Subjects -> HEALTH AND SAFETY (Total: 1527 journals)
    - CIVIL DEFENSE (22 journals)
    - DRUG ABUSE AND ALCOHOLISM (88 journals)
    - HEALTH AND SAFETY (721 journals)
    - HEALTH FACILITIES AND ADMINISTRATION (381 journals)
    - OCCUPATIONAL HEALTH AND SAFETY (113 journals)
    - PHYSICAL FITNESS AND HYGIENE (120 journals)
    - WOMEN'S HEALTH (82 journals)

HEALTH AND SAFETY (721 journals)                  1 2 3 4 | Last

Showing 1 - 200 of 203 Journals sorted alphabetically
16 de Abril     Open Access   (Followers: 1)
ACM Transactions on Computing for Healthcare     Hybrid Journal  
Acta Informatica Medica     Open Access   (Followers: 2)
Acta Scientiarum. Health Sciences     Open Access   (Followers: 2)
Adultspan Journal     Hybrid Journal  
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 11)
Advances in Public Health     Open Access   (Followers: 29)
Adversity and Resilience Science : Journal of Research and Practice     Hybrid Journal   (Followers: 2)
African Health Sciences     Open Access   (Followers: 6)
African Journal of Health Professions Education     Open Access   (Followers: 5)
Afrimedic Journal     Open Access   (Followers: 3)
Ageing & Society     Hybrid Journal   (Followers: 38)
Aging and Health Research     Open Access   (Followers: 7)
Air Quality, Atmosphere & Health     Hybrid Journal   (Followers: 8)
AJOB Empirical Bioethics     Hybrid Journal   (Followers: 2)
Akademika     Open Access  
American Journal of Family Therapy     Hybrid Journal   (Followers: 6)
American Journal of Health Economics     Full-text available via subscription   (Followers: 18)
American Journal of Health Education     Hybrid Journal   (Followers: 35)
American Journal of Health Sciences     Open Access   (Followers: 11)
American Journal of Health Studies     Full-text available via subscription   (Followers: 13)
American Journal of Preventive Medicine     Hybrid Journal   (Followers: 32)
American Journal of Public Health     Full-text available via subscription   (Followers: 188)
American Journal of Public Health Research     Open Access   (Followers: 30)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 8)
Annales des Sciences de la Santé     Open Access  
Annali dell'Istituto Superiore di Sanità     Open Access  
Annals of Clinical Medicine and Public Health     Open Access   (Followers: 11)
Annals of Global Health     Open Access   (Followers: 11)
Annals of Health Law     Open Access   (Followers: 6)
Applied Ergonomics     Hybrid Journal   (Followers: 17)
Apuntes Universitarios     Open Access   (Followers: 1)
Archives of Community Medicine and Public Health     Open Access   (Followers: 1)
Archives of Medicine and Health Sciences     Open Access   (Followers: 5)
Archives of Suicide Research     Hybrid Journal   (Followers: 9)
Archivos de Prevención de Riesgos Laborales     Open Access  
Arquivos de Ciências da Saúde     Open Access  
Asia Pacific Journal of Counselling and Psychotherapy     Hybrid Journal   (Followers: 7)
Asia Pacific Journal of Health Management     Full-text available via subscription   (Followers: 4)
Asian Journal of Gambling Issues and Public Health     Open Access   (Followers: 4)
Asian Journal of Medicine and Health     Open Access   (Followers: 1)
Asian Journal of Social Health and Behavior     Open Access   (Followers: 1)
Atención Primaria     Open Access   (Followers: 2)
Atención Primaria Práctica     Open Access  
Australasian Journal of Paramedicine     Open Access   (Followers: 7)
Australian Advanced Aesthetics     Full-text available via subscription   (Followers: 4)
Australian Family Physician     Full-text available via subscription   (Followers: 3)
Australian Indigenous HealthBulletin     Free   (Followers: 5)
Bijzijn XL     Hybrid Journal  
Biograph-I : Journal of Biostatistics and Demographic Dynamic     Open Access   (Followers: 5)
Biomedical Safety & Standards     Full-text available via subscription   (Followers: 7)
Biosafety and Health     Open Access  
Biosalud     Open Access  
Birat Journal of Health Sciences     Open Access  
BLDE University Journal of Health Sciences     Open Access  
BMC Oral Health     Open Access   (Followers: 5)
BMC Pregnancy and Childbirth     Open Access   (Followers: 20)
Brazilian Journal of Medicine and Human Health     Open Access  
British Journal of Health Psychology     Hybrid Journal   (Followers: 48)
Buletin Penelitian Kesehatan     Open Access  
Buletin Penelitian Sistem Kesehatan     Open Access  
Bulletin of the World Health Organization     Open Access   (Followers: 21)
Cadernos de Educação, Saúde e Fisioterapia     Open Access  
Cadernos de Saúde     Open Access  
Cambridge Quarterly of Healthcare Ethics     Hybrid Journal   (Followers: 14)
Canadian Family Physician     Partially Free   (Followers: 12)
Canadian Journal of Community Mental Health     Full-text available via subscription   (Followers: 13)
Canadian Journal of Human Sexuality     Hybrid Journal   (Followers: 1)
Canadian Journal of Public Health     Hybrid Journal   (Followers: 25)
Cannabis and Cannabinoid Research     Hybrid Journal   (Followers: 1)
Carta Comunitaria     Open Access  
Case Reports in Women's Health     Open Access   (Followers: 4)
CASUS : Revista de Investigación y Casos en Salud     Open Access  
Central Asian Journal of Global Health     Open Access   (Followers: 2)
CES Medicina     Open Access  
CES Salud Pública     Open Access  
Child and Adolescent Obesity     Open Access   (Followers: 4)
Child's Nervous System     Hybrid Journal  
Chinese Journal of Physiology     Open Access   (Followers: 1)
CHRISMED Journal of Health and Research     Open Access   (Followers: 1)
Christian Journal for Global Health     Open Access   (Followers: 1)
Ciencia & Salud     Open Access  
Ciencia & Trabajo     Open Access  
Ciencia e Innovación en Salud     Open Access  
Ciencia y Cuidado     Open Access   (Followers: 1)
Ciencia y Salud     Open Access   (Followers: 1)
Ciencia y Salud Virtual     Open Access  
Ciencia, Tecnología y Salud     Open Access  
Cities & Health     Hybrid Journal   (Followers: 4)
Cleaner and Responsible Consumption     Open Access   (Followers: 5)
Clinical and Experimental Health Sciences     Open Access   (Followers: 1)
ClinicoEconomics and Outcomes Research     Open Access   (Followers: 1)
CME     Hybrid Journal   (Followers: 1)
Community Health     Open Access   (Followers: 5)
Conflict and Health     Open Access   (Followers: 8)
Contraception and Reproductive Medicine     Open Access   (Followers: 1)
Cuaderno de investigaciones: semilleros andina     Open Access  
Cuadernos de la Escuela de Salud Pública     Open Access  
Current Opinion in Behavioral Sciences     Hybrid Journal   (Followers: 10)
Current Opinion in Environmental Science & Health     Hybrid Journal  
D Y Patil Journal of Health Sciences     Open Access   (Followers: 1)
Das österreichische Gesundheitswesen ÖKZ     Hybrid Journal  
Day Surgery Australia     Full-text available via subscription   (Followers: 2)
Design for Health     Hybrid Journal  
Disaster Medicine and Public Health Preparedness     Hybrid Journal   (Followers: 12)
Diversity and Equality in Health and Care     Open Access   (Followers: 9)
Diversity of Research in Health Journal     Open Access  
Dramatherapy     Hybrid Journal   (Followers: 2)
Drogues, santé et société     Open Access   (Followers: 2)
Duazary     Open Access  
Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi / Journal of Duzce University Health Sciences Institute     Open Access  
Early Childhood Research Quarterly     Hybrid Journal   (Followers: 22)
East African Journal of Public Health     Full-text available via subscription   (Followers: 3)
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity     Hybrid Journal   (Followers: 23)
EcoHealth     Hybrid Journal   (Followers: 4)
Education for Health     Open Access   (Followers: 8)
ElectronicHealthcare     Full-text available via subscription   (Followers: 2)
Emerging Trends in Drugs, Addictions, and Health     Open Access   (Followers: 5)
Ensaios e Ciência : Ciências Biológicas, Agrárias e da Saúde     Open Access  
Environmental Disease     Open Access   (Followers: 3)
Environmental Sciences Europe     Open Access   (Followers: 2)
Epidemics     Open Access   (Followers: 6)
EsSEX : Revista Científica     Open Access  
Estudios sociales : Revista de alimentación contemporánea y desarrollo regional     Open Access  
Ethics & Human Research     Hybrid Journal   (Followers: 4)
Ethics, Medicine and Public Health     Full-text available via subscription   (Followers: 6)
Ethiopian Journal of Health Development     Open Access   (Followers: 7)
Ethiopian Journal of Health Sciences     Open Access   (Followers: 6)
Ethnicity & Health     Hybrid Journal   (Followers: 15)
Eurasian Journal of Health Technology Assessment     Open Access  
EUREKA : Health Sciences     Open Access  
European Journal of Health Communication     Open Access   (Followers: 5)
European Journal of Investigation in Health, Psychology and Education     Open Access   (Followers: 5)
Evidência - Ciência e Biotecnologia - Interdisciplinar     Open Access  
Exploratory Research in Clinical and Social Pharmacy     Open Access   (Followers: 5)
Expressa Extensão     Open Access  
F&S Reports     Open Access  
Face à face     Open Access  
Families, Systems, & Health     Full-text available via subscription   (Followers: 8)
Family & Community Health     Hybrid Journal   (Followers: 13)
Family Medicine and Community Health     Open Access   (Followers: 8)
Family Relations     Partially Free   (Followers: 11)
FASEB BioAdvances     Open Access  
Fatigue : Biomedicine, Health & Behavior     Hybrid Journal   (Followers: 2)
Finnish Journal of eHealth and eWelfare : Finjehew     Open Access  
Food and Public Health     Open Access   (Followers: 11)
Food Hydrocolloids for Health     Open Access   (Followers: 6)
Food Quality and Safety     Open Access   (Followers: 2)
Frontiers in Digital Health     Open Access   (Followers: 4)
Frontiers in Neuroergonomics     Open Access  
Frontiers in Public Health     Open Access   (Followers: 7)
Frontiers of Health Services Management     Partially Free   (Followers: 6)
Gaceta Sanitaria     Open Access   (Followers: 2)
Galen Medical Journal     Open Access  
Ganesha Journal     Open Access  
Gazi Sağlık Bilimleri Dergisi     Open Access  
Geospatial Health     Open Access   (Followers: 1)
Gestão e Desenvolvimento     Open Access  
Gesundheitsökonomie & Qualitätsmanagement     Hybrid Journal   (Followers: 8)
Giornale Italiano di Health Technology Assessment     Full-text available via subscription  
Global Challenges     Open Access  
Global Health : Science and Practice     Open Access   (Followers: 7)
Global Health Annual Review     Open Access   (Followers: 2)
Global Health Innovation     Open Access  
Global Health Journal     Open Access   (Followers: 2)
Global Journal of Health Science     Open Access   (Followers: 5)
Global Journal of Public Health     Open Access   (Followers: 15)
Global Medical & Health Communication     Open Access   (Followers: 1)
Global Mental Health     Open Access   (Followers: 9)
Global Reproductive Health     Open Access  
Global Security : Health, Science and Policy     Open Access  
Global Transitions     Open Access  
Global Transitions Proceedings     Open Access   (Followers: 6)
Globalization and Health     Open Access   (Followers: 7)
Hacia la Promoción de la Salud     Open Access  
Hastane Öncesi Dergisi     Open Access  
Hastings Center Report     Hybrid Journal   (Followers: 7)
HCU Journal     Open Access  
HEADline     Hybrid Journal  
Health & Place     Hybrid Journal   (Followers: 19)
Health & Justice     Open Access   (Followers: 5)
Health and Human Rights     Open Access   (Followers: 9)
Health and Research Journal     Open Access  
Health and Social Care Chaplaincy     Hybrid Journal   (Followers: 10)
Health and Social Work     Hybrid Journal   (Followers: 62)
Health Behavior and Policy Review     Full-text available via subscription   (Followers: 5)
Health Behavior Research     Open Access   (Followers: 2)
Health Care Analysis     Hybrid Journal   (Followers: 13)
Health Equity     Open Access   (Followers: 2)
Health Information : Jurnal Penelitian     Open Access  
Health Notions     Open Access  
Health Policy     Hybrid Journal   (Followers: 44)
Health Policy and Technology     Hybrid Journal   (Followers: 5)
Health Policy OPEN     Open Access  
Health Promotion International     Hybrid Journal   (Followers: 23)
Health Promotion Journal of Australia : Official Journal of Australian Association of Health Promotion Professionals     Full-text available via subscription   (Followers: 7)
Health Prospect     Open Access  
Health Psychology     Full-text available via subscription   (Followers: 56)
Health Psychology Bulletin     Open Access   (Followers: 1)
Health Psychology Research     Open Access   (Followers: 21)

        1 2 3 4 | Last

Similar Journals
Journal Cover
Children
Number of Followers: 0  

  This is an Open Access Journal Open Access journal
ISSN (Online) 2227-9067
This journal is no longer being updated because:
    RSS is returning 403 Forbidden
  • Children, Vol. 9, Pages 1: Factors Associated with Congenital Heart
           Disease in Severely Malnourished Children under Five and Their Outcomes at
           an Urban Hospital, Bangladesh

    • Authors: Abu Sadat Mohammad Sayeem Bin Shahid, Tahmina Alam, Mst. Mahmuda Ackhter, Md. Zahidul Islam, Irin Parvin, Shamsun Nahar Shaima, Lubaba Shahrin, Tahmeed Ahmed, Fahmida Chowdhury, Mohammod Jobayer Chisti
      First page: 1
      Abstract: Congenital heart disease (CHD) is one of the most common types of birth defect with a high morbidity and mortality, particularly in severely malnourished children under five. In this study, we aim to identify the predicting factors for CHD and their outcomes. 694 malnourished children under five years of age admitted between April 2015 and December 2017 constituted the study population. Of them, 64 were cases of CHD, and by comparison 630 were without CHD. CHD was diagnosed clinically and confirmed by echocardiogram. 64% of the cases had a single defect. Cases were more likely to be present with diarrhea, cough, respiratory distress, cyanosis, hypoxemia, hypoglycemia and hypernatremia on admission. The cases also had a high proportion of severe sepsis, bacteremia, heart failure, respiratory failure and death, compared to those without CHD. Cough (95% CI = 1.09–18.92), respiratory distress (95% CI = 1.46–5.39) and hypoxemia (95% CI = 1.59–6.86) were found to be the independent predictors for CHD after regression analysis, and their early identification might be helpful to lessen ramifications, including mortality, in such populations, especially in resource-limited settings.
      Citation: Children
      PubDate: 2021-12-21
      DOI: 10.3390/children9010001
      Issue No: Vol. 9, No. 1 (2021)
       
  • Children, Vol. 9, Pages 2: Parent Mental Health and Family Coping over Two
           Years after the Birth of a Child with Acute Neonatal Seizures

    • Authors: Linda S. Franck, Renée A. Shellhaas, Monica E. Lemmon, Julie Sturza, Marty Barnes, Trisha Brogi, Elizabeth Hill, Katrina Moline, Janet S. Soul, Taeun Chang, Courtney J. Wusthoff, Catherine J. Chu, Shavonne L. Massey, Nicholas S. Abend, Cameron Thomas, Elizabeth E. Rogers, Charles E. McCulloch, Hannah C. Glass
      First page: 2
      Abstract: Little is known about parent and family well-being after acute neonatal seizures. In thus study, we aimed to characterize parent mental health and family coping over the first two years after their child’s neonatal seizures. Parents of 303 children with acute neonatal seizures from nine pediatric hospitals completed surveys at discharge and 12-, 18- and 24-months corrected age. Outcomes included parental anxiety, depression, quality of life, impact on the family, post-traumatic stress and post-traumatic growth. We used linear mixed effect regression models and multivariate analysis to examine relationships among predictors and outcomes. At the two-year timepoint, parents reported clinically significant anxiety (31.5%), depression (11.7%) and post-traumatic stress (23.7%). Parents reported moderately high quality of life and positive personal change over time despite ongoing challenges to family coping. Families of children with longer neonatal hospitalization, functional impairment, post-neonatal epilepsy, receiving developmental support services and families of color reported poorer parental mental health and family coping. Parents of color were more likely to report symptoms of post-traumatic stress and positive personal change. Clinicians caring for children with neonatal seizures should be aware of lasting risks to parent mental health and family coping. Universal screening would enable timely referral for support services to mitigate further risk to family well-being and child development.
      Citation: Children
      PubDate: 2021-12-22
      DOI: 10.3390/children9010002
      Issue No: Vol. 9, No. 1 (2021)
       
  • Children, Vol. 9, Pages 3: Intrinsic Kidney Pathology Following COVID-19
           Infection in Children and Adolescents: A Systematic Review

    • Authors: Henry H. L. Wu, Mohan Shenoy, Philip A. Kalra, Rajkumar Chinnadurai
      First page: 3
      Abstract: Introduction: COVID-19 infections resulting in pathological kidney manifestations have frequently been reported in adults since the onset of the global COVID-19 pandemic in December 2019. Gradually, there have been an increased number of COVID-19-associated intrinsic kidney pathologies in children and adolescents reported as well. The pathophysiological mechanisms between COVID-19 and the onset of kidney pathology are not fully known in children; it remains a challenge to distinguish between intrinsic kidney pathologies that were caused directly by COVID-19 viral invasion, and cases which occurred as a result of multisystem inflammatory syndrome due to the infection. This challenge is made more difficult in children, due to the ethical limitations of performing kidney biopsies to reach a biopsy-proven diagnosis. Although previous systematic reviews have summarized the various pathological kidney manifestations that have occurred in adults following acute COVID-19 infection, such reviews have not yet been published for children and adolescents. We describe the results of a systematic review for intrinsic kidney pathology following COVID-19 infection in children and adolescents. Methods: A systematic literature search of published data up until 31 October was completed through the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines. Research articles reporting new-onset or relapsed intrinsic kidney pathology in children or adolescents (≤18 years) following acute COVID-19 infection were included for qualitative review. COVID-19 infection status was defined by a positive result from a RT-PCR, or nuclear antibody testing. Only full-text articles published in the English language were selected for review. Results: Twenty-nine cases from fifteen articles were included in the qualitative synthesis of this systematic review. Nephrotic syndrome, as an umbrella condition, appeared as the most frequently observed presentation (20 cases) with disease remission noted in all cases with steroid treatment. Other cases included numerous glomerulonephritides, such as acute necrotizing glomerulonephritis, MPO vasculitis and collapsing glomerulopathy, and thrombotic microangiopathies, such as aHUS. For patients with transplanted kidneys, T-cell-mediated rejection and mild tubular interstitial infiltration were noted following testing positive for COVID-19. There were no mortalities reported in any of the included cases, although two patients remained dialysis dependent at hospital discharge. Conclusion: This systematic review highlights the various intrinsic pathological kidney manifestations in children and adolescents as a result of acute COVID-19 infection. The clinical timeline and presentation of these cases support the mechanistic hypothesis between COVID-19 infection and the onset of intrinsic kidney pathologies within this context. The progressive introduction of vaccination programs for children and adolescents may hopefully reduce the severity of COVID-19-associated illnesses, and pathological kidney manifestations in this population.
      Citation: Children
      PubDate: 2021-12-22
      DOI: 10.3390/children9010003
      Issue No: Vol. 9, No. 1 (2021)
       
  • Children, Vol. 9, Pages 4: Cardiovascular Risk Factors and Subclinical
           Atherosclerosis in Greek Adolescents with Polycystic Ovary Syndrome: Its
           Relationship with Body Mass Index

    • Authors: Anastasia Garoufi, Athanasia Pagoni, Maria Papadaki, Antonios Marmarinos, Georgios Karapostolakis, Lina Michala, Alexandra Soldatou
      First page: 4
      Abstract: Polycystic ovary syndrome (PCOS) is the most common endocrine condition affecting 6–18% of adolescents and is strongly associated with obesity and cardiovascular risk factors, enhancing the risk of atherosclerosis. Thirty-two adolescents with newly diagnosed PCOS were evaluated for lipid profile disorders, insulin resistance, inflammation, non-alcoholic fatty liver disease (NAFLD), and subclinical atherosclerosis through measurements of carotid intima–media thickness (cIMT). The relationships of the above markers with increased body mass index and abdominal obesity were investigated. Twenty-three adolescents (72%) were overweight (OW) or obese (OB). The OW/OB group had significantly higher insulin, HOMA-IR, high-sensitive C-reactive protein (hsCRP), visceral adiposity index (VAI), and lipid accumulation product (LAP) levels; and lower glucose-per-insulin ratios and HDL-C levels compared to the healthy weight group. The cIMT and small dense low-density lipoprotein cholesterol (sdLDL-C) levels did not differ between the two groups. Similarly, cIMT and sdLDL-C levels did not differ between PCOS-adolescents and healthy controls. CIMT was positively correlated with systolic blood pressure and waist circumference per height ratio. In conclusion, OW/OB PCOS-adolescents have a cluster of adverse factors predisposing them to atherosclerotic cardiovascular disease. Therefore, early cardiovascular risk assessment, as well as timely and targeted interventions, are necessary for prevention.
      Citation: Children
      PubDate: 2021-12-22
      DOI: 10.3390/children9010004
      Issue No: Vol. 9, No. 1 (2021)
       
  • Children, Vol. 9, Pages 5: Spurious Asthma Presentation during COVID-19

    • Authors: Israel Amirav, Moran Lavie
      First page: 5
      Abstract: The use of face masks as a means for preventing the spread of SARS-CoV-2 is now a common practice world-wide. Three children presented to our specialty clinic with respiratory complaints during protective face mask wearing. They were diagnosed as asthma and referred to our specialist clinic for further evaluation after asthma treatments were ineffective. Full details and a video clip demonstrating the effects of wearing the mask is presented for the first patient. The detailed evaluation confirmed the diagnosis of hyperventilation. Conclusions: In the current era of the daily use of masks, pediatricians should be aware of potential anxiety and hyperventilation while the mask is being worn, causing symptoms that mimic common respiratory disorders, such as asthma.
      Citation: Children
      PubDate: 2021-12-23
      DOI: 10.3390/children9010005
      Issue No: Vol. 9, No. 1 (2021)
       
  • Children, Vol. 9, Pages 6: Hyperuricemia and Associated Factors in
           Children with Chronic Kidney Disease: A Cross-Sectional Study

    • Authors: Jie Xu, Lingxiao Tong, Jianhua Mao
      First page: 6
      Abstract: Background: Hyperuricemia is increasingly recognized as a risk factor for chronic kidney disease (CKD) just in adults. The purpose of this study was to investigate the clinical characteristics of hyperuricemia and its associated factors in Chinese children with CKD at a single center. Methods: A cross-sectional study of 170 CKD children collected from the Department of Nephrology, The Zhejiang University Children’s Hospital was conducted. The clinical data, including anthropometric data, blood pressure measurements, and biochemical parameters, were recorded and analyzed retrospectively. The factors associated with hyperuricemia in CKD children were evaluated by Pearson and Spearman correlation analysis and multiple logistic regression analysis. Results: The mean age was 9.79 ± 4.10 years, and 72 (42.35%) were girls. Higher blood urea nitrogen (BUN), serum creatinine, cystatin C, D-dimer, lower hemoglobin, albumin, and estimated glomerular filtration rate (eGFR) were significantly associated with higher serum uric acid (SUA). In multiple logistic regression analysis, anemia and higher BUN were both positively associated factors, whereas eGFR ≥ 90 mL/min/1.73 m2 was a negatively associated factor for subjects with SUA ≥ 390 µmol/L (6.5 mg/dL). Conclusions: SUA was significantly associated with kidney risk factors in CKD children. Monitoring and controlling SUA, Hb, BUN, and Scr levels in CKD children may help to prevent the progression of CKD.
      Citation: Children
      PubDate: 2021-12-23
      DOI: 10.3390/children9010006
      Issue No: Vol. 9, No. 1 (2021)
       
  • Children, Vol. 9, Pages 7: Determinants of Gender Disparity in Nutritional
           Intake among Children in Pakistan: Evidence from PDHS

    • Authors: Awaisra Shafiq, Abid Hussain, Muhammad Asif, Arif Jameel, Saiqa Sadiq, Shahida Kanwel
      First page: 7
      Abstract: The purpose of this study is to analyze early age malnutrition on a gender basis in Pakistan. Pakistan Demographic and Health Survey (PDHS) 2012–13 data related to households’ characteristics that affect the nutrition of children less than 5 years of age are used for the estimation of results. Gender disparity (measured by girl malnourished in household/boy malnourished in a household) is constructed for the measurement of gender disparity in early age child nutrition. After synthesizing the PDHS data set, 2119 observations are used for regression results of gender disparity. Regression results are analyzed at the level of 5% confidence interval otherwise insignificant. egression results for gender disparity show that households in good socioeconomic status, a greater number of household members, a mother’s higher level of education, mother employment, and the male head of the household, causes a decrease in gender disparity in nutrition intake of children.
      Citation: Children
      PubDate: 2021-12-24
      DOI: 10.3390/children9010007
      Issue No: Vol. 9, No. 1 (2021)
       
  • Children, Vol. 9, Pages 8: Scope of Practice and Principles of Care of
           Naturopathic Medicine in North America: A Commentary

    • Authors: Leslie Solomonian
      First page: 8
      Abstract: Naturopathic medicine is a growing profession in North America that provides expertise in complementary and alternative, or integrative care to pediatric patients. It is imperative that healthcare providers have an understanding of the training and scope of other health professionals in order to effectively make decisions regarding research, collaborative clinical care, and policy. Given the prevalence of use of complementary and alternative medicine by children and families in North America, and the growing interest in “integrative” medicine, we aim to offer an overview of naturopathic care for children. This document describes the principles, training, and scope of naturopathic medicine, including health promotion, disease prevention, and illness management. It describes the process by which naturopathic doctors create an integrative healthcare plan for children, evaluate and apply evidence, and integrate ethical issues in practice management, and speaks to the role naturopathic doctors have regarding advocacy for community and planetary health as it relates to pediatrics.
      Citation: Children
      PubDate: 2021-12-24
      DOI: 10.3390/children9010008
      Issue No: Vol. 9, No. 1 (2021)
       
  • Children, Vol. 9, Pages 9: Consequences of Prematurity on Cortisol
           Regulation and Adjustment Difficulties: A 9-Year Longitudinal Study

    • Authors: Auriana Urfer, Hélène Turpin, Nevena Dimitrova, Ayala Borghini, Kerstin Jessica Plessen, Mathilde Morisod Harari, Sébastien Urben
      First page: 9
      Abstract: A preterm birth represents a stressful event having potentially negative long-term consequences. Thirty-three children born preterm (<33 weeks gestational age) and eleven full-term children participated in a nine-year longitudinal study. Perinatal Risk Inventory (PERI) was used at birth to assess the perinatal stress. Salivary cortisol, collected four times a day over two consecutive days, was measured with radioimmunoassay technique at six months and nine years to assess the hypothalamic-pituitary-adrenal (HPA) axis. Mothers reported post-traumatic symptoms on a self-report questionnaire 12 months after their child’s birth and children’s adjustment problems at 9 years of child age on the Child Behavior Checklist. Results showed a significant difference in cortisol regulation at nine years between preterm and full-term children but no differences in adjustment problems. Whereas biological factors (i.e., PERI, cortisol regulation at six months) explained cortisol at nine years, maternal post-traumatic symptoms were predictive of adjustment problems in their child. In conclusion, very preterm birth has some long-term consequences on the HPA-axis regulation at nine years. Although cortisol regulation is mostly influenced by biological factors, the presence of maternal post-traumatic symptoms predicts the manifestation of adjustment problems in both groups. This shows the importance of maternal psychological well-being for child development. Further research is needed to understand the exact consequences of premature birth on cortisol regulation and the implication for the child’s development and health.
      Citation: Children
      PubDate: 2021-12-24
      DOI: 10.3390/children9010009
      Issue No: Vol. 9, No. 1 (2021)
       
  • Children, Vol. 9, Pages 10: De Novo Vesicoureteral Reflux Following
           Ureterocele Decompression in Children: A Systematic Review and
           Meta-Analysis Comparing Laser Puncture versus Electrosurgical Incision
           Techniques

    • Authors: Sachit Anand, Tanvi Goel, Apoorv Singh, Nellai Krishnan, Prabudh Goel, Devendra Kumar Yadav, Minu Bajpai
      First page: 10
      Abstract: Background: The available endoscopic techniques for ureterocele decompression include laser puncture (LP), electrosurgical incision (ES), and cold-knife incision. This systematic review was performed to compare the efficacy of LP versus ES techniques with special emphasis on de novo VUR. Methods: Four databases were systematically searched by the authors. The inclusion criteria were all comparative studies in which ureterocele decompression was performed by either LP or ES endoscopic techniques. Outcomes including the incidence of de novo VUR, the need for endoscopic retreatment of the ureterocele, and the need for secondary surgical procedures were studied. Risk ratios (RR) were calculated for all outcomes and the Mantel-Haenszel method was utilized for the estimation of pooled RR. The methodological quality was assessed by the Downs and Black scale. Results: Five studies were considered for systematic review, while four of them were included in the meta-analysis. Out of 202 children, 67 developed de novo VUR. Significantly lower rates of reflux were observed in the LP group vis-a-vis ES group (RR = 0.17, 95% CI 0.09 to 0.32, p < 0.00001). Endoscopic retreatment rates (n = 20) demonstrated no significant difference among the two patient groups (RR = 0.66, 95% CI 0.26–1.68, p = 0.38). A total of 46 secondary procedures were performed in 170 children, mostly ureteral re-implantations, with a significantly lower need of secondary surgeries following LP versus ES (RR = 0.26, 95% CI 0.13–0.49, p < 0.0001). The risk of bias in the included studies was low-to-moderate. Conclusions: When compared to the ES technique, the LP technique is associated with a significantly low incidence of de novo VUR and requirement for secondary surgeries (particularly anti-reflux surgeries). Endoscopic retreatment rates showed no significant difference between the two techniques. However, due to the moderate risk of bias in two out of four included studies, randomized controlled trials are needed in the future.
      Citation: Children
      PubDate: 2021-12-24
      DOI: 10.3390/children9010010
      Issue No: Vol. 9, No. 1 (2021)
       
  • Children, Vol. 9, Pages 11: Paediatric Multiple Sclerosis: A Scoping
           Review of Patients’ and Parents’ Perspectives

    • Authors: Maria Luca, Nerea Ortega-Castro, Francesco Patti
      First page: 11
      Abstract: Dealing with paediatric-onset multiple sclerosis is particularly challenging for the young patients and their families, due to its unpredictable symptoms and uncertain outcome. This review aimed at synthesising the qualitative evidence regarding the perspectives about paediatric-onset multiple sclerosis, as expressed by the patients and/or their parents. A literature search was conducted on PubMed and CINAHL. The advanced multi-field search allowed to perform an abstract/title search in both databases, using keywords, combined through Boolean operators. Additional search strategies were adopted: searching the reference list of the selected papers; searching for key authors in the field. All the relevant papers were thoroughly revised using The Joanna Briggs Institute’s data extraction form for qualitative evidence as a guidance. Eight papers were selected. The analysis of these papers allowed to identify some common issues pertaining paediatric-onset multiple sclerosis: (1) onset of symptoms, (2) diagnostic process, (3) reaction to the diagnosis, (4) management and acceptance of multiple sclerosis. The burden of multiple sclerosis was confirmed. However, the young patients and their parents can adjust to the disease. Both the community and the health care professionals must strive to prevent the families dealing with multiple sclerosis from experiencing solitude and rejection.
      Citation: Children
      PubDate: 2021-12-25
      DOI: 10.3390/children9010011
      Issue No: Vol. 9, No. 1 (2021)
       
  • Children, Vol. 8, Pages 1120: Changes in Breathing Patterns after Surgery
           in Severe Laryngomalacia

    • Authors: Fabrizio Cialente, Duino Meucci, Maria Luisa Tropiano, Antonio Salvati, Miriam Torsello, Ferdinando Savignoni, Francesca Landolfo, Andrea Dotta, Marilena Trozzi
      First page: 1120
      Abstract: Background: Most of the studies regarding the surgical treatment of severe laryngomalacia (LM) have been aimed at describing the efficacy of the treatment in terms of improvement of clinical symptoms or anatomical findings. There are no studies specifically aimed at analyzing the changes in breathing patterns following surgical treatment for severe LM. Objective: To review the breathing pattern changes before and after corrective surgery in infants with severe LM. Study design: A series of retrospective cases at a tertiary referral children’s hospital. Methods: Retrospective chart review of 81 infants who underwent supra-glottoplasty (SGP) for severe laryngomalacia between 2011 and 2020 at Bambino Gesù Children’s Hospital of Rome, Italy. Among the patients, 47 (58%) were male and 34 (42%) were female. Twenty-one patients (26%) had one or more comorbidities condition. The data collected included age, symptoms, a polysomnography/pulse oximetry study, growth rate, the findings from flexible endoscopy, pre- and post-supra-glottoplasty (SGP) pulmonary function tests (PFTs) and, when indicated, 24 h pH-metry. Breathing patterns were studied during restful, normal sleep, using an ultrasonic flow-meter (Exhalyzer, Viasys) which measured: Tidal Volume (Vt), Respiratory Rate (RR), time to peak expiratory flow/expiratory time ratio (tPTEF/Te, an index of the patency of the lower airways) and mean expiratory/mean inspiratory flow ratio (MEF/MIF, an index of the patency of the upper airways) evaluated before surgical procedure (T1) and 3–6 weeks after (T2). Pre- and post-operative mean data were calculated and comparisons made with a Student T-test. Results: The surgical procedure was well tolerated by all infants and no intraoperative or post-operatory long-term complications were noted. In T1, breathing patterns were characterized by low tidal volume and high tPTEF/Te and MEF/MIF ratios, suggesting a severe reduction in the patency of the upper airways in all patients. After surgery (T2), all the previously mentioned variables significantly improved, reaching normal values for the child’s age. Conclusions: Supra-glottoplasty, as already described in several studies, is a safe and efficient procedure to treat severe laryngomalacia during infancy. The improvement in breathing patterns after surgery was reliably confirmed by a lung function test in our study, which showed the diagnostic value of testing respiratory functionality in the laryngomalacia and comparing them to clinical and endoscopic data. Moreover, considering the results obtained, we also propose the use of this available, dependable test to verify its therapeutic effects (post-surgery) and to monitor future respiratory development in these infants. Moreover, we believe that further studies will provide detailed grading guidelines for gravity of the LM, based on these functional lung tests.
      Citation: Children
      PubDate: 2021-12-03
      DOI: 10.3390/children8121120
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1121: A Three-Dimensional Finite Element Analysis
           of Displacement and Stress Distributions of Unilateral and Bilateral Cleft
           Lips by Using Developed Pre-Surgical Treatment Architecture

    • Authors: Ali A. H. Karah bash, Ergun Ercelebi
      First page: 1121
      Abstract: Cleft lips and cleft palates are the most common birth defects in newborns. Pre-surgical correction of unilateral and bilateral cleft lips and palates has been the subject of interest of many previous works. This condition has necessitated the evolution of many surgical and non-surgical techniques to mitigate the problem of this deformity in children. In this study, we proposed a new architecture that can be used instead of the conventional pre-surgical treatment. The proposed architecture has mechanical and electronic parts. This architecture was adopted to apply external stress to the cleft bones and cleft edges using an airbag that is located in the mechanical part. The amount of air in the airbag can be controlled by an available control unit in the electronic part. The effect of external stress on the cleft bones and the cleft edges was analyzed by using the finite element analysis (FEA) method. The FEA study aimed to analyze the displacement, amount of tensile and compressive forces, and Von Mises stress distributions on the cleft bones, cleft edges, nasal septum, and superior alveolar part of the maxillary jaw of unilateral and bilateral cleft models during pre-surgical treatment with the novel architecture. The results show that displacement and stress affected the clefts of both models. Displacement had a significant effect of gradually bringing the clefts closer to each other and returning them to the posterior. The analysis also investigated the effects of stress on the cleft bone and cleft edge. It was found from the results that the stresses helped to bring the incisions closer to the most appropriate position for plastic surgeons. The results prove that the positive and negative X-displacements move in the opposite direction, which means that the cleft edges gradually converge toward each other. Moreover, the negative Z-displacement affected the movement of cleft bones and cleft edges from outside to inside and gradually returned them to a suitable position. The findings show that the proposed architecture can be contributed to the pre-surgical treatment of the unilateral and bilateral clefts as an alternative to the traditional method.
      Citation: Children
      PubDate: 2021-12-03
      DOI: 10.3390/children8121121
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1122: Reducing the Burden of Care:
           Multidisciplinary Management of Late-Manifested Crouzon Syndrome—A
           Case Report

    • Authors: Sarah Achterrath, Teresa Kruse, Julia Neuschulz, Isabelle Graf, Joachim Zöller, Bert Braumann
      First page: 1122
      Abstract: The therapy of patients with Crouzon syndrome involves a multidisciplinary team. In most cases, this therapy is extensive, time-consuming, and exhausting for the patient. This case report illustrates a temporally coordinated therapy plan that succeeds in reducing the burden of care. Showing typical extraoral characteristics of Crouzon syndrome, the patient had a frontal and left-sided crossbite, and impaction of the maxillary canines. Multidisciplinary therapy included the extraction of multiple teeth, midface distraction at Le Fort III level, and alignment of the impacted teeth. Before starting, during, and after completion of the treatment, the patient’s oral health-related quality of life was assessed using COHIP-19. The combination of different treatment steps significantly reduced the duration of therapy. The therapy improved not only the patient’s oro- and craniofacial function, but also the patient’s facial appearance in a short treatment period. The patient’s quality of life improved considerably during this time. In the treatment of severe craniofacial anomalies, the highest priority should be given to keeping the burden of care low. All measures should encourage young patients’ appropriate psychosocial development despite extensive therapies, ensuring at the same time medically satisfactory treatment results.
      Citation: Children
      PubDate: 2021-12-03
      DOI: 10.3390/children8121122
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1123: Psychometric Properties of the Strengths and
           Difficulties Questionnaire-Dysregulation Profile in Italian Early
           Adolescents

    • Authors: Valentina Levantini, Eleonora Cei, Gennarina Pirri, Pietro Muratori
      First page: 1123
      Abstract: Emotional dysregulation is of great cause for concern because it is associated with severe outcomes. Currently, the identification of youths with signs of emotional and behavioral dysregulation is obtained through the assessment of a Dysregulation Profile (DP), including the Strengths and Difficulties Questionnaire-DP (SDQ-DP). Despite its increasingly frequent use in research, studies exploring the SDQ-DP properties are still limited, and no study with Italian samples is currently available. The current study aimed to explore the psychometric properties of the SDQ-DP parent-report and its association with difficulties in the school context in a sample of 332 Italian early adolescents. Results showed that the SDQ-DP parent-report is a single-factor measure with good internal consistency. Also, in both males and females, the SDQ-DP parent-report was associated with higher teacher-reported Internalizing (e.g., anxious symptoms) and Externalizing Problems (e.g., hyperactivity, conduct problems) and lower Prosocial Behavior. This study added further evidence about the utility of the SDQ-DP in the assessment, prevention, and treatment of emotional dysregulation.
      Citation: Children
      PubDate: 2021-12-03
      DOI: 10.3390/children8121123
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1124: Parenting during the COVID-19 Lockdown in
           Portugal: Changes in Daily Routines, Co-Parenting Relationships, Emotional
           Experiences, and Support Networks

    • Authors: Ana P. Antunes, Silvana Martins, Laura Magalhães, Ana T. Almeida
      First page: 1124
      Abstract: The COVID-19 pandemic challenged parental resources pertinent to coping with lockdowns. The main objective of this work was to study parenting during the COVID-19 lockdown. Specifically at focus were parental behaviors concerning key domains for the family (daily routine, co-parenting, emotional experience, and support network) and changes related to the pandemic and associated with the parents’ employment statuses. An online survey was carried out through an ad hoc questionnaire where participants completed questions about their sociodemographic data and rated how much their family routines, their co-parenting relationship, their emotional experiences, and the support available in the family network varied on a 5-point scale. The participants included 1384 parents, of which 286 responded to open questions regarding impactful experiences during the lockdown. The results showed differences in daily routine, co-parenting, emotional experience, and support network according to the parents’ employment statuses. Between-group comparisons showed that at-home parents caring for children with governmental aids generally revealed more positive parenting behavior changes, while at-home parents who were teleworking reported more difficulties in parent-child activities and co-parenting. Furthermore, the content analysis of the data confirmed how important themes such as family dynamics, professional activities, and the relationship with the school community were throughout the participants’ accounts of gains and losses. Overall, parents’ employment statuses are associated with diverse experiences during lockdown. The COVID-19 pandemic highlighted the importance of family resources and parental resilience, particularly during circumstances jeopardizing the ever-sensitive work-family balance.
      Citation: Children
      PubDate: 2021-12-03
      DOI: 10.3390/children8121124
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1125: Educational Pain Points for Pediatric Brain
           Tumor Survivors: Review of Risks and Remedies

    • Authors: Peter L. Stavinoha, Thuy Trinh-Wong, Laura N. Rodriguez, Chawncey M. Stewart, Kris Frost
      First page: 1125
      Abstract: Evolving treatment paradigms have led to increased survival rates for children diagnosed with a brain tumor, and this has increasingly shifted clinical and research focus to morbidity and quality of life among survivors. Among unfavorable outcomes, survivors of pediatric brain tumors are at risk for academic failure and low educational attainment, which may then contribute to lower health related quality of life, lower income and vocational status, and a greater likelihood of dependence on others in adulthood. Several specific risk factors for lower educational performance and attainment have been investigated. These are typically examined in isolation from one another which clouds understanding of the full range and potential interplay of contributors to educational difficulties. This review integrates and summarizes what is known about the direct and indirect barriers to educational success and performance (i.e., educational pain points) to enhance clinician knowledge of factors to consider when working with pediatric brain tumor survivors. Specific barriers to educational success include neurocognitive difficulties, school absences, psychosocial challenges, challenges to knowledge and communication, and physical and sensory difficulties. Finally, we discuss the current state of educational interventions and supports and offer recommendations for future research to improve educational outcomes for pediatric brain tumor survivors.
      Citation: Children
      PubDate: 2021-12-03
      DOI: 10.3390/children8121125
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1126: Towards Consensus on Good Practices for the
           Use of New Technologies for Intervention and Support in Developmental
           Dyslexia: A Delphi Study Conducted among Italian Specialized Professionals
           

    • Authors: Maria Luisa Lorusso, Francesca Borasio, Martina Da Rold, Andrea Martinuzzi
      First page: 1126
      Abstract: The use of new technologies for intervention in developmental dyslexia is steadily growing. In order to better understand the needs, the expectations, and the attitudes of Italian expert health professionals concerning such technologies, a national survey was conducted applying the Delphi methodology. Ad-hoc questionnaires were sent out to a group of eighteen experts over three successive rounds, and anonymously collected responses were aggregated and shared with the group after each round, aiming to reach a consensus on the proposed response. The goal was to define a series of statements that could form the basis for international “good practices” in the use of technologies for intervention to support dyslexia in children and adolescents. In the first round, the experts’ general opinions were collected with both multiple choice and open questions, and in the second round consensus was assessed on a series of statements based on the first replies. The cut-off of 75% consensus on each statement was reached after three rounds. Fifteen experts completed all the rounds of the process, and a final version of the statements regarding good practice in the use of technologies for dyslexia could be defined.
      Citation: Children
      PubDate: 2021-12-03
      DOI: 10.3390/children8121126
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1127: Spine Fractures in Children and
           Adolescents—Frequency, Causes, Diagnostics, Therapy and
           Outcome—A STROBE-Compliant Retrospective Study at a Level 1 Trauma
           Centre in Central Europe

    • Authors: Stephan Payr, Andrea Schuller, Theresia Dangl, Britta Chocholka, Harald Binder, Thomas M. Tiefenboeck
      First page: 1127
      Abstract: The aim of this study was to present the frequencies and characteristics of paediatric spine fractures, focusing on injury mechanisms, diagnostics, management, and outcomes. This retrospective, epidemiological study evaluated all patients aged 0 to 18 years with spine fractures that were treated at a level 1 trauma centre between January 2002 and December 2019. The study population included 144 patients (mean age 14.5 ± 3.7 years; 40.3% female and 59.7% male), with a total of 269 fractures. Common injury mechanisms included fall from height injuries (45.8%), with an increasing prevalence of sport incidents (29.9%) and a decreasing prevalence of road incidents (20.8%). The most common localisation was the thoracic spine (43.1%), followed by the lumbar spine (38.2%), and the cervical spine (11.8%). Initially, 5.6% of patients had neurological deficits, which remained postoperatively in 4.2% of patients. Most (75.0%) of the patients were treated conservatively, although 25.0% were treated surgically. A small proportion, 3.5%, of patients presented postoperative complications. The present study emphasises the rarity of spinal fractures in children and adolescents and shows that cervical spine fractures are more frequent in older children, occurring with a higher rate in sport incidents. Over the last few years, a decrease in road incidents and an increase in sport incidents in paediatric spine fractures has been observed.
      Citation: Children
      PubDate: 2021-12-03
      DOI: 10.3390/children8121127
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1128: Pediatric COVID-19: Low Incidence, but
           Possible Fatality—A Case Report and a Review of the Literature

    • Authors: Cristina Oana Mărginean, Lorena Elena Meliț, Iunius Simu, Claudiu Puiac, Janos Szederjesi, Maria Oana Săsăran
      First page: 1128
      Abstract: Background: Pediatric COVID-19 is a current health burden mostly due to the lack of knowledge in terms of symptoms, clinical course and management. COVID-19-associated coagulopathy is one of the most recently described complications among adults, along with acquired thrombophilia resulting in an increased risk for venous, arterial and microvascular thrombosis. Case presentation: We report the case of a 4-year-old male child, admitted to our clinic for generalized seizures being intubated and mechanically ventilated before admission, with a personal history of ureterovesical junction obstruction, mild hydronephrosis, and an episode of generalized seizures. The laboratory tests revealed anemia, an increased number of monocytes, and a mildly increased C-reactive protein. A real-time polymerase chain reaction (RT-PCR) of the oropharyngeal swab was performed and it tested positive for SARS-CoV-2 in the child and both of his parents. The thoracic CT showed consolidation in the lower lobe of the left lung associated with an opacity in the right apex, suggesting possible atelectasis. We initiated antibiotic, antiviral, corticosteroids, as well as anticoagulants and antipyretics, continuing the chronic anticonvulsant therapy. The patient’s condition deteriorated progressively, and, after 72 h of hospitalization, he developed desaturation and bradycardia. The laboratory parameters on the third day showed leucopenia, neutropenia, increased creatine kinase, a high ferritin level, hypoalbuminemia, a prolonged prothrombin time and an increased international normalized ration. The patient died on the fourth day of admission. Conclusion: In spite of its low incidence and frequent benign clinical course, COVID-19 complications such as coagulopathy might represent a leading cause of death, even in pediatric patients.
      Citation: Children
      PubDate: 2021-12-03
      DOI: 10.3390/children8121128
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1129: Increasing Prevalence of Pediatric Metabolic
           Syndrome and Its Components among Arab Youth: A Time-Series Study from
           2010–2019

    • Authors: Osama E. Amer, Shaun Sabico, Malak N. K. Khattak, Abdullah M. Alnaami, Naji J. Aljohani, Hanan Alfawaz, Abdulaziz AlHameidi, Nasser M. Al-Daghri
      First page: 1129
      Abstract: Background: Metabolic syndrome (MetS) is a cluster of cardiometabolic disorders, mostly studied in adults with certain ethnic groups, such as Arabs with higher predisposition and heritability. In this time-series study, we tried to determine the prevalence of MetS in the Arabic pediatric population from 2010–2019 to gauge the need to intervene in the younger population. Methods: A total of 7985 Saudi school children aged 12–18 coming from different sets of cohorts in different timepoints were included in this time-series studies (Year 2010, n = 2081, 877 boys and 1204 girls; Year 2015, n = 3360, 1625 boys and 1735 girls, Year 2019, n = 2544, 956 boys and 1588 girls). Anthropometrics were measured as well as fasting blood samples for the assessment of lipids and glucose. Screening for MetS was conducted using the pediatric definition obtained from the 2004 definition of de Ferranti et al. Results: In 2010, the prevalence of MetS was 11.8%, which increased sharply to 20.1% in 2015 and again in 2019 to 20.6%. Stratified according to sex, the increased prevalence of MetS was more evident in boys with only 7.8% in 2010 jumping to 25.3% in 2019. In girls, the increase in prevalence was modest with 14.8% in 2010 to 17.7% in 2019. In both boys and girls, the highest increase in prevalence among MetS components was observed to be low HDL-cholesterol, elevated triglycerides, and central obesity, respectively. Conclusions: The alarming increase in pediatric MetS among Arab children and adolescents over a short timespan have significant clinical and economic implications if not addressed immediately. Health policy makers should implement lifestyle interventions aimed at high-risk children or overweight youths.
      Citation: Children
      PubDate: 2021-12-03
      DOI: 10.3390/children8121129
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1130: The Impact of Nutritional and Lifestyle
           Changes on Body Weight, Body Composition and Cardiometabolic Risk Factors
           in Children and Adolescents during the Pandemic of COVID-19: A Systematic
           Review

    • Authors: Kalliopi Karatzi, Kalliopi-Anna Poulia, Emilia Papakonstantinou, Antonis Zampelas
      First page: 1130
      Abstract: The coronavirus (COVID-19) pandemic and the measures taken by most countries to curb virus transmission, such as social distancing, distance learning, population, home confinement and disruption of all organized activities, has affected children and adolescents worldwide. The aim of this review was to assess the role of diet and lifestyle changes due to COVID-19 measures on body weight/composition and cardiometabolic risk factors in children and adolescents. An electronic search was conducted in PUBMED, COCHRANE, Google Scholar and SCOPUS databases up to 31 October 2021. 15 eligible studies were identified. According to the studies included in the analysis, COVID-19 measures seem to have had a negative impact on the diets and lifestyles of children and adolescents, with a consequent increase in body weight and central fat accumulation. On the other hand, the parental presence and control resulted in better glycaemic control in children with diabetes mellitus (DM) Type 1, but the effect of the pandemic in the glycaemic control of children with DM2 2 is controversial. Finally, diet and lifestyle changes had a differential impact on children’s hypertension prevalence. These findings point to the need for public policy measures to prevent obesity and its complications, to and improve diet and lifestyle during the continuing and yet unresolved COVID-19 epidemic.
      Citation: Children
      PubDate: 2021-12-04
      DOI: 10.3390/children8121130
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1131: Trauma in Children during Lockdown for
           SARS-CoV-2 Pandemic. A Brief Report

    • Authors: Daniela Dibello, Marcella Salvemini, Carlo Amati, Antonio Colella, Giusi Graziano, Giovanni Vicenti, Biagio Moretti, Federica Pederiva
      First page: 1131
      Abstract: Purpose: The national lockdown established by the Italian government began on the 11th of March 2020 as a means to control the spread of SARS-CoV-2 infections. The purpose of this brief report is to evaluate the effect of the national lockdown on the occurrence and characteristics of trauma in children during lockdown. Methods: All children admitted to our paediatric orthopaedic unit with a diagnosis of fracture or trauma, including sprains and contusions, between 11 March 2020 and 11 April 2020, were retrospectively reviewed. Their demographic data, type of injury, anatomical location and need for hospitalisation were compared with the equivalent data of children admitted for trauma in the same period of 2018 and 2019. Results: Sixty-nine patients with trauma were admitted in 2020, with a significant decrease in comparison with 2019 (n = 261) and 2018 (n = 289) (p < 0.01). The patients were significantly younger, and the rate of fractures significantly increased in 2020 (p < 0.01). Conclusions: Home confinement decreased admissions to the emergency department for trauma by shutting down outdoor activities, schools and sports activities. However, the rate of fractures increased in comparison with minor trauma, involved younger children and had a worse prognosis.
      Citation: Children
      PubDate: 2021-12-04
      DOI: 10.3390/children8121131
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1132: Effectiveness and Coverage of Treatment for
           Severe Acute Malnutrition Delivered by Community Health Workers in the
           Guidimakha Region, Mauritania

    • Authors: Pilar Charle-Cuéllar, Noemí Lopez-Ejeda, Hassane Toukou Souleymane, Diagana Yacouba, Moussa Diagana, Abdias Ogobara Dougnon, Antonio Vargas, André Briend
      First page: 1132
      Abstract: Geographical and economic access barriers to health facilities (HF) have been identified as some of the most important causes of the low coverage of severe acute malnutrition (SAM) treatment. The objective of this study is to assess the effectiveness and coverage of SAM treatment delivered by community health workers (CHWs) in the Guidimakha region in Mauritania, compared to the HF based approach. This study was a nonrandomized controlled trial, including two rural areas. The control group received outpatient treatment for uncomplicated SAM from HF, whilst the intervention group received outpatient treatment for uncomplicated SAM from HF or CHWs. A total of 869 children aged 6–59 months with SAM without medical complications were included in the study. The proportion of cured children was 82.3% in the control group, and 76.4% in the intervention group, we found no significant difference between the groups. Coverage in the intervention zone increased from 53.6% to 71.7%. In contrast, coverage remained at approximately 44% in the control zone from baseline to end-line. This study is the first to demonstrate in Mauritania that the decentralization model of CHWs treating SAM improves acute malnutrition treatment coverage and complies with the international quality standards for community treatment of acute malnutrition. The non-randomized study design may limit the quality of the evidence, but these results could be used by political decision-makers as a first step in revising the protocol for acute malnutrition management.
      Citation: Children
      PubDate: 2021-12-04
      DOI: 10.3390/children8121132
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1133: Health-Related Quality of Life Assessed in
           Children with Chronic Rhinitis and Sinusitis

    • Authors: Lechosław Paweł Chmielik, Grażyna Mielnik-Niedzielska, Anna Kasprzyk, Tomasz Stankiewicz, Artur Niedzielski
      First page: 1133
      Abstract: Introduction: Quality of life (QoL) can be simply defined as an area of human life that directly affects people which they consider to be important. This can be defined in greater detail as ‘an individual perception of an individual’s life position within a cultural context, value system and in relation to their tasks, expectations and standards determined by environmental conditions’. The health-related quality of life (HRQoL) more specifically focuses on how the QoL affects health (including both medical and non-medical issues). Limitations in well-being will, by association, also occur in those children suffering with sinus diseases. Study aim: To compare the quality of life in children–adolescents suffering from some of the most commonly occurring childhood diseases of chronic rhinitis and sinusitis on a group of healthy children–adolescents. Test materials and methods: Subjects were children–adolescents with at least one of the aforementioned conditions afflicting the upper respiratory tract. Admission criteria were: ages 5 to 18 years in the presence of a chronic disease such as chronic rhinitis and paranasal sinusitis. The Child Health Questionnaire-Parent Form 50 CHQ-PF-50 (CHQ-PF50) was used, which is a general-purpose research instrument based on psychometric testing designed for assessing physical and mental well-being in children–adolescents aged 5 to 18 years. Results: Wellbeing significantly deteriorated in sick children within the following areas: current health status of the child (STAND), physical fitness (PF), social functioning resulting from behaviour or emotional state (REB), the impact of physical health on limitations in social functioning (RP), pain and discomfort (BP), behaviour (BE), mental health (MH), self-esteem (SE), general health perception (GH), influence of the child’s health condition on parental emotions (PE), limitations on parental leisure time due to the child’s health (PT) and restrictions on joint family activities (FA). Conclusions: The greatest impairment to well-being in children with chronic rhinitis and paranasal sinusitis was on the impact of the child’s health status on parents’ emotions, pain and discomfort and general perception of health. This study confirms that parents of healthy children attach great importance to their health and health-related quality of life.
      Citation: Children
      PubDate: 2021-12-04
      DOI: 10.3390/children8121133
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1134: School Performance among Children and
           Adolescents during COVID-19 Pandemic: A Systematic Review

    • Authors: Eleni Panagouli, Androniki Stavridou, Christina Savvidi, Anastasia Kourti, Theodora Psaltopoulou, Theodoros N. Sergentanis, Artemis Tsitsika
      First page: 1134
      Abstract: As a result of COVID-19 restrictions, conventional ways of schooling were not possible, and in order to continue the educational process new digital resources, such as online learning platforms, were imposed. Although virtual courses provided high-quality educational material, the efficiency in children’s and adolescents’ academic performance in general is yet to be known. The purpose of this systematic review is to examine whether the academic performance of school-aged students was impacted or not through online learning and modified educational methods during the ongoing COVID-19 pandemic. According to the studies, either students suffered from learning losses comparing to pre-pandemic years or, in some cases, they benefited from online learning, especially in mathematics. Younger students and students with neurodevelopmental disorders or special education needs seemed to suffer more. Parents/caregivers reported that their children’s performance deteriorated, while others thought that online learning was beneficial. Teachers also reported that students presented academic gaps and difficulties in mathematics and reading compared to typical years. Consequently, the new ways of schooling imposed by the restrictions have not been fully tested and the impact cannot be described thoroughly. The investment in technological equipment in schools for the majority of students, along with the training of teachers in digital competence, should be a priority.
      Citation: Children
      PubDate: 2021-12-04
      DOI: 10.3390/children8121134
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1135: Level of Adherence to the Mediterranean Diet
           and Weight Status among Adolescent Female Gymnasts: A Cross-Sectional
           Study

    • Authors: Ioanna Kontele, Maria G. Grammatikopoulou, Tonia Vassilakou
      First page: 1135
      Abstract: Adolescent female gymnasts are a vulnerable population in terms of their diet, as their nutritional needs are higher due to their growth and high daily training demands. The Mediterranean diet (MD) is a well-known dietary pattern that is associated with a greater nutritional adequacy and a lower prevalence of overweight. The aim of this cross-sectional study was to evaluate the degree of adherence to the MD among adolescent female athletes who participated in all disciplines of gymnastics in Greece, as well as to explore the potential correlations between MD adherence, body weight, and body mass index (BMI). A total of 269 female gymnasts (between 11–18 years old) completed the Mediterranean Diet Quality Index (KIDMED) and reported their weight and height. Approximately 10% of the participants were underweight and a mere 5.6% were classified as overweight. A high adherence to the MD was reported by 34.9% of the sample and this was correlated with a healthier BMI. Moreover, specific eating habits, such as eating nuts 2–3 times per week and eating fast-food less than once-weekly, were also associated with BMI. Athletes, parents, and coaches of gymnastics should be informed and educated regarding balanced nutrition habits. Future studies could evaluate adherence to MD, as well as the factors that influence the eating behaviors of adolescent female and male athletes in various sports.
      Citation: Children
      PubDate: 2021-12-04
      DOI: 10.3390/children8121135
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1136: Assessment of Oral Skills in Adolescents

    • Authors: Marta Gràcia, Jesús M. Alvarado, Silvia Nieva
      First page: 1136
      Abstract: There is broad consensus on the need to foster oral skills in middle school due to their inherent importance and because they serve as a tool for learning and acquiring other competences. In order to facilitate the assessment of communicative competence, we hereby propose a model which establishes five key dimensions for effective oral communication: interaction management; multimodality and prosody; textual coherence and cohesion; argumentative strategies; and lexicon and terminology. Based on this model, we developed indicators to measure the proposed dimensions, thus generating a self-report tool to assess oral communication in middle school. Following an initial study conducted with 168 students (mean age = 12.47 years, SD = 0.41), we selected 22 items with the highest discriminant power, while in a second study carried out with a sample of 960 students (mean age 14.11 years, SD = 0.97), we obtained evidence concerning factorial validity and the relationships between oral skills, emotional intelligence and metacognitive strategies related to metacomprehension. We concluded that the proposed model and its derived measure constitute an instrument with good psychometric properties for a reliable and valid assessment of students’ oral competence in middle school.
      Citation: Children
      PubDate: 2021-12-04
      DOI: 10.3390/children8121136
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1137: Attitudes and Perceptions of School Teachers
           in Melilla Regarding the Care Provided to Students with Type 1 Diabetes

    • Authors: Trinidad Luque-Vara, Elisabet Fernández-Gómez, Marta Linares-Manrique, Silvia Navarro-Prado, María Angustias Sánchez-Ojeda, Carmen Enrique-Mirón
      First page: 1137
      Abstract: The main objective of the study was to assess the perception of non-university teachers in the city of Melilla to help students with type 1 diabetes mellitus (T1DM), as well as their attitudes towards helping these students in diabetic emergencies. This observational, descriptive, cross-sectional study analyzed the answers given by 441 teachers from 25 public institutions in the city of Melilla to a survey on the attitude and perception regarding the capacity of educational institutions (16 questions) to help and manage students with T1DM. Out of 47.6% of teachers who represent having had students with TIDM, only 4.8% acknowledged having been trained in diabetes. The percentage that has experienced a hypoglycaemia episode at the institution was 29.9%. More than half of participants acknowledged that their educational institution is not prepared to manage diabetic emergencies. Only 5.7% stated their institutions have glucagon in their first-aid kit and less than half of participants (44.7%) would be willing to administer it if necessary. Teachers of educational institutions believe they have not been particularly trained in the care of students living with T1DM and point out that their educational institutions are not prepared to help in diabetic emergencies.
      Citation: Children
      PubDate: 2021-12-05
      DOI: 10.3390/children8121137
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1138: Spontaneous Closure of the Arterial Duct
           after Transcatheter Closure Attempt in Preterm Infants

    • Authors: Mathilde Méot, Raymond N. Haddad, Juliana Patkai, Ibrahim Abu Zahira, Anna Di Marzio, Isabelle Szezepanski, Fanny Bajolle, Elsa Kermorvant, Alexandre Lapillonne, Damien Bonnet, Sophie Malekzadeh-Milani
      First page: 1138
      Abstract: (1) Background: Transcatheter closure of the patent arterial duct (TCPDA) in preterm infants is an emerging procedure. Patent arterial duct (PDA) spontaneous closure after failed TCPDA attempts is seen but reasons and outcomes are not reported; (2) Methods: We retrospectively included all premature infants <2 kg with abandoned TCPDA procedures from our institutional database between September 2017 and August 2021. Patients’ data and outcomes were reviewed; (3) Results: The procedure was aborted in 14/130 patients referred for TCPDA. Two patients had spasmed PDA upon arrival in the catheterization laboratory and had no intervention. One patient had ductal spasm after guidewire cross. Four patients had unsuitable PDA size/shape for closure. In seven patients, device closure was not possible without causing obstruction on adjacent vessels. Among the 12 patients with attempted TCPDA, five had surgery on a median of 3 days after TCPDA and seven had a spontaneous PDA closure within a median of 3 days after the procedure. Only the shape of the PDA differed between the surgical ligation group (short and conical) and spontaneous closure group (F-type); (4) Conclusions: In the case of TCPDA failure, mechanically induced spontaneous closure may occur early after the procedure. Surgical ligation should be postponed when clinically tolerated.
      Citation: Children
      PubDate: 2021-12-05
      DOI: 10.3390/children8121138
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1139: Reducing the Weight of Spinal Pain in
           Children and Adolescents

    • Authors: Thorvaldur S. Palsson, Alessandro Andreucci, Christian Lund Straszek, Michael Skovdal Rathleff, Morten Hoegh
      First page: 1139
      Abstract: Spinal pain in adults is a significant burden, from an individual and societal perspective. According to epidemiologic data, spinal pain is commonly found in children and adolescents, where evidence emerging over the past decade has demonstrated that spinal pain in adults can, in many cases, be traced back to childhood or adolescence. Nevertheless, very little focus has been on how to best manage spinal pain in younger age groups. The purpose of this article is to put the focus on spinal pain in children and adolescents and highlight how and where these problems emerge and how they are commonly dealt with. We will draw on findings from the relevant literature from adults to highlight potential common pathways that can be used in the management of spinal pain in children and adolescents. The overall focus is on how healthcare professionals can best support children and adolescents and their caregivers in making sense of spinal pain (when present) and support them in the self-management of the condition.
      Citation: Children
      PubDate: 2021-12-05
      DOI: 10.3390/children8121139
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1140: Novel Compound Heterozygous Variants in TBCD
           Gene Associated with Infantile Neurodegenerative Encephalopathy

    • Authors: Chih-Ling Chen, Chien-Nan Lee, Yin-Hsiu Chien, Wuh-Liang Hwu, Tung-Ming Chang, Ni-Chung Lee
      First page: 1140
      Abstract: Mutations in tubulin-specific chaperon D (TBCD), the gene encoding one of the co-chaperons required for the assembly and disassembly of the α/β-tubulin heterodimers, have been reported to cause perturbed microtubule dynamics, resulting in debilitating early-onset progressive neurodegenerative disorder. Here, we identified two novel TBCD variants, c.1340C>T (p.Ala447Val), and c.817+2T>C, presented as compound heterozygotes in two affected siblings born to unaffected carrier parents. Clinical features included early-onset neurodegeneration, failure to thrive, respiratory failure, hypotonia, muscle weakness and atrophy and seizures. We established the genotype–phenotype relationship of these TBCD pathogenic variants and provided insight into the protein structural alteration that may contribute to this chaperone-associated tubulinopathy.
      Citation: Children
      PubDate: 2021-12-05
      DOI: 10.3390/children8121140
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1141: Clinical Experience with Anti-IgE Monoclonal
           Antibody (Omalizumab) in Pediatric Severe Allergic Asthma—A Romanian
           Perspective

    • Authors: Elena Camelia Berghea, Mihaela Balgradean, Carmen Pavelescu, Catalin Gabriel Cirstoveanu, Claudia Lucia Toma, Marcela Daniela Ionescu, Roxana Silvia Bumbacea
      First page: 1141
      Abstract: Background: Asthma is the most common chronic disease affecting children, with a negative impact on their quality of life. Asthma is often associated with comorbid allergic diseases, and its severity may be modulated by immunoglobulin E (IgE)-mediated allergen sensitization. Omalizumab is a humanized monoclonal anti-IgE antibody, the first biological therapy approved to treat patients aged ≥6 years with severe allergic asthma. The primary objective of our study was to investigate the efficacy and safety of Omalizumab in Romanian children with severe allergic asthma. Methods: In this observational real-life study, 12 children and adolescents aged 6 to 18 years (mean 12.4 years) with severe allergic asthma received Omalizumab as an add-on treatment. Asthma control, exacerbations, lung function, and adverse events were evaluated at baseline and after the first year of treatment. Results: We observed general improvement in total asthma symptom scores and reduction in the rate of exacerbation of severe asthma. Omalizumab treatment was associated with improvement in the measures of lung function, and no serious adverse reactions were reported. FEV1 improved significantly after one year of treatment with Omalizumab [ΔFEV1 (% pred.) = 18.3], and [similarly, ΔMEF50 (%) = 25.8]. The mean severe exacerbation rate of asthma decreased from 4.1 ± 2.8 to 1.15 ± 0.78 (p < 0.0001) during the year of treatment with Omalizumab. Conclusions: This study showed that Omalizumab can be an effective and safe therapeutic option for Romanian children and adolescents with severe allergic asthma, providing clinically relevant information on asthma control and exacerbation rate in children and adolescents. The results demonstrated the positive effect of Omalizumab in young patients with asthma, starting from the first year of treatment.
      Citation: Children
      PubDate: 2021-12-06
      DOI: 10.3390/children8121141
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1142: Surgical Treatment of Sprengel’s
           Deformity: A Systematic Review and Meta-Analysis

    • Authors: Paola Zarantonello, Giovanni Luigi Di Gennaro, Marco Todisco, Piergiorgio Cataldi, Stefano Stallone, Andrea Evangelista, Daniele Ferrari, Diego Antonioli, Giovanni Trisolino
      First page: 1142
      Abstract: (1) Background: Sprengel’s deformity (SD) is a rare congenital anomaly caused by failure in the descent of the scapula. We aimed to systematically review the current literature reporting data from children undergoing surgery for SD, in order to explore the rate of success and complications of the different surgical techniques, possibly providing recommendations about the management of SD in children. (2) Methods: we electronically searched the literature from Ovid, MEDLINE and the Cochrane Library databases. Demographic data, surgical procedures, outcomes and complications were analyzed. We categorized surgical procedures into five groups. (3) Results: 41 articles met the inclusion criteria, showing a poor overall study quality; 674 patients (711 shoulders) were analyzed. Green’s and Woodward’s procedures, both aiming the scapular relocation in a more anatomical position, were the most commonly used techniques. We counted 168 adverse events (18 major complications). The best clinical and cosmetic results seem to be achieved when surgery is performed in children aged less than eight years. (4) Conclusions: this paper represents the first systematic review reporting qualitative and quantitative data about the surgical treatment of SD. Surgery for SD seems to be effective in increasing the shoulder’s range of motion and improving the cosmetic appearance in almost all cases, with a low rate of major complications.
      Citation: Children
      PubDate: 2021-12-06
      DOI: 10.3390/children8121142
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1143: Trauma in Rapes and Assaults

    • Authors: Jean-Michel Darves-Bornoz
      First page: 1143
      Abstract: Psychological trauma primarily affects children and adolescents; it mostly results from physical and sexual maltreatment. In the Medico-Judicial Unit Center for Sexual Violence Victims in Tours, France, which I joined in 1992 for research and to give treatment, underage patients represented about three-quarters of patients. At the same time, a national survey was conducted in collaboration with Marie Choquet’s “Adolescent Health” group (INSERM), which targeted several thousand adolescents representing the general population. It revealed that almost one out of five adolescents had experienced physical or sexual assault, and that although the number of sexual assaults probably does not exceed that of physical assaults, most of the time their psychological consequences do considerably exceed those of physical assaults. Several symptoms appear after experiencing rapes or assaults. They have a distinct semiology and independent evolutions. We isolated three of them: dissociative and phobic traumatic syndrome, re-experiencing traumatic syndrome, and borderline-like traumatic syndrome. They are generally triggered all at the same time or in close succession. Re-experiencing traumatic syndrome is profound, but the other two are often more worrying, particularly in relation to children and adolescents, because they generate disorders in their psychological development.
      Citation: Children
      PubDate: 2021-12-06
      DOI: 10.3390/children8121143
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1144: COVID-19 Lesson for Respiratory Syncytial
           Virus (RSV): Hygiene Works

    • Authors: Andrea Gastaldi, Daniele Donà, Elisa Barbieri, Carlo Giaquinto, Louis J. Bont, Eugenio Baraldi
      First page: 1144
      Abstract: Respiratory syncytial virus (RSV) is a leading cause of acute lower respiratory tract infections (LRTIs) in infants worldwide. The global direct medical cost associated with RSV LRTIs reaches billions of dollars, with the highest burden in low–middle-income countries. Many efforts have been devoted to improving its prevention and management, including both non-pharmaceutical and pharmaceutical strategies, often with limited routine use in high-income countries due to high costs. During the ongoing COVID-19 pandemic, a dramatic decrease in RSV infections (up to 70–90%) has been reported around the globe, directly related to the implementation of containment measures (face masks, hand hygiene, and social distancing). Primary prevention has demonstrated the highest cost effectiveness ratio in reducing the burden of a respiratory infection such as RSV, never reached before. Thus, we emphasize the importance of non-pharmaceutical preventive hygiene measures that should be implemented and maintained even after the COVID-19 outbreak.
      Citation: Children
      PubDate: 2021-12-06
      DOI: 10.3390/children8121144
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1145: Improved Less Invasive Surfactant
           

    • Authors: Björn Liebers, Chinedu Ulrich Ebenebe, Monika Wolf, Martin Ernst Blohm, Eik Vettorazzi, Dominique Singer, Philipp Deindl
      First page: 1145
      Abstract: Less invasive surfactant administration (LISA) has been introduced at our tertiary Level IV perinatal center since 2016 with an unsatisfactory success rate, which we attributed to an inconsistent, non-standardized approach and ambiguous patient inclusion criteria. This study aimed to improve the LISA success rate to at least 75% within 12 months by implementing a highly standardized LISA approach combined with team training. The Plan Do Study Act method of quality improvement was used for this initiative. Baseline assessment included a review of patient medical records 12 months before the intervention regarding patient characteristics, method success rate, respiratory, and adverse outcomes. A multi-professional team developed a standardized LISA approach and a training program including an educational film, checklists, pocket cards, and team briefings. Twenty-one preterm infants received LISA before and 24 after the intervention. The mean LISA success rate improved from 62% before the intervention to 92% (p = 0.029) after the intervention. Implementing a highly standardized LISA approach and multi-professional team training significantly improved the methods’ success rate.
      Citation: Children
      PubDate: 2021-12-06
      DOI: 10.3390/children8121145
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1146: Active Cervical Range of Motion in Babies
           with Positional Plagiocephaly: Analytical Cross-Sectional Study

    • Authors: Iñaki Pastor-Pons, María Orosia Lucha-López, Marta Barrau-Lalmolda, Iñaki Rodes-Pastor, Ángel Luis Rodríguez-Fernández, César Hidalgo-García, José Miguel Tricás-Moreno
      First page: 1146
      Abstract: Positional plagiocephaly (PP) is a general term describing cranial distortion from pre- or postnatal forces on the infant head. Abnormal intrauterine forces, multiple births, primiparous mothers, obstetric interventions, prematurity, male sex, excessive time lying in the supine position, and mobility restrictions of the cervical spine have been considered as the main predisposing factors. The objective was to investigate the association between the severity of PP and the active cervical rotation and to analyze the influence of predisposing factors in babies with PP. An analytical cross-sectional study was performed on 74 babies with moderate PP. Clinical and demographic data, cranial vault asymmetry, and active cervical rotation range of motion (ROM) were measured. Associations were analyzed with generalized linear models. The mean age was 16.8 ± 5.0 weeks, and 56.8% were male. A restriction in the ROM of active cervical rotation, especially to the left side, was observed. Our models showed that cranial asymmetry was related with left active cervical rotation ROM (p = 0.034) and with being transported in a pushchair (p < 0.001). Conclusions: An increased severity of PP was related with being transported in a baby pushchair and with a reduced active cervical rotation ROM toward the most restricted side.
      Citation: Children
      PubDate: 2021-12-06
      DOI: 10.3390/children8121146
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1147: A Ten-Week Motor Skills Training Program
           Increases Motor Competence in Children with Developmental Coordination
           Disorder

    • Authors: Orifjon Saidmamatov, Quvondiq Raximov, Paula Rodrigues, Olga Vasconcelos
      First page: 1147
      Abstract: The present study aimed to investigate the effect of a motor skills training program in children with DCD considering their gender. The Movement Assessment Battery for Children (MABC-2) classified the children and assessed their skill changes over time. The study was implemented at four kindergartens in the Khorezm region of Uzbekistan. In the study, all the children suffered from DCD (5.17 ± 0.70 years; 10 girls), and all the indicators of MABC-2 were less than 16%. The participants were divided into an experimental group (n = 17), receiving ten weeks of motor skills training program for 45 min twice per week; and a control group (n = 7), which proceeded with exercises of everyday living. The ANCOVA showed differences between the groups in the post-test concerning each domain: manual dexterity (F (1, 20) = 18.703, p < 0.001; η2 = 0.471); aiming and catching (F (1, 20) = 9.734, p = 0.005; η2 = 0.317); balance (F (1, 20) = 35.140, p = 0.000; η2 = 0.626); and total MABC-2 test score (F (1, 20) = 66.093, p < 0.001; η2 = 0.759), with all the children in the EG exhibiting better results. The Wilcoxon test revealed statistically significant differences for the EG between moments for all the variables (p < 0.001) but not for the CG (p > 0.050). The effectiveness of the intervention program was similar across both genders. The study suggests that a 10 week motor skills training program can increase the quality of children’s motor competence and represent a valuable procedure for physical education specialists to enhance motor competence for children with DCD.
      Citation: Children
      PubDate: 2021-12-06
      DOI: 10.3390/children8121147
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1148: Characteristics of Surgical Necrotizing
           Enterocolitis: Is It Different from Medical Necrotizing Enterocolitis'
           A Single-Center Retrospective Study

    • Authors: Ara Cho, Dayoung Ko, JoongKee Youn, Hee-Beom Yang, Hyun-Young Kim
      First page: 1148
      Abstract: (1) Background: Necrotizing enterocolitis (NEC) is one of the leading causes of death in newborns despite improvements in the care of critically ill neonates. Approximately 50–70% of the cases are managed by medical therapy. However, the remaining patients require surgical intervention. The purpose of our study was to analyze the factors associated with patients requiring surgical treatment compared to patients requiring only medical treatment; (2) Method: Patients diagnosed with necrotizing enterocolitis over a period of 14 years (January 2003–December 2016) in a single tertiary referral children’s hospital were retrospectively enrolled. Demographics and clinical data were collected through the medical record and were analyzed using Pearson’s χ2 test, t-tests, and linear regression; (3) Results: A total of 189 NEC patients were analyzed. In the surgical NEC group, gestational age was lower (p = 0.018), body weight at birth was lower (p = 0.034), comorbidity with respiratory distress syndrome (RDS) was higher (p = 0.005), the days of antibiotic use were greater (p = 0.014), the percentage of breast milk feeding was lower (p = 0.001), and the length of hospital stay was longer (p < 0.000). The in-hospital mortality between the two groups was not significantly different (p = 0.196). In multivariate logistic analysis, breast milk feeding remained less associated with surgical NEC (OR = 0.366, 95% CI: 0.164–0.817), whereas the length of hospital stay was more associated with surgical NEC (OR = 1.010, 95% CI: 1.001–1.019); (4) Conclusion: Comparing medical and surgical NEC, a significantly lower percentage of surgical NEC patients were fed breast milk and their hospital stays were longer.
      Citation: Children
      PubDate: 2021-12-06
      DOI: 10.3390/children8121148
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1149: Families’ Perceptions of the Motor
           Development and Quality of Life of Their Children Aged 0–3 Years
           

    • Authors: Alicia Oliva-Arnanz, Helena Romay-Barrero, Rita-Pilar Romero-Galisteo, Elena Pinero-Pinto, Cristina Lirio-Romero, Rocío Palomo-Carrión
      First page: 1149
      Abstract: The child’s interaction with the natural environment allows different learning opportunities and favors their motor development, which may be affected after a period of environmental deprivation, a consequence of home confinement due to the COVID-19 pandemic. The main objective of the study was to analyze the different areas of motor development, as well as the quality of life of children aged 0 to 3 years old after home confinement by COVID-19 and the possible correlation between both variables, and the influence of parental stimulation on motor development during this time of exclusive interaction with the immediate environment (home and family). A descriptive study was performed. A simple and anonymous questionnaire was created for parents of children between 0 and 3 years old who lived in Spain during the period of home confinement due to COVID-19 (March to June 2020). The measurement instrument used was a questionnaire made in “Google Forms”, where the variables were collected: Motor development (measured through the Ages & Stages Questionnaire, ASQ3), Quality of life (assessed with the Pediatric Quality of Life Inventory, PedsQL) and other variables, such as stimulation, performed during home confinement. Eighty-eight questionnaires were validated. The highest score in the motor development domains were obtained in children 2–3 years old. The motor domain of children aged 2–3 years old that obtained the highest score was communication (M = 54.69 ± 10.03) and the highest score in the quality of life was obtained in children aged 0–1 years old (M = 85.47 ± 12.39), also acquiring the lowest score in the emotional domain in all age groups (0–1, 1–2 and 2–3 years old). The assessment of motor development and quality of life after home confinement due to the COVID-19 pandemic did not determine low values, so it would not have been affected during this period of lack of interaction with the natural environment. Emphasizing that the emotional aspect within quality of life was the lowest score, this indicates that children from 0 to 3 years old need more emotional support in situations of variability of daily routines and of family stress.
      Citation: Children
      PubDate: 2021-12-07
      DOI: 10.3390/children8121149
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1150: Maternal Perinatal Depression and Risk of
           Neurodevelopmental Disorders in Offspring: Preliminary Results from the
           SOS MOOD Project

    • Authors: Martina Siracusano, Assia Riccioni, Leonardo Emberti Gialloreti, Elisa Carloni, Antonia Baratta, Marialaura Ferrara, Lucrezia Arturi, Giulia Lisi, Ilaria Adulti, Rodolfo Rossi, Alessia Lucaselli, Alessandro Rossi, Cinzia Niolu, Luigi Mazzone
      First page: 1150
      Abstract: The latest research is attempting to define whether there may be an association between maternal Perinatal Depression (PD), the use of psychotropic medications during pregnancy, and a higher risk of neurodevelopmental disorders in children, including Autism Spectrum Disorder (ASD). A better understanding of the relation between PD and ASD is a key element to develop early interventions. This study has been developed in the context of the SOS MOOD project. Its aim is to evaluate the possible impact of maternal PD on the child’s cognitive and behavioral phenotype with a focus on ASD. Women included in the project were screened during pregnancy (1st, 2nd trimester) for PD—categorized as affected or not—and if necessary were prescribed pharmacological therapy; offspring of both groups of women underwent at a mean age of 43 months a standardized neuropsychiatric evaluation of developmental and cognitive skills, behavioral problems, autism symptoms and parental stress. Preliminary results on 59 women and 59 children do not suggest significant long-term effects of maternal PD on offspring’s development and behavior. Nonetheless further studies on wider samples are necessary in order to confirm such results and disentangle the role of possible confounding factors associated to the maternal illness.
      Citation: Children
      PubDate: 2021-12-07
      DOI: 10.3390/children8121150
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1151: The Effectiveness of Early Childhood Caries
           Treatment with MI Varnish Fluor in Obese Subjects: A Study from Vietnam

    • Authors: Ha Van Hung, Vo Truong Nhu Ngoc, Dinh-Toi Chu
      First page: 1151
      Abstract: Objective: We conducted this work to evaluate the effectiveness of treatment for early childhood caries (ECC) using MI Varnish Fluor in obese children aged from 36 to 71 months. Methods: This study was conducted on 300 carious teeth of obese children and normal-weight children in Hanoi, Vietnam, over the period 2019–2020. Diagnodent KaVo 2190 laser equipment was used to diagnose ECC. The children in each group were selected on the basis of similarities in age, gender, and study location, and the teeth in the two groups were selected on the basis of similarities in damage level and jaw position. ECC treatment was performed once a week for four consecutive weeks with MI Varnish Fluor. The child, the child’s family, and the child’s teacher were consulted on diet and oral hygiene during the treatment. Children were examined and monitored throughout the treatment period. Children were re-examined after 3 and 6 months from the start time of treatment. The Mann–Whitney U test and Kruskal–Wallis tests were used, with statistical significance indicated at p < 0.05. Results: After six months of treatment with MI Varnish Fluor, the number of cases of code 0 damage recovery (D0) increased in both groups. The result showed that MI Varnish fluor was effective in ECC treatment. D0 damage recovery rates of 79.3% in obese children and 62.7% in normal-weight children were observed after six months of treatment, but there was no statistically significant difference between the two groups. Furthermore, there was no statistically significant difference between the two groups according to age, tooth position, or tooth surface position in D0 damage recovery. Conclusions: MI Varnish Fluor was effective in ECC treatment, with D0 damage recovery rates of 79.3% in obese children and 62.7% in normal-weight children after six months of treatment.
      Citation: Children
      PubDate: 2021-12-07
      DOI: 10.3390/children8121151
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1152: Guided Growth in Leg Length Discrepancy in
           Beckwith-Wiedemann Syndrome: A Consecutive Case Series

    • Authors: Maurizio De Pellegrin, Lorenzo Brogioni, Guy Laskow, Graziano Barera, Roberta Pajno, Sara Osimani, Silvia Russo, Lorenzo Marcucci
      First page: 1152
      Abstract: Beckwith-Wiedemann Syndrome (BWS) is a rare genetic disorder characterized by overgrowth, macroglossia, abdominal wall defects, neonatal hypoglycemia, predisposition to embryonal tumor, lateralized overgrowth, and leg length discrepancy (LLD), which can affect normal posture and gait. Aim of this study was to evaluate the effects of guided growth (temporary epiphysiodesis technique) as LLD management in BWS patients. Between 2007 and 2021, 22 BWS patients (15 F, 7 M) with a mean age of 7.9 years (2.9–14.4) and a mean LLD at first surgery of 3.65 cm (2–10), underwent temporary proximal tibial (PTE) and distal femur epiphysiodesis (DFE). In 18 patients the first surgical procedure was PTE, in one, DFE, and in 3 cases, PTE and DFE at the same time, respectively. Eleven patients reached equality of leg length after a mean follow-up of 7.7 years (3.7–13.0) and mean age of 13.3 years (12.7–27.5); 10 patients underwent 3 surgical procedures, one 7 procedures. Fifteen patients had no complications. No severe complications, infection, articular stiffness, or neuro-vascular lesions occurred in remaining patients; complications included secondary varus or valgus axial deviation in a total of 6 patients, and two screw breakages in two patients. Guided growth as a minimally invasive procedure seems efficient for LLD treatment with low complication rate in BWS patients.
      Citation: Children
      PubDate: 2021-12-07
      DOI: 10.3390/children8121152
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1153: QTc Intervals Are Prolonged in Late Preterm
           

    • Authors: Karel Allegaert, Thomas Salaets, Robert M. Ward, Pieter Annaert, Anne Smits
      First page: 1153
      Abstract: Background: There are anecdotal reports on reversible QTc prolongation during therapeutic hypothermia (TH) for moderate to severe neonatal encephalopathy after asphyxia. As the QTc interval is a relevant biomarker for pharmacovigilance during medication development, a structured search and review on published neonatal QTc values to generate reference values is warranted to facilate medication development in this specific population. Methods: A structured search and literature assessment (PubMed, Embase, and Google Scholar) with ‘Newborn/Infant, QT and hypothermia’ was conducted (October 2021). Retrieved individual values were converted to QTc (Bazett) over postnatal age (day 1–7). Results: We retrieved 94 QTc intervals (during TH (n = 50, until day 3) or subsequent normothermia (n = 44, day 4–7)) in 33 neonates from 6 publications. The median (range) of QTc intervals during TH was 508 (430–678), and 410 (317–540) ms afterwards (difference 98 ms, or +28 ms/°C decrease). Four additional cohorts (without individual QTc intervals) confirmed the pattern and magnitude of the effect of body temperature on the QTc interval. Conclusions: We highlighted a relevant non-maturational covariate (°C dependent TH) and generated reference values for the QTc interval in this specific neonatal subpopulation. This knowledge on QTc during TH should be considered and integrated in neonatal medication development.
      Citation: Children
      PubDate: 2021-12-08
      DOI: 10.3390/children8121153
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1154: Development of an Enhanced Recovery Program
           in Pediatric, Adolescent, and Young Adult Surgical Oncology Patients

    • Authors: Stephanie J. Wells, Mary Austin, Vijaya Gottumukkala, Brittany Kruse, Lauren Mayon, Ravish Kapoor, Valerae Lewis, Donna Kelly, Alexander Penny, Brent Braveman, Eliana Shkedy, Rebekah Crowder, Karen Moody, Maria C. Swartz
      First page: 1154
      Abstract: Enhanced recovery after surgery (ERAS) protocols are standardized perioperative treatment plans aimed at improving recovery time in patients following surgery using a multidisciplinary team approach. These protocols have been shown to optimize pain control, improve mobility, and decrease postoperative ileus and other surgical complications, thereby leading to a reduction in length of stay and readmission rates. To date, no ERAS-based protocols have been developed specifically for pediatric patients undergoing oncologic surgery. Our objective is to describe the development of a novel protocol for pediatric, adolescent, and young adult surgical oncology patients. Our protocol includes the following components: preoperative counseling, optimization of nutrition status, minimization of opioids, meticulous titration of fluids, and early mobilization. We describe the planning and implementation challenges and the successes of our protocol. The effectiveness of our program in improving perioperative outcomes in this surgical population could lead to the adaptation of such protocols for similar populations at other centers and would lend support to the use of ERAS in the pediatric population overall.
      Citation: Children
      PubDate: 2021-12-08
      DOI: 10.3390/children8121154
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1155: Clinical Significance of the
           Fetuin-A-to-Adiponectin Ratio in Obese Children and Adolescents with
           Diabetes Mellitus

    • Authors: Moon-Bae Ahn, Seul-Ki Kim, Shin-Hee Kim, Won-Kyoung Cho, Jin-Soon Suh, Kyoung-Soon Cho, Byung-Kyu Suh, Min-Ho Jung
      First page: 1155
      Abstract: Fetuin-A and adiponectin are inflammatory cytokines associated with obesity and insulin resistance. This study aimed to examine the fetuin-A-to-adiponectin ratio (FAR) in diabetic children and to determine the role of FAR. A total of 54 children and adolescents with diabetes mellitus (DM) and 44 controls aged 9–16 years were included in this study. Clinical characteristics, including plasma fetuin-A and adiponectin levels, were compared with respect to body mass index (BMI) and diabetes type. Of 98 children, 54.1% were obese, whereas 18.4% were obese and diabetic. FAR was higher in obese children with DM than in non-obese children and also in type 2 DM children than in type 1. FAR showed a stronger association with BMI than with fetuin-A and adiponectin individually, and its association was more prominent in diabetic children than in controls. BMI was a risk factor for increased FAR. Plasma fetuin-A was elevated in obese children, and its association with insulin resistance and β cell function seemed more prominent in diabetic children after adjustment for adiponectin. Thus, FAR could be a useful surrogate for the early detection of childhood metabolic complications in diabetic children, particularly those who are obese.
      Citation: Children
      PubDate: 2021-12-08
      DOI: 10.3390/children8121155
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1156: Analysis of the Impact of Oral Health on
           Adolescent Quality of Life Using Standard Statistical Methods and
           Artificial Intelligence Algorithms

    • Authors: Milica Gajic, Jovan Vojinovic, Katarina Kalevski, Maja Pavlovic, Veljko Kolak, Branislava Vukovic, Rasa Mladenovic, Ema Aleksic
      First page: 1156
      Abstract: The aim of this study was to determine the impact of oral health on adolescent quality of life and to compare the results obtained using standard statistical methods and artificial intelligence algorithms. In order to measure the impact of oral health on adolescent quality of life, a validated Serbian version of the Oral Impacts on Daily Performance (OIDP) scale was used. The total sample comprised 374 respondents. The obtained results were processed using standard statistical methods and machine learning, i.e., artificial intelligence algorithms—singular value decomposition. OIDP score was dichotomized into two categories depending on whether the respondents had or did not have oral or teeth problems affecting their life quality. Human intuition and machine algorithms came to the same conclusion on how the respondents should be divided. As such, method quality and the need to perform analyses of this type in dentistry studies were demonstrated. Using artificial intelligence algorithms, the respondents can be clustered into characteristic groups that allow the discovery of details not possible with the intuitive division of respondents by gender.
      Citation: Children
      PubDate: 2021-12-08
      DOI: 10.3390/children8121156
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1157: Characteristics of Giant Cell Tumor of the
           Bone in Pediatric Patients: Our 18-Year, Single-Center Experience

    • Authors: Woo-Jong Kim, Sungmin Kim, Dae-Woong Choi, Gil-Hwan Lim, Sung-Taek Jung
      First page: 1157
      Abstract: A giant cell tumor (GCT) of the bone is characteristically found in skeletally mature patients. The tumor is rare in pediatric patients, and incidence reported in literature varies from 1.8% to 10.6%. We performed a retrospective study addressing symptoms, treatment, and outcome in pediatric patients who were diagnosed with GCT between March 1997 and January 2015 at our hospital. Fourteen (11.1%) of 126 surgically treated patients with histologically proven GCT were <19 years of age. We confirmed skeletal maturity using magnetic resonance imaging (MRI). Fourteen patients from 8 to 19 years old were identified. Sixteen lesions (76.2%) were found in long bones and 5 lesions (23.8%) in short bones. The most common site was around the knee in 8 patients (38%). GCTs mostly occur at the epi-metaphysis in 11 patients (52.3%). Regardless of the openness of epiphyseal plate, we observed GCT of bone in the epiphysis. Further study will be needed to prove the association between the presence of epiphyseal plate and location of tumor. Three patients (21.4%) had multicentric lesions, and four patients (28.5%) had local recurrence. Multicentric giant cell tumor and local recurrence occur more often in pediatric patients. The characteristics of GCT in pediatric patients do not differ from what is reported for GCT in adults.
      Citation: Children
      PubDate: 2021-12-08
      DOI: 10.3390/children8121157
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1158: Feeding Problems and Long-Term Outcomes in
           Preterm Infants—A Systematic Approach to Evaluation and Management

    • Authors: Ranjith Kamity, Prasanna K. Kapavarapu, Amit Chandel
      First page: 1158
      Abstract: Preterm infants are known to have long-term healthcare needs. With advances in neonatal medical care, younger and more preterm infants are surviving, placing a subset of the general population at risk of long-term healthcare needs. Oral feeding problems in this population often play a substantial yet under-appreciated role. Oral feeding competency in preterm infants is deemed an essential requirement for hospital discharge. Despite achieving discharge readiness, feeding problems persist into childhood and can have a residual impact into adulthood. The early diagnosis and management of feeding problems are essential requisites to mitigate any potential long-term challenges in preterm-born adults. This review provides an overview of the physiology of swallowing and oral feeding skills, disruptions to oral feeding in preterm infants, the outcomes of preterm infants with feeding problems, and an algorithmic approach to the evaluation and management of neonatal feeding problems.
      Citation: Children
      PubDate: 2021-12-08
      DOI: 10.3390/children8121158
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1159: Association of Infant Feeding Practices with
           Iron Status and Hematologic Parameters in 6-Month-Old Infants

    • Authors: Chayatat Ruangkit, Nawapat Prachakittikul, Nutthida Hemprachitchai, Oraporn Dumrongwongsiri, Sasivimon Soonsawad
      First page: 1159
      Abstract: Background: Infants’ feeding practices in the first 6 months of life and their association with iron status and hematologic parameters has not been well studied. We aim to evaluate this association. Methods: In a retrospective chart review, we identified 403 infants who received laboratory screening for anemia at 6-month visits. Infants were categorized into four groups according to feeding practices. Hematologic parameters and incidence of anemia, iron deficiency (ID), and iron deficiency anemia (IDA) were compared. Results: In total, 105 infants were breastfed (BF), 78 were breastfed with iron supplementation starting at 4 months (BI), 109 were mixed-fed (breast milk and formula) with or without iron supplementation (MF), and 111 were formula-fed (FF). The BF group had the highest incidence of anemia (38.1%), ID (28.6%), and IDA (17.1%) when compared with the other groups (p < 0.001). In multivariate logistic regression, BI, MF, and FF infants had 90.4%, 97.5%, and 96.9% decreased risk of IDA, respectively, with BF infants as a reference group. Conclusion: The incidence of anemia, ID, and IDA at age 6 months was higher in BF than FF or MF infants. However, iron supplements in BF infants starting at 4 months significantly reduced their ID and IDA incidence.
      Citation: Children
      PubDate: 2021-12-08
      DOI: 10.3390/children8121159
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1160: Mental Imagery and Social Pain in
           Adolescents—Analysis of Imagery Characteristics and
           Perspective—A Pilot Study

    • Authors: Susan Muriel Schwarz, Mersiha Feike, Ulrich Stangier
      First page: 1160
      Abstract: Background: Mental imagery (MI) may play a key role in the development of various mental disorders in adolescents. Adolescence is known to be a fragile life period, in which acceptance by one’s favored peer group is extremely important, and social rejection is particularly painful. This is the first pilot study investigating MI and its relationship to social pain (SP). Method: A sample of 80 adolescents (14–20 years; 75.3% female) completed a web-based quasi-experimental design about the contents and characteristics of their spontaneous positive and negative MI and associated emotions, and were asked to complete the Social Pain Questionnaire, the Becks Depression Inventory and the Social Phobia Inventory. Results: A higher score of SP was significantly associated with increased fear, sadness, and feelings of guilt, and less control over negative MI. Characteristics of negative MI were more precisely predicted by SP scores than depression- and social anxiety scores. Adolescents with higher SP-scores more often reported negative images including social situations and were more likely to perceive negative images in a combination of field-and observer perspectives than adolescents with lower SP scores. Conclusion: SP-sensitivity seems to be linked to unique characteristics of negative MI, which reveals the strong emotional impact of social exclusion in youths. The results do not allow causal conclusions to be drawn, but raise questions about previous studies comparing each imagery perspective individually.
      Citation: Children
      PubDate: 2021-12-08
      DOI: 10.3390/children8121160
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1161: Diagnostic Accuracy of Nasopharyngeal Swab
           Cultures in Children Less Than Five Years with Chronic Wet Cough

    • Authors: Ali A. Asseri, Nasim Khattab, Dima Ezmigna, Nabil J. Awadalla, Cori Daines, Wayne Morgan
      First page: 1161
      Abstract: Background: It is necessary to find a non-invasive and accurate procedure to predict persistent bacterial bronchitis (PBB) causative organisms and guide antibiotic therapy. The study objective was to compare the diagnostic accuracy of nasopharyngeal swab cultures with bronchoalveolar lavage (BAL) cultures in children with PBB. Methods: Nasopharyngeal swab and BAL fluid specimens were collected and cultured for bacterial pathogens prospectively from less than five-year-old children undergoing flexible bronchoscopy for chronic wet cough. Results: Of the 59 children included in the study, 26 (44.1%) patients had a positive BAL bacterial culture with neutrophilic inflammation. Prevalence of positive cultures for any of the four common respiratory pathogens implicated in PBB (Moraxella catarrhalis, Streptococcus pneumoniae, Staphylococcus aureus, and Haemophilus influenzae) was significantly higher (p = 0.001) in NP swabs compared to BAL fluids (86.4% and 44.1% of PBB cases, respectively). NP swab cultures for any of the four main bacterial pathogens had 85% (95% CI: 65–96%) and 48% (95% CI: 31–66%) sensitivity and specificity of detecting PBB, respectively. Positive and negative predictive values were 56% (95% CI: 47–65%) and 80% (95% CI: 60–91%), respectively. In conclusion, in children less than 5 years of age with chronic wet cough (PBB-clinical), a negative NP swab result reduces the likelihood of lower airway infection; however, a positive NP swab does not accurately predict the presence of lower airway pathogens. Flexible bronchoscopy should be considered in those with recurrent PBB-clinical or with clinical pointers of central airway anomalies.
      Citation: Children
      PubDate: 2021-12-08
      DOI: 10.3390/children8121161
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1162: Evaluation of Cumulative Effect of Standard
           Triple Immunosuppression on Prevention of De Novo Donor Specific
           Antibodies (dnDSA) Production in Children after Kidney
           Transplantation—A Retrospective and Prospective Study

    • Authors: Agnieszka Urzykowska, Barbara Piątosa, Urszula Grycuk, Grzegorz Kowalewski, Zbigniew Kułaga, Ryszard Grenda
      First page: 1162
      Abstract: De novo Donor Specific Antibodies (dnDSA) are associated with inferior graft outcomes. Standard immunosuppression is expected to prevent dnDSA production in low-risk patients. We have evaluated a cumulative effect of a triple immunosuppression (CNI/MMF/Pred), as well as TAC concentration and coefficient of variation on the incidence of dnDSA production. Overall, 67 transplanted patients were evaluated in retrospective (dnDSA for-cause; n = 29) and prospective (dnDSA by protocol; n = 38) groups. In the retrospective group, the eGFR value at first dnDSA detection (median interval—4.0 years post-transplant) was 41 mL/min/1.73 m2; 55% of patients presented biopsy-proven cAMR, and 41% lost the graft within next 2.4 years. Patients from the prospective group presented 97% graft survival and eGFR of 76 mL/min/1.73 m2 at 2 years follow-up, an overall incidence of 21% of dnDSA and 18% of acute (T cell) rejection. None of the patients from the prospective group developed cAMR. Median value of Vasudev score within 2 years of follow-up was not significantly higher in dsDSA negative patients, while median value of TAC C0 > 1–24 months post-transplant was 7.9 in dnDSA negative vs. 7.1 ng/mL in dnDSA positive patients (p = 0.008). Conclusion: dnDSA-negative patients presented a higher exposure to tacrolimus, while not to the combined immunosuppression.
      Citation: Children
      PubDate: 2021-12-09
      DOI: 10.3390/children8121162
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1163: Novel Use of a Bronchial Blocker in a
           Challenging Case of Congenital Diaphragmatic Hernia—A Case Report

    • Authors: Deepika Sankaran, Shinjiro Hirose, Donald Morley Null, Niroop R. Ravula, Satyan Lakshminrusimha
      First page: 1163
      Abstract: The diagnosis of congenital diaphragmatic hernia (CDH) is associated with significant morbidity and mortality. Survival of neonates with CDH has improved recently, although the clinical course is complicated by sequelae of hypoplastic pulmonary parenchyma and vasculature, pulmonary hypertension, ventilation/perfusion (V/Q) mismatch, reduced pulmonary function and poor somatic growth. In this case report, we describe an infant with an antenatal diagnosis of CDH with a poor prognosis who underwent initial surgery followed by a tracheostomy but had a worsening clinical course due to a large area of ventilated but poorly perfused lung based on a V/Q nuclear scintigraphy scan. The emphysematous left lung was causing mediastinal shift and compression of the right lung, further compromising gas exchange. The infant had clinical improvement following bronchial blockade of the under-perfused left lung. This paved the way for further management with resection of the under-perfused lung lobe and continued clinical improvement. We present the novel use of selective bronchial blockade in a challenging case of CDH to determine if surgical lung resection may benefit the infant. We also review the physiology of gas exchange during the use of a bronchial occluder and the relevant literature.
      Citation: Children
      PubDate: 2021-12-09
      DOI: 10.3390/children8121163
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1164: Patterns of Father Involvement and Child
           Development among Families with Low Income

    • Authors: Susan Yoon, Minjung Kim, Junyeong Yang, Joyce Y. Lee, Anika Latelle, Jingyi Wang, Yiran Zhang, Sarah Schoppe-Sullivan
      First page: 1164
      Abstract: This study examined patterns of father involvement and their relations with social, behavioral, and cognitive development among low-income children < 5 years. Latent class analysis on data from 2650 fathers (Mage = 29.35 years) in the Supporting Healthy Marriages program revealed four father involvement patterns: (1) High positive involvement (48%); (2) engaged but harsh discipline (42%); (3) low cognitive stimulation (8%); and (4) lower involvement (2%). The low cognitive stimulation pattern was associated with greater father- and mother-reported child behavior problems and lower child socioemotional and cognitive functioning. The engaged but harsh discipline pattern was associated with more father-reported child behavior problems. These findings highlight the need for active engagement of fathers in parenting interventions to promote child development.
      Citation: Children
      PubDate: 2021-12-09
      DOI: 10.3390/children8121164
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1165: Barrier Impairment and Type 2 Inflammation
           in Allergic Diseases: The Pediatric Perspective

    • Authors: Michele Ghezzi, Elena Pozzi, Luisa Abbattista, Luisa Lonoce, Gian Vincenzo Zuccotti, Enza D’Auria
      First page: 1165
      Abstract: Allergic diseases represent a global burden. Although the patho-physiological mechanisms are still poorly understood, epithelial barrier dysfunction and Th2 inflammatory response play a pivotal role. Barrier dysfunction, characterized by a loss of differentiation, reduced junctional integrity, and altered innate defence, underpins the pathogenesis of allergic diseases. Epithelial barrier impairment may be a potential therapeutic target for new treatment strategies Up now, monoclonal antibodies and new molecules targeting specific pathways of the immune response have been developed, and others are under investigation, both for adult and paediatric populations, which are affected by atopic dermatitis (AD), asthma, allergic rhinitis (AR), chronic rhinosinusitis with nasal polyps (CRSwNP), or eosinophilic esophagitis (EoE). In children affected by severe asthma biologics targeting IgE, IL-5 and against IL-4 and IL-13 receptors are already available, and they have also been applied in CRSwNP. In severe AD Dupilumab, a biologic which inhibits both IL-4 and IL-13, the most important cytokines involved in inflammation response, has been approved for treatment of patients over 12 years. While a biological approach has already shown great efficacy on the treatment of severe atopic conditions, early intervention to restore epithelial barrier integrity, and function may prevent the inflammatory response and the development of the atopic march.
      Citation: Children
      PubDate: 2021-12-09
      DOI: 10.3390/children8121165
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1166: Lenticulostriate Vasculopathy in
           Very-Low-Birth-Weight Preterm Infants: A Longitudinal Cohort Study

    • Authors: Yi-Li Hung, Chung-Min Shen, Kun-Long Hung, Wu-Shiun Hsieh
      First page: 1166
      Abstract: Background: The pathogenesis and clinical significance of lenticulostriate vasculopathy (LSV) are unclear. Our study aimed to determine the prevalence, presentation, and evolution of LSV, and the perinatal risk factors associated with LSV among very-low-birth-weight (VLBW) preterm infants. Methods: One-hundred-and-thirty VLBW preterm infants were retrospectively enrolled in this study. Serial cranial ultrasound examinations were performed regularly from birth until a corrected age of 1 year. Infants with LSV were assigned to early-onset (≤10 postnatal days) and late-onset (>10 postnatal days) groups. Data describing the infants’ perinatal characteristics, placental histopathology, and neonatal morbidities were collected, and the groups were compared. Results: Of the VLBW infants, 39.2% had LSV before they were 1 year old. Linear-type LSV was the most common presentation, and >50% of the infants had bilateral involvement. LSV was first detected at 112 ± 83 postnatal days, and its detection timing correlated negatively with gestational age (GA) (R2 = 0.153, p = 0.005) and persisted for 6 months on average. The infants with and without LSV had similar perinatal characteristics, placental pathologies, cytomegalovirus infection rates, and clinical morbidities. The late-onset LSV group comprised 45 (88.2%) infants who had a significantly higher rate of being small for gestational age (SGA) and used oxygen for longer than the infants without LSV. After adjusting a multivariable regression model for GA and SGA, analysis showed that the duration of oxygen usage was an independent risk factor for late-onset LSV development in VLBW infants (odds ratio: 1.030, p = 0.032). Conclusion: LSV may be a nonspecific marker of perinatal insult to the developing brains of preterm infants. Prolonged postnatal oxygen usage may predispose VLBW preterm infants to late-onset LSV development. The long-term clinical impacts of LSV should be clarified.
      Citation: Children
      PubDate: 2021-12-09
      DOI: 10.3390/children8121166
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1167: How Can We Reduce Dental Fear in
           Children' The Importance of the First Dental Visit

    • Authors: María Carrillo-Díaz, Blanca Carmen Migueláñez-Medrán, Carolina Nieto-Moraleda, Martín Romero-Maroto, María José González-Olmo
      First page: 1167
      Abstract: Dental fear is a common problem amongst children. It can affect children’s psychological well-being, quality of life, and oral and systemic health. The aim of this study was to identify whether the patients’ age at which visits to the paediatric dentist begin as well as the periodicity of these visits are factors that can prevent dental fear. This observational transversal study was conducted on 575 school children (average age 6.85 ± 0.78) and their mother/father/guardian. Parents completed a survey on the characteristics of dental visits and the child completed the index of dental anxiety and fear (IDAF-4C) to assess dental fear. The correlation between dental fear and age at first visit (r = −0.36 p < 0.01) and dental fear and frequency of visit (r = −0.65 p < 0.01) were statistically significant. The regression analysis performed showed that both variables predicted 44.4% of the dental fear in the child. In conclusion, the age of initiation to the paediatric dentist (before 2 years) and the periodic revisions (every 6 months or every year) could protect the child from dental fear.
      Citation: Children
      PubDate: 2021-12-09
      DOI: 10.3390/children8121167
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1168: Relationship between Muscle Tone of the
           Erector Spinae and the Concave and Convex Sides of Spinal Curvature in
           Low-Grade Scoliosis among Children

    • Authors: Jacek Wilczyński
      First page: 1168
      Abstract: The objective of the present research was to assess the relationship between muscle tone of the erector spinae and the concave and convex sides of spinal curvature in low-grade scoliosis found among children. The study included 251 children, aged 7–8. Examination of the spine and body posture was carried out using the Diers Formetric III 4D optoelectronic method. Surface electromyography (sEMG) was used to assess erector spinae muscle tone. The trial was carried out using the 14-channel Noraxon TeleMyo DTS apparatus. The highest generalised tone (sEMG amplitude) of the erector spinae occurred in the case of scoliosis. The higher the angle of curvature, the greater the erector spinae muscle tone. Regardless of the position adopted during examination of the thoracic spine, greater erector spinae tone (sEMG amplitude) was exhibited on the convex side of the spinal curvature. However, in the area of the lumbar spine, greater tone (sEMG amplitude) of the erector spinae occurred on the curvature’s concave side. The exception was the test performed in a standing position, during which greater muscle tone was noted on the side of the convex curvature. In therapeutic practice, within the thoracic section, too tense erector spinae muscles should be stretched on the convex side of the scoliosis, while in the lumbar region, this should be performed on the concave side. However, each case of scoliosis requires individually tailored treatment. The current research has applicative value and does fill a research gap with regard to erector spinae muscle tone in young children experiencing low-grade scoliosis. The development of scoliosis is associated with asymmetry and an increase in erector spinae tone. The uneven distribution of its tone, occurring on both sides of the spine and in its various segments, causes destabilisation and its abnormal progression.
      Citation: Children
      PubDate: 2021-12-10
      DOI: 10.3390/children8121168
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1169: Preterm Infant Outcomes Following COVID-19
           Lockdowns in Melbourne, Australia

    • Authors: Brendan Mulcahy, Daniel L. Rolnik, Alexia Matheson, Yizhen Liu, Kirsten R. Palmer, Ben W. Mol, Atul Malhotra
      First page: 1169
      Abstract: Background Community lockdowns during the coronavirus disease 2019 (COVID-19) pandemic may influence preterm birth rates, but mechanisms are unclear. Methods We compared neonatal outcomes of preterm infants born to mothers exposed to community lockdowns in 2020 (exposed group) to those born in 2019 (control group). Main outcome studied was composite of significant neonatal morbidity or death. Results Median gestational age was 35 + 4 weeks (295 infants, exposed group) vs. 35 + 0 weeks (347 infants, control group) (p = 0.108). The main outcome occurred in 36/295 (12.2%) infants in exposed group vs. 46/347 (13.3%) in control group (p = 0.69). Continuous positive airway pressure (CPAP) use, jaundice requiring phototherapy, hypoglycaemia requiring treatment, early neonatal white cell and neutrophil counts were significantly reduced in the exposed group. Conclusions COVID-19 community lockdowns did not alter composite neonatal outcomes in preterm infants, but reduced rates of some common outcomes as well as early neonatal inflammatory markers.
      Citation: Children
      PubDate: 2021-12-10
      DOI: 10.3390/children8121169
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1170: Exploring the Outcomes That Matter Most to
           Young People Treated for Chronic Pain: A Qualitative Study

    • Authors: Rhiannon Joslin, Maggie Donovan-Hall, Lisa Roberts
      First page: 1170
      Abstract: Global and national policies state that all children and young people should be part of decision making and that outcomes that matter to them should take priority, yet patient-centred outcomes have been identified as a gap in the paediatric chronic pain literature. This study gave youths experiencing chronic pain a platform to have their views heard. Using novel methods, twenty-one young people, aged 11 to 18 years old, completed a semi-structured interview in which they constructed a timeline drawing to symbolise their treatment. They identified when aspects of their life changed (outcomes) and described the importance of these changes. Thematic analysis identified four themes that emerged at different stages of the treatment: “perfect storm”; “turning points”; “disconnect”; and; “free”. “Turning points” were points in time when the narrative of the young person took a turn in a different direction. At these points, the outcomes important to them also changed. Youths initially prioritised outcomes related to pain, then during treatment the focus became their emotional functioning, with role functioning and “going out” becoming the focus at the end. The stage of treatment as perceived by the young person impacted which outcomes mattered most.
      Citation: Children
      PubDate: 2021-12-10
      DOI: 10.3390/children8121170
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1171: Comparison of McGrath Videolaryngoscope and
           Macintosh Laryngoscope in Children with Torticollis: Randomized Controlled
           Trial

    • Authors: Min Hur, Jong Yeop Kim, Sang Kee Min, Kyuheok Lee, Young Ju Won, Ji Eun Kim
      First page: 1171
      Abstract: We investigated the efficacy of the McGrath videolaryngoscope compared with the Macintosh laryngoscope in children with torticollis. Thirty children aged 1–10 years who underwent surgical release of torticollis were randomly assigned into the McGrath and Macintosh groups. Orotracheal intubation was performed by a skilled anesthesiologist. The primary outcome was the intubation time. The Cormack–Lehane grade, lifting force, intubation difficulty scale (IDS), difficulty level, and intubation failure rate were also assessed. The intubation time was significantly longer in the McGrath group than in the Macintosh group (31.4 ± 6.7 s vs. 26.1 ± 5.4 s, p = 0.025). Additionally, the Cormack–Lehane grades were comparable between the groups (p = 0.101). The lifting force and IDS were significantly lower in the McGrath group than in the Macintosh group (p < 0.001 and p = 0.022, respectively). No significant differences were observed with respect to endotracheal intubation difficulty and intubation success rate. Intubation-related complications were also not observed. In conclusion, compared with the Macintosh laryngoscope, the McGrath videolaryngoscope extended the intubation time and did not improve glottic visualization in children with torticollis, despite having a lesser lifting force, lower intubation difficulty scale, and similar success rate.
      Citation: Children
      PubDate: 2021-12-10
      DOI: 10.3390/children8121171
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1172: Low- and High-Attenuation Lung Volume in
           Quantitative Chest CT in Children without Lung Disease

    • Authors: Dimitrios Moutafidis, Maria Gavra, Sotirios Golfinopoulos, Antonios Kattamis, George Chrousos, Christina Kanaka-Gantenbein, Athanasios G. Kaditis
      First page: 1172
      Abstract: In contrast to studies of adults with emphysema, application of fixed thresholds to determine low- and high-attenuation areas (air-trapping and parenchymal lung disease) in pediatric quantitative chest CT is problematic. We aimed to assess age effects on: (i) mean lung attenuation (full inspiration); and (ii) low and high attenuation thresholds (LAT and HAT) defined as mean attenuation and 1 SD below and above mean, respectively. Chest CTs from children aged 6–17 years without abnormalities were retrieved, and histograms of attenuation coefficients were analyzed. Eighty examinations were included. Inverse functions described relationships between age and mean lung attenuation, LAT or HAT (p < 0.0001). Predicted value for LAT decreased from −846 HU in 6-year-old to −950 HU in 13- to 17-year-old subjects (cut-off value for assessing emphysema in adults). %TLCCT with low attenuation correlated with age (rs = −0.31; p = 0.005) and was <5% for 9–17-year-old subjects. Inverse associations were demonstrated between: (i) %TLCCT with high attenuation and age (r2 = 0.49; p < 0.0001); (ii) %TLCCT with low attenuation and TLCCT (r2 = 0.47; p < 0.0001); (iii) %TLCCT with high attenuation and TLCCT (r2 = 0.76; p < 0.0001). In conclusion, quantitative analysis of chest CTs from children without lung disease can be used to define age-specific LAT and HAT for evaluation of pediatric lung disease severity.
      Citation: Children
      PubDate: 2021-12-10
      DOI: 10.3390/children8121172
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1173: Problems, Stressors and Needs of Children
           and Adolescents with Cancer

    • Authors: Anna Lewandowska, Barbara Zych, Katalin Papp, Dana Zrubcová, Helena Kadučáková, Mária Šupínová, Serap Ejder Apay, Małgorzata Nagórska
      First page: 1173
      Abstract: Background: Cancer diseases in children and adolescents are considered to be one of the most serious health problems in the world. It is estimated that about 151,435 cases are diagnosed in children annually. Children with cancer experience many comorbid symptoms related to diagnosis and treatment that can profoundly affect their lives. They experience physical and emotional suffering, which affects their well-being and physical fitness, influencing the prognosis and deteriorating their physical, mental and social functioning. Given the limited data, an attempt was made to assess the problems of the biopsychosocial sphere of need and stressors among children and adolescents treated for cancer. Accurate symptom assessment is essential to ensure high-quality care and effective treatment. Patients and Methods: The qualitative study was conducted in pediatric oncology of hospitals in Poland. Children diagnosed with cancer were invited to participate in the study to assess their problems, stressors and needs. Results: The study included 520 people, where female sex constituted 48% and male 52%. The mean age of the children is 13.2 SD = 2.5. Negative experiences related to the disease are experienced by 82% of children. Among the surveyed children, the most experienced were anxiety (61%). The conducted research shows that as many as 69% of all respondents experienced states that indicate severe depression. The most common somatic problems reported by children were pain (58%). The most dominant areas of life that had a negative impact was body image (85%). Conclusions: Children and adolescents diagnosed with neoplastic disease experience many problems and stressors in every sphere of life, which undoubtedly affects a high level of unmet needs. The main category of needs concerning the challenges faced by children with cancer was psychological and care problems. In the youth group, the needs were mainly related to education and social support.
      Citation: Children
      PubDate: 2021-12-10
      DOI: 10.3390/children8121173
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1174: Advanced Management Protocol of Transanal
           Irrigation in Order to Improve the Outcome of Pediatric Patients with
           Fecal Incontinence

    • Authors: Anna Maria Caruso, Mario Pietro Marcello Milazzo, Denisia Bommarito, Vincenza Girgenti, Glenda Amato, Giuseppe Paviglianiti, Alessandra Casuccio, Pieralba Catalano, Marcello Cimador, Maria Rita Di Pace
      First page: 1174
      Abstract: Background: Transanal irrigation (TAI) is employed for children with fecal incontinence, but it can present several problems which require a study of their outcomes among different pathologies and without a tailored work up. The aim of our study was to evaluate the effectiveness of an advanced protocol in order to tailor TAI, prevent complications, and evaluate outcomes. Methods: We included 70 patients (14 anorectal malformation, 12 Hirschsprung’s disease, 24 neurological impairment, 20 functional incontinence) submitted to a comprehensive protocol with Peristeen®: fecal score, volumetric enema, rectal ultrasound, anorectal 3D manometry, and diary for testing and parameter adjustment. Results: Among the patients, 62.9% needed adaptations to the parameters, mainly volume of irrigated water and number of puffs of balloon. These adaptations were positively correlated with pre-treatment manometric and enema data. In each group, the improvement of score was statistically significant in all cases (p 0.000); the main factor influencing the efficacy was the rate of sphincter anomalies. The ARM group had slower improvement than other groups, whereas functional patients had the best response. Conclusions: Our results showed that TAI should not be standardized for all patients, because each one has different peculiarities; evaluation of patients before TAI with rectal ultrasound, enema, and manometry allowed us to tailor the treatment, highlighting different outcomes among various pathologies, thus improving the efficacy
      Citation: Children
      PubDate: 2021-12-11
      DOI: 10.3390/children8121174
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1175: Outcome Quality of Inpatient and Day-Clinic
           Treatment in Child and Adolescent Psychiatry—A Naturalistic Study

    • Authors: Leonhard Thun-Hohenstein, Franka Weltjen, Beatrix Kunas, Roman Winkler, Corinna Fritz
      First page: 1175
      Abstract: Background: Child and adolescent psychiatry has only recently been established as a separate specialty and is practiced in different settings. The epidemiology of psychological problems in childhood is high and varied, thus qualitative work is essential. Assessment of outcome as part of quality management is central to assure the service of psychiatric care to be effective. Method: Over a three-year period consecutively admitted patients from inpatient and day-clinic treatment were prospectively evaluated. A total of 200 from 442 patients (m = 80, f = 120; age 15.1 ± 2.8 y) agreed to participate. Patients, caregivers, and therapists answered a range of questionnaires to provide a multi-personnel rating. Questionnaires used for outcome assessment were Child Behavior Checklist (CBCL) and Youth-Self-Report (YSR) (at admission, discharge, and 6 weeks after discharge) and the problem score of the Inventory of Quality of Life for children (ILK), treatment satisfaction, and process quality by the Questionnaire for Treatment Satisfaction (FBB, at discharge) and as real-life outcome control assessment of quality of life (ILK) was added (admission, discharge, and 6 wks after discharge). Results: There was a significant reduction in psychopathologicalsymptoms (CBCL, YSR) and in the problem score. Furthermore, there was a significant increase in quality of life. QoL score and YSR/CBCL scores returned to normal levels. Treatment satisfaction was high and so was satisfaction with process quality. Factors significantly influencing outcome were severity of disease and the relationship to the therapist. No differences were found for gender and setting. Conclusion: The quality management analysis revealed significant improvements of symptom load, a significant increase in QoL and a high treatment satisfaction. Furthermore, process quality was scored highly by parents and therapists.
      Citation: Children
      PubDate: 2021-12-11
      DOI: 10.3390/children8121175
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1176: Early Bronchiolitis Contributes to Preschool
           Asthma

    • Authors: Jih-Chin Chang, Jeng-Yuan Chiou, Jiunn-Liang Ko, Jing-Yang Huang, Ko-Huang Lue
      First page: 1176
      Abstract: This study aims to analyze whether bronchiolitis in children younger than one-year-old contributes to subsequent asthma. Medical data were retrieved from the National Health Insurance Research Database of Taiwan. Participants were divided into study (N = 65,559) and control (N = 49,656) groups, depending on whether they had early bronchiolitis. Incidences of asthma, potential comorbidities, and associated medical conditions were compared. The incidence of childhood asthma was significantly higher in the study group (aHR = 1.127, 95% CI: 1.063–1.195). Children with bronchiolitis hospitalization displayed higher asthma risk in the period between two and four years of age. The risk diminished as the children grew up. No relevant synergistic effects were found between bronchiolitis and atopic dermatitis. In conclusion, bronchiolitis before one year of age exhibits predictive value for development of preschool asthma, especially in children with bronchiolitis hospitalizations.
      Citation: Children
      PubDate: 2021-12-13
      DOI: 10.3390/children8121176
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1177: Bone Fractures Numerical Analysis in a Femur
           Affected by Osteogenesis Imperfecta

    • Authors: Viridiana Ramírez-Vela, Luis Antonio Aguilar-Pérez, Juan Carlos Paredes-Rojas, Juan Alejandro Flores-Campos, Fernando ELi Ortiz-Hernández, Christopher René Torres-SanMiguel
      First page: 1177
      Abstract: This work presents a non-invasive methodology to obtain a three-dimensional femur model of three-year-old infants affected with Osteogenesis Imperfecta (OI) type III. DICOM® Files of a femur were processed to obtain a finite element model to assess the transverse, the oblique, and the comminuted fractures. The model is evaluated under a normal walking cycle. The loads applied were considered the most critical force generated on the normal walking cycle, and the analyses considered anisotropic bone conditions. The outcome shows stress concentration areas in the central zone of the diaphysis of the femur, and the highest levels of stress occur in the case of the comminuted fracture, while the transverse fracture presents the lowest values. Thus, the method can be helpful for determining the bone fracture behavior of certain pathologies, such as osteogenesis imperfecta, osteopenia, and osteoporosis.
      Citation: Children
      PubDate: 2021-12-14
      DOI: 10.3390/children8121177
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1178: Potential Mechanisms Underlying
           Hypoxia-Induced Diabetes in a Rodent Model: Implications for COVID-19

    • Authors: Eung-Kwon Pae, Ronald M. Harper
      First page: 1178
      Abstract: Previous studies reported that repetitive hypoxia in rat pups reduces insulin secretion and elevates fasting blood glucose levels; these sequelae persisted for several months. This report describes how episodic hypoxic events elevate a chloride ion exporter, K+-Cl− cotransporter-2 (KCC2), in the plasma membrane of insulin-secreting pancreatic β-cells. We assume that acute diabetic symptoms observed in rat pups with periodic oxygen desaturation could result from a lack of blood insulin levels due to disturbed β-cell function. This acute hypo-insulinemia may result from a disruption in chloride balance in β-cells arising from an imbalanced KCC2-NKCC1 (chloride exporter-importer) density as a consequence of periodic oxygen desaturation. Mechanistically, we postulate that a reduced insulin secretion due to the KCC2-NKCC1 imbalance subsequent to acute oxygen desaturation could result in hyperglycemia in rat pups, paralleling symptoms shown in patients with COVID-19 who experienced acute respiratory distress.
      Citation: Children
      PubDate: 2021-12-14
      DOI: 10.3390/children8121178
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1179: Digital Identities of Young People from the
           South of Spain: An Online Sexual Differentiation

    • Authors: E. Begoña García-Navarro, Jose Luis Gil Bermejo, Miriam Araujo-Hernández
      First page: 1179
      Abstract: Through a mixed methodological approach, we want to know how adolescents aged between 14 and 16 years from the south of Spain express and identify themselves on social networks, with respect to their sex. As such differences can determine gender inequality, we will analyse differences between females and males regarding the expression of identity on social networks. Analysis of obtained results demonstrates that many relevant attributes still emerge such as the socio-cultural representation of gender as sex in social networks. Differences emerged between the identity expressions of females and males which can generate inequalities favouring females and males. This implies a series of repercussions and, ultimately, defines the so-called digital gender divide. Taking into account these results we could intervene in the population of children to carry out prevention activities focused on social networks.
      Citation: Children
      PubDate: 2021-12-14
      DOI: 10.3390/children8121179
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1180: Standards of Nutritional Care for Patients
           with Cystic Fibrosis: A Methodological Primer and AGREE II Analysis of
           Guidelines

    • Authors: Maria G. Grammatikopoulou, Tonia Vassilakou, Dimitrios G. Goulis, Xenophon Theodoridis, Meletios P. Nigdelis, Arianna Petalidou, Konstantinos Gkiouras, Dimitrios Poulimeneas, Olga Alexatou, Kyriaki Tsiroukidou, Georgios Marakis, Zoe Daniil, Dimitrios P. Bogdanos
      First page: 1180
      Abstract: Although many Clinical Practice Guidelines (CPGs) have been published for the care of patients with Cystic Fibrosis (CF), including a variety of nutrition recommendations, the quality of these CPGs has never been evaluated. The aim of this study was to compare, review, and critically appraise CPGs for the nutritional management of CF, throughout the lifespan. We searched PubMed, Guidelines International Network (GIN), ECRI Institute, and Guidelines Central for CPGs, with information on the nutritional management of CF. Retrieved CPGs were appraised by three independent reviewers, using the Appraisal of Guidelines, Research and Evaluation II (AGREE II) instrument and checklist. A total of 22 CPGs (seven solely nutrition oriented), by 14 different publishers, were retrieved. The Thoracic Society of Australia and New Zealand CPGs scored the highest overall quality (94.4%), while the Paediatric Gastroenterology Society/Dietitians Association of Australia CPGs had the lowest score (27.8%). Great variation in AGREE II domain-specific scores was observed in all CPGs, suggesting the existence of different strengths and weaknesses. Despite the availability of several CPGs, many appear outdated, lacking rigor, transparency, applicability, and efficiency, while incorporating bias. Considering that CPGs adherence is associated with better outcomes and the need for improving life expectancy in patients with CF, the development of CPGs of better quality is deemed necessary.
      Citation: Children
      PubDate: 2021-12-14
      DOI: 10.3390/children8121180
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1181: The EU Strategy on the Rights of the Child
           and the European Child Guarantee—Evidence-Based Recommendations for
           Alternative Care

    • Authors: Bárbara Mourão Sacur, Elisete Diogo
      First page: 1181
      Abstract: Protection and promotion of child rights are referred to as a central purpose of the European Union (EU). Therefore in 2021, the EU Strategy on the Rights of the Child and the European Child Guarantee were published to enable children to have the best possible life in the EU and worldwide. Member states were invited to implement the directions of both documents into practice. The present study analyses and showcases the evidence on how to progress implementation of the Strategy and the Guarantee regarding alternative care in Portugal. A literature review was conducted based on international literature. Evidence-based recommendations for the Portuguese transition process towards quality, family and community-based care are stated. De-institutionalisation and strengthening specific services—kinship care, special guardianship, and foster care—are advocated, namely specialising the workforce, and promoting training for kinship carers and prospective special guardians. To conclude, the revision and monitoring of the measures for children in need of alternative care are suggested as well as integrating and publishing data from the diverse services of the alternative care system.
      Citation: Children
      PubDate: 2021-12-14
      DOI: 10.3390/children8121181
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1182: Foreign Body Ingestion in Children:
           Epidemiological, Clinical Features and Outcome in a Third Level Emergency
           Department

    • Authors: Antonio Gatto, Lavinia Capossela, Serena Ferretti, Michela Orlandi, Valeria Pansini, Antonietta Curatola, Antonio Chiaretti
      First page: 1182
      Abstract: Ingestion of foreign bodies is a frequent pediatric cause of access to the Emergency Department (ED). The aim of this study was to determine the epidemiological and clinical features of pediatric patients with a diagnosis of foreign body ingestion and to identify the factors associated with an urgent invasive procedure or hospitalization. This is a retrospective study conducted on a population of 286 pediatric patients (0–17 years) evaluated for foreign body ingestion at the Pediatric ED of “Fondazione Policlinico Universitario A. Gemelli, IRCSS” between October 2014 and June 2019. Data concerning age and gender, underlying diseases, type of foreign body, symptoms and signs, instrumental tests, specialist visits, treatment and outcome were analyzed. The majority of foreign bodies were coins (23%). Symptoms recurred in 50% of the foreign bodies with esophageal localization and between the 92 (32%) patients with symptoms the most common was vomiting (7%). X-rays was performed in 61% of patients. Among all patients, 253 patients (88.8%) had been discharged, 21 (7%) had been hospitalized, and four (1.4%) were sent to an outpatient facility. Besides, 17 (5.9%) patients had been transferred to the Observation Unit. Of the hospitalized patients (21 (7.3%)), clinical observation was performed for 57% and endoscopic procedure for 45%. Our data confirm that the ESPGHAN-ESGE guidelines application prevents interventions that are not necessary, avoiding diagnostic and therapeutic delays.
      Citation: Children
      PubDate: 2021-12-15
      DOI: 10.3390/children8121182
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1183: Change in Pediatric Health Care Spending and
           Drug Utilization during the COVID-19 Pandemic

    • Authors: Riccardo Lubrano, Emanuela Del Giudice, Alessia Marcellino, Flavia Ventriglia, Anna Dilillo, Enrica De Luca, Saverio Mallardo, Sara Isoldi, Vanessa Martucci, Mariateresa Sanseviero, Donatella Iorfida, Concetta Malvaso, Giovanni Cerimoniale, Giuseppina Ragni, Anna Lisa Grandinetti, Loredana Arenare, Silvia Bloise
      First page: 1183
      Abstract: Objective: To evaluate how the restrictive measures implemented during the SARS-CoV-2 pandemic have influenced the incidence of the most common children’s diseases and the consumption of medications in 2020 compared to 2019. Methods: We involved all family pediatricians of the local health authority of Latina, from which we requested data of monthly visits in 2019 and 2020 for six common diseases disseminated through droplets and contact, and the territorial and integrative pharmaceutical unit of the area, from which we requested data of the net expenditure regarding the most commonly used drugs at pediatric age. Results: There was significant reduction in the incidence of the evaluated diseases and in the consumption of investigated drugs between 2019 and 2020 in the months when the restrictive measures were in place, with an attenuation of this effect during the months of the gradual loosening of those measures. Conclusion: Nonpharmaceutical intervention measures have caused changes in the diffusion of common pediatric diseases. We believe that the implementation of a reasonable containment strategy, even outside of the pandemic, could positively influence the epidemiology of infectious and allergic diseases in children, and healthcare system spending.
      Citation: Children
      PubDate: 2021-12-15
      DOI: 10.3390/children8121183
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1184: The Arabic Version of the Faces Pain
           Scale-Revised: Cultural Adaptation, Validity, and Reliability Properties
           When Used with Children and Adolescents

    • Authors: Jessica Finianos, Elisabet Sánchez-Rodríguez, Jordi Miró
      First page: 1184
      Abstract: The Faces Pain Scale-Revised (FPS-R) is widely used to assess pain intensity in young people. The aims of this research were to study the convergent and discriminant validity and reliability properties of a culturally adapted version of the FPS-R for its use with Arabic-speaking individuals. The sample consisted of 292 students living in Lebanon. They were interviewed online, asked to imagine themselves in one of two given situations based on their age (8–12 and 13–18 years old), and then asked rate the intensity of pain they would experience using the FPS-R-Arabic and a Numerical Rating Scale (NRS-11-Arabic). They were also asked to respond to the Pain Catastrophizing Scale (PCS-C-Arabic). Two weeks later, participants were asked to repeat the same procedure. The data showed strong associations between the scores of the FPS-R-Arabic and NRS-11-Arabic (r = 0.72; p < 0.001), which were higher than the associations of the scores of the FPS-Arabic with the PCS-C-Arabic scores (z = 7.36, p < 0.001). The associations between the FPS-R-Arabic scores on the two measurements were also strong (r = 0.76; p < 0.001). The findings support the convergent and discriminant validity and reliability of the FPS-R-Arabic scores when used to measure pain intensity in young people aged 8 to 18 years old.
      Citation: Children
      PubDate: 2021-12-15
      DOI: 10.3390/children8121184
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1185: “It’s Very Stressful for
           Children”: Elementary School-Aged Children’s Psychological
           Wellbeing during COVID-19 in Canada

    • Authors: Laena Maunula, Julia Dabravolskaj, Katerina Maximova, Shannon Sim, Noreen Willows, Amanda S. Newton, Paul J. Veugelers
      First page: 1185
      Abstract: Emerging evidence suggests that the COVID-19 pandemic and associated public health measures, including lockdowns and school closures, have been negatively affecting school-aged children’s psychological wellbeing. To identify supports required to mitigate the negative impacts of the COVID-19 pandemic, we gathered in-depth information on school-aged children’s and parents’ lived experiences of COVID-19 and perceptions of its impact on psychological wellbeing in grade 4–6 students in Canada. In this qualitative study, we conducted telephone-based semi-structured interviews with parents (n = 15) and their children (n = 16) from six schools in small and mid-sized northern prairie communities in Canada. Interviews were analyzed through thematic analysis. Three interrelated themes have emerged. First, the start of COVID-19 brought sudden and stressful changes to children’s lives. Second, disruptions to daily life led to feelings of boredom and lack of purpose. Third, limited opportunities for social interaction led to loneliness and an increase in screen time to seek social connection with peers. Results underscore the need for resilience building and the promotion of positive coping strategies to help school-aged children thrive in the event of future health crises or natural disasters.
      Citation: Children
      PubDate: 2021-12-15
      DOI: 10.3390/children8121185
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1186: Anthropometric Indices of Giardia-Infected
           Under-Five Children Presenting with Moderate-to-Severe Diarrhea and Their
           Healthy Community Controls: Data from the Global Enteric Multicenter Study
           

    • Authors: Shamsun Nahar Shaima, Sumon Kumar Das, Shahnawaz Ahmed, Yasmin Jahan, Soroar Hossain Khan, Gazi Md. Salahuddin Mamun, Abu Sadat Mohammad Sayeem Bin Shahid, Irin Parvin, Tahmeed Ahmed, A. S. G. Faruque, Mohammod Jobayer Chisti
      First page: 1186
      Abstract: Among all intestinal parasitosis, giardiasis has been reported to be associated with delayed growth in malnourished children under 5 living in low- and middle-income countries. Relevant data on the nutritional status of children aged 0–59 months presenting with moderate-to-severe diarrhea (MSD) and giardia infection were collected from sentinel health facilities of the Global Enteric Multicenter Study’s (GEMS) seven field settings, placed in diverse countries of Sub-Saharan Africa and South Asia between, December 2007 and February 2011. Then, this study analyzed a robust dataset of study participants (n = 22,569). Children having giardiasis with MSD constituted as cases (n = 1786), and those without MSD constituted as controls (n = 3470). Among the seven field sites, symptomatic giardiasis was 15% and 22% in Asian and African sites, respectively, whereas asymptomatic giardia infection (healthy without MSD) in Asian and African sites was 21.7% and 30.7%, respectively. Wasting and underweight were more frequently associated and stunting less often associated with symptomatic giardiasis (for all, p < 0.001). Symptomatic giardiasis had a significant association with worsening of nutritional status in under-five children. Improved socio-economic profile along with proper sanitation and hygienic practices are imperative to enhance child nutritional status, particularly in resource limited settings.
      Citation: Children
      PubDate: 2021-12-15
      DOI: 10.3390/children8121186
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1187: Somatic and Abdominal Acupuncture for Pain
           Treatment in Adolescent Complex Regional Pain Syndrome (CRPS) of the Upper
           Limb: A Case Report

    • Authors: Giuliano Marchetti, Alessandro Vittori, Ilaria Mascilini, Elisa Francia, Antonella Insalaco, Fabrizio De Benedetti, Sergio Giuseppe Picardo
      First page: 1187
      Abstract: Complex regional pain syndrome (CRPS) is still poorly understood. It is a pain disorder in which pain is disproportionate to the initial stimulus. There is no specific therapy for CRPS, but it can be managed by a combination of treatments. We report a 13-year-old girl with CRPS of the upper limb treated with somatic and abdominal acupuncture. She described a severe, pulsating pain in the left wrist and hand, with hypersensitivity, allodynia, a marked reduction in strength, and swelling and sweating at the level of the fingers. Pain began three months previously, after a trauma to the left wrist. The diagnostic tests performed were negative. At the first visit we recommended oral tramadol. During the first two sessions we used somatic acupuncture. At the third session, the girl reported suffering intolerable pain in the affected limb during the previous sessions, so we decided to use abdominal acupuncture. After 8 sessions of abdominal acupuncture the pain completely disappeared. Acupuncture could be a potential alternative when conservative therapy with physical and medical treatment fails, but more often parents and adolescents prefer this therapy since other comorbidities are often present in pediatric populations and abdominal acupuncture could be a valuable alternative aid.
      Citation: Children
      PubDate: 2021-12-16
      DOI: 10.3390/children8121187
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1188: Cardio-Respiratory Events and Food Autonomy
           Responses to Early Uni-Modal Orofacial Stimulation in Very Premature
           Babies: A Randomized, Controlled Study

    • Authors: Sahra Méziane, Véronique Brévaut-Malaty, Aurélie Garbi, Muriel Busuttil, Gaelle Sorin, Barthélémy Tosello, Catherine Gire
      First page: 1188
      Abstract: Uni-modal orofacial stimulation (OFS) for preventing very preterm infants’ oral disorders is highly controversial. Our study sought to demonstrate that OFS reduced cardio-respiratory events and improved food autonomy in a population of very preterm infants. Our study was randomized, controlled, prospective, and unicentric. The preterm included were born between 26–29 weeks gestational age (GA) with a corrected postnatal age <33 weeks GA. They were randomized into two groups: the experimental group underwent OFS, according to a protocol established, over 10 consecutive days, and the control group underwent no OFS. The primary outcome was the number of cardiorespiratory events: apnea–bradycardia (with or without desaturations) or number of isolated desaturations, which were evaluated at four separate times. Measurements occurred during the first, fourth and eighth independent feedings. Seventeen patients were included in the experimental group and 18 in the control group. The number of cardiorespiratory events for all independent feeding times was significantly reduced in the OFS group (p = 0.003) with univariate analysis, but not with multivariable analysis. The quantity of milk ingested during the first autonomous feeding was higher in the experimental group. The acquisition of food autonomy and the duration of hospitalization were similar in the two groups. While our study does not affirm that an early unimodal OFS improves premature infants’ cardiorespiratory evolution and/or the acquisition of food autonomy, it does indicate an improved food efficiency during their first autonomous feedings.
      Citation: Children
      PubDate: 2021-12-16
      DOI: 10.3390/children8121188
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1189: Evaluation of a Hypersensitivity Inhibitor
           Containing a Novel Monomer That Induces Remineralization—A Case
           Series in Pediatric Patients

    • Authors: Manami Tadano, Aya Yamada, Yuriko Maruya, Ryoko Hino, Tomoaki Nakamura, Seira Hoshikawa, Satoshi Fukumoto, Kan Saito
      First page: 1189
      Abstract: Background: Recently, tooth deformities have been frequently encountered by pediatric dentists. Severe enamel hypomineralization sometimes induces pain such as hyperesthesia, but composite resin restoration is difficult because it often detaches without any cavity preparation. Resin-based hypersensitivity inhibitors for tooth physically seal the dentinal tubules. It was reported that hypersensitivity inhibitor containing novel adhesive monomers forms apatite and induces remineralization in vitro. Therefore, these case series assessed the clinical effects of remineralization and the suppression of hypersensitivity by Bio Coat Ca (Sun Medical, Shiga, Japan). Methods: After mechanical tooth cleaning was performed, the hypersensitivity inhibitors were applied and cured by light exposure. Changes in hypersensitivity were determined by visual analog scale (VAS). The improvement of hypomineralization was evaluated by the change in color tone based on the digital images of intraoral photographs. Results: After repeated monthly treatments, these cases showed decreased hypersensitivity after the fourth application, while the opaque white and brownish color improved on the seventh application. Conclusion: This novel hypersensitivity inhibitor with calcium salt of 4-methacryloxyethyl trimellitic acid (C-MET) and 10-methacryloyloxydecyl dihydrogen calcium phosphate (MDCP) not only suppressed hypersensitivity but also improved cloudiness and brown spots in recently erupted permanent teeth in presented cases.
      Citation: Children
      PubDate: 2021-12-16
      DOI: 10.3390/children8121189
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1190: The Effectiveness of an Integrated Treatment
           

    • Authors: Denise I. Siemons-Lühring, Harald A. Euler, Philipp Mathmann, Boris Suchan, Katrin Neumann
      First page: 1190
      Abstract: Background: The treatment of functional speech sound disorders (SSDs) in children is often lengthy, ill-defined, and without satisfactory evidence of success; effectiveness studies on SSDs are rare. This randomized controlled trial evaluates the effectiveness of the integrated SSD treatment program PhonoSens, which focuses on integrating phonological and phonetic processing according to the Integrated Psycholinguistic Model of Speech Processing (IPMSP). Methods: Thirty-two German-speaking children aged from 3.5 to 5.5 years (median 4.6) with functional SSD were randomly assigned to a treatment or a wait-list control group with 16 children each. All children in the treatment group and, after an average waiting period of 6 months, 12 children in the control group underwent PhonoSens treatment. Results: The treatment group showed more percent correct consonants (PCC) and a greater reduction in phonological processes after 15 therapy sessions than the wait-list control group, both with large effect sizes (Cohen’s d = 0.89 and 1.04). All 28 children treated achieved normal phonological abilities: 21 before entering school and 7 during first grade. The average number of treatment sessions was 28; the average treatment duration was 11.5 months. Conclusion: IPMSP-aligned therapy is effective in the treatment of SSD and is well adaptable for languages other than German.
      Citation: Children
      PubDate: 2021-12-16
      DOI: 10.3390/children8121190
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1191: Human Microbiome in Children, at the
           Crossroad of Social Determinants of Health and Personalized Medicine

    • Authors: Talía Sainz, Valeria Pignataro, Donato Bonifazi, Simona Ravera, María José Mellado, Antonio Pérez-Martínez, Adela Escudero, Adriana Ceci, Cristina Calvo
      First page: 1191
      Abstract: The evolving field of microbiome research offers an excellent opportunity for biomarker identification, understanding drug metabolization disparities, and improving personalized medicine. However, the complexities of host–microbe ecological interactions hinder clinical transferability. Among other factors, the microbiome is deeply influenced by age and social determinants of health, including environmental factors such as diet and lifestyle conditions. In this article, the bidirectionality of social and host–microorganism interactions in health will be discussed. While the field of microbiome-related personalized medicine evolves, it is clear that social determinants of health should be mitigated. Furthermore, microbiome research exemplifies the need for specific pediatric investigation plans to improve children’s health.
      Citation: Children
      PubDate: 2021-12-16
      DOI: 10.3390/children8121191
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1192: A Case of William’s Syndrome in a
           Ugandan Child: A Feasible Diagnosis Even in a Low-Resource Setting

    • Authors: Massimo Mapelli, Paola Zagni, Valeria Calbi, Aliku Twalib, Roberto Ferrara, Piergiuseppe Agostoni
      First page: 1192
      Abstract: Background: Williams–Beuren syndrome (WS) is a rare, complex, congenital developmental disorder including cardiovascular manifestations, intellectual disability and a peculiar cognitive and behavior profile. Supravalvular aortic stenosis (SVAS) is the most frequent cardiovascular abnormality in WS children. Data on WS patients in sub-Saharan Africa are scarce. A genetic study is usually required for a definite diagnosis, but genetic testing is often unavailable in developing countries and the combination of a typical clinical phenotype and echocardiographic profile helps to confirm the diagnosis. Case Report: We report the case of a 5-year-old Ugandan child admitted to a large no profit hospital after he was initially managed as a case of infective endocarditis. A physical examination revealed the typical features of WS. A cardiac echo showed severe SVAS (peak gradient 80 mmHg) with a normal anatomy and function of the aortic valve and mild valvular pulmonary stenosis. The child also had a moderate intellectual disability and a characteristic facies consistent with WS. Conclusion: We present the first reported case of WS in Uganda. Cardiac echo and a characteristic clinical picture could be enough to exclude more common causes of heart failure (i.e., rheumatic heart disease) and to make the diagnosis even when specific genetic tests are not available.
      Citation: Children
      PubDate: 2021-12-16
      DOI: 10.3390/children8121192
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1193: Allergic Comorbidity Is a Risk Factor for
           Not Attending Scheduled Outpatient Visits in Children with Asthma

    • Authors: Kalle Garpvall, Marie Hauerslev, Mads Marckmann, Mette N. Hermansen, Kirsten S. Hansen, Bo L. Chawes
      First page: 1193
      Abstract: Asthma is one of the most common chronic diseases in children globally. Previous studies have shown that not attending asthma primary care consultations is associated with poorer treatment adherence and increased risk of loss of asthma control on a short-term basis. Here, we investigated long-term patterns and predictors of not attending scheduled asthma outpatient visits during 5-years of follow-up in 146 children with asthma. Of the 146 children, 67 (46%) did not attend at least one scheduled appointment, amounting to a total of 122 (10.8%) missed of 1133 scheduled appointments. In a multivariate analysis adjusting for total scheduled visits in the 5-year period any allergic sensitization was a significant risk factor for not attending ≥1 scheduled appointment (aOR = 6.6 (95% CI, 1.3–39.7), p = 0.03), which was not the case for asthma treatment step or lung function. Furthermore, atopic predisposition decreased the risk of non-attendance (aOR = 0.36 (0.13–0.92), p = 0.04). We found no association between non-attendance, treatment adherence or loss of asthma control. This study highlights that allergic comorbidity, but not degree of asthma severity, identifies a group of children with asthma who are prone to not attend scheduled outpatient appointments.
      Citation: Children
      PubDate: 2021-12-16
      DOI: 10.3390/children8121193
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1194: Improving Newborn Resuscitation by Making
           Every Birth a Learning Event

    • Authors: Kourtney Bettinger, Eric Mafuta, Amy Mackay, Carl Bose, Helge Myklebust, Ingunn Haug, Daniel Ishoso, Jackie Patterson
      First page: 1194
      Abstract: One third of all neonatal deaths are caused by intrapartum-related events, resulting in neonatal respiratory depression (i.e., failure to breathe at birth). Evidence-based resuscitation with stimulation, airway clearance, and positive pressure ventilation reduces mortality from respiratory depression. Improving adherence to evidence-based resuscitation is vital to preventing neonatal deaths caused by respiratory depression. Standard resuscitation training programs, combined with frequent simulation practice, have not reached their life-saving potential due to ongoing gaps in bedside performance. Complex neonatal resuscitations, such as those involving positive pressure ventilation, are relatively uncommon for any given resuscitation provider, making consistent clinical practice an unrealistic solution for improving performance. This review discusses strategies to allow every birth to act as a learning event within the context of both high- and low-resource settings. We review strategies that involve clinical-decision support during newborn resuscitation, including the visual display of a resuscitation algorithm, peer-to-peer support, expert coaching, and automated guidance. We also review strategies that involve post-event reflection after newborn resuscitation, including delivery room checklists, audits, and debriefing. Strategies that make every birth a learning event have the potential to close performance gaps in newborn resuscitation that remain after training and frequent simulation practice, and they should be prioritized for further development and evaluation.
      Citation: Children
      PubDate: 2021-12-16
      DOI: 10.3390/children8121194
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1195: Effectiveness of Hypnoanalgesia in
           Paediatric Dermatological Surgery

    • Authors: Peláez Pérez Juana María, Sánchez Casado Marcelino, Quintana Díaz Manuel, Benhaiem Jean Marc, Escribá Alepuz Francisco Javier
      First page: 1195
      Abstract: Background and objective. Stress in surgical settings has subtle psychological and physiological repercussions in children. The objective is to evaluate whether hypnosedation is effective in reducing the doses of sedation and analgesia required during the periprocedural period in children undergoing dermatological surgery, without negatively affecting pain and satisfaction. Patients and methods: A prospective, longitudinal, observational study where paediatric patients (aged 5–16 years) scheduled for dermatological surgery were analysed according to whether they received hypnosis or distraction during surgery (both common procedures at the centre). As outcome measurements we used sedation doses (propofol) during surgery and the need for analgesia; pain assessment post-surgery and at 24 h using a visual analogue scale (VAS) or revised face pain scale (FPS-r) (both 0–10) depending on age, as well as patient and guardian satisfaction (on a scale of 0–10). Results: Of the 68 patients eligible during the follow-up period, 65 were included. Of these, 33 were treated with hypnosis and 32 with distraction. Children who underwent hypnosis required less total propofol (45.5 ± 11.8 mg vs. 69.3 ± 16.8 mg; p < 0.001) and metamizole in the immediate postoperative period (34.4% vs. 65.6%; p = 0.018). After 24 h, they required less ibuprofen (9.1% vs. 28.1%; p = 0.048) and paracetamol (48.5% vs. 75.0%; p = 0.028). Mean pain according to VAS or FPS-r at 24 h was 3.1 with hypnosis vs. 4.3 with distraction (p < 0.001). Overall satisfaction was higher in the hypnosis group (8.7 ± 0.1 vs. 8.1 ± 0.2; p = 0.009). Conclusions: Hypnoanalgesia in children undergoing dermatological outpatient surgery could not only reduce sedation and analgesia requirements, but also improve child and guardian(s) satisfaction.
      Citation: Children
      PubDate: 2021-12-17
      DOI: 10.3390/children8121195
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1196: Assessment of Platelet Mitochondrial
           Respiration in a Pediatric Population: A Pilot Study in Healthy Children
           and Children with Acute Lymphoblastic Leukemia

    • Authors: Theia Lelcu, Anca M. Bînă, Maria D. Dănilă, Călin M. Popoiu, Oana M. Aburel, Smaranda T. Arghirescu, Claudia Borza, Danina M. Muntean
      First page: 1196
      Abstract: Characterization of mitochondrial respiration in peripheral blood cells has recently emerged as a potential biomarker for the assessment of the severity of hematological malignancies (HM) in adults. Whether changes in platelet respiratory function occur in children with or without HM it is unknown. The present pilot study was double-aimed: (i) to investigate whether platelet respiration is age-dependent in non-HM children and (ii) to assess the platelet mitochondrial respiration in children with newly diagnosed acute lymphoblastic leukemia (ALL). Blood samples obtained from age-grouped children (10–11, 13–14 and 16–17 years) with non-HM and children with ALL (10–11 years) were used to isolate platelets via differential centrifugation. High-resolution respirometry studies of isolated platelets were performed according to a protocol adapted to evaluate complex I and II-supported respiration. An age-related decrease in respiration was observed in the non-HM pediatric population and had comparable values for the 13–14 and 16–17 years. groups. In children with ALL, a significant increase in C I-supported active respiration and decrease in maximal noncoupled respiration were found at the disease onset. In conclusion, in a pediatric population, platelet mitochondrial respiration is age-dependent. Platelet respiratory dysfunction occurs in children with newly-diagnosed ALL, an observation that warrants further investigation of this change as a disease biomarker.
      Citation: Children
      PubDate: 2021-12-17
      DOI: 10.3390/children8121196
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1197: Factors Associated with the Dual Use of
           Electronic Cigarettes and Cigarettes among Thai Undergraduate Students Who
           Smoked Cigarettes

    • Authors: Phantara Chulasai, Purida Vientong, Surarong Chinwong, John J. Hall, Dujrudee Chinwong
      First page: 1197
      Abstract: This study proposed to identify factors associated with the dual use of electronic cigarettes (e-cigarettes) and cigarettes among undergraduate students who smoked cigarettes. This cross-sectional study employed a self-administered, anonymous online questionnaires to collect information from undergraduate smokers in northern Thailand. Of the 494 participants, 82.8% were dual users of e-cigarettes and cigarettes. The two main reasons for using e-cigarettes were an absence of cigarette smoke odor (76.8%) and availability of flavors (70.7%). Undergraduate smokers who initiated smoking at ≥18 years old were more likely to be dual users than those who initiated smoking at younger age (adjusted odds ratio [aOR]: 2.79, 95% confidence intervals [CI]: 1.32–5.89, p = 0.007). Undergraduate smokers who smoked ≥11 cigarettes daily were more likely to be dual users than those who smoked less (aOR: 2.64, 95% CI: 1.52–4.61, p = 0.001). Conversely, undergraduate smokers who had attempted to quit during the past year were less likely to be dual users (aOR: 0.26, 95% CI: 0.12–0.56, p = 0.001). In conclusion, dual use of e-cigarettes and cigarettes among undergraduate smokers was associated with older age at cigarette smoking initiation, a higher number of cigarettes smoked daily, and having no past year’s cigarette quit attempts.
      Citation: Children
      PubDate: 2021-12-17
      DOI: 10.3390/children8121197
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1198: There Is an Inverse Correlation between
           Basic Motor Skills and Overweight in Schoolchildren Aged 8 to 12

    • Authors: Lilyan Vega-Ramirez, Rosa M. Pérez-Cañaveras, Joaquín De Juan Herrero
      First page: 1198
      Abstract: In the last three decades, childhood obesity has become a 21st century epidemic, a product of social development. The purpose of this study was to analyze the repercussions that overweight and obesity have for the basic motor skills of a group of children in primary school, as well as their interrelations. We analyzed a sample of 287 students from Spain, aged between 8 and 12 years. Anthropometric data were taken to determine their Body Mass Index (BMI). A scale of assessment of basic motor skills was used to evaluate their motor skills. The BMI data revealed that 11% of this sample was considered obese, and 26% was overweight. Children showed higher competence in locomotor skills than in object control and turn and rolling skills, for which motor competence levels were lower. Likewise, there was an inverse relationship between BMI and basic motor skills; children with obesity had the lowest levels of motor skills, and there was a significant difference regarding non-obese children (p ≤ 0.05). These results showed that overweight and obese children have lower basic motor skills, which can lead to the abandonment of physical activity and the preference for other activities that reinforce a sedentary lifestyle.
      Citation: Children
      PubDate: 2021-12-18
      DOI: 10.3390/children8121198
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1199: Effects of Physical Exercise on Prosocial
           Behavior of Junior High School Students

    • Authors: Yi Wan, Yue Zhao, Honglian Song
      First page: 1199
      Abstract: Objective: This study aims to investigate whether physical activity can promote students’ prosocial behavior by analyzing the relationship between sports participation and the prosocial behavior of junior high school students. Methods: Based on the 2014–2015 China education panel survey (CEPS), the relationship between regular athletic sports and prosocial behavior was evaluated among eighth-grade students by ordinary least squares (OLS) estimation and propensity score matching (PSM) and the relationship between OLS and PSM was evaluated by Rosenbaum’s bounds test for a robustness test; the observations were analyzed for heterogeneity to identify those who benefit more from sports. Results: The OLS results showed that sporting behavior increased prosocial behavior scores by 4%, and the PSM results showed that regular physical exercise increased students’ prosocial behavior tendencies by over 0.2 standard deviations from the mean prosocial behavior score (standardized). According to the Rosenbaum’s bounds test, the estimates were robust and reliable, and the results of the heterogeneity analysis showed that with males and students whose fathers had more than 9 years of education, the students showed more significant improvements in prosocial behavior. Conclusion: Physical activity has a significant positive effect on students’ prosocial behavior, and gender and the father’s education are significantly related to prosocial behavior.
      Citation: Children
      PubDate: 2021-12-18
      DOI: 10.3390/children8121199
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1200: Pediatric Cardio-Oncology Medicine: A New
           Approach in Cardiovascular Care

    • Authors: Hugo R. Martinez, Gary S. Beasley, Jason F. Goldberg, Mohammed Absi, Kaitlin A. Ryan, Karine Guerrier, Vijaya M. Joshi, Jason N. Johnson, Cara E. Morin, Caitlin Hurley, Ronald Ray Morrison, Parul Rai, Jane S. Hankins, Michael W. Bishop, Brandon M. Triplett, Matthew J. Ehrhardt, Ching-Hon Pui, Hiroto Inaba, Jeffrey A. Towbin
      First page: 1200
      Abstract: Survival for pediatric patients diagnosed with cancer has improved significantly. This achievement has been made possible due to new treatment modalities and the incorporation of a systematic multidisciplinary approach for supportive care. Understanding the distinctive cardiovascular characteristics of children undergoing cancer therapies has set the underpinnings to provide comprehensive care before, during, and after the management of cancer. Nonetheless, we acknowledge the challenge to understand the rapid expansion of oncology disciplines. The limited guidelines in pediatric cardio-oncology have motivated us to develop risk-stratification systems to institute surveillance and therapeutic support for this patient population. Here, we describe a collaborative approach to provide wide-ranging cardiovascular care to children and young adults with oncology diseases. Promoting collaboration in pediatric cardio-oncology medicine will ultimately provide excellent quality of care for future generations of patients.
      Citation: Children
      PubDate: 2021-12-18
      DOI: 10.3390/children8121200
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1201: Neuroleptic Malignant Syndrome in Children
           with Autism Spectrum Disorder (ASD): A Case Report and Brief Review of
           Recent Literature

    • Authors: Stefano Berloffa, Claudia Dosi, Benedetta Tascini, Beatrice Fossati, Ilaria Lupetti, Gabriele Masi
      First page: 1201
      Abstract: Neuroleptic malignant syndrome (NMS) is a rare, life-threatening, idiosyncratic adverse reaction to antipsychotic drugs. Despite the increasing rates in the prescription of antipsychotics in pediatric patients with autism spectrum disorder (ASD), little is known about the occurrence and hallmarks of NMS in this specific population. NMS appears to be part of the larger catatonia domain, based on the frequent relationship between ASD and catatonia, on the shared, when not overlapping, clinical features with malignant catatonia, and on the effectiveness of catatonia treatments on the NMS/MC symptoms. The intrinsic difficulties of exploring NMS in ASD in controlled studies accounts for the subsequent lack of available information. Based on recent reports and on our case report, clinical features of NMS in the pediatric ASD population appear to be the same as the non-ASD population. Further studies are needed to confirm these results.
      Citation: Children
      PubDate: 2021-12-18
      DOI: 10.3390/children8121201
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1202: Association between Sleep Time and Blood
           Pressure in Korean Adolescents: Cross-Sectional Analysis of KNHANES VII

    • Authors: Suk-Won Chang, Ju-Wan Kang
      First page: 1202
      Abstract: Background: Hypertension is highly related to sleep, and there have been a number of studies on sleep deprivation and the occurrence of hypertension. However, there is still insufficient research on the relationship between hypertension and various factors related to sleep. Thus, this study attempted to investigate the relationship between hypertension and sleep time-related variables in Korean adolescents. Methods: A total of 1470 adolescents (709 girls and 761 boys) between 12 and 18 years of age were enrolled through the Seventh Korea National Health and Nutrition Examination Survey (KNHANES VII). The systolic and diastolic blood pressure were measured. Sleep time-related variables such as sleep onset time, wake time, and sleep duration (weekday and weekend, each) were also investigated using a questionnaire. We performed multivariate regression analyses to determine the independent effects of the variables. Results: Systolic blood pressure was negatively correlated with the wake time (r = −0.081; p = 0.002) and sleep onset time (r = −0.088; p = 0.001) on weekends. There was a positive correlation between diastolic blood pressure and weekday sleep onset time (r = 0.158; p = 0.000) and weekend sleep onset time (r = 0.184; p = 0.000). The sleep duration on weekdays and weekends showed a negative correlation (r = −0.136; p = 0.000, r = −0.088; p = 0.001, respectively). In the multivariate linear regression analysis results, the sleep onset time on weekends was significantly correlated with elevated diastolic blood pressure. Conclusions: Delayed sleep onset time on weekends was significantly associated with increased diastolic blood pressure in Korean adolescents. Further investigation is needed to confirm the clinical significance of these findings.
      Citation: Children
      PubDate: 2021-12-18
      DOI: 10.3390/children8121202
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1203: Digital Technologies for Children and
           Parents Sharing Self-Management in Childhood Chronic or Long-Term
           Conditions: A Scoping Review

    • Authors: Jill Edwards, Jenny Waite-Jones, Toni Schwarz, Veronica Swallow
      First page: 1203
      Abstract: Worldwide, the prevalence of chronic (or long-term) conditions in children and young people from birth to 18 years (children) is increasing. Promoting competent and effective self-management skills early in the trajectory is important to improve adherence to treatment and optimise quality of life. Successful self-management, therefore, requires parents and children who are developmentally able to develop a range of complex skills, including the use of digital technologies. This scoping review aimed to identify primary research investigating digital technologies for children and parents sharing self-management in childhood chronic illnesses. A comprehensive search of electronic databases was conducted. Nineteen papers were included, assessed for quality and methodological rigour using the Hawker tool and thematically analysed. Three themes were identified: (i) the feasibility and acceptability of using technology, (ii) the usability of technologies and (iii) the effect of technologies on adherence and self-management skills. The results indicate that technologies such as mobile apps and websites can assist the management of long-term conditions, are an acceptable method of delivering information and can promote the development of effective self-management skills by parents and children. However, future technology design must include children and parents in all stages of development.
      Citation: Children
      PubDate: 2021-12-18
      DOI: 10.3390/children8121203
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1204: The Use of Auto-Titrating Continuous
           Positive Airway Pressure (AutoCPAP) for Obstructive Sleep Apnea Syndrome
           in Children with Obesity

    • Authors: Sarah Benke, Caroline U. A. Okorie, MaryAnne A. Tablizo
      First page: 1204
      Abstract: Background: Positive airway pressure can be an effective and safe therapy for children with obstructive sleep apnea syndrome (OSAS). Few studies have assessed the safety and efficacy of autoCPAP in pediatric patients with obesity. Methods: This was a retrospective chart review of children with obesity (Body Mass Index (BMI) > 99th percentile), ages 2–18, diagnosed with OSAS (Obstructive Apnea-Hypopnea Index (OAHI) > 1/h) and used autoCPAP with 30-day adherence. Exclusion criteria included patients with complex comorbidities. Adherence was defined as autoCPAP use ≥4 h/night for at least 21/30 days. Baseline PSG OAHI was compared to the AHI from the 30-day autoCPAP compliance report. We also compared autoCPAP 30-day 95th percentile pressures with the pressures from PAP titration. Results: The study included 19 children, ranging 5–15 years old. The median BMI was 99.6th percentile and average adherence was 25/30 nights with mean of 7.3 h/night. The median OAHI was 12.3/h on baseline PSG and the 30-day autoCPAP download AHI decreased to 1.7/h. No adverse outcomes were identified. The average difference between 95th percentile autoCPAP pressure and PAP titration pressure was 0.89 cmH20. Conclusion: Our study suggests autoCPAP is effective and safe for the treatment of OSAS in pediatric patients with obesity. Using autoCPAP may reduce delays in treatment. Additional research is needed to verify the long-term effectiveness of autoCPAP in this population.
      Citation: Children
      PubDate: 2021-12-19
      DOI: 10.3390/children8121204
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1205: The Effect of the ‘Touch Screen-Based
           Cognitive Training’ for Children with Severe Cognitive Impairment in
           Special Education

    • Authors: In Young Sung, Jin Sook Yuk, Dae-Hyun Jang, Gijeong Yun, Chunye Kim, Eun Jae Ko
      First page: 1205
      Abstract: Traditional education in special schools have some limitations. We aimed to investigate if the ‘touch screen-based cognitive training’ is feasible and effective for children with severe cognitive impairment (developmental age 18–36 months) in special education. In this case, 29 children were randomly allocated to intervention (n = 17, ‘touch screen-based cognitive training’, 30 min/session, 3 times/week, 12 weeks) and control (n = 12, traditional education) groups. Psychoeducational Profile-Revised (PEP-R), Early Childhood Behavior Questionnaire (ECBQ), Sequenced Language Scale for Infants (SELSI), Pediatric Evaluation of Disability Inventory (PEDI), and Goal Attainment Scale (GAS) were measured before and after 12 weeks of education. The ‘touch screen-based cognitive training’ was applicable in special education. When repeated measures analysis of variance (ANOVA) was used, significant groupⅹtime effect was found for GAS, and significant group effect was found for ECBQ (attentional shifting) and GAS. When adjusting for pre-education measurements, the intervention had a significant effect on the post-education measurements of ECBQ (attentional shifting) and GAS (p < 0.05). No relationship existed between the degree of improvements and the severeness of developmental delay in the measurements. ‘Touch screen-based cognitive training’ in special school was feasible and it improved cognition in children with severe cognitive impairment (developmental age 18–36 months), irrespective of the severeness of the developmental delay.
      Citation: Children
      PubDate: 2021-12-19
      DOI: 10.3390/children8121205
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1206: Rigid Bronchoscopy in Foreign Body
           Aspiration Diagnosis and Treatment in Children

    • Authors: Aleksandra Pietraś, Marcin Markiewicz, Grażyna Mielnik-Niedzielska
      First page: 1206
      Abstract: Foreign body aspiration in children is a common condition and can bring about serious undesired results. Fast and accurate diagnosis and foreign body extraction from airways are essential. We performed a retrospective study on rigid bronchoscopy outcomes due to suspected foreign body aspiration. A total of 66 children were admitted to the Chair and Department of Pediatric Otolaryngology, Phoniatrics and Audiology, Medical University of Lublin between 2015 and 2020 and underwent rigid bronchoscopy in general anesthesia due to suspected foreign body aspiration. We analyzed the data, including patients age and sex, reported complaints, and bronchoscopy findings. Analyzed children were aged from 8 months to 17 years old; 74.24% of them were under 3 years old during the procedure, and most of the operated patients were males. In 36.36% cases, no foreign body was identified, and 57.14% foreign bodies were located in right main bronchus. A total of 80.95% of foreign bodies extracted from airways were organic, mostly nuts. Diagnosis and treatment of suspected foreign body aspiration requires consistent cooperation between pediatricians, pulmonologists, anesthesiologists, and otolaryngologists.
      Citation: Children
      PubDate: 2021-12-20
      DOI: 10.3390/children8121206
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1207: Case Series of Variable Acute Appendicitis
           in Children with SARS-CoV-2 Infection

    • Authors: Arnis Engelis, Liene Smane, Jana Pavare, Astra Zviedre, Timurs Zurmutai, Marisa M. Berezovska, Jurijs Bormotovs, Mohit Kakar, Amulya K. Saxena, Aigars Petersons
      First page: 1207
      Abstract: This case series study consists of six children, aged 5–16 years, admitted to a centralized tertiary paediatric hospital serving a population of 1.9 million with acute appendicitis in the setting of SARS-CoV-2 infection. From the beginning of the pandemic in March 2020 until August 2021, 121 COVID-19-positive children were admitted to the hospital. A total of 49 (40.5%) of these patients presented with gastrointestinal symptoms, of which six were diagnosed with acute appendicitis. Five underwent an appendectomy, while one was treated conservatively. To date, it has been reported that appendicitis may have a plausible association with SARS-CoV-2 infection in children. With COVID-19 cases rising, every medical specialist, including all paediatric surgeons, must be ready to treat common acute diseases with SARS-CoV-2 infection as a comorbidity. Providers should consider testing for this infection in paediatric patients with severe gastrointestinal symptoms. Non-surgical treatment of acute appendicitis in children may gain new importance during and after the COVID-19 pandemic. Further studies are needed to prove the link of causality between COVID-19 and acute appendicitis in children.
      Citation: Children
      PubDate: 2021-12-20
      DOI: 10.3390/children8121207
      Issue No: Vol. 8, No. 12 (2021)
       
  • Children, Vol. 8, Pages 1208: Selective Bronchial Occlusion for Treatment
           of a Bronchopleural Fistula in an Extremely Preterm Infant

    • Authors: Giacomo Simeone Amelio, Mariarosa Colnaghi, Silvia Gulden, Genny Raffaeli, Valeria Cortesi, Ilaria Amodeo, Giacomo Cavallaro, Fabio Mosca, Stefano Ghirardello
      First page: 1208
      Abstract: Neonatal pulmonary air leak commonly occurs as a complication of mechanical ventilation in infants with underlying hyaline membrane disease. They can commonly be managed conservatively or with the application of a chest drain, but some severe cases pose a significant challenge in finding an alternative therapeutic solution. Selective bronchial occlusion represents an unconventional rescue therapy for treating bronchopleural fistula resistant to the standard therapy. A 27-week gestation preterm infant ventilated for respiratory distress syndrome developed tension right-sided pneumothorax. Conventional modalities of treatment were tried and were unsuccessful. Intermittent selective bronchial occlusion with a Fogarty’s catheter and high-frequency oscillatory ventilation resulted in considerable improvement in the infant’s clinical condition and radiographic findings.
      Citation: Children
      PubDate: 2021-12-20
      DOI: 10.3390/children8121208
      Issue No: Vol. 8, No. 12 (2021)
       
 
JournalTOCs
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
Email: journaltocs@hw.ac.uk
Tel: +00 44 (0)131 4513762
 


Your IP address: 54.224.117.125
 
Home (Search)
API
About JournalTOCs
News (blog, publications)
JournalTOCs on Twitter   JournalTOCs on Facebook

JournalTOCs © 2009-