Inequities in childhood cancer research: A scoping review.

An integral part of understanding and then designing programs to reduce childhood cancer inequities includes adequate representation of people with cancer in research, including children. A scoping review was carried out to understand how cancer research is oriented toward inequities and to identify who has participated in childhood qualitative cancer research. A systematic search identified 119 qualitative studies that met inclusion criteria, with most studies taking place in high-income countries (n=84). Overall, data were lacking on social determinants of health at multiple levels-structural, household, child, and guardian. Only 29 studies reported on race and/or ethnicity, with the majority of those including predominantly or all white children. Six articles included socioeconomic information, and across most articles, attention was absent to the financial ramifications of cancer care. Limited reporting of sociodemographics highlights a broader issue of neglecting key demographics and social factors that contribute to inequities.

A Heart for the Care: Affect, Kin, and Care Work in a Zambian Hospital.

At the only standalone pediatric hospital in Zambia, patient wellbeing often rests in the hands of bedsiders. Bedsiders are caregivers, often family, who sit at the patient's bedside, feeding, cleaning them, and running medical errands. Bedsiders are critical human infrastructure for the hospital and its staff. In our research, we heard repeatedly that bedsiders must have a "heart" for caregiving, taking on unremunerated and exhausting informal labor. We draw on Wendland's "heart for the work," a phrase commonly used among healthcare workers in Malawi and Zambia describing the medical profession, to explore what this metaphor reveals about care.

Childhood growth and education migration among ethnic Tibetan children from Nepal.

BACKGROUND: Ethnographic work among high altitude populations has shown that children are highly mobile-the most recent expression of this is the educational migration of children born at high altitude to boarding schools at lower altitudes. The impact of these patterns of migration on size for age are unknown. AIM: We investigated the association between growth in weight and height and educational migration in ethnic Tibetan children living in and out of their natal communities. SUBJECTS AND METHODS: Five hundred and fifty eight children ages three to sixteen from the Nubri Valley, Nepal participated in this study. Three hundred children were living in natal villages and 258 were attending boarding schools in Kathmandu. Height, weight, and skinfold thicknesses were collected and matched to demographic data from the community. RESULTS: There was no association between altitude of family residence and size for age z-scores. Males had lower z-scores than females; z-scores for both groups declined with age. Differences in size for age among children in boarding schools were associated with two factors: sex and type of boarding school (individual sponsor or group funded). Individuals attending individually sponsored schools had greater size for age compared to children in group funded schools or in their natal villages; younger children in collectively funded schools were smaller than village peers. CONCLUSIONS: Despite popular perceptions, educational outmigration in Himalayan communities may not be associated with improved child growth outcomes and investment in community level schools may be a practical solution for improving child growth and physical and mental health.

Maternal birth weight is associated with milk epidermal growth factor in Filipino women.

OBJECTIVES: Lactational programming, through which milk-borne bioactives influence both neonatal and long-term biological development, is well established. However, almost no research has investigated how developmental stimuli during a mother's early life may influence her milk bioactives in adulthood. Here, we investigated the association between maternal birth weight and milk epidermal growth factor (EGF) and epidermal growth factor receptor (EGF-R) in later life. We predicted there would be a decrease in both milk EGF and EGF-R in the milk produced by mothers who were themselves born low birth weight. METHODS: Study participants are from the Cebu Longitudinal Health and Nutrition Survey. Mothers (n = 69) were followed longitudinally since birth with prospective data collection. Anthropometrics, health, and dietary recalls were collected with early morning milk samples when mothers were 24 to 25 years of age. Milk samples were analyzed for EGF and its receptor (EGF-R). Analysis of variance was used to test for differences in milk EGF and EGF-R between low and average birthweight mothers after adjustment for parity, age, and maternal dietary energy intake. RESULTS: Mothers who were low birth weight produced milk with significantly less EGF and more EGF-R which resulted in a lower ratio of EGF to EGF-R. These associations persisted after adjustment for infant age, maternal adiposity, and dietary energy. CONCLUSIONS: While this is a small sample size, these preliminary findings suggest that maternal early life characteristics, such as birth weight, may be important contributors to variation in milk bioactives. Future work is necessary to understand how variation in maternal early life may influence milk composition in adulthood.