Background: Fermented foods have been proposed to prevent common infectious diseases (CIDs) in children attending day care or preschool. Objectives: To investigate the efficacy of dietary supplementation with cow’s skim milk fermented with the probiotic Lactobacillus paracasei CBA L74 in reducing CIDs in children attending day care or preschool. Methods: Multicenter, randomized, double-blind, placebo-controlled trial on healthy children (aged 12–48 months) consuming daily 7 grams of cow’s skim milk fermented with L. paracasei CBA L74 (group A), or placebo (maltodextrins group B) attending day care or preschool during the winter season. The main outcome was the proportion of children who experienced ≥1 episode of CID during a 3-month follow-up. Fecal biomarkers of innate (α- and β-defensins, cathelicidin) and acquired immunity (secretory IgA) were also monitored. Results: A total of 126 children (71 males, 56%) with a mean (SD) age of 33 (9) months completed the study, 66 in group A and 60 in group B. At intention to treat analysis, the proportion of children presenting ≥1 CID was 60% in group A vs. 83% in group B, corresponding to an absolute risk difference (ARD) of −23% (95% CI: −37% to −9%, p < 0.01). At per-protocol-analysis (PPA), the proportion of children presenting ≥1 CID was 18% in group A vs. 40% in group B, corresponding to an absolute risk difference (ARD) of −22% (95% CI: −37% to −6%, p < 0.01). PPA showed that the proportion of children presenting ≥1 acute gastroenteritis (AGE) was significantly lower in group A (18% vs. 40%, p < 0.05). The ARD for the occurrence of ≥1 AGE was −22% (95% CI: −37% to −6%, p < 0.01) in group A. Similar findings were obtained at PPA regarding the proportion of children presenting ≥1 upper respiratory tract infection (URTI), which was significantly lower in group A (51% vs. 74%, p < 0.05), corresponding to an ARD of −23% (95% CI: −40% to −7%, p < 0.01). Significant changes in innate and acquired immunity biomarkers were observed only in subjects in group A. Conclusions: Dietary supplementation with cow’s skim milk fermented with L. paracasei CBA L74 is an efficient strategy in preventing CIDs in children.
Background The COVID-19 pandemic and the subsequent national lockdowns, school closures and distance learning may have had both negative and positive effects on physical and mental health of children. Methods A cross-sectional study was conducted on a large group of children between 1 and 10 years old in Lombardy, Italy (n = 3392). Their parents filled in a survey answering single or multiple-choice questions about their offspring’s behavior changes (including sleep, dietary habits, emotional disturbances), relationship with siblings, parents and peers, the use of digital technologies, and distance learning experience during the lockdown. Results Parents reported lifestyles and emotional alterations during the lockdown. The modifications of family relationships, parents’ remote working, and screen time were associated with sleep, emotional and behavioral modifications. Distance learning was overall considered adequate. Conclusions This study reported the most updated data on the effects of COVID-19 pandemic lockdown on children between 1 and 10 years of age in a large sample of Italian schoolchildren. The results of this study point out that pediatricians and authorities should support relationships within families during the COVID-19 pandemic. Parents’ remote working might play an important role for this purpose.
New rapid diagnostic methods are needed to identify influenza infections to improve virological surveillance usually undertaken with conventional time-consuming, complex, and even expensive laboratory methods. Another reason for using a rapid test is to avoid inappropriate therapy, particularly in children, where use of antibiotics inappropriately and high influenza-related rates of hospitalisation are described. During two winter seasons, the performance of the QuickVue Influenza test (QV) was evaluated in children under 14 presenting with influenza like illness, and compared the results with those obtained from sentinel network surveillance using standard protocols for the sample collection and the laboratory analysis by virus culture and reverse transcription-polymerase chain reaction (RT-PCR). During the first influenza season (2000/2001), 22 paediatricians collected one nose- and one throat-swab from each of the 586 children 0-6 years old recruited in the study. The QV test was carried out in the physician's office by primary care staff on the nose swab material. When compared with virus culture of the throat swab, the QV test had a sensitivity of 36.5%. In the following 2001/2002-influenza season, the performance of the QV test as a rapid laboratory screening assay was assessed. 342 children aged 0-14 years were enrolled with only one throat swab collected from each patient and sent to the laboratory where the QV, virus culture, and RT-PCR tests were performed. The results showed a better sensitivity (54.5%) of the test in comparison with virus culture and RT-PCR assays. The data indicate that rapid QV testing in the physician office setting, using these easily obtained samples, may be too insensitive to be useful for surveillance and for immediate clinical management of children presenting with influenza-like illness. Nevertheless, the QV test may be a valuable diagnostic tool if used in laboratory, as a rapid screening test.
Primary pediatric care in Italy is guaranteed by family pediatricians, who may have their own private offices or work in group clinics that also have nurses/pediatric nurses in order to enrich their offer of services. The aim of this study was to investigate the activities of nurses working in pediatric practices in order to identify and classify the nursing healthcare services offered by the practices themselves. Design and study:A b e a i al d a c d c ed i cl di g e ki g i he edia icia ffice h voluntarily agreed to undergo a semi-structured interview. The investigated variables were individual, institutional and organisational. The study sample consisted of 22 nurses with a mean age of 39 ±13.3 years, 16 of whom were pediatric nurses. Results:All of the nurses stated that they had not received suitable training for working outside a hospital, and that they carried out educational, diagnostic/therapeutic, and bureaucratic administrative/support activities. Nine of the nurses working in group pediatric clinics carried out educational activities autonomously, something that the nurses working in individual or associated clinics did not perform. Twenty of the interviewees also provided telephone consultancy, and 11 of the clinics used algorithms as guides. Conclusions/Practice implications:The findings of this study underline the potential of developing the nursing profession at community level. Further studies are desirable in order to extend the investigation of the pediatric e ac i i ie im leme ed a c mm i le el i he I alia i ce .
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