Report on advances for pediatricians in 2018: allergy, cardiology, critical care, endocrinology, hereditary metabolic diseases, gastroenterology, infectious diseases, neonatology, nutrition, respiratory tract disorders and surgery.

This review reported notable advances in pediatrics that have been published in 2018. We have highlighted progresses in allergy, cardiology, critical care, endocrinology, hereditary metabolic diseases, gastroenterology, infectious diseases, neonatology, nutrition, respiratory tract disorders and surgery. Many studies have informed on epidemiologic observations. Promising outcomes in prevention, diagnosis and treatment have been reported. We think that advances realized in 2018 can now be utilized to ameliorate patient car

The role of probiotics and postbiotics in modulating the gut microbiome-immune system axis in the pediatric age

The complex microbial community of the gut microbiome plays a fundamental role in driving development and function of the human immune system. This phenomenon is named the gut microbiome-immune system axis. When operating optimally, this axis influences both innate and adaptive immunity, which orchestrates the maintenance of crucial elements of host-microorganisms symbiosis, in a dialogue that modulates responses in the most beneficial way. Growing evidence reveals some environmental factors which can positively and negatively modulate the gut microbiome-immune system axis with consequences on the body health status. Several conditions which increasingly affect the pediatric age, such as allergies, autoimmune and inflammatory disorders, arise from a failure of the gut microbiome-immune system axis. Prenatal or postnatal modulation of this axis through some interventional strategies (including diet, probiotics and postbiotics), may lead to a positive gene-environment interaction with improvement of immune-modulatory effects and final positive effect on human health. In particular probiotics and postbiotics exerting pleiotropic regulatory actions on the gut-microbiome-immune system axis provide an innovative preventive and therapeutic strategy for many pediatric conditions

Barnes Hospital Bulletin

https://digitalcommons.wustl.edu/bjc_barnes_bulletin/1276/thumbnail.jp

Report on advances for pediatricians in 2018: Allergy, cardiology, critical care, endocrinology, hereditary metabolic diseases, gastroenterology, infectious diseases, neonatology, nutrition, respiratory tract disorders and surgery

This review reported notable advances in pediatrics that have been published in 2018. We have highlighted progresses in allergy, cardiology, critical care, endocrinology, hereditary metabolic diseases, gastroenterology, infectious diseases, neonatology, nutrition, respiratory tract disorders and surgery. Many studies have informed on epidemiologic observations. Promising outcomes in prevention, diagnosis and treatment have been reported. We think that advances realized in 2018 can now be utilized to ameliorate patient care

Working Toward Pragmatic and Sustainable Exclusive Breastfeeding Practices Among Somali Mothers in Lewiston, Maine

Breastfeeding is the most complete form of infant nutrition and has numerous health benefits for both the mother and infant. The U.S. Department of Health and Human Services’ Healthy People Goals aims for approximately half of mothers to breastfeed exclusively through three months and a quarter of mothers to breastfeed exclusively through six months. Women in Somalia and in refugee camps abroad routinely breastfeed their babies, but upon immigration to the U.S., these mothers often face novel barriers that make it harder to exclusively breastfeed for the recommended amount of time. In Lewiston, Maine, health care providers find that Somali mothers frequently supplement or replace breast milk with formula. In conversation groups with Somali women, this trend was confirmed and women expressed the belief that their breast milk was insufficient for their infants’ nutritional needs. This thesis aims to understand breastfeeding knowledge and beliefs of local perinatal Somali women and how those beliefs translate to practice. Home visit interviews were conducted to collect data on breastfeeding practices and beliefs. This information was used along with public health recommendations concerning breastfeeding, to develop a culturally relevant educational workshop. By building upon Somali women’s current knowledge of breastfeeding, the workshop aimed to encourage pragmatic and sustainable exclusive breastfeeding practices, which will in turn improve mother and infant health. Culturally sensitive programs such as this have the potential to effect real progress toward the lactation objectives set forth in the Healthy People Goals and to cultivate healthier practices in the community

CHINESE WOMEN’S REPRODUCTIVE JUSTICE AND DIGITAL TECHNOLOGIES

It is well known that China has implemented a Family Planning policy. Chinese women have limited options in reproduction, and their agency is constrained by the government, the medical institutions, and the traditional Chinese patriarchal and biased culture. By utilizing rhetorical analysis as a primary methodology with a focus on rhetorical agency, this dissertation analyzes two cases where digital technologies such as social media and apps facilitate users’ rhetorical agency to counter instances of reproductive injustice. First, I focus on China’s most popular pregnancy and mothering app, Babytree, to examine how the app rhetorically positions its users to enable empowerment and how users engage with the app by writing their embodied pregnant and mothering experience into online narratives and “selling” them to generate income, and the possibilities that they seek meaningful changes in the context of the app. Second, I investigate how a new Chinese mother with postpartum depression used the craft of crocheting to identify with other depressed mothers and they worked together to use their crocheted artifacts to do a large-scale installation to raise the public’s awareness and combat the dominant biased culture that stigmatizes postpartum depression. These Chinese women adopt different rhetorical strategies to integrate their embodied experiences into medical knowledge to attract users’ attention and to recast their embodied experiences as material rhetoric to raise the public’s awareness. They take advantage of technological affordances on the app and social media to combat dominant discourses and promote reproductive justice. I argue that these Chinese women economize and materialize their embodied experience of pregnancy and motherhood, which may alter gender oppression in patriarchal and biased cultural discourses and shows a powerful feminist rhetorical agency. Meanwhile, this research also aids in theorizing how reproductive injustice occurs in relation to institutional and cultural oppression in different cultures and groups, and how digital spaces are an ideal place for women to assert rhetorical agency in enacting intercultural communication of reproductive justice

Evidence-based service modules for a sustained home visiting program

The Centre for Community Child Health (CCCH) at the Murdoch Childrens Research Institute and the Royal Children’s Hospital has undertaken two literature reviews to inform the design of a sustained home visiting program for vulnerable families with young children; the program is now known as \u27right@home\u27. This project is being led by a collaboration between three organisations: The Australian Research Alliance for Children and Youth (ARACY), CCCH, and the University of New South Wales. The first literature review undertaken by CCCH (Sustained home visiting for vulnerable families and children: A review of effective programs (McDonald et al., 2012) (hereon in referred to as the Home visiting review of effective programs) sought to answer the question ‘what works in home visiting programs?’ The conclusion reached was that it was not possible to answer the question definitively, either because the evidence regarding the ‘components’ of home visiting programs is contradictory or contested, or the evidence is not available. As the home visiting review of effective programs focused on what was delivered (ie. the efficacy of different manualised programs), rather than how services were delivered (ie. the effect of the manner in which services were delivered and the nature of the relationships established between service providers and parents), a second literature review was undertaken: Sustained home visiting for vulnerable families and children: A literature review of effective processes and strategies (Moore et al., 2012) (hereon in referred to as the Home visiting review of effective processes and strategies). The home visiting review of effective processes and strategies identified converging evidence from a number of sources to support the idea that the process aspects of service delivery matter for outcomes – how services are provided is as important as what is provided. A number of key elements of effective service delivery processes have been repeatedly identified in the research literature and these represent the threshold features or bedrock on which all services should be based: if services are not delivered in accordance with these process features, then efforts to change people’s behaviour will be less effective (Moore et al., 2012). The evidence also indicated that the identification of goals, and of strategies to achieve these goals, needs to be done in partnership with parents. However, while the ultimate choice of strategies should be made by parents, the strategies on offer used must be evidence-based. Therefore, service providers should be able to draw on a suite of evidence-based strategies to address the range of challenges that parents face in caring for their children (Moore et al., 2012). In the light of the findings of this second literature review, it was decided that the right@home home visiting program would not involve the delivery of a manualised program. Rather, service delivery would be based on the processes of effective engagement and partnership, while the content of the program would take two forms: standard modules that are delivered to all participants, and e.g. information on the stages of child development), and evidence-based ‘service modules’ (i.e. specific strategies) that could be deployed to address issues that are of particular concern to individual parents.  Related identifer: ISSN 2204-340

Metabolic imprinting, programming and epigenetics - a review of present priorities and future opportunities

Metabolic programming and metabolic imprinting describe early life events, which impact upon on later physiological outcomes. Despite the increasing numbers of papers and studies, the distinction between metabolic programming and metabolic imprinting remains confusing. The former can be defined as a dynamic process whose effects are dependent upon a critical window(s) while the latter can be more strictly associated with imprinting at the genomic level. The clinical end points associated with these phenomena can sometimes be mechanistically explicable in terms of gene expression mediated by epigenetics. The predictivity of outcomes depends on determining if there is causality or association in the context of both early dietary exposure and future health parameters. The use of biomarkers is a key aspect of determining the predictability of later outcome, and the strengths of particular types of biomarkers need to be determined. It has become clear that several important health endpoints are impacted upon by metabolic programming/imprinting. These include the link between perinatal nutrition, nutritional epigenetics and programming at an early developmental stage and its link to a range of future health risks such as CVD and diabetes. In some cases, the evidence base remains patchy and associative, while in others, a more direct causality between early nutrition and later health is clear. In addition, it is also essential to acknowledge the communication to consumers, industry, health care providers, policy-making bodies as well as to the scientific community. In this way, both programming and, eventually, reprogramming can become effective tools to improve health through dietary intervention at specific developmental point