Children, as a special group, have received public attention. Although a series of policies have been released in recent years to ensure the safety of children's medication, there are still problems such as fewer suitable varieties of drugs and irrational use of medication, which require scientific and reasonable policies on children's medication to promote their development.
To quantitatively evaluate China's pediatric drug policy texts and provide reference for the formulation and improvement of future pediatric drug policies.
Based on the text mining method, 23 pediatric drug policy documents issued at the national level from 2014 to 2023 were processed, the policy modeling consistency (PMC) index model of pediatric drug policy was constructed, and the quantitative evaluation and analysis of China's 23 pediatric drug policies were carried out through 10 primary variables and 41 secondary variables.
The mean value of PMC index of the 23 policies on pediatric drug was 5.65, and the mean value of PMC depression index was 4.35, including 1 excellent-grade policy, 17 good-grade policies and 5 qualified-grade policies, and there were no perfect-grade policies and bad policies. 23 medication policies for children scored high on policy tools and policy receptors and low on publishing organizations and policy timeliness.
China's pediatric drug policy is generally at a good level, and can be further improved in terms of policy timeliness, issuing organization and policy content.
The incidence of precocious puberty (PP) in Chinese children is increasing year by year, precocious children are more likely to have physical and mental health problems than normal children, and their growth can be affected. In view of the current clinical lack of understanding and prevention measures for PP, it's of great significance to clarify the relevant influencing factors and provide references for the prevention and treatment of PP.
To systematically evaluate the factors associated with PP in Chinese children.
We searched PubMed, Web of Science, Embase, Cochrane Library, CBM, CNKI, VIP and Wanfang databases, the search period was from the establishment of the database to April 30, 2024. Two researchers independently screened the literature, extracted data and assessed the quality of the included literature, and we performed Meta-analysis using Stata 15.0 software.
A total of 41 studies covering 44 221 cases were selected, and 31 influencing factors were extracted. Methodological quality evaluation of the literature shows that 20 medium-quality and 21 high-quality studies were included. Meta-analysis demonstrated that: female (OR=1.64) , urban settlement (OR=4.13) , residential near chemical industry park (OR=2.52) , maternal age at menarche≤12 years old (OR=2.37) , >12-14 years old (OR=3.04) , low parental education (OR=2.41) , poor parental relationship (OR=4.37) , parental companionship <0.5 years (OR=2.05) , screen time (OR=3.07) , love romantic films and novels (OR=5.94) , outdoor activity<1 h/d (OR=3.86) , sleep with the light on (OR=2.48) , use of adult chemical products (OR=5.36) , plastic products are often used at home (OR=2.45) , heavy school workload (OR=2.63) , family history of PP (OR=3.23) , high BMI (OR=1.57) , sleep duration (OR=2.57) , frequent consumption of nutritional supplements (OR=3.01) , high-calorie and high-fat diets (OR=3.05) , high protein diets (OR=2.47) , animal food (OR=3.35) , sweets (OR=5.85) , food containing pigments or preservatives (OR=1.80) , leptin (OR=5.34) , estradiol (OR=3.32) , luteinizing hormone (OR=3.71) , insulin-like growth factor 1 (OR=2.70) and follicle stimulating hormone (OR=2.40) levels were the main risk factors for PP in Chinese children (P<0.05) , whereas maternal age at menarche >14 years (OR=0.64) , outdoor activity ≥2 h/d (OR=0.73) and consumption of vegetables and fruits ≥200 g/d (OR=0.60) were protective factors (P<0.05) .
Our findings show that the occurrence of PP in Chinese children is influenced by a multitude of sociodemographic, psychosocial, genetic, physiological, dietary, and environmental factors, among which the later age of mother´s menarche, the longer outdoor activities and the consumption of vegetables and fruits ≥200 g/d are protective factors. In the future, it is necessary to investigate and intervene on controllable factors. Families, schools and hospitals can work together to avoid or reduce the occurrence of PP in children.
With the decline in fertility rates, the state has adjusted its fertility policy and optimised complementary support measures, which has had a positive impact on the willingness of families to have children and on the increase in fertility levels, but the situation of declining births is still serious. Fertility is a natural and complex behaviour, which is affected by many factors, such as the level of economic development, the availability of childcare services, the level of reproductive health and family structure. To encourage people to respond to the latest fertility policy, it is important to build a comprehensive, accessible and convenient support system for infant and child care. Group well-child care (GWCC) facilitated by healthcare professionals, allows mothers to share and learn from each other's parenting experiences and postnatal health issues. This community-based group environment fosters the health of families and the improvement of professional capabilities, and promotes cooperation and interaction among healthcare professionals, parents, and different families. This new model of parenting will expand the depth and breadth of our country's postnatal maternal and child health services. In this paper, we will review the origin and development, service content, and application effect of GWCC, discuss the inspiration and applicability of GWCC to China, and look forward to the development direction of the group well-child care. In the future, GWCC can be combined with hospitals or communities to establish an integrated healthcare service system for postpartum and childcare, which will further solve the current problems in the field of postpartum childcare services in China, and promote the improvement of the infant and childcare system as well as the construction of a birth and parenting-friendly social environment.
