In 1997, the prevalence of anaemia was 40.9 % among children aged 6-59 months in the State of Pernambuco, north-east Brazil. Using the same sample of children, we have investigated possible reasons ...for this high prevalence. A representative sample was selected through a three-stage process: proportional systematic random sampling of municipalities in the State, systematic random sampling of census sectors within these municipalities, and finally, simple random sampling of households with children aged 6-59 months to obtain the sample of 650 children. Data collection included demographic, environmental, socio-economic and maternal variables, and nutritional status and dietary intakes of the children. Multiple linear regression analysis was based on a hierarchical model of factors associated with Hb concentration. The mean Hb concentration of children aged 6-23 months was 10 g/l lower than that of older children. In the regression analysis, child age explained 8.3 % of the variance in Hb concentration. The intake of bioavailable Fe explained a further 3.3, serum retinol 2.7, diarrhoea 2.4, water treatment 1.7, sanitation 1.3 and low birth-weight 0.5 %. The final model explained 23.4 % of the variance in Hb concentration. We conclude that child age, bioavailable-Fe intake, serum retinol concentration, diarrhoea, water treatment, sanitation and low birth-weight are independently associated with Hb concentration. In north-east Brazil, anaemia prevention programmes among children should focus on those aged <2 years and should consider feasible strategies to improve intakes of bioavailable Fe and vitamin A, and reduce infection. Supplemental Fe should be given to low birth-weight infants.
Every pre‐school child requires an adult to purchase and provide a variety of foods, to help ensure a balanced selection is included in the diet to avoid any nutritional deficiencies. Children under ...5 years have a greater demand for nutrients and energy to support the body's requirements for growth and development than at any other time throughout their life cycle. The paper critically reviews the main factors that influence food choices made by parents on behalf of their pre‐school child. Dietary deficiencies in inner city areas remain a challenge for the government, educators and health professionals. A particular concern is iron deficiency as the prevalence of anaemia is common especially in British pre‐school children from various family backgrounds. Poor parenting skills often exacerbate the problem, especially the early introduction of pasteurized cow's milk, poor weaning practices and lack of dietary knowledge. Therefore, improving education and understanding about the importance of iron could potentially improve dietary iron intake. Phase 1 of the study was completed in West Bridgford area of Nottingham in the UK. This part of the study aimed to determine parental knowledge with regards to the feeding of their pre‐school child. A questionnaire and a 3‐day diet history method were employed. These methods enabled the diet adequacy of the pre‐schoolers to be analysed by NetWISP software. This study highlighted that iron deficiency remains a cause for concern and should be further addressed. The Sure Start programme is a possible means of education as it has the potential to access parents from all socio‐economic classes. The programme can support and empower parents to become healthier consumers. Good dietary habits, established early in life, contributes to a positive start, and can be advantageous to individuals throughout their lifetime. Such long‐term changes will help contribute to a healthier nation that the government envisages for the future.
Synthesizing insights from psychology and philosophy with his own wide-ranging, experiences around the world, Dr. James Garbarino takes readers on a personalized journey into the dark side of human ...experience as it is lived by children.
In recent years, notified pertussis cases have been increasingly documented in China. It raised a new public health concern of potential optimization in immunization strategy. This study was aimed to ...determine the cost-utility of different immunization strategies against pertussis-containing vaccines for 6-year-old pre-school children in Shanghai.
A Markov-decision tree model was applied to evaluate two pertussis immunization strategies for 6-year-old pre-school children as following: (1) 1 dose of acellular pertussis (aP) contained vaccine (DTaP or Tdap) booster vaccinated at 6 years of age, and (2) no booster at 6 years of age regimen. Primary outcomes included quality-adjusted life years (QALYs), costs, and incremental cost-utility ratios (ICUR). Sensitivity analyses were performed. The analysis was conducted over a study period of 14 years from a societal perspective.
Compared to no booster immunization strategy, administering 1 dose of acellular pertussis (aP) contained vaccine (DTaP or Tdap) booster at 6 years of age, resulted in an average cost reduction of CNY 814.16 (USD 115) per individual, an increase in QALYs by 0.00066, and a rise in per capita net monetary benefit (NMB) by CNY 933.51 (USD 132). The total costs over the study period were reduced by CNY 160.59 million (USD 23 million), utility increased by 130.49 QALYs, and NMB increased by CNY 184.14 million (USD 26 million).
Implementing acellular pertussis booster immunization for 6-year-old pre-school children in Shanghai emerges as a cost-saving immunization strategy, with both cost savings and utility gains.
Breastfeeding has been associated with an advantage to infant neurobehavioral development, possibly in part due to essential nutrients in breast milk. However, breast milk may be contaminated by ...environmental neurotoxicants, such as methylmercury. In the Faroe Islands, where maternal consumption of pilot whale may cause transfer of marine toxicants into breast milk, a cohort of 1022 consecutive singleton births was generated during 1986-87. Methylmercury exposure was assessed from mercury concentrations in cord blood and in the hair of the child at age 12 months, and the duration of breastfeeding was recorded. At approximately 7 years of age, 917 (90%) of the children underwent detailed neurobehavioral examination. After adjustment for confounders, breastfeeding was associated with only marginally better neuropsychological performance on most tests. These associations were robust even after adjustment for cord-blood and hair mercury concentration at age 1 year. Thus, in this cohort of children with a relatively high prenatal toxicant exposure and potential exposure to neurotoxicants through breast milk, breastfeeding was associated with less benefits on neurobehavioral development than previously published studies though not associated with a deficit in neuropsychological performance at age 7. Although the advantage may be less, Faroese women can still safely breastfeed their children.
An analysis was conducted of 291 school lunch menus for about 2,250 pre-school children of 3 to 5 years old to identify the use and cooking method for vegetables. Japanese dishes appeared in 66% of ...the menus. Many of these were soups, dressed dishes, and simmered dishes, with a few using oil. Vegetables made up about 30% of the menu content, most of which covered 61 items. Vegetables were used in 90% of all the dishes with 70 g of each being served. The most common combination in the menus was vegetables and fish or shellfish which made up 45% of the total. These results suggest that the school lunches offering vegetables were based on Japanese dishes using various foods and cooking methods and that pre-school children were acquiring the experience of eating sufficient vegetables.
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