Adequacy Of Children Research Articles

Association between provegetarian food patterns and micronutrient adequacy in preschoolers: the SENDO project

This study aims to examine the association between different versions of a provegetarian food pattern and micronutrient adequacy in a population of children from the SENDO Project. Children aged 4–5 years old were recruited and baseline information on diet, lifestyle and socio-demographic characteristics was collected through self-administered online questionnaires completed by their parents. Scores were calculated for overall, healthful, and unhealthful provegetarian food patterns (FP) using an a priori approach. Participants were categorized into tertiles according to their scores. Micronutrient adequacy was assessed using the Estimated Average Requirement (EAR) cut-off point. Multivariate analyses were performed to evaluate the relationship between tertiles of each provegetarian FP and the risk of inadequate micronutrient intake (failing to meet ≥ 3 requirements). Despite lower intakes of certain micronutrients, children with higher scores in the healthful provegetarian FP did not exhibit a higher prevalence of inadequacy. Children in the highest tertile of this index had 0.47-fold lower odds (95%CI 0.23–0.95) of having ≥ 3 inadequate micronutrient intakes than their peers in the lowest tertile, after adjusting for potential confounders. In contrast, children in the highest tertile of the unhealthful provegetarian FP had 20.06-fold higher odds (95%CI 9.19–43.79) of having ≥ 3 inadequate micronutrient intakes compared to children in the lowest tertile. Conclusions: Adherence to a healthful provegetarian food pattern is associated with improved nutritional adequacy in preschoolers, while following an unhealthful pattern is detrimental to micronutrient adequacy. These results suggest that moderate reductions in animal food consumption within a healthy diet may not compromise micronutrient adequacy in young children. Further research is needed to explore the impact of diets reduced in animal food intake on the health of children.What is Known:• There's a notable trend towards plant-based diets due to health and sustainability concerns.• Research links plant-based diets in adults with lower risks of obesity, cardiovascular disease, and cancer.What is New:• A new study examines how different versions of a provegetarian food pattern affect micronutrient adequacy in children, using a moderate and stepwise approach.• Following a healthful provegetarian food pattern enhances nutritional adequacy in preschoolers, whereas an unhealthful pattern negatively impacts micronutrient adequacy.

Macronutrient quality and its association with micronutrient adequacy in children

The double burden of malnutrition compels us to reconsider macronutrients from a diet quality perspective. The Macronutrient Quality Index (MQI) has been designed to reflect overall macronutrient quality and is based on three sub-indexes: the carbohydrate quality index (CQI), the healthy plate protein quality index (HPPQI) and the fat quality index (FQI). Nutritional adequacy is an essential aspect of diet quality that should be captured by reliable dietary indexes. We analyzed the association between the Macronutrient Quality Index (MQI) and micronutrient adequacy. Participants were children aged 4 and 5 years, recruited in the SENDO cohort. Baseline information was collected through a self-administered online questionnaire, which included information on sociodemographic, dietary, and lifestyle variables. Dietary information was obtained using a 147-item validated semi-quantitative food frequency questionnaire. Participants were categorized into tertiles based on their MQI score. We evaluated the intake of 20 micronutrients and assessed the probability of micronutrient adequacy using the Estimated Average Requirement cut-off point. Children in the highest tertile of MQI had 0.33-fold lower odds (95%CI 0.17-0.66) of having ≥3 inadequate micronutrient intakes than their peers in the lowest tertile, after adjusting for potential confounders. The adjusted proportions of children with inadequate intake of ≥3 micronutrients were 18%, 14% and 11% in the first, second, and third tertiles of MQI respectively. The MQI appears to be capable of capturing nutrient adequacy in children, although our results suggest that a modified MQI, with eggs and dairy products weighted positively, might be more adequate for the pediatric population.

The Correlation Between Eating Patterns and Nutritional Adequacy of Children with Cerebral Palsy

Due to sensory and motor dysfunction, some children with cerebral palsy (CP), have trouble chewing and ingesting, which may result in inadequate feeding. The goal of this study is to look into the correlation between eating patterns and nutritional adequacy of children with cerebral palsy. This research was carried out in 11 Special Schools Depok, Bogor and Jakarta. Taking into the topic inclusion requirements of the subjects (i.e. aged 5-18 years, had hemiplegic and diplegic types of cerebral palsy, had no infection, and good communication), 45 subjects were interviewed for data collection. A pre-test structured questionnaire which uncovered the identity and dietary intake (1x24-hour food record by caregiver) was used to guide the interviewer and also interview about the type of food of meal and snack and the frequency of eating in children. The results showed that the children with cerebral palsy liked to consume soft and liquid foods. Protein, fat, energy, and carbohydrate showed mean sufficiency levels of 80,9%, 53,5%, respectively. 62.0%, and 66.2%. Iron, calcium, zinc, Vitamins A, D, E, B9, C, calcium, iron, and zinc all exhibited mean sufficiency levels of 40.7%, 29.9%, 41.1%, 135.9%, 36.4%, 63.3%, 30.9%, and 70.8%. There was a substantial beneficial relationship between eating behaviors and protein and carbohydrate sufficiency (p<0.05). This implies that the children with cerebral palsy inadequately consume both macro- and micronutrient source foods. The result showed that there’s a correlation between eating patterns and nutritional adequacy in children with CP. Th

A Feeding Adequacy Scale for Children With Bronchiolitis: Prospective Multicenter Study.

To determine the measurement properties of the Feeding Adequacy Scale (FAS) in young children hospitalized with bronchiolitis. Multicenter cohort study of infants hospitalized with bronchiolitis at children's and community hospitals in Ontario, Canada. Caregivers and nurses completed the FAS, a 10-cm visual analog scale anchored by "not feeding at all" (score 0) and "feeding as when healthy" (score 10). The main outcome measures were feasibility, reliability, validity, and responsiveness of the FAS. A total of 228 children were included with an average (SD) age of 6.3 (5.4) months. Completing the FAS was feasible for caregivers and nurses, with no floor or ceiling effects. Test-retest reliability was moderate for caregivers (intraclass correlation coefficient [ICC] 2,1 0.73; 95% confidence interval [CI] 0.63-0.80) and good for nurses (ICC 2,1 0.75; 95% CI 0.62-0.83). Interrater reliability between 1 caregiver and 1 nurse was moderate (ICC 1,1 0.55; 95% CI 0.45-0.64). For construct validity, the FAS was negatively associated with length of hospital stay and positively associated with both caregiver and nurse readiness for discharge scores (P values <.0001). The FAS demonstrated clinical improvement from the first FAS score at admission to the last FAS score at discharge, with significant differences between scores for both caregivers and nurses (P values for paired t test <.0001). These results provide evidence of the feasibility, reliability, validity, and responsiveness of caregiver-completed and nurse-completed FAS as a measure of feeding adequacy in children hospitalized with bronchiolitis.

Adequacy of Children's Psychopharmacology Services: Variations by Race and Clinical Characteristics.

An expert consensus approach was used to determine the adequacy of children's psychopharmacology and to examine whether adequacy varied by demographic or clinical characteristics. Data were from the baseline interview of 601 children, ages 6-12 years, who had visited one of nine outpatient mental health clinics and participated in the Longitudinal Assessment of Manic Symptoms study. Children and parents were interviewed with the Kiddie Schedule for Affective Disorders and Schizophrenia and the Service Assessment for Children and Adolescents to assess the child's psychiatric symptoms and lifetime mental health services use, respectively. An expert consensus approach informed by published treatment guidelines was used to determine the adequacy of children's psychotropic medication treatment. Black children (compared with White children; OR=1.84, 95% CI=1.53-2.23) and those with anxiety disorders (vs. no anxiety disorder; OR=1.55, 95% CI=1.08-2.20) were more likely to receive inadequate pharmacotherapy; those whose caregivers had a bachelor's degree or more education (vs. those who had a high school education, general equivalency diploma, or less than high school education; OR=0.74, 95% CI=0.61-0.89) were less likely to receive inadequate pharmacotherapy. The consensus rater approach permitted use of published treatment efficacy data and patient characteristics (e.g., age, diagnoses, history of recent hospitalizations, and psychotherapy) to assess adequacy of pharmacotherapy. These results replicate findings of racial disparities reported in previous research using traditional methods to determine treatment adequacy (e.g., with a minimum number of treatment sessions) and highlight the continued need for research on racial disparities and strategies to improve access to high-quality care.

Факторный анализ влияния микронутриентного статуса на физическое и когнитивное развитие младших школьников

Introduction. Maintenance of an adequate micronutrient status is one of the components of the children’s health with the formation of normal indicators of the physical and intellectual development. Aim. To evaluate the influence of the microelement and vitamin D adequacy of 7–8-year-old children living in the Khabarovsk Territory on their physical and cognitive development. Materials and methods. An observational, analytical, cross-sectional study was performed with an analysis of the prevalence of micronutrient imbalances among apparently healthy children aged 7–8 years living in the Khabarovsk Territory (n = 60). The physical development of children was assessed by calculating the Z-scores of body weight, height and body mass index (BMI). The assessment of the children’s cognitive abilities was carried out using conventional methods. Quantification of elements (Mg, Zn, Ca, Se, Cu, Fe, Mn, Cr) in the hair and blood serum of children was carried out by inductively coupled plasma mass spectrometry. The iodine adequacy in children was determined by its content in the first-morning urine using the cerium arsenite method. Determination of 25-hydroxyvitamin D (25(OH)D) in the blood serum of children was carried out by the enzyme-linked immunosorbent assay. Results. A slowing down in growth rates was revealed with a decrease in the content of Ca, Cu, Se, Zn, and an increase in the concentration of Fe; a decrease in BMI with deficiency of Ca, Cu, Zn, Cr, and an increase with an I and 25(OH)D intake inadequacy. A decrease in cognitive profile indicators was noted in children with deficiency of Mg, Ca, I, Cu, vitamin D, and an excess of Fe. The factor analysis using the multiple correlation method revealed a combined effect of Ca, Zn, and Fe equally on both indicators of growth and BMI parameters (p &lt; 0.05). The cumulative effect of concentrations of Cu, Ca, I, and vitamin D in the blood serum of younger schoolchildren on the formation of short-term memory was shown (p &lt; 0.01). A relationship was found between the level of development of verbal-logical reasoning and the concentration of Mg and Ca (p &lt; 0.05), as well as Fe and Ca (p &lt; 0.05), while the combination of elements with 25(OH)D in the blood serum increased the significance of correlations (p &lt; 0.01). Conclusion. The study demonstrates the need for an integrated approach to evaluate the microelement and vitamin D adequacy in children, in connection with the presence of comorbidity of deficient and excess conditions, a combined effect on physical and cognitive development in order to prevent the development of nutritional diseases.

Assessment of diet quality in children and adolescents with type 1 diabetes.

Micronutrient malnutrition is a serious public health problem in most developing countries, including Morocco, due to poor and therefore lower quality diets that lack dietary diversity. The present study aimed to assess dietary diversity and variety and their relationship with micronutrient adequacy in children and adolescents with type 1 diabetes (T1D). A cross-sectional study was carried among 240 children and adolescents with T1D. Weight and height were measured and BMI was calculated. Dietary intake data were obtained from two 24-h recalls. A Dietary diversity (DDS) and dietary variety scores (DVS) and mean adequacy ratio (MAR) and nutritional adequacy ratios (NARs) were calculated and compared according to sociodemographic/anthropometric categories. 52.1% of the patients were female. The mean age of the patients was 8.49 ± 4.1 years. The mean BMI was 19.44 ± 5.24 kg/m2; the mean DDS was 4.62±1.20 and the mean MAR was 0.66 ± 0.11. Older children living in rural areas have a low DDS/DVS. Parental education and income level are associated with DDS/DVS. General and central obesity were significantly elevated in children with high DDS. In addition, a high intake of vegetables, eggs, fiber and micronutrients (Magnesium, Calcium, Potassium, Zinc, Phosphorus and Vit B1) is associated with a high DDS; however, high DVS is associated with high consumption of dairy products, carbohydrates and low intake of protein and fat. There are also positive correlations between DDS/DVS and NARs for various nutrients. The quality of the respondents' diets are moderately diversified. DDS or DVS can be used as indicators ofmicronutrient adequacy in Moroccan T1D children. Nutritional education needs to be strengthened to improve dietary diversity in children, especially in rural areas.

35.1 Adequacy of Children’s Mental Health Services: Variations by Race and Clinical Characteristics

ObjectivesThis study utilized an expert consensus approach to determine adequacy of children’s mental health services and examined whether adequacy varied by demographic and/or clinical characteristics.MethodsData were obtained from 687 children aged 6 to 12 years old who had visited 1 of 9 outpatient mental health clinics and participated in the Longitudinal Assessment of Manic Symptoms (LAMS) study. Children and their parents were interviewed using the K-SADS and the Service Assessment for Children and Adolescents (SACA) to assess youths’ psychiatric symptoms and lifetime mental health services use, respectively. Analyses employed an expert consensus approach (informed by published treatment guidelines) to determine children’s psychotropic treatment adequacy.ResultsBlack youth (compared to White youth; OR = 2.03; 95% CI, 1.53-2.70), and those with anxiety disorders (vs no anxiety disorder; OR = 1.57; 95% CI, 1.10-2.24) were more likely to receive inadequate care. Youth whose caregivers had a bachelor’s or more advanced degree (vs GED, high school, or less education; OR = 0.71; 95% CI, 0.60-0.83) were less likely to receive inadequate care.ConclusionsUsing the consensus rater approach permitted the use of published treatment efficacy data and patient characteristics (eg, age, diagnoses, history of recent hospitalization, psychotherapy). These results replicate racial disparities found in previous research using traditional methods to determine treatment adequacy (eg, with a minimum number of treatment sessions) and highlight the continued need for research on racial disparities and strategies to improve access to high-quality care.EBP, BRD, DEI ObjectivesThis study utilized an expert consensus approach to determine adequacy of children’s mental health services and examined whether adequacy varied by demographic and/or clinical characteristics. This study utilized an expert consensus approach to determine adequacy of children’s mental health services and examined whether adequacy varied by demographic and/or clinical characteristics. MethodsData were obtained from 687 children aged 6 to 12 years old who had visited 1 of 9 outpatient mental health clinics and participated in the Longitudinal Assessment of Manic Symptoms (LAMS) study. Children and their parents were interviewed using the K-SADS and the Service Assessment for Children and Adolescents (SACA) to assess youths’ psychiatric symptoms and lifetime mental health services use, respectively. Analyses employed an expert consensus approach (informed by published treatment guidelines) to determine children’s psychotropic treatment adequacy. Data were obtained from 687 children aged 6 to 12 years old who had visited 1 of 9 outpatient mental health clinics and participated in the Longitudinal Assessment of Manic Symptoms (LAMS) study. Children and their parents were interviewed using the K-SADS and the Service Assessment for Children and Adolescents (SACA) to assess youths’ psychiatric symptoms and lifetime mental health services use, respectively. Analyses employed an expert consensus approach (informed by published treatment guidelines) to determine children’s psychotropic treatment adequacy. ResultsBlack youth (compared to White youth; OR = 2.03; 95% CI, 1.53-2.70), and those with anxiety disorders (vs no anxiety disorder; OR = 1.57; 95% CI, 1.10-2.24) were more likely to receive inadequate care. Youth whose caregivers had a bachelor’s or more advanced degree (vs GED, high school, or less education; OR = 0.71; 95% CI, 0.60-0.83) were less likely to receive inadequate care. Black youth (compared to White youth; OR = 2.03; 95% CI, 1.53-2.70), and those with anxiety disorders (vs no anxiety disorder; OR = 1.57; 95% CI, 1.10-2.24) were more likely to receive inadequate care. Youth whose caregivers had a bachelor’s or more advanced degree (vs GED, high school, or less education; OR = 0.71; 95% CI, 0.60-0.83) were less likely to receive inadequate care. ConclusionsUsing the consensus rater approach permitted the use of published treatment efficacy data and patient characteristics (eg, age, diagnoses, history of recent hospitalization, psychotherapy). These results replicate racial disparities found in previous research using traditional methods to determine treatment adequacy (eg, with a minimum number of treatment sessions) and highlight the continued need for research on racial disparities and strategies to improve access to high-quality care.EBP, BRD, DEI Using the consensus rater approach permitted the use of published treatment efficacy data and patient characteristics (eg, age, diagnoses, history of recent hospitalization, psychotherapy). These results replicate racial disparities found in previous research using traditional methods to determine treatment adequacy (eg, with a minimum number of treatment sessions) and highlight the continued need for research on racial disparities and strategies to improve access to high-quality care.

Nutrient intake and adequacy in children with autism spectrum disorder: EPINED epidemiological study.

Children with autism spectrum disorder (ASD) have a fivefold elevated risk of developing eating problems, which predisposes them to nutritional deficiencies. This study assesses nutritional intake and adequacy in children with ASD, subdiagnostic autistic symptoms and typically developing (TD) children. Preschool children with ASD and subdiagnostic symptoms had slightly lower intake of monounsaturated fatty acids (MUFA), vitamin D and vitamin B12. Primary school children with ASD and subdiagnostic symptoms had slightly higher intake of protein, cholesterol, thiamine and niacin, and a higher percentage of obesity than children with TD. All children had a high intake in sugars, fats and saturated fatty acids; a very highly inadequate intake of vitamins (vitamins D and E), fibre, b-carotene, calcium and magnesium; and a moderately inadequate intake of vitamin C, folate and iron. However, although all children need nutrition advice, children with ASD and subdiagnostic autistic symptoms had a poorer quality diet than those with TD.

Evaluation of the Effect of Hydroxyzine on Preoperative Anxiety and Anesthetic Adequacy in Children: Double Blind Randomized Clinical Trial.

Surgical procedures can generate significant preoperative anxiety (POA) in as much as 70% of the paediatric population. The role of hydroxyzine and distractive techniques such as clowns in the management of anxiety is controversial. Our main objective was to evaluate the effect of hydroxyzine on the control of POA. The secondary objective was to assess the potential additive effect of hydroxyzine and distracting techniques. We performed a randomized double-blind, controlled clinical trial in children aged 2–16 years undergoing outpatient surgery (n = 165). Subjects were randomized to hydroxyzine (group 1) or placebo (group 2). For the secondary objective, two further groups were made by allocation by chance to hydroxyzine plus accompaniment with clowns (group 3) and placebo plus clowns (group 4). All patients were accompanied by their parents as the standard procedure. POA was determined by a modified Yale scale of POA (m-YPAS). Compliance of children during induction of anesthesia (Induction Compliance Checklist (ICC)) was also assessed. No differences (p = 0.788) were found in POA control at the time of induction measured by m-YPAS (group 1: 39.2 ± 27.9; group 2: 37.0 ± 26.1; group 3: 34.7 ± 25.5; group 4: 32.4 ± 20.5). No differences were found in the level of ICC between the different treatment arms (group 1: 1.8 ± 3.4; group 2: 1.5 ± 3.0; group 3: 1.2 ± 2.4; group 4: 1.5 ± 2.7). The combination of all treatments (group 3) was the only effective strategy to contain the progression of anxiety. In conclusion, hydroxyzine was not effective to control POA in children. The combination of hydroxyzine and clowns avoided the progression of POA in our patients. This trial is registered with ClinicalTrials.gov identifier: NCT03324828 (registered 21 September 2017, subject recruitment started on 12th January 2018).

A Policy Decoupled from Practice: Children’s Participation in Swedish Social Assistance

Abstract In many countries, there are calls for children to be allowed to participate in social work decision-making. This article analyses child participation vis-à-vis social assistance (SA), which is a municipal cash benefit representing the last safety net. In Sweden, SA is part of the professional field of social work and national policy recommends that children are consulted. The aim is to analyse local policies and practices regarding child participation, and the data are based on case studies in six social service offices. Unlike most participation studies, children’s participation is conceived as an institutional pressure and the concept of decoupling is used to examine how local authorities relate to participation. The findings show that in local policies there is a general openness towards participation, but in practice no efforts are being made to promote participation. The absence of participation is analysed as deriving from organisational barriers (practices are adult-centred and child welfare units are seen as responsible for participation) and the scepticism of social workers (participation is an infringement on parental obligations and children should be protected from involvement in financial issues). The article ends with a discussion on the decoupling and adequacy of children’s participation in settings comparable with Swedish SA.

Nutrient intakes and nutritional status of children of Samin indigenous people in Indonesia

Undernutrition is still a problem in the world. In Indonesia, the problem of undernutrition is high especially underweight, stunting and wasting among children under five years old. Some indigenous people usually have lower economical levels, educational levels and health status compared to the rest of the population and as a result indigenous people are usually prone to malnutrition. Samin is one example of indigenous people in Indonesia. The main objective of this study was to compare nutrient intakes and nutritional status of children under five years inClosed and OpenedSamin indigenous people in Indonesia. Closed Samin people tend to hold on to their culture firmly and are less receptive to some government programs, while Opened Samin tend to be more receptive to government programs. This was a cross-sectional study design. Participants were selected by snowball sampling technique; 120 households with children under five years were selected. Food consumption of the children was collected through direct interviews using 1x24 hours recall procedure. Nutritional status was assessed by weighing the children’s body weights. Children’santhropometric data were analyzed using the WHO AnthroPlus software. T-test and Mann-Whitney were used to analyze the difference between groups. The study showed that nutrient intakes (energy, protein, vitamin A, iron and calcium) of children In Closed Samin were significantly lower than those in Opened Samin (p&lt;0.05). The vitamin C intake of both groups was not significantly different (p&gt;0.05). The mean of energy, vitamin Cand calcium intake in both groups did not meet Indonesian Recommended Dietary Allowances(RDA). Based on the RDA reference, protein and vitamin A adequacy of children in Closed Saminand Opened Samin were sufficient. Iron adequacy was different in Closed Samin classified as inadequate, whereas Opened Samin was normal. The prevalence of underweight in Closed Samin was 49%, while in Opened Saminitwas 21%. The weight-for-age Z-score (WAZ) of children in both groups showed significant differences (p=0.006)with mean z-score -1.8±1.4 for Closed Samin and -1.1±1.4 for Opened Samin. In conclusion, the mean of nutrient intakes and nutritional status of children in Opened Samin was higher than Closed Samin. That was due to the household economic levels and maternal nutritional knowledge, which was also higher in Opened Samin. The local government must find the best approach in resolving problems related to child nutrition of Closed Samin indigenous people and be more active to encourage participationin government programs.

Literature Review: Pengaruh Pemberian Kombinasi Makanan terhadap Anak Lahir Stunting sebagai Upaya untuk Menurunkan Kejadian Malnutrisi di Indonesia

Introduction: Nutrition status is an indicator level of child welfare in Indonesia. One of the factors that affect nutritional status is food intake. Fulfilling the need for a balanced intake of food starts from the implantation until the child is 24 months old. In this age period is a period of growth that will determine the physical form of the child. Stunting is a chronic malnutrition disease that the body becomes short. The impact of stunted child birth is growth becomes inhibited, decreased cognitive function, and decreased immune function. Therefore, it is necessary to handle stunting to reduce the incidence of malnutrition, one of them with the provision of food combinations. Method: Journal search by collecting from multiple databases: Sage database, PubMed, IJHN, ProQuest, Ingenta Connect, and Google Scholar. Journal criteria used are journals from 2007 to 2017. Keywords used are diet diversification and stunting. Result: Nursing intervention in the form of food combinations, effective, efficient and safe are given to children born stunting to reduce the incidence of malnutrition in Indonesia. Discussion: The combination of food in an effort to fulfill the nutritional adequacy of children, influenced by economic status. So, it is necessary to choose a variety of foods that are cheap but nutritional quality remains met. Conclusion: Giving a combination of food to children born stunting can reduce the incidence of malnutrition in Indonesia.

Nutritional adequacy of children with critical illnesses: where are we now?

Rationale: At admission/during Pediatric Intensive Care Unit (PICU) stay malnutrition in critically ill children may lead to fat-free mass (FFM) loss, increased length of PICU/hospital stay, poor clinical outcomes and costs. Optimum nutrition support of PICU admitted patients is of particular importance to minimize morbidities and growth retardation in this era. The aim of the present study was to investigate the nutritional adequacy of children with critical illnesses and probable differences in nutrition support of critically ill children with medical and surgical underlying diseases.

Trends in Orange Juice Consumption and Nutrient Adequacy in Children 2003-2016

This study aimed to examine secular trends in 100% orange juice (OJ) consumption and trends in nutrient adequacy in children 2-18 years participating in the 2003-2016 National Health and Nutrition Examination Survey. The National Cancer Institute method was used to estimate the usual intake. Ten deciles of OJ consumption were determined based on intakes with non-consumers in the first decile. Nutrient adequacy was determined using the percentage below the Estimated Average Requirement (EAR) or the Adequate Intake (AI) percentage. Linear regression coefficients for changes in intake over time and across deciles of OJ were generated. Approximately 14% of the total sample consumed OJ with a mean intake of 40.0 g/d (77 KJ [0.9% of total energy intake]). Amounts of all 100% fruit juices consumed decreased by 44%, and whole fruit intake increased by approximately 32% from 2003-2016. Consumption of total energy, total carbohydrates, added sugars, and saturated fatty acids decreased. Intakes of folate, riboflavin, zinc, and vitamin C decreased from 2003-2016. The percentage of children below the EAR increased for vitamin C and zinc and decreased for vitamin A from 2003-2016. Percent of children above the AI increased for fiber. Across the deciles of OJ consumption, the percent of children with an inadequate vitamin D intake, calcium, iron, and phosphorus decreased. OJ and other 100% juices were major food sources of many nutrients consumed at levels below recommendations. One strategy to reduce inadequate intake of calcium, phosphorus, and potassium intake is to maintain or increase the consumption of OJ and other 100% juices

METHODOLOGICAL AND THEORETICAL SUPPORT OF INTEGRATED COMPUTER INFORMATION TECHNOLOGY FOR MONITORING AND EVALUATION OF THE HEALTH STATUS OF CHILDREN AND ADOLESCENTS INVOLVED IN SPORTS SCHOOLS

In this work, an approach is proposed to implement the screening of the health status of children and adolescents. Through the approach can be determined the reserve potential and adequacy of children and adolescents to exercise in a particular sport type. Selection of children and adolescents in professional sports would identify risk groups for the development of pathological conditions in children and adolescents. On the basis of computer-information, technology for monitoring and assessing the health status of children and adolescents involved in sports schools is the main idea of the proposed approach. Particularly, based on integrated implementation workplace automation (WA) of doctors of different profiles and workplace automations of trainers in various sports are going to be realized as the result of this work.

The study of the formation of relations of educational cooperation of younger schoolchildren

Introduction: the need to study the current state of relations of educational cooperation of younger students is determined by the increasing role of communicative universal educational activities in the development of modern society. However, a number of studies it prove that often the life of a modern school does not provide any opportunities to use the potential resources of such an important component of the development of the student, as educational cooperation. Traditional school due to many restrictions does not always provide the possibility to build a student-centered relationship of educational cooperation in combination with a differentiated approach to younger students. Numerous studies often describe the interaction of students with adults and peers separately, that prevents making unified approaches to the child's socialization.The initial step towards solving this problem should be the complex study of the areas of interaction and diverse study of the formation of relations of educational cooperation of younger schoolchildrenMaterials and Methods: in article the diagnostic program-the complex made of the techniques giving the chance to get the idea of a modern state of development of the relations of educational cooperation in elementary school is declared. They were: a technique with the working title “ the Carpet”, allowing to establish levels of development of skills of group interaction of younger schoolchildren in the lessons; “Sociometric research”, intended for identification of the social status of the child in children's group; “Self-esteem ladder”, designed to determine the adequacy of children's self-esteem in the sphere of business contacts of the child with classmates.Results: the results of the study of the formation of relations of educational cooperation among younger schoolchildren with peers in a specially created innovative conditions in the context of a given procedure of learning and initiated by the child communication. The idea of teachers about the most important for younger schoolchildren’s psychological conditions of development of relations of educational cooperation is revealed.Discussion and Conclusions: the study suggests that for the effective development of relations of educational cooperation with children it is necessary to create a special innovative learning environment, which provides a high motivational basis for younger students to achieve their goals, initiatives, independence, strengthen their social status in the group of peers, increase self-esteem.

Evaluating the Impact of the Revised Special Supplemental Nutrition Program for Women, Infants, and Children Fruit Juice Allotment on Fruit Intake, Dietary Quality, and Energy/Nutrient Intakes among Children 1-4 Years of Age

Objective: The goals of this study were to assess the impact of recent changes in the WIC allotment on fruit intake, dietary quality/adequacy, energy/nutrient intakes, and potential impact of the complete removal of 100% fruit juice (FJ) from the package. Methods: 24-hour recalls from children 1-4 years who were WIC participants or income-eligible nonparticipants in the NHANES 2007-2008 and 2011-2014 (before and after WIC package changes) were analyzed. Results: There were no differences in the Healthy Eating Index-2015 total score; subcomponent scores for “greens and beans” and for “fatty acid ratio” were higher in 2011-2014 than in 2007-2008 in children participating in WIC; scores for “sodium” were higher in 2011-2014 than in 2007-2008 in children not participating in WIC but income-eligible. In WIC participants mean intakes of riboflavin, vitamins B12 and C, and zinc were significantly (p&lt;0.01) lower, and intake of vitamin E was significantly (p&lt;0.01) higher in 2011-2014 compared to 2007-2008. One significant difference in nutrient adequacy in children was that of a lower (p&lt;0.01) percentage of inadequacy for WIC participants for vitamin E and a higher (p&lt;0.01) percentage of inadequacy for WIC participants for vitamin A in 2011-2014 as compared to those in 2007-2008. The elimination of FJ from the WIC food packages resulted in a 38-50% lower total fruit intake and a 4-5% reduction in total HEI-2015 score. Conclusion: Changes in the WIC program resulted in potential adverse effects on mean intakes of some nutrients but not on the nutrient adequacy or overall diet quality. Confirmatory studies are needed.

Improved Diet Quality and Nutrient Adequacy in Children and Adolescents with Abdominal Obesity after a Lifestyle Intervention.

High rates of childhood obesity require integral treatment with lifestyle modifications that achieve weight loss. We evaluated a lifestyle intervention on nutrient adequacy and diet quality in children and adolescents with abdominal obesity. A randomized controlled trial was performed on 107 participants, assigned either to a usual care group or to an intensive care group that followed a moderate hypocaloric Mediterranean diet and received nutritional education. Intake adequacy was evaluated using Dietary Reference Intakes and diet quality through the Diet Quality Index for Adolescents (DQI-A), the Healthy Lifestyle Diet-Index (HLD-I) and the Mediterranean Diet Quality Index (KIDMED). Both groups achieved a significant reduction in BMI standard deviation score (BMI-SDS), glucose and total cholesterol levels. Intake of Calcium, Iodine and vitamin D were higher in the intensive care group, with enhanced compliance with recommendations. Higher dietary scores were associated with lower micronutrient inadequacy. DQI-A and HLD-I were significantly higher in the intensive care group vs. usual care group after the treatment. In conclusion, we observed that an intensive lifestyle intervention was able to reduce BMI-SDS in children with abdominal obesity. Furthermore, participants significantly improved dietary indices getting closer to the nutritional recommendations. Therefore, these diet quality indices could be a valid indicator to evaluate micronutrient adequacy.

Nutritional practices and adequacy in children supported on extracorporeal membrane oxygenation

Use of extracorporeal membrane oxygenation (ECMO) in children is increasing. Yet, little is known about optimal nutritional practices in these children. We aim to describe the nutritional adequacy, factors associated with enteral nutrition, and the association between nutritional adequacy and mortality in children supported on ECMO. We conducted a retrospective review of all children (1 month-18 years) requiring ECMO between 2010 and 2016. Data on enteral and parenteral energy and protein intake in the first 7 days of ECMO were collected. Adequacy of nutrition intake was defined as total intake vs. total requirements, expressed as a percentage. 51 patients were included, of which 43 (84.3%) were supported on veno-arterial ECMO. Median ECMO duration was 8.6 days [interquartile range (IQR) 6.1-16.2]. Overall energy and protein adequacy across the first 7 days of ECMO were 48.3% (IQR 28.0-67.4) and 44.8% (IQR 26.9-67.0) respectively. Parenteral nutrition provided majority of calories [median 88.0% (IQR 62.9-100)] and protein [median 91.0% (IQR 62.3-100)] intake. Enteral nutrition (EN) was initiated in 33 (64.7%) patients. Time to EN initiation, vasoactive-inotropic score just before ECMO initiation, veno-arterial ECMO mode and continuous renal replacement therapy in the first week of ECMO were factors associated with EN energy adequacy. Hospital mortality rate was 55% (28/51). Compared to survivors, non-survivors had lower adequacy of EN energy intake [0.5% (IQR 0-4.4) vs. 11.8% (IQR 0-24.5), p=0.034]. After correcting for ECMO duration, need for continuous renal replacement therapy and number of vasoactive drugs required on ECMO, greater EN energy adequacy remained associated with lower risk of mortality [adjusted odds ratio 0.93 (95% confidence interval: 0.86-0.99), p=0.048]. Nutritional adequacy, especially that of EN, remains low in children supported on ECMO. EN energy adequacy was found to be associated with lower mortality. Further studies on nutritional adequacy in pediatric ECMO, as well as strategies to optimize EN in these children, are warranted.