The Continuing Problem of Asthma in Very Young Children: A Community-Based Participatory Research Project

Background:  Asthma is a chronic health condition that has a disproportionate effect on low-income minority children who reside in large urban areas. AfricanAmerican children report significantly higher rates than the general population of children and have more-severe asthma and poorer outcomes. This article describes the prevalence of asthma in a particularly vulnerable group: children aged 2-5 participating in Detroit Head Start programs.
Methods:  Health screens were distributed to caretakers of all children attending 6 Head Start agencies. Caretakers of children identified with active asthma symptoms were asked to complete an in-depth phone interview regarding their child's asthma.
Results:  Data collected from 3,254 children (78% African American) revealed that 27% met criteria for probable asthma. Of those with persistent symptoms, 26% were undiagnosed, and 21% were untreated. Baseline data (n = 675) showed that 95% had a regular doctor, but 36% had had no health care visit for asthma in the previous year. Of children with a history of asthma episodes, more than half reported 3 or more episodes in the preceding year. Forty-three percent of caretakers had discussed their child's asthma with Head Start, and 31% had an asthma action plan on file with Head Start.
Conclusions:  Asthma remains a significant problem in this population, especially for African Americans, as evidenced by high levels of undiagnosed children with persistent symptoms and questions regarding the care they receive. Head Start is a way to reach young children with asthma, but may need help to develop the capacity to assist families.     

Diet Quality of Australian Children and Adolescents on Weekdays versus Weekend Days: A Secondary Analysis of the National Nutrition and Physical Activity Survey 2011–2012

Daily routines may influence children and adolescents’ eating patterns, however the influence of days of the week on dietary intake has rarely been explored. This study aimed to examine discretionary choices intake in the context of diet quality on weekdays versus weekends. A secondary analysis was conducted using the Australian National Nutrition and Physical Activity Survey 2011–2012. Differences in discretionary choices intake and diet quality on weekdays versus weekends, were examined using ANCOVA analyses. Associations between child and parent-proxy characteristics and weekday/weekend discretionary choices intake were examined using multivariable regression models. Primary analyses included 2584 Australian 2–17-year-olds. There were small differences in discretionary choices intake and diet quality between weekdays and weekends in all age subgroups. Compared to weekdays, intakes on weekends were characterized by a higher intake of discretionary choices, and lower total Dietary Guidelines Index for Children and Adolescents (DGI-CA) scores across the age subgroups (all p < 0.01). Parent-proxy discretionary choices intake and child age were predictors of weekday and weekend discretionary choices intake. Parent-proxy obesity weight status compared with healthy weight status was a predictor of weekend intake, while parent-proxy education level was a predictor of weekday discretionary choices intake. Future intervention strategies should target discretionary choices intake on both weekdays and weekends.     

Effect of Fortification with Multiple Micronutrient Powder on the Prevention and Treatment of Iron Deficiency and Anaemia in Brazilian Children: A Randomized Clinical Trial

Fortification with multiple micronutrient powder has been proposed as a public health intervention able to reduce micronutrient deficiencies in children. Our objective was to compare the effectiveness of fortification with multiple micronutrient powder with drug supplementation in the prevention and treatment of iron deficiency and anaemia. This was a cluster trial with anemic and non-anaemic children between six and 42 months old, in randomization data. Non anaemic children received fortification with multiple micronutrient powder or standard drug supplementation of ferrous sulfate associated with folic acid in a prevention dose. Anaemic children who were randomized to receive multiple micronutrient powder also received the recommended iron complementation for anaemia treatment. A total of 162 children were evaluated. The prevalence of anaemia decreased from 13.58 to 1.85%. Iron deficiency decreased from 21.74% to 7.89% (by serum ferritin) and iron deficiency decreased from 66.81 to 38.27% (by soluble transferrin receptor). No difference was identified between interventions for hemoglobin (p = 0.142), serum ferritin (p = 0.288), and soluble transferrin receptor (p = 0.156). Fortification with multiple micronutrient powder was effective in preventing iron deficiency and anaemia in children aged six to 48 months. In anaemic children; it was necessary to supplement the dose of multiple micronutrient powder with ferrous sulfate.     

An Assessment of the Potential Impact of Fortification of Staples and Condiments on Micronutrient Intake of Young Children and Women of Reproductive Age in Bangladesh

Bangladesh has experienced rapid economic growth and achieved major health improvements in the past decade, but malnutrition rates remain high. A nationally representative study conducted in 2011 assessed the dietary habits of 841 children 24–59 months old; 1428 children 6–14 years old; and 1412 non-pregnant, non-lactating women. The study’s objective was to assess dietary intakes of key micronutrients and the consumption pattern of potentially fortifiable foods, and then to model the potential impact of fortification of key staple foods. The current intakes of several micronutrients, namely, iron, zinc, folate, vitamin A and vitamin B12, were found to be insufficient to meet the needs of Bangladesh’s children and women. The fortification of rice with iron and zinc and edible oil with vitamin A has the potential to fill a significant part of the nutrient gap, as these are consumed widely and in significant amounts. Wheat flour and sugar are not as promising food vehicles in the Bangladeshi context, as they were consumed by a smaller portion of the population and in smaller amounts. In conclusion, fortification of rice and oil is recommended to address the large gap in micronutrient intakes.     

Effect of Low-Energy-Dense Diet Rich in Multiple Functional Foods on Weight-Loss Maintenance,Inflammation, and Cardiovascular Risk Factors: A Randomized Controlled Trial

Background: There are no investigations regarding the effects of consuming low-energy-dense diets rich in multiple functional foods on weight-loss maintenance, inflammatory markers, and cardiovascular disease (CVD) risk factors simultaneously.

Method: This randomized controlled trial design was conducted on 90 men and women who were under a previous weight loss diet. Three months of intervention with recruitment at Allzahra Hospital, Isfahan, Iran, was done. Intervention was conducted following achieving 7–11 kg weight loss. Participants were encouraged to consumed these three: an isocaloric control diet (50% of energy from carbohydrate, 35% from fat, 15% from protein), a low-glycemic-index diet (LE) (60% from carbohydrate, 25% from fat, and 15% from protein), and a low-glycemic-index diet rich in multiple functional foods (LE + FF) (60% from carbohydrate, 25% from fat, and 15% from protein). Fasting blood glucose, serum insulin level, lipid profiles, inflammatory markers, adiponectin, systolic and diastolic blood pressure, and anthropometric measurements were assessed using standard guidelines.

Results: The percent changes of weight, waist, and body mass index (BMI), systolic and diastolic blood pressure, malondialdehyde (MDA), high-sensitivity C-reactive protein (hs-CRP), tumor necrosis factor (TNF) α, total cholesterol, low-density lipoprotein (LDL) cholesterol, triglyceride, and fasting blood glucose (FBS) were substantially more decreased in the LE + FF group compared to the LE and control groups (p ≤ 0.03). Percent change of adiponectin among the LE + FF group was significantly more enhanced (7.29 ± 0.10) compared with the LE group (1.28 ± 0.20) (p = 0.001). Significantly more increment in the percent change of total antioxidant capacity (TAC) (6.91 ± 0.10) was obtained among the LE + FF group compared to the LE group (1.79 ± 0.04).

Conclusions: This study provides established evidence supporting the beneficial effects of a low-energy-dense diet rich in multiple functional foods diet on improving weight-loss maintenance, inflammation, and cardiovascular risk factors.     

Effectiveness of Nutritional Strategies on Improving the Quality of Diet of Children from 6 to 12 Years Old: A Systematic Review

Dietary habits, that are formed during childhood and consolidated in adulthood, are known to influence the development of future chronic diseases such as metabolic syndrome or type 2 diabetes. The aim of this review was to evaluate the effectiveness of nutritional interventions carried out in recent years focused on improving the quality of the diet of the child population. A systematic search of the PubMed and Scopus databases was performed from January 2011 until September 2021. A total of 910 articles were identified and screened based on their title, abstract and full text. Finally, 12 articles were included in the current systematic review. Of those, in six studies the intervention was based on the provision of healthy meals and in the other six studies the intervention focused on modifying the school environment. Six of the studies selected included other components in their intervention such as nutritional education sessions, physical activity and/or families. A wide variety of methods were used for diet assessments, from direct method to questionnaires. The results suggest that interventions that modify the school environment or provide different meals or snacks may be effective in improving children’s dietary patterns, both in the short and long term. Further research is necessary to evaluate the real effectiveness of strategies with multidisciplinary approach (nutritional sessions, physical activity and family’s involvement).     

肺炎支原体快速培养、血清抗体检测联合应用于小儿支原体肺炎早期诊断中的价值分析

目的 分析联合应用MP快速培养、血清抗体检测在小儿支原体肺炎早期诊断中的价值.方法 选取78例疑似支原体肺炎患儿为观察组,健康儿童50名为对照组.分析两组的MP快速培养、血清MP-IgM检测阳性率,以及观察组应用抗生素治疗前后的阳性率、药物敏感试验结果.结果 观察组的MP快速培养、血清MP-IgM检测阳性率均高于对照组...     

Health-Related Quality of Life in Children with Celiac Disease: A Study Based on the Critical Incident Technique

Celiac Disease (CD) is a chronic autoimmune disease triggered by dietary gluten. Gluten avoidance, which is the only available treatment for CD, could impact on quality of life of children with CD. We present the results of a qualitative study on the emotional impact of gluten free diet (GFD) on the everyday life of children affected with CD. We investigated 76 celiac patients aged 2–18 years (average age: 9.5 years). By using the Critical Incident Technique (CIT), we defined emotions related to difficulties and awkward situations experienced by the patients. Written answers to open-ended questions from either children (older than 8 years) and parents (children younger than 8 years) were analyzed qualitatively. We found 80 dilemmas experienced in three different arenas (food situations at school, meals at home, meals outside) and characterized lived experiences of children with CD in everyday life (specific emotions, difficulties in relationships and in management of daily life). Children with CD experience strong emotions related to the GFD, permeating several aspects of everyday life. These dilemmas may be missed by a conventional, questionnaire-based approach to the psycho-social consequences of CD treatment.     

The Usefulness of Information Gathered from Parents in the Identification of Young Children with Handicaps: A Review and Discussion

ABC checklists (Adults Behaviors in Caregiving) have been created in three versions to assess caregivers of younger and older infants and caregivers of preschoolers. Two master teachers of younger infants were observed with ABC I during 46 half‐hours of observation, across daycare settings, time of day and day of week. Two master caregivers of toddlers were observed with ABC II during 59 half‐hours of observation. Piagetian activities were provided for younger infants during 1/5 of times sampled, and for older infants during 1/10 of times sampled. Master teachers practically never ignored babies who needed attention. Verbal criticisms or scolds were emitted in fewer than 1% of the times sampled. Isolation as a behavior modification technique was very rare with younger babies but occurred in 1/6 of sampled intervals with toddlers. Positive socioemotional interaction comprised 1/4 of teacher repertoire with younger babies. Language interactions represented 1/3 of the teachers’ repertoire with younger babies and almost 1/2 of the toddler teachers’ repertoire. ABC inputs varied somewhat as a function of time of day. There were no indications that caregivers became more negative later in the week. Thus, ABC proved to be a sensitive, easy to use instrument that is useful in monitoring the transactions of infant/ toddler caregivers and the effects of any inservice training procedures.     

Healthy Food,Healthy Teeth: A Formative Study to Assess Knowledge of Foods for Oral Health in Children and Adults

Eating patterns characterised by low intakes of processed carbohydrates and higher intakes of fat- and Vitamin D-rich foods are associated with protection against dental caries. The aim of this formative study was to evaluate the extent to which the knowledge of children and adults of foods for oral health reflects dietary guideline advice, and the evidence base for foods associated with increased and decreased caries burdens. Using a novel card-sorting task, the participants categorised foods according to their knowledge of each food for oral health. There were no differences between children and adults in the categorisation of fresh, minimally processed foods. Fish, chicken, and red meat were categorised as healthy by significantly fewer children than adults. High-sugar foods were correctly characterised as unhealthy by nearly all participants. More children categorised breakfast cereals as healthy than adults. There were no statistically significant differences between children and adults for the categorisation of brown or wholegrain breads categorised as healthy. The alignment of the participants’ beliefs with dietary guideline recommendations suggests education through health promotion initiatives is successful in achieving knowledge acquisition in children and adults. However, recommendations to increase the intake of refined carbohydrates inadvertently advocate foods associated with increased caries burdens.     

参与式贫富分级—确定妇幼卫生扶贫资金享受对象的有效方法

合理、准确地确定妇幼卫生扶贫资金享受对象是世界银行-云南省妇幼卫生扶贫资金项目实施过程中的一个关键的问题,较为详细地阐述了运用参与式贫富分级方法确定该项目目标人群的原则、方法及步骤。结合该方法在妇幼卫生扶贫资金项目中的实际应用,提出了确定贫困人群时应特别注意绝对贫困与相对贫困、贫困人群的动态性、贫困对象性别公平性以及对象数量的确定必须以妇幼卫生扶贫资金的数量为前提等若干关键问题。     

参与式贫富分级－确定妇幼卫生扶贫资金享受对象的有效方法

合理、准确地确定妇幼卫生扶贫资金享常驻对象是世界银行——云南省妇幼卫生扶贫资金项目实施过程中的一个关键的问题。较为详细地阐述了运用参与式贫富分级方法确定该项目目标人群的原则、方法及步骤。结合该方法在妇幼卫生扶贫资金项目中的实际应用,介出了确定贫困人群时就职特别注意绝对贫困与相对贫困、贫困人群的动态性、贫困对象性别公平性以及对象数量的确定必须以妇幼卫生扶贫资金的数量为前提等若干关键问题。     

Effect of Fortified Formula on Growth and Nutritional Status in Young Children: A Systematic Review and Meta-Analysis

Previous reviews of the effect of young child formulas on health outcomes in infants and toddlers have been inconclusive. In this study, we undertook a contemporary synthesis of studies investigating the effects of consuming fortified milk beverages (compared to cow’s milk or unfortified comparator formula) on growth and/or nutritional status in children 1–3 years of age. Five electronic databases were searched (PubMed, Web of Science, Scopus, ProQuest, and Cochrane Library) for randomised controlled trials comparing fortified milk against control milk in young children (9–48 months), published between January 1990 and June 2022. Outcomes were growth, body composition, biochemical markers, and/or nutritional status. Mean differences (MD) were pooled using random-effects meta-analysis where there were ≥3 studies. The risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool. Nineteen articles (12 studies; n = 4795) met the inclusion criteria. Heterogeneity was substantial, likely attributable to considerable variation in study characteristics. Fortified milk was associated with increased weight gain (MD = 0.14 kg [95% CI 0.06, 021], p = 0.0003) compared with control milk. Subgroup analyses demonstrated increases in weight in lower-income countries, and in studies with intervention periods > 6 months. There were no effects of fortified milks on other anthropometric measures. Haemoglobin (MD = 3.76 g/L [95% CI 0.17, 7.34], p = 0.04) and ferritin (MD = 0.01 nmol/L [95% CI 0.00, 0.02], p = 0.02) concentrations were increased in infants consuming fortified milks. Fortified milk beverages appear to offer a safe and acceptable source of complementary nutrition as a short-term strategy for addressing nutritional deficits and may modestly promote weight gain in vulnerable populations when provided for periods > 6 months. This study was prospectively registered with PROSPERO (CRD42022339920) and funded by the Infant Nutrition Council.     

A Rapid Review of the Impact of Family-Based Digital Interventions for Obesity Prevention and Treatment on Obesity-Related Outcomes in Primary School-Aged Children

Virtual delivery of obesity prevention and treatment programs may be effective for supporting children and families to adopt healthy lifestyle changes while enhancing program accessibility. This rapid review aimed to summarize the impact of family-based digital interventions for childhood obesity prevention and treatment. Four databases were searched up to February 2021 for trials of interactive digital programs aimed to prevent and/or treat obesity in children aged 5–12 years and reported diet, physical activity, sedentary behavior, sleep, or weight-related outcomes in children. A total of 23 publications (from 18 interventions) were included. Behavior change theories were used in 13 interventions with “Social Cognitive Theory” applied most frequently (n = 9). Interventions included websites (n = 11), text messaging (n = 5), video gaming (n = 2), Facebook (n = 3), and/or mobile applications (n = 2). Studies reported changes in body mass index (BMI; n = 11 studies), diet (n = 11), physical activity (n = 10), screen time (n = 6), and/or sleep (n = 1). Significant improvements were reported for diet (n = 5) or physical activity (n = 4). Two of the six interventions were effective in reducing screen time. Digital interventions have shown modest improvements in child BMI and significant effectiveness in diet and physical activity, with emerging evidence supporting the use of social media and video gaming to enhance program delivery.