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  • In addition to the potential for adverse effects of

    2019-04-25

    In addition to the potential for adverse effects of poor growth on brain outcomes in this cohort, the prevalence of iron deficiency was also alarmingly high. All the hospitals recommended iron supplements at discharge and throughout the intervention period, but levels of compliance could not be determined, and almost three quarters of infants were iron deficient (serum ferritin <12 ug/dL) at 12 months. As the authors state, this might relate to the vegetarian diets received by most infants, co-consumption of phytates and oxalates, low ascorbic cyclooxygenase pathway levels, or poor iron bio-availability in the supplements used. Furthermore, delayed umbilical cord clamping was not routine. Iron deficiency has important and long lasting effects on brain development and the high prevalence of iron deficiency observed in this study suggests this must be an important priority for further work in this population.
    Worldwide, it has been recognised that violence against women and violence against children are significant human rights and public health issues, with WHO describing violence against women as a “global health problem of epidemic proportions”. Globally, a third of women have been the victims of gender-based violence and over 1 billion children have experienced violence in the past year. Furthermore, a quarter of all adults report being victims of physical abuse as children, with a fifth of women reporting being victims of child sexual abuse. This violence not only results in injury and mortality, but is associated with further health effects including increased risk of non-communicable diseases and reproductive, developmental, and mental health issues. Effective and scalable efforts to address violence against women and violence against children have historically developed as parallel but separate fields with distinct funding streams, governing agencies, approach strategies, and bodies of research. Existing global research nonetheless demonstrates important intersections between the two that have significant implications for health programmes, policies and research. Emma Fulu and colleagues\' study in is thus very timely, and is a major advance in understanding the pathways between violence against women and violence against children. Their analyses of the UN Multi-Country Study on Men and Violence in Asia and the Pacific reveal a cycle of abuse, with child abuse leading to higher risk of violence against women and additional child maltreatment, which in turn increases the risk of adult violence. Overall, this study highlights that violence against women and violence against children can no longer be treated as distinct issues and that a deeper understanding of the pathways between the two are cyclooxygenase pathway needed. The UN Sustainable Development Goals (SDGs) include two zero-based targets aiming to end all forms of violence against women and violence against children. In other words, every country that has committed to these global goals must not only reduce, but eliminate, violence against women and violence against children by 2030. Data collection and a clearer understanding of the complex inter-relationship of many factors relating to violence are essential to achieving these goals. Currently, the research on violence against women and violence against children is overwhelmingly concentrated in high-income countries, with a dearth of information from low-income and middle-income countries (LMICs), including those of the Asia and Pacific region. Fulu and colleagues\' study makes important contributions by demonstrating that child abuse and maltreatment is highly prevalent among women and men in the general population across the Asia-Pacific region, while also pointing to the interface between child abuse and violence against women in a LMIC setting, which has also been found in previous research concentrated in high-income countries. These findings illustrate strong links between childhood experiences of abuse and the perpetration or experience of violence against women in adults, and that this cycle of violence is driven by gender inequality and social norms. Fulu and colleagues\' study recognises the importance of these macro-level factors with regard to both violence against women and violence against children and indicates that the environment in which a child develops is extremely important for violence prevention, complementing other emerging evidence on the drivers of violence. At this stage, many countries worldwide lack the necessary data to evaluate the progress of the SDGs and this research not only provides data for the region but also offers much needed direction for prevention and intervention.