Healthy Growth Of Children Research Articles

The 5th national survey on the physical growth and development of children in the nine cities of China: Anthropometric measurements of Chinese children under 7years in 2015.

To describe the physical growth of healthy children under 7years in China based on the latest national survey and provide more data for revising growth reference and monitoring the impact of social development on children's health and growth. In the cross-sectional survey, 161,774 healthy children under 7years were selected by multistage stratified cluster sampling method in nine cities of China. According to the geographical location, the nine cities were divided into northern, central and southern regions, and each city included urban and suburban areas. Anthropometric measurements were obtained on the spots and other related information was collected with questionnaires. There were slight urban-suburban difference and obvious regional difference in anthropometric measurements in China. Comparison with the 4th NSPGDC in 2005, measurements increased 0.1-1.1kg in weight, 0.5-1.8cm in height in urban areas (except children under 3years) and 0.1-2.5kg in weight, 0.2-3.8cm in height in suburban areas. The urban-suburban difference of those measurements became smaller than 10years ago, but their regional difference persistently exist. Chinese children were 0.36 SD in weight, 0.43 SD in height in urban areas and 0.30 SD in weight, 0.30 SD in height in suburban areas higher than WHO standards. Physical growth of children under 7years old was undergoing a slowly positive secular trend during the latest decade in more economically developed regions of China. Urban-suburban difference of those measurements became smaller, while their regional difference persistently exist. Chinese healthy children under 7years in nine cities was taller and heavier than WHO standards.

Assessment of Knowledge, Attitude and Practice on Initiation of Complementary Feeding Among Under Two Years Children in Fiche Town, North Showa Zone, Ethiopia

<i>Background:</i> - Healthy complementary feeding is critical for the achievement of a healthy growth and development of children. In Ethiopia inappropriate complementary feeding practices, combined with poverty, are major determinants of the high prevalence of malnutrition among young children. Community based a prospective cross- sectional study was conducted from December to January 2015/2016. Almost two-third of the mothers initiated complementary feeding at the sixth month of child's age. Factors like maternal and husband educational level, family size, place of delivery, ANC follow up, and PNC follow up were significantly. Most mothers initiate complementary feedings timely. Maternal literacy, family size and relation of mothers affect timely initiation of complementary feeding. Educating the mothers by mass media and house to house by health extension workers is important to increase timely initiation of complementary feeding.

Social work’s fingerprint on the evolution of attachment theory: Some essential knowledge for care practice

INTRODUCTION: Social work practice knowledge was seminal to the evolution of attachment theory. This disciplinary connection is little known to many social work practitioners. This article seeks to remind care practice social workers specifically of this association, as the social work skills upon which early attachment knowledge was premised remain important to contemporary care practice.METHOD: Through a three-part discussion, this article aims to deepen care practice social workers’ understanding of attachment theory and its practical relevance for care practice assessment. The first section outlines the watershed moments of the theory’s development. The second highlights social work’s connection to this development. The third and final section reviews the construct of the internal working model and its value for distinguishing emotional differences in an adult’s relational biography.FINDINGS AND IMPLICATIONS: A key care practice goal is to facilitate the healthy growth and development of children and young people who have been placed in foster care due to maltreatment. A growing number of attachment researchers have found that the internal working model of a child’s new caregivers, with respect to attachment, is an important element in the revision of the child’s internal working model of relationships (Pace &amp; Zavattini, 2011). Thus, care practice social workers need to pay close attention to relational facets in prospective caregivers’ assessments as some literature suggests that practitioners struggle to understand the role attachment orientation plays in the care relationship (Bick &amp; Dozier, 2008).CONCLUSIONS: This article highlights and elaborates upon the utility of attachment theory for present-day care practice and argues that a deep understanding of this theory is likely to be instrumental to achieving better relational outcomes in foster care. This knowledge is foundational to conceptualising the different relational expectancies that prospective foster parents might bring to a new relationship.

The course of pregnancy and delivery in patients with prolactinoma during treatment with cabergoline

Objectives: To assess the risk of pregnancy and fetal pathology in patients with prolactin-secreting tumors treated with cabergoline in the early stages of gestation.Materials and methods: The study included 24 patients in the age from 24 to 38 years old with prolactin-secreting tumors, become pregnant during therapy with cabergoline (Dostinex). A retrospective analysis of the course and outcomes of 33 pregnancies based on available medical records and questioning of the patients data.Results: Of the 33 pregnancies resulted in births 26 (78.8%), registered a spontaneous miscarriage at 7 weeks period (3%), six women required medical abortions due to the undeveloping pregnancy for a period of 4 to 7 weeks (18.2%). In 6% of cases (two pregnant) gestational diabetes mellitus (GDM) has been diagnosed. The average gestational age was 39.8 weeks (36–41 weeks). Preterm delivery occurred in 4 women, accounting for 15.3%. In 6% of cases (two pregnant) gestational diabetes mellitus (GDM) has been diagnosed. In total 27 children were born (in 1 case - twins), 26 (96.3%) of which at the time of birth – are healthy. The vast majority of pregnancies ended with the birth of a healthy child growth and development that did not differ from those of their peers in the general population, which corresponds to the data released by the majority of foreign researchers.Conclusions: The study confirms the absence of direct adverse effects of cabergoline (Dostinex) on the course and outcome of pregnancies in women receiving the drug at therapeutic doses before pregnancy and during the first 8 weeks of gestation.

Identifying individual sleep apnea/hypoapnea epochs using smartphone-based pulse oximetry.

Sleep apnea, characterized by frequent pauses in breathing during sleep, poses a serious threat to the healthy growth and development of children. Polysomnography (PSG), the gold standard for sleep apnea diagnosis, is resource intensive and confined to sleep laboratories, thus reducing its accessibility. Pulse oximetry alone, providing blood oxygen saturation (SpO2) and blood volume changes in tissue (PPG), has the potential to identify children with sleep apnea. Thus, we aim to develop a tool for at-home sleep apnea screening that provides a detailed and automated 30 sec epoch-by-epoch sleep apnea analysis. We propose to extract features characterizing pulse oximetry (SpO2 and pulse rate variability [PRV], a surrogate measure of heart rate variability) to create a multivariate logistic regression model that identifies epochs containing apnea/hypoapnea events. Overnight pulse oximetry was collected using a smartphone-based pulse oximeter, simultaneously with standard PSG from 160 children at the British Columbia Children's hospital. The sleep technician manually scored all apnea/hypoapnea events during the PSG study. Based on these scores we labeled each epoch as containing or not containing apnea/hypoapnea. We randomly divided the subjects into training data (40%), used to develop the model applying the LASSO method, and testing data (60%), used to validate the model. The developed model was assessed epoch-by-epoch for each subject. The test dataset had a median area under the receiver operating characteristic (ROC) curve of 81%; the model provided a median accuracy of 74% sensitivity of 75%, and specificity of 73% when using a risk threshold similar to the percentage of apnea/hypopnea epochs. Thus, providing a detailed epoch-by-epoch analysis with at-home pulse oximetry alone is feasible with accuracy, sensitivity and specificity values above 73% However, the performance might decrease when analyzing subjects with a low number of apnea/hypoapnea events.

Healthy Caregivers-Healthy Children: A Train-the-Trainer (TTT) Implemented Childcare Center-Based Obesity Prevention Program

The purpose of this project is to evaluate the effectiveness of the train-the-trainer (TTT)-implemented “Healthy Caregivers-Healthy Children” (HC2) obesity prevention toolkit on parent and teacher adoption of healthy lifestyle role modeling behaviors, and policy integration in childcare centers. A total of 24 Quality Rating and Improvement System (QRIS) childcare centers were randomized to HC2 or an attention control arm. Treatment centers (n=12) are currently receiving the HC2 program via a TTT model that includes menu modifications, a child-centered curriculum for healthy eating and physical activity, and a parent-and teacher-centered curriculum for healthy meal preparation, reinforced through an adult role-modeling curriculum. Control centers (N=12) are receiving an injury prevention (safety) intervention. Over a quarter of the sample (27%) is overweight/obese. Mean BMI percentile is 60.1% and z score is 0.33. Analysis of the Health Environment Rating Scale showed that at baseline only 59% have water available to drink throughout the day, 13% served vegetables 1xday (20% never), 40% always serve whole grain snacks, 38% spend at least 1.5 hours doing vigorous activity. Lower child BMI was significantly correlated with more daily vegetable servings (R=-.55, p=0.04). Health Environment Rating Scale baseline center-level analysis showed that most centers are not meeting HC2 policy standards (water as beverage choice, fruits/vegetables served daily, at least 120 minutes of physical activity/day, and < ½ hour of screen time per week). center level nutrition behavior, and serving more vegetables in particular, has a positive impact on child healthy weight. implementing standardized nutrition and physical activity policies in childcare centers can have a significant impact on child healthy growth and development.

HomeStyles: Shaping Home Environments and Lifestyle Practices to Prevent Childhood Obesity- A Randomized Controlled Trial

ObjectiveTo create an effective, sustainable, population-level obesity-prevention intervention that enables and motivates parents of preschoolers to shape their home environment and lifestyle behavioral practices to prevent excessive weight gain in their children and compare its effectiveness to control condition participants.DescriptionIntervention development and implementation was guided by Social Cognitive and Adult Learning Theories, community-based participatory research, and motivational interviewing. The randomized controlled intervention trial is delivered by in-home visitors or online to English and Spanish parents of preschoolers. Focus groups with parents guided development of intervention materials. Cognitive testing with parents was used to refine intervention materials.EvaluationCognitive testing of intervention materials indicated high audience acceptance and satisfaction. Training of home visitation staff delivering the intervention in-home was rated highly satisfactory by staff. Instruments for benchmarking participants and assessing intervention outcomes are valid and reliable. Preliminary time x treatment analyses indicate that, compared to control group parents, experimental group parents had significant improvements in family support for healthy eating, parental modeling of healthy eating behaviors, and self-efficacy for preparing healthy family meals, reducing children’s intake of sugary drinks, helping children get and keep a healthy weight, and teaching children about the selling intent and poor nutritional value of foods advertised on TV. Experimental group parents also reported significantly increased overall quality of life.Conclusions and ImplicationsYear 5 activities which focused on recruiting and retaining participants will be summarized. Parent cognitions and behaviors along with home environments and family lifestyle behaviors that promote healthy child growth and development have the potential to prevent excessive weight gain in preschoolers.FundingUSDA Grant #2011-68001-30170 ObjectiveTo create an effective, sustainable, population-level obesity-prevention intervention that enables and motivates parents of preschoolers to shape their home environment and lifestyle behavioral practices to prevent excessive weight gain in their children and compare its effectiveness to control condition participants. To create an effective, sustainable, population-level obesity-prevention intervention that enables and motivates parents of preschoolers to shape their home environment and lifestyle behavioral practices to prevent excessive weight gain in their children and compare its effectiveness to control condition participants. DescriptionIntervention development and implementation was guided by Social Cognitive and Adult Learning Theories, community-based participatory research, and motivational interviewing. The randomized controlled intervention trial is delivered by in-home visitors or online to English and Spanish parents of preschoolers. Focus groups with parents guided development of intervention materials. Cognitive testing with parents was used to refine intervention materials. Intervention development and implementation was guided by Social Cognitive and Adult Learning Theories, community-based participatory research, and motivational interviewing. The randomized controlled intervention trial is delivered by in-home visitors or online to English and Spanish parents of preschoolers. Focus groups with parents guided development of intervention materials. Cognitive testing with parents was used to refine intervention materials. EvaluationCognitive testing of intervention materials indicated high audience acceptance and satisfaction. Training of home visitation staff delivering the intervention in-home was rated highly satisfactory by staff. Instruments for benchmarking participants and assessing intervention outcomes are valid and reliable. Preliminary time x treatment analyses indicate that, compared to control group parents, experimental group parents had significant improvements in family support for healthy eating, parental modeling of healthy eating behaviors, and self-efficacy for preparing healthy family meals, reducing children’s intake of sugary drinks, helping children get and keep a healthy weight, and teaching children about the selling intent and poor nutritional value of foods advertised on TV. Experimental group parents also reported significantly increased overall quality of life. Cognitive testing of intervention materials indicated high audience acceptance and satisfaction. Training of home visitation staff delivering the intervention in-home was rated highly satisfactory by staff. Instruments for benchmarking participants and assessing intervention outcomes are valid and reliable. Preliminary time x treatment analyses indicate that, compared to control group parents, experimental group parents had significant improvements in family support for healthy eating, parental modeling of healthy eating behaviors, and self-efficacy for preparing healthy family meals, reducing children’s intake of sugary drinks, helping children get and keep a healthy weight, and teaching children about the selling intent and poor nutritional value of foods advertised on TV. Experimental group parents also reported significantly increased overall quality of life. Conclusions and ImplicationsYear 5 activities which focused on recruiting and retaining participants will be summarized. Parent cognitions and behaviors along with home environments and family lifestyle behaviors that promote healthy child growth and development have the potential to prevent excessive weight gain in preschoolers. Year 5 activities which focused on recruiting and retaining participants will be summarized. Parent cognitions and behaviors along with home environments and family lifestyle behaviors that promote healthy child growth and development have the potential to prevent excessive weight gain in preschoolers.

Impact of Intimate Partner Violence on Primary Health Care Use for Children: Evidences from Rio de Janeiro, Brazil.

Objectives To assess whether severe physical intimate partner violence (PIPV) after childbirth affects the number of pediatric visits in Primary Health Care (PHC) units during this period. Methods Cross-sectional study including 927 mothers of infants under 6months, users of 27 PHC units in Rio de Janeiro, Brazil. PIPV from childbirth to the date of interview was measured using the Revised Conflict Tactics Scales (CTS2). The number of pediatric visits in the first 6months of life was the outcome measure of interest. Poisson and multinomial regression models were used for data analysis to control for confounders. Results Children of mothers who experienced severe PIPV had a reduced number of pediatric visits than those not reporting it. This finding was identified only among children who had health problems: relative to five or more baseline pediatric visits, the chance of 3-4 and 1-2 visits increased three- and five-fold, respectively, when severe PIPV was present. Conclusions The maternal experience of severe PIPV reduces the number of pediatric visits in PHC services among the most vulnerable children. This is a hindrance to adequate health promotion, prevention and care, required for the healthy growth and development of children. Early violence detection by pediatricians and other health professionals could be a step in the right direction.

Pediatric Reference Values and Z Score Equations for Left Ventricular Systolic Strain Measured by Two-Dimensional Speckle-Tracking Echocardiography

In pediatric echocardiography, myocardial strain measurements are likely influenced by cardiac size and growth in healthy children. The application of this technique in clinical practice has been hampered by the lack of good normal reference values for the pediatric population. The aim of this study was to determine reference values and Z score equations for left ventricular systolic circumferential and longitudinal strain in ahealthy pediatric population. Two hundred thirty-three healthy subjects 1 to 18years of age were prospectively recruited. Left ventricular systolic longitudinal and circumferential strain measurements were recorded using two-dimensional speckle-tracking. Normalization for body size was performed using parametric nonlinear regression modeling. Several analyses were performed to detect potential residual associations with body size, residual heteroscedasticity, or departure from an adequate Z score distribution. There were weak but statistically significant nonlinear associations between body size and most strain values. Body surface area was superior to adjust for body size compared with age, height, and weight. Most strain values displayed a second-order polynomial relationship with body surface area. Z score equations were computed with adequate normal distributions and without residual associations in relation to BSA for most strain parameters. There was a weak but significant influence of body size on most left ventricular circumferential and longitudinal systolic strain parameters used in pediatric echocardiography. Z scores are presented for strain measurements normalized to body surface area and adjusted for heteroscedasticity. The use of these normalized values may reduce the risk for misclassification caused by normal variation in myocardial strain values during growth.

Growth charts: do they reflect healthy growth in Sri Lankan children?

BackgroundAnthropometry has been used in the assessment of growth with “normal” range of growth being considered to span within ±2SD of median. Generally the practice is to make a child to grow within this standard deviation (SD) range. This study aims to investigate the hypothesis that all children with anthropometrical parameters within the designated “normal growth range” (within ±2SD of median), have a healthy body composition irrespective of the SD value.ResultsFive to 15-year-old apparently healthy Sri Lankan children were studied. SD scores for height, weight and BMI, for age were calculated based on WHO 2007 standards. Sample was stratified according to age, sex, and SD score. %FM (assessed by isotope dilution methods using D2O) was compared between each SD group of each anthropometric parameter for gender and age. There were 278 (M/F:154/124) children. Non-parametric Kruskal–Wallis test revealed that the %FM of children differed significantly between SD groups even when they were within the accepted “normal limits of growth” and had higher levels of %FM in the upper SD groups.ConclusionsThis study shows that Sri Lankan children have unacceptably high body fat at levels that have been designated by growth charts as “normal”. Children who are positioned at a higher SD score, +1 to +2SD, (within normal range) in the weight for age and BMI for age charts are mainly due to the deposition of fat rather than the growth in both fat and fat free compartments of body. Therefore the implication of using current cutoff values would be leading to the accumulation of excess fat in the body of those with higher SD values, but still considered to be within “normal” limits. Therefore in the absence of local standards, it would be important to revise the cutoff values of the WHO growth charts to suite Sri Lankan children which would be between −3SD and +1SD.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-016-2016-4) contains supplementary material, which is available to authorized users.

Strengthening health services to deliver nutrition education to promote complementary feeding and healthy growth of infants and young children: formative research for a successful intervention in peri-urban Trujillo, Peru.

Formative research is critical for developing effective nutrition-specific interventions to improve infant and young child (IYC) feeding practices and promote healthy growth. Health workers interact with caregivers during health facility visits, yet there is limited research about how to optimize delivery of such interventions during these visits. The extensive reach of IYC health services globally calls for research to address this gap. In Trujillo, Peru, formative research was conducted to explore complementary feeding practices with caregivers as well as health worker routines and interactions with caregivers related to feeding and healthy growth; results informed the development and delivery of an educational intervention. Multiple qualitative methods were used to collect data on a purposive sample of health workers and caregivers from three health facilities and communities: household trials followed. Complementary feeding messages with doable behaviours were developed, and three were selected as key to promote based on their nutritional impact and cultural acceptability. In the health facilities, medical consultation, well-child visits and nutrition consultation all dealt with aspects of IYC nutrition/growth during their interactions with caregivers but were independent and inconsistent in approach. A nutrition education strategy was developed based on consistency, quality and coverage in the IYC health services. We conclude that formative research undertaken in the community and IYC health services was critical to developing a successful and culturally relevant intervention to promote optimal complementary feeding practices and healthy growth during interactions between health workers and caregivers at routine health facility visits. © 2016 John Wiley & Sons Ltd.

Pleuritic chest pain due to migratory bullet

There has been a continuous effort to develop standard growth charts for neonates. Reference growth charts based on cross-sectional intrauterine data were developed from measurement of anthropometric parameters of neonates of different gestations at birth. Similarly postnatal charts for preterm neonates were developed based on longitudinal measurements of infant's parameters over intervals. Fetal–infant growth charts were devised by combining cross-sectional intrauterine data and postnatal infant's longitudinal parameters. Revised Fenton 2013 charts incorporating neonatal anthropometric data look to be most adequate for preterm infants of 22 weeks gestation till 50 weeks post-menstrual age. These growth references describe how infants grew in certain time in a defined population. There was a need of developing growth standard defining growth of healthy population in optimal conditions. WHO Multicentre Growth Reference Study charts were developed as growth standards describing the growth of healthy children from term gestation till 5 years of age. Intergrowth 21st growth chart is the new growth standards for preterm infants and looks promising in infants of gestation 33 weeks or more.

Serum NT-proCNP levels increased after initiation of GH treatment in patients with achondroplasia/hypochondroplasia.

Serum amino-terminal propeptide of C-type natriuretic peptide (NT-proCNP) levels have been proposed as a biomarker of linear growth in healthy children. The usefulness of NT-proCNP in patients with achondroplasia (ACH)/hypochondroplasia (HCH) remains to be elucidated. The objective was to study whether serum NT-proCNP level is a good biomarker for growth in ACH/HCH and other patients of short stature. This was a longitudinal cohort study. Sixteen children with ACH (aged 0·4-4·3 years), six children with HCH (2·7-6·3 years), 23 children with idiopathic short stature (ISS) (2·2-9·0 years), eight short children with GH deficiency (GHD) (2·9-6·8 years) and five short children born small for gestational age (SGA) (2·0-6·6 years). Patients with ACH/HCH received GH treatment for 1 year. Serum NT-proCNP levels and height were measured. NT-proCNP levels positively correlated with height velocity in these short children (P < 0·05, r = 0·27). NT-proCNP levels inversely correlated with age in children with ISS alone (P < 0·01, r = -0·55). Serum NT-proCNP levels in patients with ACH/HCH were increased 3 months following the initiation of GH treatment (P < 0·05). Height SDS gain during GH treatment for 1 year was positively correlated with the changes in NT-proCNP levels after the initiation of GH (P < 0·01, r = 0·72). Serum NT-proCNP levels may be a good biomarker to indicate the effect of GH treatment on growth in patients with ACH/HCH at least in the first year and height velocity in short stature patients.

Sialylated Milk Oligosaccharides Promote Microbiota-Dependent Growth in Models of Infant Undernutrition

Identifying interventions that more effectively promote healthy growth of children with undernutrition is a pressing global health goal. Analysis of human milk oligosaccharides (HMOs) from 6-month-postpartum mothers in two Malawian birth cohorts revealed that sialylated HMOs are significantly less abundant in those with severely stunted infants. To explore this association, we colonized young germ-free mice with a consortium of bacterial strains cultured from the fecal microbiota of a 6-month-old stunted Malawian infant and fed recipient animals a prototypic Malawian diet with or without purified sialylated bovine milk oligosaccharides (S-BMO). S-BMO produced a microbiota-dependent augmentation of lean body mass gain, changed bone morphology, and altered liver, muscle, and brain metabolism in ways indicative of a greater ability to utilize nutrients for anabolism. These effects were also documented in gnotobiotic piglets using the same consortium and Malawian diet. These preclinical models indicate a causal, microbiota-dependent relationship between S-BMO and growth promotion.

Intake of essential fatty acids in Indonesian children: secondary analysis of data from a nationally representative survey.

Essential fatty acids (EFA) such as α-linolenic acid (ALA) and linoleic acid (LA) are needed for healthy growth and development of children. Worldwide, reliable intake data of EFA are often lacking. The objective of this study was to investigate dietary intake of EFA in Indonesian children. Dietary intake data of 4-12-year-old children (n 45,821) from a nationally representative Indonesian survey were used to estimate median intake and distribution of population fatty acid intake. Missing data on individual fatty acids in the Indonesian food composition table were complemented through chemical analyses of national representative food samples and imputation of data from the US nutrient database. Nutrient adequacy ratios were calculated as a percentage of FAO/WHO intake recommendations. The medians of total fat intake of the children was 26·7 (10th-90th percentile 11·2-40·0) percentage of total daily energy (%E). Intakes of fatty acids were 4·05 (10th-90th percentile 1·83-7·22) %E for total PUFA, 3·36 (10th-90th percentile 1·14-6·29) %E for LA and 0·20 (10th-90th percentile 0·07-0·66) %E for ALA. Median intake of PUFA was 67 % and that of ALA 40 % of the minimum amounts recommended by FAO/WHO. These data indicate that a majority of Indonesian children has intakes of PUFA and specifically ALA that are lower than recommended intake levels. Total fat and LA intakes may be suboptimal for a smaller yet considerable proportion of children. Public health initiatives should provide practical guidelines to promote consumption of PUFA-rich foods.

Competitive interactions between glucose and lactose with BSA: which sugar is better for children?

The interactions of the sugars glucose and lactose with the transport protein bovine serum albumin (BSA) were investigated using fluorescence, FT-IR and circular dichroism (CD) techniques. The results indicated that glucose could be bonded and transported by BSA, mainly involving hydrogen bonds and van der Waals interactions (ΔH = -86.13 kJ mol(-1)). The obtained fluorescence data from the binding of sugar and BSA were processed by the multivariate curve resolution-alternating least squares (MCR-ALS) method, and the extracted concentration profiles showed that the equilibrium constant, rglucose:BSA, was about 7. However, the binding of lactose to BSA did not quench the fluorescence significantly, and this indicated that lactose could not be directly transported by BSA. The binding experiments were further performed using the fluorescence titration method in the presence of calcium and BSA. Calcium was added so that the calcium/BSA reactions could be studied in the presence or absence of glucose, lactose or hydrolysis products. The results showed that hydrolyzed lactose seemed to enhance calcium absorption in bovine animals. It would also appear that for children, lactose provides better nutrition; however, glucose is better for adults.

Determinants of failure to thrive (FTT) among infants aged 6-24 months: a case-control study.

Failure to thrive (FTT) in children is one of the most important health issues around the world, especially in developing countries. Lack of success in identifying and controlling this health problem may lead to dangerous health consequences for children. The aim of this research was to explore the risk factors for this health problem in infants under two years of age in Urmia, Northwest of Iran. This case-control study was carried out on 445 infants of 6 to 24 months (180 as cases, and 265 as controls) in Urmia, Northwest of Iran, during 2013. The study samples were selected from six health centers, using the purposeful sampling method. To collect data, a questionnaire including items regarding sociodemographics of the children's families, and demographic and nutrition-related variables of infants was utilized. To analysis data and determine the real effect of the aforementioned factors on growth status of infants, a chi-square test and logistic regression analysis were applied. The regression analysis revealed that education level of infants' mothers [AOR = 1.421, 95% CI (1.172, 1.724)], duration of breastfeeding [AOR = 1.859, 95% CI (1.212, 2.852)], birth weight of infants [AOR = 2.777, 95% CI (1.276, 7.166)], family's monthly income [AOR = 1.492, 95% CI (1.117, 2.230)] were correlated with FTT as significant risk factors (P < 0.05). Birth order of infants [AOR = .741, 95% CI ( .573- .958)], however, appeared to be a protective factor for child growth (P < 0.05). The findings of the study may help health care providers in designing and implementing appropriate interventions for improving children's health. In addition, taking into account the importance of healthy growth of children, educating mothers/caretakers would seem beneficial in preventing dangerous diseases in children.

Micronutrient Intake among Children in Puerto Rico: Dietary and Multivitamin-Multimineral Supplement Sources.

Micronutrients are critical for healthy growth and development of children. Micronutrient intake from dietary sources is inadequate among some children and may be improved by use of multivitamin and multimineral (MVMM) supplements. To assess micronutrient intake from dietary and MVMM supplement sources among 12-year-old children in Puerto Rico. A representative sample of 732 children enrolled in an oral health study in Puerto Rico, who completed dietary and MVMM assessments through one 24-h recall, were included in this analysis. Micronutrient intake sources were described and compared to the Dietary Reference Intakes (DRIs) using the Estimated Average Requirement when available (used Adequate Intake for vitamin K and pantothenic acid). Micronutrient profiles of MVMM users and non-users were compared using t-tests. Mean intakes of vitamins A, D, E, and K, pantothenic acid, calcium, and magnesium from food and beverage sources were below the DRIs. From food and beverage sources, MVMM users had higher intakes of riboflavin and folate compared to non-users (p < 0.05). When MVMM supplements were taken into account, users had higher intakes of all nutrients except vitamin K. With the help of MVMM, users increased intake of vitamins E, A, D, and pantothenic acid to IOM-recommended levels but calcium, magnesium, and vitamin K remained below guidelines. Micronutrient intake from diet was below the IOM-recommended levels in the total sample. MVMM use improved intake of selected micronutrients and facilitated meeting recommendations for some nutrients. Public health measures to improve micronutrient intake among children in Puerto Rico are needed.

Development of the SAFE Checklist Tool for Assessing Site-Level Threats to Child Protection: Use of Delphi Methods and Application to Two Sites in India.

BackgroundThe child protection community is increasingly focused on developing tools to assess threats to child protection and the basic security needs and rights of children and families living in adverse circumstances. Although tremendous advances have been made to improve measurement of individual child health status or household functioning for use in low-resource settings, little attention has been paid to a more diverse array of settings in which many children in adversity spend time and how context contributes to threats to child protection. The SAFE model posits that insecurity in any of the following fundamental domains threatens security in the others: Safety/freedom from harm; Access to basic physiological needs and healthcare; Family and connection to others; Education and economic security. Site-level tools are needed in order to monitor the conditions that can dramatically undermine or support healthy child growth, development and emotional and behavioral health. From refugee camps and orphanages to schools and housing complexes, site-level threats exist that are not well captured by commonly used measures of child health and well-being or assessments of single households (e.g., SDQ, HOME).MethodsThe present study presents a methodology and the development of a scale for assessing site-level child protection threats in various settings of adversity. A modified Delphi panel process was enhanced with two stages of expert review in core content areas as well as review by experts in instrument development, and field pilot testing.ResultsField testing in two diverse sites in India—a construction site and a railway station—revealed that the resulting SAFE instrument was sensitive to the differences between the sites from the standpoint of core child protection issues.

Public health nurses’ concerns in preschool-aged children’s health check-ups

The aim is to describe Finnish public health nurses’ concerns during regular health check-ups of preschool-aged children. In 2011, focus-group interviews were conducted with 12 public health nurses. The data were analysed using inductive content analysis. Public health nurses’ concerns dealt with the healthy growth and development of children and their ability to cope with difficult family situations, as well as the everyday reality of parenting. The concerns of public health nurses related to children’s health focused on their psychosocial development. Concerns also focused on the interaction between mother and baby, children’s behavioural problems and their cognitive development, parents’ mental health problems and families’ social circumstances. The everyday reality of parenting caused concern, including the lack of sufficient family time and conflicting parenting roles. Based on the available evidence, the role of public health nurses in child health care has broadened remarkably from the traditional physical follow-up of growth and development to support the well-being of the entire family. Children’s psychosocial problems and families’ difficult circumstances increasingly represent the challenges faced by public health nurses during preschool-aged children’s health check-ups. Public health nurses’ concerns revealed that, in order to respond to the needs of families, they may need to increasingly rely on multi-disciplinary cooperation with other professionals.