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Children
Number of Followers: 0  Open Access journalISSN (Online) 2227-9067 Published by MDPI  [258 journals]
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- Children, Vol. 11, Pages 886: Exploring the Influence of Concurrent
Nutritional Therapy on Children with Spinal Muscular Atrophy Receiving
Nusinersen Treatment
Authors: Eymen Pinar, Bilal Berke Ayvaz, Erkan Akkus, Ipek Ulkersoy, Tugce Damla Dilek, Yilmaz Zindar, Fitnat Ulug, Aysel Guzeler, Huseyin Kilic, Serhat Guler, Omer Faruk Beser, Sema Saltik, Fugen Cullu Cokugras
First page: 886
Abstract: Background This study examines spinal muscular atrophy (SMA), a neuromuscular disease associated with malnutrition. Our goals are to assess how effectively screening tools can detect malnutrition and evaluate the impact of nutritional interventions on neurological outcomes, particularly motor functions. Methods Thirty-seven genetically diagnosed SMA patients (types 1, 2, and 3) under nusinersen therapy were included in the study. The nutritional status of these patients was assessed by using anthropometric measurements, including height for age (HFA), weight for height (WFH), and body mass index (BMI) before and after the study. Additionally, the risk of malnutrition was determined using screening tools, namely the Pediatric Yorkhill Malnutrition Score (PYMS) and the Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP). Nutritional counseling followed the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) guidelines and considered the patients’ dietary history, including content and administration method. Motor functions were assessed by validated tests: the Children’s Hospital of Philadelphia Infant Test of Neuromuscular Disorders (CHOP-INTEND) and the Hammersmith Functional Motor Scale—Expanded (HFMSE). Result The study showed an improvement in HFA, by a change from −0.95 to −0.65 (p = 0.015). Conversely, BMI scores decreased from 0.08 to −0.54 (p = 0.015), while WFH and MUAC showed no significant alterations (p = 0.135, p = 0.307). Following nutritional interventions, HFMSE demonstrated a median increase from 29.5 to 30.5 (p = 0.023). Patients identified as being at high risk for malnutrition based on PYMS and STAMP belonged to the moderate-to-severe malnutrition group (BMI Z-score ≤ −2, p = 0.001). Conclusions Use of screening tools in SMA patients is highly beneficial for the early detection of malnutrition. Future research should highlight the importance of combining nutritional management with nusinersen therapy to potentially alter the disease trajectory, especially in motor and neurological functions.
Citation: Children
PubDate: 2024-07-23
DOI: 10.3390/children11080886
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 887: Effect of Summer Holiday Programs on
Children’s Mental Health and Well-Being: Systematic Review and
Meta-Analysis
Authors: Emily Eglitis, Catherine Simpson, Ben Singh, Timothy Olds, Amanda Machell, Rosa Virgara, Mandy Richardson, Kylie Brannelly, Aniella Grant, Jessica Gray, Terri Wilkinson, Zoe Rix, Carol Maher
First page: 887
Abstract: Poor youth mental health is an area of global concern. Summer holiday programs may provide environments that support mental health when the structures and supports of school are not available. The aim of this review was to determine the effectiveness of summer holiday programs in improving the mental health, social–emotional well-being, and cognitive (non-academic) outcomes of children and adolescents. Studies of summer holiday programs for school-aged children (5–18 years) were included if they measured any mental, socio-emotional or cognitive (non-academic) outcome. Studies were excluded if they were published prior to 2000, targeted clinical populations or lasted less than five days. Six databases were searched (April 2023). Risk of bias was assessed using the PEDro tool. Study outcomes were grouped according to three main constructs: mental health (psychological well-being, anxiety, depression, distress, and self-perception including self-esteem, self-worth, self-concept, confidence, and competence); social–emotional well-being (behavior and social skills, e.g., communication, bullying, conflict resolution, empathy, and social skills); and cognitive function (memory, selective attention, and executive function). A fourth “other” group captured substance use, personality traits, character skills, and values. Effect sizes were calculated as the standardized mean difference between pre- and post-intervention scores. The synthesis involved a random-effects meta-analysis (presented in forest plots), where possible, with the remaining outcomes narratively synthesized. Twenty-six studies (n = 6812 participants) were included. The results of the meta-analysis suggested that summer programs showed a statistically non-significant trend toward reducing symptoms of anxiety and depression (k = 2 studies, SMD = −0.17, 95% CI −2.94, 2.60), psychological distress (k = 2 studies, SMD −0.46, 95% CI –1.71, 0.79), and no effect on self-esteem (k = 6 studies, SMD = 0.02, 95% CI −0.02, 0.06) or self-worth (k = 3 studies, SMD = 0.05, 95% CI 0.00, 0.11). Narrative syntheses indicated a pattern toward improvements in general mental health, self-perception, social–emotional outcomes, and cognition. Studies were generally small, with a high risk of bias. Summer holiday programs for children and adolescents show trends toward improving mental, social, emotional, and cognitive outcomes. Programs targeting disadvantaged children showed stronger patterns of improvement related to mental health and self-perception than programs targeting the general population. While effect sizes are small to negligible, they consistently indicate improvements. Summer programs present a promising avenue to promote mental health in children; however, further rigorously designed, clearly reported control-group studies are required to more fully understand their effects.
Citation: Children
PubDate: 2024-07-23
DOI: 10.3390/children11080887
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 888: Prevalence of Hypertension and Its
Associated Factors among Adolescents in Eastern Sudan: A Community-Based
Study
Authors: Saeed M. Omar, Ahmed A. Hassan, Abdullah Al-Nafeesah, Ashwaq AlEed, Jaber Alfaifi, Ishag Adam
First page: 888
Abstract: Background: Elevated blood pressure, or hypertension, is one of the main health problems among adolescents globally. However, there are limited data on hypertension among adolescents in Sudan. This survey aimed to investigate the prevalence of elevated blood pressure/hypertension and associated factors among adolescents in Gadarif City, Sudan. Methods: A community-based cross-sectional survey was conducted during a three-month period (August to October 2023) in Gadarif City, Eastern Sudan. A face-to-face interview questionnaire was used to collect sociodemographic information. Adolescents’ anthropometric (weight and height) measurements were taken, and blood pressure was measured. Multivariate binary and linear regression analyses were performed to analyze the data. Results: A total of 384 adolescents (178 [46.4%] boys and 206 [53.6%] girls) were included in the study. The median (interquartile range, IQR) of the age was 14.0 (12.1–16.1) years, and that of the body mass index (BMI) was 16.9 (15.2–20.0) kg/m2. Thirty-four (8.9%) adolescents had hypertension/elevated blood pressure (≥95th percentile). After adjusting for confounders, multivariable binary regression analysis showed that age (adjusted odds ratio [AOR], 1.20; 95% confidence interval [CI], 1.03–1.42) and BMI (AOR, 1.12; 95% CI, 1.04–1.20) were associated with hypertension. Conclusion: Approximately one in ten adolescents in Eastern Sudan was hypertensive. Adolescents with higher age and BMI were at higher risk for hypertension. Maintaining a healthy BMI during adolescence is recommended to promote adolescents’ health.
Citation: Children
PubDate: 2024-07-24
DOI: 10.3390/children11080888
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 889: Relationship between Maternal Stress and
Neurobehavioral Indicators of Preterm Infants in the Neonatal Intensive
Care Unit
Authors: Bruna Abreu Ramos, Cibelle Kayenne Martins Roberto Formiga, Nayara Rodrigues Gomes de Oliveira, Patricia Gonçalves Evangelista Marçal, Rui Gilberto Ferreira, Tárik Kassem Saidah, Waldemar Naves do Amaral
First page: 889
Abstract: Background: Preterm birth and prolonged neonatal hospitalization are potential sources of stress for mothers of preterm and low birth weight infants. Aim: To evaluate maternal stress and its association with neurobehavioral indicators of preterm infants during hospitalization in the neonatal intensive care unit. Methods: A cross-sectional study was conducted in a neonatal intensive care unit of a hospital in Goiânia, Brazil. The study included preterm and low birth weight infants of both genders and their mothers. The Parental Stressor Scale: Neonatal Intensive Care Unit and the Neurobehavioral Assessment of the Preterm Infant were respectively applied to mothers and infants in the neonatal intensive care unit. Results: The study involved 165 premature infants and their mothers. The mean age of the mothers was 26.3 years and most had a high school education level (57.6%). Mothers perceived the experience of having an infant in the neonatal intensive care unit as moderately stressful (2.96 ± 0.81). The parental role alteration (4.11 ± 1.03) and sights and sounds (2.15 ± 0.90) subscales exhibited the highest and lowest stress levels, respectively. Significant correlations (rho < −0.3; p < 0.05) were found between maternal stress and neurobehavioral indicators of infants. In the multivariate analysis, low leg tone was a predictor of higher maternal stress. Low tone and limited arm movement were predictors of higher maternal stress in the maternal role item. Conclusions: The experience of having a preterm infant hospitalized was considered moderately stressful for mothers. Maternal stress levels were significantly correlated with low scores on neonatal neurobehavioral indicators.
Citation: Children
PubDate: 2024-07-24
DOI: 10.3390/children11080889
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 890: Changes in Smartphone Usage among
Adolescents and Associated Subjective Health Concerns: A Secondary
Analysis of the Korea Youth Risk Behavior Survey
Authors: Geun Woo Lee, Jongwon Moon, Donghun Lee
First page: 890
Abstract: Background: We evaluated changes in the smartphone use rate and time among Korean adolescents and their awareness of associated health problems. Methods: This study was a secondary analysis of the Korea Youth Risk Behavior Survey (2020–2023) conducted by the Korean Disease Control and Prevention Agency. The total number of enrolled adolescents aged 12–18 years was 214,526. Results: The weekly smartphone usage rate increased from 96.4% to 97.1% (p = 0.03), with no significant changes observed in weekend usage. The average smartphone use time was 4.7 h on weekdays (p = 0.17) and 6.6 h on weekends (p = 0.37). Middle school adolescents had a higher weekday use rate than high school adolescents, but the average smartphone use time was significantly less. By 2023, the proportion of adolescents with overdependence was 28% (n = 14,672). Additionally, 11.8% (n = 6255) responded that they had experienced health problems due to smartphone use. Conclusions: The longer they used their smartphones for on the weekends, the more likely they considered their health to be worse. In conclusion, our youth population needs to be educated on the proper use of smartphones.
Citation: Children
PubDate: 2024-07-25
DOI: 10.3390/children11080890
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 891: Regional Disparities in Growth Patterns of
Children with Cerebral Palsy: A Comparative Analysis of Saudi Arabian, UK,
and US Data
Authors: Mshari Alghadier, Reem M. Basuodan, Reem A. Albesher, Saadia Waqas, Eman Misbah Suliman, Mohammed Hassan
First page: 891
Abstract: Aim: In order to understand the global variations in the growth trajectories of cerebral palsy patients, this study aimed to compare the growth patterns of cerebral palsy patients in Saudi Arabi with United States and United Kingdom counterparts. Method: Anthropometric data from 107 participants with cerebral palsy in Saudi Arabia were collected, including age, gender, cerebral palsy type, Gross Motor Function Classification System level, birth weight, weight at assessment, height at assessment, body mass index, and head circumference at assessment. Results: This study found discrepancies between the growth patterns of Saudi Arabian children with cerebral palsy and United Kingdom and the United States growth charts, particularly among those with severe cerebral palsy. Significant differences were observed in weight, height, and body mass index z-scores when comparing Saudi Arabian data with the United kingdom and United States reference data. Interpretation: These findings emphasize the importance of validating growth charts across different populations to ensure accurate monitoring and clinical management of children with cerebral palsy. Additionally, this study highlights the need for region-specific growth references to better address the diverse needs of individuals with cerebral palsy worldwide.
Citation: Children
PubDate: 2024-07-25
DOI: 10.3390/children11080891
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 892: Biologics and Small Molecule Targeted
Therapies for Pediatric Alopecia Areata, Psoriasis, Atopic Dermatitis, and
Hidradenitis Suppurativa in the US: A Narrative Review
Authors: Robin C. Yi, Shannon K. Moran, Hannah Y. Gantz, Lindsay C. Strowd, Steven R. Feldman
First page: 892
Abstract: Background: The management of pediatric dermatological conditions such as alopecia areata (AA), psoriasis, atopic dermatitis (AD), and hidradenitis suppurativa (HS) has significantly evolved with the introduction of biologics and small molecule targeted therapies. The advancement in understanding the immunopathogenesis of these chronic skin conditions has led to the development and approval of novel biologics and small molecule therapies. Initially approved by the United States Food and Drug Administration (FDA) for adults, most of these therapies are now being evaluated in clinical trials for safety and efficacy in adolescents and children, expanding new treatment options for pediatric patients. The role of the FDA in drug approval is multifaceted from drug inception, ensuring that research, data, and evidence show that the proposed drug is effective and safe for the intended use. Objective: The goal of this review article is to provide an overview of the recently FDA-approved and potential biologic and oral small molecule therapies in clinical trials for AA, psoriasis, AD, and HS in pediatric patients. Methods: The search for this review included keywords in ClinicalTrials.gov, PubMed, and Google Scholar for the latest research and clinical trials relevant to these conditions and treatments without the PRISMA methodology. Results: For pediatric AA, ritlecitinib is FDA-approved, while baricitinib and updacitinib are in phase 3 clinical trials for pediatric approval. The FDA-approved drugs for pediatric psoriasis include secukinumab, ustekinumab, ixekizumab, etanercept, and apremilast. Other phase 3 clinical trials for pediatric psoriasis include risankizumab, guselkumab, tildrakizumab, brodalumab, and deucravacitinib. For pediatric AD, the FDA-approved drugs are dupilumab, tralokinumab, abrocitinib, and upadacitinib, with many other drugs in phase 3 trials. Adalimumab is an FDA-approved biologic for pediatric HS, with various clinical trials ongoing for adults. The approved biologics and small molecule therapies had higher efficacy and improved safety profiles compared to traditional medications. Conclusions: With numerous ongoing trials, the success of these clinical trials could lead to their inclusion in treatment guidelines for these chronic skin conditions. Biologics and small molecule therapies offer new avenues for effective disease management, enabling personalized therapeutic interventions and improving pediatric health outcomes.
Citation: Children
PubDate: 2024-07-25
DOI: 10.3390/children11080892
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 893: Associations between Agility, the Relative
Authors: Daniel González-Devesa, Alba López-Eguía, Lucas Amoedo, Carlos Ayán-Pérez
First page: 893
Abstract: Background: This study aims to analyze the influence of relative age effects, siblings, and digit ratio on the agility of children and adolescents. Methods: The study included 283 children (9.54 ± 1.36 years) and 296 adolescents (14.68 ± 1.36 years) from four different schools. The analyzed variables included anthropometric data, the presence of siblings, relative age effect, and results from the 10 × 5 m shuttle run test. Results: The findings indicated no significant association between agility and either the 2D:4D ratio or the relative age effect in both children and adolescents (p > 0.05). Additionally, having siblings did not have a notable impact on agility. Multiple regression analysis confirmed that relative age did not influence this lack of association (quarter of birth: p = 0.345, β = 0.039; siblings: p = 0.100, β = −0.069). However, boys showed higher performance than girls in the 10 × 5 m shuttle run test, and higher body mass index was related to lower agility. Conclusions: These findings contribute to existing knowledge on the relative effects of age and provide valuable information for physical education teachers on the influence of the 2D:4D ratio and the presence of siblings on the physical fitness of children and adolescents.
Citation: Children
PubDate: 2024-07-25
DOI: 10.3390/children11080893
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 894: Relations between Neurocognitive Function
and Visual Acuity: A Cross-Sessional Study in a Cohort of Premature
Children
Authors: Chun-Hsien Tu, Wei-Chi Wu, Wei-Chih Chin, Shih-Chieh Hsu, I Tang, Jen-Fu Hsu, Hung-Da Chou, Eugene Yu-Chuan Kang, Yu-Shu Huang
First page: 894
Abstract: Background: Premature children with retinopathy of prematurity (ROP) have been reported to an have increased risk of visual and neurocognitive impairments, yet little is known about whether vision could affect specific neurocognition. This study aimed to clarify the correlations between neurocognition and vision in premature children. Materials and Methods: This is a nonrandomized, cross-sectional, observational study in a pediatric cohort with five groups: (1) full-term (n = 25), (2) prematurity without ROP (n = 154), (3) prematurity with ROP but without treatment (n = 39), (4) prematurity with ROP and with bevacizumab (IVB) treatment (n = 62), and (5) prematurity with ROP and with laser/laser + IVB treatment (n = 20). Neurocognitive function was evaluated by the Wechsler Preschool and Primary Scale of Intelligence, Fourth Edition (WPPSI-IV) around the age of 4 years. Visual acuity (VA) and refractive errors were tested. Correlations between WPPSI parameters and visual outcomes were analyzed across five groups. Results: Among the 300 recruited children (mean age = 4.02 + 0.97 years, male = 56.3%), 297 were assessed by WPPSI-IV and 142 were assessed by vision tests. The Full-Scale Intelligence Quotient (FSIQ) index was worse in the premature groups. After adjusting for covariates, seven items, including FSIQ-Index (p = 0.047), fluid-reasoning index (p = 0.004), FR-percentile ranking (p = 0.008), object assembly (p = 0.034), picture concept (p = 0.034), zoo locations (p = 0.014) and bug search (p = 0.020), showed significant differences between groups. The better the best corrected VA (BCVA), the higher the scores on Verbal Comprehension Index (VCI), VCI-PR, and the subtest of information. Conclusions: Specific cognitive dysfunctions are related to the BCVA in this large cohort. Subtest performance profiles in WPPSI can be affected by prematurity, ROP treatment, and different ROP treatment. FSIQ is generally lower in premature children and even lower in children with ROP.
Citation: Children
PubDate: 2024-07-25
DOI: 10.3390/children11080894
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 895: Mepolizumab in Severe Pediatric Asthma:
Certainties and Doubts through a Single-Center Experience and Review of
the Literature
Authors: Marco Maglione, Melissa Borrelli, Alessandro Dorato, Chiara Cimbalo, Luigi Antonio del Giudice, Francesca Santamaria
First page: 895
Abstract: Background: Although, in most children with asthma, good symptom control is achieved with a low to moderate dose of inhaled corticosteroids, a small group of patients still experiences frequent symptoms, and even severe exacerbations, impairment of lung function, and reduced quality of life. Some of these subjects with severe asthma require biologic drugs as add-on therapy. In the past decade, numerous monoclonal antibodies have been approved for children or adolescents with severe asthma, in addition to their increasing use in adult asthma. However, the available evidence on how to select the most appropriate biologic based on a single patient’s clinical, functional, and laboratory characteristics is still scant, and is insufficient to guide clinicians in the decision-making process of a personalized treatment. Materials and Methods: We report a case series of four patients with severe eosinophilic asthma treated with mepolizumab, an anti-interleukin-5 monoclonal antibody, and review the existing literature on this treatment in children and adolescents. Results: Our patients, all with blood eosinophilia and elevated fractional exhaled nitric oxide levels, developed poor symptom control despite prolonged treatment with high-dose inhaled corticosteroids plus a second controller, addressing the addition of a biologic drug. In all of them, a 12-month treatment with subcutaneous mepolizumab showed a reduction in the blood eosinophil count and in asthma exacerbations, as well as an improvement on the Asthma Control Test. The results of the literature search focused on the strengths and limitations of the pediatric use of mepolizumab and highlighted the areas worthy of further research. Conclusions: Mepolizumab has proven effective in improving symptom control in pediatric patients with severe asthma. Additional well-powered clinical trials will be helpful in developing evidence-based guidelines regarding biologic drugs in the pediatric population.
Citation: Children
PubDate: 2024-07-25
DOI: 10.3390/children11080895
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 896: Wilms Tumor with Vena Caval Intravascular
Extension: A Surgical Perspective
Authors: Daniel B. Gehle, Zachary D. Morrison, Huma F. Halepota, Akshita Kumar, Clark Gwaltney, Matthew J. Krasin, Dylan E. Graetz, Teresa Santiago, Umar S. Boston, Andrew M. Davidoff, Andrew J. Murphy
First page: 896
Abstract: Wilms tumor (WT) is the most common kidney tumor in pediatric patients. Intravascular extension of WT above the level of the renal veins is a rare manifestation that complicates surgical management. Patients with intravascular extension are frequently asymptomatic at diagnosis, and tumor thrombus extension is usually diagnosed by imaging. Neoadjuvant chemotherapy is indicated for thrombus extension above the level of the hepatic veins and often leads to thrombus regression, obviating the need for cardiopulmonary bypass in cases of cardiac thrombus at diagnosis. In cases of tumor extension to the retrohepatic cava, neoadjuvant therapy is not strictly indicated, but it may facilitate the regression of tumor thrombi, making resection safer. Hepatic vascular isolation and cardiopulmonary bypass increase the risk of bleeding and other complications when utilized for tumor thrombectomy. Fortunately, WT patients with vena caval with or with intracardiac extension have similar overall and event-free survival when compared to patients with WT without intravascular extension when thrombectomy is successfully performed. Still, patients with metastatic disease at presentation or unfavorable histology suffer relatively poor outcomes. Dedicated pediatric surgical oncology and pediatric cardiothoracic surgery teams, in conjunction with multimodal therapy directed by a multidisciplinary team, are preferred for optimized outcomes in this patient population.
Citation: Children
PubDate: 2024-07-25
DOI: 10.3390/children11080896
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 897: Thirteen New Patients of PPP2R5D Gene
Mutation and the Fine Profile of Genotype–Phenotype Correlation
Unraveling the Pathogenic Mechanism Underlying Macrocephaly Phenotype
Authors: Yinmo Jiang, Bingbing Wu, Xi Zhang, Lin Yang, Sujuan Wang, Huiping Li, Shuizhen Zhou, Yanyan Qian, Huijun Wang
First page: 897
Abstract: Background: Neurodevelopmental disorders (NDDs) are a group of diseases that severely affect the physical and mental health of children. The PPP2R5D gene encodes B56δ, the regulatory subunit of protein phosphatase 2A (PP2A). NDDs related to the PPP2R5D gene have recently been defined as Houge–Janssens syndrome 1. Methods: Clinical/whole exome sequencing was performed on approximately 3000 patients with NDDs from 2017 to 2023. In vitro experiments were performed to assess the impairment of variants to protein expression and the assembly of PP2A holoenzyme. The genetic information and phenotypes of the reported patients, as well as patients in this study, were summarized, and the genotype–phenotype relationship was analyzed. The probability of pathogenic missense variants in PPP2R5D was predicted using AlphaMissense (AM), and the relationship between certain phenotype and 3D protein structural features were analyzed. Results: Thirteen new patients carrying twelve PPP2R5D gene variants were detected, including five novel missense variants and one novel frameshift variant. In vitro experiments revealed that the frameshift variant p.H463Mfs*3 resulted in a ~50 kDa truncated protein with lower expression level. Except for E420K and T536R, other missense variants impaired holoenzyme assembly. Furthermore, we found that pathogenic/likely pathogenic (P/LP) variants that have been reported so far were all missense variants and clustered in three conserved regions, and the likelihood of P/LP mutations located in these conserved regions was extremely high. In addition, the macrocephaly phenotype was related to negatively charged residues involved in substrate recruitment. Conclusions: We reported thirteen new patients with PPP2R5D gene variants and expanded the PPP2R5D variant spectrum. We confirmed the pathogenicity of novel variants through in vitro experiments. Our findings in genotype–phenotype relationship provide inspiration for genetic counseling and interpretation of variants. We also provide directions for further research on the mechanism of macrocephaly phenotype.
Citation: Children
PubDate: 2024-07-26
DOI: 10.3390/children11080897
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 898: Confirming the Suitability of a Gentamicin
Dosing Strategy in Neonates Using the Population Pharmacokinetic Approach
with Truncated Sampling Duration
Authors: Bonifasius Siyuka Singu, Roger Karel Verbeeck, Clarissa Hildegard Pieper, Ene I. Ette
First page: 898
Abstract: (1) Background: Gentamicin is known to be nephrotoxic and ototoxic. Although gentamicin dosage guidelines have been established for preterm and term neonates, reports do show attainment of recommended peak concentrations but toxic gentamicin concentrations are common in this age group. (2) Methods: This was a prospective, observational study conducted in Namibia with 52 neonates. A dose of 5 mg/kg gentamicin was administered over 3–5 s every 24 h in combination with benzylpenicillin 100,000 IU/kg/12 h or ampicillin 50 mg/kg/8 h. Two blood samples were collected from each participant using a truncated pharmacokinetic sampling schedule. (3) Results: The one-compartment linear pharmacokinetic model best described the data. Birthweight, postnatal age, and white blood cell count were predictive of clearance (CL), while birthweight was predictive of volume (V). For the typical neonate (median weight 1.57 kg, median postnatal age 4 days (0.011 years), median log-transformed WBC of 2.39), predicted CL and V were 0.069 L/h and 0.417 L, respectively—similar to literature values. Simulated gentamicin concentrations varied with respect to postnatal age and bodyweight. (4) Conclusions: A 5 mg/kg/24 h dosage regimen yielded simulated gentamicin concentrations with respect to age and birthweight similar to those previously reported in the literature to be safe and efficacious, confirming its appropriateness.
Citation: Children
PubDate: 2024-07-26
DOI: 10.3390/children11080898
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 899: Association between Motor Skills,
Occupational Performance, and Mental Health in Japanese Children with
Neurodevelopmental Disorders: A Cross-Sectional Correlational Study
Authors: Masanori Yasunaga, Hideki Miyaguchi, Chinami Ishizuki, Yosuke Kita, Akio Nakai
First page: 899
Abstract: Background: Motor skills have been linked to executive functions (EFs) in children with developmental coordination disorder (DCD). However, the traits of other neurodevelopmental disorders (NDDs), such as attention-deficit/hyperactivity disorder and autism spectrum disorder, remain overlooked. Therefore, this study explored the association between motor skills, occupational performance, and mental health in older kindergarten children with DCD and other NDDs. Overall, 95 participants aged 5–6 years were included in this study and divided into four groups: DCD traits (DCD-t), DCD-t + NDD traits (DCD-t + NDD-t), NDD-t-only, and typically developing children. Motor skills, EFs, and mental health were assessed using the DCD Questionnaire (DCDQ-J) and Movement Assessment Battery for Children—Second Edition, School Assessment of Motor and Process Skills (S-AMPS), and the Strengths and Difficulties Questionnaire (SDQ), respectively. The DCD-t + NDD-t group exhibited a strong correlation between the S-AMPS motor skill score and the DCDQ-J fine motor skill score (r = 0.88, p < 0.001) and between the total DCDQ-J score and the SDQ Total Difficulties Score (r = −0.94, p < 0.001). The findings indicate that children with DCD-t and NDD-t are more likely to experience EF and mental health problems than those with DCD-t only.
Citation: Children
PubDate: 2024-07-26
DOI: 10.3390/children11080899
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 900: Orofacial Features, Oral Health-Related
Quality of Life, and Exposure to Bullying in Osteogenesis Imperfecta: A
Cross-Sectional Study
Authors: Alice Broutin, Jean-Pierre Salles, Valérie Porquet-Bordes, Thomas Edouard, Frédéric Vaysse, Emmanuelle Noirrit-Esclassan
First page: 900
Abstract: Background/Objectives: Osteogenesis imperfecta (OI) is a rare genetic disease that is responsible for bone fragility, but also for dental malocclusions and dentinogenesis imperfecta (DI). The aim of this study was to assess whether the severity of dental malocclusion influenced the oral health-related quality of life (OHRQoL) and exposure to bullying in a paediatric OI population compared with a control group. Methods: Dental and occlusal characteristics were noted during oral and radiographic examination. The severity of malocclusion was assessed using the PAR index. P-CPQ, COHIP(34), and BCS-A questionnaires were used to evaluate, respectively, externally and self-perceived OHRQoL and bullying. Results: We included 39 patients with a mean age of 11.3 (±4.8 SD) in the OI group, and 45 patients with a mean age of 12.3 (±3.2 SD) in the control group. There were no significant differences between the two groups in terms of occlusal vertical and transverse dimensions. Patients with severe OI, presenting with bone fractures, bones deformities, and short stature, had significantly more anterior (p < 0.05) and posterior openbites (p < 0.05) and more DI (p < 0.05) compared to patients who had moderate or mild OI. Self-perceived OHRQoL was negatively impacted by the disease (p = 0.01), particularly in the domains of oral health (p < 0.05) and self-image (p < 0.001), but not by its severity. Exposure to bullying did not differ significantly between the two groups, although more patients with OI reported being teased (21.4% face to face and 7.1% online vs. 14.6% and 2.4% in the control group). Conclusion: Interventions for dental malocclusion and oral health in OI patients would help to improve their quality of life and self-image.
Citation: Children
PubDate: 2024-07-26
DOI: 10.3390/children11080900
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 901: Understanding Knowledge Mobilisation between
Community Champions and Parents: Evidence from a Community-Based Programme
to Support Parents with Young Children
Authors: Wilkinson, Berry, Lloyd, Marks, Lang
First page: 901
Abstract: Background: Community champions have been employed across various settings to disseminate evidence-based public health information. The Building Babies’ Brains programme trains champions to work with parents in communities, equipping them with child development knowledge and parental engagement strategies. We explored what makes community champions effective in distributing information to parents, including how the champion–parent relationship and champions’ personal characteristics affect information dissemination. Methods: Champions included both peers and professionals working with parents in target communities. We administered an online survey (n = 53) and follow-up interviews (n = 14) with champions, with representation from across all training cohorts. We conducted a realist-informed reflexive thematic analysis to generate themes in the data and highlight the contexts, mechanisms, and outcome patterns identified. Results: We observed 15 Context–Mechanism–Outcome configurations across five themes: information sharing opportunities, information relevance, the nature of the champion–parent relationship, interaction expectations, and champion confidence. Our programme theory for how the community champion approach works identified that peer champions focused more on building rapport, modelling behaviours, and being a trusted community resource than direct information transfer. Professional champions, in contrast, showed greater expertise and confidence in discussing parenting practices directly. For both groups, traits such as friendliness and the ability to establish a trusting relationship enhanced effectiveness. Conclusions: This research identifies the impacts of champion role, characteristics, and the champion–parent relationship on the effectiveness of knowledge mobilisation in this context, with implications for training and recruitment of champions. Those using a champion model in comparable settings should ensure that champions have the necessary knowledge, skills, and confidence to engage parents and share information effectively.
Citation: Children
PubDate: 2024-07-26
DOI: 10.3390/children11080901
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 902: Decoding India’s Child Malnutrition
Puzzle: A Multivariable Analysis Using a Composite Index
Authors: Gulzar Shah, Maryam Siddiqa, Padmini Shankar, Indira Karibayeva, Amber Zubair, Bushra Shah
First page: 902
Abstract: Background: This study examines the levels and predictors of malnutrition in Indian children under 5 years of age. Methods: Composite Index of Anthropometric Failure was applied to data from the India National Family Health Survey 2019–2021. A multivariable logistic regression model was used to assess the predictors. Results: 52.59% of children experienced anthropometric failure. Child predictors of lower malnutrition risk included female gender (adjusted odds ratio (AOR) = 0.881) and average or large size at birth (AOR = 0.729 and 0.715, respectively, compared to small size). Higher birth order increased malnutrition odds (2nd-4th: AOR = 1.211; 5th or higher: AOR = 1.449) compared to firstborn. Maternal predictors of lower malnutrition risk included age 20–34 years (AOR = 0.806), age 35–49 years (AOR = 0.714) compared to 15–19 years, normal BMI (AOR = 0.752), overweight and obese BMI (AOR = 0.504) compared to underweight, and secondary or higher education vs. no education (AOR = 0.865). Maternal predictors of higher malnutrition risk included severe anemia vs. no anemia (AOR = 1.232). Protective socioeconomic factors included middle (AOR = 0.903) and rich wealth index (AOR = 0.717) compared to poor, and toilet access (AOR = 0.803). Children’s malnutrition risk also declined with paternal education (primary: AOR = 0.901; secondary or higher: AOR = 0.822) vs. no education. Conversely, malnutrition risk increased with Hindu (AOR = 1.258) or Islam religion (AOR = 1.369) vs. other religions. Conclusions: Child malnutrition remains a critical issue in India, necessitating concerted efforts from both private and public sectors. A ‘Health in All Policies’ approach should guide public health leadership in influencing policies that impact children’s nutritional status.
Citation: Children
PubDate: 2024-07-26
DOI: 10.3390/children11080902
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 903: Evaluating Malnutrition Practices and
Mother’s Education on Children Failure to Thrive Symptoms Using
Entropy-Weight and TOPSIS Method
Authors: Maria Tzitiridou-Chatzopoulou, Georgia Zournatzidou, Eirini Orovou, Maria Lithoxopoulou, Eftychia Drogouti, George Sklavos, Evangelia Antoniou, Christos Tsakalidis
First page: 903
Abstract: Background/Objectives: Failure to thrive (FTT) is mostly caused by insufficient consumption of nutrient-rich food, recurrent infections like diarrhea and intestinal worms, substandard caregiving practices, and limited availability of health and other vital services. Furthermore, there was a correlation between the educational level of mothers and the occurrence of FTT in children aged 6–12 months. Thus, the objective of the current research is twofold: (i) to investigate other factors related to FTT and (ii) to evaluate the impact of them on FTT in Sub-Saharan African countries and their urban areas. Methods: We used weight entropy and TOPSIS methods to approach the research question. In particular, the entropy-weight method is effective for precisely evaluating the relative significance of the selected criteria for TOPSIS computation. Thus, data were retrieved from the database of UNICEF for the year 2019 for nine Sub-Saharan countries, and based on the methods used, five criteria have been selected for consideration. Those of mothers in higher education were identified as having a higher weight, which means that this can affect positively the ability of mothers to mitigate the situation of FTT and protect their children. Results: The findings of the study highlight the factors of maternal education at a higher level and unhealthy habits as those with the greatest weight and impact on the FTT. Moreover, the results indicate that the association between maternal education, and especially higher education, and FTT is stronger in Ethiopia. Despite the limited amount of research on the specified relationship in Sub-Saharan countries, this study is among the initial ones to examine it. Conclusions: The current study can aid policymakers in devising appropriate policies and implementing effective measures to tackle FTT in Sub-Saharan Africa, like enhancing the number of mothers in these countries to be integrated into the educational system to help both themselves and their children mitigate or avoid the symptoms of FTT.
Citation: Children
PubDate: 2024-07-26
DOI: 10.3390/children11080903
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 904: The Clinical Approach to Interstitial Lung
Disease in Childhood: A Narrative Review Article
Authors: Simona Drobňaková, Veronika Vargová, László Barkai
First page: 904
Abstract: Interstitial lung disease (ILD) comprises a group of respiratory diseases affecting the interstitium of the lungs, which occur when a lung injury triggers an abnormal healing response, and an inflammatory process leads to altered diffusion and restrictive respiratory dysfunction. The term “interstitial” may be misleading, as other components of the lungs are usually also involved (epithelium, airways, endothelium, and so on). Pediatric conditions (childhood interstitial lung disease, chILD) are different from adult forms, as growing and developing lungs are affected and more diverse and less prevalent diseases are seen in childhood. Diffuse parenchymal lung disease (DPLD) and diffuse lung disease (DLD) can be used interchangeably with ILD. Known etiologies of chILD include chronic infections, bronchopulmonary dysplasia, aspiration, genetic mutations leading to surfactant dysfunction, and hypersensitivity pneumonitis due to drugs or environmental exposures. Many forms are seen in disorders with pulmonary involvement (connective tissue disorders, storage diseases, malignancies, and so on), but several conditions have unknown origins (desquamative pneumonitis, pulmonary interstitial glycogenosis, neuroendocrine cell hyperplasia in infancy, and so on). Currently, there is no consensus on pediatric classification; however, age grouping is proposed as some specific forms are more prevalent in infancy (developmental and growth abnormalities, surfactant dysfunction mutations, etc.) and others are usually seen in older cohorts (disorders in normal or immunocompromised hosts, systemic diseases, etc.). Clinical manifestations vary from mild nonspecific symptoms (recurrent respiratory infections, exercise intolerance, failure to thrive, dry cough, etc.) to a severe clinical picture (respiratory distress) and presentation related to the child’s age. The diagnostic approach relies on imaging techniques (CT), but further investigations including genetic tests, BAL, and lung biopsy (VATS) are needed in uncertain cases. Pharmacological treatment is mostly empiric and based on anti-inflammatory and immunomodulatory drugs. Lung transplantation for selected cases in a pediatric transplantation center could be an option; however, limited data and evidence are available regarding long-term survival. International collaboration is warranted to understand chILD entities better and improve the outcomes of these patients.
Citation: Children
PubDate: 2024-07-26
DOI: 10.3390/children11080904
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 905: Efficacy and Safety of Vagus Nerve
Stimulation in Lennox–Gastaut Syndrome: A Scoping Review
Authors: Debopam Samanta
First page: 905
Abstract: Lennox–Gastaut syndrome (LGS) is a severe developmental and epileptic encephalopathy characterized by drug-resistant seizures, cognitive impairments, and abnormal electroencephalographic patterns. Vagus nerve stimulation (VNS) is a widely used neuromodulation therapy for LGS, but its effects on seizure outcomes, different seizure types, non-seizure outcomes, and adverse events in this population have not been comprehensively reviewed. To conduct a scoping review on the use of VNS in LGS, a literature search was performed in PubMed, OVID, Web of Science, and Embase from inception to 9 June 2024, using relevant keywords and without restrictions on study design. The search yielded forty eligible studies (twenty-four retrospective cohorts, fourteen prospective cohorts, and two registry analyses) comprising 1400 LGS patients treated with VNS. No randomized controlled trials were identified. Across studies, the median seizure reduction ranged from 20.6% to 65%, with 0% to 100% of patients achieving a ≥50% seizure reduction. No consistent preoperative biomarker of VNS responsiveness was identified in LGS. Although inconsistent among different studies, tonic, atonic, and tonic–clonic seizures responded best, while focal seizures responded worst. Improvements in seizure severity, alertness, and quality of life were reported in some studies, but cognitive and adaptive functioning generally remained unchanged. Adverse events were mostly mild and transient, including hoarseness, cough, and paresthesia. Device-related complications and infections were uncommon. In conclusion, further research is needed to better understand VNS’s position in the evolving LGS treatment landscape and its cost effectiveness.
Citation: Children
PubDate: 2024-07-27
DOI: 10.3390/children11080905
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 906: Management of Pediatric Elbow Fractures and
Dislocations
Authors: Marko Bašković, Domagoj Pešorda, Luca Zaninović, Damir Hasandić, Katarina Lohman Vuga, Zenon Pogorelić
First page: 906
Abstract: Pediatric elbow fractures and dislocations have always been a challenge from a diagnostic and therapeutic point of view, primarily due to the complex nature of the pediatric elbow, especially its developmental anatomy. They must be diagnosed and treated on time to prevent numerous complications with long-term consequences. With the development of radiology and pediatric surgery and orthopedics, as well as the development of modern osteosynthesis materials, concerning current scientific and professional knowledge, the outcomes are getting better, with fewer acute and chronic complications. This comprehensive review aims to provide clinicians current knowledge about pediatric elbow fractures and dislocations so that in daily practice they have as few doubts as possible with the best possible treatment outcomes.
Citation: Children
PubDate: 2024-07-27
DOI: 10.3390/children11080906
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 907: Exploring the Continuous Glucose Monitoring
in Pediatric Diabetes: Current Practices, Innovative Metrics, and Future
Implications
Authors: Agata Chobot, Claudia Piona, Bruno Bombaci, Olga Kamińska-Jackowiak, Valentina Mancioppi, Stefano Passanisi
First page: 907
Abstract: Continuous glucose monitoring (CGM) systems, including real-time CGM and intermittently scanned CGM, have revolutionized diabetes management, particularly in children and adolescents with type 1 diabetes (T1D). These systems provide detailed insights into glucose variability and detect asymptomatic and nocturnal hypoglycemia, addressing limitations of traditional self-monitoring blood glucose methods. CGM devices measure interstitial glucose concentrations constantly, enabling proactive therapeutic decisions and optimization of glycemic control through stored data analysis. CGM metrics such as time in range, time below range, and coefficient of variation are crucial for managing T1D, with emerging metrics like time in tight range and glycemia risk index showing potential for enhanced glycemic assessment. Recent advancements suggest the utility of CGM systems in monitoring the early stages of T1D and individuals with obesity complicated by pre-diabetes, highlighting its therapeutic versatility. This review discusses the current CGM systems for T1D during the pediatric age, established and emerging metrics, and future applications, emphasizing the critical role of CGM devices in improving glycemic control and clinical outcomes in children and adolescents with diabetes.
Citation: Children
PubDate: 2024-07-27
DOI: 10.3390/children11080907
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 908: Neck Circumference as a Valuable Tool to
Identify the Risk of Metabolic Syndrome in Mexican Children
Authors: Evelyn Valencia-Sosa, Guillermo Julián González-Pérez, Clío Chávez-Palencia, María Guadalupe Vega-López, Enrique Romero-Velarde
First page: 908
Abstract: Background/Objectives: Neck circumference (NC) has been proposed as a simple measurement to identify patients with overweight and obesity. It has been found that adipose tissue at the cervical level is associated with the presence of metabolic alterations. The aim of this study was to estimate the association between NC and indicators of Metabolic Syndrome (MS) to subsequently estimate its capacity to identify the risk of MS compared to waist circumference (WC) and Body Mass Index (BMI). Methods: A cross-sectional study was carried out with a sample of 286 children 6–9 years old who attended six public primary schools in Jalisco, Mexico. Pearson’s correlation coefficients along with sensitivity and specificity tests were performed to analyze the relationship between NC and MS indicators. Odds ratio (OR) and concordance analyses were performed considering the Kappa index. Results: NC showed statistically significant correlations with all MS indicators except for LDL cholesterol and total cholesterol. The cut-off points of NC to identify MS according to sex was >27.4 cm for girls and >29.8 cm for boys. The association of NC with values above the cutoff point and the presence of MS was OR: 21.6 (CI: 7.11–65.74). Conclusions: NC represents a simple and cost-effective alternative to identify children at risk of MS when compared to BMI and WC.
Citation: Children
PubDate: 2024-07-27
DOI: 10.3390/children11080908
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 909: Executive Functioning Profiles in
Neurodevelopmental Disorders: Parent–Child Outcomes
Authors: Ana Pardo-Salamanca, Daniela Paoletti, Gemma Pastor-Cerezuela, Simona De Stasio, Carmen Berenguer
First page: 909
Abstract: Background/Objectives: Children with autism spectrum disorder (ASD) and/or attention deficit hyperactivity disorder (ADHD) exhibit more executive function (EF) deficits compared to typically developing (TD) peers. EF deficits are linked to various impairments in daily functioning and increased parental stress. The first aim of the present study is to investigate EFs in children with ASD and ADHD compared to their TD peers. The second aim is to explore profiles of executive functions in children with ASD and ADHD and, finally, to determine the differences of EF profiles in relation to parental stress and children’s functional impairments. Methods: The sample comprised 30 TD children, 47 children with ASD, and 34 children with ADHD, aged 8 to 12 years. Parents completed questionnaires of parenting stress, and children’s social and daily-life functioning. Parents and teachers reported information about children’s EF. Results: The results indicated significantly greater impairment of EFs in the clinical groups compared to the TD group. Moreover, three distinct clusters of functioning were identified based on the severity of reported EF difficulties. The significant findings showed that children with more severe EF profiles were associated with greater daily impairment and higher levels of perceived parental stress. Conclusions: Given the impact of EF deficits on the lives of children with ASD and ADHD and their families, it is crucial that studies like this enhance our understanding and inspire future interventions aimed at improving executive functions in children with ASD and ADHD. Such interventions could help reduce parental stress and improve daily functioning.
Citation: Children
PubDate: 2024-07-27
DOI: 10.3390/children11080909
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 910: Non-Genetic Healthcare Providers’
Experiences and Perspectives with Rapid Genome-Wide Sequencing in Canadian
Neonatal Intensive Care Units
Authors: Lauren Piers, Tasha Wainstein, Gustavo Pelligra, Horacio Osiovich, GenCOUNSEL Study GenCOUNSEL Study, Alison M. Elliott
First page: 910
Abstract: Background/Objectives: Rapid genome-wide sequencing (rGWS) continues to transform the care provided to infants with genetic conditions in neonatal intensive care units (NICUs). Previous research has demonstrated that rGWS has immense benefits on patient care; however, little is known about non-genetic healthcare providers’ (HCPs) experiences and perspectives of working with rGWS and supporting families through the rGWS testing process in Canadian NICU facilities. To address this gap, we surveyed and conducted semi-structured interviews with non-genetic HCPs of diverse professions from NICUs in British Columbia. Methods: An interpretive description approach was used to analyze interview transcripts to identify patterns and variations in non-genetic HCPs’ experiences and perceptions with rGWS. Results: Participants had varying degrees of exposure to rGWS and levels of comfort with the testing process. Numerous barriers affecting the implementation of rGWS were identified, including low levels of comprehension of rGWS, longer turn-around times than expected, and having to apply for provincial government approval to access testing. Participants desired more education on rGWS, clear guidelines on the use of rGWS in NICUs, and resources for non-genetic HCPs and parents to support implementation. Conclusions: The results from this study can inform the development of workflows and educational resources on the use of rGWS in NICUs, helping to ensure that the NICU team is supported to optimize rGWS implementation.
Citation: Children
PubDate: 2024-07-28
DOI: 10.3390/children11080910
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 911: Surgical Strategies in Total Colonic
Aganglionosis: Primary Pullthrough-Pathway of Care
Authors: Stefanie Märzheuser, Felix Schulze, Judith Lindert
First page: 911
Abstract: Background: Total colonic aganglionosis, as a rare variant of Hirschsprung Disease, still poses challenges to surgeons in terms of diagnosis and management. The optimal preparation for pullthrough is crucial for reconstructive surgery. This study aims to explore our surgical pathway for children with total colonic aganglionosis (TCA) and to describe the prehabilitation necessary to prepare for successful reconstructive pullthrough surgery. Methods: A prospective review of children with TCA receiving an abdominal surgical intervention between 1/22 and 4/24. The cohort included children receiving mapping +/− primary ileoanal pullthrough. An analysis of preoperative, perioperative, and postoperative data, and a short-term follow-up were performed. Results: A total of 18 children with TCA and no prior pullthrough received an abdominal intervention during the 29-month study period, and 5/18 (27.8%) were female. The children had a median of 4 (range 2–7) prior external surgeries; all had a stoma; 6 (33%) children received parental nutrition; 12 children underwent a mapping of the ganglia distribution and bowel length at a median age of 11 months (range 3–54), and in 10 of them, we relocated the stoma. There was a mean involvement of 15 (5–93) cm small bowel aganglionosis, with the remaining mean ganglionic small bowel having a length of 178 cm (110–254). A total of 11 children underwent straight primary ileoanal pullthrough of the stoma site at a median age of 16.7 months (10–133). Conclusions: The timely diagnosis of TCA still challenges the care team, and most children have a rough journey involving several surgeries until their diagnosis is established. The ensure bowel function with an adequate working stoma is the key to enabling enteral nutrition and growth, which are the baseline requirements to undertake a successful pullthrough procedure and restore continuity. Careful perioperative bowel management and parents’ active involvement supports children with Hirschsprung Disease achieving the best possible quality of life.
Citation: Children
PubDate: 2024-07-28
DOI: 10.3390/children11080911
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 912: Study of rs7759938, rs314280, and rs314276
Polymorphisms of LIN28B in Relation to Age at Menarche in Girls of Greek
Descent
Authors: Vasiliki Rengina Tsinopoulou, Flora Bacopoulou, Liana Fidani, Dimitrios Dimitriadis, Spyridon Gerou, Athanasios Christoforidis
First page: 912
Abstract: Background: Single-nucleotide polymorphisms in LIN28B, critical regulators of female growth and puberty, have been linked to age at menarche. Methods: We assessed the association of rs7759938, rs314280, and rs314276 with menarcheal age in girls of Greek descent. We reviewed the records of 248 girls who had their first menstruation before 18 years and who attended the Greek Departments of Pediatric Endocrinology from January 2021 to July 2023. Genotyping was performed by standard DNA-based methods. Association analyses involved both parametric and non-parametric tests. Results: The average age of breast and pubic hair development was 9.95 years, and the age at menarche was 11.55 years. Menarche occurred ≤11 years (mean 10.24 years) in 108 girls (43.5%) and >11 years (mean 12.55 years) in 140 (56.5%). The girls’ menarcheal age correlated significantly with that of their mothers (average 12.1 years, p-value < 0.0001, Spearman’s r 0.350). The dominant rs7759938(TT) genotype was the most common (55.2%), followed by the dominant rs314276(CC) (53.2%) and dominant rs314280(TT) (14.5%) genotypes. Conclusions: There was no association between age at menarche and any of the polymorphism genotypes/alleles or between genotypes/alleles and birth weight, gestational week, mode of delivery, and maternal age at menarche. Future large sample studies are warranted to confirm these results.
Citation: Children
PubDate: 2024-07-29
DOI: 10.3390/children11080912
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 913: Hormonal Imbalance as a Prognostic Factor of
Physical Development of Children with Intellectual Disability
Authors: Olga V. Smirnova, Elizaveta S. Ovcharenko, Edward V. Kasparov
First page: 913
Abstract: Introduction: The purpose was to study the indicators of physical development of primary-school-aged children with intellectual disability by observing the type of autonomic nervous regulation and their levels of catecholamines and serotonin. Methods: A total of 168 primary school age children were examined, of which 54 had intellectual disability. The autonomic nervous system was assessed using cardiointervalography; anthropometric parameters were applied in accordance with recommendations. The contents of serotonin and catecholamines in blood plasma and lymphocytes were assessed using enzyme immunoassay and luminescent histochemical methods. Results and conclusions: Delayed physical and mental development in children with intellectual disability were associated with low serotonin levels in this group of children. The optimal option for the physical development of children with intellectual disability is a sympathetic type of autonomic nervous regulation, while negative-type vagotonic nervous regulation was associated with the maximum delay in physical development. The hypersympathetic type of nervous regulation was accompanied by minimal changes in physical development, despite the hormonal imbalance in the ratio of catecholamines and serotonin. The level of the neurotransmitter serotonin is a prognostic marker of the physical development of children of primary school age. The total amount of catecholamines and serotonin in blood plasma has a direct relationship with the amount of these neurotransmitters in blood lymphocytes; the more hormones in plasma, the more of them in lymphocytes. Therefore, the determination of the contents of catecholamines and serotonin in lymphocytes can be used as a model for studying neurotransmitters in humans.
Citation: Children
PubDate: 2024-07-29
DOI: 10.3390/children11080913
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 914: Screens and Preschools: The Bilingual
English Language Learner Assessment as a Curriculum-Compliant Digital
Application
Authors: Hechmi Kilani, Ilia V. Markov, David Francis, Elena L. Grigorenko
First page: 914
Abstract: Background/Objectives: The increase in digital tools in early childhood education highlights the need for evidence-based assessments that support cognitive development and align with educational requirements and technological advances. This study contributes to the evaluation of the Bilingual English Language Learner Assessment (BELLA), designed to enhance early learning through curriculum-aligned tasks in preschool-aged children. Methods: Data were collected from 17 schools, including 506 preschool children, using a mixed-model approach to assess BELLA’s capacity to appraise early numeracy, literacy, science, and social/emotional development. Analyses included a three-way ANOVA to examine the effects of sex, age, and sub-domain on pass rates and mixed-effects models to evaluate interactions between age and domain. Results: The results indicated a significant effect of age on performance across all domains, with older children demonstrating higher pass rates (p < 0.0001). No significant gender bias was detected. The interaction between age and domain was also significant (p < 0.0001), suggesting domain-specific age-related performance trends, which aligns with internal validity requirements. Conclusion: These findings position BELLA within the growing body of literature on digital media use in early childhood assessment and education, highlighting its potential as a curriculum-compliant digital assessment tool that evaluates and supports cognitive development without a gender bias. This study contributes to the field by providing empirical evidence of BELLA’s effectiveness and suggesting future research directions, including the exploration of its bilingual (and potentially multilingual) applications and external validation against existing evidence-based assessments.
Citation: Children
PubDate: 2024-07-29
DOI: 10.3390/children11080914
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 915: Screening Accuracy for Developmental
Dysplasia of the Hip by Child Health Nurses
Authors: Larissa Smart, William Cundy, Nicole Williams, Abigail Arnold, Jessie Childs, Lemuel Pelentsov, Adrian Esterman
First page: 915
Abstract: Background: Developmental Dysplasia of the Hip (DDH) describes a spectrum of abnormalities that impact the normal function of the joint. These abnormalities are detectable during infancy using physical assessment, universal ultrasound, or a combination of both. In Australia, child health nurses predominantly screen for this disease using physical assessment. The aim of this study was to determine if child health nurses can accurately screen for DDH using physical assessment. Methods: This Australian study estimated the accuracy and utility of child health nurses using physical assessment to screen for DDH by comparing it to a handheld ultrasound device. Results: This study (N = 44) concluded that using a point prevalence study design, child health nurses in Australia are unable to accurately assess for DDH in infants using physical assessment; overall, clinicians had 50.5% sensitivity (95% CI, 15.7 to 84.3), a specificity of 75.0% (95% CI, 57.8 to 87.9), and 71.3% accuracy (95% CI, 55.6 to 83.9). Conclusion: This study suggests that child health nurses cannot screen for DDH using physical assessment. Understanding education, experience and what assessments are used suggests that the utility of nurses performing DDH screening requires further investigation.
Citation: Children
PubDate: 2024-07-29
DOI: 10.3390/children11080915
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 916: Accurate Prediction of Children’s
Target Height from Their Mid-Parental Height
Authors: Danny Zeevi, Adi Ben Yehuda, Dafna Nathan, David Zangen, Leonid Kruglyak
First page: 916
Abstract: Background: For the past 50 years, standard guidelines have recommended the use of sex-adjusted mid-parental height to predict a child’s final height. Here, we studied the accuracy of this procedure. Methods: We used height data in a cohort of 23 very large nuclear families (mean = 11 adult children per family). We compared the actual final height of the children to their height predicted by the standard procedure, as well as to alternative height predictions that incorporate corrections of mid-parental height for age, sex, and regression to the mean. Results: Standard mid-parental height explained 36% of the variance in children’s heights, with a heritability of 74%, and children were on average 2.7 cm taller than predicted by their target heights. When we introduced a nonlinear correction for the age of the parents, employed a multiplicative (rather than additive) correction for sex, and accounted for regression to the mean, the variance explained increased to 40%, heritability increased to 80%, and prediction bias was reduced from 2.7 cm to 0.14 cm (representing an improvement in prediction by half a standard deviation of the height distribution). We further measured the empirical distribution of the heights of adult children around their predicted height. We describe how this distribution can be used to estimate the probability that a child’s height is within the normal expected range. Conclusions and Relevance: Based on these observations, we propose an improved method for predicting children’s target heights. Our procedure for determining whether the deviation of a child’s projected height from the target height is in the normal range can be used to assess whether the child should be tested further for potential medical abnormalities.
Citation: Children
PubDate: 2024-07-30
DOI: 10.3390/children11080916
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 917: Use of Lung Ultrasound in Cystic Fibrosis:
Is It a Valuable Tool'
Authors: Alessandra Boni, Luca Cristiani, Fabio Majo, Nicola Ullmann, Marianna Esposito, Maria Chiara Supino, Paolo Tomà, Alberto Villani, Anna Maria Musolino, Renato Cutrera
First page: 917
Abstract: Cystic fibrosis (CF) is a multisystem disorder characterized by progressive respiratory deterioration, significantly impacting both quality of life and survival. Over the years, lung ultrasound (LUS) has emerged as a promising tool in pediatric respiratory due to its safety profile and ease at the bedside. In the era of highly effective CF modulator therapies and improved life expectancy, the use of non-ionizing radiation techniques could become an integral part of CF management, particularly in the pediatric population. The present review explores the potential role of LUS in CF management based on available data, analyzing all publications from January 2015 to January 2024, focusing on two key areas: LUS in CF pulmonary exacerbation and its utility in routine clinical management. Nonetheless, LUS exhibits a robust correlation with computed tomography (CT) scans and serves as an additional, user-friendly imaging modality in CF management, demonstrating high specificity and sensitivity in identification, especially in consolidations and atelectasis in the CF population. Due to its ability, LUS could be an instrument to monitor exacerbations with consolidations and to establish therapy duration and monitor atelectasis over time or their evolution after therapeutic bronchoalveolar lavage. On the basis of our analysis, sufficient data emerged showing a good correlation between LUS score and respiratory function tests. Good sensitivity and specificity of the methodology have been found in rare CF pulmonary complications such as effusion and pneumothorax. Regarding its use in follow-up management, the literature reports a moderate correlation between LUS scores and the type, extent, and CT severity score of bronchiectasis. A future validation of ultrasound scores specifically in CF patients could improve the use of LUS to identify pulmonary exacerbations and monitor disease progression. However, further research is needed to comprehensively establish the role of LUS in the CF population, particularly in elucidating its broader utility and long-term impact on patient care.
Citation: Children
PubDate: 2024-07-30
DOI: 10.3390/children11080917
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 918: Differences in the Development of Motor
Skills in Portuguese Children Aged 12 Months after 3 Years of COVID-19
Confinement
Authors: Miguel Rebelo, Rui Paulo, Samuel Honório, João Petrica, Marco Batista, Pedro Duarte-Mendes, Catarina Marques, João Serrano
First page: 918
Abstract: (1) Background: The objective of the study was to verify the effects of COVID-19 confinement on motor skills through a longitudinal study in Portuguese children who were one year old at the beginning of the pandemic. (2) Methods: The sample consisted of 88 children of both sexes, in the pre-COVID-19 assessment, they were 13.31 ± 2.4 months old and in the post-COVID-19 assessment, the same children were already 49.31 ± 2.5 months old. Motor skills were assessed using the PDMS-2 scales. For the statistical analysis, the Kolmogorov–Smirnov test was used to test normality, and the Wilcoxon test was used to compare the results of the two assessments in the same sample. (3) Results: There were statistically significant differences in all motor skills assessed, with children presenting, on average, worse results in all global motor skills in the post-COVID-19 assessment, as opposed to fine motor skills, showing better results in the post-COVID-19 assessment. (4) Conclusions: These results show the negative impact of the pandemic on children evaluated with a special emphasis on global motor skills, with the majority demonstrating values considered below average for their age, noting that the pandemic protocols may have had serious consequences on children’s motor development, warning professionals who deal daily with children in these age groups about the importance of stimulating global motor skills.
Citation: Children
PubDate: 2024-07-30
DOI: 10.3390/children11080918
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 919: Impact of a Primary School Health Promotion
Programme on Adolescents’ Health Behaviour and Well-Being
Authors: Gabriella Nagy-Pénzes, Ferenc Vincze, Ágnes Víghné Arany, Éva Bíró
First page: 919
Abstract: Background/Objectives: Schools can play a key role in promoting health among adolescents, and Hungarian legislation gives them sufficient space to do so. In our study, we examined the impact of a multiyear school health promotion programme on pupils’ health behaviour and well-being. Methods: We carried out our investigation in an intervention and a control primary school in Hungary. All 5th and 7th grade pupils were invited to participate in the questionnaire-based survey between 2017 and 2021. The effect of the intervention was quantified using univariate and multivariate logistic regression analyses. Results: Our results show that for those behaviours where pupils’ personal choices had a greater influence (unhealthy eating, smoking, screen time), the health promotion programme was more effective. For those behaviours where family background and parental influence were more pronounced (healthy eating, physical activity), the intervention had less impact. Self-perceived health was better in the 7th-grade intervention group. Conclusions: Our findings are in line with the conclusion of systematic reviews that more intensive, longer-term, multi-behavioural school health promotion programmes can be effective in promoting positive behaviour. To be more effective, it would be worth using a well-structured curriculum, well-developed teaching materials, and greater involvement of teachers, parents, and various local organisations.
Citation: Children
PubDate: 2024-07-30
DOI: 10.3390/children11080919
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 920: Assessment of Psychosocial Stress and Mental
Health Disorders in Parents and Their Children in Early Childhood:
Cross-Sectional Results from the SKKIPPI Cohort Study
Authors: Julia Fricke, Marie Bolster, Katja Icke, Natalja Lisewski, Lars Kuchinke, Christiane Ludwig-Körner, Franziska Schlensog-Schuster, Thomas Reinhold, Anne Berghöfer, Stephanie Roll, Thomas Keil
First page: 920
Abstract: Background/Objectives: Early childhood can be a stressful period for families with a significant impact on parents’ mental health, the child’s healthy development, and the development of a secure mother–child attachment. The goal of the cross-sectional study part of SKKIPPI was to assess the occurrence of psychosocial stress and mental health disorders in parents as well as in their offspring in early childhood in three German regions. Methods: Based on random samples from three residents’ registration offices, parents with infants aged up to 12 months were invited to participate. An online screening questionnaire was developed in four languages to assess common psychosocial stressors and mental health problems of parents with small children. Results: The study enrolled 4984 mothers and 962 fathers. The most common potential psychosocial stressors were professional problems (mothers 22%, fathers 33%), lack of social support (20%, 14%), and severe, negative experiences in childhood (22%, 16%). Obsessive–compulsive thoughts (21%, 16%) and depressive (9%, 9%) and anxiety symptoms (11%, 7%) were the most frequently reported mental health problems by both parents. Regulatory problems of the child were reported by between 1.5% and 5.1% of parents. Conclusions: The study showed that a substantial proportion of parents are burdened by psychosocial problems and suffer from mental health problems in the first years after the birth of their children. Early preventive and low-threshold support measures should be available in the health and social care system. Low-threshold questionnaires, which cover a wide range of possible stress factors, should be further developed for the practical healthcare of this group of people.
Citation: Children
PubDate: 2024-07-30
DOI: 10.3390/children11080920
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 921: Is the Transrectal Diameter (TRD) Suitable
for Assessing Faecal Loads and Monitoring Bowel Management in Children
with Hirschsprung Disease—ReKiSo Study: Prospective Study
Authors: Judith Lindert, Daniel Erkel, Felix Schulze, Meike Hofer, Edyta Rzepka, Stefanie Märzheuser
First page: 921
Abstract: Background: Constipation and outlet obstruction may persist after successful pull-through in Hirschsprung Disease (HD). The radiographic assessment of the faecal load is widely used but exposes the child to radiation. This study aims to evaluate whether the transrectal diameter (TRD) assessed with ultrasound correlates with symptoms of faecal load and whether the TRD normalises when symptoms disappear. Method: Children with HD after pullthrough and functional constipation presenting to our colorectal clinic between 4/23 and 4/24 were assessed for symptoms of constipation, smearing and outlet obstruction, as well as healthy controls. Ultrasound measurement of the TRD was conducted. Bowel management was initiated according to our institutional pathway using Peristeen© irrigation after an orthograde disimpaction regime. Results: A total of 193 children underwent TRD assessment. Of 60 children with HD, 26 (43.3%) presented with obstructive symptoms, and 34 (56.7%) were asymptomatic. In asymptomatic patients with HD, the mean TRD of 2.26 cm (SD 0.61) was significantly (p < 0.001) lower than in HD with symptoms, with a mean TRD of 3.35 cm (SD 1.03). Individuals without colorectal pathology had a mean TRD of 2.04 cm (SD 0.37), and children with functional constipation and symptoms showed a mean TRD of 4.36 cm (SD 1.32). The mean TRD after symptom resolution was 2.37 cm. Conclusions: Children with HD without obstructive symptoms have a TRD < 3 cm, as do controls. The transrectal diameter allows the clinician to sonographically assess the faecal load in children with HD at the bedside without radiation. The TRD is useful for monitoring a bowel management program in children with HD.
Citation: Children
PubDate: 2024-07-30
DOI: 10.3390/children11080921
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 922: Clinical Features of RS Virus Infection
before, during, and after COVID-19 Pandemic
Authors: Natsu Ide, Kyosuke Tabata, Norihiro Tokuma, Yayoi Murano, Daisuke Yoneoka, Tomoyuki Nakazawa, Hiromichi Shoji
First page: 922
Abstract: The COVID-19 pandemic has impacted the epidemiology of other infectious diseases. In particular, the respiratory syncytial (RS) virus infects almost all children during their first or second year of life. However, during the COVID-19 pandemic, many restrictions were enforced that isolated children from other children. Therefore, we hypothesized that the clinical features of RS virus infection were altered and conducted a study to evaluate these changes. This observational study included children below the age of six years who were admitted to the Tokyo Metropolitan Toshima Hospital. Their clinicodemographic data were extracted from medical records. The 369 children eligible for the study were assigned to three groups: “pre-pandemic” (group 1, n = 253); “during pandemic” (group 2, n = 77), and “post-pandemic” (group 3, n = 39). Logistic regression analysis revealed that compared to group 1, the odds ratio (OR) for oxygen use was significantly higher in groups 2 (OR 1.85. 95% confidence interval [CI] 1.06–3.23; p < 0.05) and 3 (OR 3.36, 95% CI 1.59–7.12; p < 0.01), and the use of mechanical ventilation was significantly higher in group 3 (OR 4.89, 95% CI 1.71–13.94; p < 0.01). This study highlights changes in the clinical features of RS virus infection during and after the COVID-19 pandemic.
Citation: Children
PubDate: 2024-07-30
DOI: 10.3390/children11080922
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 923: Hospital and Patient Characteristics
Associated with Neonatal Blood Stream Infection in Inpatient Care:
Insights from the 2019 HCUP KID Database
Authors: Michael Samawi, Gulzar H. Shah, Linda Kimsey, Kristie C. Waterfield, Susan Hendrix
First page: 923
Abstract: Background: This study explores the associations between pediatric adverse events (PAEs) and both hospital and patient characteristics within the inpatient hospital setting, specifically focusing on Neonatal Blood Stream Infection (NBSI) as defined by pediatric quality indicators (PDIs) from the Agency for Healthcare Research and Quality (AHRQ). This research aims to answer questions regarding the relationship between hospital characteristics and patient demographics with the occurrence of NBSI. Methods: This study utilized discharge data from the Healthcare Cost and Utilization Project (HCUP) Kids’ Inpatient Databases (KID) for the year 2019. Bivariate and multivariate logistic regression models were employed to analyze patient-level encounters of NBSIs. The analysis examined various factors including hospital size, location, and teaching status, as well as patient-specific variables such as gender, age, race, service lines, payment sources, and major operating room procedures. Results: The results indicate that Public and Private not-for-profit hospitals showed significantly lower odds of experiencing NBSIs when compared to Private investor-owned hospitals, as did smaller, rural, and nonteaching hospitals when compared to large hospitals. Additionally, individual factors such as gender, age, race, service lines, payment sources, and types of major operating room procedures were found to have varying levels of significance in relation to NBSI. Conclusions: This study provides important insights into PAEs within the inpatient hospital setting, particularly focusing on NBSIs within the PDI framework. The findings highlight critical areas for the development of evidence-based interventions and guidelines, which are essential for clinicians and policymakers. Ultimately, this study contributes to the understanding and improvement of pediatric patient safety by emphasizing the necessity for targeted strategies to mitigate the risk of NBSI.
Citation: Children
PubDate: 2024-07-30
DOI: 10.3390/children11080923
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 924: The Legacy of the COVID-19 Pandemic: Impact
on Infant and Maternal and Health from an Appalachian Academic Medical
Center
Authors: Kelsey Haarbauer, Rebecca Burke, M. Cody Smith, Audrey N. Miller, Patricia N. Moran, Alicia A. Moise, Lesley Cottrell, Mark J. Polak
First page: 924
Abstract: Background/Objectives: The COVID-19 pandemic period from 2020 to 2022 had a significant impact on maternal infant health with mothers impacted more than their infants. We questioned whether there have been any lingering effects from the pandemic. Methods: We examined intermediate and long-term pandemic effects on maternal and neonatal outcomes before, during, and after the COVID-19 pandemic period. We reviewed mother–infant pairs from the following three epochs: (1) the pre–COVID-19 period, (2) the COVID-19 pandemic period, and (3) the post-pandemic period. The Case Mix Index (CMI) for the neonates from all three epochs were detailed. Results: Post-pandemic, we noted a rising trend of LGA infants (10%) and an increase in SGA infants (13%). For women in 2023, we noted an increase in hypertension, preeclampsia, diabetes, and a higher BMI than in the pre-pandemic period. There have also been more congenital anomalies (9%), and neonatal CMI increased in the post-pandemic period. Conclusions: Well after the pandemic period, maternal–infant health continues to be affected. For women, the increase in hypertension and diabetes during pregnancy is concerning. For infants, being LGA or SGA may have long-term consequences. The post-pandemic increase in infants with congenital anomalies compared to the pre-pandemic era is an area that needs ongoing review.
Citation: Children
PubDate: 2024-07-30
DOI: 10.3390/children11080924
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 925: Fear of Fat, Processes of Change, and
Weight-Related Behaviors in Mexican and Spanish Adolescents
Authors: María Marentes-Castillo, Isabel Castillo, Inés Tomás, Olivia González-Acevedo, Octavio Álvarez
First page: 925
Abstract: Background: Fear of fat is a relevant variable in initiating weight regulation behaviors in adolescents. However, little is known about the experiential and behavioral change processes that mediate the choice between healthy and unhealthy weight regulation behaviors in this population. Method: The general objective was to examine the predictive role of fear of fat on weight-related behaviors (healthy and unhealthy weight control behaviors) through the mediation of experiential and behavioral change processes (consciousness raising, counterconditioning, helping relationships, reinforcement management, self-liberation, self-reevaluation, stimulus control, substance use) in 838 adolescents aged 15–19 years from Mexico and Spain using parallel mediation analysis. Additionally, the study examined the correlations between the variables with regard to gender and country, as well as the differences in the use of processes of change across stages of change through the use of a multivariate analysis of variance. The Spanish version of the Fear of Fat, Stages of Change, Processes of Change, and Weight-Related Behaviors scales were used. Results: The mediation analysis showed that fear of fat predicted healthy weight control behaviors through consciousness raising, self-liberation, and stimulus control. On the other hand, fear of fat predicted unhealthy weight control behaviors through counterconditioning, stimulus control, and the use of weight loss substances. Intervening to reduce fear of fat may be a way to modify the processes of change used by adolescents to regulate their weight. Conclusions: The results of this study indicate that adolescents may initiate weight control behaviors as a result of fear of fat. This process is mediated by experiential and behavioral processes that influence weight regulation.
Citation: Children
PubDate: 2024-07-30
DOI: 10.3390/children11080925
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 926: Feasibility and Acceptability of a Newborn
Screening Program Using Targeted Next-Generation Sequencing in One
Maternity Hospital in Southern Belgium
Authors: Tamara Dangouloff, Kristine Hovhannesyan, Davood Mashhadizadeh, Frederic Minner, Myriam Mni, Laura Helou, Flavia Piazzon, Leonor Palmeira, François Boemer, Laurent Servais
First page: 926
Abstract: Purpose: Genomic newborn screening programs are emerging worldwide. With the support of the local pediatric team of Liege, Belgium, we developed a panel of 405 genes that are associated with 165 early-onset, treatable diseases with the goal of creating a newborn screening test using targeted next-generation sequencing for all early-onset, treatable, and serious conditions. Methods: A process was developed that informed the future parents about the project and collected their consent during a face-to-face discussion with a trained investigator. The first baby was screened on 1 September 2022. The main objective of the study was to test the feasibility and the acceptability of targeted sequencing at birth as a first-tier newborn screening approach to detect treatable genetic conditions or genetic conditions for which a pre-symptomatic or early symptomatic clinical trial is available. Results: As of 20 June 2024, the parents of 4425 children had been offered the test; 4005 accepted (90.5%) and 420 refused (9.5%). The main reasons for refusal were the research nature of the project and the misunderstanding of what constitutes genetic conditions. Conclusions: These data demonstrate the high acceptability of genomic newborn screening in a properly informed population.
Citation: Children
PubDate: 2024-07-30
DOI: 10.3390/children11080926
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 927: Comparison of Single-Treatment Efficacy of
Bevacizumab and Ranibizumab for Retinopathy of Prematurity
Authors: Fumio Takano, Kaori Ueda, Yuko Yamada-Nakanishi, Makoto Nakamura
First page: 927
Abstract: Background: Retinopathy of prematurity (ROP) is a significant cause of blindness in infants. Appropriate therapeutic intervention is essential because retinal detachment due to the progression of ROP is critical to visual function. The intravitreal injection of anti-vascular endothelial growth factor (VEGF) agents has been increasingly applied to inhibit the development and progression of ROP. In this study, we compared the efficacy of single intravitreal bevacizumab (IVB) and ranibizumab (IVR) injections for the treatment of ROP. Methods: A total of 39 eyes in 21 patients with severe ROP and IVB (15 eyes of 8 patients) and IVR (24 eyes of 13 patients) were retrospectively reviewed. Patient background, the severity of ROP, and the percentage of cases in which ROP regressed without additional treatment were compared between the two groups. Results: Patient background and ROP severity were not significantly different between the two groups. Recurrence was observed in one eye of one patient in the IVB group, and thirteen eyes in seven patients in the IVR group required additional laser photocoagulation, which was significantly different in the two groups (p < 0.01, Fisher’s exact test). In the IVR group, two eyes of two patients underwent vitreous surgery. Conclusion: Compared with IVR, IVB is likely to control the severity of ROP with a single treatment.
Citation: Children
PubDate: 2024-07-31
DOI: 10.3390/children11080927
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 928: Nadir Creatinine in Congenital Anomalies of
the Kidney and Urinary Tract (CAKUT): A Single-Center Experience
Authors: Marius-Cosmin Colceriu, Paul Luchian Aldea, Bogdan Bulată, Dan Delean, Alexandra Sevastre-Berghian, Simona Clichici, Andreea-Liana Boț (Răchişan), Teodora Mocan
First page: 928
Abstract: Background/Objectives: Congenital anomalies of the kidney and urinary tract (CAKUT) are the main cause of chronic kidney disease (CKD) requiring renal replacement therapy (RRT) in children, being the leading cause (50–70%) of end-stage renal disease (ESRD) in children and young adults. Our study aimed to assess the natural evolution of various antenatally diagnosed renal malformations and to identify potential prognostic factors to guide the therapeutic management of patients with CAKUT. Methods: We conducted a retrospective study on 205 children with CAKUT. For each patient, analyzing their medical records, we established the nadir value of serum creatinine, defined as the lowest creatinine level during the first year of life. We assessed the value of nadir creatinine as a prognostic marker in patients with CAKUT, and using an ROC curve, we also determined a threshold value of nadir creatinine that predicted progression to ESRD. Results: The male-to-female ratio was 2.8 to 1. The mean gestational age at detection was 29.85 weeks (±6.71). A total of 36 patients (17.6%) had impaired renal function, of which 8 (3.9% of the total) progressed to ESRD. The mean nadir creatinine in patients with ESRD was 1.39 mg/dL. A nadir creatinine cut-off of 0.98 mg/dL had high sensitivity and specificity in identifying patients with progression to ESRD, with an AUC of 0.95 and a 95% confidence interval between 0.86 and 1.05 mg/dL. Conclusions: Our results support the value of nadir creatinine in predicting progression to ESRD, consistent with previously published data.
Citation: Children
PubDate: 2024-07-31
DOI: 10.3390/children11080928
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 929: Unveiling the Psychological Consequences of
Illness Perception in Pediatric Multiple Sclerosis: A Parent–Child
Study
Authors: Roy Aloni, Gaya Asher, Amichai Ben-Ari, Shay Menascu
First page: 929
Abstract: Background: Previous research has emphasized the significant role of illness perception in chronic diseases, including Multiple Sclerosis. Limited research has been conducted on exploring illness perception in Pediatric Onset Multiple Sclerosis (POMS), parental illness perception, and the impact of differences in their illness perceptions on the emotional well-being of the child. Method: This study included 65 dyads of children aged 10–17 and their parents, divided into the following two groups: (I) 32 dyads of children with POMS and their parents; and (II) 33 dyads of healthy children and their parents. Results: Overall, 73.1% and 43.8% of the children with POMS met the criteria for probable anxiety and depression, respectively, compared to 27.3% and 0% of the healthy children. Differences were found between the dimensions of illness perception in the POMS children and their parents, in the areas of consequences, personal control, identity, and control factors. Multinomial Logistic Regression indicated that differences in child–parent illness perception increased the likelihood of comorbid anxiety and depression by 37%. Discussion: These findings underscore the importance of alignment between children with POMS and their parents in illness perception. Healthcare providers should prioritize interventions that address illness perceptions and be mindful of the potential impact on depression and anxiety comorbidity.
Citation: Children
PubDate: 2024-07-31
DOI: 10.3390/children11080929
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 930: Evaluation of Family-Based Interventions as
a Therapeutic Tool in the Modulation of Childhood Obesity: A Systematic
Review
Authors: Diego Fernández-Lázaro, Ana M. Celorrio San Miguel, Evelina Garrosa, Ana M. Fernández-Araque, Juan Mielgo-Ayuso, Enrique Roche, Soledad Arribalzaga
First page: 930
Abstract: Childhood obesity is a major public health burden. The prevalence of weight excess for children and the adolescent population (8 to 16 years) is 34.9%. During childhood, lifestyles are acquired, which are developed in adulthood. In this context, the role of parents is crucial, since they are the model to imitate. We aimed to evaluate the current evidence on the effects of family-based interventions as a tool in the treatment of childhood obesity. We reviewed studies indexed in several databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Original articles published from 1 January 2014 to 30 May 2024 with a controlled trial design were considered, in which family-based interventions were carried out compared to a control group or to data before the intervention. Although 148 records were identified in the search, 6 studies met inclusion criteria. Overall, studies reported beneficial effects of family-based interventions on improving anthropometric parameters: BMI z-score, BMI, waist circumference, and body fat percentage. Regarding nutritional and physical activity guidelines, general recommendations must consider increased consumption of fruits and vegetables, reducing sugary drinks, controlled screen time, and 30–60 min of physical activity/day. Thus, family-based interventions could be an effective non-pharmacological strategy for modulating childhood obesity, allowing families to modify their lifestyles.
Citation: Children
PubDate: 2024-07-31
DOI: 10.3390/children11080930
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 931: Contributions of Artificial Intelligence to
Analysis of Gut Microbiota in Autism Spectrum Disorder: A Systematic
Review
Authors: Pau Climent-Pérez, Agustín Ernesto Martínez-González, Pedro Andreo-Martínez
First page: 931
Abstract: Background: Autism spectrum disorder (ASD) is a highly heterogeneous neurodevelopmental disorder whose etiology is not known today, but everything indicates that it is multifactorial. For example, genetic and epigenetic factors seem to be involved in the etiology of ASD. In recent years, there has been an increase in studies on the implications of gut microbiota (GM) on the behavior of children with ASD given that dysbiosis in GM may trigger the onset, development and progression of ASD through the microbiota–gut–brain axis. At the same time, significant progress has occurred in the development of artificial intelligence (AI). Methods: The aim of the present study was to perform a systematic review of articles using AI to analyze GM in individuals with ASD. In line with the PRISMA model, 12 articles using AI to analyze GM in ASD were selected. Results: Outcomes reveal that the majority of relevant studies on this topic have been conducted in China (33.3%) and Italy (25%), followed by the Netherlands (16.6%), Mexico (16.6%) and South Korea (8.3%). Conclusions: The bacteria Bifidobacterium is the most relevant biomarker with regard to ASD. Although AI provides a very promising approach to data analysis, caution is needed to avoid the over-interpretation of preliminary findings. A first step must be taken to analyze GM in a representative general population and ASD samples in order to obtain a GM standard according to age, sex and country. Thus, more work is required to bridge the gap between AI in mental health research and clinical care in ASD.
Citation: Children
PubDate: 2024-07-31
DOI: 10.3390/children11080931
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 932: Increase in Breastfeeding Rates in
Baby-Friendly Hospitals in Greece: Comparison with the National Study of
2017
Authors: Evangelos Christou, Eftychia Liakou, Abraham Pouliakis, Rozeta Sokou, Paraskevi Volaki, Styliani Paliatsou, Theodora Boutsikou, Nicoletta Iacovidou, Zoi Iliodromiti
First page: 932
Abstract: Background/Objectives: The primary purpose of this study was to correlate the factors influencing the onset and duration of exclusive breastfeeding (EBF) and breastfeeding (BF) rates at different time points in baby-friendly hospitals (BFHs) in Greece. Methods: This study was conducted from October 2020 to January 2022. The sample consisted of 1201 mothers with corresponding newborn births out of the total 7201 that took place during the same period. We used a questionnaire that the mothers answered during the first hour after birth, before being discharged from the maternity hospital, and at the 2nd, 4th, and 6th month of the infant’s life. The results were compared with the data of the national study from 2017 (concerning births from general maternity hospitals and not only from BFHs). Results: The EBF rate within 1 h after birth was 71.3%, which gradually declined to 21.2% in the 6th month. Between the two studies, differences were recorded in BF and EBF rates at the 6th and 4th month of the infants’ life, respectively, especially in mothers who are less likely to breastfeed (e.g., those without breastfeeding experience, those over 40 years old, etc.). Conclusion: This study showed that EBF and BF rates are higher in infants born in BFHs compared to non-BFHs both during their hospitalization in the first days of life and during the first 6 months of life. BFHs also play a decisive role in mothers who, due to their socio-economic profile, have lower chances of starting to breastfeed.
Citation: Children
PubDate: 2024-07-31
DOI: 10.3390/children11080932
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 933: Relationship between Gross Motor
Coordination and Health-Related Fitness in Serbian Preschool Children
Authors: Nenad Stojiljković, Nebojša Trajković, Doroteja Rančić, Mihai Olanescu, Adrian Suciu, Danut Popa
First page: 933
Abstract: Background: The relationship between motor coordination and physical fitness in preschool children is of significant interest due to its implications for overall health and development. This study aims to investigate the correlation between gross motor coordination, as assessed by the Körperkoordinationstest für Kinder (KTK), and health-related physical fitness components. Methods: A cross-sectional study, involving 139 preschool-aged children, was conducted. Physical fitness was assessed using the PREFIT fitness test battery, which includes measures of flexibility, muscular strength, speed/agility, and cardiorespiratory fitness. Motor coordination was evaluated using the KTK test, comprising four subtests. Results: Pearson correlation analysis revealed weak to strong positive and negative correlations between motor coordination and various physical fitness measures, including flexibility (r = 0.402; p = 0.01), muscular strength (r = 0.178; r = 0.487; r = 0.601; p < 0.05), speed/agility (r = −0.742; p = 0.01), and endurance (r = 0.539; p = 0.01). Additionally, hierarchical regression analysis demonstrated significant influence of motor coordination on physical fitness, explaining a notable percentage of the variance across different fitness components (3.2–55%). Conclusions: The findings underscore the importance of motor coordination in shaping physical fitness levels in preschool children. Promoting motor coordination skills early in childhood may have long-term benefits for overall health and fitness.
Citation: Children
PubDate: 2024-07-31
DOI: 10.3390/children11080933
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 934: Impact of the Choice of Diagnostic Criteria
and Growth Reference on the Prevalence of Extrauterine Growth Restriction
in Extremely-Low-Birthweight Infants
Authors: Clara González López, Gonzalo Solís Sánchez, Belén Fernández Colomer, Laura Mantecón Fernández, Sonia Lareu Vidal, Sara Fernández Castiñeira, Ana Rubio Granda, Alicia Pérez Pérez, Marta Suárez Rodríguez
First page: 934
Abstract: Background and objectives: Variable diagnostic criteria and growth charts have been used for extrauterine growth restriction (EUGR). The objective was to assess the prevalence and concordance of EUGR in extremely-low-birthweight (ELBW) infants with the most frequent diagnostic criteria and growth charts. Materials and methods: An observational, retrospective and multicenter study was conducted from 2011 to 2020 including ELBW infants from the Spanish SEN1500 Network. EUGR prevalence was calculated at discharge using different definitions: cross-sectional (anthropometry less than the 10th centile), longitudinal (decrease of more than 1 SD from birth to discharge), “true” cross-sectional and “true” longitudinal (using the criteria previously described, excluding infants small for gestational age at birth). Concordance among Fenton, Olsen and INTERGROWTH-21st was assessed with Fleiss’ Kappa coefficient. Results: The prevalence of EUGR was variable with the different definitions and growth references studied in the 7914 ELBW infants included. Overall, it was higher with Fenton for all the EUGR criteria studied by weight and length. The agreement among growth charts was substantial (κ > 0.6) for all the definitions except for longitudinal EUGR by weight (moderate, κ = 0.578). Conclusions: The prevalence of EUGR was variable in our cohort with the different diagnostic criteria and growth charts. The agreement among charts was good for all the definitions of EUGR except longitudinal EUGR by weight.
Citation: Children
PubDate: 2024-07-31
DOI: 10.3390/children11080934
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 935: Robotic-Assisted Surgery in Children Using
the Senhance® Surgical System: An Observational Study
Authors: Rianne E. M. Killaars, Ruben G. J. Visschers, Marc Dirix, Olivier P. F. Theeuws, Roxanne Eurlings, Dianne J. H. Dinjens, Hamit Cakir, Wim G. van van Gemert
First page: 935
Abstract: Background: Robotic-assisted surgery (RAS) holds many theoretical advantages, especially in pediatric surgical procedures. However, most robotic systems are dedicated to adult surgery and are less suitable for smaller children. The Senhance® Surgical System (SSS®), providing 3 mm and 5 mm instruments, focuses on making RAS technically feasible for smaller children. This prospective observational study aims to assess whether RAS in pediatric patients using the SSS® is safe and feasible. Methods and Results: A total of 42 children (aged 0–17 years, weight ≥ 10 kg) underwent a RAS procedure on the abdominal area using the SSS® between 2020 and 2023. The study group consisted of 20 male and 22 female individuals. The mean age was 10.7 years (range 0.8 to 17.8 years), with a mean body weight of 40.7 kg (range 10.1 to 117.3 kg). The 3-mm-sized instruments of the SSS® were used in 12 of the 42 children who underwent RAS. The RAS procedures were successfully completed in 90% of cases. The conversion rate to conventional laparoscopy was low (10%), and there were no conversions to open surgery. One of the 42 cases (2%) experienced intraoperative complications, whereas six children (14%) suffered from a postoperative complication. Overall, 86% of the patients had an uncomplicated postoperative course. Conclusions: The results of the current observational study demonstrate the safety and feasibility of utilizing the SSS® for abdominal pediatric RAS procedures. The study provides new fundamental information supporting the implementation of the SSS® in clinical practice in pediatric surgery.
Citation: Children
PubDate: 2024-07-31
DOI: 10.3390/children11080935
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 936: Child Motor Development before and after the
COVID-19 Pandemic: Are There Social Inequalities'
Authors: Mariann Rigó, Simone Weyers
First page: 936
Abstract: Abstract: Background: COVID-19 pandemic has influenced all children’s motor development. We examine whether this differs by social circumstances. We hypothesise that socially disadvantaged children experienced more pronounced motor problems compared with better-off children. Methods: Our trend study includes three representative waves of preschoolers (school years 2018/19, 2019/20, 2023/24) from a German school enrolment medical screening. Based on logistic regressions, we computed predicted prevalences of motor problems separately for children in different social circumstances (neighbourhood, migration background, family status). Results: Motor development of preschoolers slightly worsened by 2023 compared to pre-pandemic level (6.3 percent 2018 to 7.4 percent 2023). Results by neighbourhood highlight that preschoolers from well-off districts experienced a deterioration of motor development (4.9 percent 2018–6.4 percent 2023). The prevalence of motor problems is, however, below that of children from deprived neighbourhoods with consistently high prevalence (9.2–10 percent). Results by migration background show a worsening trend for children without migration background and the gap between the groups disappears in 2023. Results by family status do not indicate significant differences. Conclusion: Contrary to our hypothesis, socially disadvantaged children experienced smaller change in motor problems. However, our results highlight the potential of structured physical activities in daycare centres and sports facilities to enhance the motor development of these children.
Citation: Children
PubDate: 2024-07-31
DOI: 10.3390/children11080936
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 937: Association of Maternal Air Pollution
Exposure and Infant Lung Function Is Modified by Genetic Propensity to
Oxidative Stress
Authors: Dwan Vilcins, Wen Ray Lee, Cindy Pham, Sam Tanner, Luke D. Knibbs, Dave Burgner, Tamara L. Blake, Toby Mansell, Anne-Louise Ponsonby, Peter D. Sly, Barwon Infant Study Investigator Group
First page: 937
Abstract: Background and objective: The association between air pollution and poor respiratory health outcomes is well established. Children are particularly at risk from air pollution, especially during the prenatal period as their organs and systems are still undergoing crucial development. This study investigated maternal exposure to air pollution during pregnancy and oxidative stress (OS), inflammation, and infant lung function at 4 weeks of age. Methods: Data from the Barwon Infant Study were available for 314 infants. The exposure to NO2 and PM2.5 were estimated. Infant lung function (4 weeks) was measured by multiple-breath washout. Glycoprotein acetyls (GlycA) (36 weeks prenatal), cord blood, and OS biomarkers were measured in maternal urine (28 weeks). A genetic pathway score for OS (gPFSox) was calculated. Linear regression was used and potential modification by the OS genotype was tested. Results: There was no relationship between maternal exposure to air pollution and infant lung function, or with GlycA or OS during pregnancy. We found an association in children with a genetic propensity to OS between NO2 and a lower functional residual capacity (FRC) (β = −5.3 mls, 95% CI (−9.3, −1.3), p = 0.01) and lung clearance index (LCI) score (β = 0.46 turnovers, (95% CI 0.10, 0.82), p = 0.01). Conclusion: High prenatal exposure to ambient NO2 is associated with a lower FRC and a higher LCI score in infants with a genetic propensity to oxidative stress. There was no relationship between maternal exposure to air pollution with maternal and cord blood inflammation or OS biomarkers.
Citation: Children
PubDate: 2024-07-31
DOI: 10.3390/children11080937
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 938: Relationship between Body Mass Index and
Health-Related Physical Fitness Components in HIV-Diagnosed Children and
Adolescents
Authors: João Antônio Chula de Castro, Luiz Rodrigo Augustemak de Lima, Diego Augusto Santos Silva
First page: 938
Abstract: Background/Objectives: There is a need to monitor physical fitness in HIV-diagnosed children and adolescents, and body mass index (BMI) could be an option for this due to its usability for assessing nutritional status and fat mass. The present study aimed to explore the relationship between BMI and physical fitness in HIV-diagnosed children and adolescents. Methods: A cross-sectional study was conducted with 86 HIV-diagnosed children and adolescents aged 5–15, with participants from two research protocols (Study I, n = 65; Study II, n = 21). Physical fitness was assessed through body composition (anthropometric measurements and dual energy X-ray absorptiometry), cardiorespiratory fitness (peak oxygen consumption [VO2peak]), muscle strength/endurance (handgrip strength, standing broad jump, and abdominal and modified push-up endurance), and flexibility (sit-to reach test). The relationship between BMI and physical fitness components was analyzed through correlation and simple and multiple linear regression analysis. Results: Eutrophic participants (mean age 11.44 ± 2.20) presented a normal fat mass percentage and overweight participants (mean age 11.50 ± 2.54) presented adequate handgrip strength. The adjusted models could explain 71% of fat-free mass, 57% of fat mass percentage, 70% of bone mineral content, 72% of bone mineral density, and 52% of handgrip strength. Conclusions: Increases in BMI were associated with increases in fat-free mass, fat mass percentage, bone mineral content, bone mineral density, and handgrip strength. BMI was capable of distinguishing those presenting a normal fat mass percentage and those presenting adequate handgrip strength.
Citation: Children
PubDate: 2024-08-02
DOI: 10.3390/children11080938
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 939: How to Link Assessment and Suitable
Interventions for Adolescents: Relationships among Mental Health,
Friendships, Demographic Indicators and Well-Being at School
Authors: Rokas Šambaras, Agnė Butvilaitė, Justina Andruškevič, Natalja Istomina, Sigita Lesinskienė
First page: 939
Abstract: Background: Over the last 10 years, a noticeable deterioration in mental health has affected adolescents’ lives. Methods: This study was conducted in 12 secondary schools and 14 high schools located in different cities across Lithuania from October to December 2023. The survey included students aged 12 to 17 years. The adolescents filled out a questionnaire about the need for outside help, friendships, and well-being at school and the Strengths and Difficulties Questionnaire. The goal of our study was to analyze the risk factors that influence adolescents’ psycho-emotional state. Results: A total of 4124 students were involved in this study, with a mean age of 14.48 ± 1.15 years. The sample consisted of 50.9% males and 49.1% females. The boys showed a statistically significantly lower total difficulty score on the Strength and Difficulties Questionnaire (SDQ TDS) and internalizing score (IS) than the girls (12.45 ± 5.39 vs. 14.93 ± 5.76; 5.39 ± 3.30 vs. 7.49 ± 3.64, p < 0.001). Also, the SDQ TDS, IS, and externalizing score (ES) were statistically significantly lower in the group of adolescents who lived with both parents (13.50 ± 5.69 vs. 14.76 ± 5.72; 6.32 ± 3.61 vs. 6.98 ± 3.65; 7.18 ± 3.23 vs. 7.78 ± 3.35, p < 0.001). Linear regression analysis of the SDQ TDS (R2 = 0.406) indicated a significant impact on the feeling of safety at schools (β = −0.173, p < 0.001) and loneliness (β = 0.314, p < 0.001). Linear regression of the SDQ IS (R2 = 0.469) showed that there was a significant predictor effect of bullying (β = 0.170, p < 0.001) and loneliness (β = 0.345, p < 0.001). However, the linear regression of the SDQ ES (R2 = 0.256) showed that there was a significant predictor effect of the feeling of teacher care (β = −0.163, p < 0.001) and loneliness (β = 0.166, p < 0.001). We determined that gender (OR = 2.30) and loneliness (OR = 1.77) were the most significant factors associated with adolescents seeking help. Conclusions: It is crucial to determine specific risk factors and particular groups of teenagers who need psycho-emotional support the most. The findings of this study may offer valuable insights for advancing additional prevention or support programs aimed at adolescents within higher-risk groups.
Citation: Children
PubDate: 2024-08-03
DOI: 10.3390/children11080939
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 940: The Motor Optimality Score—Revised
Improves Early Detection of Unilateral Cerebral Palsy in Infants with
Perinatal Cerebral Stroke
Authors: Natascia Bertoncelli, Lucia Corso, Luca Bedetti, Elisa Muttini Della Della Casa, Maria Federica Roversi, Greta Toni, Marisa Pugliese, Isotta Guidotti, Francesca Miselli, Laura Lucaccioni, Cecilia Rossi, Alberto Berardi, Licia Lugli
First page: 940
Abstract: Background: Neonatal cerebral stroke includes a range of focal and multifocal ischemic and hemorrhagic brain lesions, occurring in about one of 3000 live births. More than 50% of children with neonatal stroke develop adverse outcomes, mainly unilateral cerebral palsy. Asymmetries in segmental movements at three months have been proven to be an early sign of CP in infants with unilateral brain damage. Recognition of additional early signs could enhance prognostic assessment and enable an early and targeted intervention. Aim: The aim of the study was to assess early signs of CP in infants with arterial cerebral stroke through the General Movements Assessment and the Motor Optimality Score—Revised (MOS-R). Method: Twenty-four infants born at term (12 females and 12 males) diagnosed with ACS, and 24 healthy infants (16 females and 8 males) were assessed. The GMs (fidgety movements) and MOS-R were assessed from videos recorded at 11–14 weeks of post-term age. Cognitive and motor outcomes were assessed at 24 months using the Griffiths III developmental quotient and Amiel-Tison neurological examination. The gross motor function classification system expanded and revised (GMFCS-E&R) was adopted to categorize CP. Results: Among infants with ACS, 21 (87.5%) developed unilateral CP. Most of them showed non-disabling CP (14 had GMFCS-E&R grade 1 [66.6%], 6 grade 2 [28.6%], and 1 grade 5 [4.8%]). Fidgety movements (FMs) were absent in 17 (70.8%), sporadic in 4 (16.7%) infants, and normal in 3 (12.5%). Segmental movement asymmetry was found in 22/24 (91.7%). According to the MOS-R, motor items (kicking, mouth movements), postural patterns (midline centered head, finger posture variability), and movement character (monotonous and stiff) were statistically different among infants with ACS and healthy infants. The MOS-R median global score was lower in the group with ACS compared to the control group (6 vs 26; p < 0.01). FMs, segmental movement asymmetry, and MOS-R global score were significantly correlated with abnormal outcome. MOS-R global scores less than or equal to 13 had 100% specificity and sensitivity in predicting GMFCS-E&R grade ³ 2 CP in infants with ACS. Conclusions: The rate of CP was high among infants with ACS, but in most cases it showed low GMFCS-E&R grades. The study highlighted a significant correlation between MOS-R, together with absent FMs and unilateral CP in infants with ACS. Moreover, the MOS-R showed high sensitivity and specificity in the prediction of CP. Combined assessment of FMs and MOS-R could help to better identify infants at high risk of developing UCP in a population of infants with ACS. Early identification of precocious signs of unilateral CP is fundamental to providing an early individualized intervention.
Citation: Children
PubDate: 2024-08-04
DOI: 10.3390/children11080940
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 941: Respiratory Status in Children and Exposure
to Animal Allergens—The Problem of Reverse Causality in
Cross-Sectional Studies
Authors: Agata Wypych-Ślusarska, Karolina Krupa-Kotara, Klaudia Oleksiuk, Joanna Głogowska-Ligus, Jerzy Słowiński
First page: 941
Abstract: Background: Some epidemiological studies suggest that early exposure to animal allergens during infancy reduces the risk of bronchial asthma in school-age children. However, the observed associations in some cases may be an effect of the study used (epidemiological observational studies, especially a cross-sectional study) and indicate reverse causality. Aim: This study aimed to determine the association between exposure to animal allergens and the prevalence of respiratory diseases, including bronchial asthma, considering the potential impact of reverse causality on the observed relationships. Material and methods: An analysis of data from a cross-sectional epidemiological study conducted in 2020 involving 3237 primary school students aged 7–15 years in the Silesian Province (Southern Poland) was carried out. The parents of students completed a questionnaire based on The International Study on Asthma and Allergies in Childhood (ISAAC). The relationship between the occurrence of chronic cough, wheezing, and dyspnea in the last 12 months, night waking due to dyspnea, and asthma in the presence of pets was assessed. Exposure to animal allergens was determined by answering the question, “Are there any furry or feathered animals in the home'” with three response options: “yes; they have been in the past; no” (Scenario 1). For the analyses and to reveal a potential reverse causality effect, the last two response categories regarding pet ownership were combined to form a “no” category in Scenario 2, and the first two answers were combined into a “yes” category in Scenario 3. A chi-square test was used to assess the relationship between variables, and a statistical significance level of p < 0.05 was adopted. Results: Chronic cough affected 9.5% of children, wheezing in the last 12 months—9.2%, night waking due to dyspnea—5.8%, dyspnea in the last 12 months—4.8%, bronchial asthma—9.2%. Analysis considering the category of having or not having pets (yes vs. no) showed that bronchial asthma was statistically significantly more common in children who did not have pets at home (10.9% vs. 7.9%, p = 0.002). A similar situation was observed for wheezing in the past 12 months (10.7% vs. 8.1%; p = 0.01) and nocturnal awakening due to dyspnea (6.8% vs. 5.1%, p = 0.03). No statistically significant differences were observed for the other symptoms. Analysis by time of pet ownership (a. present; b. present but in the past; c. not present) highlighted similar relationships. Asthma (a. 7.7% vs. b. 13.4% vs. c. 7.7%; p = 0.004), wheezing in the past 12 months (a. 8.1% vs. b. 8.9% vs. c. 10.9%, p = 0.03) and night waking (a. 5.0% vs. b. 4.5% vs. c. 7.1%; p = 0.04) were more common in children without pets and those who had owned pets in the past. The highest proportion of children with asthma was in homes where pets were present in the past. Conclusions: Analyses indicating a relationship between a higher prevalence of asthma and some respiratory symptoms, and the absence of pets cannot be considered as a casual association. The analysis conducted did not reveal a reverse causality effect. The results of observational epidemiological studies, especially a cross-sectional study, should always be interpreted with caution, considering possible distortions and conclusions drawn.
Citation: Children
PubDate: 2024-08-05
DOI: 10.3390/children11080941
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 942: Comparison of Titanium versus Resorbable
Intramedullary Nailing in Pediatric Forearm Fractures
Authors: Ádám László Dávid, Flóra Mucsina, Eszter Antal, Anna Gabriella Lamberti, Aba Lőrincz, Gergő Józsa
First page: 942
Abstract: Pediatric forearm fractures, particularly involving the shaft or diaphysis, are common injuries typically resulting from accidental trauma during various activities. Traditional treatment involves closed reduction and casting; however, surgical intervention may be necessary in certain cases. The gold standard surgical approach utilizes elastic stable intramedullary nailing (ESIN), but a newer technique uses bioabsorbable intramedullary nails made of poly(lactic-co-glycolic acid) (PLGA). This study aims to compare the outcomes of these two surgical methods in pediatric diaphyseal forearm fractures. We retrospectively reviewed 86 patients who underwent operative treatment due to the diaphyseal fractures of the forearm in the Surgical Division, Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary between 2018 and September 2022. The mean age was 9.48 (ranging from 4 to 17). A total of 41 patients underwent surgery with PLGA implants (RESIN technique), while 45 patients were treated with titanium elastic nails (ESIN technique). Various factors including patient demographics, injury mechanisms, fracture characteristics, and complications were assessed. Both groups showed similar gender distribution, with a majority of fractures occurring in boys (the male–female ratio was 31:10 in the PLGA group, while in the titanium elastic nailing (TEN) group, this ratio was 29:16, with no statistical difference between the groups (p > 0.005). The average age of the patients treated with PLGA implants (8.439 years) was lower compared to those treated with titanium nails (10.422 years). A statistically significant difference was found regarding the average age of the two groups (p = 0.0085). Left-sided injuries were more prevalent in both groups (59% of the cases in the PLGA group and 69% in the TEN group, with no statistically significant difference, p = 0.716), and fractures typically involved both the radius and ulna. This represents 93% of the cases in the PLGA group and 80% in the TEN group. Regarding the involvement of bones, we also did not find a statistically significant difference (p = 0.123). The mechanisms of injury predominantly involved indirect force, such as falls (30 cases in the PLGA group and 27 cases in the TEN group), and no statistically significant difference was found (p = 0.139) regarding the mechanism of the injury. Complication rates were lower in the PLGA group (7%) compared to the titanium group (20%). The treatment of pediatric diaphyseal forearm fractures using PLGA implants appears to be a viable alternative to traditional titanium implants. Advantages include no need for secondary surgery and associated cost savings and reduced complication rate and stress associated with anesthesia and surgery. Prospective randomized trials are warranted to further validate these findings and explore long-term outcomes.
Citation: Children
PubDate: 2024-08-05
DOI: 10.3390/children11080942
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 943: Impact of Cyberbullying on Academic
Performance and Psychosocial Well-Being of Italian Students
Authors: Antonio Ragusa, Sandra Núñez-Rodríguez, Paulo Vaz, José Silva, Virginia Caliciotti, Jerónimo J. González-Bernal, Alfonso J. López-Rivero, Ema Petrillo, Manuela Gatto, Ana Isabel Obregón-Cuesta, Josefa González-Santos
First page: 943
Abstract: Cyberbullying is a growing problem in the Italian educational sector, with a prevalence of 17%. This study analyzes its impact on the psychosocial well-being and academic performance of Italian adolescents. Method: A cross-sectional study was conducted with 502 students from six schools in different Italian regions, using the European Cyberbullying Intervention Project Questionnaire (ECIPQ) to assess cyberbullying, in addition to collecting data on satisfaction, friends, and academic performance. Chi-square and ANOVA analyses were conducted to identify significant associations between the variables. Results: The analyses showed significant associations between cyberbullying and gender and in psychosocial well-being, with significant differences in personal satisfaction and body satisfaction. On the other hand, there were no significant differences in academic performance or in the ability to make new friends, although victims showed a significantly lower ability to make new friends compared to those who were neither victims nor aggressors. Conclusions: Cyberbullying has a significant impact on students’ psychosocial well-being, especially on personal satisfaction and school happiness, making it essential to implement interventions that promote safe school environments to mitigate these negative effects.
Citation: Children
PubDate: 2024-08-05
DOI: 10.3390/children11080943
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 944: Child Migrants in Family Detention in the
US: Addressing Fragmented Care
Authors: Shela Sridhar, Vasileia Digidiki, Leah Ratner, Dennis Kunichoff, Matthew G. Gartland
First page: 944
Abstract: Background/Objectives: Migrant children in family detention facilities often experience frequent relocations and prolonged stays in precarious living conditions. This frequent relocation results in fragmentation of necessary medical care, leading to delays and inadequate medical care. We aim to highlight the critical need for comprehensive medical documentation in immigration detention facilities, a fragmented health care system and potential harm to these children without appropriate medical documentation. Methods: We conducted a retrospective review of 165 medical records from children detained at the Karnes County Family Residential Center between June 2018 and October 2020 to evaluate the adequacy of pediatric medical documentation in an Immigration and Customs Enforcement (ICE) family detention facility. Specific areas of interest included acute care, nutrition, immunization, developmental screening, and tuberculosis screening. Simple descriptive statistics were used to analyze the data. Results: Only 25% of 418 acute medical care visits included specific diagnoses. There was no documentation regarding follow-up recommendations upon release. 97% of children had a chest X-ray completed for tuberculosis screening, however no follow-up recommendations were documented for those with granulomas. Vaccination histories were inconsistently documented. No nutritional categorizations were completed despite 16% of children being at risk for malnutrition or already malnourished. Conclusions: Our findings revealed significant gaps in documentation, particularly in medical decision-making and clinical reasoning. In a fragmented medical system, inadequate documentation can result in avoidable errors in diagnosis and management. Improving documentation practices is crucial to ensure that all children, regardless of immigration status, receive quality healthcare aligned with national and international standards.
Citation: Children
PubDate: 2024-08-05
DOI: 10.3390/children11080944
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 945: Application of Galenic Strategies for
Developing Gastro-Resistant Omeprazole Formulation for Pediatrics
Authors: Khadija Rouaz-El-Hajoui, Encarnación García-Montoya, Marc Suñé-Pou, Josep María Suñé-Negre, Pilar Pérez-Lozano
First page: 945
Abstract: Objectives: This study addresses a critical need in pediatric pharmacotherapy by focusing on the development of an enteric formulation of omeprazole for pediatric use. Omeprazole, a widely used proton pump inhibitor, is essential for treating various gastrointestinal disorders in children. The main objective is to design a compounding formula that can be prepared in hospital pharmacy services without the need for industrial equipment, which is often unavailable in these settings. Methods: The research applied different galenic strategies to overcome the challenges of omeprazole’s instability in acidic environments and its complex pharmacokinetic and physicochemical properties. The experiments were conducted sequentially, employing salting out, ionic gelation, and matrix granulation strategies. Based on the results obtained, the control conditions and parameters for the various trials were established. Results: Among the techniques used, wet granulation proved to be the most promising, achieving a gastro-resistance level of 44%. In contrast, the ionic gelation and salting-out techniques did not yield satisfactory results. Conclusions: The findings of this study underscore the need to adopt alternative formulation strategies to ensure the stability of omeprazole. This goal requires a multidisciplinary approach and continuous effort to design omeprazole formulations that meet quality standards and appropriate gastro-resistance requirements.
Citation: Children
PubDate: 2024-08-05
DOI: 10.3390/children11080945
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 946: Analysis of the Energy Expenditure of Sports
School Activities in Children
Authors: Daniel González-Devesa, Miguel Adriano Sanchez-Lastra, Carlos Ayán-Pérez, Nerea Blanco-Martínez, María Soutullo Rivas, María Vidal-Mariño, Silvia Varela
First page: 946
Abstract: (1) Background: This study explores the potential energy expenditure associated with participation in after-school sports activities among primary school children. (2) Methods: The study involved 129 children age (11.35 ± 0.55 years) recruited from eight different public after-school sport programs. (3) Results: Data analyses revealed significant differences between the eight sports in total calories per session, calories per minute, and METs (p < 0.05). All sports showed higher energy expenditure compared to chess (p < 0.05), with soccer and rugby exhibiting the highest energy expenditure per session. Team sports showed elevated energy consumption per session (p < 0.01, r > 0.30), calories per minute (p = 0.01, r > 0.40), and METs (p < 0.01, r > 0.40) in comparison with individual sports. (4) Conclusions: These findings enhance our understanding of the energy expenditure observed in primary school children following various after-school sports activities. The results indicate that team sports, in particular, are pivotal in elevating physical activity levels, thereby playing an essential role in fostering healthier lifestyles among children.
Citation: Children
PubDate: 2024-08-05
DOI: 10.3390/children11080946
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 947: Non-Suicidal Self-Injury in Eating and
Feeding Disorder Patients: Characteristics and Clinical Implications in a
Group of Referred Female Adolescents
Authors: Gianluca Sesso, Cristina Mazzullo, Elena Valente, Francesca Ditaranto, Pamela Fantozzi, Vittorio Belmonti, Stefano Berloffa, Francesca Placini, Raffaella Tancredi, Gabriele Masi, Annarita Milone
First page: 947
Abstract: Background: Non-suicidal self-injury (NSSI) and Feeding or Eating Disorders (FEDs) often coexist during adolescence with reciprocal influences on their clinical picture. The present study aimed to identify differences and similarities in the clinical presentation of young patients with both conditions compared to those with the two non-comorbid disorders. Methods: We consecutively recruited forty-five female patients aged between 11 and 18 at our third-level hospital and subdivided them into three groups (NSSI: n = 15; FED: n = 15; NSSI + FED: n = 15). Patients underwent a full clinical assessment. Results: Based on our results, the NSSI + FED group was characterized by higher rates of binging/purging behaviors, greater prevalence of Cyclothymic Disorder, and a more severe clinical presentation compared to the non-comorbid groups. Moreover, higher levels of suicidal ideation were found in the NSSI + FED group. Pharmacological treatment patterns also differed, with SSRI being prescribed more frequently to NSSI + FED patients while mood stabilizers were prescribed more frequently to NSSI ones. A Principal Component Analysis identified four main dimensions: “Body Image” impairment was more pronounced in NSSI + FED patients, indicating negative attitudes towards their own body; “Metacognition” deficits were higher in NSSI than FED. Conclusions: The present study underscores distinctive clinical features in patients with comorbid NSSI and FED, emphasizing the urgent need for tailored intervention strategies focusing on specific symptom domains.
Citation: Children
PubDate: 2024-08-06
DOI: 10.3390/children11080947
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 948: Physical, Cognitive, Emotional, and Social
Health Outcomes of Parents in the First Six Months after Childhood
Critical Illness: A Prospective Single Centre Study
Authors: Pei-Fen Poh, Jan Hau Lee, Rehena Sultana, Joseph C. Manning, Matthew C. Carey, Jos M. Latour
First page: 948
Abstract: Childhood critical illness can have long-term effects on families, but the extent and trajectory of recovery for parents are unknown. Using prospective longitudinal design, we describe the health outcomes of parents and their trajectory six months after paediatric intensive care unit (PICU) discharge. Parents reported health outcomes at PICU discharge (baseline), and 1-, 3-, and 6-months post-discharge. We used the Pediatric Quality-of-Life Family Impact Module, Patient Health Questionnaire-4, and post-traumatic stress disorder (PTSD) Checklist for DSM-5. The group-based trajectory model was used to identify recovery patterns. We included 128 parents of children aged 1 month to 18 years, admitted to the PICU for ≥48 h. Three post-discharge composite health trajectory groups were classified: 54 mild (42%), 68 moderate (53%), and 6 severe (4%). Parents in the mild and moderate groups returned to baseline health within the first 3 months, but those in the severe group exhibited worse outcomes at 6-months. The mean (SD) PICU stay durations for mild, moderate, and severe groups were 9 (16), 7 (10), and 38 (61) days; days of mechanical ventilation were 4 (5), 4 (7), and 18 (25) days; and readmission rates were 12 (22%), 23 (34%), and 4 (66%), respectively. Identifying these trajectories enables novel, targeted interventions for at-risk parents, underscoring the significance of integrated PICU follow-up care.
Citation: Children
PubDate: 2024-08-06
DOI: 10.3390/children11080948
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 949: Child and Family Outcomes and Experiences
Related to Family-Centered Care Interventions for Hospitalized Pediatric
Patients: A Systematic Review
Authors: Christine R. Hodgson, Renee Mehra, Linda S. Franck
First page: 949
Abstract: Background/Objectives: Family-centered care (FCC) is the recommended model for pediatric inpatient care. Our overall aim was to conduct a narrative synthesis of the contemporary published research on the effectiveness of FCC interventions for pediatric inpatients. Our specific objective was to critique studies of inpatient pediatric FCC interventions that evaluated child or parent outcomes. Methods: We searched five databases (Pubmed, CINAHL, Embase, PsychInfo, and Web of Science) for peer-reviewed research published from 1 January 2017 to 6 February 2024. Independent reviewers evaluated each study based on pre-specified inclusion and exclusion criteria, then extracted and narratively synthesized the data. Results: We found 16 studies of 15 interventions conducted in six countries. The studies were quantitative (n = 11), qualitative (n = 3), and mixed methods (n = 2), with most designs being of low to moderate quality based on a modified Mixed-Methods Appraisal Tool. Interventions included family-centered rounds, parent-focused health information technology, education, patient navigation, parent–peer support, partnership, and parent participation in caregiving. Most studies found significant improvements in parents’ well-being, knowledge, and participation, as well as decreased stress and anxiety with the FCC interventions compared to usual care. One study found no differences in child outcomes (infant feeding, length of stay) between usual care and a parent-participation intervention. Conclusions: Although FCC interventions led to many improved outcomes for parents, there were few well-designed comparison studies using validated tools and well-defined interventions. Higher quality research is needed to promote greater uptake and sustainability of FCC interventions globally.
Citation: Children
PubDate: 2024-08-06
DOI: 10.3390/children11080949
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 950: A Pathway to Positive Youth Development:
Unpacking the Asian American Youth Paradox and Cultural Orientations among
Filipino American and Korean American Youth
Authors: Yoonsun Choi, Michael Park, Miwa Yasui
First page: 950
Abstract: This study used longitudinal survey data of Filipino American and Korean American youth in the Chicago Metropolitan area (N = 786, MAGE = 15.00, SD = 1.91 at Wave 1 in 2014) to examine whether and how a set of organized predictors (i.e., universal predictors of youth outcomes and cultural orientations) independently and collectively explains internalizing and externalizing problems and academic performance. The results were that universal predictors such as youth antisocial beliefs, peer antisocial behaviors, and the quality of parent–child relations, were extensively predictive of youth outcomes in the expected directions. The magnitudes of universal predictors were largely unchanged when bilinear and multidimensional cultural orientation variables were accounted for together. The magnitudes of cultural orientation variables were slightly attenuated in full models but showed independent associations with youth outcomes. Specifically, English and heritage language proficiencies were protective of externalizing and internalizing problems. Behavioral practices in respective cultures increased youth problems. In addition, ethnic identity, although beneficial to mental health, can increase externalizing problems. The findings of this study provide insights into understanding the mixed outcomes among Asian Americans and important empirical evidence that can inform intervention programs to prevent youth problems, ultimately toward a pathway to positive youth development among Asian American youth.
Citation: Children
PubDate: 2024-08-06
DOI: 10.3390/children11080950
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 951: Systemic Adverse Events Associated with
Locally Administered Corticosteroids
Authors: Femke De Vleeschhauwer, Kristina Casteels, Ilse Hoffman, Marijke Proesmans, Anne Rochtus
First page: 951
Abstract: Topical corticosteroids are a mainstay in the treatment of many pediatric disorders. While they have proven beneficial therapeutic effects and are generally considered safe, systemic adverse events may occur. This study presents four cases of children who experienced systemic adverse events after using inhaled and intranasal topical corticosteroids, as well as topical corticosteroids in other forms. A comprehensive literature review was performed to explore the existing evidence on this topic. The aim of this study is to raise awareness among healthcare providers about the possibility of systemic adverse events associated with the use of locally administered corticosteroids in pediatric patients. This information underscores the importance of careful monitoring, individualized treatment plans, and further research to better understand and mitigate the risks associated with corticosteroids, even those not given systemically.
Citation: Children
PubDate: 2024-08-06
DOI: 10.3390/children11080951
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 952: Overview of the Treatment Goal, the Method
of Evaluating Disease Activity/Physical Function, Activities of Daily
Living, and Traditional Care for Systemic or Articular Juvenile Idiopathic
Arthritis in Japan
Authors: Masaaki Mori
First page: 952
Abstract: Juvenile idiopathic arthritis (JIA) is a chronic arthritis of unknown cause that develops in patients younger than 16 years of age and persists for at least 6 weeks. It is an important cause of short- and long-term physical and mental impairments in children. The goal of treatment for JIA is remission. A T2T (treatment-to-target) has been proposed and practiced as a means of achieving remission. The method of evaluating the disease activity of JIA depends on the disease type. For systemic JIA, disease activity is determined by comprehensively considering joint findings, systemic inflammatory findings, changes in inflammatory and synovitis markers, imaging findings, and other factors. For articular JIA other than systemic JIA, the Juvenile Arthritis Disease Activity Score (JADAS-27) is used to evaluate disease activity. The CHAQ (Childhood Health Assessment Questionnaire) and the Japanese version of the modified Rankin Scale (mRS) are mainly used to assess the physical function and ADL. The CHAQ is a global standard assessment method with the advantage that it can be transitioned to the HAQ used in adults, making it useful for international comparisons. The mRS is used to classify the severity of JIA as a chronic disease, and is an indispensable evaluation method in the specific disease procedure in Japan. It is necessary to have pediatric-specific knowledge of growth and development and routine childhood immunizations and to consider transition support tailored to the patient’s situation. Ultimately, the goal is to foster the patient’s independence and to provide an uninterrupted follow-up in the adult care department. Continuous follow-up will be provided during the schooling (and later, employment) period, and the relationship with the patient will be tailored to their developmental stage. It is also important to understand and communicate the importance of contraception and the drugs that cannot be used during pregnancy.
Citation: Children
PubDate: 2024-08-06
DOI: 10.3390/children11080952
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 953: High Prevalence of Varus Knee Malalignment
in Adolescent Football Players—Clinical Lower Leg Axis Measurements
of Male Junior Football Players Aged 7 to 18 Years
Authors: Clemens Memmel, Dominik Sporrer, Dominik Szymski, Johannes Weber, Alexander Hanke, Markus Denzinger, Maximilian Kerschbaum, Volker Alt, Werner Krutsch, Matthias Koch
First page: 953
Abstract: Background: Football, as the most popular sport worldwide, has long been under suspicion of causing varus knee alignment as early as adolescence. However, no causal relationship has yet been found. The first step to do so would be to determine the prevalence of lower leg malalignment among male junior football players depending on age, performance level and the number of active seasons played. Methods: Leg axis alignment in frontal plane was determined in male junior football players of different age levels between 7 and 18 years by measuring the intercondylar/intermalleolar distance (ICD/IMD) in an upright position. In addition to anthropometric data, multiple sport-specific data such as the start of their football career or training time per week were collected by means of questionnaires (clinical trial registration number: DRKS00020446). Results: 207 male junior football players were included in this survey. The mean age was 12.8 years. Within the group of 15 to 18 year olds, the prevalence of varus knee malalignment was highest at just under a third (32.1%). In the subpopulation that played actively for more than ten seasons, 28.9% showed varus leg axis. Regarding performance level, the highest IMD/ICD values and highest prevalence of varus alignment were found among football players who play on a semi-professional level (16.7%), compared to amateur (11.4%) and high-performance levels (2.8%). Conclusions: Further research is necessary to investigate if this high prevalence of varus knee in children of a higher age and higher playing levels is due to the selection bias of football players with varus knee or a real development of varus knee in individuals.
Citation: Children
PubDate: 2024-08-07
DOI: 10.3390/children11080953
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 954: Effects of Ramadan Fasting on Sleep and
Physical Fitness among Young Female Handball Players
Authors: Mohamed Alaeddine Guembri, Ghazi Racil, Mohamed Tounsi, Chirine Aouichaoui, Luca Russo, Gian Mario Migliaccio, Yassine Trabelsi, Nizar Souissi, Johnny Padulo
First page: 954
Abstract: Objectives: This study examines the potential impact of Ramadan fasting on sleep patterns and physical fitness in under 14 (U14) and under 17 (U17) female handball players. Methods: For this study, sixty-five female handball players’ (U14, n = 33 and U17, n = 32) sleep habits were assessed before (BR) and during the first (R1) and last weeks (R4) of Ramadan using: the Pittsburgh Sleep Quality Index (PSQI), the Insomnia Severity Index (ISI), and the Epworth Sleepiness Scale (ESS). Physical ability tests including balance and jumps were conducted throughout these periods.; Results: During Ramadan, both groups noted significant increases in PSQI and ISI scores during R1 (p < 0.01 and p < 0.05, respectively) and R4 (p < 0.05 and p < 0.05, respectively) compared to before Ramadan (BR). For the U14 group, a significant increase occurred in ESS scores during R1 (p < 0.01) and R4 (p < 0.05), whereas for the U17 group, this increase was limited over the R1 period (p < 0.05). In contrast, for all physical ability parameters, both groups showed no significant difference during R1 and R4; Conclusions: During adolescence, Ramadan fasting may alter sleep patterns in young female athletes but appears to have no effect on their performance in short-duration exercises.
Citation: Children
PubDate: 2024-08-07
DOI: 10.3390/children11080954
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 955: First Description of a Large Clinical Series
of Fetal Alcohol Spectrum Disorders Children and Adolescents in Reunion
Island, France
Authors: Laëtitia Sennsfelder, Susie Guilly, Sonia Henkous, Christophe Lebon, Sébastien Leruste, Pauline Beuvain, Fanny Ferroul, Stéphanie Benard, Frédérique Payet, Meissa Nekaa, Maité Bagard, Magaly Lauret, Virginie Hoareau, Aurélie Caillier, Stéphanie Robin, Justine Lanneaux, Léa Etchebarren, Michel Spodenkiewicz, Jean-Luc Alessandri, Godelieve Morel, Bérénice Roy-Doray
First page: 955
Abstract: Background: Despite several diagnostic guidelines, Fetal Alcohol Spectrum Disorders (FASDs) remain underdiagnosed or misdiagnosed, delaying the care of these patients and support for families. Objective: This study aims to help professionals caring for these children and their families to suspect this diagnosis earlier and to provide the most appropriate follow-up. Methods: A retrospective chart review with monocentric recruitment was performed at the Genetics Unit of the University Hospital of Reunion Island. A total of 147 children and adolescents with FASDs were included. Results: Prenatal alcohol exposure was associated with paternal alcohol consumption in 42.9%, and a high rate of prematurity (33.3%) was observed. Sixty percent of children or adolescents were placed in foster families. Learning difficulties without cognitive deficits were found in 65.8% of cases (50/76). Postural control and fine motor skills disabilities were described, respectively, in 54.7% (35/64) and 72.5% (50/69) of cases. A systematic genetic assessment was carried out, identifying in these FASD patients an associated Copy Number Variation (CNVs) in 22.6% of cases. Conclusion: Children with FASDs combine significant vulnerabilities, associating exposure to alcohol during the preconception and/or the prenatal period, prematurity, complex familial and sociocultural living conditions, and a genetic anomaly in almost a quarter of cases.
Citation: Children
PubDate: 2024-08-07
DOI: 10.3390/children11080955
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 956: “Vis-à-Vis Training” to
Improve Emotional and Executive Competences in Very Preterm Children: A
Pilot Study and Randomised Controlled Trial
Authors: Maria Chiara Liverani, Vanessa Siffredi, Greta Mikneviciute, Emma Mazza, Russia Ha-Vinh Leuchter, Petra Susan Hüppi, Cristina Borradori Tolsa, Edouard Gentaz
First page: 956
Abstract: Background/Objectives: Premature birth can lead to socio-emotional, behavioural and executive problems that impact quality of life and school performance in the long term. The aim of this pilot study was to evaluate the feasibility and efficacy of a 12-week computerised training called Vis-à-vis to enhance these competencies in a cohort of very preterm (VPT) children aged 6 to 9. Methods: This pilot randomised controlled trial included 45 children born before 32 gestational weeks. Socio-emotional, behavioural and executive competencies were evaluated at three time points using computerised tasks, neuropsychological tests and questionnaires. Results: Among the eligible VPT children, 20% (n = 45) accepted to be part of the study, and 40% (n = 18) dropped out. Finally, 60% (n = 27) of the enrolled participants completed the study. Results showed a significant improvement in emotion knowledge and recognition immediately after the completion of the training. Conclusions: Overall, our results indicate that the implementation of this type of computerised training is feasible, but the overall compliance is unsatisfactory given the high dropout rate. Nevertheless, the positive effect of the training on emotion recognition encourages further exploration of these kinds of interventions to prevent adverse consequences in children born too soon.
Citation: Children
PubDate: 2024-08-08
DOI: 10.3390/children11080956
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 957: Isolated Fetal Ventriculomegaly: Diagnosis
and Treatment in the Prenatal Period
Authors: Mateusz Zamłyński, Olena Zhemela, Anita Olejek
First page: 957
Abstract: Fetal ventriculomegaly (VM) is a defect of the central nervous system, typically diagnosed during the second-trimester ultrasound in fetuses with an atrial diameter (AD) of >10 mm. Non-isolated ventriculomegaly (NIVM) is heterogeneous in nature, coexisting with additional intracranial and/or extracranial malformations and genetic syndromes, resulting in an unfavorable prognosis for the further development of the child. Both the pregnancy management and counseling are dependent on the findings of combined ultrasound/MRI, genetic testing, and gestational age at diagnosis. The purpose of this review is to propose a hypothesis that diagnostic advancements allow to define the process of identification of the isolated forms of VM (IVM). Based on the evidence presented in the literature, we consider whether prenatal decompression for severe isolated VM (ISVM) is supported by the experimental trials and whether it might be implemented in clinical practice. Also, we describe the evolution of the diagnostic methods and expert opinions about the previously used prenatal decompression techniques for ISVM. In conclusion, we introduce the idea that fetal surgery centers have either reached or nearly reached the necessary level of expertise to perform such procedures. Endoscopic cystoventriculostomy (ETV) appears to be the most promising, as it is associated with minimal perinatal complications and favorable neurological outcomes in the neonatal period. Randomized trials with long-term neurodevelopmental follow-up of children who underwent prenatal decompression due to ISVM are necessary.
Citation: Children
PubDate: 2024-08-08
DOI: 10.3390/children11080957
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 958: A Pilot Phase 2 Randomized Trial to Evaluate
the Safety and Potential Efficacy of Etravirine in Friedreich Ataxia
Patients
Authors: Gabriella Paparella, Cristina Stragà, Nicola Pesenti, Valentina Dal Molin, Gian Antonio Martorel, Vasco Merotto, Cristina Genova, Arianna Piazza, Giuseppe Piccoli, Elena Panzeri, Alessandra Rufini, Roberto Testi, Andrea Martinuzzi
First page: 958
Abstract: Background: A drug repositioning effort supported the possible use of the anti-HIV drug etravirine as a disease-modifying drug for Friedreich ataxia (FRDA). Etravirine increases frataxin protein and corrects the biochemical defects in cells derived from FRDA patients. Because of these findings, and since etravirine displays a favorable safety profile, we conducted a pilot open-label phase 2 clinical trial assessing the safety and potential efficacy of etravirine in FRDA patients. Methods: Thirty-five patients were stratified into three severity groups and randomized to etravirine 200 mg/day or 400 mg/day. They were treated for 4 months. Safety endpoints were the number and type of adverse events and number of dropouts. Efficacy endpoints were represented by changes in peak oxygen uptake and workload as measured by incremental exercise test, SARA score, cardiac measures, measures of QoL and disability. Data were collected 4 months before the start of the treatment (T − 4), at the start (T0), at the end (T4) and 4 months after the termination of the treatment (T + 4). Results: Etravirine was reasonably tolerated, and adverse events were generally mild. Four months of etravirine treatment did not significantly increase the peak oxygen uptake but was associated with a change in the progression of the SARA score (p value < 0.001), compared to the 4 months pre- and post-treatment. It also significantly increased peak workload (p value = 0.021). No changes in the cardiac measures were observed. Health and QoL measures showed a worsening at the suspension of the drug. Conclusions: In this open trial etravirine treatment was safe, reasonably well tolerated and appreciably improved neurological function and exercise performance. Even though a placebo effect cannot be ruled out, these results suggest that etravirine may represent a potential therapeutic agent in FRDA deserving testing in a randomized placebo-controlled clinical trial.
Citation: Children
PubDate: 2024-08-09
DOI: 10.3390/children11080958
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 959: Improving Evidence-Synthesis for
School-Based Obesity Prevention Interventions. Comment on Ginell et al.
Unreliable Findings Due to Miscalculations and Errors. Comment on Nally et
al. The Effectiveness of School-Based Interventions on Obesity-Related
Behaviours in Primary School Children: A Systematic Review and
Meta-Analysis of Randomised Controlled Trials. Children 2021, 8, 489.
Children 2023, 10, 1660
Authors: Vanessa A. Shrewsbury, Rachael M. Taylor, Tammie Jakstas, Angeliek Verdonschot, Clare E. Collins
First page: 959
Abstract: As researchers with substantial experience in the child obesity field [...]
Citation: Children
PubDate: 2024-08-09
DOI: 10.3390/children11080959
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 960: Pediatric Gaucher Disease Type 3 Presenting
with Oculomotor Apraxia: A Case Report
Authors: Di Costanzo, de Paulis, Cannalire, Morelli, Biasucci
First page: 960
Abstract: We report on a 4-year-old boy affected by Gaucher disease (GD) type 3, who presented with splenomegaly and a history of oculomotor apraxia. GD is a rare lysosomal storage disorder caused by glucocerebrosidase deficiency with multi-organ involvement. Besides common clinical features such as hepatosplenomegaly and skeletal involvement, less frequent neurological symptoms, such as oculomotor apraxia, are indicative of neuronopathic forms of the disease, namely GD type 3, to be confirmed both by enzyme activity and genetic testing. Overall, GD management requires a multidisciplinary approach involving metabolic pediatricians, neurologists, psychologists, and geneticists, and currently relies on early enzyme replacement therapy. Although enzyme replacement therapy has proved to be effective in improving systemic signs and symptoms, it is unable to alleviate neurological complications once these have occurred, as it does not pass across the blood–brain barrier. Neurological improvements may occur through indirect mechanisms. Thus, our case report aims to highlight the importance of considering GD in the differential diagnosis of pediatric patients presenting with splenomegaly associated with neurological manifestations, as early intervention may significantly modify the disease progression and prevent further irreversible complications.
Citation: Children
PubDate: 2024-08-09
DOI: 10.3390/children11080960
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 961: Optimizing Therapeutic Strategies for
Syringomyelia Associated with Tethered Cord Syndrome: A Comprehensive
Review
Authors: Mohammad Mohsen Mosleh, Moon-Jun Sohn
First page: 961
Abstract: This review highlights the need for therapeutic guidelines for syringomyelia associated with tethered cord syndrome (TCS) caused by spinal dysraphism (SD). A comprehensive literature review was conducted, selecting twelve articles to analyze common therapeutic strategies. Surgical cord untethering alone has recently become a preferred treatment, with 45 ± 21.1% of patients experiencing remission or improvement, 47 ± 20.4% unchanged and asymptomatic, and 4 ± 8% worsened. Untethering with direct surgical drainage for the syrinx had better outcomes than untethering alone (78% vs. 45%, p = 0.05). Terminal syringostomy was beneficial for syrinxes extending to the filum terminale but not for asymptomatic small syrinxes with a syrinx index < 0.4. Syrinx shunting was recommended for symptomatic large syrinxes (>2 cm in length and syrinx index > 0.5). Various shunt procedures for syrinxes are still advocated, mainly for refractory syringomyelia in Chiari malformation, posttraumatic cases, SD, or other causes. Personalized surgical methods that address the root cause of syringomyelia, particularly those improving cerebrospinal fluid flow, offer promising results with minimized complications. Ongoing studies are required to enhance management strategies for syringomyelia associated with TCS, optimize patient outcomes, and reduce the risk of recurrent symptoms.
Citation: Children
PubDate: 2024-08-09
DOI: 10.3390/children11080961
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 962: Perinatal Outcomes of Singleton, Twin and
Triplet Gestations after Oocyte Donation: A Retrospective,
Population-Based Cohort Analysis
Authors: Or Eliner, Roni Rahav Koren, Hila Shalev Ram, Mattan Levi, Einat Haikin Herzberger, Amir Wiser, Netanella Miller
First page: 962
Abstract: Background/Objectives: Although high live birth rates are associated with oocyte donation (OD), these pregnancies are associated with increased obstetric and perinatal risks. This study evaluated maternal and neonatal risks after OD compared to in vitro fertilization (IVF) with autologous oocytes, and to spontaneous pregnancies (SPs), among singletons, twins and triplets. Methods: A retrospective, large, population-based cohort study was conducted based on electronic data from Maccabi Healthcare Services. A total of 469,134 pregnancies were grouped according to the mode of conception. The main outcome measures were preterm birth (PTB), small for gestational age (SGA) and pregnancy-induced hypertension (PIH). The data were analyzed separately for singletons, twins and triplets. Results: The mean maternal age was older in the OD group compared with the IVF and SP groups (singletons: 39.7 ± 4.1 vs. 34.5 ± 4.8 and 31.7 ± 5.3 years; twins: 39 ± 4.6 vs. 32.6 ± 4.4 and 31.2 ± 5.1 years; and triplets: 35.6 ± 2.5 vs. 32 ± 3.9 and 29.7 ± 5 years). The mean gestational age was younger among the OD group compared to the SP group (singletons: 37.5 ± 3 vs. 39 ± 2 p = 0.001, and twins: 35 ± 3 vs. 36 ± 2.5 p = 0.001). Higher rates of PTB < 37, PTB < 34 and PTB < 28 weeks were found among OD singletons. Multivariable logistic regressions for PTB < 37 weeks and SGA in singletons demonstrated that OD and IVF are significant risk factors (OR = 4.1, 95%CI = 3.3–5.2; OR = 4.3, 95%CI = 4.1–4.6; OR = 1.9, 95%CI = 1.3–2.6; OR = 2.2, 95%CI = 2–2.4, respectively). Significantly higher rates of PIH were demonstrated among the OD vs. IVF and SP groups in singleton (4.3% vs. 1.7% and 0.7%) and in twin pregnancies (7.5% vs. 4.3% and 3.4%). Conclusions: OD pregnancies are at increased risk for PTB, SGA and PIH.
Citation: Children
PubDate: 2024-08-10
DOI: 10.3390/children11080962
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 963: Benefits of Table Tennis for Children and
Adolescents: A Narrative Review
Authors: Daniel González-Devesa, Miguel Adriano Sanchez-Lastra, Martín Pintos-Barreiro, Carlos Ayán-Pérez
First page: 963
Abstract: This study aims to review the scientific evidence regarding the effects of table tennis practice on children and adolescents. Studies were searched in three electronic databases (PubMed, Scopus, and SportDiscus) from their inception up to May 2024. The methodological quality of the included studies was assessed using the 10-point Physiotherapy Evidence Database (PEDro) and Methodological Index for Non-Randomized Studies (MINORS). A total of twelve studies were examined, with interventions involving children with intellectual disabilities, ADHD, DCD, ASD, and typically developing children. A variety of training programs were assessed over durations ranging from 6 weeks to 1 year in the studies included. Table tennis was shown to positively impact various domains, including executive function, motor skills, visual perception, graphomotor function, gross motor skills, coordination capacity, behavioral inhibition, and social behavior. Nonetheless, it is imperative to expand the number of studies on children and adolescents with diverse conditions to more comprehensively evaluate the benefits of table tennis for each specific condition.
Citation: Children
PubDate: 2024-08-10
DOI: 10.3390/children11080963
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 964: Prevalence and Regional Differences in
Migrated Hips in Danish Children with Cerebral Palsy from 2008 to
2021—A Comparison of Ambulant vs. Non-Ambulant Children
Authors: Muhammed Bakhtiyar, Afrim Iljazi, Michael Mørk Petersen, Anders Odgaard, Christian Wong
First page: 964
Abstract: Purpose: This study aims to assess the incidence of hip displacement and dislocation (denominated as hip migration) among ambulant and non-ambulant Danish children with cerebral palsy (CP) by estimating their cumulative incidence of migrated hips. A secondary objective is to compare the prevalence across different Danish regions. Methods: Data were obtained from the Danish Cerebral Palsy Follow-Up Program (CPOP) from the years 2008 to 2021. This population-based cohort study included 1388 children with CP (58% male; 42% female) as subjects; aged 0–15 years; with an average age of 5.4 years at their last follow-up. The children were categorized according to their Gross Motor Function Classification System (GMFCS) level into ambulators (GMFCS I–III) and non-ambulators (GMFCS IV–V). The Kaplan–Meier estimator was employed to calculate the cumulative incidence of migrated hips from birth until the date of their last radiographic follow-up. Differences between ambulatory and non-ambulatory children and regional differences were assessed with the Log-rank test. Results: Median radiological follow-up for ambulators was 51 months and 94 months for non-ambulators. The cumulative incidence of hip dislocation was 0.3% (95% CI: 0–0.8%) and 22.0% (95% CI: 9.2–34.8%) for ambulators and non-ambulators, respectively (p < 0.0001), whereas the incidence of hip displacement was 21.1% (95% CI: 16.3–25.9%) and 76.7% (95% CI: 68.6–84.7%) for ambulators and non-ambulators, respectively (p < 0.0001). There were no significant regional differences in the incidence of hip dislocation among ambulators, but there were significant differences for non-ambulators. Moreover, significant regional differences were detected in hip displacement for both ambulators and non-ambulators. Conclusions: The prevalence of hip migration in Danish children with CP is significantly higher among non-ambulators, who are at an increased risk of hip migration compared to their ambulant counterparts. However, the low frequency of radiographic follow-up for ambulators might cause the incidence of hip migration to be underestimated. This study highlights the necessity of continued targeted surveillance and interventions in Danish non-ambulators.
Citation: Children
PubDate: 2024-08-10
DOI: 10.3390/children11080964
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 966: Inclusion Goals: What Sex Education for
LGBTQIA+ Adolescents'
Authors: Stefano Eleuteri, Marta Girardi, Rossella Spadola, Elisabetta Todaro
First page: 966
Abstract: According to the World Health Organization and the World Association for Sexual Health (WAS) Declaration of Sexual Rights, sex education aims to provide children and adolescents with comprehensive knowledge, skills, attitudes, and values, promoting equality and nondiscrimination while upholding freedom of thought and expression. However, current school curricula often focus on dichotomous sexual identity and hetero-cis-normative prevention strategies, neglecting the needs of gender minority (GM) and sexual minority (SM) youths. In family settings, discussions typically revolve around sexual risk reduction and basic contraception, omitting relational aspects and components of sexual identity such as orientations and gender expressions. This discrepancy highlights a gap between the official goals of sex education and its practical implementation, reflecting a cultural deficit in familial sex education. This study reviews the scientific literature on sexual health promotion interventions from 2015 to 2024 to identify inclusive approaches that enhance the participation of all youths, not just hetero-cis-normative individuals. The hypothesis is that most interventions primarily serve heterosexual and cisgender youths, indicating a need for more inclusive strategies to achieve better sexual health and educational outcomes. The study also suggests expanding curricula to align with recognized guidelines and the diverse needs of youth.
Citation: Children
PubDate: 2024-08-10
DOI: 10.3390/children11080966
Issue No: Vol. 11, No. 8 (2024)
- Children, Vol. 11, Pages 866: The Mediating Role of Cardiorespiratory
Fitness in the Association between a Negative Lifestyle and Poor Mental
Health in Chilean Schoolchildren
Authors: Pedro Delgado-Floody, Felipe Caamaño-Navarrete, Guillermo Barahona-Fuentes, Carlos Arriagada-Hernández, Pablo Valdés-Badilla, Indya Del-Cuerpo, Mauricio Cresp-Barría, Manuel Gómez-López
First page: 866
Abstract: Background: A negative lifestyle has a reported relationship with psychological problems and deteriorated well-being. However, there is little information regarding the mediating role of cardiorespiratory fitness (CRF) in this relationship. Objectives: The objectives of the present study are twofold: first, to investigate the association between negative lifestyle, physical self-concept (PSC), and depression, and second, to assess the potential mediating role of CRF in this complex relationship. Methods: This cross-sectional study included 612 schoolchildren aged between 9 and 14 years from the Araucanía region (southern Chile). CRF was measured using the Leger test, and lifestyle, depression, and PSC were measured using validated questionnaires. Results: A negative lifestyle reported an inverse association with PSC (p < 0.001) and a positive association with depression levels (p < 0.001). The mediation analysis showed that CRF was positively related to PSC (p < 0.001) and inversely related to depression (p = 0.001); besides, the indirect effect CRF acted as a partial mediator in the association between a negative lifestyle and PSC (indirect effect = −1.15; SE = 0.01; 95% CI, −1.87, −0.55) and depression levels (indirect effect = 0.22; SE = 0.08; 95% CI, 0.08, 0.38). Conclusion: In conclusion, CRF in schoolchildren played a potential mediating role in the association between a negative lifestyle and depression and PSC.
Citation: Children
PubDate: 2024-07-17
DOI: 10.3390/children11070866
Issue No: Vol. 11, No. 7 (2024)
- Children, Vol. 11, Pages 867: Effect of School-Based Educational
Intervention on Childhood Obesity in Croatian Urban and Rural Settings
Authors: Sara Cobal, Darija Vranešić Bender, Jasenka Gajdoš Kljusurić, Ivana Rumora Samarin, Željko Krznarić
First page: 867
Abstract: Background: Childhood obesity is a global public health concern. Development of effective public health interventions represents the only viable option for decreasing the prevalence of childhood obesity. The objective of this study was to assess the effectiveness of a school-based “PETICA—Play for Health” obesity prevention program in urban and rural areas in Croatia. Methods: This before-and-after study included 28 elementary schools in Croatia focused on pupils (n = 753, 2nd grade) and their guardians (n = 753) during the school year 2022/2023. “PETICA” multicomponent lessons and workshops (10) were implemented in the school curriculum and home settings (parents) as part of the intervention. Knowledge and lifestyle habit changes were evaluated via the questionnaire on knowledge and habits regarding nutrition and physical activity pre-/post-education. The Wilcoxon test for paired samples, Student’s t-test (dependent and independent samples), multiple Mann Whitney U tests (p < 0.05), Spearman’s correlation, and heatmaps were used. Results: The analysis showed a significant increase in acquired knowledge among pupils (both settings) and habits in the rural setting (increase in sports activities participation, breakfast, and vegetables consumption (p < 0.001, p = 0.003, p = 0.004)), decrease of sweets and salty snacks intake (p = 0.027, p = 0.011), and also, the link between parents’ and children’s physical activity levels (p = 0.028 vs. p = 0.022), emphasizing the importance of parents as healthy lifestyle role-models. Conclusion: The study shows that “PETICA” is an efficient school-based educational model that contributes to positive changes in children’s knowledge and lifestyle habits that are a prerequisite for childhood obesity prevention.
Citation: Children
PubDate: 2024-07-17
DOI: 10.3390/children11070867
Issue No: Vol. 11, No. 7 (2024)
- Children, Vol. 11, Pages 868: Neck Circumference and Its Relation with
Body Fat Percentage in Children 5–10 Years Old
Authors: Enrique Romero-Velarde, Karen G. Córdova-García, Laura C. Robles-Robles, Ingrid J. Ventura-Gómez, Clío Chávez-Palencia
First page: 868
Abstract: Background: Neck circumference (NC) has been proposed as an indicator of upper trunk adiposity and a potential indicator of metabolic risk. The objective was to evaluate NC and its correlation with body fat percentage (BF%) and other indicators of adiposity in children with normal weight, overweight, and obesity. Methods: In a cross-sectional study, 112 children 5 to 10 years of age were included in the outpatient clinic from a public hospital. Measures of weight and height to calculate BMI (kg/m2), NC, mid-upper arm circumference, waist circumference, and tricipital skinfold thickness. Body composition measurements were performed using an electrical bioimpedance device (BIA). The relationship between anthropometric variables and BF% obtained by BIA was determined using Spearman correlation tests. Multivariate models were constructed with BF% as the dependent variable and anthropometric parameters as independent. Results: In the entire group, there was a direct correlation between NC and BF% (r = 0.50, p < 0.001), but lost statistical significance in the case of normal weight. The relationship maintained its significance in subjects from the overweight and obesity groups. In multivariate models, BMI exhibited the highest correlation with BF%, followed by waist circumference and mid-upper arm circumference; for NC, the R2 value was 0.30 (p < 0.001). Conclusions: Neck circumference is useful in the screening of population groups with the advantage of not requiring any specialized instruments for its measurement other than a tape measure. BMI and waist circumference were the best indicators of general and central adiposity, respectively.
Citation: Children
PubDate: 2024-07-17
DOI: 10.3390/children11070868
Issue No: Vol. 11, No. 7 (2024)
- Children, Vol. 11, Pages 869: Nutritional Deficiencies and Associated Oral
Health in Adolescents: A Comprehensive Scoping Review
Authors: Man Hung, Amy Blazejewski, Samantha Lee, Johanna Lu, Andres Soto, Connor Schwartz, Amir Mohajeri
First page: 869
Abstract: Introduction: The shift to processed foods in American diets has increased vitamin and mineral deficiencies among adolescents, impacting growth and health, often manifesting as oral lesions. This review study aimed to explore the link between nutritional deficiencies and adolescent oral health to improve guidance and prevent long-term issues. Methods: A systematic review of literature from 2013 to 2023 was conducted on adolescents aged 10–19 years, using PRISMA guidelines. Searches in PubMed, Web of Science, Dentistry & Oral Sciences Source—Ebscohost, and Scopus included peer-reviewed articles, excluding reviews and non-empirical studies. Data were screened and extracted with independent reviews for accuracy. Results: Malnutrition strongly correlates with poor oral health. Undernourished children have a 60% increase in dental caries, exacerbated by high sugar intake. Early malnutrition delays dental eruption, temporarily protecting against caries, while stunting and infections cause enamel defects. Chronic conditions like cerebral palsy and celiac disease worsen oral health, with risks persisting into adulthood. Conclusions: Nutritional deficiencies and oral health are interconnected, requiring integrated healthcare. Early interventions and holistic strategies can improve outcomes and reduce long-term burdens. Comprehensive health education and routine dental evaluations are essential for prevention and treatment, enhancing health across all demographics.
Citation: Children
PubDate: 2024-07-18
DOI: 10.3390/children11070869
Issue No: Vol. 11, No. 7 (2024)
- Children, Vol. 11, Pages 870: Parental Attitudes and Practices regarding
Atopic Dermatitis: A Cross-Sectional Study among a Thai Population
Authors: Phurithat Nummak, Leelawadee Techasatian, Rattapon Uppala, Phanthila Sitthikarnkha, Suchaorn Saengnipanthkul, Prapassara Sirikarn
First page: 870
Abstract: Background: Atopic dermatitis (AD) is a chronic inflammatory skin disorder common in children. Successful pediatric AD therapy requires parental assistance. Thus, evaluating parental knowledge, attitudes, and behaviors regarding childhood AD may lead to more educational recommendations to help children control AD in the future. This study examined parents’ knowledge, attitudes, and conduct concerning AD in families with and without children with AD. Method: The Pediatric Department, Faculty of Medicine, Khon Kaen University, Thailand, conducted a cross-sectional study from June to December 2023. Parents of children who visited the dermatology clinic with or without AD were asked to complete a Google form questionnaire. Results: A total of 372 parents answered a questionnaire about AD pathophysiology, knowledge, attitudes, and practices. The participants were 293 (78.8%) female participants and 79 (21.2%) male participants. The average age was 29.79 (SD 4.91). Most parents (319, 85.8%) did not work in the medical field, and more than half (228 instances, 61.29%) had children diagnosed with AD. Conclusions: Parents of children with AD understood AD causes and triggers better than parents of children without AD. But, “exposure to furry toys” that may contain dust and allergies and “infection” that may cause AD flare-ups were the most common triggers, regardless of the group. Appropriate information should be supplied because both the parents of children with AD and those of children without AD reported immediate food avoidance without confirmatory testing, which might lead to malnutrition. Clinicians and families handling patients with AD require further education.
Citation: Children
PubDate: 2024-07-18
DOI: 10.3390/children11070870
Issue No: Vol. 11, No. 7 (2024)
- Children, Vol. 11, Pages 871: Antibiotics, Analgesic Sedatives, and
Antiseizure Medications Frequently Used in Critically Ill Neonates: A
Narrative Review
Authors: Angeliki Kontou, Eleni Agakidou, Ilias Chatziioannidis, William Chotas, Evanthia Thomaidou, Kosmas Sarafidis
First page: 871
Abstract: Antibiotic, analgesic sedative, and antiseizure medications are among the most commonly used medications in preterm/sick neonates, who are at high risk of nosocomial infections, central nervous system complications, and are exposed to numerous painful/stressful procedures. These severe and potentially life-threatening complications may have serious short- and long-term consequences and should be prevented and/or promptly treated. The reported variability in the medications used in neonates indicates the lack of adequate neonatal studies regarding their effectiveness and safety. Important obstacles contributing to inadequate studies in preterm/sick infants include difficulties in obtaining parental consent, physicians’ unwillingness to recruit preterm infants, the off-label use of many medications in neonates, and other scientific and ethical concerns. This review is an update on the use of antimicrobials (antifungals), analgesics (sedatives), and antiseizure medications in neonates, focusing on current evidence or knowledge gaps regarding their pharmacokinetics, indications, safety, dosage, and evidence-based guidelines for their optimal use in neonates. We also address the effects of early antibiotic use on the intestinal microbiome and its association with long-term immune-related diseases, obesity, and neurodevelopment (ND). Recommendations for empirical treatment and the emergence of pathogen resistance to antimicrobials and antifungals are also presented. Finally, future perspectives on the prevention, modification, or reversal of antibiotic resistance are discussed.
Citation: Children
PubDate: 2024-07-18
DOI: 10.3390/children11070871
Issue No: Vol. 11, No. 7 (2024)
- Children, Vol. 11, Pages 872: Association among Household Wealth, Maternal
Employment, and Undernutrition in Children under Three Years of Age in
Pakistan
Authors: Muhammad Shahid, Yuantao Xie, Shamshad Bashir, Nazia Noureen, Jiayi Song, Najma Iqbal Malik, Kun Tang
First page: 872
Abstract: Background: There is an abundance of studies explaining the separate impact of female employment and household wealth status in reducing malnutrition. However, our study has unraveled the combined impact of maternal employment and household wealth on undernutrition among children under three in Pakistan. Methods: Using a sample of 1093 children under three years of age from the Pakistan Demographic and Health Survey 2017–2018, a binary logistic model was employed to gauge factors influencing the children’s undernutrition. Results: Our results indicated that children up to a certain age (three years old) with residence in certain regions (Pakistan) and recent episodes of diarrhea had an increased risk of undernutrition. Conversely, secondary and higher maternal education, access to improved water sources, and sanitation facilities lowered the chances of undernutrition in children under three in Pakistan. The interaction between maternal employment and household wealth showed that maternal employment significantly lowered the risk of stunting, being underweight, and wasting among the average, rich, and richest households; however, it did not contribute to child nutrition among the poorer and poor households. Notably, regardless of whether the mother was employed, the wealth status of being rich and richest reduced the risk of stunting, being underweight, and wasting. Conclusions: In overcoming undernutrition, maternal employment significantly contributed to middle-income households. However, in the richer and richest households, the wealth status played a more crucial role compared to the maternal employment. This indicates that while employment plays a supportive role in household resources, the wealth status is overall more influential in reducing undernutrition.
Citation: Children
PubDate: 2024-07-18
DOI: 10.3390/children11070872
Issue No: Vol. 11, No. 7 (2024)
- Children, Vol. 11, Pages 873: Use of N-Acetylcysteine in Preterm Neonates
with Enteral Feeding Intolerance and Intestinal Obstruction: A Case Series
and Review of the Literature
Authors: Domenico Umberto De Rose, Francesca Landolfo, Flaminia Pugnaloni, Paola Giliberti, Alessandra Santisi, Claudia Columbo, Ludovica Martini, Maria Paola Ronchetti, Paolo Maria Schingo, Guglielmo Salvatori, Fabio Fusaro, Pietro Bagolan, Andrea Dotta, Irma Capolupo, Andrea Conforti
First page: 873
Abstract: (1) Background: The use of N-acetylcysteine (NAC) to relieve meconium obstruction of prematurity in the first days of life has been reported, with NAC reducing the viscosity of luminal contents by cleaving the disulfide bonds of mucoproteins. However, its use in this population should be further explored since it has been associated with hypernatremia and transient increase in transaminases and bilirubin. (2) Methods: In this retrospective study, we included neonates admitted because of enteral feeding intolerance and intestinal obstruction from 2019 to 2021 who received NAC as a rescue therapy before explorative laparotomy. (3) Results: We summarized the clinical presentation of six preterm neonates with enteral feeding intolerance and intestinal obstruction who received NAC as a rescue therapy. Four infants (66.7%) gradually improved without the need for explorative laparotomy, whereas two infants (33.3%) underwent the creation of an ileostomy. No cases of hypernatremia or hepatic derangement associated with NAC therapy were observed. (4) Conclusions: We described the use of NAC treatment by nasogastric tube and/or rectal enemas in preterm infants with enteral feeding intolerance and intestinal obstruction after a multidisciplinary assessment, but the limited sample size did not allow us to obtain definitive conclusions and further research is needed in this field, given the limited evidence about NAC treatment in preterm infants.
Citation: Children
PubDate: 2024-07-18
DOI: 10.3390/children11070873
Issue No: Vol. 11, No. 7 (2024)
- Children, Vol. 11, Pages 874: Assessment and Treatment of Pain in
Hospitalized Children at a Tertiary Children’s Hospital: A
Cross-Sectional Mixed Methods Survey
Authors: Nadia Roessler De Angulo, Andrea C. Postier, Lisa Purser, Lena Ngo, Karen Sun, Stefan Friedrichsdorf
First page: 874
Abstract: (1) Background: Acute pain in hospitalized children remains under-recognized and under-treated. Our objective is to benchmark pain assessment, documentation, treatment, and patient experience in children admitted to a US children’s hospital. (2) Methods: A cross-sectional, mixed-method survey of pain for children hospitalized ≥24 h. Charts were reviewed for modalities of pain assessment and treatment for all inpatients. If pain was documented, patients/caregivers were surveyed regarding their experience with pain and its management. (3) Results: Chart review: All 107 patients had ≥1 pain score documented. A total of 47 patients had a pain score ≥0, 35 (74.5%) of whom had ≥1 moderate-severe score. Seventy (65.4%) patients received ≥1 intervention for pain, including medications from ≥1 class (e.g., opioids) (n = 55, 51.4%) and/or integrative/non-pharmacologic intervention(s) (n = 39, 36.4%). There were assessment and documentation gaps. Patient survey: A total of 39 (83.0%) interviews were attempted; 25 (53.2%) were completed. The worst pain was mostly caused by acute illness (n = 13, 52%) and painful procedures (n = 10, 40%). Suggestions for improvement included increasing the use of integrative modalities and optimizing patient–clinician communication. (4) Conclusions: All patients admitted ≥24 h had ≥1 pain score documented; however, gaps in documentation were common. Multimodal treatment and integrative modalities were underutilized. Procedures were a frequent cause of under-treated pain, prompting an institution-wide quality improvement project.
Citation: Children
PubDate: 2024-07-19
DOI: 10.3390/children11070874
Issue No: Vol. 11, No. 7 (2024)
- Children, Vol. 11, Pages 875: Atypical Sensory Processing in
Neurodevelopmental Disorders: Clinical Phenotypes in Preschool-Aged
Children
Authors: Federica Gigliotti, Federica Giovannone, Arianna Belli, Carla Sogos
First page: 875
Abstract: Background: Sensory processing issues are frequent in neurodevelopmental disorders (NDDs), with very variable prevalence rates ranging from 20% to 95%. This study aimed to investigate sensory processing in preschool-aged children with NDDs, to clarify the epidemiology, and to identify associated or correlated clinical and psychometric variables. Methods: A total of 141 NDD children (age range 2–5 years old) were included and enrolled in two subgroups: 72 with ASD and 69 with other NDDs. A standardized neuropsychological evaluation was assessed (Griffiths III/WPPSI-III/Leiter-R, ADOS-2) and the parents completed the CBCL ½–5, the SPM-P, and the ADI-R. Results: Atypical sensory processing was reported in 39.7% of the total sample, more frequently in ASD (44.4%) than in other NDDs (34.8%). No statistically significant differences were found regarding gender and developmental level. A positive correlation was found between sensory processing abnormalities and behavioral problems (p < 0.01). Conclusions: Compared to other NDDs, ASDs more frequently have atypical sensory processing and appear to present a specific vulnerability in the processing of proprioceptive and vestibular inputs. Our results suggest that sensory processing difficulties should be considered regardless of developmental level and in children with behavioral problems.
Citation: Children
PubDate: 2024-07-19
DOI: 10.3390/children11070875
Issue No: Vol. 11, No. 7 (2024)
- Children, Vol. 11, Pages 876: HEP® (Homeostasis-Enrichment-Plasticity)
Approach Changes Sensory–Motor Development Trajectory and Improves
Parental Goals: A Single Subject Study of an Infant with Hemiparetic
Cerebral Palsy and Twin Anemia Polycythemia Sequence (TAPS)
Authors: Aymen Balikci, Teresa A. May-Benson, Gamze Cagla Sirma, Gul Ilbay
First page: 876
Abstract: Background: Early intervention (EI) for infants identified as being at high risk for cerebral palsy (CP), or who have been diagnosed with it, is critical for promotion of postnatal brain organization. The aim of this study was to explore the effectiveness of the Homeostasis-Enrichment-Plasticity (HEP) Approach, which is a contemporary EI model that applies the key principles of enriched environment paradigms and neuronal plasticity from experimental animal studies to ecological theories of human development on the motor development, sensory functions, and parental goals of an infant with twin anemia polycythemia sequence (TAPS) and CP. Methods: An AB phase with follow-up single case study design which consisted of multiple baseline assessments with the Peabody Developmental Motor Scales-2 (PDMS-2) and the Test of Sensory Functions in Infants (TSFI) was used. Non-overlapping confidence intervals analysis was used for pre–post PDMS-2 scores. The measurement of progress toward goals and objectives was conducted using the Goal Attainment Scale (GAS). The HEP Approach intervention consisted of 12 one-hour sessions implemented over a period of 3 months, where a physical therapist provided weekly clinic-based parental coaching. Results: Results found a stable baseline during Phase A and improvement in response to the HEP Approach intervention during Phase B in both the PDMS-2 and TSFI according to 2SD Band analysis. The confidence intervals for the PDMS-2 scores also indicated a significant improvement after HEP intervention. The scores for both the PDMS-2 and the TSFI were consistent or showed improvement throughout the Follow-Up phase. A GAS t-score of 77.14 indicated that the infant exceeded intervention goal expectations. Conclusions: Although our findings suggest that the HEP Approach intervention has promise in enhancing sensory functions, motor skill outcomes, and parental goals in an infant with TAPS and CP, further research is required to validate and apply these results more broadly.
Citation: Children
PubDate: 2024-07-19
DOI: 10.3390/children11070876
Issue No: Vol. 11, No. 7 (2024)
- Children, Vol. 11, Pages 877: Diving into the Digital Landscape: Assessing
the Quality of Online Information on Neonatal Jaundice for Parents
Authors: Michael Karl Baumgartner, Anna-Lena Behr, Anne Christina Garbe, Christoph Quatember, Heiko Reutter, Joachim Woelfle, Fabian Benedikt Fahlbusch, Gregor Hanslik
First page: 877
Abstract: Background: Hyperbilirubinemia is a common condition in newborns. While mild cases of jaundice are common and typically resolve spontaneously, severe hyperbilirubinemia can lead to serious neurologic complications if left untreated. With the constant adaptation of guidelines, clinical management has significantly improved, and treatment has become routine for pediatricians. However, for parents of affected children, managing the condition is not routine. In today’s digital age, parents often seek additional information by accessing a wide range of medical resources on the internet. While this can be empowering, it also presents challenges, as the quality and accuracy of online medical information can vary widely. Therefore, we analyzed the current quality of information on jaundice found on the internet by parents. Methods: A simulated internet search (using the Google search engine) was conducted from a layperson’s perspective using German (“Neugeborenes Gelbsucht”, “Baby Gelbsucht”) and English (“jaundice newborn”, “jaundice baby”) search terms. Subsequently, the quality of the search results was assessed by two independent neonatologists based on the DISCERN Plus Score, HONcode certification, and the JAMA criteria. Results: Websites targeting non-medical laypersons exhibited significant variability in quality. Notably, the content of English websites was superior to that of websites in the German language. The majority of English sites were predominantly institutional, whereas most German sites were commercially oriented. Conclusions: Although information on jaundice is readily accessible online for non-medical individuals, there were notable differences in quality based on language and significant variability in the quality of information warranting attention from healthcare professionals. Furthermore, German websites providing information on jaundice were often hosted by commercial organizations. We propose that pediatric societies engage in developing and maintaining organization-based medical information to improve online resources for parents.
Citation: Children
PubDate: 2024-07-19
DOI: 10.3390/children11070877
Issue No: Vol. 11, No. 7 (2024)
- Children, Vol. 11, Pages 878: Importance of Cardiovascular Magnetic
Resonance Applied to Congenital Heart Diseases in Pediatric Age: A
Narrative Review
Authors: Sara Moscatelli, Alice Pozza, Isabella Leo, Jessica Ielapi, Alessandra Scatteia, Sofia Piana, Annachiara Cavaliere, Elena Reffo, Giovanni Di Salvo
First page: 878
Abstract: Congenital heart diseases (CHDs) represent a heterogeneous group of congenital defects, with high prevalence worldwide. Non-invasive imaging is essential to guide medical and surgical planning, to follow the patient over time in the evolution of the disease, and to reveal potential complications of the chosen treatment. The application of cardiac magnetic resonance imaging (CMRI) in this population allows for obtaining detailed information on the defects without the necessity of ionizing radiations. This review emphasizes the central role of CMR in the overall assessment of CHDs, considering also the limitations and challenges of this imaging technique. CMR, with the application of two-dimensional (2D) and tri-dimensional (3D) steady-state free precession (SSFP), permits the obtaining of very detailed and accurate images about the cardiac anatomy, global function, and volumes’ chambers, giving essential information in the intervention planning and optimal awareness of the postoperative anatomy. Nevertheless, CMR supplies tissue characterization, identifying the presence of fat, fibrosis, or oedema in the myocardial tissue. Using a contrast agent for angiography sequences or 2D/four-dimensional (4D) flows offers information about the vascular, valvular blood flow, and, in general, the cardiovascular system hemodynamics. Furthermore, 3D SSFP CMR acquisitions allow the identification of coronary artery abnormalities as an alternative to invasive angiography and cardiovascular computed tomography (CCT). However, CMR requires expertise in CHDs, and it can be contraindicated in patients with non-conditional devices. Furthermore, its relatively longer acquisition time and the necessity of breath-holding may limit its use, particularly in children under eight years old, sometimes requiring anesthesia. The purpose of this review is to elucidate the application of CMR during the pediatric age.
Citation: Children
PubDate: 2024-07-19
DOI: 10.3390/children11070878
Issue No: Vol. 11, No. 7 (2024)
- Children, Vol. 11, Pages 879: Construct Validity of the Athlete
Introductory Movement Screen in Grassroots Footballers Aged 11–13
Years
Authors: Michael J Duncan, Matteo Crotti, Ricardo Martins, Lucas Guimaraes-Ferreira, Jason Tallis, William Pattison
First page: 879
Abstract: Background: This study examined the construct validity of the Athlete Introductory Movement Screen (AIMS) in children. Methods: Following ethics approval, parental consent, and child assent, 87 children (50 boys, 37 girls) aged 11–13 years (Mean ± SD = 12.4 ± 0.6 years) performed the AIMS and Test of Gross Motor Development (TGMD-3) in a counterbalanced order. AIMS tertiles were subsequently created, classifying children with ‘high’, ‘medium’, or ‘low’ movement skills. Results: A 2 (Gender) X 3 (AIMS tertile) ways analysis of covariance (ANCOVA), controlling for age and age at peak height velocity, with TGMD-3 scores as the dependant variable, indicated that TGMD-3 scores were significantly higher for girls categorised as having a medium movement skill compared to girls categorised as low, and those categorised having high movement skill compared to medium and low movement skill groups (all, p = 0.001). There was no difference in TGMD-3 scores for boys classed as having low and medium movement skills. Boys categorised as high for movement skills had significantly greater TGMD-3 scores than their peers categorised as having both low and medium movement skills (p = 0.001). Conclusions: As the AIMS differentiates the theoretically related construct of motor competence, this study demonstrates that the AIMS has construct validity as a measure of movement skill in children aged 11–13 years.
Citation: Children
PubDate: 2024-07-19
DOI: 10.3390/children11070879
Issue No: Vol. 11, No. 7 (2024)
- Children, Vol. 11, Pages 880: Physical Activity Participation among
Children and Youth with Mental Health Symptoms: Clinician Perspectives
Authors: Madeline Crichton, Julie Vu, Barbara Fenesi
First page: 880
Abstract: Background/Objectives: Physical activity supports mental health and well-being in children and youth. However, there are significant barriers to physical activity participation among individuals impacted by mental health disorders. This study investigates these barriers through the perspective of mental health clinicians who support children and youth. Methods: Fourteen mental health clinicians, including registered professional psychologists, psychotherapists, and social workers, were interviewed in a semi-structured format. Qualitative content analysis was performed to identify key themes, including both barriers and facilitators to physical activity. Results: Content analysis revealed that clinicians perceive both internal and external barriers and facilitators to their clients’ participation in physical activity. Barriers included intrapersonal factors, such as the presence of depression, anxiety, or eating disorder symptoms; lack of motivation; and negative self-talk, as well as factors related to the influence of caregivers, financial limitations, screen time use, environmental and cultural factors, and lack of time. Facilitators included enjoyment of physical activity, knowledge about the benefits of physical activity, and caregiver participation. Conclusions: Mental health clinicians demonstrated clear knowledge about the barriers to and facilitators of their clients’ participation in physical activity. These findings provide valuable insights that can be used to support children and youth experiencing mental health difficulty to access the beneficial effects of physical activity.
Citation: Children
PubDate: 2024-07-20
DOI: 10.3390/children11070880
Issue No: Vol. 11, No. 7 (2024)
- Children, Vol. 11, Pages 881: The TRUST Study—TRansition US
Together: Evaluating the Impact of a Parent- and Adolescent-Centered
Transition Toolkit on Transition Readiness in Patients with Juvenile
Idiopathic Arthritis and Childhood-Onset Systemic Lupus Erythematosus
Authors: Simran Heera, Karen Beattie, Zubin Punthakee, Briano DiRezze, Julie Herrington, Tania Cellucci, Liane Heale, Mark Matsos, Jan Willem Gorter, Michelle Batthish
First page: 881
Abstract: Objective: Adolescents with chronic rheumatic disease must increasingly take on more responsibility for disease management from parents as they transition from pediatric to adult care. Yet, there are limited resources to inform and support parents about transition. Here, we evaluate the impact of a Transition Toolkit, geared towards parents and adolescents, on transition readiness, and explore the potential impact of parent–adolescent communication. Methods: A prospective cohort study of youths aged 14–18 years old and their parents was performed. Participant demographics, disease characteristics, transition readiness scores (Transition-Q, max 100), and parent–adolescent communication scores (PACS, max 100) were collected at enrollment (when the Transition Toolkit was shared with adolescents and their parents. Generalized estimating equation (GEE) analyses determined the influence of the Toolkit on transition readiness and explored the role of parent–adolescent communication quality. Subgroup analyses were conducted by sex. Results: A total of 21 patients were included; 19 completed one post-intervention Transition-Q and 16 completed two. Transition-Q scores increased over time and the rate of increase doubled after the Toolkit was shared (β = 7.8, p < 0.05, and β = 15.5, p < 0.05, respectively). Conclusion: Transition readiness improved at each follow-up, the greatest increase was seen after the Toolkit was shared. Parent–adolescent communication quality did not appear to impact changes in transition readiness.
Citation: Children
PubDate: 2024-07-20
DOI: 10.3390/children11070881
Issue No: Vol. 11, No. 7 (2024)
- Children, Vol. 11, Pages 882: Examining Caregiver- and Family-Level
Psychosocial Influences on Child Oral Health Behavioral Outcomes in
Racially and Economically Minoritized Urban Families
Authors: Sally M. Weinstein, Helen H. Lee, John J. Dziak, Michael L. Berbaum, Tong Zhang, David Avenetti, Anna Sandoval, Molly A. Martin
First page: 882
Abstract: Objectives: Understanding the pathways linking caregiver- and family-level psychosocial factors and child oral health behaviors is critical for addressing oral health disparities. The current study examined the associations between caregiver psychosocial functioning and family chaos and child toothbrushing behaviors in children at high risk for poor oral health outcomes. Methods: Data were drawn from the baseline wave of the CO-OP Chicago Cohort Study (U01DE030067), a longitudinal study on child/caregiver dyads exploring oral health behaviors and caries development in young children (N = 296 dyads; child mean age = 5.36, SD = 1.03; caregiver mean age = 33.8 years, SD = 6.70; caregiver race = 43% Black; caregiver ethnicity = 55% Latinx). The oral health behavioral outcomes included child toothbrushing frequency, child plaque levels, and caregiver assistance with child toothbrushing. The data included demographics; caregiver depression, anxiety, post-traumatic stress disorder (PTSD) symptoms, social functioning, social support, and resilience; and family-level household chaos. Results: Multiple regression models indicated that greater household chaos was significantly related to lower caregiver assistance with child toothbrushing (p = 0.0075). Additionally, caregiver anxiety and PTSD symptoms as well as number of children in the home significantly predicted higher levels of household chaos (p < 0.01). Notably, 18% of caregivers reported clinically significant PTSD. The relationships between caregiver-level psychosocial factors and child oral health behaviors were not significant. Conclusions: The results suggest household chaos may play an important role in child oral health behaviors and highlight the importance of investigating family-level factors for understanding and addressing child oral health risk.
Citation: Children
PubDate: 2024-07-21
DOI: 10.3390/children11070882
Issue No: Vol. 11, No. 7 (2024)
- Children, Vol. 11, Pages 883: Leisure Time Habits and Levels of Physical
Activity in Children and Adolescents
Authors: Juan-José Mijarra-Murillo, Beatriz Polo-Recuero, Adrián Solera-Alfonso, Alberto Arribas-Romano, Miriam Gacía-González, Sofía Laguarta-Val, José Manuel Delfa-de-la-Morena
First page: 883
Abstract: Abstract: Background/Objectives: Childhood and adolescence are important stages of life for acquiring healthy habits. There is a high prevalence of sedentary lifestyles worldwide during these ages, which negatively impacts health. This is attributed, in part, to excessive time spent engaging in sedentary behaviors. The aim of this study was to assess the time spent on sedentary behaviors and their relationship with physical activity levels in children and adolescents in the Community of Madrid. Methods: A total of 26,729 participants aged 10–17 from various schools and institutes took part in this study. The International Physical Activity Questionnaire Short Form (IPAQ-SF) was used, and they were asked about the time they spent on different leisure time habits (specific sedentary behaviors and organized physical activity). A generalized linear model was used to analyze the association between the time spent in sedentary activities and the time spent in physical activity. Results: The results revealed that children and adolescents engage in low levels of physical activity and most of them spend considerable time in sedentary behaviors such as studying, watching television, or using social media. Completing school homework (Coef: 1.23, 95% CI: −0.51 to 2.97, p = 0.167) or using social media for more than 2 h (Coef: 1.29, 95% CI: −2.98 to 0.40, p = 0.133) compared to not dedicating time to them did not show a significant association with daily physical activity time. Watching television for more than 2 h was associated with a decrease of 2.60 min (95% CI: −4.41 to −0.78, p = 0.005). Thus, no or only irrelevant associations were found between time spent in sedentary activities and physical activity time. Conclusions: Despite the drawbacks of spending time engaging in sedentary behaviors, they seem to be compatible with physical activity levels. Therefore, it is important to continue research on physical activity adherence strategies to promote overall health and well-being.
Citation: Children
PubDate: 2024-07-21
DOI: 10.3390/children11070883
Issue No: Vol. 11, No. 7 (2024)
- Children, Vol. 11, Pages 884: Pediatric Cardio-Oncology: Screening, Risk
Stratification, and Prevention of Cardiotoxicity Associated with
Anthracyclines
Authors: Xiaomeng Liu, Shuping Ge, Aijun Zhang
First page: 884
Abstract: Anthracyclines have significantly improved the survival of children with malignant tumors, but the associated cardiotoxicity, an effect now under the purview of pediatric cardio-oncology, due to its cumulative and irreversible effects on the heart, limits their clinical application. A systematic screening and risk stratification approach provides the opportunity for early identification and intervention to mitigate, reverse, or prevent myocardial injury, remodeling, and dysfunction associated with anthracyclines. This review summarizes the risk factors, surveillance indexes, and preventive strategies of anthracycline-related cardiotoxicity to improve the safety and efficacy of anthracyclines.
Citation: Children
PubDate: 2024-07-22
DOI: 10.3390/children11070884
Issue No: Vol. 11, No. 7 (2024)
- Children, Vol. 11, Pages 885: Nutritional Status in Pediatric Psoriasis: A
Case–Control Study in a Tertiary Care Referral Centre
Authors: Adelina-Maria Sendrea, Sinziana Cristea, Carmen Maria Salavastru
First page: 885
Abstract: Background: Psoriasis and obesity are chronic, inflammatory diseases, sharing certain pathophysiological factors. Psoriasis, increasingly viewed as a systemic inflammatory condition, may have various symptoms beyond the skin manifestations. Methods: This research aimed to explore the connection between body mass index (BMI) and pediatric psoriasis, through a case–control study on 100 psoriasis cases and 100 controls who were matched in terms of age and sex. The percentiles of the BMI by age and sex determined the nutritional status of each patient and control. The severity of psoriasis was evaluated based on the psoriasis area and severity index (PASI), nail involvement based on the nail psoriasis severity index (NAPSI), and quality of life impairment with the dermatology life quality index (DLQI). Results: While no statistically significant relationship was identified between increased BMI and PASI (p = 0.074), the risk of being overweight and obesity was significantly higher in the psoriasis group (OR 6.93, p = 0.003; OR 12.6, p < 0.001, respectively). The BMI increased with the PASI for psoriasis vulgaris but not for psoriasis inverse. No connections were found between disease duration and BMI (p = 0.56) or between BMI and PASI based on sex (p = 0.26). The NAPSI increased significantly with increased BMI (p = 0.000015). Conclusions: This study highlights the association between elevated BMI, psoriasis diagnosis, and severity of psoriatic onychopathy in pediatric patients, advocating for further large-scale studies to confirm these explorations and increasing awareness for better screening and management of such cases for overweight/obese patients.
Citation: Children
PubDate: 2024-07-22
DOI: 10.3390/children11070885
Issue No: Vol. 11, No. 7 (2024)
