Effects of Nutrient Fortified Complementary Food Supplements on Anemia of Infants and Young Children in Poor Rural of Gansu

Objective To assess the effectiveness of complementary food supplements with protein and multi-micronutrients on hemoglobin and anemia in infants and young children. Methods In 5 poor counties of Gansu, 984 children aged 6-12 months were enrolled and divided into two groups. In addition to the usual home-made complementary food, all the children were fed one sachet of either Formula Ⅰ or Formula Ⅱ supplements each day. Protein and micronutrients were provided in Formula Ⅰ, while the same energy intake was secured in Formula Ⅱ as in Formula Ⅰ. A massive dose of vitamin A was supplemented to all the children every 6 months. Hemoglobin test was done at the same time. Results Prevalence of anemia was about 35% in both Formula Ⅰ and Formula Ⅱ group at baseline, and there were no differences in hemoglobin concentration between the two groups, During the 6-month and 12-month supplementation, hemoglobin of children in Formula Ⅰ group was higher than that in Formula Ⅱ group （P〈0.05）, and hemoglobin increase in Formula Ⅰ group was significantly higher than that in Formula Ⅱ group （P〈0.001）. After 6- and 12-mouth supplementation, the prevalence of anemia in Formula Ⅰ group dropped to 19.1% and 8.2% respectively, and it was 28.0% and 12.4% in Formula 2 group. The prevalence of anemia in Formula Ⅰ group was significantly lower than that in Formula Ⅱ group （P〈0.05）. After adjusting age and hemoglobin level at baseline, the hemoglobin increase at age of 24 months in formula 1 group was higher （10.7 g/L vs 7.9 g/L, P〈0.0001）. Conclusion Micronutrient fortified complementary food supplements, with large-dose vitamin A, is effective for children aged 6-12 months in terms of iron deficiency prevention.

Performance and correlation of QuantiFERON-TB Gold, T-SPOT.TB and tuberculin skin test in young children with or exposed to tuberculosis

Objective:To evaluate the performance of interferon gamma release assays and tuberculin skin test in Bacillus Calmette-Guerin vaccinated young children.Methods:A cross-sectional study was conducted in healthy children younger than 5 years who were recently diagnosed with tuberculosis or had recent exposure to active tuberculosis.QuantiFERON-TB Gold,T-SPOT.TB and tuberculin skin test were performed in each patient.Results:Of the 60 children,median age 3.3 years,17 had tuberculosis and 43 had recent tuberculosis exposure.Overall,15(25.0%)children had tuberculin skin test reaction≥10 mm;8(13.3%)were positive by QuantiFERON-TB Gold In-Tube test,and 12(20.0%)by T-SPOT.TB.Nineteen(31.7%)children had at least one positive test.There was a moderate agreement between interferon gamma release assays and tuberculin skin test.Conclusions:The positive rates of interferon gamma release assays and tuberculin skin test were low in young children who were infected with tuberculosis,supporting the management strategy of not testing children younger than 5 years.

Young children with multidrug-resistant epilepsy and vagus nerve stimulation responding to perampanel: A case report

BACKGROUND Perampanel(PER),a third-generation antiepileptic drug,is a selective and noncompetitiveα-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor antagonist,and has been approved for the treatment of adults and adolescents with focal epilepsy.However,there are only a few studies about the efficacy and tolerability of PER in young children with multidrug-resistant epilepsy.In this case,we aimed to share our clinical experience in this group.CASE SUMMARY A 4-year-old boy without perinatal asphyxia and familial history of epilepsy began to have ictal seizures from age 14 mo,with jerky movement of four limbs and head nodding.Abnormal multifocal discharge and background activity were recorded through electroencephalography,and no pathogenic mutation was found in the whole exome sequencing for the patient and his parents.He had received valproate,levetiracetam,topiramate,oxcarbazepine,clonazepam and lacosamide sequentially at different times,but he still had frequent seizures even after vagus nerve stimulation(VNS)implantation.He was diagnosed with idiopathic multidrug-resistant epilepsy.However,his seizure frequency was significantly reduced after PER administration in a dose-dependent manner,and better cognitive behavior was observed.In addition,the adverse reactions of anger and aggression also appeared.CONCLUSION PER is effective as add-on therapy for young children with multidrug-resistant epilepsy who have previously undergone VNS implantation.

Population Education for young Children

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Aggression and Conduct Disorder in Young Children. A Case Report

Childhood Onset Conduct Disorder [CD] is a condition characterized by at least one symptom of conduct disorder (based on Diagnostic and Statistical Manual of Mental Disorders criteria—Fifth Edition) prior to 10 years of age. Children affected exhibit disruptive behaviors, usually negative, hostile, and defiant behavior similar to Oppositional Defiant Disorder [ODD]. As the child gets older they begin to display more characteristic of Conduct Disorder (lying, fighting, and stealing, vindictive behavior). These children are also likely to have comorbidities including Attention Deficit Hyperactivity Disorder (ADHD), learning disabilities, poor academic achievement, and substance abuse. Distinguishing early between symptoms of Conduct Disorder versus other differential diagnoses is essential in effective treatment. Early intervention with these children leads to a better prognosis and likelihood of functioning in society. This case illustrates the difficulty of diagnosing a young child with Childhood Onset Conduct Disorder.

Development of Child-Friendly Fish Dishes to Increase Young Children’s Acceptance and Consumption of Fish

Background: The Dietary Guidelines for Americans 2010 recommend that Americans age two years and older consume seafood, especially fish high in omega-3 polyunsaturated fatty acids, at least twice a week. Although fish is of particular importance during childhood to support proper brain and eye development, it is under-consumed in the US pediatric population. This study examined if substituting salmon for chicken would increase preschooler’s fish consumption. Methods: Two-to-five years old children (n = 45) were served eight lunches (four pairs of comparable chicken versus salmon dishes) twice, totaling sixteen lunches over a period of three months to test the hypothesis that children will consume fish at least once a week, thus increasing docosahexaenoic acid (DHA) intake. The plate waste method was used to collect intake data and consumption of total energy and DHA intake in the chicken and the fish dishes were compared using contrasts within a mixed effect ANOVA (significance at P Results: Dietary intake estimates showed that there were no significant differences in energy intake when the chicken and fish dishes looked similar (macaroni-and-cheese and wraps), but when the fish dishes looked new (nuggets and dumplings), energy intake on fish days was lower than on the chicken day. DHA intake increased significantly on all days the fish was served. Conclusions: This pilot study indicates that fish intake can meet recommendations if salmon is incorporated into familiar dishes such as salad wraps or macaroni-and-cheese, in the childcare setting. Although fish is more expensive, childcare centers may serve this highly nutritious protein once a week without experiencing undue amounts of food wastes if incorporated into well-accepted main dishes. Further studies in larger and more diverse samples of children, different experimental dishes, and longer exposure periods may elucidate additional venues to increase children’s diet quality by increasing consumption of fatty fish.

Overview of Intervention Programs for Parents of Young Children (0 - 6)

In most of the world’s societies and cultures, the biological mother and father bear primary responsibility to?care for their child’s needs and to guide him or her through the process of entry into society [1]. The parent serves, for the most part, as the significant figure with the greatest amount of influence over the child’s life. Through his parent, the child learns the skills necessary to experience the world and function in it, whether the skills are in relation to survival needs such as eating, washing and mobility or developmental and social needs such as forming social relationships and developing the capacity to think and learn through play and supervision [2]. Thus the parent plays a critical but complex role in the development of his or her child, a role that requires development of a wide range of new behavioral, communicational, cognitive and emotional skills and capabilities in order to understand and cope with the challenges of child-rearing. Similarly, parenting styles and characteristics are influenced by a number of variables: The parent, the child, the interaction between them, and environmental variables such as culture, socio-economic status, and the existing family unit [2]. When children who suffer from behavioral difficulties do not receive the parental care they need, there is reasonable cause for concern that difficulties will develop in adulthood in a range of life areas that will have an impact on their lives and well-being and on their ability to adapt to society and contribute to it [3]. Accordingly, over the past 50 years parent-training programs have been developed to strengthen parents through learning and providing tools of experience and developmental knowledge, for the purpose of promoting the child’s sense of wellbeing and quality of life [2] [4]. Objective: The purpose of this review is to provide an overview of evidence-based interventions for parents of young children (0 - 6), programs that are currently active in Israel and in the world, and to explicate the significant characteristics common to them that contribute to their effectiveness and success.

Impact of Seven Valent Pneumococcal Conjugate Vaccine on Nasopharyngeal Carriage in Young Children in Okinawa, Japan

In Japan, the heptavalent pneumococcal conjugate vaccine (PCV7) became available in February 2010 and was subsidized by the national funding system from May 2011 in Okinawa, after which it was incorporated into the national immunization practice (NIP) in April 2013 using a 3 + 1 schedule for all infants. We conducted an annual survey in 2012 to determine the effect of PCV7 on nasopharyngeal colonization by pneumococcal serotypes and to analyze the risk factors for colonization in infants. Nasopharyngeal swabs for pneumococcal isolation and serotyping were obtained from infant 2 to 22 months of age before and after PCV7 immunization among 4 clinics in Okinawa, Japan. Between January 2012 and December 2012, nasopharyngeal swabs for bacterial cultures were obtained among 782 infants aged 2 to 22 months old and demographic data was obtained among 725 participant infants. Among the 725 evaluable infants, 193 pneumococcal strains were detected in 180 infants for an overall nasopharyngeal carriage of 24.8%. The main capsular serotypes isolated were 6C (16.1%), 19A (12.4%) and 15B (9.8%). Carriage of PCV7 serotypes accounted for 21.8% (42/193). The result of multivariate data analysis showed the pneumococcal carriage rate of non-PCV7 serotypes was significantly (P < 0.001) high in infant with siblings and daycare attendance. On the other hand, the result of multivariate data analysis showed that carriage rate of PCV7 serotype had only significantly high risk in infant with siblings and did not have a significant risk dependent on age and daycare attendance. Carriage PCV7 serotypes increased in the presence of other siblings, while PCV7 vaccination was shown to eliminate daycare attendance as a risk. The results of this study demonstrates that PCV7 vaccination decrease the overall nasopharyngeal carriage of PCV7 serotypes in vaccinated children including children at risk such as children attending day-care centers.

Consensus on pediatric epilepsy Che up surgery for young children:an investigation by the China Association Against Epilepsy task force on epilepsy surgery

Researchers have widely acknowledged the therapeutic value of epilepsy surgery for drug-resistant epilepsy.None-theless,there is a substantial gap in the surgical treatment for appropriate candidates owing to several factors,particularly in the population of young children.To standardize the protocols of preoperative evaluation and sur-gery of young children for epilepsy surgery,the China Association Against Epilepsy has appointed an expert task force to standardize the protocols of preoperative evaluation and surgery in pediatric epilepsy patients.It adopted the modifed Delphi method and performed two rounds of surveys through an anonymous inquiry among 75 experts from four subgroups including pediatric neurologists,epileptologists,pediatric epilepsy surgeons,and functional neurosurgeons.The survey contents contained:(1)the participants,comprising children aged≤6 years;(2)adopted DRE definition proposed by the International League Against Epilepsy in 2010;and(3)investigated epilepsy surgery,principally referring to curative epilepsy surgeries.The neuromodulation therapies were excluded because of the differences in treatment mechanisms from the above-mentioned surgeries.According to the Delphi process,a con-sensus was achieved for most aspects by incorporating two rounds of surveys including preoperative assessment,sur-gical strategies and techniques,and perioperative and long-term postoperative management,despite controversial opinions on certain items.We hope the results of this consensus will improve the level of surgical treatment and man-agement of intractable epilepsy in young children.

Stress Relief Measurements in Young Adults and Adolescents—A Comparative Pilot Study with Different Relaxation Programs

Background: Chronic stress is a emotional challenge. Constant pressure presents a serious risk of damage to mental and physical health and hence is associated with increased incidence of various diseases. The ability to cope with chronic stress may be a function of psychological resilience including intellectual capacities, but more so of external factors such as life experience and education. Adolescents are more vulnerable to chronic stress than adults. The measures introduced during the COVID-19 pandemic brought up major societal problems. As both children and adolescents lost their life anchors, the prevalence of stress in adolescents increased from 20% to 45%. Chronic psychological stress can impede the normal development of schoolchildren. It may cause anxiety, social withdrawal, interpersonal conflicts and aggression. This applies particularly to those in puberty, with the adolescent already facing unstable social bonds and elevated fear about the future. It is likely that the puberty cohort accounts for the dramatic increase in the prevalence of stress. Since it impacts public health, chronic stress among school-age children is increasingly taking on a socio-political dimension. Non-clinical stress intervention studies can investigate how to achieve stress reduction in school children. Methods: In a small pilot study, we analysed the effects of a training program with four different standard interventions, i.e. mindfulness training, progressive muscle reflection, autogenic training, and sound meditation. We obtained baseline scores of 10 stress-indicators, and re-tested after the interventions were performed. Results: The four applied interventions resulted in a reduction of 8 (out of 10) stress-indicators, such as “feeling stressed” or stress related symptoms (headaches, dizziness, sweating). This positive impact of the interventions significantly reduced “Fears about the future” (p Discussion: School children recognise the positive potential of stress reducing training or interventions. Our results provide evidence in support of integrating the training of relaxation techniques in the school curriculum. We propose that a larger study be undertaken to determine which methods would be most effective.

Update on the safety of anesthesia in young children presenting for adenotonsillectomy

Tonsillectomy with and without adenoidectomy is a frequently performed surgical procedure in children.Although a common procedure,it is not without significant risk.It is critical for anesthesiologists to consider preoperative,intraoperative,and postoperative patient factors and events to optimize safety,especially in young children.In the majority of cases,the indication for adenotonsillectomy in young children is obstructive breathing.Preoperative evaluation for patient comorbidities,especially obstructive sleep apnea,risk factors for a difficult airway,and history of recent illness are crucial to prepare the patient for surgery and develop an anesthetic plan.Communication and collaboration with the otolaryngologist is key to prevent and treat intraoperative events such as airway fires or hemorrhage.Postoperative analgesia planning is critical for safe pain control especially for those patients with a history of obstructive sleep apnea and opioid sensitivity.In young children,it is important to also consider the impact of anesthetic medications on the developing brain.This is an area of continuing research but needs to be weighed when planning for surgical treatment and when discussing risks and benefits with patients’families.

DEVELOPING YOUNG CHILDREN'S LITERACY: FAMILY LITERACY PRACTICES

This paper will present two researches on family literacy and how they develop the children's early literacy behaviors. The first research looked into the literacy behaviors of preschool-age children with ages ranging from three to five years and what home environment factors influenced the acquisition of these literacy behaviors. The second research looked into the training of urban poor families into literacy and numeracy through training modules, and looked into how these parents can develop and enhance their own literacy and numeracy and then teach these to their children.

Plasma gelsolin level predicts acute kidney injury after cardiopulmonary bypass in infants and young children

Background Acute kidney injury(AKI)after cardiopulmonary bypass(CPB)is a common complication especially in pedi-atric population.Plasma gelsolin(pGSN)is an anti-inflammatory factor through binding with actin and pro-inflammatory cytokines in circulation.Decrease in pGSN has been reported in some pathologic conditions.The purpose of the study was to determine the alterations of pGSN level in infants and young children after CPB and the role of pGSN as a predictor for the morbidity and severity of post-CPB AKI.Methods Sixty-seven infants and young children at age≤3 years old undergoing CPB were prospectively enrolled.PGSN levels were measured during peri-operative period with enzyme-linked immuno-sorbent assay and normalized with plasma total protein concentration.Other clinical characteristics of the patients were also recorded.Results In patients developing AKI,the normalized pGSN(pGSN_(N))levels significantly decreased at 6 h post-operation and remained low for 24 h post-operation as compared to the patients with non-AKI.PGSNN at 6 h post-operation combining with CPB time presents an excellent predictive value for AKI.Conclusions Decreased pGSN_(N)identifies post-CPB AKI in the patients≤3 years old,and is associated with adverse clini-cal outcomes.The findings suggest that circulating GSN in post-CPB patients may have beneficial effects on diminishing inflammatory responses.

Influences of teachers’attitudes and oral guidance on the persistence of young children aged 3-6 years old

Persistence is important in developing pre-school children’s ego control.Based on the fact that during the teaching process a teacher’s communication and actions will have a significant influence on young children,which is due to the teachers’high degree of control over them,four experiments were designed to probe the influences of teachers’attitudes and oral guidance on the development of persistence among infant students.The results indicate that different attitudes and oral guidance influence the development of persistence of young children differently.

Local Literature in a Global World？ Catalan Literature for Children and Young People

This paper is part of a wider project being carried out by the Research Group Literary Education, Culture and Society, which has been subsidised by the Ministry of University of Spain. Our project＇s main aim is the close study of three closely interrelated phenomena, globalisation, exclusion and multiculturality, in order to determine the influences on the children and young people Literature. We intend in this paper to show the results of a first research made in a smaller corpus in order to better draw up the entire project.

Intensive diabetes management and goal setting are key aspects of improving metabolic control in children and young people with type 1 diabetes mellitus

Diabetes control in children remains poor in spite of advances in treatment for last 10 years. The aim of this review was to look at various aspects of intensive therapy in the management of type 1 diabetes such as insulin regimes, role of target setting, psycho-educational approaches and self-management. To achieve good metabolic control, clear goal setting with adequate support for self-management are essential. Psycho-educational and behavioural interventions aimed at specific areas of management have shown significant improvement in quality of life and diabetes control.

《生长减缓婴幼儿的追赶生长:指导临床医师的专家建议》解读

生长减缓是帮助早期识别营养问题的重要临床表现,尽早识别和干预婴幼儿生长减缓对改善其近远期健康结局意义重大。之前发表的相关指南和专家共识对生长减缓缺乏统一的定义,影响临床识别、评估与规范管理。2023年3月,Journal of Pediatric Gastroenterology and Nutrition杂志发表了《生长减缓婴幼儿的追赶生长:指导临床医师的专家建议》,不仅阐述了追赶生长的重要性,还针对如何适当地定义、评估和管理生长减缓制定了切实可行的共识建议,对临床医生具有现实的指导价值。本文结合我国临床现状,对该“建议”进行解读,以期为我国临床医师管理生长减缓婴幼儿提供指导和参考。

婴幼儿头皮医用粘胶相关性皮肤损伤防护方案的构建与应用

目的降低视频脑电图监测婴幼儿头皮医用粘胶相关性皮肤损伤。方法采用历史对照设计,将2018年1月至2019年12月入住癫痫监测单元行头皮视频脑电图监测的患儿856例纳入对照组,实施常规皮肤护理;将2021年1月至2022年12月入住癫痫监测单元行头皮视频脑电图监测的患儿851例纳入观察组,构建和实施医用粘胶相关性皮肤损伤防护方案。比较两组头皮医用粘胶相关性皮肤损伤发生率。结果观察组头皮医用粘胶相关性皮肤损伤发生率显著低于对照组(P<0.05)。结论婴幼儿头皮医用粘胶相关性皮肤损伤防护方案的应用,可有效降低婴幼儿头皮医用粘胶相关性皮肤损伤发生率。

血清YKL⁃40与气道炎性因子在婴幼儿喘息中的表达及临床意义

目的探讨血清YKL-40及气道炎性因子白细胞介素(IL)-5和IL-8在婴幼儿喘息中的表达情况及临床意义。方法选择2021年6月—2023年5月收治的喘息急性发作(急性期)患儿70例,其中初次喘息发作32例,反复喘息38例。经治疗恢复期34例。另选取同期体检健康婴幼儿22例为健康对照组。反复喘息患儿依据哮喘预测指数(API)分为阳性组23例和阴性组15例。检测上述各组血清YKL-40、IL-5和IL-8水平,分析YKL-40与IL-5、IL-8、外周血中性粒细胞及嗜酸粒细胞的相关性。结果喘息急性期患儿血清YKL-40、IL-5、IL-8水平均高于喘息恢复期和健康对照组(P<0.01)。反复喘息组血清YKL-40和IL-8水平均高于初次喘息组(P<0.01)。API阳性组与API阴性组血清YKL-40、IL-5和IL-8水平比较差异无统计学意义(P>0.05)。血清YKL-40与IL-8呈显著正相关(r=0.926,P<0.001),但与IL-5、外周血嗜酸粒细胞绝对值、中性粒细胞绝对值均无相关性(P>0.05)。结论血清YKL-40、IL-5和IL-8参与婴幼儿喘息急性气道炎症过程,YKL-40可能与中性粒细胞炎症有关。YKL-40水平增高可能是婴幼儿喘息发作和反复喘息的危险因素,但与API无关。