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Nutritional resilience in a hostile environment: positive deviance in child nutrition.

The term "positive deviance" applies to the study of children who demonstrate above-average growth in impoverished environments. Favorable values on known malnutrition correlates and attentive child care characterize positive deviants. Best-growing children do not necessarily mirror the malnourished; for example, best- and worst-nourished infants may both get more breast-milk substitutes than middle growers. Positive deviants receive more high-quality foods, physical interaction, affection and praise, and verbal and environmental stimulation. Factors that influence child growth through care quality also predict cognitive development, health, and social adjustment. They include: the type of society; parental education, mental health, initiative, and work burden; family and community structure; and the value of children to parents. Feeding practices related to growth include: permitting the child to control the length of feeding, encouraging eating while avoiding a power struggle, actively spoon- or hand-feeding, not displacing appetite by giving frequent sweets, and timely introduction of appropriate foods.

Child↗

Microbiology. How to get along--friendly microbes in a hostile world.

Microbiologists have long been puzzled by the finding that the gut mucosa does not respond to the myriad varieties of bacteria that normally reside in the gut. As Xavier and Podolsky explain in their Perspective, this may be because bacteria that are indigenous to the gut have learned ways to switch off pathways in gut epithelial cells that lead to switching on of genes involved in inflammation (Neish et al.).

Cell Nucleus↗

The hostile environment of the aging human aorta and the smaller patient--their implications for the intra-aortic balloon.

Intra-aortic balloon counterpulsation (IABC) has been a clinical modality since 1968. In the intervening years the patient population has become older, sicker and smaller. Modern balloon design permits the insertion of balloons into this evolving patient population and the balloon is increasingly threatened by the calcific plaque of the aging aorta and by the geometry of the shorter descending thoracic aorta in the smaller patient. Balloon sizing consideration and radiographic verification of balloon position within the aorta will reduce the incidence of balloon damage during IABC.

Aged↗