the future

Child Health and Nutrition in China

BackgroundChild healthcare practices in China over the last 60 years have extensively improved children’s health and growth, yet new challenges lie ahead. This review aims to summarise the successful experiences and the newly identified problems in child healthcare in China.Method  Information, available to the public, was obtained from Chinese databases and Chinese Government websites, chiefly the Chinese National Knowledge Infrastructure database, the Chinese Biomedical Literature database, the Ministry of Health website and the National Working Committee on Children and Women website.ResultsDuring its poverty-stricken 1950s–1970s, China protected children’s health mainly through prevention and control of common infectious diseases and severe malnutrition within a comprehensive healthcare system. After the subsequent 30 years of rapid socio-economic development, China has achieved great success in reducing childhood mortality rates and promoting child growth, meeting the Millennium Development Goal 4 targets and the WHO child growth standards. Meanwhile, new challenges for children’s healthcare emerged, including: large disparities in the health, growth and nutritional status of children, and in the accessibility and quality of child healthcare, between urban and rural areas and across different regions of China; the nutritional and healthcare concerns of the fast-expanding population of migrant children and rural left-behind children; the burgeoning epidemic of childhood obesity in urban and economically developed areas; micronutrient deficiencies such as calcium, iron, zinc and vitamin A; and increasing prevalence of mental and behavioural disorders.ConclusionUnder poor economic conditions, healthcare plays a key role in protecting children against diseases. With the development of social economy, new challenges present to healthcare services, specifically, to comprehensively promote and optimise childrens’ health and nutrition

Yesterday's coolies, today's maids : a critical comparative study

This paper compares the situations of immigrant labourers in Singapore between two eras and establishes whether it is indeed true that today’s foreign domestic workers are the coolies of the past

The Proposed Neurotoxin beta-N-Methylamino-l-Alanine (BMAA) Is Taken up through Amino-Acid Transport Systems in the CyanobacteriumAnabaenaPCC 7120

Produced by cyanobacteria and some plants, BMAA is considered as an important environmental factor in the occurrence of some neurodegenerative diseases. Neither the underlying mechanism of its toxicity, nor its biosynthetic or metabolic pathway in cyanobacteria is understood. Interestingly, BMAA is found to be toxic to some cyanobacteria, making it possible to dissect the mechanism of BMAA metabolism by genetic approaches using these organisms. In this study, we used the cyanobacteriumAnabaenaPCC 7120 to isolate BMAA-resistant mutants. Following genomic sequencing, several mutations were mapped to two genes involved in amino acids transport, suggesting that BMAA was taken up through amino acid transporters. This conclusion was supported by the protective effect of several amino acids against BMAA toxicity. Furthermore, targeted inactivation of genes encoding different amino acid transport pathways conferred various levels of resistance to BMAA. One mutant inactivating all three major amino acid transport systems could no longer take up BMAA and gained full resistance to BMAA toxicity. Therefore, BMAA is a substrate of amino acid transporters, and cyanobacteria are interesting models for genetic analysis of BMAA transport and metabolism

Assessment and Prediction of Extreme Temperature Indices in the North China Plain by CMIP6 Climate Model

Extreme temperature events are becoming more frequent due to global warming, and have critical effects on natural ecosystems, social and economic spheres, human production and life. Predicting changes in temperature extremes and trends under future climate scenarios helps to assess the impact of climate change accurately. Based on climate observations from 54 meteorological stations in the North China Plain and the projection data from seven general circulation models (GCMs) from the Coupled Model Intercomparison Project phase 6 (CMIP6), this paper researches nine representative extreme temperature indices under four typical climate scenarios. The aim is to reveal the temporal and spatial variations in extreme temperature indices in the North China Plain during the past (1971–2010) and the future (2061–2100). The results show that: using a support vector machine (SVM) to perform regression analysis on the multi-GCMs prediction results, the root mean square error (RMSE) and relative standard deviation (RSD) of the multi-model ensemble simulations obtained by the SVM method are lower than those of the arithmetic mean method and can better match the trend of the historical extreme temperature index; the extreme high temperature index is predicted to show a significant upward trend in the future, while the extreme low temperature index will decrease significantly; and there are significant spatial differences in the extreme temperature index in both historical and future periods, with the extreme temperature index under the high radiation forcing scenario (SSP585) showing the most considerable variation and the most significant spatial differences