Special Issue "5th Anniversary Issue"

A special issue of Children (ISSN 2227-9067).

Deadline for manuscript submissions: closed (15 May 2018)

Special Issue Editor

Guest Editor
Prof. Dr. Sari A. Acra

D. Brent Polk Division of Gastroenterology, Hepatology, and Nutrition, Vanderbilt Children’s Hospital, 2200 Children’s Way, 9214 Doctors’ Office Tower, Nashville, TN 37232-9175, USA
Website | E-Mail
Phone: +1 615 343 9034
Interests: diarrheal disorders; functional dyspepsia; GERD; aerodigestive disorders; inflammatory bowel diseases; nutritional disorder

Special Issue Information

Dear Colleagues

A little less than five years ago, Children was launched with the goal of creating a “forum for sharing information and engaging in discussions and dialogue relevant to the health care of children, unimpeded by limitations imposed by traditional print media”.

It has been a steady march towards that goal, one in which the editorial team, the publisher and I, have been joined by a hugely-energetic and supportive Editorial Board, selfless reviewers, inspired global researchers, content experts and thought leaders, and an interested and engaged global readership.

Today, Children’s accomplishments stand worthy of recognition—an agent of global promulgation with listings on the Web of Science and PubMed databases, over 37,000 downloads and 60,000 unique page views per year, and timely original contributions from researchers and health thought leaders from a spectrum of low, middle and high income countries (to be exact, seventeen countries in 2017). These successes were achieved with both rigor and timeliness, such that less than one of two submitted manuscripts where deemed worthy of publication, and the average time from submission to publication was 57 days. We are also proud that, consistent with our goal of broad dissemination, access to the reader, our most important constituent, has always been without any charge.

Five years on, I thank you for joining us on this wonderful journey of discovery and global cross fertilization, where all medical and scientific work related to children’s health deserving of a voice can reverberate globally. In celebration, we have launched our 5th Anniversary issue, with timely and informed contributions from many of you who are at the forefront of improving our children’s health.

A heartfelt thank you to all. We look forward to your contributions and your continued engagement as informed readers.

Best wishes,

Prof. Dr. Sari A. Acra
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Children is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 550 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (11 papers)

View options order results:
result details:
Displaying articles 1-11
Export citation of selected articles as:

Editorial

Jump to: Research, Review, Other

Open AccessEditorial Anti-Epileptic Drug Toxicity in Children
Received: 23 April 2018 / Revised: 30 April 2018 / Accepted: 30 April 2018 / Published: 1 May 2018
PDF Full-text (173 KB) | HTML Full-text | XML Full-text
Abstract
Anti-epileptic drugs (AEDs) have had a major impact on children, improving their quality of life and significantly reducing both morbidity and mortality. They are, however, associated with significant toxicity. Behavioural problems and somnolence are the most frequent adverse drug reactions for many AEDs.
[...] Read more.
Anti-epileptic drugs (AEDs) have had a major impact on children, improving their quality of life and significantly reducing both morbidity and mortality. They are, however, associated with significant toxicity. Behavioural problems and somnolence are the most frequent adverse drug reactions for many AEDs. Unfortunately, the comparative risk of drug toxicity for different AEDs has been inadequately studied. Drug toxicity is poorly reported in randomised controlled trials. Prospective cohort studies are the best way to study drug toxicity. There have been a few prospective cohort studies of children with epilepsy, but the numbers of children have been small. Systemic reviews of the toxicity of individual AEDs have been helpful in identifying the risk of drug toxicity. Parents of children with epilepsy and the children and young people who are due to receive AED treatment have the right to know the likelihood of them experiencing drug toxicity. Unfortunately, the evidence base on which health professionals can provide such information is limited. Full article
(This article belongs to the Special Issue 5th Anniversary Issue)

Research

Jump to: Editorial, Review, Other

Open AccessArticle Understanding the Relative Contributions of Sensitive and Insensitive Parent Behaviors on Infant Vaccination Pain
Children 2018, 5(6), 80; https://doi.org/10.3390/children5060080 (registering DOI)
Received: 17 May 2018 / Revised: 12 June 2018 / Accepted: 12 June 2018 / Published: 18 June 2018
PDF Full-text (258 KB) | HTML Full-text | XML Full-text
Abstract
Parents play a critical role in supporting infants’ ability to manage strong emotions. Routine vaccinations provide an ideal context to observe the effect of parents’ behaviors on infants’ pain-related distress. Previous research in the vaccination context showed that parent sensitivity, operationalized by variables
[...] Read more.
Parents play a critical role in supporting infants’ ability to manage strong emotions. Routine vaccinations provide an ideal context to observe the effect of parents’ behaviors on infants’ pain-related distress. Previous research in the vaccination context showed that parent sensitivity, operationalized by variables such as emotional availability and proximal soothing behaviors, is associated with infant pain-related distress behavior. However, the magnitudes of these relationships were smaller than expected given the established importance of parents in the development of distress regulation. In recent work, a reliable and valid measure to operationalize insensitive behaviors was developed. The objective of the current study was to examine the relative contribution of variables representing sensitive and insensitive behaviors to the prediction of infant pain-related distress behaviors during the reactivity and regulation phases of needle pain. Archival data was used to analyze a subsample of infants followed during their two-month, six-month, and 12-month vaccinations (n = 81). Results of regression analyses indicated that parent insensitive behaviors generally had the strongest relationships with pain outcomes across all ages, with a greater influence on regulation-phase pain-related distress behavior, rather than reactivity-phase pain-related distress behavior. Our findings support the utility of a measure of distress-promoting parent behaviors in a vaccination context, and highlight the potential value of this measure for clinicians and researchers. Full article
(This article belongs to the Special Issue 5th Anniversary Issue)
Open AccessArticle Parent Attributions of Ambiguous Symptoms in Their Children: A Preliminary Measure Validation in Parents of Children with Chronic Pain
Received: 18 May 2018 / Revised: 7 June 2018 / Accepted: 8 June 2018 / Published: 13 June 2018
PDF Full-text (405 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
How parents attribute cause to their child’s physical symptoms is likely important in understanding how the parent responds to the child, as well as the child’s health outcomes, especially within the context of chronic illness. Here, we adapt the Symptom Interpretation Questionnaire for
[...] Read more.
How parents attribute cause to their child’s physical symptoms is likely important in understanding how the parent responds to the child, as well as the child’s health outcomes, especially within the context of chronic illness. Here, we adapt the Symptom Interpretation Questionnaire for parent report (SIQ-PR) and provide preliminary validation in a sample of parents of children with chronic pain (N = 311). Confirmatory factor analysis revealed that the SIQ-PR structure is consistent with the original measure, with three distinct attribution types: psychological (emotional/affective), somatic (illness/disease), and environmental (situational/transient) causes. All three subscales demonstrated satisfactory to good internal consistency, and temporal stability. Parents typically endorsed more than one attribution for each symptom, indicating that parents of children with chronic pain have a multidimensional interpretation of physical symptoms in their children. Further, parent psychological and somatic attributions, but not environmental attributions, were significantly associated with (i) parent protective responses towards their child, and (ii) the child’s self-reported somatic and psychological symptoms, indicating convergent and divergent validity. The SIQ-PR may be a useful measure for future studies investigating intergenerational and interpersonal models of pediatric chronic pain, and more broadly, to examine parent attributions of children’s ambiguous symptoms within the context of childhood chronic illness. Full article
(This article belongs to the Special Issue 5th Anniversary Issue)
Figures

Figure 1

Open AccessCommunication Food Allergy Perceptions and Health-Related Quality of Life in a Racially Diverse Sample
Received: 11 May 2018 / Revised: 4 June 2018 / Accepted: 4 June 2018 / Published: 6 June 2018
PDF Full-text (424 KB) | HTML Full-text | XML Full-text
Abstract
This study examined caregiver perceptions of risk of food allergen exposure, and food allergy severity, worry, and health-related quality of life, and identified variations by race/ethnicity. Given the lack of data on racial/ethnic background in research on the psychosocial impacts of food allergy,
[...] Read more.
This study examined caregiver perceptions of risk of food allergen exposure, and food allergy severity, worry, and health-related quality of life, and identified variations by race/ethnicity. Given the lack of data on racial/ethnic background in research on the psychosocial impacts of food allergy, this study meets a pressing need for research regarding food allergy-related experiences among diverse populations. This study found there were significant differences in perceived risk of allergen exposure among racial/ethnic groups with Asian Americans reporting significantly higher perceived risk of allergen exposure than Hispanic, Caucasian, and African American caregivers. There were no significant differences in food allergy severity, food allergy worry, or health-related quality of life among racial/ethnic groups; however, variability among racial/ethnic groups was apparent. Data may inform screening, counseling, and education practices for families from diverse backgrounds and aid in hypothesis generation for future research. Full article
(This article belongs to the Special Issue 5th Anniversary Issue)
Figures

Figure 1

Open AccessArticle Development and Validation of a Nausea Severity Scale for Assessment of Nausea in Children with Abdominal Pain-Related Functional Gastrointestinal Disorders
Received: 13 April 2018 / Revised: 23 May 2018 / Accepted: 30 May 2018 / Published: 1 June 2018
PDF Full-text (225 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
The objective of this study was to develop a pediatric measure of chronic nausea severity, the Nausea Severity Scale (NSS), and evaluate its reliability and validity in youth with abdominal pain-related functional gastrointestinal disorders (AP-FGID). Pediatric patients (aged 11–17 years-old, n = 236)
[...] Read more.
The objective of this study was to develop a pediatric measure of chronic nausea severity, the Nausea Severity Scale (NSS), and evaluate its reliability and validity in youth with abdominal pain-related functional gastrointestinal disorders (AP-FGID). Pediatric patients (aged 11–17 years-old, n = 236) presenting to an outpatient clinic for evaluation of abdominal pain completed the NSS, Children’s Somatization Inventory (CSI), Functional Disability Inventory (FDI), Abdominal Pain Index (API), Patient-Report Outcomes Measurement Information System (PROMIS), Anxiety and Depression Scales and the Pediatric Rome III Questionnaire for FGIDs. The NSS demonstrated good concurrent, discriminant, and construct validity, as well as good internal consistency. One-third (34%) of AP-FGID patients reported experiencing nausea “most” or “every day” in the previous two weeks. The severity of nausea was higher in females than males and correlated significantly with the severity of somatic symptoms, functional disability, anxiety, and depression. The NSS is a valid and reliable measure of nausea in children with AP-FGID. Full article
(This article belongs to the Special Issue 5th Anniversary Issue)
Open AccessArticle Pediatric Patients Receiving Specialized Palliative Home Care According to German Law: A Prospective Multicenter Cohort Study
Received: 2 May 2018 / Revised: 26 May 2018 / Accepted: 28 May 2018 / Published: 31 May 2018
PDF Full-text (600 KB) | HTML Full-text | XML Full-text
Abstract
In Germany, every child with a life-limiting condition suffering from symptoms that cannot sufficiently be controlled is eligible by law for specialized pediatric palliative home care (SPPHC). It is the aim of this study to describe the demographic and clinical characteristics of children
[...] Read more.
In Germany, every child with a life-limiting condition suffering from symptoms that cannot sufficiently be controlled is eligible by law for specialized pediatric palliative home care (SPPHC). It is the aim of this study to describe the demographic and clinical characteristics of children referred to SPPHC and to compare patients with cancer and non-cancer conditions. The prospective multicenter study includes data on 75 children (median age 7.7 years, 50.7% male). The majority had non-cancer conditions (72%). The most common symptoms were cognitive impairment, somatic pain, impairment in communication or swallowing difficulties. Swallowing difficulties, seizures, and spasticity occurred significantly more often in non-cancer patients (p < 0.01). Cancer patients received antiemetics significantly more often (permanent and on demand) than non-cancer patients (p < 0.01). Significantly more non-cancer patients had some type of feeding tube (57.3%) or received oxygen (33.3%) (p < 0.01). Central venous catheters had been fitted in 20% of the patients, mostly in cancer patients (p < 0.001). Tracheostomy tubes (9.3%) or ventilation (14.7%) were only used in non-cancer patients. In conclusion, patients referred to SPPHC are a diverse cohort with complex conditions including a large range of neurologically originating symptoms. The care of pediatric palliative care patients with cancer is different to the care of non-cancer patients. Full article
(This article belongs to the Special Issue 5th Anniversary Issue)
Figures

Figure 1

Open AccessCommunication Safety of Oral Food Challenges in Early Life
Received: 10 May 2018 / Revised: 26 May 2018 / Accepted: 28 May 2018 / Published: 30 May 2018
PDF Full-text (170 KB) | HTML Full-text | XML Full-text
Abstract
Oral food challenges are becoming more frequent in the allergy clinic due to an increased demand related to early food introduction in infants. We examined the safety of oral food challenges in 18 high-risk infants with prior allergic reactions, as well as infants
[...] Read more.
Oral food challenges are becoming more frequent in the allergy clinic due to an increased demand related to early food introduction in infants. We examined the safety of oral food challenges in 18 high-risk infants with prior allergic reactions, as well as infants with no known exposure to the food, presenting consecutively in a dedicated food allergy clinic for an oral food challenge. Foods challenged included peanut, tree nuts, sesame, baked egg, baked milk, and soy. A total of 17/18 (94%) infants had a negative challenge. Only 1/18 (6%) had a positive challenge, and in this case, symptoms were mild and limited to the skin. Our results suggest that food challenges in infants and young children up to the age of 2 years are safe with symptoms limited to the skin when reactions occur. In our cohort, the large majority of food challenges were negative, with most infants being sensitized rather than allergic to the food. Larger studies are needed to confirm this finding. Full article
(This article belongs to the Special Issue 5th Anniversary Issue)
Open AccessArticle Efficacy, Safety, and Usability of Remifentanil as Premedication for INSURE in Preterm Neonates
Received: 24 April 2018 / Revised: 15 May 2018 / Accepted: 19 May 2018 / Published: 22 May 2018
PDF Full-text (528 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Background: We previously reported a 67% extubation failure with INSURE (Intubation, Surfactant, Extubation) using morphine as analgosedative premedication. Remifentanil, a rapid- and short-acting narcotic, might be ideal for INSURE, but efficacy and safety data for this indication are limited. Objectives: To
[...] Read more.
Background: We previously reported a 67% extubation failure with INSURE (Intubation, Surfactant, Extubation) using morphine as analgosedative premedication. Remifentanil, a rapid- and short-acting narcotic, might be ideal for INSURE, but efficacy and safety data for this indication are limited. Objectives: To assess whether remifentanil premedication increases extubation success rates compared with morphine, and to evaluate remifentanil’s safety and usability in a teaching hospital context. Methods: Retrospective review of remifentanil orders for premedication, at a large teaching hospital neonatal intensive care unit (NICU). We compared INSURE failure rates (needing invasive ventilation after INSURE) with prior morphine-associated rates. Additionally, we surveyed NICU staff to identify usability and logistic issues with remifentanil. Results: 73 remifentanil doses were administered to 62 neonates (mean 31.6 ± 3.8 weeks’ gestation). Extubation was successful in 88%, vs. 33% with morphine premedication (p < 0.001). Significant adverse events included chest wall rigidity (4%), one case of cardiopulmonary resuscitation (CPR) post-surfactant, naloxone reversal (5%), and notable transient desaturation (34%). Among 137 completed surveys, 57% indicated concerns, including delayed drug availability (median 1.1 h after order), rapid desaturations narrowing intubation timeframes and hindering trainee involvement, and difficulty with bag-mask ventilation after unsuccessful intubation attempts. Accordingly, 33% of ultimate intubators were attending neonatologists, versus 16% trainees. Conclusions: Remifentanil premedication was superior to morphine in allowing successful extubation, despite occasional chest wall rigidity and unfavorable conditions for trainees. We recommend direct supervision and INSURE protocols aimed at ensuring rapid intubation. Full article
(This article belongs to the Special Issue 5th Anniversary Issue)
Figures

Figure 1

Review

Jump to: Editorial, Research, Other

Open AccessReview Respiratory Diagnostic Tools in Neuromuscular Disease
Received: 10 May 2018 / Revised: 9 June 2018 / Accepted: 11 June 2018 / Published: 15 June 2018
PDF Full-text (22855 KB) | HTML Full-text | XML Full-text
Abstract
Children with neuromuscular disease (NMD) are at risk of acquiring respiratory complications. Both clinical assessments and respiratory diagnostic tests are important to optimize the respiratory health and care of such children. The following respiratory diagnostic tools and their utility for evaluating children with
[...] Read more.
Children with neuromuscular disease (NMD) are at risk of acquiring respiratory complications. Both clinical assessments and respiratory diagnostic tests are important to optimize the respiratory health and care of such children. The following respiratory diagnostic tools and their utility for evaluating children with NMD are discussed in this article: lung function testing (spirometry and lung volumes), peak cough flow (PCF), respiratory muscle strength testing, oximetry, capnography, and polysomnography. Full article
(This article belongs to the Special Issue 5th Anniversary Issue)
Figures

Figure 1

Other

Jump to: Editorial, Research, Review

Open AccessBrief Report Interval Outcomes of a Lifestyle Weight-Loss Intervention in Early Adolescence
Received: 8 April 2018 / Revised: 12 June 2018 / Accepted: 13 June 2018 / Published: 15 June 2018
PDF Full-text (192 KB) | HTML Full-text | XML Full-text
Abstract
We undertook a feasibility study to reassess metabolic outcomes in young people with early onset obesity who attended a hospital-based lifestyle weight-loss intervention during adolescence. Comparisons of metabolic assessments, including body mass index standard deviation scores (BMI–SDSs), blood pressure (BP), oral glucose tolerance
[...] Read more.
We undertook a feasibility study to reassess metabolic outcomes in young people with early onset obesity who attended a hospital-based lifestyle weight-loss intervention during adolescence. Comparisons of metabolic assessments, including body mass index standard deviation scores (BMI–SDSs), blood pressure (BP), oral glucose tolerance tests (OGTTs), lipid profile, and alanine transaminase (ALT), before and after treatment were made. Twenty-five subjects (10 males) with median ages (interquartile range, IQR) of 14.5 (12.6–15.4) years at the beginning of intervention and 18.2 (17.2–18.9) years at reassessment and who were 3.5 (2.4–6.5) years post-intervention were recruited. Twenty-eight percent had a ≥0.25 reduction in BMI–SDS from baseline (responders). Responders demonstrated significantly lower BMI–SDS, systolic BP, and glucose disposal at reassessment compared with baseline. They also showed significantly lower total fat percentage SDSs, trunk fat percentages, 120 min insulin, and ALT, as well as higher insulin sensitivity index (ISIcomp) than non-responders. Male gender and younger age at the initiation of intervention showed a non-significant trend towards greater success in weight loss. Long-term benefits were demonstrated in around one-quarter of obese adolescents after lifestyle modification treatment, with associated improvements in body composition and metabolic parameters. Full article
(This article belongs to the Special Issue 5th Anniversary Issue)
Open AccessCommentary Specialized Care without the Subspecialist: A Value Opportunity for Secondary Care
Received: 10 April 2018 / Revised: 22 May 2018 / Accepted: 30 May 2018 / Published: 4 June 2018
PDF Full-text (170 KB) | HTML Full-text | XML Full-text
Abstract
An underutilized value strategy that may reduce unnecessary subspecialty involvement in pediatric healthcare targets the high-quality care of children with common chronic conditions such as obesity, asthma, or attention deficit hyperactivity disorder within primary care settings. In this commentary, we propose that “secondary
[...] Read more.
An underutilized value strategy that may reduce unnecessary subspecialty involvement in pediatric healthcare targets the high-quality care of children with common chronic conditions such as obesity, asthma, or attention deficit hyperactivity disorder within primary care settings. In this commentary, we propose that “secondary care”, defined as specialized visits delivered by primary care providers, a general pediatrician, or other primary care providers, can obtain the knowledge, skill and, over time, the experience to manage one or more of these common chronic conditions by creating clinical time and space to provide condition-focused care. This care model promotes familiarity, comfort, proximity to home, and leverages the provider’s expertise and connections with community-based resources. Evidence is provided to prove that, with multi-disciplinary and subspecialist support, this model of care can improve the quality, decrease the costs, and improve the provider’s satisfaction with care. Full article
(This article belongs to the Special Issue 5th Anniversary Issue)
Back to Top