Abstracts
Cardiovascular Disease (childhood)
Cardiovascular Disease
The three authors present a review of the cardiac challenges currently facing home care professionals from a "nutritional" perspective. As the knowledge regarding pathophysiology, technology, and treatment regimens become more complex so do the nutritional interventions. This article clearly presents such interventions.
Murray-ND et al: The role of nutrition in cardiovascular disease. J of Home Health Care Practice. 1991 Nov; 4(1): 13-21.
Childhood Fever (1)
Childhood Fever (1)
Childhood "fever" is a common symptom, reflective of multiple causes. As the child is often unable to express himself, the physician must rely on parents' observations and the physical examination.
The majority of febrile children have non-bacterial upper respiratory tract "infection" and indiscriminate use of antibiotics is inappropriate, ineffective and leads to drug-resistance such as the emergence of "Penicillin"-resistant "Streptococcus" pneumoniae.
Zealous overprescription of "antipyretics" needs to be avoided with attention directed to the cause of the fever, the child's coping capacity and parental education.
Chong, CY & Allen, DM: Childhood fever. Singapore Med J 1996 Feb;37(1):96-100.
Childhood Fever (2)
Childhood Fever (2)
This section focuses on issues in "infectious" disease that are commonly encountered in pediatric office practice. Paul McCarthy discusses recent literature regarding the evaluation and management of acute "fevers" without apparent source on clinical examination in infants and children and the evaluation of children with prolonged fevers of unknown origin. Jean Klig reviews recent literature about lower respiratory tract infection in children. Eugene Shapiro discusses recent developments in the literature concerning several infectious diseases commonly facing practitioners in the office. Michael Baron reviews recent literature about "gastroenteritis" and "diarrhea" of infancy and early childhood.
McCarthy, PL et al: Fever without apparent source on clinical examination, lower respiratory infections in children, other infectious diseases, and acute gastroenteritis and diarrhea of infancy and early childhood. Curr Opin Pediatr 1996 Feb;8(1):75-93.
Critically ill
Critically ill
In the provision of nutritional support to critically ill children in today's ICU, a knowledge of both acute and chronic illness is required. The unique nutritional needs of these children are outlined, the pathophysiologic response to starvation and "stress" are explored, and current nutritional strategies are discussed. A comparison is made between the needs of a child experiencing an acute illness or injury versus the acute "exacerbation" of an underlying chronic illness.
Huddleston-KC: Nutritional support of the critically ill child. Critical-Care-Nursing-Clinics-of-North-America. 1993 Mar; 5(1): 65-78 (54 ref)
Health Promotion
Health Promotion
To develop a valid and reliable instrument to measure school-"age" children's attitudes toward cardiovascular health promotion.
The Children's Cardiovascular Health Promotion Attitude Scale (CVHPAS) a [16 item four-point forced choice Likert scale] was developed. The factors identified in the development of the instrument were: nutrition, physical activity, "smoking", and stress control.
Arvidson-CR: Children's Cardiovascular Health Promotion Attitude Scale: an instrument development. TEXAS WOMAN'S UNIVERSITY 1990 PH.D. (152 p)
Heart (Childhood Diseases)
Heart
"Eat Smart For Your "Heart"" is a school-based educational program which has been designed for parents of elementary school-"aged" children. The program offers nutritional information in an effort to promote cardiovascular health for families. This article describes the process involved in the design, implementation, and evaluation of the program.
Letizia-M: Eat Smart for Your Heart: an educational program. J of-School-Nursing. 1995 Feb; 11(1): 10-5 (21 ref).
Immunization
Immunization
Nursing has an important role in improving the incidence of childhood "immunization". An understanding of the immunologic deficiencies of children, especially those younger than 5 years, demonstrates the need for this population-wide protection. Knowledge of the various products, their efficacy, schedule, side effects, and contraindications will assist the neonatal and pediatric nurse in coordinating immunizations and teaching parents about this important health priority for their children. Research is focusing on the development of combination vaccines and products for infectious diseases that currently have difficult or nonexistent treatment.
Bellig, LL: Immunization and the prevention of childhood diseases. J Obstet Gynecol Neonatal Nurs 1995 Sep;24(7):669-77.
Immunization Schedule
Immunization Schedule
The need for a single childhood immunization schedule prompted the unification of previous vaccine recommendations made by the American Academy of Pediatrics (AAP) and the Advisory Committee on Immunization Practices (ACIP). In addition to presenting the newly recommended schedule for the administration of vaccines during childhood, this report addresses the previous differences between the AAP and ACIP childhood vaccination schedules and the rationale for changing previous recommendations.
Recommended childhood immunization schedule--United States, 1995. Centers for Disease Control and Prevention. MMWR. 1995 Jun 16;44(RR-5):1-9.
International Child Health
International Child Health
Emergencies in the pediatric populations of Third World and developing countries are of a much different sort than those to which pediatricians in developing countries are familiar.
Many of these emergencies derive from conditions, situations, and etiologies that no longer represent a threat to children in developed countries:
· malnutrition,
· immunizable illnesses,
· infectious diseases from pathogens easily treated or prevented,
· urbanization, and
· armed conflict.
Programs directed at improving basic public health, health education, access to basic health care, and immunization have been shown to have a major and positive impact on children's health status in these countries.
Stidham GL: Emergencies in international child health. Curr Opin Pediatr, 1997 Jun, 9:3, 254-8.
Low Birth Weight
Low Birth Weight
The purpose of this study was to determine whether moderately low birth weight, singleton babies without "congenital" anomalies are at increased risk for postperinatal infectious disease mortality.
Postperinatal infectious disease mortality was assessed through age 7 years.
Moderately low birth weight infants and children were at increased risk of infectious disease mortality. The risk persisted throughout the age interval under analysis.
Moderate low birth weight renders individuals vulnerable to infectious disease mortality during both infancy and childhood. Among moderately low birth weight infants and children, this vulnerability appeared to be attributable primarily to preterm birth rather than to intrauterine growth retardation.
Read, JS et al: Moderate low birth weight and infectious disease mortality during infancy and childhood. Am J Epidemiol 1994 Oct 15;140(8):721-33.
Survival (Childhood Diseases)
Survival
Five health problems continue to jeopardize the survival of the world's children including prenatal factors, level of nutrition, communicable diseases common to childhood, "diarrheal" diseases, and acute respiratory infections. Although some of these concerns are being managed effectively in the United States and other Western countries, they still pose tremendous risks for the child born in Asia, Africa, Latin America, or the South Pacific.
Mandelbaum-JK: Child survival: what are the issues? J of-Pediatric-Health-Care 1992 May-Jun; 6(3): 132-7 (17 ref).
Vaccination
Vaccination
Many childhood diseases can be prevented by proper immunization. The purpose of this article is to provide information about the risks and benefits associated with vaccines used in the United States for children under one year of age. Vaccines can be made from live or killed organisms and can stimulate both local and systemic "immunity". The immunization schedule recommended by the American Academy of Pediatrics is presented. Information about the use of routine vaccines, their risks and the diseases they prevent, is presented. Vaccines included are "diphtheria", pertussis, tetanus, poliomyelitis, Haemophilus influenzae, "influenza" "viruses" and "hepatitis" B. Research is ongoing to develop new vaccines and improve those currently in use.
Belcher, EA: Prevention of childhood diseases through vaccination. Neonatal Netw 1993 Apr;12(3):35-9.
Vaccine
Vaccine
In 1993, the Childhood Immunization Initiative (CII) established disease elimination goals for six childhood vaccine-preventable diseases. Specific goals for 1996 include elimination of indigenous transmission of "measles", rubella (and congenital rubella syndrome [CRS]), poliomyelitis (polio) caused by wild poliovirus, and diphtheria in all age groups; elimination of tetanus in children aged 15 years; and elimination of invasive disease due to Haemophilus influenzae type b (Hib) in children aged 5 years. This report summarizes progress toward reaching these goals during January-August 1994, compares these findings with those from the same "period" during 1993, and provides information about "mumps" and pertussis--diseases for which reduction goals will be established.
MMWR : Update: childhood vaccine-preventable diseases--United States, 1994. MMWR. 1994 Oct 7;43(39):718-20.
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