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Child undernutrition afflicts >150 million children worldwide, contributing to poor child growth, increased risk of infections, and loss of developmental potential. Animal-source foods (ASF) can ameliorate these problems by providing high-quality, high-density, and bioavailable protein and micronutrients. However, many children in developing countries lack ASF in their diet, although generally milk is the ASF most often consumed. Nevertheless, the relation of ASF—and that of specific ASF—to child growth in these contexts has been difficult to define, as has the association between diet and child and household factors in influencing growth outcomes. To better understand these relationships, we evaluated child growth by age groups (6–23 mo, 24–60 mo, and >60 mo) in relation to ASF consumption in rural Nepal. We used an observational study design that leveraged a data set generated through a 3-yr longitudinal controlled impact evaluation of a communitydevelopment intervention. Child anthropometry and 24-h diet recall were obtained at 5 household visits. At baseline, children were generally undernourished: 47% were stunted, 46% underweight, 17% wasted, and 24% microcephalic. Patterns of undernutrition varied with age but improved somewhat over time. Over the 3-yr period of study (9,283 observations), ASF were consumed infrequently: milk in 28% of assessments, meat in 27%, and eggs in 15%. Consumption patterns differed by age group, with younger children (6–23 mo) consuming more milk and less meat than children 24 to 60 or >60 mo. Consumption of even a single ASF at any of the 5 surveys was associated with greater growth in bivariate analysis. After adjustment for household (group assignment, survey round and its interaction, wealth, income, livestock and land ownership, maternal education) and child factors (age, sex, baseline anthropometry), mixed-effect linear regression analysis showed that milk consumption related to higher height for age and weight for age z-scores for children >60 mo of age and to higher head circumference z-score for children age 24 to 60 mo. For children >60 mo, egg consumption also related to higher weight z-scores. Household and child factors also influenced these outcomes. Of the ASF, milk had the strongest and most consistent relationship to child growth. Better measures of diet intake could reveal stronger associations between diet consumption patterns and child growth. Regardless, milk may be a key ASF to target for growth promotion among undernourished rural Nepali children. [ABSTRACT FROM AUTHOR]

Nutrition-sensitive agricultural interventions have the potential to improve child dietary quality in rural households, as evidenced by a growing body of work which concurrently measures agricultural and nutrition indicators. Our objective was to investigate whether children in rural farming communities of Nepal participating in a community-level, nutrition-sensitive development intervention had improved dietary quality compared with children living in non-participating matched rural communities. Six rural communities of Nepal where livelihoods were predominantly agricultural were selected to participate in the phased implementation of a community-level development intervention by Heifer International . Households and children in each community were surveyed at baseline, and follow-up surveys were implemented every six months for twenty-four months. Detailed data on food consumption for children older than 6 months of age were collected using a 24 h recall for 17 foods and food groups; parents responded for children. A difference-in-differences model with household fixed-effects and an analysis of covariance model were used to analyze the resulting panel data. Results indicated that the impacts of the intervention varied by agro-ecological region and by season. In the Hills region, which is poorer on average and more conducive to livestock production, children who had received the intervention for two years were 2.2 times as likely to have consumed food from an additional food group, 1.27 times as likely to have achieved minimum dietary diversity and 1.38 times as likely to have consumed animal source foods as children who received the intervention for only one year. In the Terai region, which is more conducive to crop production, there was no significant change in dietary quality attributable to the intervention. These results provide evidence that particularly vulnerable families can take advantage of community-level development activities. Given that the effects of community-level development activities were disparate across communities within the same country, we conclude that tailoring development activities for particular locations is necessary for success. [ABSTRACT FROM AUTHOR]

• 54% of international adoptees in France, Italy, Norway, and Spain had ≥ 1 special need. • Learning disabilities (40%) and ADHD (30%) were most common. • Patterns of special needs diagnoses differed in the 4 receiving countries. • Mothers' adoption satisfaction was similar in all 4 receiving countries. • Child ADHD, behavior/psychiatric issues related to lower mothers' adoption satisfaction. The extent and nature of SN among international adoptees at adolescence in different receiving countries (RC) has not been completely described, nor have differences between children of Eastern Europe (EE) and non-EE origin been fully assessed. Furthermore, the impact of SN on parent adoption satisfaction has not been systematically assessed or compared between RC. In 4 European RC (1) determine the prevalence and type of SN among internationally adopted adolescents, (2) compare these for children of EE and non-EE origin, (3) relate SN to mothers' adoption satisfaction. 685 mothers of internationally adopted adolescents in four different RC (France n = 246, Italy n = 322, Norway n = 60, Spain n = 57) completed on-line surveys including (a) child's medical, behavior, psychological, or school problems, (b) Pinderhughes' Adoption Satisfaction Questionnaire. Mothers reported that 54% of the adolescents (58 %M, arrival age:53.53±40.35 months, current:14.98±1.70 years, 44% EE origin) had at least one SN. Learning disabilities were most common (40% of adolescents), followed by ADHD (30%), and medical issues (21%), but patterns differed by receiving country. Except for speech/language problems, the frequency of specific SN (developmental delay, attention deficit hyperactivity disorder [ADHD], behavior problems, learning disabilities, psychiatric issues, prenatal alcohol exposure) varied significantly between RC. The frequency of these conditions between children of EE and non-EE origin also varied by RC. Mothers' adoption satisfaction did not differ significantly between RC; the presence of ADHD, behavior and/or psychiatric problems consistently related to mothers' adoption satisfaction in all 4 RC. The relation to mothers' ASQ and the presence and number of SN was assessed by hierarchical linear regression, controlling for child demographic characteristics. Both the presence and number of SN negatively predicted mothers' adoption satisfaction. Child's age at adoption (and to a lesser extent, current age) also negatively predicted mothers' ASQ score. SN were relatively common among internationally adopted adolescents in 4 European RC, but the pattern of specific conditions and relationship to mothers' adoption satisfaction differed among RC. However, ADHD, behavioral and/or psychiatric problems consistently related to mothers' ASQ in all 4 RC. In regressions controlling for demographic characteristics, the presence of any SN and the number of SN related to mothers' adoption satisfaction. SN represent an additional stress on adoptive families; further work is needed to understand how differences in RC may impact post-adoption adjustment and experiences. [ABSTRACT FROM AUTHOR]

• 65% of French parents report >1 special need in their internationally adopted child. • Child SN were associated with different feelings and perceptions among parents. • Parents reported that children with SN more often experienced exclusion and prejudice. • Special needs (SN) may complicate stigma due to adoption or ethnic differences. Both adoption status and ethnic differences may contribute to stigmatization and microaggressions experienced by adopted individuals and their families. Internationally adopted children have been increasingly recognized to have elevated rates of special needs (SN), especially learning disabilities, attention deficit hyperactivity disorder (ADHD), emotional-behavioral problems, and medical-physical issues. However, relatively little is known about the feelings, perceptions, and stigma experienced by families of internationally adopted children with SN. 461 French parents responded to a questionnaire (308 on-line, 153 paper) regarding their feelings and perceptions after international adoption (feelings of difference, ease of attachment, similarities to and dissimilarities from their child), as well as their views of their child's feelings and experiences (difference, exclusion, and prejudice). Parents were asked if their children were diagnosed by professionals as having special needs, specifically: (1) medical/physical conditions, (2) ADHD, (3) learning disabilities, or (4) emotional-behavioral difficulties. Results were compared for parents of children with or without SN. The children (57%M; 43%F) of the parent respondents were adopted from 47 countries. The children were age (mean ± SD) 3.19 ± 2.59 years old at arrival and 11.33 ± 5.03 years old at the time of the survey. 301 (65%) parents reported that their child had at least one SN: physical-medical SN (13% of children) were reported significantly less often than the other 3 categories (ADHD 39%, learning disabilities 36%, emotional-behavioral problems 40%). Overall, parents reported 652 distinct SN among these 301 children: 102/301 (34%) had a diagnosis in a single category, whereas 199/301 (66%) had diagnoses in at least two categories. SN diagnoses varied by continent of origin: Eastern European children had proportionally more ADHD, learning disabilities, and emotional-behavior problems, as well as more diagnoses per child. Compared with parents of non-SN children, parents of SN children (especially those with learning disabilities or emotional-behavioral problems) significantly more often endorsed feelings of difference, more difficulties attaching to their child, and fewer similarities to and more dissimilarities from their child. The SN parents also more often reported that their child experienced exclusion and/or prejudice. The more SN diagnosed in their children, the more likely their parents' feelings and perceptions differed from parents of children without SN. These relationships remained significant after controlling for arrival age, current age, gender, and adoption visibility, and after adjusting for exclusion due to adopted status or country of origin. Compared to adoptive parents of children without SN, parents of children with SN report differing patterns of perceptions and feelings. Child SN represent an additional burden for parents of internationally adopted children, and for their children's feelings and experiences (difference, exclusion, and prejudice, as reported by the parents). These perceptions and feelings are present, even when the SN are not physically obvious. SN must be recognized as an increasingly common, complex, and added dimension to the issues of adoptive status and (often) ethnic differences faced by internationally adopted children and their parents. [ABSTRACT FROM AUTHOR]

Abstract: Vitamin D levels depend on many variables, including sun exposure, age, ethnicity, body mass index, use of medications and supplements. A much higher oral vitamin D intake than the current guidelines is necessary to maintain adequate circulating 25(OH)D levels in the absence of UVB radiation of the skin. In addition to the traditional known metabolic activities, vitamin D has been shown to modulate the immune system, and its deficiency has been linked to the development of several autoimmune disorders including type 1 diabetes and multiple sclerosis. Experimental use of vitamin D has revealed a novel role in the immunopathogenesis of autoimmune diseases. Disorders such as systemic lupus erythematosus, rheumatoid arthritis, Behçet''s, polymyositis/dermatomyositis and systemic scleroderma have all been associated to some extent to vitamin D deficiency. If vitamin D deficiency occurs at a higher rate in patients with autoimmune disorders, then appropriate supplementation may be indicated. [Copyright &y& Elsevier]