婴幼儿边缘型维生素B_1缺乏症

目的探讨婴幼儿夜寐不安的原因及更有效地治疗夜寐不安的婴幼儿。方法对２５例以夜寐不安为主要表现，同时伴有烦躁、纳差的２岁以下小儿进行临床观察和红细胞转酮醇酶活力（ＴＰＰ效应）的测定。结果１６％的小儿属边缘型维生素Ｂ１缺乏，２０％属严重缺乏，而对照组小儿仅有６．７％属维生素Ｂ１缺乏症。经统计学处理，两组有显著差异（Ｐ＜０．０５）。实验组小儿经补充维生素Ｂ１１０ｍｇ１日３次口服１周后，临床症状明显好转的约占５０％，好转占３０％～４０％，而症状无改善的仅占１０％左右。治疗前ＴＰＰ效应异常者，经上述治疗后ＴＰＰ效应全部转为正常。结论口服补充维生素Ｂ１对治疗边缘型维生素Ｂ１缺乏症的效果是满意的。     

陕西贫困地区某县6～24月龄婴幼儿辅食及营养素添加现状分析

目的 分析陕西贫困地区某县6～24月龄婴幼儿辅食及营养素添加状况,为制定合理的膳食方案提供科学依据,为促进本地区婴幼儿营养健康水平提供参考依据。方法 2017年7-8月采用整群分层随机抽样方法对陕西贫困地区某县920名6～24月龄婴幼儿辅食及营养素添加现状进行问卷调查,并对数据进行分析。结果 陕西贫困地区某县6～24月龄婴幼儿辅食添加种类较少,主要是米面类(82.0%)和蛋类(54.0%),营养素以维生素A(8.8%)、维生素D(10.0%)摄入少,搭配不合理,在辅食添加时间上存在过早和过晚两种极端。断乳后婴幼儿平均每人每日三大营养素比不符合中国营养学会制定膳食参考摄入量(DRIS)标准,随月龄增加,三大营养素摄入量逐渐增加,占膳食营养素推荐摄入量(RNI)百分比呈上升趋势。断乳后12～18月龄婴幼儿钙、铁、锌、钠摄入分别为274.5、3.3、2.4、198.6 mg,18月龄以上分别为298.3、3.8、2.4、175.5 mg,两组婴幼儿维生素A、D、B₁、B₂、C、E实际摄入量均低于DRIS标准。结论 陕西贫困地区某县6～24月龄婴幼儿辅食及营养素添加不均衡,添加过早和过晚均存在;三大营养素摄入量比不符合中国营养学会制定DRIS标准;矿物质及维生素实际摄入量均低于DRIS标准;普及贫困地区婴幼儿辅食及营养素添加的相关知识很有必要。     

Efficacy of a Home-Based Parent Training-Focused Weight Management Intervention for Preschool Children: The DRIVE Randomized Controlled Pilot Trial

ObjectivesTo pilot-test a home-based parent training intervention aimed at maintaining body weight among children at risk for obesity (> the 75th body mass index percentile).MethodsSixteen parent–child dyads were randomized to a health education or Developing Relationships that Include Values of Eating and Exercise (DRIVE) intervention arm. The DRIVE curriculum was a structured parenting program to promote healthy weight in children by relying on behavioral principles to promote skill acquisition in the family's natural setting. Body weight and waist circumference were measured at baseline and weeks 9 and 19.ResultsBody mass index z-score, body weight, and percent body weight increased in children in the health education arm vs DRIVE at weeks 9 and 19. Body weight, percent body weight, and waist circumference decreased in parents in DRIVE vs the health education arm at week 19, whereas no differences were shown at week 9.Conclusions and ImplicationsThe DRIVE program mitigated weight gain in a small sample of at-risk children and showed promising results in reducing weight in parents. Home-based interventions emphasizing parent–child interactions are indicated as a practical model to deliver weight management in children.     

Toddler interaction during play in the Swedish preschool

This article focuses on how children aged 17–24 months initiate play and interact with their peers during self-initiated play in preschools. Play is looked upon as a rich arena for observing toddler interaction. The ethnographic study was carried out in a toddler unit with 15 children. Six one-year-old girls and boys were observed during five weeks at the end of a longer research period. The study follows a phenomenological tradition with participatory observations and video recordings. The overall findings support a theoretical perspective where very young children are seen as social actors, with social competences. Play invitation strategies, as well as play enactment and play-closing moves, were mostly found to be based on nonverbal communication such as locomotion, gestures, physical actions and facial expressions. This study also shows that the competence of taking others’ perspectives was found recurrently in play among younger children. Furthermore, the young children used negotiating skills during their play.     

Development of body-part vocabulary in toddlers in relation to self-understanding

To better understand young children's ability to communicate about their bodies, toddlers' comprehension and production of 27 common body-part words was assessed using parental report at 20 and 30 months (n?=?64), and self-awareness was assessed using mirror self-recognition. Children at both ages comprehended more body-part words that referred to themselves than to others' bodies, and more words referring to locations that they could see on themselves than to those they could not see. Children with more advanced mirror self-recognition comprehended and produced more body-part words. These findings suggest that with age and better understanding of the self, children also possess a better understanding of the body, and they provide new information about factors that affect how young children begin to talk about their own and others' bodies. They should be useful for practitioners who need to ask children about their bodies and body parts.     

Infant and Toddler Interactions With a New Infant in a Group Environment

This research project, which is the first stage of a five-year longitudinal study, was designed to investigate infants' and toddlers' social interactions with a baby in a group care setting. The 15 children ranged in age from four (4) to 42 months. A target infant, ranging in age from three (3) weeks to two (2) months, was placed in a specified observational area in a playroom and a behavioral checklist was used by trained observers to record interactions. Results showed that toddlers' interactional behaviors toward an infant increased significantly at 18 months and older. At all ages, females demonstrated more social interactive behaviors than males. When the behaviors were grouped into categories of comforting, sharing, and cooperation, significant differences were found by age and by sex. Infant and toddler behaviors can be mediated and expanded upon by a caregiver who is knowledgeable and responsive to these beginning social interactions.     

A library based literacy program for mothers and their preschool children

The program, “Parents as Teachers” was funded by the Library Services and Construction Act, Title VI, from the U.S. Department of Education. This grant was geared toward promoting the literacy of parents through educating them to teach their children. The target population was mothers and their children ages 0-5 living in the Austin neighborhood, a primarily Black, low income neighborhood on the west side of Chicago. Fifteen mothers and twenty-six children volunteered for the project. Pre and post intervention questionnaires were administered to the parents. Parents stated that they had learned the following from the project: 1] how to play games, read books, and make simple toys for children; 2] how children can learn from everyday things; 3] how to observe what children like rather than give them things preferred by the parent. The parents stated that their children had learned the following through the project: 1] to sing new songs, 2] to pick out favorite books, 3] to make arts and crafts projects, 4] to share with other children, 5] to enjoy listening to stories, 6] to love books.     

The outcome of chronic dialysis in infants and toddlers--advantages and drawbacks of haemodialysis.

BACKGROUND: Improvements in dialysis technology allow replacement therapy for even the youngest of children with end stage renal disease. Nevertheless, the cumulative experience in this age group is limited. METHODS: We compared the outcome of 20 children who initiated chronic dialysis before the age of 1 year (weight 4.9 +/- 2 kg, Group 1), with a particular focus on those under the age of 1 month (eight children, weight 2.9 +/- 0.34), to that of 14 patients, aged 1.1-3 years when starting dialysis (weight 10.1 +/- 1.7, Group 2). RESULTS: The outcome was poor in the youngest age group; only 3/8 survived to 3 years. Of those who started dialysis between the ages of 0.3 and 3 years, 84% underwent kidney transplantation. One-, three-, five-, and eight-year patient survival was 96%, 88%, 84% and 84% respectively [corrected] Severe co-morbidities were present in almost half of those who died. Hospital stay was 3.5 times longer in Group 1 than in Group 2 during the first 3 months of dialysis. Permanent central venous catheters inserted under ultrasound guidance resulted in a 4.4-fold increase in catheter survival compared to non-cuffed catheters. Marked blood loss at beginning of haemodialysis (HD) is attributable to residual volume in the dialysis system (15.7 mL/kg/month) and frequent blood tests (12.1 +/- 5.9 mL/kg/month). These values decreased 2-fold after 8 months of treatment. CONCLUSIONS: The main factors determining the poor outcome of infants on dialysis are extremely young age at initiation and severe co-morbidities. Despite some disadvantages, HD may be successfully implemented in infants and toddlers, in highly specialized centres with a well-trained nursing staff.     

Comparison of Mothers' and Child-Minders' Ratings of Toddlers' Temperament: An Inter-rater Reliability Study

This study reports on an assessment of temperament by mothers and child-minders of twenty five 2–3-year-old children, using eight factors of the Short Temperament Scale for Toddlers (Prior, Sanson and Oberklaid, 1989). Issues highlighted are the function of temperament in behavioural adjustment and the problems associated with cross-informant congruence in evaluating traits and behaviours. Both Pearson's product-moment correlation coefficient and generalised kappa were used to assess the degree of inter-rater reliability between child-minders. High inter-rater agreement was found on the “easy-difficult” scale of temperament, r=.821 (mean of three raters) and moderately high agreement on the “approach/adaptability” factor, k = .638. Inter-rater agreement was low for the other seven temperament factors. Agreement between mothers and child-minders was low on the “easy-difficult” scale, r = .262. These findings are discussed in the context of other studies. The relevance of inter-rater reliability studies as an area of concern to health care delivery is also discussed.