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  Subjects -> HEALTH AND SAFETY (Total: 1283 journals)
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HEALTH AND SAFETY (514 journals)                  1 2 3 | Last

Showing 1 - 200 of 203 Journals sorted alphabetically
16 de Abril     Open Access  
A Life in the Day     Hybrid Journal   (Followers: 9)
Acta Informatica Medica     Open Access   (Followers: 1)
Acta Scientiarum. Health Sciences     Open Access  
Adultspan Journal     Hybrid Journal  
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10)
Advances in Public Health     Open Access   (Followers: 20)
African Health Sciences     Open Access   (Followers: 2)
African Journal for Physical, Health Education, Recreation and Dance     Full-text available via subscription   (Followers: 6)
African Journal of Health Professions Education     Open Access   (Followers: 4)
Afrimedic Journal     Open Access   (Followers: 2)
Air Quality, Atmosphere & Health     Hybrid Journal   (Followers: 3)
AJOB Primary Research     Partially Free   (Followers: 2)
American Journal of Family Therapy     Hybrid Journal   (Followers: 10)
American Journal of Health Economics     Full-text available via subscription   (Followers: 13)
American Journal of Health Education     Hybrid Journal   (Followers: 25)
American Journal of Health Promotion     Hybrid Journal   (Followers: 23)
American Journal of Health Studies     Full-text available via subscription   (Followers: 8)
American Journal of Preventive Medicine     Hybrid Journal   (Followers: 21)
American Journal of Public Health     Full-text available via subscription   (Followers: 177)
American Journal of Public Health Research     Open Access   (Followers: 27)
American Medical Writers Association Journal     Full-text available via subscription   (Followers: 2)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 2)
Annali dell'Istituto Superiore di Sanità     Open Access  
Annals of Global Health     Open Access   (Followers: 8)
Annals of Health Law     Open Access   (Followers: 3)
Annals of Tropical Medicine and Public Health     Open Access   (Followers: 15)
Applied Biosafety     Hybrid Journal  
Applied Research In Health And Social Sciences : Interface And Interaction     Open Access  
Archives of Medicine and Health Sciences     Open Access   (Followers: 2)
Asia Pacific Journal of Counselling and Psychotherapy     Hybrid Journal   (Followers: 8)
Asia Pacific Journal of Health Management     Full-text available via subscription   (Followers: 1)
Asia-Pacific Journal of Public Health     Hybrid Journal   (Followers: 8)
Asian Journal of Gambling Issues and Public Health     Open Access   (Followers: 3)
Association of Schools of Allied Health Professions     Full-text available via subscription   (Followers: 5)
Atención Primaria     Open Access   (Followers: 1)
Australasian Journal of Paramedicine     Open Access   (Followers: 2)
Australian Advanced Aesthetics     Full-text available via subscription   (Followers: 4)
Australian Family Physician     Full-text available via subscription   (Followers: 2)
Australian Indigenous HealthBulletin     Free   (Followers: 6)
Autism & Developmental Language Impairments     Open Access   (Followers: 1)
Behavioral Healthcare     Full-text available via subscription   (Followers: 4)
Best Practices in Mental Health     Full-text available via subscription   (Followers: 6)
Bijzijn     Hybrid Journal   (Followers: 2)
Bijzijn XL     Hybrid Journal   (Followers: 1)
Biomedical Safety & Standards     Full-text available via subscription   (Followers: 9)
BLDE University Journal of Health Sciences     Open Access  
BMC Oral Health     Open Access   (Followers: 5)
BMC Pregnancy and Childbirth     Open Access   (Followers: 19)
BMJ Simulation & Technology Enhanced Learning     Full-text available via subscription   (Followers: 7)
Brazilian Journal of Medicine and Human Health     Open Access  
Buletin Penelitian Kesehatan     Open Access   (Followers: 2)
Buletin Penelitian Sistem Kesehatan     Open Access  
Bulletin of the World Health Organization     Open Access   (Followers: 15)
Cadernos de Educação, Saúde e Fisioterapia     Open Access   (Followers: 1)
Cadernos Saúde Coletiva     Open Access   (Followers: 1)
Canadian Family Physician     Partially Free   (Followers: 11)
Canadian Journal of Community Mental Health     Full-text available via subscription   (Followers: 10)
Canadian Journal of Human Sexuality     Hybrid Journal   (Followers: 1)
Canadian Journal of Public Health     Full-text available via subscription   (Followers: 18)
Case Reports in Women's Health     Open Access   (Followers: 2)
Case Studies in Fire Safety     Open Access   (Followers: 11)
Central Asian Journal of Global Health     Open Access   (Followers: 2)
Central European Journal of Public Health     Full-text available via subscription   (Followers: 4)
CES Medicina     Open Access  
Child Abuse Research in South Africa     Full-text available via subscription   (Followers: 1)
Child's Nervous System     Hybrid Journal  
Childhood Obesity and Nutrition     Open Access   (Followers: 10)
Children     Open Access   (Followers: 2)
CHRISMED Journal of Health and Research     Open Access  
Christian Journal for Global Health     Open Access  
Ciência & Saúde Coletiva     Open Access   (Followers: 2)
Ciencia y Cuidado     Open Access  
Ciencia, Tecnología y Salud     Open Access  
ClinicoEconomics and Outcomes Research     Open Access   (Followers: 1)
CME     Hybrid Journal   (Followers: 1)
CoDAS     Open Access  
Community Health     Open Access   (Followers: 1)
Conflict and Health     Open Access   (Followers: 8)
Curare     Open Access  
Current Opinion in Behavioral Sciences     Hybrid Journal   (Followers: 1)
Day Surgery Australia     Full-text available via subscription   (Followers: 2)
Digital Health     Open Access  
Dramatherapy     Hybrid Journal   (Followers: 2)
Drogues, santé et société     Full-text available via subscription  
Duazary     Open Access   (Followers: 1)
Early Childhood Research Quarterly     Hybrid Journal   (Followers: 13)
East African Journal of Public Health     Full-text available via subscription   (Followers: 3)
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity     Hybrid Journal   (Followers: 16)
EcoHealth     Hybrid Journal   (Followers: 3)
Education for Health     Open Access   (Followers: 4)
electronic Journal of Health Informatics     Open Access   (Followers: 4)
ElectronicHealthcare     Full-text available via subscription   (Followers: 3)
Elsevier Ergonomics Book Series     Full-text available via subscription   (Followers: 5)
Emergency Services SA     Full-text available via subscription   (Followers: 2)
Ensaios e Ciência: Ciências Biológicas, Agrárias e da Saúde     Open Access  
Environmental Disease     Open Access  
Environmental Sciences Europe     Open Access   (Followers: 2)
Epidemics     Open Access   (Followers: 3)
Epidemiology, Biostatistics and Public Health     Open Access   (Followers: 18)
Ethics, Medicine and Public Health     Full-text available via subscription  
Ethiopian Journal of Health Development     Open Access   (Followers: 8)
Ethiopian Journal of Health Sciences     Open Access   (Followers: 7)
Ethnicity & Health     Hybrid Journal   (Followers: 14)
European Journal of Investigation in Health, Psychology and Education     Open Access   (Followers: 1)
European Medical, Health and Pharmaceutical Journal     Open Access  
Evaluation & the Health Professions     Hybrid Journal   (Followers: 8)
Evidence-based Medicine & Public Health     Open Access   (Followers: 4)
Evidência - Ciência e Biotecnologia - Interdisciplinar     Open Access  
Face à face     Open Access   (Followers: 1)
Families, Systems, & Health     Full-text available via subscription   (Followers: 8)
Family & Community Health     Partially Free   (Followers: 12)
Family Medicine and Community Health     Open Access   (Followers: 3)
Family Relations     Partially Free   (Followers: 11)
Fatigue : Biomedicine, Health & Behavior     Hybrid Journal   (Followers: 1)
Food and Public Health     Open Access   (Followers: 10)
Frontiers in Public Health     Open Access   (Followers: 8)
Gaceta Sanitaria     Open Access   (Followers: 3)
Galen Medical Journal     Open Access  
Geospatial Health     Open Access  
Gesundheitsökonomie & Qualitätsmanagement     Hybrid Journal   (Followers: 11)
Giornale Italiano di Health Technology Assessment     Full-text available via subscription  
Global Health : Science and Practice     Open Access   (Followers: 4)
Global Health Promotion     Hybrid Journal   (Followers: 15)
Global Journal of Health Science     Open Access   (Followers: 6)
Global Journal of Public Health     Open Access   (Followers: 9)
Global Medical & Health Communication     Open Access  
Globalization and Health     Open Access   (Followers: 5)
Hacia la Promoción de la Salud     Open Access  
Hastings Center Report     Hybrid Journal   (Followers: 7)
HEADline     Hybrid Journal  
Health & Place     Hybrid Journal   (Followers: 14)
Health & Justice     Open Access   (Followers: 5)
Health : An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine     Hybrid Journal   (Followers: 7)
Health and Human Rights     Free   (Followers: 8)
Health and Social Care Chaplaincy     Hybrid Journal   (Followers: 9)
Health and Social Work     Hybrid Journal   (Followers: 45)
Health Behavior and Policy Review     Full-text available via subscription   (Followers: 1)
Health Care Analysis     Hybrid Journal   (Followers: 11)
Health Inform     Full-text available via subscription  
Health Information Management Journal     Hybrid Journal   (Followers: 10)
Health Issues     Full-text available via subscription   (Followers: 1)
Health Policy     Hybrid Journal   (Followers: 32)
Health Policy and Technology     Hybrid Journal  
Health Professional Student Journal     Open Access   (Followers: 1)
Health Promotion International     Hybrid Journal   (Followers: 20)
Health Promotion Journal of Australia : Official Journal of Australian Association of Health Promotion Professionals     Full-text available via subscription   (Followers: 10)
Health Promotion Practice     Hybrid Journal   (Followers: 15)
Health Prospect     Open Access   (Followers: 1)
Health Psychology     Full-text available via subscription   (Followers: 47)
Health Psychology Research     Open Access   (Followers: 18)
Health Psychology Review     Hybrid Journal   (Followers: 39)
Health Renaissance     Open Access  
Health Research Policy and Systems     Open Access   (Followers: 9)
Health SA Gesondheid     Open Access   (Followers: 2)
Health Science Reports     Open Access  
Health Sciences and Disease     Open Access   (Followers: 2)
Health Services Insights     Open Access   (Followers: 1)
Health Systems     Hybrid Journal   (Followers: 2)
Health Voices     Full-text available via subscription  
Health, Culture and Society     Open Access   (Followers: 10)
Health, Risk & Society     Hybrid Journal   (Followers: 9)
Healthcare     Open Access   (Followers: 1)
Healthcare in Low-resource Settings     Open Access   (Followers: 1)
Healthcare Quarterly     Full-text available via subscription   (Followers: 8)
HERD : Health Environments Research & Design Journal     Full-text available via subscription  
Highland Medical Research Journal     Full-text available via subscription  
Hispanic Health Care International     Full-text available via subscription  
HIV & AIDS Review     Full-text available via subscription   (Followers: 10)
Home Health Care Services Quarterly     Hybrid Journal   (Followers: 5)
Hong Kong Journal of Social Work, The     Hybrid Journal   (Followers: 2)
Hospitals & Health Networks     Free   (Followers: 2)
IEEE Journal of Translational Engineering in Health and Medicine     Open Access   (Followers: 3)
IMTU Medical Journal     Full-text available via subscription  
Indian Journal of Health Sciences     Open Access   (Followers: 1)
Inmanencia. Revista del Hospital Interzonal General de Agudos (HIGA) Eva Perón     Open Access  
Innovative Journal of Medical and Health Sciences     Open Access  
Institute for Security Studies Papers     Full-text available via subscription   (Followers: 6)
interactive Journal of Medical Research     Open Access  
International Health     Hybrid Journal   (Followers: 4)
International Journal for Equity in Health     Open Access   (Followers: 7)
International Journal for Quality in Health Care     Hybrid Journal   (Followers: 32)
International Journal of Applied Behavioral Sciences     Open Access   (Followers: 2)
International Journal of Behavioural and Healthcare Research     Hybrid Journal   (Followers: 7)
International Journal of Circumpolar Health     Open Access   (Followers: 1)
International Journal of Community Medicine and Public Health     Open Access   (Followers: 5)
International Journal of E-Health and Medical Communications     Full-text available via subscription   (Followers: 2)
International Journal of Environmental Research and Public Health     Open Access   (Followers: 19)
International Journal of Evidence-Based Healthcare     Hybrid Journal   (Followers: 8)
International Journal of Food Safety, Nutrition and Public Health     Hybrid Journal   (Followers: 13)
International Journal of Health & Allied Sciences     Open Access   (Followers: 1)
International Journal of Health Care Quality Assurance     Hybrid Journal   (Followers: 7)
International Journal of Health Geographics     Open Access   (Followers: 6)
International Journal of Health Policy and Management     Open Access   (Followers: 2)
International Journal of Health Professions     Open Access   (Followers: 2)
International Journal of Health Promotion and Education     Hybrid Journal   (Followers: 12)
International Journal of Health Sciences Education     Open Access   (Followers: 2)
International Journal of Health Services     Full-text available via subscription   (Followers: 9)
International Journal of Health Studies     Open Access   (Followers: 3)
International Journal of Health System and Disaster Management     Open Access   (Followers: 2)

        1 2 3 | Last

Journal Cover Children
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  This is an Open Access Journal Open Access journal
   ISSN (Online) 2227-9067
   Published by MDPI Homepage  [148 journals]
  • Children, Vol. 4, Pages 31: Mind–Body Therapy for Children with
           Attention-Deficit/Hyperactivity Disorder

    • Authors: Anne Herbert, Anna Esparham
      First page: 31
      Abstract: Attention-deficit/hyperactivity disorder (ADHD) is pervasive among the pediatric population and new treatments with minimal adverse effects are necessary to be studied. The purpose of this article is to review current research studying mind–body therapies for treatment of children diagnosed with ADHD. Literature was reviewed pertaining to the effectiveness of movement-based therapies and mindfulness/meditation-based therapies for ADHD. Many positive effects of yoga, Tai Chi, physical activity, and meditation may significantly improve symptoms of ADHD among children.
      PubDate: 2017-04-25
      DOI: 10.3390/children4050031
      Issue No: Vol. 4, No. 5 (2017)
  • Children, Vol. 4, Pages 32: A Pilot Study of Mindfulness Meditation for
           Pediatric Chronic Pain

    • Authors: Lynn Waelde, Amanda Feinstein, Rashmi Bhandari, Anya Griffin, Isabel Yoon, Brenda Golianu
      First page: 32
      Abstract: Despite advances in psychological interventions for pediatric chronic pain, there has been little research examining mindfulness meditation for these conditions. This study presents data from a pilot clinical trial of a six-week manualized mindfulness meditation intervention offered to 20 adolescents aged 13–17 years. Measures of pain intensity, functional disability, depression and parent worry about their child’s pain were obtained at baseline and post-treatment. Results indicated no significant changes in pain or depression, however functional disability and frequency of pain functioning complaints improved with small effect sizes. Parents’ worry about child’s pain significantly decreased with a large effect size. Participants rated intervention components positively and most teens suggested that the number of sessions be increased. Three case examples illustrate mindfulness meditation effects and precautions. Mindfulness meditation shows promise as a feasible and acceptable intervention for youth with chronic pain. Future research should optimize intervention components and determine treatment efficacy.
      PubDate: 2017-04-26
      DOI: 10.3390/children4050032
      Issue No: Vol. 4, No. 5 (2017)
  • Children, Vol. 4, Pages 33: An Evaluation of a Continuing Education
           Program for Family Caregivers of Ventilator-Dependent Children with Spinal
           Muscular Atrophy (SMA)

    • Authors: Deborah Boroughs
      First page: 33
      Abstract: Until 25 years ago, there were limited options for long-term mechanical ventilation of children, and the majority of children were cared for in hospitals. However, with improving technology, the pediatric intensive care unit has moved from the hospital to a home setting, as children with increasingly complex healthcare needs are now often cared for by family members. One of the most complex care conditions involves ventilator and tracheostomy support. Advanced respiratory technologies that augment natural respiratory function prolong the lives of children with respiratory compromise; however, this care often comes with serious risks, including respiratory muscle impairment, respiratory failure, and chronic pulmonary disease. Both non-invasive assisted ventilation and assisted ventilation via tracheostomy can prolong survival into adulthood in many cases; however, mechanical ventilation in the home is a high-stakes, high risk intervention. Increasing complexity of care over time requires perpetual skill training of family caregivers that is delivered and supported by professional caregivers; yet, opportunities for additional training outside of the hospital rarely exist. Recent data has confirmed that repetitive caregiver education is essential for retention of memory and skills in adult learners. This study analyzes the use of continued education and training in the community for family caregivers of ventilator-dependent children diagnosed with spinal muscular atrophy (SMA).
      PubDate: 2017-04-29
      DOI: 10.3390/children4050033
      Issue No: Vol. 4, No. 5 (2017)
  • Children, Vol. 4, Pages 34: Natural History of NAFLD Diagnosed in
           Childhood: A Single-Center Study

    • Authors: Catherine Cioffi, Jean Welsh, Rebecca Cleeton, Shelley Caltharp, Rene Romero, Mark Wulkan, Juna Konomi, Jennifer Frediani, Miriam Vos
      First page: 34
      Abstract: Little is known regarding the subsequent course of non-alcoholic fatty liver disease (NAFLD) diagnosed in childhood. The objectives of this single-center study were to gather data on long-term health outcomes and to assess the feasibility of contacting former pediatric patients. In a large pediatric medical center, electronic records were searched to initially identify 162 former patients who had a liver biopsy between 2000 and 2010. Of these, 44 subjects met the criteria for age at follow-up (≥18 year) and biopsy-proven NAFLD, and were recruited via postal and electronic mail. Participants were invited to complete a brief telephone survey on current health status. Supplemental data was also obtained from pediatric medical charts of all subjects. At NAFLD diagnosis, 18% of subjects had diabetes, 91% were obese, 61% had NASH, and 56% had fibrosis on biopsy. At follow-up, 10 subjects (23%) responded to the survey. Based on the survey and chart review, after a mean follow-up of 4.5 years, 5 additional subjects developed diabetes for a period prevalence of 30%, and most subjects (78%) remained obese at last follow-up. Additional prospective studies are needed to fully describe the longitudinal risks associated with pediatric NAFLD, and will require multi-dimensional strategies to successfully recruit former patients.
      PubDate: 2017-05-03
      DOI: 10.3390/children4050034
      Issue No: Vol. 4, No. 5 (2017)
  • Children, Vol. 4, Pages 35: After the Visit: An Overview of Government and
           Community Programs Supporting Children with Medical Complexity

    • Authors: Kaitlyn Olson
      First page: 35
      Abstract: The optimal care of children with medical complexity (CMC) requires involvement from a network of professionals that includes physicians, nurses, ancillary service providers, and educators. Pediatric health care providers typically have early and frequent contact with the families of CMC. Therefore, they are in a unique position to connect families to developmental, educational, and psychosocial supports. This article reviews important government and community programs that support CMC living in the United States. It outlines the educational rights of children with disabilities and offers practical tips for collaborating with Early Intervention and the public school system. The article also provides an overview of financial assistance programs, respite care services, and support groups that are beneficial to CMC and their families.
      PubDate: 2017-05-04
      DOI: 10.3390/children4050035
      Issue No: Vol. 4, No. 5 (2017)
  • Children, Vol. 4, Pages 36: Low Family Support and Risk of Obesity among
           Black Youth: Role of Gender and Ethnicity

    • Authors: Shervin Assari, Cleopatra Caldwell
      First page: 36
      Abstract: Most studies on the role of family environment in developing risk of obesity among youth have focused on parenting behaviors that are directly involved in energy balance in regional, non-representative White samples. Using a national sample of ethnically diverse Black youth, the current study tested the association between low family support and risk of obesity. We also tested the heterogeneity of this association based on gender, ethnicity, and their intersection. We used data from the National Survey of American Life-Adolescent Supplement (NSAL-A), a national survey of Black adolescents in the United States. The study enrolled 1170 African American and Caribbean Black 13–17 year old youth. Obesity was defined based on the cutoff points of body mass index (BMI) appropriate for age and gender of youth. Family support was measured using a five-item measure that captured emotional and tangible social support. Age, gender, and ethnicity were also measured. Logistic regressions were utilized in the pooled sample, and also based on gender, ethnicity, and their intersection, to test the link between low family support and risk for obesity. Results: In the pooled sample, low family support was not associated with an increased risk of obesity (OR = 1.35, 95% Confidence Interval (CI) = 0.96–1.89). The association between low family support and risk of obesity was, however, significant among African American females (OR = 1.60, 95% CI = 1.01–2.55). There was no association for African American males (OR = 1.26, 95% CI = 0.82–1.92), Caribbean Black males (OR = 0.68, 95% CI = 0.01–54.85), and Caribbean Black females (OR = 0.78, 95% CI = 0.42–1.44). In conclusion, policies and programs that enable African American families to provide additional family support may prevent obesity among African American female youth. Future research should test the efficacy of promoting family support as a tool for preventing obesity among African American female youth.
      PubDate: 2017-05-12
      DOI: 10.3390/children4050036
      Issue No: Vol. 4, No. 5 (2017)
  • Children, Vol. 4, Pages 37: Neonatal and Maternal 25-OH Vitamin D Serum
           Levels in Neonates with Early-Onset Sepsis

    • Authors: Taha Gamal, Abd-Allah Madiha, Mostafa Hanan, Mohamed Abdel-Azeem, Gamil Marian
      First page: 37
      Abstract: Vitamin D is a fat-soluble vitamin that is important for calcium metabolism and plays an important role in the immune functions. The aim of this study was to measure neonatal and maternal 25-OH vitamin D serum levels in neonates with early onset sepsis. The study included fifty neonates with early onset sepsis (25 full-term and 25 preterm infants) and thirty age and sex matched healthy neonates as controls. After history taking and clinical examination, complete blood count, C-reactive protein and 25-OH vitamin D serum levels (neonatal and maternal) were measured for all neonates. The mean gestational age for neonates with sepsis was (37.5 ± 0.98 for full term and 34.1 ± 1.26 for preterm neonates). Neonatal and maternal 25-OH vitamin D serum levels were significantly lower in patients (6.4 ± 1.8 and 24.6 ± 2.2 nmol/L) than controls (42.5 ± 20.7 and 50.4 ± 21.4 nmol/L). Significant negative correlations between neonatal and maternal 25-OH vitamin D serum levels and all sepsis markers and significant positive correlations between neonatal and maternal 25-OH vitamin D levels were present. At cut-off values <20 nmol/L for neonatal and <42 nmol/L for maternal 25-OH vitamin D for detection of neonatal sepsis, the sensitivity, specificity, positive predicted value (PPV) and negative predicted value (NPV) were 84%, 79%, 94.7% and 82.3% for neonatal and 82%, 77%, 91.4% and 80.6% for maternal 25-OH vitamin D, respectively. Positive correlations between neonatal and maternal 25-OH Vitamin D serum levels are present and they are negatively correlated with all sepsis markers. They can be sensitive early predictors for early onset sepsis in neonates.
      PubDate: 2017-05-09
      DOI: 10.3390/children4050037
      Issue No: Vol. 4, No. 5 (2017)
  • Children, Vol. 4, Pages 38: First Nations Approaches to Childhood Obesity:
           Healthy Lifestyles in Canada Compared with Alternatives for Alaska Native

    • Authors: Peter de Schweinitz, Janet Wojcicki
      First page: 38
      Abstract: Alaska Native and American Indian children have among the highest prevalence of obesity in the United States. Canadian Aboriginal populations including First Nations also have high rates of obesity but obesity rates among children are noticeably lower. We highlight some of the important differences between American and Canadian approaches to healthy lifestyles and Aboriginal/Native health, including diet and physical activity, which may in part explain the differences in obesity prevalence. Specifically, the Canadian government provides a food subsidy program to bring perishable fruits and vegetable to remote, rural Canadian areas and secondly supports the use of traditional foods and harvesting/gathering through a number of government supported programs. Lastly, there may be a better sense of community and overall life satisfaction for Aboriginals compared with Alaska Natives, in part because of the incorporation of healthcare and other services within the larger overall community, as opposed to separate services as is the case for Alaska Natives. This perspective provides insight into some of these potential differences.
      PubDate: 2017-05-11
      DOI: 10.3390/children4050038
      Issue No: Vol. 4, No. 5 (2017)
  • Children, Vol. 4, Pages 39: Predictors of Caregiver Burden among Mothers
           of Children with Chronic Conditions

    • Authors: Karina Javalkar, Eniko Rak, Alexandra Phillips, Cara Haberman, Maria Ferris, Miranda Van Tilburg
      First page: 39
      Abstract: Objective: The complex medical regimens of children and adolescents with chronic conditions can have a significant impact on families and households. Caregivers may experience burden, which can lead to negative health consequences and poor quality of life. The objective of this study was to determine child-related predictors and risk factors for caregiver burden among parents of children with chronic conditions. Methods: We distributed an institutional review board (IRB)-approved, online cross-sectional survey to parents of children who attended the Victory Junction therapeutic camp. Parents provided information on child demographics, disease characteristics, and healthcare utilization. Parents also answered the adapted Zarit Burden Interview, which measured caregiver burden. Children completed scales about self-management and self-efficacy. Linear regression analyses determined how children’s disease characteristics, health utilization, and self-management skills were associated with caregiver burden. Results: We enrolled 150 mother-child dyads. The mean age of child participants was 12.23 years (±2.5), with an age range of 6 to 16 years. It was determined that children’s number of medicines and injections (β = 0.161, p = 0.047), a diagnosis of attention-deficit/hyperactivity disorder (ADHD) in addition to the primary medical condition (β = 0.216, p = 0.008), frequent visits with a primary care provider (PCP) (β = 0.209, p = 0.026) and emergency room (ER) visits (β = 0.197, p = 0.038), and lower child self-efficacy (β = −0.241, p = 0.041) were predictors of increased caregiver burden. Conclusions: We identified risk factors for caregiver burden among mothers. Future studies should explore additional child-related characteristics as they relate to caregiver burden, and should determine if interventions for mothers of children with chronic conditions can lead to positive outcomes.
      PubDate: 2017-05-16
      DOI: 10.3390/children4050039
      Issue No: Vol. 4, No. 5 (2017)
  • Children, Vol. 4, Pages 40: Mental Health Service Utilization among Black
           Youth; Psychosocial Determinants in a National Sample

    • Authors: Shervin Assari, Cleopatra Caldwell
      First page: 40
      Abstract: Racial disparity in mental health service utilization (MHSU) persists, and youths are not an exception to the underutilization of services. Very limited research has been conducted on the determinants of MHSU among Black youth. Using a national sample of American Black youth, the current study investigated the association between demographic factors, socioeconomic status, psychiatric disorders, and self-rated health (SRH) on MHSU. We also tested the heterogeneity of the effects of SRH and psychiatric disorders based on ethnicity, gender, and their intersection. We used data from the National Survey of American Life-Adolescents supplement (NSAL-A), 2003–2004. The study enrolled 1170 Black youth between 13 and 17 years old including 810 African Americans and 360 Caribbean Blacks. Age, gender, ethnicity, socioeconomic status, SRH, 12-month psychiatric disorders (Composite International Diagnostic Interview modified version), and MHSU (last year) were measured. Logistic regressions were used for data analysis. Ethnicity (odds ratio (OR) = 0.33, 95% confidence interval (CI) = 0.17–0.65), subjective socioeconomic status (OR = 1.43, 95% CI = 1.09–1.88), SRH (OR = 2.45, 95% CI = 1.00–6.37), and psychiatric disorders (OR = 2.17, 95% CI = 1.05–4.48) were associated with MHSU. Age, gender, and objective socioeconomic status were not associated with MHSU. Gender and ethnicity did not interact with SRH and psychiatric disorders on MHSU. Actual and perceived need both universally influence Black youths’ likelihood of MHSU, regardless of their ethnicity and gender. Ethnicity and perceived socioeconomic status also play unique roles in MHSU. Future research is needed to understand pathways to MHSU for Black youth who both have and perceive mental health needs. There is also a need to find ways to promote MHSU for those with a need for mental health services.
      PubDate: 2017-05-17
      DOI: 10.3390/children4050040
      Issue No: Vol. 4, No. 5 (2017)
  • Children, Vol. 4, Pages 41: Respiratory Care Considerations for Children
           with Medical Complexity

    • Authors: Jackie Chiang, Reshma Amin
      First page: 41
      Abstract: Children with medical complexity (CMC) are a growing population of diagnostically heterogeneous children characterized by chronic conditions affecting multiple organ systems, the use of medical technology at home as well as intensive healthcare service utilization. Many of these children will experience either a respiratory-related complication and/or they will become established on respiratory technology at home during their care trajectory. Therefore, healthcare providers need to be familiar with the respiratory related complications commonly experienced by CMC as well as the indications, technical and safety considerations and potential complications that may arise when caring for CMC using respiratory technology at home. This review will outline the most common respiratory disease manifestations experienced by CMC, and discuss various respiratory-related treatment options that can be considered, including tracheostomy, invasive and non-invasive ventilation, as well as airway clearance techniques. The caregiver requirements associated with caring for CMC using respiratory technology at home will also be reviewed.
      PubDate: 2017-05-19
      DOI: 10.3390/children4050041
      Issue No: Vol. 4, No. 5 (2017)
  • Children, Vol. 4, Pages 19: Clinical Hypnosis, an Effective Mind–Body
           Modality for Adolescents with Behavioral and Physical Complaints

    • Authors: Anju Sawni, Cora Breuner
      First page: 19
      Abstract: Mind–body medicine is a system of health practices that includes meditation/relaxation training, guided imagery, hypnosis, biofeedback, yoga, art/music therapy, prayer, t’ai chi, and psychological therapies such as cognitive behavioral therapy. Clinical hypnosis is an important mind–body tool that serves as an adjunct to conventional medical care for the adolescent patient. Clinical hypnosis specifically uses self-directed therapeutic suggestions to cultivate the imagination and facilitate the mind–body connection, leading to positive emotional and physical well-being. There are many similarities between clinical hypnosis and other mind–body/self-regulatory modalities such as visual imagery, mindfulness meditation, yoga, and biofeedback that incorporate experiential learning and mechanisms for change. They may be viewed as subtypes of the hypnotic experience and share the common experience of trance as the entrée into self-empowered change in physiologic and psychological states. Clinical hypnosis can be used by health care providers to teach adolescents coping skills to deal with a wide variety of conditions such as chronic headaches, recurrent abdominal pain, anxiety, depression, grief and bereavement, phobias, anger, family stressors, sleep disorders, or enuresis. Clinical vignettes are given to help illustrate the effectiveness of hypnosis in adolescents.
      PubDate: 2017-03-24
      DOI: 10.3390/children4040019
      Issue No: Vol. 4, No. 4 (2017)
  • Children, Vol. 4, Pages 20: Perspectives on Technology-Assisted Relaxation
           Approaches to Support Mind-Body Skills Practice in Children and Teens:
           Clinical Experience and Commentary

    • Authors: Timothy Culbert
      First page: 20
      Abstract: It has been well-established that a variety of mind-body (MB) techniques, including yoga, mental imagery, hypnosis, biofeedback, and meditation, are effective at addressing symptoms such as pain, anxiety, nausea, and insomnia, as well as helping with a wide variety of medical, emotional, and behavioral issues in pediatric populations. In addition, MB skills can also be health promoting in the long-term, and with regular practice, could potentially contribute to longer attention spans, social skills, emotional regulation, and enhanced immune system functioning. Importantly, the benefits accrued from MB skills are largely dose dependent, meaning that individuals who practice with some consistency tend to benefit the most, both in the short- and long-term. However, clinical experience suggests that for busy patients, the regular practice of MB skills can be challenging and treatment adherence commonly becomes an issue. This commentary reviews the concept of technology assisted relaxation as an engaging and effective option to enhance treatment adherence (i.e., daily practice) for pediatric patients, for whom MB skills have been recommended to address physical and mental health challenges.
      PubDate: 2017-04-04
      DOI: 10.3390/children4040020
      Issue No: Vol. 4, No. 4 (2017)
  • Children, Vol. 4, Pages 21: Review of Randomized Controlled Trials of
           Massage in Preterm Infants

    • Authors: Anna-Kaisa Niemi
      First page: 21
      Abstract: Preterm birth affects about 10% of infants born in the United States. Massage therapy is being used in some neonatal intensive care units for its potential beneficial effects on preterm infants. This article reviews published randomized controlled trials on the effects of massage in preterm infants. Most studies evaluating the effect of massage in weight gain in premature infants suggest a positive effect on weight gain. Increase in vagal tone has been reported in infants who receive massage and has been suggested as a possible mechanism for improved weight gain. More studies are needed on the underlying mechanisms of the effects of massage therapy on weight gain in preterm infants. While some trials suggest improvements in developmental scores, decreased stress behavior, positive effects on immune system, improved pain tolerance and earlier discharge from the hospital, the number of such studies is small and further evidence is needed. Further studies, including randomized controlled trials, are needed on the effects of massage in preterm infants.
      PubDate: 2017-04-03
      DOI: 10.3390/children4040021
      Issue No: Vol. 4, No. 4 (2017)
  • Children, Vol. 4, Pages 22: Mind–Body Interventions for Pediatric
           Inflammatory Bowel Disease

    • Authors: Ann Ming Yeh, Anava Wren, Brenda Golianu
      First page: 22
      Abstract: Pediatric inflammatory bowel disease is an autoimmune disease that causes chronic inflammation of the gastrointestinal mucosa. There is emerging evidence that the brain–gut connection affects inflammatory bowel disease (IBD) patients more than previously thought. This is evidenced by comorbid mood disorders, irritable bowel symptoms concurrent with quiescent IBD, and the potential of psychosocial stressors to trigger IBD flares. Mind–body interventions such as psychotherapy, relaxation, mindfulness, biofeedback, yoga, and clinical hypnosis offer an adjunct to standard medical treatment for IBD. We will review the current evidence base for these mind– body interventions in the treatment of pediatric IBD, illustrate a case study, and offer suggestions for future research for this promising field.
      PubDate: 2017-04-03
      DOI: 10.3390/children4040022
      Issue No: Vol. 4, No. 4 (2017)
  • Children, Vol. 4, Pages 23: Links between Autism Spectrum Disorder
           Diagnostic Status and Family Quality of Life

    • Authors: Andrew McKechanie, Vivien Moffat, Eve Johnstone, Sue Fletcher-Watson
      First page: 23
      Abstract: Quality of life is often relatively lowered in families of children with additional needs, and this may be particularly the case where additional needs are accompanied by an autism spectrum disorder (ASD). Here we explore the effects of diagnostic status specifically, comparing families with children with an ASD diagnosis with others who a) have additional needs but no signs of ASD; and b) have additional needs and signs of ASD but no diagnosis. Mothers (n = 76) of children with additional needs completed standardised questionnaires about quality of life, stress, service provision, child behaviour and presence and severity of ASD traits. In addition, a group of mothers of typically developing young people (n = 17) completed standardised questionnaires on individual and family quality of life and on the behaviour of their son or daughter. Mothers of typically developing young people had significantly higher individual and family quality of life scores than each of the three other groups. Increased severity of ASD was associated with increased maternal stress, which in turn was associated with decreased family and maternal quality of life. The group reporting the lowest quality of life and the highest stress were the mothers of individuals with signs of ASD but no diagnosis. This pattern did not seem to be explained by lack of access to services, or rates of intellectual disability or challenging behaviour in this sub‐group. The finding that poor quality of life and high stress was most apparent in the sub‐group of mothers with children who had signs of ASD but did not have a diagnosis of ASD suggests that an interesting topic for further investigation is whether receipt of a diagnosis itself can positively influence quality of life and levels of maternal stress.
      PubDate: 2017-04-03
      DOI: 10.3390/children4040023
      Issue No: Vol. 4, No. 4 (2017)
  • Children, Vol. 4, Pages 24: The Case for the Use of Nurse Practitioners in
           the Care of Children with Medical Complexity

    • Authors: Cheryl Samuels, Tomika Harris, Traci Gonzales, Ricardo Mosquera
      First page: 24
      Abstract: Although children with medically complex illness represent less than one percent of the total pediatric population, their health care expenditures and health care system utilization far exceed the numbers of other pediatric patients. Nurse practitioners, with their educational background focused on health care promotion and education, are uniquely qualified to reduce this inequity with cost effective care. Currently, nurse practitioners are used in a variety of health care settings and can provide acute and chronic care. Incorporating nurse practitioners at each step in the care of children with medical complexity can improve the quality of life for these children and their families, increase family satisfaction and decrease costs.
      PubDate: 2017-04-07
      DOI: 10.3390/children4040024
      Issue No: Vol. 4, No. 4 (2017)
  • Children, Vol. 4, Pages 25: Pressure Injuries in Medically Complex
           Children: A Review

    • Authors: Katherine Freundlich
      First page: 25
      Abstract: Pressure injuries are a challenging problem in the care of medically complex children. Available evidence is limited, and there are theoretical reasons to use caution before extrapolating adult data, including key differences in body composition, common locations of pressure injury, and association with medical devices. The focus of this article will be to review the definition of a pressure injury and what is known about pathophysiology, prevention, recognition, staging, and treatment of pressure injuries in children with medical complexity.
      PubDate: 2017-04-07
      DOI: 10.3390/children4040025
      Issue No: Vol. 4, No. 4 (2017)
  • Children, Vol. 4, Pages 26: A Narrative Review: Actigraphy as an Objective
           Assessment of Perioperative Sleep and Activity in Pediatric Patients

    • Authors: Nicole Conrad, Joelle Karlik, Amy Lewandowski Holley, Anna Wilson, Jeffrey Koh
      First page: 26
      Abstract: Sleep is an important component of pediatric health and is crucial for cognitive development. Actigraphy is a validated, objective tool to capture sleep and movement data that is increasingly being used in the perioperative context. The aim of this review is to present recent pediatric studies that utilized actigraphy in the perioperative period, highlight gaps in the literature, and provide recommendations for future research. A literature search was completed using OVID and PubMed databases and articles were selected for inclusion based on relevance to the topic. The literature search resulted in 13 papers that utilized actigraphic measures. Results of the review demonstrated that actigraphy has been used to identify predictors and risk factors for poor postoperative sleep, examine associations among perioperative pain and sleep patterns, and assess activity and energy expenditure in both inpatient and outpatient settings. We propose expansion of actigraphy research to include assessment of sleep via actigraphy to: predict functional recovery in pediatric populations, to study postoperative sleep in high-risk pediatric patients, to test the efficacy of perioperative interventions, and to assess outcomes in special populations for which self-report data on sleep and activity is difficult to obtain.
      PubDate: 2017-04-18
      DOI: 10.3390/children4040026
      Issue No: Vol. 4, No. 4 (2017)
  • Children, Vol. 4, Pages 27: Nasopharyngeal Carriage and Antimicrobial
           Susceptibility Patterns of Streptococcus pneumoniae among Children under
           Five in Southwest Ethiopia

    • Authors: Tiglu Gebre, Mulualem Tadesse, Dossegnaw Aragaw, Dagne Feye, Habtamu Beyene, Dinberu Seyoum, Mekidim Mekonnen
      First page: 27
      Abstract: Nasopharyngeal carriage of Streptococcus pneumoniae is found to play an important role in the development and transmission of pneumococcal diseases. In this study, we assessed the nasopharyngeal carriage, antimicrobial susceptibility patterns and associated risk factors of S. pneumoniae among children under five. A total of 361 children under five attending the outpatient department of Shanan Gibe Hospital in Jimma, Southwest Ethiopia were enrolled from June to September 2014. Nasopharyngeal specimens were collected using sterile plastic applicator rayon tipped swab and inoculated on tryptone soy agar supplemented with 5% sheep blood and 5 µg/mL gentamycin. Antimicrobial susceptibility testing was performed using the modified disk diffusion method. The overall prevalence of S. pneumoniae carriage was 43.8% (158/361) among children under five. Resistance to tetracycline, cotrimoxazole, penicillin, chloramphenicol and erythromycin was observed in 53.2% (84/158), 43.7% (69/158), 36.1% (57/158), 13.3% (21/158) and 8.9% (14/158) of isolates respectively. Multidrug resistance was seen in 17.7% (28/158) of isolates. In multivariate logistic regression analysis, children living with sibling(s) < 5 years old (adjusted odds ratio (AOR) = 1.798; 95% confidence interval (CI), 1.169–2.766) and malnutrition (AOR = 2.065; 95% CI, 1.239–3.443) were significantly associated with S. pneumoniae carriage. A high nasopharyngeal carriage of S. pneumoniae was observed among children under five in Southwest Ethiopia. There should be a strategy to prevent S. pneumoniae nasopharyngeal colonization and identify the appropriate antibiotic to the individual child.
      PubDate: 2017-04-19
      DOI: 10.3390/children4040027
      Issue No: Vol. 4, No. 4 (2017)
  • Children, Vol. 4, Pages 28: Comparison of CPAP and HFNC in Management of
           Bronchiolitis in Infants and Young Children

    • Authors: Majken Pedersen, Signe Vahlkvist
      First page: 28
      Abstract: Continuous positive airway pressure (CPAP) has been used in infants with bronchiolitis for decades. Recently, high flow nasal cannula (HFNC) therapy was introduced We conducted a retrospective study of treatment with CPAP vs. HFNC between 2013 and 2015, comparing the development in respiratory rate, fraction of inspired oxygen (FiO2) and heart rate, treatment failure, duration of treatment, and length of hospital stay. A sample size of 49 children were included. Median age was 1.9 months. Median baseline pCO2 was 7.4 kPa in both groups, respiratory rate per minute was 57 vs. 58 (CPAP vs. HFNC). Respiratory rate decreased faster in the CPAP group (p < 0.05). FiO2 decreased in the CPAP group and increased in the HFNC group during the first 12 h, whereafter it decreased in both groups. (p < 0.01). Heart rate development was similar in both groups. Twelve children (55%) changed systems from HFNC to CPAP due to disease progression. There was no difference in length of treatment, hospital stay, or transmission to intensive care unit between the groups. CPAP was more effective than HFNC in decreasing respiratory rate (RR) and FiO2. No differences were observed in length of treatment or complications. Further studies should be conducted to compare the efficacy of the two treatments of bronchiolitis, preferably through prospective randomized trials.
      PubDate: 2017-04-20
      DOI: 10.3390/children4040028
      Issue No: Vol. 4, No. 4 (2017)
  • Children, Vol. 4, Pages 29: Parent, partner, co-parent or partnership'
           The need for clarity as family systems thinking takes hold in the quest to
           motivate behavioural change

    • Authors: Chris May, Li Kheng Chai, Tracy Burrows
      First page: 29
      Abstract: Research is increasingly pointing to the importance of extending the focus of childhood obesity intervention to include fathers, fathering figures, and other members of a child’s primary parenting network. Advances in communication technology are now making it possible to achieve this aim, within current resources, using modalities such text messaging, web-based resources and apps that extend intervention to parents not in attendance at face to face interactions. However, published research is often unclear as to which parent/s they targeted or engaged with, whether interventions planned to influence behaviours and capabilities across family systems, and how this can be achieved. As childhood obesity research employing information technology to engage with family systems takes hold it is becoming important for researchers clearly describe who they engage with, what they hope to achieve with them, and the pathways of influence that they aim to activate. This paper integrates extant knowledge on family systems thinking, parenting efficacy, co-parenting, and family intervention with the way parents are represented and reported in childhood obesity research. The paper concludes with recommendations on terminology that can be used to describe parents and parenting figures in future studies.
      PubDate: 2017-04-21
      DOI: 10.3390/children4040029
      Issue No: Vol. 4, No. 4 (2017)
  • Children, Vol. 4, Pages 30: Overview of Four Functional Classification
           Systems Commonly Used in Cerebral Palsy

    • Authors: Andrea Paulson, Jilda Vargus-Adams
      First page: 30
      Abstract: Cerebral palsy (CP) is the most common physical disability in childhood. CP comprises a heterogeneous group of disorders that can result in spasticity, dystonia, muscle contractures, weakness and coordination difficulty that ultimately affects the ability to control movements. Traditionally, CP has been classified using a combination of the motor type and the topographical distribution, as well as subjective severity level. Imprecise terms such as these tell very little about what a person is able to do functionally and can impair clear communication between providers. More recently, classification systems have been created employing a simple ordinal grading system of functional performance. These systems allow a more precise discussion between providers, as well as better subject stratification for research. The goal of this review is to describe four common functional classification systems for cerebral palsy: the Gross Motor Function Classification System (GMFCS), the Manual Ability Classification System (MACS), the Communication Function Classification System (CFCS), and the Eating and Drinking Ability Classification System (EDACS). These measures are all standardized, reliable, and complementary to one another.
      PubDate: 2017-04-24
      DOI: 10.3390/children4040030
      Issue No: Vol. 4, No. 4 (2017)
  • Children, Vol. 4, Pages 15: Lifestyle Risk Factors for Weight Gain in
           Children with and without Asthma

    • Authors: Megan Jensen, Peter Gibson, Clare Collins, Jodi Hilton, Lisa Wood
      First page: 15
      Abstract: A higher proportion of children with asthma are overweight and obese compared to children without asthma; however, it is unknown whether asthmatic children are at increased risk of weight gain due to modifiable lifestyle factors. Thus, the aim of this cross-sectional study was to compare weight-gain risk factors (sleep, appetite, diet, activity) in an opportunistic sample of children with and without asthma. Non-obese children with (n = 17; age 10.7 (2.4) years) and without asthma (n = 17; age 10.8 (2.3) years), referred for overnight polysomnography, underwent measurement of lung function, plasma appetite hormones, dietary intake and food cravings, activity, and daytime sleepiness. Sleep latency (56.6 (25.5) vs. 40.9 (16.9) min, p = 0.042) and plasma triglycerides (1.0 (0.8, 1.2) vs. 0.7 (0.7, 0.8) mmol/L, p = 0.013) were significantly greater in asthmatic versus non-asthmatic children. No group difference was observed in appetite hormones, dietary intake, or activity levels (p > 0.05). Sleep duration paralleled overall diet quality (r = 0.36, p = 0.04), whilst daytime sleepiness paralleled plasma lipids (r = 0.61, p =0.001) and sedentary time (r = 0.39, p = 0.02). Disturbances in sleep quality and plasma triglycerides were evident in non-obese asthmatic children referred for polysomnography, versus non-asthmatic children. Observed associations between diet quality, sedentary behavior, and metabolic and sleep-related outcomes warrant further investigation, particularly the long-term health implications.
      PubDate: 2017-02-25
      DOI: 10.3390/children4030015
      Issue No: Vol. 4, No. 3 (2017)
  • Children, Vol. 4, Pages 16: The Role of Mindfulness in Reducing the
           Adverse Effects of Childhood Stress and Trauma

    • Authors: Robin Ortiz, Erica Sibinga
      First page: 16
      Abstract: Research suggests that many children are exposed to adverse experiences in childhood. Such adverse childhood exposures may result in stress and trauma, which are associated with increased morbidity and mortality into adulthood. In general populations and trauma-exposed adults, mindfulness interventions have demonstrated reduced depression and anxiety, reduced trauma-related symptoms, enhanced coping and mood, and improved quality of life. Studies in children and youth also demonstrate that mindfulness interventions improve mental, behavioral, and physical outcomes. Taken together, this research suggests that high-quality, structured mindfulness instruction may mitigate the negative effects of stress and trauma related to adverse childhood exposures, improving short- and long-term outcomes, and potentially reducing poor health outcomes in adulthood. Future work is needed to optimize implementation of youth-based mindfulness programs and to study long-term outcomes into adulthood.
      PubDate: 2017-02-28
      DOI: 10.3390/children4030016
      Issue No: Vol. 4, No. 3 (2017)
  • Children, Vol. 4, Pages 17: Differential Influences of Parenting
           Dimensions and Parental Physical Abuse during Childhood on Overweight and
           Obesity in Adolescents

    • Authors: Thomas Mößle, Sören Kliem, Anna Lohmann, Marie Bergmann, Dirk Baier
      First page: 17
      Abstract: Besides other explanatory variables, parenting styles and parental violence might also be responsible for setting a path towards overweight/obesity in childhood. While this association has consistently been observed for adults, findings for adolescents still remain scarce and inconsistent. Therefore, the goal of this study is to add evidence on this topic for children and adolescents. Analyses are based on a sample of 1729 German, ninth-grade students. To analyze associations between parenting dimensions and weight status, non-parametric conditional inference trees were applied. Three gender-specific pathways for a heightened risk of overweight/obesity were observed: (1) female adolescents who report having experienced severe parental physical abuse and medium/high parental warmth in childhood; (2) male adolescents who report having experienced low or medium parental monitoring in childhood; and (3) this second pathway for male adolescents is more pronounced if the families receive welfare. The importance of promoting parenting styles characterized by warmth and a lack of physical abuse is also discussed. This is one of only a few studies examining the association of parenting dimensions/parental physical abuse and weight status in adolescence. Future studies should include even more parenting dimensions, as well as parental physical abuse levels, in order to detect and untangle gender-specific effects on weight status.
      PubDate: 2017-03-07
      DOI: 10.3390/children4030017
      Issue No: Vol. 4, No. 3 (2017)
  • Children, Vol. 4, Pages 18: Incorporating Hypnosis into Pediatric Clinical

    • Authors: Robert Pendergrast
      First page: 18
      Abstract: Increasing numbers of licensed health professionals who care for children have been trained in clinical hypnosis. The evidence base for the safety and efficacy of this therapeutic approach in a wide variety of conditions is also growing. Pediatricians and other health professionals who have received training may wish to apply these skills in appropriate clinical scenarios but still may be unsure of the practical matters of how to incorporate this skill-set into day to day practice. Moreover, the practical application of such skills will take very different forms depending on the practice setting, types of acute or chronic conditions, patient and family preferences, and the developmental stages of the child or teen. This article reviews the application of pediatric clinical hypnosis skills by describing the use of hypnotic language outside of formal trance induction, by describing natural trance states that occur in children and teens in healthcare settings, and by describing the process of planning a clinical hypnosis encounter. It is assumed that this article does not constitute training in hypnosis or qualify its readers for the application of such skills; rather, it may serve as a practical guide for those professionals who have been so trained, and may serve to inform other professionals what to expect when referring a patient for hypnotherapy. The reader is referred to specific training opportunities and organizations.
      PubDate: 2017-03-16
      DOI: 10.3390/children4030018
      Issue No: Vol. 4, No. 3 (2017)
  • Children, Vol. 4, Pages 8:
           Pediatric Mortality in a Rural Tertiary Care Center in Liberia

    • Authors: Carmelle Tsai, Camila Walters, John Sampson, Francis Kateh, Mary Chang
      First page: 8
      Abstract: Liberia is a low‐income country in West Africa that has faced significant challenges, including a civil war and the recent Ebola epidemic. Little data exists on the more current post‐war and pre‐Ebola trends of child health in Liberia in the rural setting. This study is a retrospective chart review of pediatric mortality in 2013 at a rural tertiary care center in Liberia, 10 years post‐war. From January 2013 to December 2013, there were 50 pediatric deaths, or 5.4% of the 920 total pediatric admissions. The most common cause of neonatal death was sepsis, and the most common cause of death under five years of age was malaria. The majority (82.0%) of the deaths were in children under five. Pediatric mortality at this hospital was similar to other reported mortality six years post‐war, and lower than that reported immediately post‐war. Neonatal sepsis and malaria are two significant causes of pediatric mortality in this community and, therefore, further efforts to decrease childhood mortality should focus on these causes.
      PubDate: 2017-01-30
      DOI: 10.3390/children4020008
      Issue No: Vol. 4, No. 2 (2017)
  • Children, Vol. 4, Pages 9: Evidence-Based Psychological Interventions for
           the Management of Pediatric Chronic Pain: New Directions in Research and
           Clinical Practice

    • Authors: Rachael Coakley, Tessa Wihak
      First page: 9
      Abstract: Over the past 20 years our knowledge about evidence-based psychological interventions for pediatric chronic pain has dramatically increased. Overall, the evidence in support of psychological interventions for pediatric chronic pain is strong, demonstrating positive psychological and behavioral effects for a variety of children with a range of pain conditions. However, wide scale access to effective psychologically-based pain management treatments remains a challenge for many children who suffer with pain. Increasing access to care and reducing persistent biomedical biases that inhibit attainment of psychological services are a central focus of current pain treatment interventions. Additionally, as the number of evidence-based treatments increase, tailoring treatments to a child or family’s particular needs is increasingly possible. This article will (1) discuss the theoretical frameworks as well as the specific psychological skills and strategies that currently hold promise as effective agents of change; (2) review and summarize trends in the development of well-researched outpatient interventions over the past ten years; and (3) discuss future directions for intervention research on pediatric chronic pain.
      PubDate: 2017-02-04
      DOI: 10.3390/children4020009
      Issue No: Vol. 4, No. 2 (2017)
  • Children, Vol. 4, Pages 10:
           Acceptance and Commitment Therapy for Pediatric 
           Chronic Pain: Theory and Application

    • Authors: Melissa Pielech, Kevin Vowles, Rikard Wicksell
      First page: 10
      Abstract: Acceptance and Commitment Therapy (ACT) is a third wave behavior therapy approach which aims to increase engagement in activities that bring meaning, vitality, and value to the lives of individuals experiencing persistent pain, discomfort, or distress. This goal is particularly relevant when these aversive experiences cannot be effectively avoided or when avoidance efforts risk their exacerbation, all of which may be common experiences in children and adolescents with chronic pain conditions. The primary aim of the present paper is to review and summarize the extant literature on the application, utility, and evidence for using ACT with pediatric chronic pain populations by: (1) defining the theoretical assumptions of the ACT model; (2) summarizing research study findings and relevant measures from the published literature; and (3) critically discussing the strengths, limitations and areas in need of further development.
      PubDate: 2017-01-30
      DOI: 10.3390/children4020010
      Issue No: Vol. 4, No. 2 (2017)
  • Children, Vol. 4, Pages 11: Parent and Child Report of Pain and Fatigue in
           JIA: Does Disagreement between Parent and Child Predict Functional

    • Authors: Amy Gaultney, Maggie Bromberg, Mark Connelly, Tracy Spears, Laura Schanberg
      First page: 11
      Abstract: While previous research in juvenile idiopathic arthritis (JIA) has identified discrepancy between parent and child perception of disease-related symptoms such as pain, the significance and impact of this disagreement has not been characterized. We examined the extent to which parent-child discordance in JIA symptom ratings are associated with child functional outcomes. Linear regression and mixed effects models were used to test the effects of discrepancy in pain and fatigue ratings on functional outcomes in 65 dyads, consisting of youth with JIA and one parent. Results suggested that children reported increased activity limitations and negative mood when parent and child pain ratings were discrepant, with parent rated child pain much lower. Greater discrepancy in fatigue ratings was also associated with more negative mood, whereas children whose parent rated child fatigue as moderately lower than the child experienced decreased activity limitations relative to dyads who agreed closely on fatigue level. Implications of these results for the quality of life and treatment of children with JIA are discussed.
      PubDate: 2017-01-30
      DOI: 10.3390/children4020011
      Issue No: Vol. 4, No. 2 (2017)
  • Children, Vol. 4, Pages 12: Medical Yoga Therapy

    • Authors: Ina Stephens
      First page: 12
      Abstract: Medical yoga is defined as the use of yoga practices for the prevention and treatment of  medical conditions. Beyond the physical elements of yoga, which are important and effective for  strengthening  the  body,  medical  yoga  also  incorporates  appropriate  breathing  techniques,  mindfulness, and meditation in order to achieve the maximum benefits. Multiple studies have  shown that yoga can positively impact the body in many ways, including helping to regulate blood  glucose levels, improve musculoskeletal ailments and keeping the cardiovascular system in tune. It  also has been shown to have important psychological benefits, as the practice of yoga can help to  increase mental energy and positive feelings, and decrease negative feelings of aggressiveness,  depression and anxiety.
      PubDate: 2017-02-10
      DOI: 10.3390/children4020012
      Issue No: Vol. 4, No. 2 (2017)
  • Children, Vol. 4, Pages 13: Do Mothers Benefit from a Child-Focused
           Cognitive Behavioral Treatment (CBT) for Childhood Functional Abdominal
           Pain? A Randomized Controlled Pilot Trial

    • Authors: Claudia Calvano, Martina Groß, Petra Warschburger
      First page: 13
      Abstract: While the efficacy of cognitive-behavioral treatment (CBT) approaches for childhood functional abdominal pain (FAP) is well-established for child outcomes, only a few studies have reported on parent-specific outcomes. This randomized controlled pilot trial analyzed effects of a group CBT on maternal variables (i.e., pain-related behavior, worries and self-efficacy, as well as general psychosocial strain). Methods: The sample constituted of 15 mothers in the intervention group (IG) and 14 mothers in the waitlist control group (WLC). Outcome measures were assessed pre-treatment, post-treatment and at three months follow-up. Results: Analyses revealed significant, large changes in maladaptive maternal reactions related to the child’s abdominal pain in the IG compared to the WLC—i.e., reduced attention (d = 0.95), medical help-seeking (d = 0.92), worries (d = 1.03), as well as a significant increase in behaviors that encourage the child’s self-management (d = 1.03). In addition, maternal self-efficacy in dealing with a child’s pain significantly increased in the IG as well (d = 0.92). Treatment effects emerged post-treatment and could be maintained until three months follow-up. There were no effects on general self-efficacy and maternal quality of life. Conclusion: While these results are promising, and underline the efficacy of the CBT approach for both the child and mothers, further studies, including long-term follow-ups, are warranted.
      PubDate: 2017-02-15
      DOI: 10.3390/children4020013
      Issue No: Vol. 4, No. 2 (2017)
  • Children, Vol. 4, Pages 14: Neighborhood Safety and Major Depressive
           Disorder in a National Sample of Black Youth; Gender by Ethnic Differences

    • Authors: Shervin Assari, Cleopatra Caldwell
      First page: 14
      Abstract: Adolescence is a developmental period marked by increased stress, especially among Black youth. In addition to stress related to their developmental transition, social factors such as a perceived unsafe neighborhood impose additional risks. We examined gender and ethnic differences in the association between perceived neighborhood safety and major depressive disorder (MDD) among a national sample of Black youth. We used data from the National Survey of American Life - Adolescents (NSAL-A), 2003–2004. In total, 1170 Black adolescents entered the study. This number was composed of 810 African American and 360 Caribbean Black youth (age 13 to 17). Demographic factors, perceived neighborhood safety, and MDD (Composite International Diagnostic Interview, CIDI) were measured. Logistic regressions were used to test the association between neighborhood safety and MDD in the pooled sample, as well as based on ethnicity by gender groups. In the pooled sample of Black youth, those who perceived their neighborhoods to be unsafe were at higher risk of MDD (Odds Ratio [OR] = 1.25; 95% Confidence Interval [CI] = 1.02-1.51). The perception that one’s neighborhood is unsafe was associated with a higher risk of MDD among African American males (OR=1.41; 95% CI = 1.03–1.93) but not African American females or Caribbean Black males and females. In conclusion, perceived neighborhood safety is not a universal psychological determinant of MDD across ethnic by gender groups of Black youth; however, policies and programs that enhance the sense of neighborhood safety may prevent MDD in male African American youth.
      PubDate: 2017-02-23
      DOI: 10.3390/children4020014
      Issue No: Vol. 4, No. 2 (2017)
  • Children, Vol. 4, Pages 1: Environmental Factors Affecting Growth and
           Occurrence of Testicular Cancer in Childhood: An Overview of the Current
           Epidemiological Evidence

    • Authors: Fabrizio Giannandrea, Stefania Fargnoli
      First page: 1
      Abstract: Testicular cancer (TC) is the most frequently occurring malignancy among adolescents and young men aged 15–34 years. Although incidence of TC has been growing over the past 40 years in several western countries, the explanations for this increase still remain uncertain. It has been postulated that early life exposure to numerous occupational and environmental estrogenic chemicals, such as endocrine-disrupting chemicals (EDCs), may play a contributing role in the etiology of TC, but the subject is still open to additional investigation. Recently, it has also been suggested that prenatal and postnatal environmental exposures associated with child growth and development might also be involved in TC progression. This review of current epidemiological studies (2000–2015) aims to identify environmental factors associated with TC, with a particular focus on infancy and childhood factors that could constitute a risk for disease development. It may also contribute towards recognizing gaps in knowledge and recent research requirements for TC, and to point out possible interactions between child growth and development in relation to prenatal and postnatal environmental exposures.
      PubDate: 2017-01-05
      DOI: 10.3390/children4010001
      Issue No: Vol. 4, No. 1 (2017)
  • Children, Vol. 4, Pages 2: The Development of Urease Inhibitors: What
           Opportunities Exist for Better Treatment of Helicobacter pylori Infection
           in Children?

    • Authors: Sherif Hassan, Miroslava Šudomová
      First page: 2
      Abstract: Stomach infection with Helicobacter pylori (H. pylori) causes severe gastroduodenal diseases in a large number of patients worldwide. The H. pylori infection breaks up in early childhood, persists lifelong if not treated, and is associated with chronic gastritis and an increased risk of peptic ulcers and gastric cancer. In recent years, the problem of drug-resistant strains has become a global concern that makes the treatment more complicated and the infection persistent at higher levels when the antibiotic treatment is stopped. Such problems have led to the development of new strategies to eradicate an H. pylori infection. Currently, one of the most important strategies for the treatment of H. pylori infection is the use of urease inhibitors. Despite the fact that large numbers of molecules have been shown to exert potent inhibitory activity against H. pylori urease, most of them were prevented from being used in vivo and in clinical trials due to their hydrolytic instability, toxicity, and appearance of undesirable side effects. Therefore, it is crucial to focus attention on the available opportunities for the development of urease inhibitors with suitable pharmacokinetics, high hydrolytic stability, and free toxicological profiles. In this commentary, we aim to afford an outline on the current status of the use of urease inhibitors in the treatment of an H. pylori infection, and to discuss the possibility of their development as effective drugs in clinical trials.
      PubDate: 2017-01-04
      DOI: 10.3390/children4010002
      Issue No: Vol. 4, No. 1 (2017)
  • Children, Vol. 4, Pages 3: Impact of a Transition from Respiratory Virus
           Shell Vial to Multiplex PCR on Clinical Outcomes and Cost in Hospitalized

    • Authors: Pui-Ying Iroh Tam, Lei Zhang, Zohara Cohen
      First page: 3
      Abstract: While respiratory virus PCR panel (RVPP) is more expensive than shell vial (SV) cell culture, it has been shown to reduce unnecessary diagnostic procedures, decrease the inappropriate use of antimicrobials, and shorten the hospital length of stay (LOS). We therefore hypothesized that, for hospitalized children, RVPP would be associated with improved clinical outcomes but higher hospital charges than SV cell culture. We performed a retrospective cohort study of hospitalized children. Multivariate analysis was performed, and p-values were calculated. Respiratory virus testing was collected in a total of 1625 inpatient encounters, of which 156 were tested positive by RVPP (57.7%) and 112 were tested positive by SV (11.1%, p < 0.05). Excluding human rhinovirus (HRV) and human metapneumovirus (hMPV) from the analysis, patients with a positive test from SV had more comorbidities (p = 0.04) and higher mortality (p = 0.008). Patients with a positive test from RVPP had shorter LOS (p = 0.0503). Hospital charges for patients with a positive test from RVPP were lower, but not significantly so. When a multivariate analysis was performed, there were no statistically significant differences in comorbidities, mortality, LOS, or median hospital charges between those patients with a positive SV and those with a positive RVPP. Although testing with RVPP significantly increased the detection of respiratory viruses, clinical outcomes remained comparable to those tested with SV, however RVPP was found to not be associated with higher long-term hospital costs.
      PubDate: 2017-01-07
      DOI: 10.3390/children4010003
      Issue No: Vol. 4, No. 1 (2017)
  • Children, Vol. 4, Pages 4: Acknowledgement to Reviewers of Children in

    • Authors: Children Editorial Office
      First page: 4
      Abstract: The editors of Children would like to express their sincere gratitude to the following reviewers  for assessing manuscripts in 2016.[...]
      PubDate: 2017-01-13
      DOI: 10.3390/children4010004
      Issue No: Vol. 4, No. 1 (2017)
  • Children, Vol. 4, Pages 5: Body Weight Status and Dietary Intakes of Urban
           Malay Primary School Children: Evidence from the Family Diet Study

    • Authors: Wai Yang, Tracy Burrows, Lesley MacDonald-Wicks, Lauren Williams, Clare Collins, Winnie Chee, Kim Colyvas
      First page: 5
      Abstract: Malaysia is experiencing a rise in the prevalence of childhood obesity. Evidence for the relationship between dietary intake and body weight among Malaysian children is limited, with the impact of energy intake misreporting rarely being considered. This paper describes the dietary intakes of urban Malay children in comparison to national recommendations and by weight status. This cross-sectional Family Diet Study (n = 236) was conducted in five national primary schools in Malaysia (August 2013–October 2014). Data on socio-demographics, anthropometrics, 24-h dietary recalls, and food habits were collected from Malay families, consisting of a child aged 8 to 12 years and their main caregiver(s). Multivariable analyses were used to assess dietary intake-body weight relationships. The plausibility of energy intake was determined using the Black and Cole method. Approximately three in 10 Malay children were found to be overweight or obese. The majority reported dietary intakes less than national recommendations. Children with obesity had the lowest energy intakes relative to body weight (kcal/kg) compared to children in other weight categories (F = 36.21, p < 0.001). A positive moderate correlation between energy intake and weight status was identified (r = 0.53, p < 0.001) after excluding energy intake mis-reporters (n = 95), highlighting the need for the validation of dietary assessment in obesity-related dietary research in Malaysia.
      PubDate: 2017-01-20
      DOI: 10.3390/children4010005
      Issue No: Vol. 4, No. 1 (2017)
  • Children, Vol. 4, Pages 6: Pediatric Exercise Testing: Value and
           Implications of Peak Oxygen Uptake

    • Authors: Paolo Pianosi, Robert Liem, Robert McMurray, Frank Cerny, Bareket Falk, Han Kemper
      First page: 6
      Abstract: Peak oxygen uptake (peak V ˙ O 2 ) measured by clinical exercise testing is the benchmark for aerobic fitness. Aerobic fitness, estimated from maximal treadmill exercise, is a predictor of mortality in adults. Peak V ˙ O 2 was shown to predict longevity in patients aged 7–35 years with cystic fibrosis over 25 years ago. A surge of exercise studies in young adults with congenital heart disease over the past decade has revealed significant prognostic information. Three years ago, the first clinical trial in children with pulmonary arterial hypertension used peak V ˙ O 2 as an endpoint that likewise delivered clinically relevant data. Cardiopulmonary exercise testing provides clinicians with biomarkers and clinical outcomes, and researchers with novel insights into fundamental biological mechanisms reflecting an integrated physiological response hidden at rest. Momentum from these pioneering observations in multiple disease states should impel clinicians to employ similar methods in other patient populations; e.g., sickle cell disease. Advances in pediatric exercise science will elucidate new pathways that may identify novel biomarkers. Our initial aim of this essay is to highlight the clinical relevance of exercise testing to determine peak V ˙ O 2 , and thereby convince clinicians of its merit, stimulating future clinical investigators to broaden the application of exercise testing in pediatrics.
      PubDate: 2017-01-24
      DOI: 10.3390/children4010006
      Issue No: Vol. 4, No. 1 (2017)
  • Children, Vol. 4, Pages 7: Time to Consider Moving Beyond Exclusive
           Breastfeeding in Southern Africa

    • Authors: Janet Wojcicki
      First page: 7
      Abstract: While there have been considerable advances in the reduction of mother to child transmission of HIV (MTCT) in sub-Saharan Africa with the advance of anti-retroviral therapies (ART), there remain challenges in the late postpartum period.  Structural issues including food insecurity and stigma make better maternal ART adherence and exclusive breastfeeding unreachable for some women. There are no other scientifically researched feeding options as there have been few studies on different types of mixed feeding practices and risk of HIV infection. Additional studies are warranted to assess detailed feeding practices in HIV exposed infants in relation to clinical outcomes.
      PubDate: 2017-01-24
      DOI: 10.3390/children4010007
      Issue No: Vol. 4, No. 1 (2017)
  • Children, Vol. 3, Pages 17: Malnutrition Affects the Urban-Poor
           Disproportionately: A Study of Nigerian Urban Children of Different
           Socio-Economic Statuses

    • Authors: Chukwunonso Ejike
      First page: 17
      Abstract: Income inequality within the same place of residence may impact the nutritional status of children. This study therefore investigated the impact of income inequality on the nutritional status of children living in the same place of residence, using anthropometric tools. Children in four schools (Schools 1–4) within the vicinity of a housing estate in Umuahia, Nigeria, that charge fees making them ‘very affordable’, ‘affordable’, ‘expensive’ and ‘very expensive’, respectively, were recruited for the study. Thinness, overweight and obesity were defined using the Cole et al. reference standards. Thinness was present in 10.4% (13.0% of boys, 7.6% of girls); 20.4% (15.6% of boys, 27.3% of girls; and 0.7% (1.4% of boys, 0.0% of girls) of children in Schools 1–3, respectively; but absent in school 4. Only 3.7% (1.4% of boys, 6.1% of girls) and 5.6% (6.3% of boys, 4.5% of girls) of children in Schools 1 and 2, respectively, were overweight/obese. Conversely, 25.8% (18.9% of boys, 32.5% of girls) and 41.6% (38.8% of boys, 45.3% of girls) of children in Schools 3 and 4, respectively, were overweight/obese. The urban-poor (School 2) are clearly affected by malnutrition disproportionately.
      PubDate: 2016-09-23
      DOI: 10.3390/children3040017
      Issue No: Vol. 3, No. 4 (2016)
  • Children, Vol. 3, Pages 18: Reflux Incidence among Exclusively Breast Milk
           Fed Infants: Differences of Feeding at Breast versus Pumped Milk

    • Authors: Jennifer Yourkavitch, Sabrina Zadrozny, Valerie Flax
      First page: 18
      Abstract: The practice of feeding infants expressed breast milk is increasing in the United States, but the impacts on infant and maternal health are still understudied. This study examines the monthly incidence of regurgitation (gastro-esophageal reflux) in exclusively breast milk fed infants from ages two to six months. Among infants whose mothers participated in the Infant Feeding Practices II Study (IFPS II; 2005–2007), data on reflux and feeding mode were collected by monthly questionnaires. A longitudinal, repeated measures analysis was used, with feeding mode lagged by one month in order to compare reflux incidence among infants fed directly at the breast to infants receiving pumped breast milk. Mothers in both feeding groups had similar characteristics, although a greater proportion feeding at least some pumped milk were primiparous. The number of exclusively breastfed infants decreased steadily between months 2 and 6, although the proportion fed at the breast remained similar over time. An association between feeding mode and reflux incidence was not found; however, the analyses were limited by a small number of reported reflux cases. More studies are needed to further explain the relationship between different feeding modes and infant reflux.
      PubDate: 2016-10-14
      DOI: 10.3390/children3040018
      Issue No: Vol. 3, No. 4 (2016)
  • Children, Vol. 3, Pages 19: Age-Related Effect of Viral-Induced Wheezing
           in Severe Prematurity

    • Authors: Geovanny Perez, Amisha Jain, Bassem Kurdi, Rosemary Megalaa, Krishna Pancham, Shehlanoor Huseni, Natalia Isaza, Carlos Rodriguez-Martinez, Mary Rose, Dinesh Pillai, Gustavo Nino
      First page: 19
      Abstract: Premature children are prone to severe viral respiratory infections in early life, but the age at which susceptibility peaks and disappears for each pathogen is unclear. Methods: A retrospective analysis was performed of the age distribution and clinical features of acute viral respiratory infections in full-term and premature children, aged zero to seven years. Results: The study comprised of a total of 630 hospitalizations (n = 580 children). Sixty-seven percent of these hospitalizations occurred in children born full-term (>37 weeks), 12% in preterm (32–37 weeks) and 21% in severely premature children (<32 weeks). The most common viruses identified were rhinovirus (RV; 60%) and respiratory syncytial virus (RSV; 17%). Age-distribution analysis of each virus identified that severely premature children had a higher relative frequency of RV and RSV in their first three years, relative to preterm or full-term children. Additionally, the probability of RV- or RSV-induced wheezing was higher overall in severely premature children less than three years old. Conclusions: Our results indicate that the vulnerability to viral infections in children born severely premature is more specific for RV and RSV and persists during the first three years of age. Further studies are needed to elucidate the age-dependent molecular mechanisms that underlie why premature infants develop RV- and RSV-induced wheezing in early life.
      PubDate: 2016-10-20
      DOI: 10.3390/children3040019
      Issue No: Vol. 3, No. 4 (2016)
  • Children, Vol. 3, Pages 20: International Medical Collaboration: Lessons
           from Cuba

    • Authors: Mauro Castelló González, Reinaldo Pons Vásquez, David Rodriguez Bencomo, Imti Choonara
      First page: 20
      Abstract: Over 50,000 Cuban health professionals are currently working overseas in 67 different countries. They work in conjunction with local health professionals. The majority work in primary care in deprived areas. The aim is to reduce morbidity and mortality but also improve health in the long term by training local health professionals, and building both institutions and a structure to deliver health care alongside educating the local population. Cuba is a small, middle-income country. It has, however, made a significant international contribution in relation to medical collaboration. Cuba’s international collaboration is based on the principles of social justice and equity for all. It has set an example for other countries to emulate.
      PubDate: 2016-10-18
      DOI: 10.3390/children3040020
      Issue No: Vol. 3, No. 4 (2016)
  • Children, Vol. 3, Pages 21: Attachment and Chronic Pain in Children and

    • Authors: Theresa Donnelly, Tiina Jaaniste
      First page: 21
      Abstract: Although attachment theory is not new, its theoretical implications for the pediatric chronic pain context have not been thoroughly considered, and the empirical implications and potential clinical applications are worth exploring. The attachment framework broadly focuses on interactions between a child’s developing self-regulatory systems and their caregiver’s responses. These interactions are believed to create a template for how individuals will relate to others in the future, and may help account for normative and pathological patterns of emotions and behavior throughout life. This review outlines relevant aspects of the attachment framework to the pediatric chronic pain context. The theoretical and empirical literature is reviewed regarding the potential role of attachment-based constructs such as vulnerability and maintaining factors of pediatric chronic pain. The nature and targets of attachment-based pediatric interventions are considered, with particular focus on relevance for the pediatric chronic pain context. The potential role of attachment style in the transition from acute to chronic pain is considered, with further research directions outlined.
      PubDate: 2016-10-25
      DOI: 10.3390/children3040021
      Issue No: Vol. 3, No. 4 (2016)
  • Children, Vol. 3, Pages 22: Mothers’ Use of Social Media to Inform Their
           Practices for Pumping and Providing Pumped Human Milk to Their Infants

    • Authors: Rei Yamada, Kathleen Rasmussen, Julia Felice
      First page: 22
      Abstract: Despite U.S. mothers’ wide adoption of pumps and bottles to provide human milk (HM) to their infants, mothers lack comprehensive, evidence-based guidelines for these practices. Thus, some women use online sources to seek information from each other. We aimed to characterize the information women sought online about pumping. We used data provided by ~25,000 women in an open cohort within a discussion forum about parenting. We examined 543 posts containing questions about providing pumped HM cross-sectionally and longitudinally in three time intervals: prenatal, 0 through 1.5 months postpartum, and 1.5 to 4.5 months postpartum. We used thematic analysis with Atlas.ti to analyze the content of posts. During pregnancy, women commonly asked questions about how and where to obtain pumps, both out-of-pocket and through insurance policies. Between 0–1.5 months postpartum, many mothers asked about how to handle pumped HM to ensure its safety as fed. Between 1.5–4.5 months postpartum, mothers sought strategies to overcome constraints to pumping both at home and at work and also asked about stopping pumping and providing their milk. Women’s questions related to ensuring the safety of pumped HM represent information women need from health professionals, while their questions related to obtaining pumps suggest that women may benefit from clearer guidelines from their insurance providers. The difficulties women face at home and at work identify avenues through which families and employers can support women to meet their goals for providing HM.
      PubDate: 2016-10-31
      DOI: 10.3390/children3040022
      Issue No: Vol. 3, No. 4 (2016)
  • Children, Vol. 3, Pages 23: Compliance of Parenting Magazines
           Advertisements with American Academy of Pediatrics Recommendations

    • Authors: Michael Pitt, Jennifer Berger, Karen Sheehan
      First page: 23
      Abstract: This study examined 3218 advertisements from the two parenting magazines with highest circulation in the United States. The authors compared each advertisement for a product for use by children, against all the published recommendations of the American Academy of Pediatrics (AAP) on topics such as toy safety, helmet use, age-defined choking hazards, infant sleep safety, and others. Any advertisement with images or products which went against a published AAP recommendation was deemed as non-adherence and was categorized according to the statement it contradicted. Nearly one in six (15.7%) of the advertisements contained example(s) of non-adherence to AAP recommendations, with twelve categories of offense represented. Categories ranked by overall share from most to least include: non-Food and Drug Administration (FDA) approved medical treatments, age-defined choking hazards, vitamins, cold medicine, formula, oral care, screen time, toy/playground safety, infant sleep, nutrition, water safety, and fall risk. Given that repeated exposure to messages in advertisements has been associated with changes in health decision-making, and parents often turn to parenting magazines for advice and ideas regarding their children, the publishers might consider screening the content in order to prevent confusing and potentially dangerous messages from being disseminated in the media.
      PubDate: 2016-11-01
      DOI: 10.3390/children3040023
      Issue No: Vol. 3, No. 4 (2016)
  • Children, Vol. 3, Pages 24: Practicalities and Research Considerations for
           Conducting Childhood Obesity Prevention Interventions with Families

    • Authors: Philip Morgan, Rachel Jones, Clare Collins, Kylie Hesketh, Myles Young, Tracy Burrows, Anthea Magarey, Helen Brown, Trina Hinkley, Rebecca Perry, Leah Brennan, Alison Spence, Karen Campbell
      First page: 24
      Abstract: Internationally, childhood obesity is a major public health concern. Given the established difficulties in treating obesity, designing and evaluating effective obesity prevention interventions are research priorities. As parents play a crucial role in establishing positive health behaviours in children, they are a key target for child obesity prevention programs. However, recruiting and engaging parents in such interventions can be a considerable challenge for researchers and practitioners. Members of the ‘Parenting, Child Behaviour and Well-being’ stream of the Australasian Child and Adolescent Obesity Research Network (ACAORN) have considerable and varied expertise in conducting such interventions and can provide insights into addressing these challenges. This paper aims to highlight considerations regarding the design, implementation, and evaluation of obesity prevention interventions with families and provide practical insights and recommendations for researchers and practitioners conducting family-based research in this area. Case studies of three family-based interventions conducted by ACAORN members are highlighted to provide examples and contextualise the recommendations proposed.
      PubDate: 2016-11-08
      DOI: 10.3390/children3040024
      Issue No: Vol. 3, No. 4 (2016)
  • Children, Vol. 3, Pages 25: The Potential Impact of Reliance on Expressed
           Milk Feeding for Maternal and Child Health

    • Authors: Genevieve Becker
      First page: 25
      Abstract: Human milk has nourished human babies for thousands of years and its importance is widely recognised.[...]
      PubDate: 2016-11-03
      DOI: 10.3390/children3040025
      Issue No: Vol. 3, No. 4 (2016)
  • Children, Vol. 3, Pages 26: Beyond Acute Pain: Understanding Chronic Pain
           in Infancy

    • Authors: Miranda DiLorenzo, Rebecca Pillai Riddell, Liisa Holsti
      First page: 26
      Abstract: This topical review presents the current challenges in defining chronic pain in infants, summarizes evidence from animal and human infant studies regarding the biological processes necessary for chronic pain signaling, and presents observational/experiential evidence from clinical experts. A literature search of four databases (CINAHL, EMBASE, PsycINFO, and MEDLINE) was conducted, along with hand searches of reference lists. Evidence from animal studies suggest that important neurophysiological mechanisms, such as the availability of key neurotransmitters needed for maintenance of chronic pain, may be immature or absent in the developing neonate. In some cases, human infants may be significantly less likely to develop chronic pain. However, evidence also points to altered pain perception, such as allodynia and hyperalgesia, with significant injury. Moreover, clinicians and parents in pediatric intensive care settings describe groups of infants with altered behavioral responses to repeated or prolonged painful stimuli, yet agreement on a working definition of chronic pain in infancy remains elusive. While our understanding of infant chronic pain is still in the rudimentary stages, a promising avenue for the future assessment of chronic pain in infancy would be to develop a clinical tool that uses both neurophysiological approaches and clinical perceptions already presented in the literature.
      PubDate: 2016-11-09
      DOI: 10.3390/children3040026
      Issue No: Vol. 3, No. 4 (2016)
  • Children, Vol. 3, Pages 27: Probiotics as Dietary Supplements for
           Eradication of Helicobacter pylori Infection in Children: A Role Beyond

    • Authors: Sherif Hassan, Miroslava Šudomová
      First page: 27
      Abstract: For decades, treatment of infectious diseases has been a strong focus of interest, for both researchers and healthcare providers. Chronic infection with Helicobacter pylori (H. pylori) has been reported to be associated with several diseases, such as ulcer disease, gastric adenocarcinoma and mucosa-associated lymphoid tissue (MALT) lymphoma. Infection with H. pylori is generally acquired during childhood and can persist indefinitely, if not treated systematically. Unfortunately, although several strategies have shown high efficacy results, treatment of the H. pylori infection fails in about 25%–30% of infected children. One main reason for this is due to the extensive use of antibiotics, which has created antibiotic resistance, associated with other adverse effects as well. Therefore, it is crucial to find alternative strategies to combat this resistance, and increase treatment efficacy results. Probiotics, which are live microorganisms that are orally administrated, have been found to be a useful regimen in the treatment of the H. pylori infection in children. Their use as a dietary supplement alone, or in combination with antibiotics, resulted in reduced side effects and higher efficacy rates of the H. pylori infection in children. Some probiotics can be considered an adjunctive treatment, especially when eradication of the H. pylori infection fails during initial treatment, and to help reduce adverse effects. However, the evidence of the beneficial role of probiotics is limited due to the small number of clinical trials that have been conducted and heterogeneity across studies in strains and dosage. Additionally, no investigations have been carried out in asymptomatic children. Therefore, large well-conducted studies are needed to evaluate the efficacy and safety of probiotics as an adjuvant therapy of the H. pylori infection.
      PubDate: 2016-11-10
      DOI: 10.3390/children3040027
      Issue No: Vol. 3, No. 4 (2016)
  • Children, Vol. 3, Pages 28: Child Feeding and Parenting Style Outcomes and
           Composite Score Measurement in the ‘Feeding Healthy Food to Kids
           Randomised Controlled Trial’

    • Authors: Kerith Duncanson, Tracy Burrows, Clare Collins
      First page: 28
      Abstract: Child feeding practices and parenting style each have an impact on child dietary intake, but it is unclear whether they influence each other or are amenable to change. The aims of this study were to measure child feeding and parenting styles in the Feeding Healthy Food to Kids (FHFK) Randomized Controlled Trial (RCT) and test a composite child feeding score and a composite parenting style score. Child feeding and parenting style data from 146 parent-child dyads (76 boys, aged 2.0–5.9 years) in the FHFK study were collected over a 12-month intervention. Parenting style was measured using parenting questions from the Longitudinal Study of Australian Children and the Child Feeding Questionnaire (CFQ) was used to measure child feeding practices. Data for both measures were collected at baseline, 3 and 12 months and then modelled to develop a composite child feeding score and a parenting score. Multivariate mixed effects linear regression was used to measure associations between variables over time. All child feeding domains from the CFQ were consistent between baseline and 12 months (p < 0.001), except for monitoring (0.12, p = 0.44). All parenting style domain scores were consistent over 12 months (p < 0.001), except for overprotection (0.22, p = 0.16). A significant correlation (r = 0.42, p < 0.0001) existed between child feeding score and parenting style score within the FHFK RCT. In conclusion, composite scores have potential applications in the analysis of relationships between child feeding and dietary or anthropometric data in intervention studies aimed at improving child feeding or parenting style. These applications have the potential to make a substantial contribution to the understanding of child feeding practices and parenting style, in relation to each other and to dietary intake and health outcomes amongst pre-school aged children.
      PubDate: 2016-11-10
      DOI: 10.3390/children3040028
      Issue No: Vol. 3, No. 4 (2016)
  • Children, Vol. 3, Pages 29: “What Does Weight Have to Do with It?”
           Parent Perceptions of Weight and Pain in a Pediatric Chronic Pain

    • Authors: Keri Hainsworth, Kristen Jastrowski Mano, Alison Stoner, Kim Anderson Khan, Renee Ladwig, W. Davies, Ellen Defenderfer, Steven Weisman
      First page: 29
      Abstract: Tailored pain management strategies are urgently needed for youth with co-occurring chronic pain and obesity; however, prior to developing such strategies, we need to understand parent perspectives on weight in the context of pediatric chronic pain. Participants in this study included 233 parents of patients presenting to a multidisciplinary pediatric chronic pain clinic. Parents completed a brief survey prior to their child’s initial appointment; questions addressed parents’ perceptions of their child’s weight, and their perceptions of multiple aspects of the relationship between their child’s weight and chronic pain. The majority (64%) of parents of youth with obesity accurately rated their child’s weight; this group of parents was also more concerned (p < 0.05) about their child’s weight than parents of youth with a healthy weight. However, the majority of parents of youth with obesity did not think their child’s weight contributed to his/her pain, or that weight was relevant to their child’s pain or pain treatment. Overall, only half of all parents saw discussions of weight, nutrition, and physical activity as important to treating their child’s pain. Results support the need for addressing parents’ perceptions of their child’s weight status, and educating parents about the relationship between excessive weight and chronic pain.
      PubDate: 2016-11-14
      DOI: 10.3390/children3040029
      Issue No: Vol. 3, No. 4 (2016)
  • Children, Vol. 3, Pages 30: A Clinical Pilot Study of Individual and Group
           Treatment for Adolescents with Chronic Pain and Their Parents: Effects of
           Acceptance and Commitment Therapy on Functioning

    • Authors: Marie Kanstrup, Rikard Wicksell, Mike Kemani, Camilla Wiwe Lipsker, Mats Lekander, Linda Holmström
      First page: 30
      Abstract: Pediatric chronic pain is common and can result in substantial long-term disability. Previous studies on acceptance and commitment therapy (ACT) have shown promising results in improving functioning in affected children, but more research is still urgently needed. In the current clinical pilot study, we evaluated an ACT-based interdisciplinary outpatient intervention (14 sessions), including a parent support program (four sessions). Adolescents were referred to the clinic if they experienced disabling chronic pain. They were then randomized, along with their parents, to receive group (n = 12) or individual (n = 18) treatment. Adolescent pain interference, pain reactivity, depression, functional disability, pain intensity and psychological flexibility, along with parent anxiety, depression, pain reactivity and psychological flexibility were assessed using self-reported questionnaires. There were no significant differences in outcomes between individual and group treatment. Analyses illustrated significant (p < 0.01) improvements (medium to large effects) in pain interference, depression, pain reactivity and psychological flexibility post-treatment. Additionally, analyses showed significant (p < 0.01) improvements (large effects) in parent pain reactivity and psychological flexibility post-treatment. On all significant outcomes, clinically-significant changes were observed for 21%–63% of the adolescents across the different outcome measures and in 54%–76% of the parents. These results support previous findings and thus warrant the need for larger, randomized clinical trials evaluating the relative utility of individual and group treatment and the effects of parental interventions.
      PubDate: 2016-11-16
      DOI: 10.3390/children3040030
      Issue No: Vol. 3, No. 4 (2016)
  • Children, Vol. 3, Pages 31: Supporting Teens with Chronic Pain to Obtain
           High School Credits: Chronic Pain 35 in Alberta

    • Authors: Kathy Reid, Mark Simmonds, Michelle Verrier, Bruce Dick
      First page: 31
      Abstract: Chronic pain is a significant problem in children and teens, and adolescents with chronic pain often struggle to attend school on a regular basis. We present in this article a novel program we developed that integrates attendance at a group cognitive-behavioural chronic pain self-management program with earning high school credits. We collaborated with Alberta Education in the development of this course, Chronic Pain 35. Adolescents who choose to enroll are invited to demonstrate their scientific knowledge related to pain, understanding of and engagement with treatment homework, and demonstrate their creativity by completing a project, which demonstrates at least one concept. Integrating Chronic Pain 35 into an adolescent’s academic achievements is a creative strategy that facilitates the engagement of adolescents in learning and adopting pain coping techniques. It also helps teens to advocate for themselves in the school environment and improve their parents’ and teachers’ understanding of adolescent chronic pain. This is one of the first successful collaborations between a pediatric health program and provincial education leaders, aimed at integrating learning and obtaining school credit for learning about and engaging in health self-management for teens. The authors hope this paper serves as an effective reference model for any future collaborating programs aimed at supporting teens with chronic pain to obtain high school credits.
      PubDate: 2016-11-19
      DOI: 10.3390/children3040031
      Issue No: Vol. 3, No. 4 (2016)
  • Children, Vol. 3, Pages 32: The Parent Psychological Flexibility
           Questionnaire (PPFQ): Item Reduction and Validation in a Clinical Sample
           of Swedish Parents of Children with Chronic Pain

    • Authors: Camilla Wiwe Lipsker, Marie Kanstrup, Linda Holmström, Mike Kemani, Rikard Wicksell
      First page: 32
      Abstract: In pediatric chronic pain, research indicates a positive relation between parental psychological flexibility (i.e., the parent’s willingness to experience distress related to the child’s pain in the service of valued behavior) and level of functioning in the child. This points to the utility of targeting parental psychological flexibility in pediatric chronic pain. The Parent Psychological Flexibility Questionnaire (PPFQ) is currently the only instrument developed for this purpose, and two previous studies have indicated its reliability and validity. The current study sought to validate the Swedish version of the 17-item PPFQ (PPFQ-17) in a sample of parents (n = 263) of children with chronic pain. Factor structure and internal reliability were evaluated by means of principal component analysis (PCA) and Cronbach’s alpha. Concurrent criterion validity was examined by hierarchical multiple regression analyses with parental anxiety and depression as outcomes. The PCA supported a three-factor solution with 10 items explaining 69.5% of the total variance. Cronbach’s alpha (0.86) indicated good internal consistency. The 10-item PPFQ (PPFQ-10) further explained a significant amount of variance in anxiety (29%), and depression (35.6%), confirming concurrent validity. In conclusion, results support the reliability and validity of the PPFQ-10, and suggest its usefulness in assessing psychological flexibility in parents of children with chronic pain.
      PubDate: 2016-11-19
      DOI: 10.3390/children3040032
      Issue No: Vol. 3, No. 4 (2016)
  • Children, Vol. 3, Pages 33: Specialized Rehabilitation Programs for
           Children and Adolescents with Severe Disabling Chronic Pain: Indications,
           Treatment and Outcomes

    • Authors: Lorin Stahlschmidt, Boris Zernikow, Julia Wager
      First page: 33
      Abstract: Children and adolescents with highly disabling chronic pain of high intensity and frequency are admitted to specialized pain rehabilitation programs. Some barriers to obtaining this specialized care include a lack of availability of treatment centers, a perceived social stigma and individual barriers such as socioeconomic status. Specialized rehabilitation programs for severe disabling chronic pain worldwide have similarities regarding admission criteria, structure and therapeutic orientation. They differ, however, regarding their exclusion criteria and program descriptions. The short- and long-term effectiveness of some rehabilitation programs is well documented. All countries should promote the establishment of future pediatric pain centers to improve the health care of children and adolescents suffering from severe chronic pain. Standardized reporting guidelines should be developed to describe treatments and outcomes to enable comparability across treatment centers.
      PubDate: 2016-11-21
      DOI: 10.3390/children3040033
      Issue No: Vol. 3, No. 4 (2016)
  • Children, Vol. 3, Pages 34: Perinatal Risk Factors and Genu Valgum
           Conducive to the Onset of Growing Pains in Early Childhood

    • Authors: Angelos Kaspiris, Efstathios Chronopoulos, Elias Vasiliadis
      First page: 34
      Abstract: The most prevalent musculoskeletal disorder of childhood with unclear aetiology is growing pains (GPs). Anatomic deformities and factors that change bone turnover are implicated in GP pathophysiology. Perinatal risk factors alter the bone metabolism affecting the bone mineral density and content. The aim of our study was to analyze the relationship between GPs, knock knees and perinatal factors. The examined population consisted of 276 children aged 3–7 years. Among them, ten pairs of dizygotic twins were evaluated. The data were collected by using a combination of semi-structured questionnaires, clinical examinations and medical charts of the children and the obstetric history of the mothers. A total of 78 children presenting GPs met Peterson’s criteria. Genu valgum severity was a significant factor for GP manifestation and for their increased frequency and intensity. Subsequently, perinatal factors regarding gestational age, Apgar score, head circumference (lower than 33 cm) and birth length or weight (smaller than 50 cm and 3000 g, respectively) made a remarkable contribution to the development of GPs. Conversely, antenatal corticosteroid treatment, increased maternal age and maternal smoking during pregnancy were not predictive of the disorder. Our data are potentially supportive for the “bone strength” theory and for the contribution of anatomical disturbances in GP appearance.
      PubDate: 2016-11-18
      DOI: 10.3390/children3040034
      Issue No: Vol. 3, No. 4 (2016)
  • Children, Vol. 3, Pages 35: Neighborhood Characteristics: Influences on
           Pain and Physical Function in Youth at Risk for Chronic Pain

    • Authors: Cathleen Schild, Emily Reed, Tessa Hingston, Catlin Dennis, Anna Wilson
      First page: 35
      Abstract: Neighborhood features such as community socioeconomic status, recreational facilities, and parks have been correlated to the health outcomes of the residents living within those neighborhoods, especially with regard to health-related quality of life, body mass index, and physical activity. The interplay between one’s built environment and one’s perceptions may affect physical health, well-being, and pain experiences. In the current study, neighborhood characteristics and attitudes about physical activity were examined in a high-risk (youths with a parent with chronic pain) and low-risk (youths without a parent with chronic pain) adolescent sample. There were significant differences in neighborhood characteristics between the high-risk (n = 62) and low-risk (n = 77) samples (ages 11–15), with low-risk participants living in residences with more walkability, closer proximity to parks, and higher proportion of neighborhood residents having college degrees. Results indicate that neighborhood features (e.g., walkability and proximity to parks), as well as positive attitudes about physical activity were correlated with lower levels of pain and pain-related disability, and higher performance in physical functioning tests. These findings suggest that the built environment may contribute to pain outcomes in youth, above and beyond the influence of family history of pain.
      PubDate: 2016-11-19
      DOI: 10.3390/children3040035
      Issue No: Vol. 3, No. 4 (2016)
  • Children, Vol. 3, Pages 36: Goal Pursuit in Youth with Chronic Pain

    • Authors: Emma Fisher, Tonya Palermo
      First page: 36
      Abstract: Children and adolescents frequently experience chronic pain that can disrupt their usual activities and lead to poor physical and emotional functioning. The fear avoidance model of pain with an emphasis on the maladaptive behaviors that lead to activity avoidance has guided research and clinical practice. However, this model does not take into consideration variability in responses to pain, in particular the active pursuit of goals despite pain. This review aims to introduce a novel conceptualization of children’s activity engagement versus avoidance using the framework of goal pursuit. We propose a new model of Goal Pursuit in Pediatric Chronic Pain, which proposes that the child’s experience of pain is modified by child factors (e.g., goal salience, motivation/energy, pain-related anxiety/fear, and self-efficacy) and parent factors (e.g., parent expectations for pain, protectiveness behaviors, and parent anxiety), which lead to specific goal pursuit behaviors. Goal pursuit is framed as engagement or avoidance of valued goals when in pain. Next, we recommend that research in youth with chronic pain should be reframed to account for the pursuit of valued goals within the context of pain and suggest directions for future research.
      PubDate: 2016-11-22
      DOI: 10.3390/children3040036
      Issue No: Vol. 3, No. 4 (2016)
  • Children, Vol. 3, Pages 37: Finding Harmony between Science and Art in
           Pediatric Cardiology: Acknowledging When Being “Objective” May Not
           Truly Be Objective

    • Authors: Rohit Loomba
      First page: 37
      Abstract: As pediatric cardiologists, we greatly value objective decision-making and logic. [...]
      PubDate: 2016-11-23
      DOI: 10.3390/children3040037
      Issue No: Vol. 3, No. 4 (2016)
  • Children, Vol. 3, Pages 38: A Broad Consideration of Risk Factors in
           Pediatric Chronic Pain: Where to Go from Here?

    • Authors: Hannah McKillop, Gerard Banez
      First page: 38
      Abstract: Pediatric chronic pain is a significant problem associated with substantial functional impairment. A variety of risk factors have been found to be associated with chronic pain in youth. The greatest amount of evidence appears to support that temperament, anxiety, depression, subjective experience of stress, passive coping strategies, sleep problems, other somatic-related problems, and parent and/or family factors are important variables. However, a great deal of this research focuses on a single risk factor or on multiple risk factors in isolation. Much of the literature utilizes older diagnostic criteria and would benefit from replication, larger sample sizes, and comparison across pain disorders. Problems also exist with disagreement across definitions, resulting in inconsistency or unclear use of terms. Furthermore, recent consideration has suggested that outcome measures should include functional disability in addition to pain. A second generation of research is needed to shed light on the complex interactions that likely play a role in the transition from acute to chronic pain. Building on recent calls for changes in research in this area, we propose the next steps for this research, which involve consideration of both biopsychosocial and developmental contexts.
      PubDate: 2016-11-30
      DOI: 10.3390/children3040038
      Issue No: Vol. 3, No. 4 (2016)
  • Children, Vol. 3, Pages 39: Pain in School: Patterns of Pain-Related
           School Impairment among Adolescents with Primary Pain Conditions, Juvenile
           Idiopathic Arthritis Pain, and Pain-Free Peers

    • Authors: Anna Agoston, Laura Gray, Deirdre Logan
      First page: 39
      Abstract: Children with chronic pain frequently experience impairment in the school setting, but we do not yet understand how unique these struggles are to children with primary pain conditions compared to peers with disease-related pain or those without chronic pain symptoms. The objective of this study is to examine school functioning, defined as school attendance rates, overall quality of life in the school setting, and school nurse visits among adolescents with primary pain conditions, those with juvenile idiopathic arthritis (JIA)-related pain, and healthy peers. Two hundred and sixty adolescents participated in the study, including 129 with primary pain conditions, 61 with JIA, and 70 healthy comparison adolescents. They completed self- and parent-reported measures of school function. Findings show that as a group, youth with primary pain conditions reported more school absences, lower quality of life in the school setting, and more frequent school nurse visits compared to both adolescents with JIA-related pain and healthy peers. We conclude that compared to those who experience pain specific to a disease process, adolescents with primary pain conditions may face unique challenges in the school setting and may require more support to help them succeed in school in spite of pain.
      PubDate: 2016-11-30
      DOI: 10.3390/children3040039
      Issue No: Vol. 3, No. 4 (2016)
  • Children, Vol. 3, Pages 40: Mental Health Comorbidities in Pediatric
           Chronic Pain: A Narrative Review of Epidemiology, Models, Neurobiological
           Mechanisms and Treatment

    • Authors: Jillian Vinall, Maria Pavlova, Gordon Asmundson, Nivez Rasic, Melanie Noel
      First page: 40
      Abstract: Chronic pain during childhood and adolescence can lead to persistent pain problems and mental health disorders into adulthood. Posttraumatic stress disorders and depressive and anxiety disorders are mental health conditions that co-occur at high rates in both adolescent and adult samples, and are linked to heightened impairment and disability. Comorbid chronic pain and psychopathology has been explained by the presence of shared neurobiology and mutually maintaining cognitive-affective and behavioral factors that lead to the development and/or maintenance of both conditions. Particularly within the pediatric chronic pain population, these factors are embedded within the broader context of the parent–child relationship. In this review, we will explore the epidemiology of, and current working models explaining, these comorbidities. Particular emphasis will be made on shared neurobiological mechanisms, given that the majority of previous research to date has centered on cognitive, affective, and behavioral mechanisms. Parental contributions to co-occurring chronic pain and psychopathology in childhood and adolescence will be discussed. Moreover, we will review current treatment recommendations and future directions for both research and practice. We argue that the integration of biological and behavioral approaches will be critical to sufficiently address why these comorbidities exist and how they can best be targeted in treatment.
      PubDate: 2016-12-02
      DOI: 10.3390/children3040040
      Issue No: Vol. 3, No. 4 (2016)
  • Children, Vol. 3, Pages 41: Psychological Neuromodulatory Treatments for
           Young People with Chronic Pain

    • Authors: Jordi Miró, Elena Castarlenas, Rocío de la Vega, Rubén Roy, Ester Solé, Catarina Tomé-Pires, Mark Jensen
      First page: 41
      Abstract: The treatment of young people with chronic pain is a complex endeavor. Many of these youth do not obtain adequate relief from available interventions. Psychological neuromodulatory treatments have been shown to have potential benefit for adults with chronic pain. Here, we review and summarize the available information about the efficacy of three promising psychological neuromodulatory treatments—neurofeedback, meditation and hypnosis—when provided to young people with chronic pain. A total of 16 articles were identified and reviewed. The findings from these studies show that hypnotic treatments are effective in reducing pain intensity for a variety of pediatric chronic pain problems, although research suggests variability in outcomes as a function of the specific pain problem treated. There are too few studies evaluating the efficacy of neurofeedback or meditation training in young people with chronic pain to draw firm conclusions regarding their efficacy. However, preliminary data indicate that these treatments could potentially have positive effects on a variety of outcomes (e.g., pain intensity, frequency of pain episodes, physical and psychological function), at least in the short term. Clinical trials are needed to evaluate the effects of neurofeedback and meditation training, and research is needed to identify the moderators of treatment benefits as well as better understand the mechanisms underlying the efficacy of all three of these treatments. The findings from such research could enhance overall treatment efficacy by: (1) providing an empirical basis for better patient-treatment matching; and (2) identifying specific mechanisms that could be targeted with treatment.
      PubDate: 2016-12-06
      DOI: 10.3390/children3040041
      Issue No: Vol. 3, No. 4 (2016)
  • Children, Vol. 3, Pages 42: Chronic Pain in Children and Adolescents:
           Diagnosis and Treatment of Primary Pain Disorders in Head, Abdomen,
           Muscles and Joints

    • Authors: Stefan Friedrichsdorf, James Giordano, Kavita Desai Dakoji, Andrew Warmuth, Cyndee Daughtry, Craig Schulz
      First page: 42
      Abstract: Primary pain disorders (formerly “functional pain syndromes”) are common, under-diagnosed and under-treated in children and teenagers. This manuscript reviews key aspects which support understanding the development of pediatric chronic pain, points to the current pediatric chronic pain terminology, addresses effective treatment strategies, and discusses the evidence-based use of pharmacology. Common symptoms of an underlying pain vulnerability present in the three most common chronic pain disorders in pediatrics: primary headaches, centrally mediated abdominal pain syndromes, and/or chronic/recurrent musculoskeletal and joint pain. A significant number of children with repeated acute nociceptive pain episodes develop chronic pain in addition to or as a result of their underlying medical condition “chronic-on-acute pain.” We provide description of the structure and process of our interdisciplinary, rehabilitative pain clinic in Minneapolis, Minnesota, USA with accompanying data in the treatment of chronic pain symptoms that persist beyond the expected time of healing. An interdisciplinary approach combining (1) rehabilitation; (2) integrative medicine/active mind-body techniques; (3) psychology; and (4) normalizing daily school attendance, sports, social life and sleep will be presented. As a result of restored function, pain improves and commonly resolves. Opioids are not indicated for primary pain disorders, and other medications, with few exceptions, are usually not first-line therapy.
      PubDate: 2016-12-10
      DOI: 10.3390/children3040042
      Issue No: Vol. 3, No. 4 (2016)
  • Children, Vol. 3, Pages 43: Pain Neuroscience Education: State of the Art
           and Application in Pediatrics

    • Authors: Hannah Robins, Victoria Perron, Lauren Heathcote, Laura Simons
      First page: 43
      Abstract: Chronic pain is a widespread problem in the field of pediatrics. Many interventions to ameliorate pain-related dysfunction have a biobehavioral focus. As treatments for chronic pain (e.g., increased movement) often stand in stark contrast to treatments for an acute injury (e.g., rest), providing a solid rationale for treatment is necessary to gain patient and parent buy-in. Most pain treatment interventions incorporate psychoeducation, or pain neuroscience education (PNE), as an essential component, and in some cases, as a stand-alone approach. The current topical review focuses on the state of pain neuroscience education and its application to pediatric chronic pain. As very little research has examined pain neuroscience education in pediatrics, we aim to describe this emerging area and catalyze further work on this important topic. As the present literature has generally focused on adults with chronic pain, pain neuroscience education merits further attention in the realm of pediatric pain in order to be tailored and implemented in this population.
      PubDate: 2016-12-21
      DOI: 10.3390/children3040043
      Issue No: Vol. 3, No. 4 (2016)
  • Children, Vol. 3, Pages 44: Natural History of Asymptomatic and Unrepaired
           Vascular Rings: Is Watchful Waiting a Viable Option? A New Case and Review
           of Previously Reported Cases

    • Authors: Rohit Loomba
      First page: 44
      Abstract: Vascular rings are a rare form of congenital heart disease in which abnormal aortic arch anatomy leads to encircling of the esophagus and/or trachea by the aortic vasculature. Symptoms can develop from this and prompt the need for surgery. A natural history study has been done on mildly symptomatic patients but no such study has been done on asymptomatic patients. We present a case report of three children with asymptomatic vascular rings who continue to receive follow-up without intervention and review all published cases of asymptomatic or unrepaired vascular rings. Clinical observation of asymptomatic and mildly symptomatic vascular rings, regardless of aortic arch anatomy, seems to be a safe approach. Children with mild symptoms almost invariably seem to have resolution of their symptoms by four years of age.
      PubDate: 2016-12-21
      DOI: 10.3390/children3040044
      Issue No: Vol. 3, No. 4 (2016)
  • Children, Vol. 3, Pages 45: Acute Diarrhoea in Children: Determination of
           Duration Using a Combined Bismuth Hydroxide Gel and Oral Rehydration
           Solution Therapy vs. Oral Rehydration Solution

    • Authors: Adriana Oviedo, Mirna Díaz, María Valenzuela, Victoria Vidal, Liliana Racca, Hebe Bottai, Graciela Priore, Graciela Peluffo, Susana Di Bartolomeo, Graciela Cabral, María del Carmen Toca
      First page: 45
      Abstract: Oral rehydration salt (ORS) treatment in young children with acute diarrhoea (AD) has contributed to decrease mortality associated with dehydration although effective strategies to reduce morbidity associated with this disease are required. The aim of this study was to evaluate the diarrhoea duration when using combined colloidal bismuth hydroxide gel (CBHG) and oral rehydration salt treatment compared with ORS therapy in children with AD. We designed a double-blind, randomised prospective study with treatment and control groups. Patients aged one to 12 years, with no prior pathology and with AD of less than 48 h were included. The Chi-squared and Mann-Whitney tests were used, as well as the Cox proportional hazards model and the Kaplan-Meier estimator. Patients were randomised into an ORS and CBHG treatment group and a control group for ORS plus placebo. (Average age: 3.2 years). The result of the post-treatment evaluation with respect to the average duration of AD was 25.5 h for the treated group vs. 41.5 h for the control group (p = 0.015). The average number of stools was 4.8 in the treated group and 8.2 in the control group (p = 0.032). We conclude that the use of CBHG plus ORS significantly reduced the duration of AD, the number of stools and the percentage of children with persistent AD after 24 h of treatment compared to the control group. AD remitted almost twice as fast in patients treated with CBHG and ORS compared to those who received ORS plus placebo.
      PubDate: 2016-12-21
      DOI: 10.3390/children3040045
      Issue No: Vol. 3, No. 4 (2016)
  • Children, Vol. 3, Pages 11: Putting Children’s Sleep Problems to Bed:
           Using Behavior Change Theory to Increase the Success of Children’s Sleep
           Education Programs and Contribute to Healthy Development

    • Authors: Sarah Blunden, Tessa Benveniste, Kirrilly Thompson
      First page: 11
      Abstract: Sleep is critical for the healthy development of children, yet most children simply don’t get enough. Whilst school based sleep education programs have been developed for parents and their children, they have had mixed success. We consider how use of behavior change theory in existing school-based sleep education programs can be improved by applying and apply a broader model to these programs. We find that the mixed success of school-based sleep education programs may be due to a plausible but misleading assumption that simply increasing information about the importance of sleep and the risks of insufficient and/or inefficient sleep will necessarily result in improved sleep behaviors. We identify the potential benefits of using behavior change theory in the development of sleep education programs but in particular, there is a need for theories incorporate the multiple biological, environmental and social impacts on children’s sleep. Bronfenbrenner’s Bioecological model is presented to illustrate how one such behavior change theory could significantly improve the success of sleep education programs and ultimately support the healthy development of children.
      PubDate: 2016-07-01
      DOI: 10.3390/children3030011
      Issue No: Vol. 3, No. 3 (2016)
  • Children, Vol. 3, Pages 12: Effects of Cardiorespiratory Fitness and
           Obesity on Salivary Secretory IgA and Alpha-Amylase in South African

    • Authors: Dorota Starzak, Kristen Konkol, Andrew McKune
      First page: 12
      Abstract: This study examined whether cardiorespiratory fitness (CRF) and body composition are associated with salivary secretory immunoglobulin A (SIgA), a mucosal immunity marker, and salivary alpha-amylase (sAA), a marker of stress-related sympathetic nervous system (SNS) activity, in South African children. Morning (7:30–8:00 a.m.) saliva samples were collected from 132 children (10.05 ± 1.68 years old, 74 females, 58 males). Body composition, resting blood pressure, and predicted maximal aerobic capacity (VO2max) were determined, and SIgA and sAA were quantified. Obese children had significantly higher sAA compared with overweight and normal weight children (p < 0.01). SIgA secretion rate was significantly lower in obese and overweight vs. normal weight children (p < 0.01). Multiple-linear regression analysis revealed that body mass index (BMI) (p < 0.05) and diastolic blood pressure (DBP) (p < 0.05) were independent predictors of sAA with CRF acting as a mitigator. Age and BMI predicted SIgA secretion rate (p < 0.05) with BMI (p < 0.001) found to be an independent predictor of SIgA secretion rate. Obesity, based on BMI, was associated with elevated SNS activity and lowered mucosal immunity. CRF-mitigated sympathetic activation was not associated with mucosal immunity.
      PubDate: 2016-07-30
      DOI: 10.3390/children3030012
      Issue No: Vol. 3, No. 3 (2016)
  • Children, Vol. 3, Pages 13: Actual Body Weight and the Parent’s
           Perspective of Child’s Body Weight among Rural Canadian Children

    • Authors: Chandima Karunanayake, Donna Rennie, Carole Hildebrand, Joshua Lawson, Louise Hagel, James Dosman, Punam Pahwa, The Saskatchewan Rural Health Study Team
      First page: 13
      Abstract: The prevalence of being overweight during childhood continues to increase in the USA and Canada and children living in rural areas are more at risk than their urban counterparts. The objectives of this study were to evaluate how well the parent’s perception of their child’s weight status correlated with objectively measured weight status among a group of rural children and to identify predictors of inaccurate parental perceptions of child’s weight status. Participants were children from the Saskatchewan Rural Health Study conducted in 2010. Self-administered questionnaires were distributed through rural schools to parents of children in grades one to eight. Parents reported their child’s height and weight and rated their child’s weight status (underweight, just about the right weight, or overweight). Standardized body mass index (BMI) categories were calculated for clinically measured height and weight and for parental report of height and weight for 584 children. Logistic regression analysis was performed to identify predictors of misclassification of the parent’s perception of child’s weight status adjusting for potential confounders. Clinically measured overweight was much higher (26.5%) compared to parental perceived overweight (7.9%). The misclassification of the child’s BMI was more likely to occur if the child was a boy (odds ratio (OR) = 1.58) or non-Caucasian (OR = 2.03). Overweight was high in this group of rural children and parental perception of weight status underestimated the actual weight status of overweight school-age children. Parental reporting of child weight status has implications for public health policy and prevention strategies. Future research should focus on assessing longitudinal effects of parental misperceptions of child’s weight status.
      PubDate: 2016-08-04
      DOI: 10.3390/children3030013
      Issue No: Vol. 3, No. 3 (2016)
  • Children, Vol. 3, Pages 14: Reliance on Pumped Mother’s Milk Has an
           Environmental Impact

    • Authors: Genevieve Becker, Yvonne Ryan-Fogarty
      First page: 14
      Abstract: Breastfeeding is an environmentally friendly process; however when feeding relies on pumped mother’s milk, the environmental picture changes. Waste plastics and heavy metals raise concerns regarding resource efficiency, waste treatment, and detrimental effects on health. Reliance on pumped milk rather than breastfeeding may also effect obesity and family size, which in turn have further environmental impacts. Information on pump equipment rarely includes environmental information and may focus on marketing the product for maximum profit. In order for parents, health workers, and health policy makers to make informed decisions about the reliance on pumped mother’s milk, they need information on the broad and far reaching environmental aspects. There was no published research found that examined the environmental impact of using pumped mother’s milk. A project is ongoing to examine this issue.
      PubDate: 2016-09-10
      DOI: 10.3390/children3030014
      Issue No: Vol. 3, No. 3 (2016)
  • Children, Vol. 3, Pages 15: Parental Protectiveness Mediates the
           Association between Parent-Perceived Child Self-Efficacy and Health
           Outcomes in Pediatric Functional Abdominal Pain Disorder

    • Authors: Melissa DuPen, Miranda van Tilburg, Shelby Langer, Tasha Murphy, Joan Romano, Rona Levy
      First page: 15
      Abstract: Previous studies have shown that parental protectiveness is associated with increased pain and disability in Functional Abdominal Pain Disorder (FAPD) but the role that perceived child self-efficacy may play remains unclear. One reason why parents may react protectively towards their child’s pain is that they perceive their child to be unable to cope or function normally while in pain (perceived low self-efficacy). This study sought to examine (a) the association between parent-perceived child pain self-efficacy and child health outcomes (symptom severity and disability); and (b) the role of parental protectiveness as a mediator of this association. Participants were 316 parents of children aged 7–12 years with FAPD. Parents completed measures of perceived child self-efficacy when in pain, their own protective responses to their child’s pain, child gastrointestinal (GI) symptom severity, and child functional disability. Parent-perceived child self-efficacy was inversely associated with parent-reported child GI symptom severity and disability, and parental protectiveness mediated these associations. These results suggest that parents who perceive their child to have low self-efficacy to cope with pain respond more protectively when they believe he/she is in pain, and this, in turn, is associated with higher levels of GI symptoms and disability in their child. This finding suggests that directly addressing parent beliefs about their child’s ability to manage pain should be included as a component of FAPD, and potentially other child treatment interventions.
      PubDate: 2016-09-19
      DOI: 10.3390/children3030015
      Issue No: Vol. 3, No. 3 (2016)
  • Children, Vol. 3, Pages 16: Rewiring of Developing Spinal Nociceptive
           Circuits by Neonatal Injury and Its Implications for Pediatric Chronic

    • Authors: Mark Baccei
      First page: 16
      Abstract: Significant evidence now suggests that neonatal tissue damage can evoke long-lasting changes in pain sensitivity, but the underlying cellular and molecular mechanisms remain unclear. This review highlights recent advances in our understanding of how injuries during a critical period of early life modulate the functional organization of synaptic networks in the superficial dorsal horn (SDH) of the spinal cord in a manner that favors the excessive amplification of ascending nociceptive signaling to the brain, which likely contributes to the generation and/or maintenance of pediatric chronic pain. These persistent alterations in synaptic function within the SDH may also contribute to the well-documented “priming” of developing pain pathways by neonatal tissue injury.
      PubDate: 2016-09-20
      DOI: 10.3390/children3030016
      Issue No: Vol. 3, No. 3 (2016)
  • Children, Vol. 3, Pages 6: Erratum: Ingelfinger, J.R.; et al. Averting the
           Legacy of Kidney Disease—Focus on Childhood. Children 2016, 3, 4

    • Authors: Children Editorial Office
      First page: 6
      Abstract: The Children Editorial Office wishes to notify its readers of a correction in [1].[...]
      PubDate: 2016-04-18
      DOI: 10.3390/children3020006
      Issue No: Vol. 3, No. 2 (2016)
  • Children, Vol. 3, Pages 7: Vaccine Hesitancy in Children—A Call for

    • Authors: Annabelle de St. Maurice, Kathryn Edwards
      First page: 7
      Abstract: Immunizations have made an enormous impact on the health of children by decreasing childhood morbidity and mortality from a variety of vaccine-preventable diseases worldwide. The eradication of polio from Nigeria and India is one of the most recent victories for one of the greatest technological advances in human history. Despite these international successes, the United States has experienced the re-emergence of measles, driven largely by increasing parental refusal of vaccines. Pediatricians should be trained to be very knowledgeable about vaccines and should continue to advocate for parents to immunize their children.
      PubDate: 2016-04-29
      DOI: 10.3390/children3020007
      Issue No: Vol. 3, No. 2 (2016)
  • Children, Vol. 3, Pages 8: Resistance to Cry Intensive Sleep Intervention
           in Young Children: Are We Ignoring Children’s Cries or Parental

    • Authors: Sarah Blunden, Hayley Etherton, Yvonne Hauck
      First page: 8
      Abstract: The majority of behavioural sleep interventions for young children (defined as 5 years of age or less) involve extinction procedures where parents must ignore their child’s cries for a period. Many parents have difficulties implementing and maintaining these procedures, leading to attrition, non-compliance and treatment avoidance. Yet the reasons for these methods being difficult to implement for parents have not been well understood or addressed in the literature. In fact, they are being ignored. We discuss that understanding and addressing parental concerns may enable better targeted sleep interventions.
      PubDate: 2016-05-10
      DOI: 10.3390/children3020008
      Issue No: Vol. 3, No. 2 (2016)
  • Children, Vol. 3, Pages 9: Malaysia’s First Transplanted Case of Chronic
           Granulomatous Disease: The Journey of Overcoming Obstacles

    • Authors: Intan Ismail, Faizah Jamli, Ida Othman, Lokman Noh, Amir Abdul Latiff
      First page: 9
      Abstract: The awareness of primary immunodeficiency (PID) in Malaysia is still not forthcoming. Certain practical issues such as lack of clinical immunologists and specialized laboratory diagnostic facilities remain to be addressed. However, great efforts taken by passionate clinicians and scientists in the immunology networking have ascertained some prevalence. Despite the limitation, all suspected cases of PID are being properly investigated and competently managed. In this case report we highlighted the obstacles we faced in managing PID patients, particularly preparing for bone marrow transplant. This is the first transplanted case of chronic granulomatous disease in Malaysia, which emphasizes the importance of collaborative work to ensure further morbidities or mortalities are prevented.
      PubDate: 2016-05-17
      DOI: 10.3390/children3020009
      Issue No: Vol. 3, No. 2 (2016)
  • Children, Vol. 3, Pages 10: Maternal Anxiety and Children’s Laboratory
           Pain: The Mediating Role of Solicitousness

    • Authors: Subhadra Evans, Laura Payne, Laura Seidman, Kirsten Lung, Lonnie Zeltzer, Jennie Tsao
      First page: 10
      Abstract: There has been limited empirical examination of how parent variables such as anxiety and solicitousness collectively impact child pain response. We sought to examine the relationships among maternal anxiety, solicitous parenting, and children’s laboratory anxiety and pain intensity in children with chronic pain. Participants included 80 children and adolescents (ages 8–18) with chronic pain and their mothers. Children completed questionnaires and lab pain tasks measuring their parents’ solicitous parenting, pressure, cold and heat pain anticipatory anxiety and pain intensity. Using bootstrapping analysis, maternal anxiety predicted child anticipatory anxiety and pain intensity in girls with chronic pain, which was mediated by the child’s report of parental solicitousness. For boys with chronic pain, maternal anxiety predicted boys’ anticipatory anxiety and pain intensity, with no support for mediation. This study adds to the growing literature demonstrating the impact of maternal anxiety on children’s pain. The study highlights the importance of considering parents in treatment designed to reduce children’s pain.
      PubDate: 2016-06-20
      DOI: 10.3390/children3020010
      Issue No: Vol. 3, No. 2 (2016)
  • Children, Vol. 3, Pages 1: Learning Lessons from Adverse Drug Reactions in

    • Authors: Helen Sammons, Imti Choonara
      First page: 1
      Abstract: Drug toxicity is, unfortunately, a significant problem in children both in the hospital and in the community. Drug toxicity in children is different to that seen in adults. At least one in 500 children will experience an adverse drug reaction each year. For children in hospital, the risk is far greater (one in ten). Additionally, different and sometimes unique adverse drug reactions are seen in the paediatric age groups. Some of the major cases of drug toxicity historically have occurred in neonates. It is important that we understand the mechanism of action of adverse drug reactions. Greater understanding alongside rational prescribing should hopefully reduce drug toxicity in children in the future.
      PubDate: 2016-01-08
      DOI: 10.3390/children3010001
      Issue No: Vol. 3, No. 1 (2016)
  • Children, Vol. 3, Pages 2: Acknowledgement to Reviewers of Children in

    • Authors: Children Editorial Office
      First page: 2
      Abstract: The editors of Children would like to express their sincere gratitude to the following reviewers for assessing manuscripts in 2015. [...]
      PubDate: 2016-01-28
      DOI: 10.3390/children3010002
      Issue No: Vol. 3, No. 1 (2016)
  • Children, Vol. 3, Pages 3: Determinants of Body Mass Index and
           Intelligence Quotient of Elementary School Children in Mountain Area of
           Nepal: An Explorative Study

    • Authors: Chhabi Ranabhat, Chun-Bae Kim, Myung Park, Chang Kim, Leila Freidoony
      First page: 3
      Abstract: The physical growth and cognitive development of elementary school children are very crucial and this group is large in number but has little research dedicated to it. The physical growth and cognitive development of children occur simultaneously and can be measured by body mass index (BMI) and intelligence quotient (IQ). Previous studies could not sufficiently focus on both aspects. The aim of this study was to identify determinants of BMI and IQ of students in two elementary schools in the Humla district of Nepal. Two randomly selected elementary schools and all children available there (n = 173) participated in the study. BMI was calculated with the objective of proper measurement of height and weight of the children. Likewise, the updated universal nonverbal intelligence test (UNIT) was applied for IQ. Descriptive statistics, t-test, analysis of variance and multiple linear regressions were used when appropriate. Study findings showed that one-tenth of the children had grade 2 thinness (-2SD) and about one-third had poor IQ (<85). The age of the children (p < 0.05) and household economic status (p < 0.001) were significant for the BMI. Likewise, frequencies of illness in the previous year, mother’s education (p < 0.05) and father’s education (p < 0.001) were significant factors for the IQ score. More commonly, BMI and IQ scores were significantly lower in the ultra-poor group. Economic status and parent education are still major determinants of IQ and BMI in these students. Special programs and strategies should be launched to improve the poor ranking of IQ and BMI.
      PubDate: 2016-02-03
      DOI: 10.3390/children3010003
      Issue No: Vol. 3, No. 1 (2016)
  • Children, Vol. 3, Pages 4: Averting the Legacy of Kidney
           Disease—Focus on Childhood

    • Authors: Julie Ingelfinger, Kamyar Kalantar-Zadeh, Franz Schaefer, on  behalf of the World Kidney Day Steering Committee
      First page: 4
      Abstract: World Kidney Day 2016 focuses on kidney disease in childhood and the antecedents of adult kidney disease that can begin in earliest childhood. Chronic kidney disease (CKD) in childhood differs from that in adults, as the largest diagnostic group among children includes congenital anomalies and inherited disorders, with glomerulopathies and kidney disease in the setting of diabetes being relatively uncommon. In addition, many children with acute kidney injury will ultimately develop sequelae that may lead to hypertension and CKD in later childhood or in adult life. Children born early or who are small-for date newborns have relatively increased risk for the development of CKD later in life. Persons with a high-risk birth and early childhood history should be watched closely in order to help detect early signs of kidney disease in time to provide effective prevention or treatment. Successful therapy is feasible for advanced CKD in childhood; there is evidence that children fare better than adults if they receive kidney replacement therapy, including dialysis and transplantation, while only a minority of children may require this ultimate intervention.  Since there are disparities in access to care, effort is needed so that those children with kidney disease, wherever they live, may be treated effectively, irrespective of their geographic or economic circumstances. Our hope is that World Kidney Day will inform the general public, policy makers and caregivers about the needs and possibilities surrounding kidney disease in childhood. “For in every adult there dwells the child that was, and in every child there lies the adult that will be.”—John Connolly, The Book of Lost Things.
      PubDate: 2016-02-08
      DOI: 10.3390/children3010004
      Issue No: Vol. 3, No. 1 (2016)
  • Children, Vol. 3, Pages 5: Functional Nausea in Children: A Review of the
           Literature and Need for Diagnostic Criteria

    • Authors: Alexandra Russell, Amanda Stone, Lynn Walker
      First page: 5
      Abstract: Nausea is common amongst children with functional gastrointestinal disorders and is associated with a high burden of somatic and psychosocial comorbidities in both the short and long-term. Current treatments including medications, phytotherapy, stress-reduction techniques, and gastric electrical stimulation for recalcitrant cases, are reviewed. Functional nausea merits its own diagnostic criteria as a pediatric functional gastrointestinal disorder.
      PubDate: 2016-03-10
      DOI: 10.3390/children3010005
      Issue No: Vol. 3, No. 1 (2016)
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
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Fax: +00 44 (0)131 4513327
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