RESUMEN
OBJECTIVE: To assess the effects of daily consumption of a synbiotic yogurt drink on the health, growth, and quality of life of healthy children 12-48 months of age in out-of-home child care. STUDY DESIGN: Healthy children attending child care centers were enrolled in a prospective, double-blind, placebo-controlled clinical trial. The intervention was a yogurt drink containing Streptococcus thermophilus, Lactobacillus bulgaricus, and Bifidobacterium animalis subspecies lactis (BB-12) (5 × 10(9) cfu/100 mL serving), and 1 g of inulin (synbiotic group) vs a similar nonsynbiotic-containing acidified milk drink (placebo group) once daily for 16 weeks. The end points were days of diarrhea, fever, vomiting, symptoms of upper respiratory tract infection, use of antibiotics, physician visits, child care absenteeism, parental work absenteeism, and quality of life (PedsQL 4.0; Mapi Research Trust, Lyon, France). RESULTS: Compared with placebo (n = 73), children receiving synbiotic (n = 76) had significantly fewer days of reported fever (1.85 vs 1.95, P < .05), significant improvement in social functioning (P < .035; pre-to-end intervention), and school functioning (P < .045; pre-to-mid intervention). More days with ≥ 3 loose/watery stools were reported in the synbiotic group (P < .05). CONCLUSIONS: Daily supplementation of children's diet with yogurt containing probiotic bacteria BB-12 and inulin significantly reduced days of fever and improved social and school functioning. The increased frequency of bowel movements may be explained by an accelerating effect of BB-12 and inulin on intestinal transit. Further research on the possible benefits of synbiotics on children's health is advised. TRIAL REGISTRATION: ClinicalTrials.gov: NCT00653705.
Asunto(s)
Simbióticos , Yogur , Preescolar , Método Doble Ciego , Femenino , Crecimiento , Humanos , Lactante , Masculino , Placebos , Estudios Prospectivos , Calidad de VidaRESUMEN
BACKGROUND: To address the public health crisis of overweight and obese preschool-age children, the Nutrition And Physical Activity Self Assessment for Child Care (NAP SACC) intervention was delivered by nurse child care health consultants with the objective of improving child care provider and parent nutrition and physical activity knowledge, center-level nutrition and physical activity policies and practices, and children's body mass index (BMI). METHODS: A seven-month randomized control trial was conducted in 17 licensed child care centers serving predominantly low income families in California, Connecticut, and North Carolina, including 137 child care providers and 552 families with racially and ethnically diverse children three to five years old. The NAP SACC intervention included educational workshops for child care providers and parents on nutrition and physical activity and consultation visits provided by trained nurse child care health consultants. Demographic characteristics and pre - and post-workshop knowledge surveys were completed by providers and parents. Blinded research assistants reviewed each center's written health and safety policies, observed nutrition and physical activity practices, and measured randomly selected children's nutritional intake, physical activity, and height and weight pre- and post-intervention. RESULTS: Hierarchical linear models and multiple regression models assessed individual- and center-level changes in knowledge, policies, practices and age- and sex-specific standardized body mass index (zBMI), controlling for state, parent education, and poverty level. Results showed significant increases in providers' and parents' knowledge of nutrition and physical activity, center-level improvements in policies, and child-level changes in children's zBMI based on 209 children in the intervention and control centers at both pre- and post-intervention time points. CONCLUSIONS: The NAP SACC intervention, as delivered by trained child health professionals such as child care health consultants, increases provider knowledge, improves center policies, and lowers BMI for children in child care centers. More health professionals specifically trained in a nutrition and physical activity intervention in child care are needed to help reverse the obesity epidemic. TRIAL REGISTRATION: National Clinical Trials Number NCT01921842.
Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Obesidad Infantil/prevención & control , Índice de Masa Corporal , California , Guarderías Infantiles , Preescolar , Connecticut , Femenino , Humanos , Masculino , Actividad Motora , North Carolina , Estado Nutricional , Obesidad Infantil/fisiopatología , Resultado del TratamientoRESUMEN
OBJECTIVE: The objective of this study was to determine whether the installation of equipment for diaper-changing, hand-washing, and food preparation that is specifically designed to reduce the transmission of infectious agents would result in a decrease in the rate of diarrheal illness among children and their teachers in child care centers. METHODS: Twenty-three pairs of child care centers were matched on size and star-rated license level. One member of each pair was randomly assigned to an intervention group and the other to a control group. Intervention centers received new diaper-changing, hand-washing, and food-preparation equipment, and both intervention and control centers received hygiene and sanitation training with reinforcement and follow-up as needed. Families with children in participating classrooms were called biweekly to ascertain the frequency and severity of any diarrheal illness episodes. Staff attendance was monitored, and staff hygiene and sanitation behaviors were observed and recorded monthly. RESULTS: Although hygiene and sanitation behaviors improved in both intervention and control centers, there was a significant difference favoring the intervention centers with respect to frequency of diarrheal illness (0.90 vs 1.58 illnesses per 100 child-days in control centers) and proportion of days ill as a result of diarrhea (4.0% vs 5.0% in control centers) among the children. Staff in those same classrooms were reported to have a significantly lower proportion of days absent as a result of any illness (0.77% in treatment centers versus 1.73% in control centers). CONCLUSION: Diapering, hand-washing, and food-preparation equipment that is specifically designed to reduce the spread of infectious agents significantly reduced diarrheal illness among the children and absence as a result of illness among staff in out-of-home child care centers.
Asunto(s)
Guarderías Infantiles , Control de Enfermedades Transmisibles , Pañales Infantiles , Diarrea/prevención & control , Desinfección de las Manos , Preescolar , Equipos y Suministros , Servicios de Alimentación , Humanos , Higiene , LactanteRESUMEN
OBJECTIVE: To determine how discipline practices changed over time for young children. METHODS: A cohort of parents with young children were interviewed in clinic about a broad array of disciplinary practices at two points in time. RESULTS: A total of 182 parents were interviewed at Time 1, and 94 were interviewed at Time 1 and 2. Mean age of the child was 16.2 months at Time 1 and 35.8 months at Time 2. Monitoring, verbal communication, and distracting were the most common types of discipline when the children were one year old. Corporal punishment (P < 0.05), verbal communication (P < 0.001), timeout (< 0.0001), removing privileges (< 0.0001), negative demeanor (< 0.0001), and sternness (< 0.0001) increased significantly from Time 1 to Time 2. Distracting (< 0.001) decreased significantly and positive demeanor also decreased. CONCLUSIONS: Most discipline practices increased in frequency over the 20 months of this study. The increase in parental negative demeanor seems particularly important and worthy of further study.
Asunto(s)
Crianza del Niño , Padres/psicología , Refuerzo en Psicología , Adolescente , Adulto , Factores de Edad , Ira , Preescolar , Femenino , Humanos , Lactante , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Psicometría , Factores Socioeconómicos , Conducta VerbalRESUMEN
BACKGROUND: Physicians are encouraged to provide counseling regarding parental discipline. Quality counseling requires knowledge of disciplinary practices and factors that affect these practices. METHODS: One hundred and eighty two parents of 12- to 19-month-old children from general pediatric clinics in North Carolina and Alabama were interviewed regarding discipline using the Discipline Survey. Measures of contextual factors were analyzed to see which predicted disciplinary practices. RESULTS: Ninety-two percent of the participants were mothers; 6% were fathers; participation rate: 78%. Monitoring was the most common type of discipline used and time out was the least common. Parent, child, and family characteristics were all importantly associated with a broad array of disciplinary practices and modes of administration. However, the situation in which discipline occurred was found to be significant for most disciplinary practices even after controlling for other factors. Our study found that the specific misbehavior was most likely, and the presence of the other parent was least likely, to affect the type of discipline which was utilized. CONCLUSIONS: When counseling families about discipline, practitioners should incorporate the fact that misbehavior happens in various contexts.
Asunto(s)
Crianza del Niño/psicología , Conducta del Lactante/psicología , Padres/psicología , Adolescente , Adulto , Comunicación , Composición Familiar , Femenino , Encuestas Epidemiológicas , Humanos , Lactante , Masculino , Persona de Mediana Edad , Relaciones Padres-Hijo , Medio SocialRESUMEN
OBJECTIVES: To develop a new measure of parental discipline of children encompassing a broad array of types of discipline and modes of administration. METHODS: Parents of 12- to 19-month-old children were interviewed using a new 45-item structured survey about discipline in general pediatric clinics in North Carolina and Alabama. Demographic data describing the population studied were linked from another study in which these families were participating. Principal component analysis and confirmatory reliability analysis were used to define subscales and determine which items were retained in the survey. RESULTS: One hundred eighty-two parents were interviewed about disciplinary practices. Disciplinary subscales were robust for a number of disciplinary types (monitoring, verbal communication, modeling behavior, corporal punishment, and ignoring) and modes of administration (follow-through, consistency, positive demeanor, negative demeanor). CONCLUSIONS: The Discipline Survey is a promising new measure of parental discipline. A survey instrument to assess disciplinary practices like the one developed fills a gap and can enhance research methodology for those interested in the effects of interventions on parental discipline.