http://www.hindawi.com The latest articles from Hindawi Publishing Corporation © 2013 , Hindawi Publishing Corporation . All rights reserved. Thu, 09 May 2013 14:03:14 +0000 http://www.hindawi.com/journals/ijped/2013/514578/ This study quantifies the impact of Heptavalent-Pneumococcal Conjugate Vaccine (PCV7) in Panama on indigenous children younger than 5 years old, based on clinical pneumonia cases. This study demonstrates a significant 41.2% reduction in hospitalizations and 38.6% reduction in referrals for pneumonia following the introduction of PCV7. Burden of disease from pneumonia appears reduced in the ≤12-month- and 13-to-24-month-old groups. Javier Nieto Guevara, Carlos Daza, and Rebecca Smith Copyright © 2013 Javier Nieto Guevara et al. All rights reserved. Tue, 30 Apr 2013 11:07:51 +0000 http://www.hindawi.com/journals/ijped/2013/373790/ Objective. To evaluate the immune function in HIV-exposed uninfected (HIV-EU) infants fed human donor milk. Methods. Ultrasound-obtained thymic index (Ti), T-lymphocyte subsets, and the number of infections were examined from birth to 18 months of age in 18 HIV-EU infants. The infants were compared to a cohort of 47 term, HIV-unexposed breastfed or formula-fed infants. Results. The thymic size at 12 months of age was not significantly different between the HIV-EU group and the control infants (). At 4 months of age, the HIV-EU infants had significantly fewer infections than the control infants (). Furthermore, in the control group, the infants exclusively breastfed at 4 months of age had significantly fewer infections at 8 months when compared to age-matched formula-fed infants (). Conclusion. HIV-EU infants fed human donor milk have normal growth of thymus and contract fewer infections than other healthy infants. This finding along with fewer infections in exclusively breastfed infants compared to formula-fed infants supports the beneficial effect of human milk on the immune system. We suggest, when breastfeeding is not possible, that providing human donor milk to vulnerable groups of infants will be beneficial for their maturing immune system. Dorthe Lisbeth Jeppesen, Annette Kjær Ersbøll, Tine Ursula Hoppe, Susanne Dam Nielsen, and Niels Henrik Valerius Copyright © 2013 Dorthe Lisbeth Jeppesen et al. All rights reserved. Mon, 29 Apr 2013 15:28:50 +0000 http://www.hindawi.com/journals/ijped/2013/168459/ The dense representation of trigeminal mechanosensitive afferents in the lip vermilion, anterior tongue, intraoral mucosa, and temporomandibular joint allows the infant’s orofacial system to encode a wide range of somatosensory experiences during the critical period associated with feed development. Our understanding of how this complex sensorium processes texture is very limited in adults, and the putative role of texture encoding in the infant is unknown. The purpose of this study was to examine the short-term effects of a novel textured pacifier experience in healthy term infants (). Nonnutritive suck (NNS) compression pressure waveforms were digitized in real time using a variety of custom-molded textured pacifiers varying in spatial array density of touch domes. MANCOVA, adjusted for postmenstrual age at test and sex, revealed that infants exhibited an increase in NNS burst attempts at the expense of a degraded suck burst structure with the textured pacifiers, suggesting that the suck central pattern generator (sCPG) is significantly disrupted and reorganized by this novel orocutaneous experience. The current findings provide new insight into oromotor control as a function of the oral somatosensory environment in neurotypically developing infants. Austin L. Oder, David L. Stalling, and Steven M. Barlow Copyright © 2013 Austin L. Oder et al. All rights reserved. Thu, 18 Apr 2013 17:37:58 +0000 http://www.hindawi.com/journals/ijped/2013/856743/ Aim. “The combined DAK therapy for obesity in children and adolescents” combines a 6-week inpatient with a 10.5-month outpatient treatment. The aim of the study is to evaluate whether the therapeutic achievements are maintained two and four years after intervention. Method. All subjects who had participated in the 12-month program in 2004/2005 were included in the follow-up study. Body weight, height, and physical fitness were assessed through direct measurements, behaviour, and quality of life by self-report questionnaires. Statistical analysis is based on an intention-to-treat analysis. Results. The response rate after three years was 63.4% and 42.2% after five years. Within three years, participants reduced their BMI-SDS significantly by 0.20 (SD 0.49) and by 0.15 (SD 0.51) within five years. Significant positive changes could be observed with respect to the participants eating behaviour. Similarly, the food intake, particularly the consumption of calorie-reduced beverages, increased significantly while that of nonrecommended foods decreased. Improvement was also seen in the subjective quality of life as well as several aspects of self-perception. Conclusion. Compared to baseline data, significant reduction of BMI-SDS and positive changes of health-related behaviours could be observed even three and five years after the start of the initial program. Sibylle Adam, Joachim Westenhoefer, Birgit Rudolphi, and Hanna-Kathrin Kraaibeek Copyright © 2013 Sibylle Adam et al. All rights reserved. Tue, 16 Apr 2013 12:10:11 +0000 http://www.hindawi.com/journals/ijped/2013/953150/ This paper reviews the literature pertaining to the impact of preeclampsia not only on the mother but particularly on the children. The review points to the higher blood pressure in children born to preeclamptic mothers compared to controls, their increased tendency to suffer strokes, the reduction in their cognitive ability, and their vulnerability to depression. Mechanisms that may induce these changes are emphasized, particularly the placental vascular insufficiency and the resulting hypoxic and proinflammatory environments in which the fetus develops. The hypothesis proposed is that these changes in the fetal-placental environment result in epigenetic programming of the child towards a higher propensity for vascular disease. The review’s main recommendation is that, within ethical boundaries, the medical records of individuals born to preeclamptic mothers should clearly indicate this event and should be made available to the affected individuals so that preventive measures against vascular complications and lifestyle changes that may mitigate the latter can be instituted. Julie Hakim, Mary K. Senterman, and Antoine M. Hakim Copyright © 2013 Julie Hakim et al. All rights reserved. Sun, 03 Mar 2013 16:15:10 +0000 http://www.hindawi.com/journals/ijped/2013/612403/ Acute diarrhoea is a leading cause of child mortality in developing countries. Principal pathogens include Escherichia coli, rotaviruses, and noroviruses. 90% of diarrhoeal deaths are attributable to inadequate sanitation. Acute diarrhoea is the second leading cause of overall childhood mortality and accounts for 18% of deaths among children under five. In 2004 an estimated 1.5 million children died from diarrhoea, with 80% of deaths occurring before the age of two. Treatment goals are to prevent dehydration and nutritional damage and to reduce duration and severity of diarrhoeal episodes. The recommended therapeutic regimen is to provide oral rehydration solutions (ORS) and to continue feeding. Although ORS effectively mitigates dehydration, it has no effect on the duration, severity, or frequency of diarrhoeal episodes. Adjuvant therapy with micronutrients, probiotics, or antidiarrhoeal agents may thus be useful. The WHO recommends the use of zinc tablets in association with ORS. The ESPGHAN/ESPID treatment guidelines consider the use of racecadotril, diosmectite, or probiotics as possible adjunctive therapy to ORS. Only racecadotril and diosmectite reduce stool output, but no treatment has yet been shown to reduce hospitalisation rate or mortality. Appropriate management with validated treatments may help reduce the health and economic burden of acute diarrhoea in children worldwide. Christophe Faure Copyright © 2013 Christophe Faure. All rights reserved. Mon, 11 Feb 2013 15:49:22 +0000 http://www.hindawi.com/journals/ijped/2013/821693/ Introduction. Motor vehicle crashes are the leading cause of death among US children aged 4–14 years. In theory, health provider counseling about Child Passenger Safety (CPS) could be a useful deterrent. The data about the effectiveness of CPS dissemination is sparse, but existing results suggest that providers are not well informed. Moreover, there is insufficient evidence to determine whether provider counseling about CPS is effective. Methods. We therefore assessed CPS best practice knowledge among 217 healthcare workers at hospitals in seven cities throughout the USA and evaluated the impact of a brief, lunch and learn educational intervention with a five-item questionnaire. Attendees were comprised of physicians, nurses, social workers, pediatric residents, and pediatric trauma response teams. Results. Pre-post survey completion was nearly 100% (216 of 217 attendees). Participation was fairly evenly distributed according to age (18–29, 30–44, and 45+ years). More than 80% of attendees were women. Before intervention, only 4% of respondents (9/216) answered all five questions correctly; this rose to 77% (167/216) (, using a Wilcoxon signed-rank test) after intervention. Conclusion. Future research should consider implementation and controlled testing of comparable educational programs to determine if they improve dissemination of CPS best practice recommendations in the long term. O. James Ekundayo, Gennifer Jones, Angela Brown, Muktar Aliyu, Robert Levine, and Irwin Goldzweig Copyright © 2013 O. James Ekundayo et al. All rights reserved. Sun, 03 Feb 2013 09:23:25 +0000 http://www.hindawi.com/journals/ijped/2013/763191/ Neonatal sepsis remains a burden problem by showing minimal initial symptoms of subtle character, nonspecific manifestation, and diagnostic pitfalls. The clinical course can be fulminant and fatal if treatment is not commenced promptly. It is therefore crucial to establish early diagnosis and initiate adequate therapy. Besides clinical symptoms, the most reliable laboratory markers in establishing diagnosis is currently the combined measurement of CRP and a cytokine (IL-6 and IL-8). Due to their different kinetics, a diagnostic gap might occur and thus withholding antimicrobial therapy in clinical suspicion of infection is not acceptable. We therefore need parameters which unerringly differentiate between infants in need for antimicrobial therapy and those who are not. Flow cytometry promises to be a useful tool in this field, allowing the determination of different cellular, dissolved, and functional pathophysiological components of sepsis. Despite technical and methodical advances in flow cytometry, its use in clinical routine is still limited. Advantages and disadvantages of promising new parameters in diagnosis of sepsis performed by flow cytometry, particularly CD64, HLA-DR, and apoptosis, are reviewed here. The necessity of tests to be used as an “ideal” parameter is presented. Volker N. Umlauf, Stephan Dreschers, and Thorsten W. Orlikowsky Copyright © 2013 Volker N. Umlauf et al. All rights reserved. Thu, 17 Jan 2013 16:22:24 +0000 http://www.hindawi.com/journals/ijped/2013/136524/ Pharmacogenetics is considered as a prime example of how personalized medicine nowadays can be put into practice. However, genotyping to guide pharmacological treatment is relatively uncommon in the routine clinical practice. Several reasons can be found why the application of pharmacogenetics is less than initially anticipated, which include the contradictory results obtained for certain variants and the lack of guidelines for clinical implementation. However, more reproducible results are being generated, and efforts have been made to establish working groups focussing on evidence-based clinical guidelines. For another pharmacogenetic hurdle, the speed by which a pharmacogenetic profile for a certain drug can be obtained in an individual patient, there has been a revolution in molecular genetics through the introduction of next generation sequencing (NGS), making it possible to sequence a large number of genes up to the complete genome in a single reaction. Besides the enthusiasm due to the tremendous increase of our sequencing capacities, several considerations need to be made regarding quality and interpretation of the sequence data as well as ethical aspects of this technology. This paper will focus on the different NGS applications that may be useful for pharmacogenomics in children and the challenges that they bring on. O. M. Vanakker and A. De Paepe Copyright © 2013 O. M. Vanakker and A. De Paepe. All rights reserved. Mon, 14 Jan 2013 18:58:05 +0000 http://www.hindawi.com/journals/ijped/2013/874726/ Nosocomial sepsis is associated with increased mortality and morbidity including neurodevelopmental impairment and prolonged hospital stay. Prevention of sepsis especially in the preterm infants in the neonatal intensive care unit remains a major challenge. The gastrointestinal tract is an important source of potential pathogens causing nosocomial sepsis as the immature intestinal epithelium can permit translocation of bacteria and yeast. The intestinal tract and its microflora play an important role in the immunity. Altering the gut microflora has been extensively studied for immunomodulation in preterm infants. Probiotics are live microorganisms which when administered in adequate amounts confer a health benefit on the host. Probiotics have been used for prevention and treatment of various medical conditions in children and adults. Studies on probiotics in premature infants have focused on normalizing intestinal flora, improvement in feeding intolerance, prevention of necrotizing enterocolitis and sepsis. In this paper, we discuss the intestinal bacterial colonization pattern; the rational for probiotics and prebiotic therapy with special focus on the prevention of nosocomial sepsis in preterm infants. Vrinda Nair and Amuchou S. Soraisham Copyright © 2013 Vrinda Nair and Amuchou S. Soraisham. All rights reserved. Thu, 10 Jan 2013 16:30:16 +0000 http://www.hindawi.com/journals/ijped/2013/768784/ Background. In adults severely disturbed microcirculatory flow can be observed by Orthogonal Polarized Spectral (OPS) imaging techniques during sepsis. Therefore we set out to assess for microcirculatory changes in term newborns with suspected early onset infection using OPS. Methods. OPS images were obtained prospectively from the vascular bed of the ear conch and upper arm of 47 newborns on their 1st, 2nd, and 3rd day of life. OPS sequences were analyzed semiquantitatively offline and blinded to clinical status of the infant. Flow in vessels was classified as continuous or noncontinuous flow and given as proportion of total vessels per image as in the studies in adults. Results. The proportion of vessels with continuous flow was significantly lower in the infants with infection (69% [56–81] versus 90% [87–94] ). None of the infants with infection was in shock or severely septic. Conclusion. In term neonates the microcirculatory flow is impaired in a large proportion of vessels even in mild to moderate infection. These changes can be observed at the onset of disease at the external ear, an optimal site for microcirculatory measurements in term infants. Irene Alba-Alejandre, Stephan Hiedl, and Orsolya Genzel-Boroviczény Copyright © 2013 Irene Alba-Alejandre et al. All rights reserved. Tue, 08 Jan 2013 09:49:19 +0000 http://www.hindawi.com/journals/ijped/2013/872596/ Arsenic, cadmium, lead, and mercury present potential health risks to children who are exposed through inhalation or ingestion. Emerging Market countries experience rapid industrial development that may coincide with the increased release of these metals into the environment. A literature review was conducted for English language articles from the 21st century on pediatric exposures to arsenic, cadmium, lead, and mercury in the International Monetary Fund's (IMF) top 10 Emerging Market countries: Brazil, China, India, Indonesia, Mexico, Poland, Russia, South Korea, Taiwan, and Turkey. Seventy-six peer-reviewed, published studies on pediatric exposure to metals met the inclusion criteria. The reported concentrations of metals in blood and urine from these studies were generally higher than US reference values, and many studies identified adverse health effects associated with metals exposure. Evidence of exposure to metals in the pediatric population of these Emerging Market countries demonstrates a need for interventions to reduce exposure and efforts to establish country-specific reference values through surveillance or biomonitoring. The findings from review of these 10 countries also suggest the need for country-specific public health policies and clinician education in Emerging Markets. Lindsey M. Horton, Mary E. Mortensen, Yulia Iossifova, Marlena M. Wald, and Paula Burgess Copyright © 2013 Lindsey M. Horton et al. All rights reserved. Sun, 30 Dec 2012 10:16:43 +0000 http://www.hindawi.com/journals/ijped/2012/162648/ Maria A. Fragala-Pinkham, Margaret E. O'Neil, Kristie F. Bjornson, and Roslyn N. Boyd Copyright © 2012 Maria A. Fragala-Pinkham et al. All rights reserved. Tue, 18 Dec 2012 12:56:14 +0000 http://www.hindawi.com/journals/ijped/2012/938306/ The Convention concerning the Prohibition and Immediate Action for the Elimination of the Worst Forms of Child Labour was adopted by the International Labour Organization in 1999. 174 countries around the world have signed or ratified the convention, which requires countries to adopt laws and implement programs to prohibit and eliminate child labor that poses harms to health or safety. Nonetheless, child labor continues to be common in the agriculture and mining sectors, where safety and environmental hazards pose significant risks. Drawing upon recent human rights investigations of child labor in tobacco farming in Kazakhstan and gold mining in Mali, the role of international human rights mechanisms, advocacy with government and private sector officials, and media attention in reducing harmful environmental exposures of child workers is discussed. Human rights-based advocacy in both cases was important to raise attention and help ensure that children are protected from harm. Joseph J. Amon, Jane Buchanan, Jane Cohen, and Juliane Kippenberg Copyright © 2012 Joseph J. Amon et al. All rights reserved. Thu, 13 Dec 2012 09:54:02 +0000 http://www.hindawi.com/journals/ijped/2012/473541/ Increasingly, our acoustic environment is filled with amplified sound sources (e.g., MP3 players, video game stations, and sports/entertainment venues). There is serious concern and also some controversy about the risks of acoustic trauma in children. This overview provides some basic information on the physiological mechanisms that lead to noise induced hearing loss, a survey of various studies that, on balance, indicates that there is cause for concern, and finally a discussion on measures that can help to prevent noise induced hearing loss in children. This paper is designed for public health and other healthcare professions (ENT, audiologists, family doctors, and pediatricians) who should understand the risks of noise induced hearing loss and its prevention. Robert V. Harrison Copyright © 2012 Robert V. Harrison. All rights reserved. Sun, 09 Dec 2012 15:43:23 +0000 http://www.hindawi.com/journals/ijped/2012/141854/ Objective. This study identifies the prevalence of emotional and behavioral problems and the associated factors in orphanage children. Methods. This cross-sectional study was conducted in three private orphanages in Cairo. Two hundred sixty-five children of ages ranging from 6 to 12 years living in three different orphanages care systems were included in the study. A sociodemographic information form and the Child Behavior Checklist (CBCL) were used. Children were clinically interviewed and psychiatric disorders were identified. Diagnoses were done according to the manual for diagnosis and statistics of mental disorder fourth version (DSMIV). A written formal consent from the director of social solidarity was obtained before inclusion in the study. Results. The prevalence of behavioral disturbances was 64.53% among those in institutional care and the most prominent psychiatric disorders were nocturnal enuresis (23.3%), attention deficit hyperkinetic disorder (ADHD) (19.62%), oppositional defiant disorder (17.36%). Age at first admission, causes of receiving institutional care, and moves 2 or more times between institutions were significantly associated with an increased risk of behavioral and emotional problems. Conclusion. Our study showed that children living in institutions are prone to suffer from psychiatric disorders. Stability of the caregiver acts as a protective variable. Mohamed A. EL Koumi, Yasser F. Ali, Ehab A. El Banna, Usama M. Youssef, Yasser M. Raya, and Aly A. Ismail Copyright © 2012 Mohamed A. EL Koumi et al. All rights reserved. Thu, 06 Dec 2012 08:26:43 +0000 http://www.hindawi.com/journals/ijped/2012/427358/ Mold and other allergen exposures exacerbate asthma symptoms in sensitized individuals. We evaluated allergen concentrations, skin test sensitivities, and asthma morbidity for 182 children, aged 4–12 years, with moderate to severe asthma, enrolled 18 months after Katrina, from the city of New Orleans and the surrounding parishes that were impacted by the storm, into the Head-off Environmental Asthma in Louisiana (HEAL) observational study. Dust (indoor) and air (indoor and outdoor) samples were collected at baseline of 6 and 12 months. Dust samples were evaluated for dust mite, cockroach, mouse, and Alternaria by immunoassay. Air samples were evaluated for airborne mold spore concentrations. Overall, 89% of the children tested positive to ≥1 indoor allergen, with allergen-specific sensitivities ranging from 18% to 67%. Allergen concentration was associated with skin sensitivity for 1 of 10 environmental triggers analyzed (cat). Asthma symptom days did not differ with skin test sensitivity, and surprisingly, increased symptoms were observed in children whose baseline indoor airborne mold concentrations were below median levels. This association was not observed in follow-up assessments. The lack of relationship among allergen levels (including mold), sensitivities, and asthma symptoms points to the complexity of attempting to assess these associations during rapidly changing social and environmental conditions. L. F. Grimsley, J. Wildfire, M. Lichtveld, S. Kennedy, J. M. El-Dahr, P. C. Chulada, R. Cohn, H. Mitchell, E. Thornton, M. Mvula, Y. Sterling, W. Martin, K. Stephens, and L. White Copyright © 2012 L. F. Grimsley et al. All rights reserved. Wed, 05 Dec 2012 11:33:04 +0000 http://www.hindawi.com/journals/ijped/2012/467918/ Prenatal cocaine exposure has been linked to neurocognitive and developmental outcomes throughout childhood. The cardiovascular toxicity of cocaine is also markedly increased in pregnancy, but it is unknown whether this toxicity affects anthropometric growth and the development of cardiometabolic disease risk factors in the offspring across the lifespan. During the early 1990s, the Miami Prenatal Cocaine Study enrolled a cohort of 476 African American children (253 cocaine-exposed, 223 non-cocaine-exposed) and their biological mothers at delivery in a prospective, longitudinal study. The MPCS has collected 12 prior waves of multidomain data on over 400 infants and their mothers/alternate caregivers through mid-adolescence and is now embarking on an additional wave of data collection at ages 18-19 years. We describe here the analytical methods for examining the relationship between prenatal cocaine exposure, anthropometric growth, and cardiometabolic disease risk factors in late adolescence in this minority, urban cohort. Findings from this investigation should inform both the fields of substance use and cardiovascular research about subsequent risks of cocaine ingestion during pregnancy in offspring. Sarah E. Messiah, Steven E. Lipshultz, Tracie L. Miller, Veronica H. Accornero, and Emmalee S. Bandstra Copyright © 2012 Sarah E. Messiah et al. All rights reserved. Tue, 04 Dec 2012 17:40:44 +0000 http://www.hindawi.com/journals/ijped/2012/294530/ The health and wellbeing of children in lower-income countries is the focus of much international effort, yet there has been very little direct measurement of this. Objective. The current objective was to study the health-related quality of life (HRQoL) in a general population of secondary school children in Fiji, a low middle-income country in the Pacific. Methods. Self-reported HRQoL was measured by the Pediatric Quality of Life Inventory 4.0 in 8947 school children (aged 12–18 years) from 18 secondary schools on Viti Levu, the main island of Fiji. HRQoL in Fiji was compared to that of school-aged children in 13 high- and upper middle-income countries. Results. The school children in Fiji had lower HRQoL than the children in the 13 comparison countries, with consistently lower physical, emotional, social, and school functioning and wellbeing. HRQoL was particularly low amongst girls and Indigenous Fijians. Conclusions. These findings raise concerns about the general functioning and wellbeing of school children in Fiji. The consistently low HRQoL across all core domains suggests pervasive underlying determinants. Investigation of the potential determinants in Fiji and validation of the current results in Fiji and other lower-income countries are important avenues for future research. Solveig Petersen, Helen Mavoa, Boyd Swinburn, Gade Waqa, Ramneek Goundar, and Marjory Moodie Copyright © 2012 Solveig Petersen et al. All rights reserved. Thu, 22 Nov 2012 15:20:48 +0000 http://www.hindawi.com/journals/ijped/2012/921604/ Street children, or children who live and/or spend time on the streets, are a vulnerable group of considerable concern to the global public health community. This paper describes the results of two linked qualitative studies conducted with children living or spending time on the street and in orphanages in and around urban areas in the Republic of Georgia between 2005 and 2006. The studies examined perceived causes of children going to the street, as well as indicators of healthy functioning and psychosocial problems among these children. Results on causes indicated a range of “push” factors leading children to the street and “pull” factors that keep children living on the street. Findings also showed a range of internalizing and externalizing mental health symptoms among children on the street and within orphanages. Some differences in responses were found between children living on the street and in institutions. It is important to understand the perspectives of these vulnerable populations to guide decisions on appropriate interventions that address their primary problems. Laura K. Murray, Namrita S. Singh, Pamela J. Surkan, Katherine Semrau, Judy Bass, and Paul Bolton Copyright © 2012 Laura K. Murray et al. All rights reserved. Mon, 19 Nov 2012 12:45:34 +0000 http://www.hindawi.com/journals/ijped/2012/452909/ Introduction. Anemia is prevalent in adult heart failure patients and appears to be an independent risk factor for morbidity and mortality. The purpose of this work is to determine the prevalence of anemia in children with heart failure from dilated cardiomyopathy (DCM) and to evaluate its influence on morbidity and mortality. Methods. A homogenous group of 58 children with congestive heart failure from DCM was evaluated for heart failure symptoms, appearance of anemia, hospitalization, age of first clinical appearance, necessity of transfusion, and death during medical attendance. Anemic and nonanemic patients were analyzed for differences in age distribution, morbidity, and mortality. Results. Anemia was present in 64% of DCM patients. Hospitalization secondary to heart failure was significantly elevated in heart failure patients with anemia (mean versus days per year, ). However, mortality was not elevated. Significant relations of age and prevalence of anemia or age and severity of anemia did not appear. Conclusion. Anemia is prevalent in pediatric patients with congestive heart failure from DCM and appears in all age classes. Hospitalization as a surrogate of morbidity is elevated in heart failure patients developing anemia, but mortality risk did not increase. Goetz Christoph Mueller, Emmy Lou Schlueter, Florian Arndt, Ali Dodge-Khatami, Jochen Weil, and Thomas S. Mir Copyright © 2012 Goetz Christoph Mueller et al. All rights reserved. Mon, 05 Nov 2012 09:27:24 +0000 http://www.hindawi.com/journals/ijped/2012/572341/ Chantal Lau, Donna Geddes, Katsumi Mizuno, and Benoist Schaal Copyright © 2012 Chantal Lau et al. All rights reserved. Thu, 18 Oct 2012 10:37:06 +0000 http://www.hindawi.com/journals/ijped/2012/608920/ The purpose of the study was to determine the change in body weight and body mass index (BMI), as well as diet behaviors at 4 months after intervention between obese adolescent girls who participated in the school-based nutritional education program, addressed by pediatrician, compared to those who attended regular nutritional class. Methods. 49 obese girls were recruited from a secondary school. Those, were randomized into 2 groups of intervention and control. The intensive interactive nutritional program was provided to the intervention group. Weight and height, dietary record and % fat consumption, as well as self-administered questionnaires on healthy diet attitudes were collected at baseline and 4-month follow-up, and then compared between two groups. Results. There was a statistically significant change of BMI in the intervention group by  kg/m2 () compared to the control group ( kg/m2, ) but no significant change in calorie and % fat consumption between groups. The attitudes on healthy eating behaviors in the intervention group were shown improving significantly (). Conclusions. Interactive and intensive nutritional education program as shown in the study was one of the most successful school-based interventions for obese adolescents. Supinya In-Iw, Tridsanun Saetae, and Boonying Manaboriboon Copyright © 2012 Supinya In-Iw et al. All rights reserved. Thu, 11 Oct 2012 15:25:44 +0000 http://www.hindawi.com/journals/ijped/2012/820680/ Aim. To examine whether mothers' early employment status is related to the development of severe early childhood caries in their child. Methods. Questionnaire survey of 429 first-time mothers in metropolitan Adelaide, South Australia, and dental examinations of their child at 20 months of age. Results. At months of age, 5.6% of children exhibited caries defined as one or more demineralized or cavitated lesions on the upper incisors. Of the mothers, 52.2% had no paid employment, 39.6% were part-time and 8.2% full-time employed. Overall, mothers' participation in the workforce had no influence on the frequency of severe early childhood caries in their child, but there was a significant interaction with family structure. For mothers without employment there was no difference between single, and two-parent families, but children with an employed single mother more frequently had caries than those with a working mother in a two-parent family (). However, there were no significant differences in children's reported general health. Conclusions. The data indicate a need to explore strategies that may assist single mothers and especially those in the workforce to prevent severe early childhood caries in their child. Kamila Plutzer and Marc J. N. C. Keirse Copyright © 2012 Kamila Plutzer and Marc J. N. C. Keirse. All rights reserved. Wed, 26 Sep 2012 10:25:44 +0000 http://www.hindawi.com/journals/ijped/2012/129328/ Understanding the developmental origins of congenital capabilities such as sucking is fundamental knowledge that can contribute to improving the clinical management of early feeding and facilitate the onset of oral ingestion. We describe analyses in rats showing that sensory stimulation in utero and during birth establishes the newborn’s sucking responses to maternal cues. We mimicked elements of labor and delivery (viz., compressions simulating labor contractions, stroking simulating postnatal maternal licking of the newborn, and postnatal thermal flux), and used them to induce postnatal respiration and nipple attachment in caesarian-delivered pups. We report herein new data showing that, by simulating a fetal rat’s experience of being born, specific components of vaginal birth provide sufficient conditions for the odor learning that guides newborn’s sucking responses. In contrast, the absence of in utero compressions was associated with poor sucking onset. Knowing how birth stimuli contribute to the first nipple attachment and constitute a context for learning to suckle is an important step toward better management of some early feeding problems. It can serve also as a foundation for understanding the challenges of facilitating sucking by babies born prematurely so that they do not experience the typical contingencies mediating onset of oral ingestion. Jeffrey R. Alberts and April E. Ronca Copyright © 2012 Jeffrey R. Alberts and April E. Ronca. All rights reserved. Tue, 18 Sep 2012 11:59:53 +0000 http://www.hindawi.com/journals/ijped/2012/730673/ Traditionally, the development of oral feeding is viewed as a continuous, unitary process in which reflex-dominated sucking behavior gives rise to a more varied and volitional feeding behavior. In contrast, we consider the thesis that the infant develops two separable ingestive systems, one for suckling and one for feeding. First, we apply an evolutionary perspective, recognizing that suckling-feeding is a universal, mammalian developmental sequence. We find that in mammalian evolution, feeding systems in offspring were established prior to the evolution of lactation, and therefore suckling is a separable feature that was added to feeding. We next review an experimental literature that characterizes suckling and feeding as separable in terms of their topography, sensory controls, physiological controls, neural substrates, and experience-based development. Together, these considerations constitute a view of “dual ingestive systems.” The thesis, then, is that suckling is not a simple precursor of feeding but is a complete behavior that emerges, forms, and then undergoes a dissolution that overlaps with the emergence of independent feeding. This thesis guides us to focus differently on the challenges of properly managing and facilitating oral ingestion in infants, especially those born preterm, prior to the developmental onset of suckling. Jeffrey R. Alberts and Rita H. Pickler Copyright © 2012 Jeffrey R. Alberts and Rita H. Pickler. All rights reserved. Tue, 21 Aug 2012 11:31:31 +0000 http://www.hindawi.com/journals/ijped/2012/270725/ Mouin Seikaly, Sabeen Habib, Amin J. Barakat, Jyothsna Gattineni, Raymond Quigley, and Dev Desi Copyright © 2012 Mouin Seikaly et al. All rights reserved. Wed, 15 Aug 2012 13:46:33 +0000 http://www.hindawi.com/journals/ijped/2012/309863/ Sheila Gahagan, Ricardo Uauy, and Tessa J. Roseboom Copyright © 2012 Sheila Gahagan et al. All rights reserved. Mon, 13 Aug 2012 11:46:29 +0000 http://www.hindawi.com/journals/ijped/2012/364716/ Over the past several decades, childhood hypertension has undergone a considerable conceptual change, as hypertension is a predictor of future development of cardiovascular disease in adults. Childhood hypertension has distinctive features that distinguish it from hypertension in adults. Pediatric hypertension is often secondary. It is widely believed that therapeutic intervention at an early age favorably modifies the long-term outcome of hypertension. Despite its significance as a cause for morbidity, childhood hypertension is underdiagnosed and less studied with many basic issues remaining contentious. Mouin G. Seikaly Copyright © 2012 Mouin G. Seikaly. All rights reserved. Thu, 09 Aug 2012 08:18:56 +0000 http://www.hindawi.com/journals/ijped/2012/976425/ Aim. To identify and systematically review the clinimetric properties of habitual physical activity (HPA) measures in young children with a motor disability. Method. Five databases were searched for measures of HPA including: children aged <6.0 years with a neuromuscular disorder, physical activity defined as “bodily movement produced by skeletal muscles causing caloric expenditure”, reported HPA as duration, frequency, intensity, mode or energy expenditure, and evaluated clinimetric properties. The quality of papers was assessed using the COSMIN-checklist. A targeted search of identified measures found additional studies of typically developing young children (TDC). Results. Seven papers assessing four activity monitors met inclusion criteria. Four studies were of good methodological quality. The Minimod had good ability to measure continuous walking but the demonstrated poor ability to measure steps during free-living activities. The Intelligent Device for Energy Expenditure and Activity and Ambulatory Monitoring Pod showed poor ability to measure activity during both continuous walking and free-living activities. The StepWatch showed good ability to measure steps during continuous walking in TDC. Interpretation. Studies assessing the clinimetric properties of measures of HPA in this population are urgently needed to allow assessment of the relationship between HPA and health outcomes in this group. Stina Oftedal, Kristie L. Bell, Louise E. Mitchell, Peter S. W. Davies, Robert S. Ware, and Roslyn N. Boyd Copyright © 2012 Stina Oftedal et al. All rights reserved.