Children

12 pages, 569 KiB

Open AccessArticle

Evaluation of an Early Intervention Model for Child and Adolescent Victims of Interpersonal Violence

by Claudia Calvano, Elena Murray, Lea Bentz, Sascha Bos, Kathrin Reiter, Loretta Ihme and Sibylle M. Winter

Children 2021, 8(10), 941; https://doi.org/10.3390/children8100941 - 19 Oct 2021

Cited by 1 | Viewed by 2456

Abstract

Only the minority of youth exposed to traumatic events receive mental health care, as trauma-informed clinical services are lacking or are poorly accessible. In order to bridge this gap, the Outpatient Trauma Clinic (OTC) was founded, an easily accessible early, short-time intervention, with [...] Read more.

Only the minority of youth exposed to traumatic events receive mental health care, as trauma-informed clinical services are lacking or are poorly accessible. In order to bridge this gap, the Outpatient Trauma Clinic (OTC) was founded, an easily accessible early, short-time intervention, with onward referral to follow-up treatment. This report presents the OTC’s interventional approach and first outcome data. Using a retrospective naturalistic design, we analyzed trauma- and intervention-related data of the sample (n = 377, 55.4% female, mean age 10.95, SD = 4.69). Following drop-out analyses, predictors for treatment outcome were identified by logistic regression. The majority (81.9%) was suffering from posttraumatic stress disorder (PTSD) or adjustment disorders. Around one forth dropped out of treatment; these cases showed higher avoidance symptoms at presentation. In 91%, psychological symptoms improved. Experience of multiple traumatic events was the strongest predictor for poor treatment outcome (B = −0.823, SE = 0.313, OR = 0.439, 95% CI 0.238–0.811). Around two thirds were connected to follow-up treatment. The OTC realized a high retention rate, initial improvement of symptoms and referral to subsequent longer-term psychotherapeutic treatment in the majority. Further dissemination of comparable early intervention models is needed, in order to improve mental health care for this vulnerable group. Full article

(This article belongs to the Special Issue Recent Advances in Child and Adolescent Psychiatry)

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12 pages, 5407 KiB

Open AccessArticle

Novel Neonatal Simulator Provides High-Fidelity Ventilation Training Comparable to Real-Life Newborn Ventilation

by Joanna Haynes, Peder Bjorland, Øystein Gomo, Anastasia Ushakova, Siren Rettedal, Jeffrey Perlman and Hege Ersdal

Children 2021, 8(10), 940; https://doi.org/10.3390/children8100940 - 19 Oct 2021

Cited by 11 | Viewed by 3581

Abstract

Face mask ventilation of apnoeic neonates is an essential skill. However, many non-paediatric healthcare personnel (HCP) in high-resource childbirth facilities receive little hands-on real-life practice. Simulation training aims to bridge this gap by enabling skill acquisition and maintenance. Success may rely on how [...] Read more.

Face mask ventilation of apnoeic neonates is an essential skill. However, many non-paediatric healthcare personnel (HCP) in high-resource childbirth facilities receive little hands-on real-life practice. Simulation training aims to bridge this gap by enabling skill acquisition and maintenance. Success may rely on how closely a simulator mimics the clinical conditions faced by HCPs during neonatal resuscitation. Using a novel, low-cost, high-fidelity simulator designed to train newborn ventilation skills, we compared objective measures of ventilation derived from the new manikin and from real newborns, both ventilated by the same group of experienced paediatricians. Simulated and clinical ventilation sequences were paired according to similar duration of ventilation required to achieve success. We found consistencies between manikin and neonatal positive pressure ventilation (PPV) in generated peak inflating pressure (PIP), mask leak and comparable expired tidal volume (eV_T), but positive end-expiratory pressure (PEEP) was lower in manikin ventilation. Correlations between PIP, eV_T and leak followed a consistent pattern for manikin and neonatal PPV, with a negative relationship between eV_T and leak being the only significant correlation. Airway obstruction occurred with the same frequency in the manikin and newborns. These findings support the fidelity of the manikin in simulating clinical conditions encountered during real newborn ventilation. Two limitations of the simulator provide focus for further improvements. Full article

(This article belongs to the Section Pediatric Neonatology)

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6 pages, 446 KiB

Open AccessPerspective

The Emergence of Planetary Pediatrics

by Charles Oberg

Children 2021, 8(10), 939; https://doi.org/10.3390/children8100939 - 19 Oct 2021

Cited by 1 | Viewed by 1911

Abstract

Pediatrics has witnessed an evolution from primary care, family-centered care, community pediatrics, social pediatrics and global pediatrics, which has shifted our attention beyond the clinic setting to an appreciation of children in their lived environment. We are witnessing the emergence of planetary pediatrics [...] Read more.

Pediatrics has witnessed an evolution from primary care, family-centered care, community pediatrics, social pediatrics and global pediatrics, which has shifted our attention beyond the clinic setting to an appreciation of children in their lived environment. We are witnessing the emergence of planetary pediatrics that further broadens the focus of children’s health to include the continued importance of clinical care, but also the impacts of climate change, environmental degradation, child migration, unrelenting war and conflict, social injustice, pandemics and violence against children. If we do not acknowledge the present and ever-increasing adverse planetary changes of what children are experiencing now and in the future, we will have failed to adequately protect them from impending catastrophes. The hope of pediatrics for the future is to improve the health and well-being of all children. This hope remains as relevant today as it was for our predecessors and serves as a beacon for the voyage through the remainder of the twenty-first century. Full article

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12 pages, 7996 KiB

Open AccessArticle

Epidemiology and Trends over Time of Foreign Body Injuries in the Pediatric Emergency Department

by Honoria Ocagli, Danila Azzolina, Silvia Bressan, Daniele Bottigliengo, Elisabetta Settin, Giulia Lorenzoni, Dario Gregori and Liviana Da Dalt

Children 2021, 8(10), 938; https://doi.org/10.3390/children8100938 - 19 Oct 2021

Cited by 6 | Viewed by 2208

Abstract

This paper presents the epidemiology of foreign body injuries in the Pediatric Emergency Department (PED) of Padova (Italy) along with its trends over an eleven-year period based on administrative data. Annual incidence rates (IRs) of PED presentations for foreign body (FB) injuries per [...] Read more.

This paper presents the epidemiology of foreign body injuries in the Pediatric Emergency Department (PED) of Padova (Italy) along with its trends over an eleven-year period based on administrative data. Annual incidence rates (IRs) of PED presentations for foreign body (FB) injuries per 1000 person-years were calculated. Univariable and multivariable generalized linear (GLM) Poisson models were estimated to evaluate the relationship between FB injury incidence and year, triage priority, nationality, injury site, and FB type. During the study period, there were 217,900 presentations of pediatric residents in the province of Padova; of these, 3084 (1.5%) reported FB injuries involving the ears, nose, throat, gastrointestinal tract or eyes. The annual IR of FB injury episodes increased from 10.45 for 1000 residents in 2007 (95% CI, 9.24, 11.77) to 12.66 for 1000 residents in 2018 (95% CI, 11.35, 14.08). Nonfood items were the FBs that were most frequently reported. The intermediate urgent triage code was the most represented for FB injuries, with IRs ranging from 5.44 (95% CI: 4.59, 6.40) in 2008 to 8.56 in 2018 (95% CI: 7.50, 9.74). A total of 170 patients who presented for FB injuries were hospitalized (5.5%). The annual FB-related injury IR has increased over time, although most episodes are not life threatening. Educational and prevention programs on FB-related injuries should be promoted and dedicated to childcare providers. Full article

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13 pages, 912 KiB

Open AccessArticle

Healthy Habits and Emotional Balance in Women during the Postpartum Period: Differences between Term and Preterm Delivery

by Andrea Gila-Díaz, Gloria Herranz Carrillo, Silvia M. Arribas and David Ramiro-Cortijo

Children 2021, 8(10), 937; https://doi.org/10.3390/children8100937 - 18 Oct 2021

Cited by 11 | Viewed by 3492

Abstract

Breastfeeding could be considered as a vulnerable period, rising the risk to shift from optimism to pessimism. Preterm delivery is an event that increases postpartum maternal stress and depression, which can have a negative impact on breastfeeding and maternal–filial wellbeing. The adherence to [...] Read more.

Breastfeeding could be considered as a vulnerable period, rising the risk to shift from optimism to pessimism. Preterm delivery is an event that increases postpartum maternal stress and depression, which can have a negative impact on breastfeeding and maternal–filial wellbeing. The adherence to healthy habits may have a positive influence on this vulnerable population. We aimed to analyze the impact of prematurity on maternal psychological aspects during postpartum and to study if adherence to the Healthy Food Pyramid influences psychological variables. Fifty-five breastfeeding women being attended in the Hospital Clínico San Carlos (Madrid, Spain) were recruited during the first day postpartum. The medical data were collected from the obstetrical records. The women answered an auto-administered questionnaire with several sections: sociodemographic characteristics, Perceived Stress Scale (PSS), and Life Orientation Test (LOT), at 14 days and 6 months postpartum, Adherence to the Healthy Food Pyramid Questionnaire (AP-Q) at 28 days postpartum and the Edinburgh Postpartum Depression Scale (EPDS) at 6 months postpartum. The PSS and LOT scores were not statistically different in mothers with preterm compared to term delivery either at 14 days or at 6 months postpartum. Longitudinally, the PSS did not show significant differences, but the LOT score was lower at 6 months compared to 14 days postpartum (p-Value = 0.046). A higher EPDS score was significantly found in mothers with preterm delivery (9.0 ± 4.7) than those with a term delivery (5.4 ± 4.2; p-value = 0.040). A significant and positive correlation was observed between the AP-Q score and LOT both at 14 days and 6 months postpartum. Conclusively, maternal optimism decreases during the postpartum period, women with preterm delivery being at risk of postpartum depression. Furthermore, there is a relationship between optimism and adherence to healthy habits. Healthcare professional counseling is essential during the entire breastfeeding period, particularly in vulnerable mothers with preterm delivery. Full article

(This article belongs to the Special Issue The Impact of Breastfeeding on Maternal, Child and Organizations Health)

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4 pages, 182 KiB

Open AccessBrief Report

In-Silico Evaluation of Anthropomorphic Measurement Variations on Electrical Cardiometry in Neonates

by David B. Healy, Eugene M. Dempsey, John M. O’Toole and Christoph E. Schwarz

Children 2021, 8(10), 936; https://doi.org/10.3390/children8100936 - 18 Oct 2021

Cited by 5 | Viewed by 1787

Abstract

Non-invasive cardiac output methods such as Electrical Cardiometry (EC) are relatively novel assessment tools for neonates and they enable continuous monitoring of stroke volume (SV). An in-silico comparison of differences in EC-derived SV in relation to preset length and weight was performed. EC [...] Read more.

Non-invasive cardiac output methods such as Electrical Cardiometry (EC) are relatively novel assessment tools for neonates and they enable continuous monitoring of stroke volume (SV). An in-silico comparison of differences in EC-derived SV in relation to preset length and weight was performed. EC (ICON, Osypka Medical) was simulated using the “demo” mode for various combinations of length and weight representative of term and preterm infants. One-centimetre length error resulted in a SV-change of 1.8–3.6% (preterm) or 1.6–2.0% (term) throughout the tested weight ranges. One-hundred gram error in weight measurement resulted in a SV-change of 5.0–7.1% (preterm) or 1.5–1.8% (term) throughout the tested length ranges. Algorithms to calculate EC-derived SV incorporate anthropomorphic measurements. Therefore, inaccuracy in physical measurement can impact absolute EC measurements. This should be considered in the interpretation of previous findings and the design of future clinical studies of EC-derived cardiac parameters in neonates, particularly in the preterm cohorts where a proportional change was noted to be greatest. Full article

(This article belongs to the Special Issue Stabilization and Resuscitation of Newborns)

12 pages, 914 KiB

Open AccessArticle

Amblyopia and Routine Eye Exam in Children: Parent’s Perspective

by Alhanouf Alatawi, Naif Alali, Abrar Alamrani, Faris Hashem, Seham Alhemaidi, Shaker Alreshidi and Hani Albalawi

Children 2021, 8(10), 935; https://doi.org/10.3390/children8100935 - 18 Oct 2021

Cited by 11 | Viewed by 3351

Abstract

Amblyopia is a reduced best-corrected visual acuity of one or both eyes that cannot be attributed to a structural abnormality; it is a functional reduction in the vision of an eye caused by disuse during a critical period of visual development. It is [...] Read more.

Amblyopia is a reduced best-corrected visual acuity of one or both eyes that cannot be attributed to a structural abnormality; it is a functional reduction in the vision of an eye caused by disuse during a critical period of visual development. It is considered the leading cause of visual defects in children. With early diagnosis and treatment, children with amblyopia can significantly improve their vision. However, if it is neglected and not treated during childhood, unfortunately, it permanently decreases vision. Therefore, prevention, detection, and treatment largely depend on parents. This article explores parents’ perspectives on amblyopia and routine examination of their children’s eyes. A cross-sectional study used an electronic questionnaire consisting of five main sections to assess the level of awareness of amblyopia among parents. As a result, a total of 325 participants were included in our analysis. 209 (64.3%) were mothers, and 116 (35/7%) were fathers. The age groups were 35–50 years of age (61.5%), 20–34 years (23.4%), and older than 50 years (15%). Participants with a history of amblyopia numbered 23 (7.1%), and 39 had an amblyopic child (12%). A good awareness level of amblyopia among parents was found in only 10 (3%) participants, a fair awareness level in 202 (62%), and 113 (35%) participants were classified as having a poor awareness level of amblyopia. Only 13.8% of the parents took their children for yearly routine eye exams, while the majority (72%) took their children only if they had a complaint, and 14.2% took them for eye checkups only before school entry. In conclusion, parents’ awareness of amblyopia in Tabuk City, KSA, was low. In addition, a limited proportion of parents reported consistently taking their children for routine eye exams. Therefore, raising awareness should be considered in public education regarding the disease. Full article

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21 pages, 4858 KiB

Open AccessArticle

Estimating Growth in Height from Limited Longitudinal Growth Data Using Full-Curves Training Dataset: A Comparison of Two Procedures of Curve Optimization—Functional Principal Component Analysis and SITAR

by Miroslav Králík, Ondřej Klíma, Martin Čuta, Robert M. Malina, Sławomir Kozieł, Lenka Polcerová, Anna Škultétyová, Michal Španěl, Lubomír Kukla and Pavel Zemčík

Children 2021, 8(10), 934; https://doi.org/10.3390/children8100934 - 18 Oct 2021

Cited by 5 | Viewed by 2504

Abstract

A variety of models are available for the estimation of parameters of the human growth curve. Several have been widely and successfully used with longitudinal data that are reasonably complete. On the other hand, the modeling of data for a limited number of [...] Read more.

A variety of models are available for the estimation of parameters of the human growth curve. Several have been widely and successfully used with longitudinal data that are reasonably complete. On the other hand, the modeling of data for a limited number of observation points is problematic and requires the interpolation of the interval between points and often an extrapolation of the growth trajectory beyond the range of empirical limits (prediction). This study tested a new approach for fitting a relatively limited number of longitudinal data using the normal variation of human empirical growth curves. First, functional principal components analysis was done for curve phase and amplitude using complete and dense data sets for a reference sample (Brno Growth Study). Subsequently, artificial curves were generated with a combination of 12 of the principal components and applied for fitting to the newly analyzed data with the Levenberg–Marquardt optimization algorithm. The approach was tested on seven 5-points/year longitudinal data samples of adolescents extracted from the reference sample. The samples differed in their distance from the mean age at peak velocity for the sample and were tested by a permutation leave-one-out approach. The results indicated the potential of this method for growth modeling as a user-friendly application for practical applications in pediatrics, auxology and youth sport. Full article

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11 pages, 3632 KiB

Open AccessArticle

Diagnosis and Treatment for Pediatric Supracondylar Humerus Fractures with Brachial Artery Injuries

by Tu Ngoc Vu, Son Hong Duy Phung, Long Hoang Vo and Uoc Huu Nguyen

Children 2021, 8(10), 933; https://doi.org/10.3390/children8100933 - 18 Oct 2021

Cited by 8 | Viewed by 3930

Abstract

(1) Background: This study aims to describe the clinical and paraclinical characteristics of and the diagnostic approach to brachial artery injuries in pediatric supracondylar humerus fractures, as well as to evaluate intraoperative vascular anatomical lesions and early postoperative results. (2) Methods: A retrospective, [...] Read more.

(1) Background: This study aims to describe the clinical and paraclinical characteristics of and the diagnostic approach to brachial artery injuries in pediatric supracondylar humerus fractures, as well as to evaluate intraoperative vascular anatomical lesions and early postoperative results. (2) Methods: A retrospective, hospital-based analysis of medical records at Viet Duc University Hospital (Vietnam), using a sample of children under 16 years who met the diagnostic criteria for supracondylar humerus fractures with brachial artery injuries between January 2016 and December 2020, was performed. A total of 50 patients were included in the analysis. (3) Results: Out of 50 pediatric patients, 36 patients were male (72%) and the mean age was 5.85 years (range, 1.5–14 years). Before treatment, there were 46 patients with severely displaced fractures which were classified as Gartland type III (92%). Following casting, the percentage of those with severely displaced fractures was reduced significantly to 12%, while there were no patients with Gartland type III fractures after percutaneous pinning. Doppler sonography failed to assess vascular lesions at the fracture site before and after casting in most patients. Two-thirds of surgical cases had only vasospasm, without physical damage to the vessel wall or intravascular thrombosis. Preoperative Doppler spectrum analysis was not consistent with the severity of intraoperative brachial artery injury. Out of 24 patients with vasospasm, we performed vascular blockade using papaverin in 11 cases and intraoperative balloon angioplasty of the brachial artery using the Fogarty catheter in 13 cases. Brachial artery graft was performed with 12 patients who had anatomical damage to the vascular wall. A complication of embolism occurred in one patient immediately after surgery, and two patients had superficial infections. One month following surgery, 2 out of 36 patients had a temporary loss of sensation in the area of incision. (4) Conclusions: Most pediatric patients did not present with symptoms of critical limb ischemia similar to those associated with lower extremity vascular injuries. The diagnosis and treatment of pediatric supracondylar humerus fractures with vascular injury is difficult and time-consuming, especially in cases of transverse fractures. Full article

(This article belongs to the Special Issue Pediatric Fractures)

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16 pages, 291 KiB

Open AccessArticle

Exploring the Relation between Atopic Diseases and Lifestyle Patterns among Adolescents Living in Greece: Evidence from the Greek Global Asthma Network (GAN) Cross-Sectional Study

by George Antonogeorgos, Kostas N. Priftis, Demosthenes B. Panagiotakos, Philippa Ellwood, Luis García-Marcos, Evangelia Liakou, Alexandra Koutsokera, Pavlos Drakontaeidis, Dafni Moriki, Marina Thanasia, Maria Mandrapylia and Konstantinos Douros

Children 2021, 8(10), 932; https://doi.org/10.3390/children8100932 - 18 Oct 2021

Cited by 12 | Viewed by 2792

Abstract

Introduction: Diet and physical activity might be associated with the risk of allergic diseases in childhood. However, evidence in literature is sparse and diverse. We aim to examine the associations between four healthy dietary consumption pattern drinks, plus the adherence to a physically [...] Read more.

Introduction: Diet and physical activity might be associated with the risk of allergic diseases in childhood. However, evidence in literature is sparse and diverse. We aim to examine the associations between four healthy dietary consumption pattern drinks, plus the adherence to a physically active lifestyle with atopic diseases (asthma, allergic rhinitis and eczema) in adolescence and their relative importance. Methods: A total of 1934 adolescents (921 boys, 47.5%) and their parents completed a validated questionnaire assessing atopic diseases’ symptoms prevalence in the past 12 months, as well as nutritional and physical activity information. Four healthy dietary and one physical active lifestyle patterns were identified and logistic regression was applied to assess their relation with allergic diseases. Results: A high weekly consumption of fruits, vegetables and pulses and low consumption of unhealthy foods was negatively associated with all atopic symptoms while adherence to a physical active lifestyle was inversely associated with asthma and allergic rhinitis symptoms and dairy products with asthma and eczema symptoms in the past 12 months after adjustment for several confounders (all p < 0.05). Fruits, vegetables and pulses consumption per week emerged as the most important lifestyle pattern negatively associated for all atopic diseases, after the adjustment for all the remaining lifestyle patterns and confounders (all p < 0.05) Conclusions: Our findings suggest that a high fruit, vegetable and pulse intake should be the first lifestyle intervention every clinician and public health care worker evolving in the management of atopic adolescents should encourage and promote. Full article

(This article belongs to the Section Global Pediatric Health)

12 pages, 665 KiB

Open AccessArticle

Socioeconomic Factors and Quality of Life Perceived by Parents and Children with Complex Chronic Conditions in Spain

by Bibiana Pérez-Ardanaz, María José Peláez-Cantero, José Miguel Morales-Asencio, Concepción Vellido-González, Alberto Gómez-González, Álvaro León-Campos and Laura Gutiérrez-Rodríguez

Children 2021, 8(10), 931; https://doi.org/10.3390/children8100931 - 17 Oct 2021

Cited by 5 | Viewed by 1959

Abstract

Health-related quality of life of children with complex chronic conditions could be affected by sociodemographic factors. Most studies focus exclusively on the parents’ perceptions of quality of life. This study aimed to determine the health-related quality of life of these children, according to [...] Read more.

Health-related quality of life of children with complex chronic conditions could be affected by sociodemographic factors. Most studies focus exclusively on the parents’ perceptions of quality of life. This study aimed to determine the health-related quality of life of these children, according to their parents and the children themselves. A cross-sectional study was developed on children aged over five years with complex chronic conditions. Health-related quality of life, educational attainment, and social status were evaluated. A total of 101 children were included with a mean age of 10.48 years, and 35.6% were female. The most frequent disease was oncological (28.7%). Children perceived a better health-related quality of life, compared to their parents’ assessment: median difference −8.4 (95%CI: −9.2 to −3.8). Moreover, differences were observed by socioeconomic factors. Parents and children with complex chronic conditions perceive differently the health-related quality of life. Social determinants associate with an uneven perceived quality of life. Full article

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14 pages, 301 KiB

Open AccessArticle

Parental Internalizing Psychopathology and PTSD in Offspring after the 2012 Earthquake in Italy

by Barbara Forresi, Marcella Caputi, Simona Scaini, Ernesto Caffo, Gabriella Aggazzotti and Elena Righi

Children 2021, 8(10), 930; https://doi.org/10.3390/children8100930 - 17 Oct 2021

Cited by 7 | Viewed by 2481

Abstract

Post-traumatic stress disorder (PTSD) is common in youths after earthquakes, with parental psychopathology among the most significant predictors. This study investigated the contribution and the interactional effects of parental internalizing psychopathology, the severity of exposure to the earthquake, and past traumatic events to [...] Read more.

Post-traumatic stress disorder (PTSD) is common in youths after earthquakes, with parental psychopathology among the most significant predictors. This study investigated the contribution and the interactional effects of parental internalizing psychopathology, the severity of exposure to the earthquake, and past traumatic events to predict PTSD in offspring, also testing the reverse pattern. Two years after the 2012 earthquake in Italy, 843 children and adolescents (9–15 years) living in two differently affected areas were administered a questionnaire on traumatic exposure and the UCLA PTSD Reaction Index. Anxiety, depression, and somatization were assessed in 1162 parents through the SCL-90-R. General linear model showed that, for offspring in the high-impact area, predictors of PTSD were earthquake exposure, past trauma, and parental internalizing symptoms, taken individually. An interaction between earthquake exposure and parental depression or anxiety (not somatization) was also found. In the low-impact area, youth PTSD was only predicted by earthquake exposure. The reverse pattern was significant, with parental psychopathology explained by offspring PTSD. Overall, findings support the association between parental and offspring psychopathology after natural disasters, emphasizing the importance of environmental factors in this relationship. Although further research is needed, these results should be carefully considered when developing mental health interventions. Full article

(This article belongs to the Special Issue Recent Advances in Child and Adolescent Psychiatry)

9 pages, 480 KiB

Open AccessArticle

Can AI Help Pediatricians? Diagnosing Kawasaki Disease Using DRSA

by Bartosz Siewert, Jerzy Błaszczyński, Ewelina Gowin, Roman Słowiński and Jacek Wysocki

Children 2021, 8(10), 929; https://doi.org/10.3390/children8100929 - 17 Oct 2021

Viewed by 2232

Abstract

The DRSA method (dominance-based rough set approach) was used to create decision-making rules based on the results of physical examination and additional laboratory tests in the differential diagnosis of Kawasaki disease (KD), infectious mononucleosis and S. pyogenes pharyngitis in children. The study was [...] Read more.

The DRSA method (dominance-based rough set approach) was used to create decision-making rules based on the results of physical examination and additional laboratory tests in the differential diagnosis of Kawasaki disease (KD), infectious mononucleosis and S. pyogenes pharyngitis in children. The study was conducted retrospectively. The search was based on the ICD-10 (International Classification of Diseases) codes of final diagnosis. Demographic and laboratory data from one Polish hospital (Poznan) were collected. Traditional statistical methods and the DRSA method were applied in data analysis. The algorithm formed 45 decision rules recognizing KD. The rules with the highest sensitivity (number of false negatives equals zero) were based on the presence of conjunctivitis and CRP (C-reactive Protein) ≥ 40.1 mg/L, thrombocytosis and ESR (Erythrocyte Sedimentation Rate) ≥ 77 mm/h; fair general condition and fever ≥ 5 days and rash; fair general condition and fever ≥ 5 days and conjunctivitis; fever ≥ 5 days and rash and CRP ≥ 7.05 mg/L. The DRSA analysis may be helpful in diagnosing KD at an early stage of the disease. It can be used even with a small amount of clinical or laboratory data. Full article

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2 pages, 184 KiB

Open AccessEditorial

Parenting and Health: The Major Challenge of Complex Relations

by Dora Pereira

Children 2021, 8(10), 928; https://doi.org/10.3390/children8100928 - 17 Oct 2021

Cited by 2 | Viewed by 1693

Abstract

Parenting is an interpersonal process associated with taking care and fostering the healthy development of children and young people [...] Full article

(This article belongs to the Special Issue Parenting in Face of Health Challenges: Research and Interventions)

9 pages, 276 KiB

Open AccessArticle

Obstetric Outcomes in the Surviving Fetus after Intrauterine Fetal Death in Bichorionic Twin Gestations

by María de la Calle, Jose L. Bartha, Henar Serrano and David Ramiro-Cortijo

Children 2021, 8(10), 927; https://doi.org/10.3390/children8100927 - 16 Oct 2021

Cited by 2 | Viewed by 2918

Abstract

Twin pregnancies are high-risk gestations that increase the odds of obstetrical complications. They can also present specific and rare complications such as single intrauterine fetal death (IUFD). This complication has been extensively studied in monochorionic but not in bichorionic gestations. Today, the repercussions [...] Read more.

Twin pregnancies are high-risk gestations that increase the odds of obstetrical complications. They can also present specific and rare complications such as single intrauterine fetal death (IUFD). This complication has been extensively studied in monochorionic but not in bichorionic gestations. Today, the repercussions of IUFD may have on the surviving fetus, mother and bichorionic pregnancy are not known. Our objective was to study materno-obstetrical, fetal, and immediate delivery neonatal complications in bichorionic twin gestations with single IUFD compared to those with both fetuses alive. A retrospective and observational case-control study was performed in bichorionic biamniotic twin pregnancies, 22 complicated with single IUFD after 14 weeks (cases; IUFD group) and 51 with both fetuses alive (controls; non-IUFD group, from Obstetrics Service of La Paz Hospital (Madrid, Spain). The data were collected from obstetrical records. No significant differences were found in the rates of gestational diabetes, gestational hypertension, preeclampsia, neonatal complications, and prematurity between IUFD and non-IUFD groups. Statistical differences were found for the incidence of intrauterine growth restriction in the surviving fetus compared to first fetus of pregnancy with both fetuses alive (22.7% versus 2.0%, respectively; p-value = 0.012). There were no differences compared to second fetus (11.8%; p-value = 0.23). There was a high C-section rate in both groups (IUFD = 63.6%, non-IUFD = 64.7%; p-value = 0.19). In conclusion, single IUFD in bichorionic biamniotic twin gestations is a rare complication that should be closely monitored. It is essential that these gestations be attended by a clinical multidisciplinary team. Full article

(This article belongs to the Special Issue Parenting in Face of Health Challenges: Research and Interventions)

18 pages, 18892 KiB

Open AccessArticle

Complex Evaluation of Tissue Factors in Pediatric Cholesteatoma

by Kristaps Dambergs, Gunta Sumeraga and Māra Pilmane

Children 2021, 8(10), 926; https://doi.org/10.3390/children8100926 - 16 Oct 2021

Cited by 4 | Viewed by 2470

Abstract

The aim of this study was to describe the appearance and distribution of tissue remodeling markers (MMP-2, MMP-9, TIMP-2, TIMP-4), Sonic hedgehog gene protein (Shh), pro- and anti-inflammatory cytokines (IL–1, IL–10), transcription factor (NF-κβ), proliferation marker (Ki–67), angiogenetic factor (VEGF), tissue defensins (HβD–2, [...] Read more.

The aim of this study was to describe the appearance and distribution of tissue remodeling markers (MMP-2, MMP-9, TIMP-2, TIMP-4), Sonic hedgehog gene protein (Shh), pro- and anti-inflammatory cytokines (IL–1, IL–10), transcription factor (NF-κβ), proliferation marker (Ki–67), angiogenetic factor (VEGF), tissue defensins (HβD–2, HβD–4) of the pediatric cholesteatoma. Sixteen cholesteatoma samples were obtained from children, eleven skin controls from cadavers. Tissues were stained for MMP-2, MMP-9, TIMP-2, TIMP-4, Shh, IL–1, IL–10, NF-κβ, Ki–67, VEGF, HβD–2, HβD–4. Non-parametric statistic, Mann–Whitney, and Spearman’s coefficient was used. A statistically significant difference was seen between Shh and HβD–2 in perimatrix and control connective tissue, between NF-κβ in cholesteatoma and control skin, and between HβD–4 in matrix and skin epithelium. Complex intercorrelations between MMPs, NF-κβ and VEGF cause the intensification of angiogenesis in cholesteatoma. The persistent increase in Shh gene protein expression in cholesteatoma perimatrix suggests the stimulation of the cholesteatoma growth in children. Similar expression of IL-1 and IL-10 and their intercorrelation, proves there is a balance between pro- and anti-inflammatory cytokines. NF-κβ, and not Ki-67, seems to be the main inducer of cellular proliferation. The main antimicrobial protection is provided by HβD-2. Full article

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16 pages, 313 KiB

Open AccessArticle

Adolescents’ Online Pornography Exposure and Its Relationship to Sociodemographic and Psychopathological Correlates: A Cross-Sectional Study in Six European Countries

by Elisabeth K. Andrie, Irene Ikbale Sakou, Eleni C. Tzavela, Clive Richardson and Artemis K. Tsitsika

Children 2021, 8(10), 925; https://doi.org/10.3390/children8100925 - 16 Oct 2021

Cited by 24 | Viewed by 8804

Abstract

The aim of the study was to assess the prevalence of online exposure to pornography in European adolescents and its relationship to sociodemographic and psychopathological correlates. A cross-sectional school-based survey of 10,930 adolescents (5211 males/5719 females), aged 14–17 years old (mean age 15.8 [...] Read more.

The aim of the study was to assess the prevalence of online exposure to pornography in European adolescents and its relationship to sociodemographic and psychopathological correlates. A cross-sectional school-based survey of 10,930 adolescents (5211 males/5719 females), aged 14–17 years old (mean age 15.8 ± 0.7) was carried out in six European countries (Greece, Spain, Poland, Romania, the Netherlands, and Iceland). Anonymous self-completed questionnaires covered exposure to pornography, internet use and dysfunctional internet behavior, and psychopathological syndromes (measured by Achenbach’s Youth Self-Report). The prevalence of any online exposure to pornography was 59% overall and 24% for exposure at least once a week. The likelihood of online exposure to pornography was greater in male adolescents, heavier internet users, and those who displayed dysfunctional internet behavior. Country-specific analyses confirmed that the gender effect existed in every country, although its strength varied, from an odds ratio of 1.88 in Poland to 14.9 in Greece. Online exposure to pornography was shown to be associated with externalizing problem scale scores, especially rule-breaking and aggressive behavior, but also associated with higher scores in competences, namely activities and social competence. Exposure to pornography is ubiquitous, more relevant to boys, and is associated with both positive qualities/competences and externalizing behavioral problems. Full article

(This article belongs to the Special Issue New Frontiers in Adolescent Health and Development)

13 pages, 280 KiB

Open AccessReview

Invasive Infections Associated with the Use of Probiotics in Children: A Systematic Review

by Martina D’Agostin, Domenica Squillaci, Marzia Lazzerini, Egidio Barbi, Lotte Wijers and Prisca Da Lozzo

Children 2021, 8(10), 924; https://doi.org/10.3390/children8100924 - 16 Oct 2021

Cited by 22 | Viewed by 3561

Abstract

Although the effectiveness of probiotics has only been proven in specific conditions, their use in children is massively widespread because of their perception as harmless products. Recent evidence raises concerns about probiotics’ safety, especially but not only in the paediatric population due to [...] Read more.

Although the effectiveness of probiotics has only been proven in specific conditions, their use in children is massively widespread because of their perception as harmless products. Recent evidence raises concerns about probiotics’ safety, especially but not only in the paediatric population due to severe opportunistic infections after their use. This review aimed at summarising available case reports on invasive infections related to probiotics’ use in children. For this purpose, we assessed three electronic databases to identify papers describing paediatric patients with documented probiotic-derived invasive infections, with no language restrictions. A total of 49 case reports from 1995 to June 2021 were identified. The infections were caused by Lactobacillus spp. (35%), Saccharomyces spp. (29%), Bifidobacterium spp. (31%), Bacillus clausii (4%), and Escherichia coli (2%). Most (80%) patients were younger than 2 years old and sepsis was the most observed condition (69.4%). All the patients except one had at least one condition facilitating the development of invasive infection, with prematurity (55%) and intravenous catheter use (51%) being the most frequent. Three (6%) children died. Given the large use of probiotics, further studies aiming at evaluating the real incidence of probiotic-associated systemic infections are warranted. Full article

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8 pages, 2081 KiB

Open AccessCase Report

A Four-Year Follow-Up Case Report of Hypomineralized Primary Second Molars Rehabilitated with Stainless Steel Crowns

by Luísa Bandeira Lopes, Vanessa Machado and João Botelho

Children 2021, 8(10), 923; https://doi.org/10.3390/children8100923 - 16 Oct 2021

Cited by 1 | Viewed by 4471

Abstract

Hypomineralized primary second molars (HPSM) are characterized by enamel opacities accompanied by hypersensitivity and atypical caries lesion, on one to four primary second molars. The correct treatment and follow-ups of those teeth have an important impact on a correct eruption of the first [...] Read more.

Hypomineralized primary second molars (HPSM) are characterized by enamel opacities accompanied by hypersensitivity and atypical caries lesion, on one to four primary second molars. The correct treatment and follow-ups of those teeth have an important impact on a correct eruption of the first permanent molars and future occlusion. Hence, this report aims to describes a case of a severe HPSM in all second molars of a four-year-old girl and subsequent four-year follow-ups. The rehabilitation involved the placement of four stainless steel crowns on all four second primary molars under general anesthesia. Concerning the available literature and the case severity of HPSM, the treatment approach proposed for the case provided good functional outcome. Full article

(This article belongs to the Collection Advance in Pediatric Dentistry)

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13 pages, 275 KiB

Open AccessArticle

Developmental Traits of Impulse Control Behavior in School Children under Controlled Attention, Motor Function, and Perception

by Hsin-Yung Chen, Ling-Fu Meng, Yawen Yu, Chen-Chi Chen, Li-Yu Hung, Shih-Che Lin and Huang-Ju Chi

Children 2021, 8(10), 922; https://doi.org/10.3390/children8100922 - 16 Oct 2021

Cited by 7 | Viewed by 3992

Abstract

This research surveyed the characteristics of the developmental traits of impulse control behavior in children through parent-report questionnaires. After matching for gender and attention behavior, as well as controlling for variables (motor and perception) which might confound impulse control, 710 participants (355 girls [...] Read more.

This research surveyed the characteristics of the developmental traits of impulse control behavior in children through parent-report questionnaires. After matching for gender and attention behavior, as well as controlling for variables (motor and perception) which might confound impulse control, 710 participants (355 girls and 355 boys; grade, 1–5; age, 7–12 years) were recruited from a database of 1763 children. Results demonstrated that there was a significant difference between grade 1 and grade 5 in impulse control. Conversely, no significant differences were found when comparing other grades. The present findings indicate that a striking development of impulse control occurs from grade 4 to 5. Moreover, the plateau of impulse control development from grade 1 to 4 implies that a long transition period is needed to prepare children to develop future impulse control. In conclusion, the age-dependent maturation associated with stage-wise development is a critical characteristic of impulse control development in school age children. Further discussions are made regarding this characteristic, such as from the perspective of frontal lobe development. Full article

(This article belongs to the Special Issue Physical Medicine and Rehabilitation in Children)

33 pages, 620 KiB

Open AccessEditor’s ChoiceSystematic Review

The Effect of Adenotonsillectomy on Children’s Behavior and Cognitive Performance with Obstructive Sleep Apnea Syndrome: State of the Art

by Paola Di Mauro, Salvatore Cocuzza, Antonino Maniaci, Salvatore Ferlito, Deborak Rasà, Roberta Anzivino, Claudio Vicini, Giannicola Iannella and Ignazio La Mantia

Children 2021, 8(10), 921; https://doi.org/10.3390/children8100921 - 15 Oct 2021

Cited by 28 | Viewed by 5016

Abstract

(1) Background: This systematic review was designed to analyze adenotonsillectomy’s role in treating behavioural disorders and sleep-related quality of life in pediatric OSAS. (2) Methods: Papers that report pre-operative and post-operative outcomes by using the Epworth sleepiness scale, OSA-18, NEPSY, Conners’ rating scale, [...] Read more.

(1) Background: This systematic review was designed to analyze adenotonsillectomy’s role in treating behavioural disorders and sleep-related quality of life in pediatric OSAS. (2) Methods: Papers that report pre-operative and post-operative outcomes by using the Epworth sleepiness scale, OSA-18, NEPSY, Conners’ rating scale, BRIEF, PSQ-SRBD, PedsQL and CBCL. We performed a comprehensive review of English papers published during the last 20 years regarding behavioural disorders in OSAS patients and adenotonsillectomy. (3) Results: We included 11 studies reporting behavioral outcomes and sleep related quality of life after surgery. We investigated changes in behavior and cognitive outcomes after AT, and we found significant improvements of the scores post-AT in almost all studies. After comparing the AT group and control group, only one study had no difference that reached significance at one year post-AT. In another study, it did not show any significant improvement in terms of all behavioural and cognitive outcomes. The questionnaires on sleep-related quality of life after AT (PSQ-SRBD or ESS or OSA-18 or KOSA) may improve with positive changes in sleep parameters (AHI, ODI and SpO2). Furthermore, there is a significantly higher decrease in OSAS symptoms than the pre-AT baseline score. (4) Conclusion: Future studies should pay more attention to characterizing patient populations as well as rapid surgical treatments through existing criteria. Full article

(This article belongs to the Special Issue Obstructive Sleep Apnea Syndrome in Children)

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15 pages, 1001 KiB

Open AccessArticle

Performance of the Toddler and Infant (TANDI) Health-Related Quality of Life Instrument in 3–4-Year-Old Children

by Janine Verstraete, Andrew J. Lloyd and Jennifer Jelsma

Children 2021, 8(10), 920; https://doi.org/10.3390/children8100920 - 15 Oct 2021

Cited by 6 | Viewed by 2229

Abstract

The Toddler and Infant (TANDI) dimensions of Health-Related Quality of Life assess ‘age appropriate’ behaviour and measurement could be extended to older children. A sample of 203 children 3–4 years of age was recruited, and their caregivers completed the TANDI, Pediatric Quality of [...] Read more.

The Toddler and Infant (TANDI) dimensions of Health-Related Quality of Life assess ‘age appropriate’ behaviour and measurement could be extended to older children. A sample of 203 children 3–4 years of age was recruited, and their caregivers completed the TANDI, Pediatric Quality of Life Inventory (PedsQL) and EQ-5D-Y Proxy. Spearman and Pearson’s correlation coefficients, and Kruskal–Wallis H-test were used to explore the feasibility, known-group validity, discriminate validity and concurrent validity of the TANDI. Children with a health condition (n = 142) had a lower ceiling effect (p = 0.010) and more unique health profiles (p < 0.001) than the healthy group (n = 61). The TANDI discriminated between those with and without a health condition. In children with a health condition, the TANDI discriminated between clinician rated severity of the health condition. The TANDI had moderate to strong correlations with similar PedsQL and EQ-5D-Y items and scores. The TANDI is valid for children aged 3–4 years and is recommended for children with a health condition, whereas the PedsQL may be better for healthy children. The TANDI is recommended for studies with young children whereas the EQ-5D-Y Proxy is recommended for a sample including older children or for longitudinal studies with preschoolers. Further work on the TANDI is recommended to establish test-retest reliability and responsiveness. Full article

(This article belongs to the Section Global Pediatric Health)

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12 pages, 1021 KiB

Open AccessArticle

Progress of Home-Based Food Allergy Treatment during the Coronavirus Disease Pandemic in Japan: A Cross-Sectional Multicenter Survey

by Akihiro Maeta, Yuri Takaoka, Atsuko Nakano, Yukiko Hiraguchi, Masaaki Hamada, Yutaka Takemura, Tomoko Kawakami, Ikuo Okafuji, Makoto Kameda and Kyoko Takahashi

Children 2021, 8(10), 919; https://doi.org/10.3390/children8100919 - 15 Oct 2021

Cited by 4 | Viewed by 2079

Abstract

The coronavirus disease 2019 (COVID-19) pandemic’s impact on food allergy treatment such as home-based oral immunotherapy (OIT) is not known. This cross-sectional, questionnaire-based anonymized survey screened 2500 parents of children with allergic diseases and was conducted in the pediatric outpatient clinics of 24 [...] Read more.

The coronavirus disease 2019 (COVID-19) pandemic’s impact on food allergy treatment such as home-based oral immunotherapy (OIT) is not known. This cross-sectional, questionnaire-based anonymized survey screened 2500 parents of children with allergic diseases and was conducted in the pediatric outpatient clinics of 24 hospitals. Basic clinical data of the children were collected along with the degree of allergy control, parental anxiety about emergency visits, and the risk of COVID-19 in the first state of emergency. A total of 2439 (97.6%) questionnaires were collected, and 1315 parents who were instructed to initiate home-based OIT for their children were enrolled (OIT group). Subjective OIT progress compared to before the COVID-19 pandemic was ascertained as “Full”, “Middle”, “Low”, “Little”, and “Stop” in 264 (20.1%), 408 (31.0%), 384 (29.2%), 203 (15.4%), and 56 (4.3%) participants, respectively. Anxiety about emergency visits and the risk of COVID-19 were negatively associated with the subjective OIT progress. In Japan, approximately half of the children continued smoothly the home-based OIT during the COVID-19 pandemic. Parents with high levels of anxiety about the disruption of the medical care system due to COVID-19 and the risk of COVID-19 did not experience a smooth continuation of home-based OIT. Full article

(This article belongs to the Special Issue Clinical Research and Recent Advances in Paediatric Allergic Diseases)

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7 pages, 1286 KiB

Open AccessCase Report

Changes of Neural Pathways after Vojta Approach in a Child with Developmental Delay

by Sun-Young Ha and Yun-Hee Sung

Children 2021, 8(10), 918; https://doi.org/10.3390/children8100918 - 15 Oct 2021

Cited by 4 | Viewed by 2996

Abstract

The development of motor function is related to the development of neural pathways in the white matter. Children with developmental delay (DD) and hypotonia have reduced motor function, and their neural pathways are observed differently from those of typically developed children. We investigated [...] Read more.

The development of motor function is related to the development of neural pathways in the white matter. Children with developmental delay (DD) and hypotonia have reduced motor function, and their neural pathways are observed differently from those of typically developed children. We investigated changes in neural pathways through diffusion tensor imaging (DTI) after utilizing the Vojta approach. The participant was a child with DD and hypotonia, and had delayed motor function. Although he had no brain damage on magnetic resonance imaging findings, damage to the neural pathway was confirmed through DTI due to cytomegalovirus infection in the mother’s womb. From 11 months of age, the Vojta approach was performed for a total of 8 months. In this study, we found that in CST, the left FA and right TV increased in follow-up DTI more than in the initial DTI. In CRP, Wallerian degeneration was observed in the left FA, MD, and TV in follow-up DTI. GMFM-88 improved after intervention. The structural change of neural pathways through the Vojta approach influenced the improvement of gross motor function. Therefore, it is thought that the Vojta approach can be suggested as a meaningful intervention for children with DD and hypotonia. Full article

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14 pages, 317 KiB

Open AccessReview

Chorioamnionitis, Inflammation and Neonatal Apnea: Effects on Preterm Neonatal Brainstem and on Peripheral Airways: Chorioamnionitis and Neonatal Respiratory Functions

by Giovanna Vitaliti and Raffaele Falsaperla

Children 2021, 8(10), 917; https://doi.org/10.3390/children8100917 - 15 Oct 2021

Cited by 3 | Viewed by 1840

Abstract

Background: The present manuscript aims to be a narrative review evaluating the association between inflammation in chorioamnionitis and damage on respiratory centers, peripheral airways, and lungs, explaining the pathways responsible for apnea in preterm babies born by delivery after chorioamnionitis. Methods: A combination [...] Read more.

Background: The present manuscript aims to be a narrative review evaluating the association between inflammation in chorioamnionitis and damage on respiratory centers, peripheral airways, and lungs, explaining the pathways responsible for apnea in preterm babies born by delivery after chorioamnionitis. Methods: A combination of keywords and MESH words was used, including: “inflammation”, “chorioamnionitis”, “brainstem”, “cytokines storm”, “preterm birth”, “neonatal apnea”, and “apnea physiopathology”. All identified papers were screened for title and abstracts by the two authors to verify whether they met the proper criteria to write the topic. Results: Chorioamnionitis is usually associated with Fetal Inflammatory Response Syndrome (FIRS), resulting in injury of brain and lungs. Literature data have shown that infections causing chorioamnionitis are mostly associated with inflammation and consequent hypoxia-mediated brain injury. Moreover, inflammation and infection induce apneic episodes in neonates, as well as in animal samples. Chorioamnionitis-induced inflammation favors the systemic secretion of pro-inflammatory cytokines that are involved in abnormal development of the respiratory centers in the brainstem and in alterations of peripheral airways and lungs. Conclusions: Preterm birth shows a suboptimal development of the brainstem and abnormalities and altered development of peripheral airways and lungs. These alterations are responsible for reduced respiratory control and apnea. To date, mostly animal studies have been published. Therefore, more clinical studies on the role of chorioamninitis-induced inflammation on prematurity and neonatal apnea are necessary. Full article

(This article belongs to the Section Pediatric Neonatology)

13 pages, 467 KiB

Open AccessArticle

Cross-Sectional Descriptive Pilot Study on the Risk of Psychotic Disorders among Adolescents

by Carmen Cendrero-Luengo, María Jiménez-Palomares, Juan Rodríguez-Mansilla and Elisa María Garrido-Ardila

Children 2021, 8(10), 916; https://doi.org/10.3390/children8100916 - 14 Oct 2021

Cited by 2 | Viewed by 2096

Abstract

Background: Adolescence is a key stage for the development of different mental disorders, particularly psychotic disorders. This stage of life is accompanied by new habits or behaviours that can make a person more vulnerable to developing a psychotic disorder or, on the contrary, [...] Read more.

Background: Adolescence is a key stage for the development of different mental disorders, particularly psychotic disorders. This stage of life is accompanied by new habits or behaviours that can make a person more vulnerable to developing a psychotic disorder or, on the contrary, play a protective role. Objective: To study the vulnerability to developing a psychotic disorder in adolescents and to analyse the main risk factors. Materials and methods: This is an observational, descriptive and cross-sectional study. The data collection was conducted using the Prodromal Questionnaire Brief Version (PQ-B) test and a self-developed questionnaire based on the vulnerability–stress model. Results: Of the total sample (n = 44), 65.9% were male and 100% lived in a rural environment. In general, among risk factors (stress, alcohol and cannabis consumption, history, bullying, traumatic event and sedentary lifestyle), alcohol consumption and the presence of stress were found to have high values. Furthermore, a risk of psychosis was found in 38.6% of the studied population. Of this percentage of adolescents at risk, 64.7% consumed alcohol (p = 0.99) and 82.4% suffered from stress (p = 0.7161). The protective factor (physical activity) was found in more than half (59% p = 0.16). Conclusions: There is a high risk of psychosis among the young adolescents assessed in this study, where the explanatory factors identified with higher values were alcohol consumption and the presence of stress. Full article

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13 pages, 468 KiB

Open AccessSystematic Review

Attachment and the Development of Moral Emotions in Children and Adolescents: A Systematic Review

by Mariana Costa Martins, Ana Filipa Santos, Marília Fernandes and Manuela Veríssimo

Children 2021, 8(10), 915; https://doi.org/10.3390/children8100915 - 14 Oct 2021

Cited by 6 | Viewed by 5676

Abstract

In recent years, the development of social and moral emotions (often associated to pro-social behaviors) has become the subject of increased research interest. However, the relation between these emotions and attachment is less studied. The present systematic literature review (PROSPERO: CRD42021247210) was designed [...] Read more.

In recent years, the development of social and moral emotions (often associated to pro-social behaviors) has become the subject of increased research interest. However, the relation between these emotions and attachment is less studied. The present systematic literature review (PROSPERO: CRD42021247210) was designed to synthesize current empirical contributions that explore the link between attachment and the development of moral emotions (e.g., empathy, sympathy, altruism, and guilt) during childhood and adolescence. Article exclusion criteria included: studies with participants not living in natural contexts (e.g., institutionalized); studies on mental illness; qualitative research; research that does not reliably evaluate attachment or moral emotions; research on intervention programs; and non-peer-reviewed articles. Only 10 studies were found eligible. Results highlight a present focus on empathy and guilt and gaps regarding sympathy and altruism. The mediator role and positive effect of emotion regulation was noted. Significant positive correlations between attachment security and guilt, shame and forgiveness were emphasized. Limitations of the eligible studies included: representativeness of the participants; causality of the results; and the validity and significance of the instruments (e.g., lack of results reported by various parties involved). The present review aims to contribute to the understanding of an empathic, healthy development, in contrast to the alienation and bullying affecting the youth’s emotional, relational and academic lives. Full article

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9 pages, 1436 KiB

Open AccessArticle

Toys in the Playrooms of Children’s Hospitals: A Potential Source of Nosocomial Bacterial Infections?

by Viktorija Aleksejeva, Anastasija Dovbenko, Juta Kroiča and Ingus Skadiņš

Children 2021, 8(10), 914; https://doi.org/10.3390/children8100914 - 14 Oct 2021

Cited by 1 | Viewed by 2411

Abstract

Pediatric patients are more susceptible and vulnerable to nosocomial infections, in part because of their nascent and developing immune system and in part due to certain congenital conditions. Consequently, we found limited literature that investigated and reported children’s toys in hospital playrooms as [...] Read more.

Pediatric patients are more susceptible and vulnerable to nosocomial infections, in part because of their nascent and developing immune system and in part due to certain congenital conditions. Consequently, we found limited literature that investigated and reported children’s toys in hospital playrooms as potential reservoirs of pathogenic microbes. Hence, in the present study, we aimed to investigate toys as potential vectors for nosocomial infections in children’s hospitals. Microbiological samples from 120 toys were collected between April 2018 and November 2018. The specimens were cultivated on suitable cultivation agars for 24–72 h at 37 °C and CFU/cm² (colony forming units) was determined. Antibiotic susceptibility testing was performed using disc diffusion and E-tests. Our results indicate that 84% of samples were contaminated with different microbes. Four distinct genera and thirty-seven species of bacteria were identified. The most frequently isolated pathogen was Sphingomonas paucimobilis (>603 CFU/cm²). Most of the identified microorganisms were members of normal human microbiota. Although Staphylococcus aureus and Acinetobacter baumannii were identified, CFU/cm² was relatively low and they were found to be sensitive to antibiotics. Additionally, plastic toys showed the highest average CFU/cm² of 91.9. Our results bolster the need for adoption and strict enforcement of proper disinfection techniques for toys in the hospital playrooms. Full article

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8 pages, 247 KiB

Open AccessArticle

Characteristics of Kawasaki Disease Patients during the COVID-19 Pandemic in Japan: A Single-Center, Observational Study

by Shoichi Shimizu, Mamoru Ayusawa, Hidetoshi Go, Kimitaka Nakazaki, Hidemasa Namiki, Yuki Kasuga, Koji Nishimura, Koji Kanezawa, Tamaki Morohashi and Ichiro Morioka

Children 2021, 8(10), 913; https://doi.org/10.3390/children8100913 - 13 Oct 2021

Cited by 2 | Viewed by 1887

Abstract

Background: Under the Coronavirus disease 2019 (COVID-19) pandemic, manifestations in children with Kawasaki disease (KD) are different between the Western and the Eastern countries. Particularly, there has not been a report comparing a series of KD in Japan, where KD was originally discovered [...] Read more.

Background: Under the Coronavirus disease 2019 (COVID-19) pandemic, manifestations in children with Kawasaki disease (KD) are different between the Western and the Eastern countries. Particularly, there has not been a report comparing a series of KD in Japan, where KD was originally discovered and has a large number of registered cases. Methods: We compared patients with KD under the period of the COVID-19 pandemic in Japan with the report from Italy during its reported period by a retrospective, cohort, observational study in a Japanese single center. Results: Thirty-two patients with typical KD were treated during the study period, while the Italian study reported 10 patients with the signs of KD. Concerning the proof of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection, none (0%) of our KD cases showed a positive result and one and no patients developed the macrophage activation syndrome (MAS) and Kawasaki disease shock syndrome (KDSS), respectively; however, eight (80%) patients in the Italian series were confirmed with SARS-CoV-2 infection. MAS and KDSS developed in six and five patients, respectively. Conclusions: Cases reported as COVID-19 pandemic-related KD in Italy showed significantly different clinical characteristics from the typical KD symptoms known in Japan. Although they show KD-like manifestations, we cannot conclude that SARS-CoV-2 has the same etiology of our ‘classic’ KD at the present stage. Full article

(This article belongs to the Special Issue Clinic Research on Kawasaki Disease in Children)

10 pages, 749 KiB

Open AccessReview

Acute Arthritis in Children: How to Discern between Septic and Non-Septic Arthritis?

by Lisa Gamalero, Giovanna Ferrara, Teresa Giani and Rolando Cimaz

Children 2021, 8(10), 912; https://doi.org/10.3390/children8100912 - 13 Oct 2021

Cited by 10 | Viewed by 5502

Abstract

The term septic arthritis refers to an infection of the synovial space. This is an infrequent condition in healthy children, but it should be considered a medical emergency potentially leading to irreversible articular damage. Therefore, prompt diagnosis and antimicrobial treatment play a crucial [...] Read more.

The term septic arthritis refers to an infection of the synovial space. This is an infrequent condition in healthy children, but it should be considered a medical emergency potentially leading to irreversible articular damage. Therefore, prompt diagnosis and antimicrobial treatment play a crucial role in improving the prognosis. Although septic arthritis is the most common cause of acute arthritis, many other diseases may mimic a similar clinical picture, constituting a diagnostic challenge for the clinician who first approaches the patient. Herein we analyze the main features of septic arthritis, offering an overview of the main conditions involved in the differential diagnosis and suggesting a diagnostic workup plan. Full article

(This article belongs to the Special Issue Septic Arthritis and Related Conditions)

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