International Journal of Child Health and Nutrition

114-123

Authors: Mahama Saaka, Sofo Mutaru

Objective: The main aim of the study was to identify factors contributing to positive deviance in growth of children in rural communities of Northern Ghana. Methods: Weassessed factors contributing to nutritional positive deviance among rural poor households by comparing household feeding care practices and health seeking behaviour in families with normal children (that is, neither stunted nor wasted) with children having at least one form of under nutrition. Results:The prevalence of stunting and wasting was 28.0 % (CI: 25.3 - 30.9), and 10.5 % (CI: 9.0 - 12.3) respectively. Multivariable logistic regression adjusted for cluster sampling showed that positive deviant children (that is, neither wasted nor stunted) were 2.4 times more likely to have taller (
160 cm) mothers [AOR 2.38; 95% CI (1.83 - 3.10)]. Female children were significantly more likely to be positive deviant [AOR 1.44; 95% CI (1.17 - 1.77)]. Households using salt of adequate iodine content were more likely to have positive deviant children [AOR 1.36; 95% CI (1.03 - 1.80)]. Conclusion and Recommendation:Positive deviance in child growth was characterized by taller mothers, being a female child, high maternal nutrition knowledge and being resident in the Upper West Region. The persistent high levels of child under nutrition in Northern Ghana can be mediated through a sustainable focused intervention strategy to improv e maternal nutrition.

130-138

Authors: Wendy Gwirtzman Lane, Howard Dubowitz, Susan Feigelman, Gina Poole

Background:Food insecure children are at increased risk for medical and developmental problems. Effective screening and intervention are needed. Methods:Our purpose was to (1) evaluate the validity and stability of a single item food insecurity (FI) screen. (2) Assess whether use may lead to decreased FI. Part of a larger cluster randomized controlled trial, pediatric residents were assigned to SEEK or control groups. A single FI question (part of a larger questionnaire) was used on SEEK days. SEEK residents learned to screen, assess, and address FI. A subset of SEEK and control clinic parents was recruited for the evaluation. Parents completed the USDA Food Security Scale (“gold standard”), upon recruitment and 6-months later. Validity, positive and negative predictive values (PPV, NPV) was calculated. The proportion of screened families with initial and subsequent FI was measured. Screening effectiveness was evaluated by comparing SEEK and control screening rates and receipt of Supplemental Nutrition Assistance Program (SNAP) benefits between initial and 6-month assessments. Results:FI screen stability indicated substantial agreement (Cohen's kappa =0.69). Sensitivity and specificity was 59% and 87%, respectively. The PPV was 70%; NPV was 81%. SEEK families had a larger increase in screening rates than control families (24% vs. 4.1%, p<0.01). SEEK families were more likely to maintain SNAP enrollment (97% vs. 81%, p=0.05). FI rates remained stable at approximately 30% for both groups. Conclusions:A single question screen can identify many families with FI, and may help maintain food program enrollment. Screening may not be adequate to alleviate FI.

148-155

Authors: Antonio Imbasciati

This paper clarifies the meaning of Perinatal Clinical Psychology by removing the prejudice and the stereotypes that unfortunately pervade children health care facilities still nowadays. The author goes over the basic principles that neuroscience has recently demonstrated in the development of the brain from the fetus to the infant, the child and the adult. The brain is self-generating through experience and not on the basis of genome. Epygenetics accounts for it. The brain needs to learn so as to be able to develop. Nobody has a brain that is the same as anybody else’s and therefore nobody has a mind that is the same as anybody else’s. The brain generates the mind and, in turn, the mind regenerates the brain in a ceaseless feedback. The experience that generates and renews the brain continuously comes from interpersonal relationships. The greatest incidence of this kind of development comes from the relationships with the parents and the caregivers and depends on the emotional moment of the relationship. This opens up transgenerational perspectives. The quality of the mind (and the brain) of the parents and caregivers produces the quality of the mind of the children. The latter, in turn, become adults, condition the mind of their children in cascade effectfrom one generation to the following. This transmission can produce an improvement but also a worsening for the future generations. As a consequence, Perinatal Clinical Psychology becomes important for prevention and psychological support to the children and the families at risk