Impact of blood transfusion and burn injury on microbial translocation and bacterial survival

The role of the immune system in microbial translocation must be clarified. In these studies, the effect of blood transfusion-related immunosuppression on translocation was investigated in a burn animal model previously known to increase the gut's permeability to 14C-radiolabeled Escherichia coli. In a first experiment, Balb/c mice underwent transfusion (T) with 0.2 mL per mouse of allogeneic C3H/HeJ mouse blood 5 days prior to undergoing 30-percent burn injury (B) and simultaneous gavage (G) with 10(9) E. coli bacteria labeled with 14C. An additional six groups of Balb/c mice underwent different combinations of T, B, and G procedures (TG, BG, TB, T, B, G). Survival rate was recorded for all groups on Day 10. This experiment suggested that B and T, to a lesser extent, were the factors affecting survival, although the combination of T, B, and G clearly showed a synergistic effect on mortality. In a second experiment, 18 Balb/c mice belonging to TBG, BG, TG, and G groups were sacrificed 1, 4, and 24 hours after burn or gavage. The residual radioactivity and the percentage of viable bacteria were computed for mesenteric lymph nodes, spleen, liver, lungs, blood, and peritoneal fluid. Statistical analysis of the radionuclide counts recognized B as the only variable able to enhance the magnitude of 14C E. coli translocation. The percentage of viable bacteria showed that T and, more moderately, B were the factors leading to the failure of bacterial clearance in the tissues.     

Physical activity and mental health in schoolchildren: a complicated relationship

According to a study by Parfitt and Eston, physical activity was positively associated with child mental health and self-esteem. In this commentary, gender differences, causal links and implications for prevention are discussed.

Conclusion: The relationship between physical activity and mental health is not as simple as to say that activity will invariably lead to improved mental health. For youngsters to be engaged in physical exercise, it is important that the needs of the particular child be taken into account. Forced and frightening activities should be avoided. The context should be one of enjoyment rather than of harsh discipline and skill-dependent games where many children are apt to fail.     

Child health services in transition: I. Theories, methods and launching

AIM: To describe an evidence-based model for preventive child health care and present some findings from baseline measurements. METHODS: The model includes: parent education; methods for interaction and language training; follow-up of low birthweight children; identification and treatment of postnatal depression, interaction difficulties, motor problems, parenthood stress, and psychosocial problems. After baseline measurements at 18 mo (cohort I), the intervention was tested on children from 0 to 18 mo at 18 child health centres in Uppsala County (cohort II). Eighteen centres in other counties served as controls. Two centres from a privileged area were included in the baseline measurements as a "contrasting" sample. Data are derived from health records and questionnaires to nurses and mothers. RESULTS: Baseline experiment (n = 457) and control mothers (n = 510) were largely comparable in a number of respects. Experiment parents were of higher educational and occupational status, and were more frequently of non-Nordic ethnicity. Mothers in the privileged area (n = 72) differed from other mothers in several respects. Experiment nurses devoted considerably fewer hours per week to child health services and to child patients than did control nurses. CONCLUSIONS: Despite certain differences, experiment and control samples appeared comparable enough to permit, in a second step, conclusions about the effectiveness of the intervention.     

Child health services in transition: II. Mothers' perceptions of 18-month-old children in the light of socio-economic status and some subjective factors

AIMS: To analyse mothers' self-assessed quality of interaction with their children and their opinions about child difficulty with respect to socio-economic status and subjective factors: postnatal depression, social isolation, sense of coherence and locus of control. METHODS AND MATERIAL: A comprehensive questionnaire was completed by 1039 mothers of 18-mo-old children participating in the baseline measurements of a Swedish multicentre study developing and testing a new psychosocial model for the child health services. RESULTS: All subjective factors, including the number of factors, showed significant associations with perceived interaction and difficultness. Effect sizes of subjective factors ranged from about 0.3 to 1 SD for interaction, and from about 0.2 to 0.8 SD for difficultness. As for difficultness, effect sizes were larger for boys. There were no associations between high socio-economic status and high-quality interaction or low child difficultness: the few significant differences in fact favoured low-status children. CONCLUSION: The results provided some contradictory findings to the well-known association between high socio-economic status and favourable outcome. This result is of practical relevance for interventions: supportive programmes cannot be limited to areas and families of low socio-economic status. Positive effects may ensue if subjective factors like those studied here can be promoted among parents and children through the child health services.