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Children
Volume 11
Issue 6
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Children, Volume 11, Issue 6 (June 2024) – 139 articles

Cover Story (view full-size image): For lesbian, gay, bisexual, transgender, queer, or other sexual and gender minority identity (LGBTQ+) parents, the stress of having an infant in the neonatal intensive care unit (NICU) may be compounded by health disparities and fear of stigma and discrimination. In this integrative review, researchers sought to better understand the experiences of LGBTQ+ parents of NICU infants, with a focus on stigma and discrimination, sources of strength and resilience, and family-centered care. LGBTQ+ parents (N = 12–14) interviewed in six qualitative studies reported instances of perceived stigma and discrimination in the NICU. Parents in two studies mentioned strength and resilience, and parents in three studies described elements of family-centered care. There is a need for research on family-centered NICU care that focuses on sources of strength and resilience in addition to challenges. View this paper
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11 pages, 237 KiB  
Article
Exploring the Role of ChatGPT-4, BingAI, and Gemini as Virtual Consultants to Educate Families about Retinopathy of Prematurity
by Ceren Durmaz Engin, Ezgi Karatas and Taylan Ozturk
Children 2024, 11(6), 750; https://doi.org/10.3390/children11060750 - 20 Jun 2024
Viewed by 349
Abstract
Background: Large language models (LLMs) are becoming increasingly important as they are being used more frequently for providing medical information. Our aim is to evaluate the effectiveness of electronic artificial intelligence (AI) large language models (LLMs), such as ChatGPT-4, BingAI, and Gemini in [...] Read more.
Background: Large language models (LLMs) are becoming increasingly important as they are being used more frequently for providing medical information. Our aim is to evaluate the effectiveness of electronic artificial intelligence (AI) large language models (LLMs), such as ChatGPT-4, BingAI, and Gemini in responding to patient inquiries about retinopathy of prematurity (ROP). Methods: The answers of LLMs for fifty real-life patient inquiries were assessed using a 5-point Likert scale by three ophthalmologists. The models’ responses were also evaluated for reliability with the DISCERN instrument and the EQIP framework, and for readability using the Flesch Reading Ease (FRE), Flesch-Kincaid Grade Level (FKGL), and Coleman-Liau Index. Results: ChatGPT-4 outperformed BingAI and Gemini, scoring the highest with 5 points in 90% (45 out of 50) and achieving ratings of “agreed” or “strongly agreed” in 98% (49 out of 50) of responses. It led in accuracy and reliability with DISCERN and EQIP scores of 63 and 72.2, respectively. BingAI followed with scores of 53 and 61.1, while Gemini was noted for the best readability (FRE score of 39.1) but lower reliability scores. Statistically significant performance differences were observed particularly in the screening, diagnosis, and treatment categories. Conclusion: ChatGPT-4 excelled in providing detailed and reliable responses to ROP-related queries, although its texts were more complex. All models delivered generally accurate information as per DISCERN and EQIP assessments. Full article
(This article belongs to the Special Issue Recent Advances in Retinopathy of Prematurity)
11 pages, 1402 KiB  
Article
High Rate of Change of the Foot in Ecuadorian Children: The Need for Proper Shoe Design
by Laura Martín-Casado, Inés Palomo-Fernández, Alberto Aldana-Caballero, Ivan Baltasar-Fernandez and Felix Marcos-Tejedor
Children 2024, 11(6), 749; https://doi.org/10.3390/children11060749 - 20 Jun 2024
Viewed by 518
Abstract
Background: Physiological changes in the foot may be influenced by external factors such as shoe types or demographic parameters, leading to podiatric conditions in adulthood. The aim of this study was to assess the changes in morphological measurements of the feet of boys [...] Read more.
Background: Physiological changes in the foot may be influenced by external factors such as shoe types or demographic parameters, leading to podiatric conditions in adulthood. The aim of this study was to assess the changes in morphological measurements of the feet of boys and girls during childhood and adolescence. Methods: A total of 1678 Ecuadorian children aged 8 to 17 years participated in the study. The length, width, and height of the foot were analyzed using a 3D scanner to obtain the arch height ratio for the diagnosis of pediatric flat foot. Results: Statistical differences were observed for lengths, widths, and perimeters of the foot in boys aged 5 to 15–16 years and girls aged 5 to 12–13 years. Differences in the height of the navicular bone were found in all age groups, with changes from 2.8 to 4.1% in boys and from 1.3 to 1.5% in girls. The greatest differences between boys and girls of the same age were found at 14 years old onwards. The highest prevalence of flat foot was found in 8-year-old girls (64.9%) and in 12-year-old boys (82.5%). Conclusions: The feet of Ecuadorian children develop progressively during childhood and adolescence. Boys presented with longer and wider feet than girls of the same age. The highest prevalence of flat foot was found in 12-year-old boys and 8-year-old girls. Full article
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17 pages, 2460 KiB  
Review
Metabolic Bone Diseases Affecting Tooth Eruption: A Narrative Review
by Christianna Iris Papadopoulou, Iosif Sifakakis and Symeon Tournis
Children 2024, 11(6), 748; https://doi.org/10.3390/children11060748 - 20 Jun 2024
Viewed by 352
Abstract
Tooth eruption is an essential process for the development of the oral and maxillofacial system. Several inherited and acquired diseases might affect this tightly regulated process, resulting in premature, delayed, or even failed tooth eruption. The purpose of this article is to review [...] Read more.
Tooth eruption is an essential process for the development of the oral and maxillofacial system. Several inherited and acquired diseases might affect this tightly regulated process, resulting in premature, delayed, or even failed tooth eruption. The purpose of this article is to review the literature and the clinical parameters of metabolic bone diseases that affect tooth eruption. It examines the physiological aspects of tooth eruption and the pathophysiological changes induced by metabolic bone diseases, including changes in bone metabolism, density, and structure. The search strategy for this review included an electronic search in PubMed, Google Scholar, Medline, Scopus, and the Cochrane Library using the following keywords: “metabolic bone diseases”, “tooth eruption”, “delayed tooth eruption”, and each reported disease in combination with “tooth eruption disorders”, covering publications up to March 2024 and limited to English-language sources. Understanding the influence of metabolic bone diseases on tooth eruption is crucial for managing both dental and skeletal manifestations associated with these disorders. This review suggests that a multidisciplinary approach to treatment may significantly improve oral outcomes for patients suffering from such conditions. Clinicians should be aware of the specific dental abnormalities that may arise and consider comprehensive evaluations and individualized treatment plans. These findings underscore the need for further research into targeted therapies that address these abnormalities. Full article
(This article belongs to the Special Issue Advances in Orthodontic Technology and Individualized Treatment Volume II)
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12 pages, 238 KiB  
Systematic Review
Correlation between Early Visual Functions and Cognitive Outcome in Infants at Risk for Cerebral Palsy or Other Neurodevelopmental Disorders: A Systematic Review
by Olena Chorna, Giulia Corsi, Sabrina Del Secco, Ada Bancale and Andrea Guzzetta
Children 2024, 11(6), 747; https://doi.org/10.3390/children11060747 - 19 Jun 2024
Viewed by 252
Abstract
Early key visual skills, such as tracking objects, sustaining gaze, and shifting attention, rapidly develop within the first 6 months of infant life. These abilities play a significant role in the development of cognitive functions but are frequently compromised in infants at risk [...] Read more.
Early key visual skills, such as tracking objects, sustaining gaze, and shifting attention, rapidly develop within the first 6 months of infant life. These abilities play a significant role in the development of cognitive functions but are frequently compromised in infants at risk of developing neurodevelopmental disorders. This systematic review evaluates the potential of early vision function in the prediction of cognition at or above 12 months. Five databases were searched for relevant articles, and their quality was assessed with the Quality Assessment of Diagnostic Accuracy Studies tool. Eight studies were suitable, including 521 preterm-born infants at varying risk of developing Cerebral Palsy (CP). Each study showed a significant correlation between vision and cognitive outcome. Predictive analysis including sensitivity and specificity was possible for three studies. Methodological quality was variable. Sensitivity ranged between 57 and 100% in the vision function assessments items, while specificity ranged from 59 to 100%. In conclusion, early vision showed strong correlation with cognition ≥ 12 months. While no single vision assessment was found to be superior, evaluation of specific functions, namely fixation and following, both at term age and between 3 and 6 months, demonstrated strong predictive validity. Full article
14 pages, 223 KiB  
Case Report
Selective Mutism and Comorbidity with Specific Learning Disorders: Evaluation and Multimodal Intervention in a Clinical Case of a Female Child from 7 to 11 Years of Age
by Micaela Capobianco and Alberto Costa
Children 2024, 11(6), 746; https://doi.org/10.3390/children11060746 - 19 Jun 2024
Viewed by 300
Abstract
Selective mutism (SM) is an anxiety disorder that is characterized by a child’s persistent inability to communicate verbally in some or all contexts of social life. It is often associated with other cognitive–affective disorders. Performing cognitive–behavioral assessments and psychological interventions can be challenging [...] Read more.
Selective mutism (SM) is an anxiety disorder that is characterized by a child’s persistent inability to communicate verbally in some or all contexts of social life. It is often associated with other cognitive–affective disorders. Performing cognitive–behavioral assessments and psychological interventions can be challenging due to the difficulty in administering standardized neuropsychological tests and involving family and teachers in the intervention program. In a single case study, a young Filipina girl with SM underwent a comprehensive neuropsychological assessment and received multimodal therapeutic intervention between the ages of 7 and 11. The psychological intervention included cognitive–behavioral psychotherapy to improve social–cognitive skills and learning abilities, reduce anxiety, and provide speech therapy. The parents and teachers were actively involved in the therapeutic process and a underwent a psycho-education program. Following this treatment, at the age of 11, the girl started verbalizing in therapy and school contexts, although she still used non-verbal strategies. There was also a gradual improvement in her communicative–linguistic skills and school learning. In conclusion, this report emphasizes the importance of applying an integrated and multimodal intervention to treat SM in children, including psychoeducation for parents and teachers. Full article
16 pages, 276 KiB  
Review
Validity, Reliability, Accessibility, and Applicability of Young Children’s Developmental Screening and Assessment Tools across Different Demographics: A Realist Review
by Stefan Kurbatfinski, Jelena Komanchuk, Aliyah Dosani and Nicole Letourneau
Children 2024, 11(6), 745; https://doi.org/10.3390/children11060745 - 18 Jun 2024
Viewed by 401
Abstract
Valid and reliable developmental screening and assessment tools allow professionals to identify disabilities/delays in children, enabling timely intervention to limit adverse lifelong impacts on health. However, differences in child development related to culture, genetics, and perinatal outcomes may impact tool applicability. This study [...] Read more.
Valid and reliable developmental screening and assessment tools allow professionals to identify disabilities/delays in children, enabling timely intervention to limit adverse lifelong impacts on health. However, differences in child development related to culture, genetics, and perinatal outcomes may impact tool applicability. This study evaluated the validity, reliability, and accessibility of multidomain developmental screening tools for young children, analyzed the applicability of tools across different contexts, and created a compendium of tools. Employing adapted realist review methods, we searched APA PsycInfo, MEDLINE, CINAHL, ERIC, and Google to identify relevant articles and information. We assessed accessibility, validity, reliability, and contextual applicability (N = 4110 evidence sources) to create tool ratings and make recommendations. Of 33 identified tools, 22 were screening and 11 were assessment tools. Fewer screening tools than assessment tools were rated highly overall. Evidence for use in different cultures was often lacking for both types of tools. The ASQ (screening) and BDI (assessment) tools were rated most favorably and are recommended for use, though other tools may be more applicable in different contexts (e.g., NEPSY among children with Asperger’s Syndrome). Future research should focus on assessing the validity and reliability of tools across different demographics to increase accessibility and ensure all children are properly supported. Full article
(This article belongs to the Collection Emotional and Behavioral Problems in Children and Adolescents: Assessment and Intervention)
11 pages, 750 KiB  
Article
Contribution of Treatment with Ear Popper for Hearing in Children with Middle Ear Effusion
by Ronit Priner and Ophir Ilan
Children 2024, 11(6), 744; https://doi.org/10.3390/children11060744 - 18 Jun 2024
Viewed by 237
Abstract
Objectives: we aim to assess the contribution of the EarPopper device to hearing in children with middle ear effusion (MEE). Methods: The study has three parts, including 1. tympanometry and audiometry before and six weeks after using the EarPopper to evaluate the treatment’s [...] Read more.
Objectives: we aim to assess the contribution of the EarPopper device to hearing in children with middle ear effusion (MEE). Methods: The study has three parts, including 1. tympanometry and audiometry before and six weeks after using the EarPopper to evaluate the treatment’s effect over time compared to a control group; 2. tympanometry before and immediately after using the EarPopper to evaluate immediate changes in middle ear pressure (MEP); 3. length of effect 90 min after use to assess pressure fluctuations over time. Results: Part 1 was a follow-up six weeks after using the device, and the patients in the study group that completed the study showed a significant improvement in hearing threshold. The average gain in hearing threshold ranged from 9.1 dB to 14 dB compared to the control group’s max improvement of 1.1 dB. In addition, MEP was significantly improved in the study group, as most Type Bs improved to Type A and C. Part 2 was the tympanometry immediately after using EarPopper and showed the majority of Type Cs turned into Type As. The majority of Type Bs remained unchanged. Part 3 was a follow-up 90 min after use; Type Cs that had improved to Type A demonstrated a decrease in pressure and return to negative pressure. Conclusions: use of the EarPopper device for six weeks is associated with an improved hearing threshold and middle ear status. Full article
(This article belongs to the Special Issue Assessing the Auditory System across Infancy and Childhood: From Ear Level to Brain)
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14 pages, 986 KiB  
Systematic Review
The Childbirth Experiences of Pregnant Women Living with HIV Virus: Scoping Review
by Andréa Paula de Azevedo, Jorge Fonte de Rezende Filho, Cristina Barroso Hofer and Francisca Rego
Children 2024, 11(6), 743; https://doi.org/10.3390/children11060743 - 18 Jun 2024
Viewed by 300
Abstract
OBJECTIVE: Understand and explore the childbirth experiences of pregnant women living with HIV (PWLWHIV). With the advent of several measures to decrease the intrapartum HIV infection and a strong emphasis on the humanization of childbirth, there is a growing focus on providing positive [...] Read more.
OBJECTIVE: Understand and explore the childbirth experiences of pregnant women living with HIV (PWLWHIV). With the advent of several measures to decrease the intrapartum HIV infection and a strong emphasis on the humanization of childbirth, there is a growing focus on providing positive childbirth experiences for pregnant women. Indeed, a positive childbirth experience is even more important in the group of pregnant women living with HIV (PWLWHIV) as it plays a pivotal role in enhancing the mother’s adherence to her postpartum treatment and the newborn’s engagement in Infectious Disease services. METHODOLOGY: A scoping review was conducted. Searches were performed on databases, such as MEDLINE, PUBMED, WEB OF SCIENCE and Cochrane Library, using the following keywords: childbirth, birth, parturition, HIV, humaniz*, perceived safety, experience, maternal satisfaction, healthcare professional and midwi*. Articles meeting pre-established criteria were selected within the timeframe of 2013 to 2023 for inclusion in the review. RESULTS: Out of a total of 2,340,391 articles, 4 were chosen based on our defined criteria. Three primary themes emerged from the selected articles: the assessment of childbirth experience quality, vulnerability and autonomy. CONCLUSIONS: The four studies identified had a small sample size and were not adequately conducted with a specific focus on studying the childbirth experience of pregnant women living with HIV (PWLWHIV). This scoping review revealed a gap in the existing literature, indicating a need for further research and clarification in the identified area. Full article
(This article belongs to the Special Issue Maternal and Child's Health)
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8 pages, 370 KiB  
Article
Gastrointestinal Symptoms and Fermentable Oligosaccharides, Disaccharides, Monosaccharides, and Polyols Sources in Schoolchildren—A Pilot Study
by Miguel Saps, Carlos Alberto Velasco-Benitez, Daniela Alejandra Velasco-Suarez, Maura Alvarez-Baumgartner, Amber N. Balda and Samantha Arrizabalo
Children 2024, 11(6), 742; https://doi.org/10.3390/children11060742 - 18 Jun 2024
Viewed by 419
Abstract
Bothersome gastrointestinal (GI) signs/symptoms, including abdominal pain, distension, nausea, and flatulence, are common in children. A diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) is frequently recommended for children with GI symptoms. Currently, there are no studies on the effect of [...] Read more.
Bothersome gastrointestinal (GI) signs/symptoms, including abdominal pain, distension, nausea, and flatulence, are common in children. A diet low in fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAPs) is frequently recommended for children with GI symptoms. Currently, there are no studies on the effect of FODMAPs in healthy schoolchildren. In this cross-sectional study, schoolchildren reported an association between FODMAPs and GI symptoms through a standardized questionnaire and images of 20 common staples known to be rich in FODMAPs. A total of 208 schoolchildren aged 8–18 years old participated. A proportion of 38.0% of children reported GI symptoms, with abdominal pain (33%) being the most common complaint followed by abdominal distension (24%) and nausea (23%). The majority of children who reported intolerances to FODMAP-containing foods were intolerant to less than two food groups (76%). While vegetables and legumes (26%), particularly black beans (11%) and onions (7%), emerged as the most common group of triggers, milk (12%) stood out as the single food most frequently associated with GI symptoms. In conclusion, there was a high prevalence of FODMAPs intolerance among schoolchildren. Larger studies are recommended to confirm these findings and to inform possible dietary interventions to reduce the effect of FODMAPs on schoolchildren. Full article
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9 pages, 1628 KiB  
Article
Intra- and Interobserver Variability in Ultrasound Measurement of Testicular Volumes in Pubertal Boys
by Frank-Mattias Schäfer, Daniel Bürgener, Maximilian Stehr and Oliver Rompel
Children 2024, 11(6), 741; https://doi.org/10.3390/children11060741 - 17 Jun 2024
Viewed by 310
Abstract
Accurate measurement of testicular volume (TV) in boys is an important tool in clinical practice, e.g., in varicocele treatment. This study aims to assess the degree of intra- and interobserver variability of testicular volume measurements. In a prospective study, boys between 11 and [...] Read more.
Accurate measurement of testicular volume (TV) in boys is an important tool in clinical practice, e.g., in varicocele treatment. This study aims to assess the degree of intra- and interobserver variability of testicular volume measurements. In a prospective study, boys between 11 and 17 years of age without testicular pathology were enrolled. Testicular ultrasound was performed by three investigators (A: pediatric radiologist; B: pediatric surgery/urology resident; C: pediatric urologist). Intraobserver variability was calculated in investigators B and C and interobserver variability between all three investigators. A total of 30 boys were enrolled. Mean intraobserver variability in both observers was +0.3% with a range of −39.6 to 51.5%. The proportion of measurements with a difference >20% was 18.6%. The mean interobserver variability was −1.0% (range: −74.1% to 62.8%). The overall proportion of measurements with a difference >20% was 35%. A lower testicular size of < 4 mL showed a significantly higher rate of >20% difference in both the intraobserver group (31.1% vs. 14.4%; p = 0.035) and the interobserver group (63.2% vs. 26.2%; p = 0.000031). Furthermore, the rate of >20% difference was significantly lower in obese compared to non-obese patients in both the intraobserver (2.8% vs. 22.4%; p = 0.0084) and the interobserver group (24% vs. 40.8%, p = 0.0427). Both intraobserver and interobserver variability in ultrasound-based TV measurements in pubertal boys contain a relevant degree of uncertainty that renders them unsuitable for individualized follow-up care. At the cohort level, however, mean differences in ultrasound-based TV measurements are low enough to make ultrasound comparisons reasonable. Full article
(This article belongs to the Section Pediatric Surgery)
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9 pages, 223 KiB  
Article
Skin Reactions in Children with Type 1 Diabetes Associated with the Use of New Diabetes Technologies—An Observational Study from a Regional Polish Pediatric Diabetes Center
by Ewa Ledwoń, Paula Zemła-Szten, Thekla von dem Berge, Krzysztof Nalewajko, Stefano Passanisi, Claudia Piona, Tiago Jeronimo dos Santos, Jannet Svensson, Anna Korsgaard Berg and Agata Chobot
Children 2024, 11(6), 740; https://doi.org/10.3390/children11060740 - 17 Jun 2024
Viewed by 344
Abstract
The study aimed to estimate the prevalence of skin problems in children and adolescents with type 1 diabetes (T1D) using insulin pumps (IPs) and/or continuous glucose monitoring (CGM) in our center and analyze their association with various factors. As part of the international [...] Read more.
The study aimed to estimate the prevalence of skin problems in children and adolescents with type 1 diabetes (T1D) using insulin pumps (IPs) and/or continuous glucose monitoring (CGM) in our center and analyze their association with various factors. As part of the international ISPAD JENIOUS-initiated SKIN-PEDIC project, we interviewed and examined patients who visited the regional pediatric diabetes center in Opole (Poland) for four weeks regarding the use of IP and/or CGM and the presence of skin problems. Body mass index (BMI) and glycemic parameters were obtained retrospectively from medical records. Among 115 individuals (45.2% girls, 83.5% IP users, 96.5% CGM users), old scars were the most common skin problem (IP users 53.1%; CGM users 66.4%), while ≥2 types of skin problems co-occurred (IP users 40.6%; CGM users 27.3%). Longer IP use was associated with a higher prevalence of skin problems (50% for IP < 1 year, 98.1%-IP 1–3 years, 100% for IP > 3 years; p < 0.001), pointing out extra attention with IP use > 1 year. No significant associations were found between skin problems and gender, age, BMI centile and glycemic parameters. Dermatological complications were common among children using IP and CGM in our center, highlighting the need for vigilant monitoring and early intervention to manage these skin-related issues effectively. Full article
(This article belongs to the Special Issue Glycemic Control in Children and Adolescents with Type 1 Diabetes)
11 pages, 2861 KiB  
Article
The Impact of Parental Involvement in the Prevention and Management of Obesity in Children: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
by Abdulsalam M. Aleid, Noor M. Sabi, Ghaida Saleh Alharbi, Atheer A. Alharthi, Sarah M. Alshuqayfi, Nirmeen S. Alnefiae, Gawaher M. Ismail, Abdulaziz K. Allhybi, Awatif M. Alrasheeday, Bushra Alshammari, Yasmine Alabbasi and Abbas Al Mutair
Children 2024, 11(6), 739; https://doi.org/10.3390/children11060739 - 17 Jun 2024
Viewed by 586
Abstract
Background: Obesity in children is a critical public health issue in developed countries and developing countries. The establishment of health-related behaviors in childhood, significantly influenced by parental involvement, underscores the need for effective intervention measures. Aim: This original research is a systematic review [...] Read more.
Background: Obesity in children is a critical public health issue in developed countries and developing countries. The establishment of health-related behaviors in childhood, significantly influenced by parental involvement, underscores the need for effective intervention measures. Aim: This original research is a systematic review and meta-analysis that aimed to investigate the impact of parental involvement on the prevention and management of childhood obesity, focusing on outcomes such as BMI z-score, exercise levels, screen time, dietary self-efficacy, and percentage body fat. Methods: Adhering to the PRISMA guidelines, we conducted a systematic review and meta-analysis of 12 randomized controlled trials (RCTs) identified through comprehensive searches of PubMed, Scopus, Web of Science, and the Cochrane Library, including RCTs involving children aged 2–18 years with parental or caregiver participation, reporting on the specified outcomes. Data analysis was performed using RevMan 5.3, employing a random effects model. Results: A total of 5573 participants were included. The meta-analysis revealed a significant reduction in BMI z-score (MD = −0.06, 95% CI: −0.09 to −0.02, p = 0.005, I2 = 58%), a non-significant increase in exercise levels (SMD = 0.26, 95% CI: −0.01 to 0.52, p = 0.05, I2 = 52%), and a significant reduction in screen time (MD = −0.36 h per day, 95% CI: −0.61 to −0.11, p = 0.005, I2 = 0%). Dietary self-efficacy also improved significantly (MD = 0.59, 95% CI: 0.12 to 1.05, p = 0.01, I2 = 0%). However, changes in percentage body fat did not reach statistical significance (MD = −1.19%, 95% CI: −2.8% to 0.41%, p = 0.15, I2 = 0%). Conclusion: Parental involvement in childhood obesity interventions significantly impacts BMI z-score, exercise levels, screen time, and dietary self-efficacy but not percentage body fat. These findings highlight the importance of engaging parents in obesity prevention and management strategies. Full article
(This article belongs to the Special Issue Obesity in Children: Public Health Challenge from Lifestyle Modification to Treatment of Its Complications)
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12 pages, 869 KiB  
Article
Prevalence and Risk Factors of Healthcare-Associated Infections among Hospitalized Pediatric Patients: Point Prevalence Survey in Thailand 2021
by Visal Moolasart, Chaisiri Srijareonvijit, Lantharita Charoenpong, Winnada Kongdejsakda, Suvaporn Anugulruengkitt, Anond Kulthanmanusorn, Varaporn Thienthong, Sang Usayaporn, Wanwisa Kaewkhankhaeng, Oranat Rueangna, Jiratchaya Sophonphan, Weerawat Manosuthi and Viroj Tangcharoensathien
Children 2024, 11(6), 738; https://doi.org/10.3390/children11060738 - 17 Jun 2024
Viewed by 481
Abstract
Background: Healthcare-associated infections (HAIs) pose a grave threat to patient safety, morbidity, and mortality, contributing to antimicrobial resistance. Thus, we estimated the point prevalence, risk factors, types, and pathogens of HAIs in hospitalized pediatric patients. Methods: A point prevalence survey (PPS) of HAIs [...] Read more.
Background: Healthcare-associated infections (HAIs) pose a grave threat to patient safety, morbidity, and mortality, contributing to antimicrobial resistance. Thus, we estimated the point prevalence, risk factors, types, and pathogens of HAIs in hospitalized pediatric patients. Methods: A point prevalence survey (PPS) of HAIs in hospitalized pediatric patients < 18 years old was conducted from March to May 2021. Outcomes, risk factors, and types of HAIs associated with HAIs in 41 hospitals across Thailand were collected. Results: The prevalence of HAIs was 3.9% (95% CI 2.9–5.0%) (56/1443). By ages < 1 month, 1 month–2 years, 2–12 years, and 12–18 years, the prevalence of HAIs was 4.2%, 3.3%, 4.1%, and 3.0%, respectively (p = 0.80). Significant independent risk factors were extended hospital length of stay (LOS) and central venous catheter (CVC) use. Compared to an LOS of <4 days, LOSs of 4–7 days, 8–14 days, and >14 days had adjusted odds ratios (aORs) of 2.65 (95% CI 1.05, 6.68), 5.19 (95% CI 2.00, 13.4), and 9.03 (95% CI 3.97, 20.5), respectively. The use of a CVC had an aOR of 2.45 (95% CI 1.06–5.66). Lower respiratory tract infection (LRTI) was the most common HAI type (46.4%: 26/56). The highest prevalence of HAIs was predominantly observed in LRTI diagnoses, with the highest among these in the <1 month age category at 2.3% (17/738). Conclusion: The prevalence of HAIs in hospitalized pediatric patients was 3.9%. Extended LOS and use of CVC were HAI risk factors. A strategy for reducing LOS and reviewing insertion indications or the early planned removal of a CVC was implemented. The surveillance of HAIs stands as a cornerstone and fundamental component of IPC, offering invaluable insights that enhance hospital IPC interventions aimed at preventing HAIs. Full article
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12 pages, 1259 KiB  
Article
Identifying Key Biomarkers in Pediatric Pulmonary Hypertension: An Investigative Approach
by Farida Mindubayeva, Lyudmila Akhmaltdinova, Mariya Ospanova, Bibigul Tukbekova, Zhanat Bolatbekuly, Yuliya Niyazova, Yelena Salikhova, Olga Avdienko and Meruert Akhmetova
Children 2024, 11(6), 737; https://doi.org/10.3390/children11060737 - 17 Jun 2024
Viewed by 386
Abstract
This study assesses the utility of early biomarkers—5-hydroxyindoleacetic acid (5-HIAA) and insulin-like growth factor 1 (IGF-1)—for diagnosing and monitoring pulmonary hypertension (PH) in children with congenital heart defects (CHD). Due to the risks associated with invasive diagnostics, such as right heart catheterization, non-invasive [...] Read more.
This study assesses the utility of early biomarkers—5-hydroxyindoleacetic acid (5-HIAA) and insulin-like growth factor 1 (IGF-1)—for diagnosing and monitoring pulmonary hypertension (PH) in children with congenital heart defects (CHD). Due to the risks associated with invasive diagnostics, such as right heart catheterization, non-invasive biomarkers provide a safer alternative for early PH detection. This cohort-based study utilized blood and urine samples to measure 5-HIAA and IGF-1 levels via enzyme immunoassays. Our findings revealed significant changes in 5-HIAA concentrations across various biological matrices, supporting its potential as a diagnostic tool. Specifically, altered levels in urine and plasma reflect its role in serotonin metabolism and vascular remodeling in PH. IGF-1 levels were notably reduced in plasma, suggesting its involvement in PH pathophysiology. ROC analysis confirmed the diagnostic efficacy of these biomarkers, particularly 5-HIAA’s high specificity and sensitivity. In conclusion, 5-HIAA and IGF-1 levels correlate well with PH, underscoring their diagnostic value for early PH detection in children with CHD. Full article
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11 pages, 1551 KiB  
Article
Application of Interferon-γ Release Assay in the Assessment of T-Cell Immunity to SARS-CoV-2 Antigens in the Cohort of Pediatric Patients with Juvenile Idiopathic Arthritis
by Katarzyna Kapten, Krzysztof Orczyk and Elzbieta Smolewska
Children 2024, 11(6), 736; https://doi.org/10.3390/children11060736 - 16 Jun 2024
Viewed by 479
Abstract
Background: an accurate assessment of the immunity against SARS-CoV-2 can facilitate a better understanding and management of not only the recent coronavirus but similar pathogens as well. Objective: the aim of this study was to evaluate T-cell immunity with reference to antibody titers [...] Read more.
Background: an accurate assessment of the immunity against SARS-CoV-2 can facilitate a better understanding and management of not only the recent coronavirus but similar pathogens as well. Objective: the aim of this study was to evaluate T-cell immunity with reference to antibody titers in a group of pediatric patients with autoimmune arthritides utilizing the widely known Interferon-γ Release Assay (IGRA). Materials and Methods: This study was conducted in the cohort of 55 children suffering from Juvenile Idiopathic Arthritis (JIA). This research analyzed the SARS-CoV-2 T-cell response measured by a specific quantitative IGRA, followed by a serological ELISA test measuring the presence and quantity of IgG, IgM, and IgA antibodies in serum. Results: The cellular response to SARS-CoV-2 measured by the IGRA test significantly correlated with the antibody titers, IgA (p < 0.00003, R = 0.537), IgG (p < 0.0001, R = 0.668), and IgG nucleocapsid protein (NCP) (p < 0.003, R = 0.0399), with no correlation with IgM levels. The antibody levels in patients receiving biological agents were significantly lower compared to the rest of the cohort (p = 0.0369), while traditional disease-modifying antirheumatic drugs had no such effect. Limitations: the main limitation of the research is the small sample size, mostly due to the specific cohort of patients and the lack of a healthy control. Conclusions: IGRA appears to be a viable tool in the accurate evaluation of T-cell responses to SARS-CoV-2, and serodiagnostics alone is not always sufficient in the assessment of immune responses. Full article
(This article belongs to the Special Issue Diagnosis, Treatment and Care of Pediatric Rheumatology)
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9 pages, 229 KiB  
Article
Younger Children with Respiratory Tract Infections Are More Exposed to Off-Label Treatments: An Exploratory Retrospective Study in a Pediatric Emergency Setting
by Greta Venckute, Erika Zekaite-Vaisniene, Urte Oniunaite and Lina Jankauskaite
Children 2024, 11(6), 735; https://doi.org/10.3390/children11060735 - 16 Jun 2024
Viewed by 515
Abstract
Off-label drug use is prevalent in the pediatric population and represents a patient safety concern. We aimed to identify factors for off-label drug use in our pediatric emergency department (PED). Methods. We performed a retrospective data analysis. All patients aged 0–18 referred to [...] Read more.
Off-label drug use is prevalent in the pediatric population and represents a patient safety concern. We aimed to identify factors for off-label drug use in our pediatric emergency department (PED). Methods. We performed a retrospective data analysis. All patients aged 0–18 referred to PED from 1 September to 1 October 2022, were included. Further analysis was performed when respiratory tract infections were diagnosed. Data collected: gender, age, triage group, chronic diseases, vital signs, and PED-prescribed treatment (medications, dosages, methods of administration). Statistical analysis used SPSS 28.0, with significance at p < 0.05. Results. Data from 473 patients were analyzed, median age 3.5 years. Chronic diseases were present in 17.1% of children. 387 medications were prescribed, 47.5% being off-label. Off-label treatment was common for external otitis, acute laryngitis, and acute bronchitis (p < 0.001). There was incorrect administration of tobramycin with dexamethasone for otitis (n = 16, 100%) and inappropriate use of salbutamol inhalations by age (34.8%, n = 16). Some medications were given orally instead of injections (ondansetron n = 5, 62.5%; dexamethasone n = 82, 98.7%) or intranasally instead of intravenously (IV) (midazolam n = 7, 87.5%). IV adrenalin was prescribed for inhalations (n = 46). Younger children were more likely to receive off-label treatment (p < 0.001). Conclusion. Our study highlights the widespread issue of off-label and unlicensed drug prescribing in pediatric emergency care. Further research is necessary, because this reliance on off-label prescribing raises concerns about patient safety and compliance, especially given the limited clinical trials and therapeutic options available. Full article
12 pages, 233 KiB  
Article
Families of Children with Intellectual and Developmental Disabilities: Variables Associated with Family Quality of Life
by Ghaleb H. Alnahdi and Susanne Schwab
Children 2024, 11(6), 734; https://doi.org/10.3390/children11060734 - 15 Jun 2024
Viewed by 468
Abstract
Families of children with intellectual and developmental disabilities often face unique challenges that significantly impact their quality of life. Understanding the predictors of family quality of life (FQOL) is crucial for developing effective support systems and interventions. Aim: This study investigated the predictors [...] Read more.
Families of children with intellectual and developmental disabilities often face unique challenges that significantly impact their quality of life. Understanding the predictors of family quality of life (FQOL) is crucial for developing effective support systems and interventions. Aim: This study investigated the predictors that might influence the perception of families having a member with a disability regarding their quality of life (FQOL). Method: The sample consisted of 320 family members from the Riyadh region of Saudi Arabia. Results: The overall results showed that participants’ satisfaction with FQOL was at a moderate level. Further results indicated that variables associated with severity, type of disability, and the mother’s age and education were significant predictors of the FQOL. Conclusions: These results emphasize the importance of considering the variables that impact FQOL, such as the severity and type of disability, and mother’s related variables, when directing support to families with a member with a disability. The recommendations and limitations of the study were discussed. Full article
(This article belongs to the Section Child and Adolescent Psychiatry)
14 pages, 962 KiB  
Systematic Review
Anatomical Studies Evaluating Pediatric Regional Anesthesia: A Scoping Review
by Lucas Ferreira Gomes Pereira, Ricardo Vieira Carlos, Albert van Schoor, Adrian Bosenberg, Natália Mariana Silva Luna, Rebeca da Costa Silva, Bianca de Fátima Bertanha, Maria José Carvalho Carmona and Vinícius Caldeira Quintão
Children 2024, 11(6), 733; https://doi.org/10.3390/children11060733 - 15 Jun 2024
Viewed by 300
Abstract
Background: Pediatric regional anesthesia has been driven by the gradual rise in the adoption of opioid-sparing strategies and the growing concern over the possible adverse effects of general anesthetics on neurodevelopment. Nonetheless, performing regional anesthesia studies in a pediatric population is challenging and [...] Read more.
Background: Pediatric regional anesthesia has been driven by the gradual rise in the adoption of opioid-sparing strategies and the growing concern over the possible adverse effects of general anesthetics on neurodevelopment. Nonetheless, performing regional anesthesia studies in a pediatric population is challenging and accounts for the scarce evidence. This study aimed to review the scientific foundation of studies in cadavers to assess regional anesthesia techniques in children. Methods: We searched the following databases MEDLINE, EMBASE, and Web of Science. We included anatomical cadaver studies assessing peripheral nerve blocks in children. The core data collected from studies were included in tables and comprised block type, block evaluation, results, and conclusion. Results: The search identified 2409 studies, of which, 16 were anatomical studies on the pediatric population. The techniques evaluated were the erector spinae plane block, ilioinguinal/iliohypogastric nerve block, sciatic nerve block, maxillary nerve block, paravertebral block, femoral nerve block, radial nerve block, greater occipital nerve block, infraclavicular brachial plexus block, and infraorbital nerve block. Conclusion: Regional anesthesia techniques are commonly performed in children, but the lack of anatomical studies may result in reservations regarding the dispersion and absorption of local anesthetics. Further anatomical research on pediatric regional anesthesia may guide the practice. Full article
(This article belongs to the Section Pediatric Intensive Care Medicine)
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9 pages, 521 KiB  
Article
Epidemiology of Pediatric Cardiomyopathy in a Mediterranean Population
by Alena Bagkaki, Fragiskos Parthenakis, Gregory Chlouverakis, Aris Anastasakis, Ioannis Papagiannis, Emmanouil Galanakis and Ioannis Germanakis
Children 2024, 11(6), 732; https://doi.org/10.3390/children11060732 - 15 Jun 2024
Viewed by 354
Abstract
Background. Our knowledge regarding the epidemiology of pediatric cardiomyopathy is based on large national population studies reporting an annual incidence of 1 case per 100,000 children, with a higher incidence observed in infancy and among selected populations. The aim here is to document [...] Read more.
Background. Our knowledge regarding the epidemiology of pediatric cardiomyopathy is based on large national population studies reporting an annual incidence of 1 case per 100,000 children, with a higher incidence observed in infancy and among selected populations. The aim here is to document the epidemiology of pediatric cardiomyopathy in a Mediterranean population. Methods. Children younger than 18 years of age living on the Mediterranean island of Crete, Greece, who have been evaluated since the establishment of tertiary pediatric cardiology services (2002–2022) were included in this retrospective study. Results. A total of 40 children were included, corresponding to an average annual incidence of pediatric cardiomyopathy of 1.59 cases (95% CI: 1.4–2.3) and a prevalence of 26 cases per 100,000 children. In decreasing order of frequency, most cases corresponded to dilated (50%), followed by hypertrophic (42.5%), arrhythmogenic (5%), and restrictive (2.5%) cardiomyopathy. An etiology was identified in 40%, including a genetic diagnosis in 22.5%. Conclusions. The incidence of pediatric cardiomyopathy in the Mediterranean island of Crete is higher compared with that reported previously for other Caucasian populations. Further study is needed to investigate the exact prevalence and specific genetic factors associated with the epidemiology of pediatric cardiomyopathy in Mediterranean populations. Full article
(This article belongs to the Section Pediatric Cardiology)
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11 pages, 221 KiB  
Article
Antibiotic Exposure of Critically Ill Children at a Tertiary Care Paediatric Intensive Care Unit in Switzerland
by Anica Fenner, Melanie Huber, Verena Gotta, Vera Jaeggi, Luregn J. Schlapbach and Philipp Baumann
Children 2024, 11(6), 731; https://doi.org/10.3390/children11060731 - 15 Jun 2024
Viewed by 466
Abstract
Antibiotic overtreatment fosters multidrug-resistance that threatens healthcare systems worldwide as it increases patient morbidity and mortality. Contemporary data on antibiotic usage on tertiary care paediatric intensive care units for in- and external benchmarking are scarce. This was a single-centre retrospective quality control study [...] Read more.
Antibiotic overtreatment fosters multidrug-resistance that threatens healthcare systems worldwide as it increases patient morbidity and mortality. Contemporary data on antibiotic usage on tertiary care paediatric intensive care units for in- and external benchmarking are scarce. This was a single-centre retrospective quality control study including all patients with antibiotic treatment during their hospitalization at a paediatric intensive care unit in the time period 2019–2021. Antibiotic treatment was calculated as days of therapy (DOT) per 100 patient days (DOT/100pd). Further, the variables PIM II score, length of stay in intensive care (LOS), gender, age, treatment year, reason for intensive care unit admission, and death were assessed. Two thousand and forty-one cases with a median age of 10 months [IQR 0–64] were included; 53.4% were male, and 4.5% of the included patients died. Median LOS was 2.73 days [0.07–5.90], and PIM II score was 1.98% [0.02–4.86]. Overall, the antibiotic exposure of critically ill children and adolescents was 59.8 DOT/100pd. During the study period, the antibiotic usage continuously increased (2019: 55.2 DOT/100pd; 2020: 59.8 DOT/100pd (+8.2%); 2021: 64.5 DOT/100pd (+8.0%)). The highest antibiotic exposure was found in the youngest patients (0–1 month old (72.7 DOT/100pd)), in patients who had a LOS of >2–7 days (65.1 DOT/100pd), those who had a renal diagnosis (98 DOT/100pd), and in case of death (91.5 DOT/100pd). Critically ill paediatric patients were moderately exposed to antibiotics compared to data from the previously published literature. The current underreporting of antimicrobial prescription data in this cohort calls for future studies for better internal and external benchmarking. Full article
10 pages, 227 KiB  
Article
Self-Assessed Educational Needs of Chinese Pediatric Clinicians Regarding Pediatric Palliative Care: A Cross-Sectional Investigation
by Xiaoxia Lu, Yanmei Wang, Jingke Li, Yue-Cune Chang and Niang-Huei Peng
Children 2024, 11(6), 730; https://doi.org/10.3390/children11060730 - 14 Jun 2024
Viewed by 266
Abstract
Background: An important first step in enhancing professional palliative care training is to investigate the educational needs of pediatric clinicians in this field. The aims of this research were to analyze the extent of end-of-life care experience of Chinese pediatric clinicians and identify [...] Read more.
Background: An important first step in enhancing professional palliative care training is to investigate the educational needs of pediatric clinicians in this field. The aims of this research were to analyze the extent of end-of-life care experience of Chinese pediatric clinicians and identify the differing educational needs of physicians and nurses as well as associated impact factors. Methods: A cross-sectional descriptive survey via a structural questionnaire was used in this research. Results: In total, 187 clinicians, comprising 52 physicians and 135 nurses, participated in this study. The topics “pain management”, “symptom management”, and “discussing the prognosis with family members” were the most expressed educational needs among both physicians and nurses. Compared to nurses, physicians placed greater emphasis on the importance of “communication” and “pain and symptom management” (p < 0.05). Clinicians with more extensive end-of-life care experience more strongly felt the importance of learning about pain management and communication regarding end-of-life care (p < 0.05). Conclusions: Research showed that the education currently provided to pediatric clinicians does not meet their distinctive needs. Future palliative care education must be a continuing multi-level, interdisciplinary program and different education should be provided to physicians and nurses based on their respective needs. Full article
(This article belongs to the Topic Diversity, Educational Inclusion, Emotional Intelligence, Coping, and Other Factors That Influence Psychological Health and Well-Being)
52 pages, 1044 KiB  
Systematic Review
Vulnerability in Children with Celiac Disease: Findings from a Scoping Review
by Lúcia Macedo, Marta Catarino, Constança Festas and Paulo Alves
Children 2024, 11(6), 729; https://doi.org/10.3390/children11060729 - 14 Jun 2024
Viewed by 323
Abstract
(1) Background: The scientific literature highlights that children diagnosed with celiac disease (CD) are at a heightened risk of experiencing physical, psychological, and social challenges, impacting their overall healthy childhood development. However, there remains a lack of a clear understanding regarding the factors [...] Read more.
(1) Background: The scientific literature highlights that children diagnosed with celiac disease (CD) are at a heightened risk of experiencing physical, psychological, and social challenges, impacting their overall healthy childhood development. However, there remains a lack of a clear understanding regarding the factors that contribute to this vulnerability. The purpose of this study is to analyze and map the evidence on the sociopsychosomatic vulnerability of these children and identify gaps in this topic. (2) Methods: Following Joanna Briggs Institute’s guidelines for scoping reviews, we executed a detailed search of key electronic databases and explored the grey literature to capture a broad spectrum of studies. Our focus was on identifying research that looked into the multiple dimensions of vulnerability—physical, psychological, and social—in children with CD. We included a diverse range of study designs as well as systematic reviews, ensuring a comprehensive analysis. The selection process was stringent, utilizing clearly defined inclusion and exclusion criteria. (3) Results: We identified 61 studies that met our inclusion criteria. The review highlighted significant adverse health outcomes in children with CD and elucidated various individual and environmental determinants that influenced these vulnerabilities. It also underscored the lack of assessment tools to evaluate the risk of health problems in this population. (4) Conclusions: The findings underscore a critical need for further research to deepen our understanding of the vulnerabilities associated with CD in children. Developing targeted assessment tools will be crucial in stratifying health risks and enhancing care strategies for this vulnerable population. Full article
(This article belongs to the Section Pediatric Nursing)
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8 pages, 239 KiB  
Article
Evaluation of Sleep Quality in Asthmatic Children with the Paediatric Sleep Questionnaire (PSQ)
by Mehmet Yaşar Özkars, Seda Çevik, Serap Ata, Alican Sarısaltık and Uğur Altaş
Children 2024, 11(6), 728; https://doi.org/10.3390/children11060728 - 14 Jun 2024
Viewed by 353
Abstract
Considering the high prevalence of sleep-related breathing disorders (SRBD) in asthmatic patients, we aimed to compare asthmatic children and healthy children in terms of SRBD according to Paediatric Sleep Questionnaire (PSQ) scores. A questionnaire covering sociodemographic characteristics of the patients and the PSQ, [...] Read more.
Considering the high prevalence of sleep-related breathing disorders (SRBD) in asthmatic patients, we aimed to compare asthmatic children and healthy children in terms of SRBD according to Paediatric Sleep Questionnaire (PSQ) scores. A questionnaire covering sociodemographic characteristics of the patients and the PSQ, which evaluates sleep quality and consists of 22 questions, was administered. During the data collection process, 180 patients in the patient group and 170 patients in the control group were included. The patient group showed statistically significantly higher total scores and subscale scores for snoring, sleepiness, and inattention compared to the control group. Statistically significant correlations were found between the sleepiness subscale and body mass index z score in a negative direction and between age at presentation and duration of asthma in a positive direction. Our findings endorse employing the PSQ as a screening instrument in the outpatient environment to ensure timely referral of asthma patients to a sleep specialist for SRBD evaluation. Considering the widespread occurrence of snoring and asthma, this tool could aid in identifying patients with an elevated risk of SRBD and expedite the scheduling of nocturnal polysomnography for these children. Full article
(This article belongs to the Special Issue Sleep-Disordered Breathing and Allergy in Children: Current Research Insights and Future Directions)
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12 pages, 1350 KiB  
Article
Characterization of Primary IGF-1 Deficiency in a Cohort of Canadian Children with Short Stature Using a Novel Algorithm Tailored to Electronic Medical Records
by Rinila Haridas, Carly Baxter, Saunya Dover, Ellen B. Goldbloom, Ivan Terekhov and Marie-Eve Robinson
Children 2024, 11(6), 727; https://doi.org/10.3390/children11060727 - 14 Jun 2024
Viewed by 357
Abstract
(1) Background: Severe primary insulin-like growth factor-I deficiency (SPIGFD) is a rare disorder causing short stature in children due to low insulin-like growth factor 1 (IGF-1) levels. Given the sparsity of reported cases of SPIGFD worldwide, the condition may be underdiagnosed, potentially preventing [...] Read more.
(1) Background: Severe primary insulin-like growth factor-I deficiency (SPIGFD) is a rare disorder causing short stature in children due to low insulin-like growth factor 1 (IGF-1) levels. Given the sparsity of reported cases of SPIGFD worldwide, the condition may be underdiagnosed, potentially preventing affected children from receiving therapy with recombinant human IGF-1 (rhIGF-1). Our objective was to determine the prevalence of SPIGFD among children with short stature at a large pediatric tertiary care center through the use of a novel electronic medical record (EMR) algorithm. (2) Methods: We queried our EMR using an algorithm that detected all children seen at our center between 1 November 2013 and 31 August 2021 with short stature and low IGF-1. We then conducted chart reviews, applying established diagnostic criteria for those identified with potential SPIGFD. (3) Results: From a cohort of 4863 children with short stature, our algorithm identified 30 (0.6%) patients with potential SPIGFD. Using chart reviews, we determined that none of these patients had SPIGFD. (4) Conclusions: Our algorithm can be used in other EMRs to identify which patients are likely to have SPIGFD and thus benefit from treatment with rhIGF-1. This model can be replicated for other rare diseases. Full article
(This article belongs to the Special Issue Pediatric Growth and Skeletal Disorders)
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18 pages, 317 KiB  
Article
Lifestyle Habits Related to Internet Use in Adolescents: Relationships between Wellness, Happiness, and Mental Health
by Sigita Lesinskienė, Rokas Šambaras, Agnė Butvilaitė, Justina Andruškevič, Margarita Kubilevičiūtė, Urtė Stanelytė, Severija Skabeikaitė, Izabelė Jūraitytė, Ieva Ridzvanavičiūtė, Kamilė Pociūtė and Natalja Istomina
Children 2024, 11(6), 726; https://doi.org/10.3390/children11060726 - 14 Jun 2024
Viewed by 736
Abstract
Background: Studies in recent years have shown a significant increase in problematic internet use. Prolonged internet usage negatively impacts various aspects of adolescents’ lifestyles. Methods: The survey was conducted in three Lithuanian cities—Vilnius, Klaipėda, and Molėtai—between October and December of 2023. The survey [...] Read more.
Background: Studies in recent years have shown a significant increase in problematic internet use. Prolonged internet usage negatively impacts various aspects of adolescents’ lifestyles. Methods: The survey was conducted in three Lithuanian cities—Vilnius, Klaipėda, and Molėtai—between October and December of 2023. The survey involved students between the ages of 12 and 16. The participants completed a questionnaire that included questions about wellness and happiness, the Internet Addiction Test (IAT), and the Strengths and Difficulties Questionnaire (SDQ). Our study aimed to investigate problematic internet use among Lithuanian adolescents and its relationships with wellness, happiness, and mental health. Results: This study included 1412 adolescents, with a mean age of 14.41 ± 1.20, with the sample composed of 52.3% boys. Boys indicated that they felt healthier and happier than girls (69.4% vs. 47.4%; 51.4% vs. 29.6%), p < 0.001. A total of 20.8% of students had IAT scores that reflect a normal level of internet usage. For IAT, the average score of girls was statistically significantly higher than that of boys (41.87 ± 12.24 vs. 39.96 ± 12.37), p < 0.001. The IAT score was higher in the group of students who felt less happy and healthy, had more frequent headaches or abdominal pain, and had problems with sleep, p < 0.001. A statistically significant, positive weak correlation was found between students’ IAT scores and SDQ internalizing and SDQ externalizing scores (r = 0.366; r = 0.385, p < 0.001). Conclusions: Prolonged internet use is arising as a serious problem among adolescents. Negative feelings, unhappiness, and poor emotion regulation have an association with internet addiction. Also, the female gender may be more associated with possible internet addiction. The results of this study can serve as initial steps toward developing preventive interventions. Full article
(This article belongs to the Special Issue Physical Activity and Lifestyle Habits in Children and Adolescents)
10 pages, 1391 KiB  
Article
Relationship between Baseline Serum Potassium and 1-Year Readmission in Pediatric Patients with Heart Failure: A Retrospective Cohort Study
by Yong Han, Yuqin Huang, Danyan Su, Dongli Liu, Cheng Chen and Yusheng Pang
Children 2024, 11(6), 725; https://doi.org/10.3390/children11060725 - 14 Jun 2024
Viewed by 381
Abstract
Pediatric heart failure (HF) is associated with high readmission rates, but the optimal serum potassium range for this population remains unclear. In this single-center retrospective cohort study, 180 pediatric patients hospitalized for HF between January 2016 and January 2022 were stratified into low-potassium [...] Read more.
Pediatric heart failure (HF) is associated with high readmission rates, but the optimal serum potassium range for this population remains unclear. In this single-center retrospective cohort study, 180 pediatric patients hospitalized for HF between January 2016 and January 2022 were stratified into low-potassium (<3.7 mmol/L), middle-potassium (3.7–4.7 mmol/L), and high-potassium (≥4.7 mmol/L) groups based on the distribution of potassium levels in the study population. The primary outcome was readmission for HF within 1 year of discharge. Cox regression and restricted cubic spline models were used to assess the association between potassium levels and 1-year HF readmission rates. Notably, 38.9% of patients underwent 1 or more 1-year readmissions for HF within 1 year. The high-potassium group had a significantly higher readmission frequency than the middle-potassium group. In multivariate Cox regression models, potassium levels of ≥4.7 mmol/L were independently associated with increased 1-year readmission risk. A J-shaped relationship was observed between baseline potassium levels and 1-year readmission risk, with the lowest risk at 4.1 mmol/L. In pediatric patients with HF, a serum potassium level ≥ 4.7 mmol/L was independently associated with increased 1-year readmission risk. Maintaining potassium levels within a narrow range may improve outcomes in this population. Full article
(This article belongs to the Special Issue Heart Failure in Children and Adolescents)
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11 pages, 503 KiB  
Article
Validity of the BOT-2 Short Form for Korean School-Age Children: A Preliminary Study
by Deukgeun Yoon, Dabin Choi, Misun Kim, Seokyeon Ji, Yoo-Sook Joung and Eun Young Kim
Children 2024, 11(6), 724; https://doi.org/10.3390/children11060724 - 13 Jun 2024
Viewed by 294
Abstract
The Bruininks–Oseretsky Test of Motor Proficiency Second Edition (BOT-2) is the most common motor assessment in Korea. The BOT-2–Short Form (SF) is preferred over the complete form (CF) in settings with limited time. The present study aimed to assess the validity of the [...] Read more.
The Bruininks–Oseretsky Test of Motor Proficiency Second Edition (BOT-2) is the most common motor assessment in Korea. The BOT-2–Short Form (SF) is preferred over the complete form (CF) in settings with limited time. The present study aimed to assess the validity of the BOT-2 SF in Korean school-age children. First, we verified that the BOT-2 SF reflects developmental changes in motor skills. Second, we compared the BOT-2 SF scores to those of the BOT-2 CF. A total of 283 Korean school-age children performed the BOT-2. The differences in the BOT-2 SF point according to age group (7 years, 8–9 years, and 10–12 years) were analyzed. A correlation analysis of the standard scores between the BOT-2 SF and CF was conducted. The sensitivity and specificity of the BOT-2 SF were calculated in reference to its CF. Overall, the BOT-2 SF point scores increased with age. The correlation between the total scores of the BOT-2 SF and CF was strong. The BOT-2 SF had a sensitivity of 83% and specificity of 92%. This study has demonstrated the validity of the BOT-2 SF in Korean school-age children. The BOT2 SF can be useful in screening Korean school-age children with motor skills problems. Full article
(This article belongs to the Special Issue Motor Development in Children)
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13 pages, 982 KiB  
Article
Incidence and Importance of Peripheral Vestibular Dysfunction in Adolescent Idiopathic Scoliosis
by Liliana Vlădăreanu, Mădălina Gabriela Iliescu, Iulia Tania Andronache and Elena Danteș
Children 2024, 11(6), 723; https://doi.org/10.3390/children11060723 - 13 Jun 2024
Viewed by 355
Abstract
Adolescent idiopathic scoliosis (AIS) is a common form of scoliosis. As the name suggests, etiopathogenesis is not clearly defined, so treatment is still anchored in the musculoskeletal theory and correction/prevention of high Cobb angle values. This study aimed to determine whether there is [...] Read more.
Adolescent idiopathic scoliosis (AIS) is a common form of scoliosis. As the name suggests, etiopathogenesis is not clearly defined, so treatment is still anchored in the musculoskeletal theory and correction/prevention of high Cobb angle values. This study aimed to determine whether there is any connection between developing scoliotic curvature and a positive history of motion sickness as a symptom of a peripheral vestibular dysfunction/deficit, and if vestibular rehabilitation exercises could be integrated into the treatment plan. The study was conducted over 12 months on a selected population of 159 patients to evaluate or treat scoliotic curvatures in a private clinic. The collected data were analyzed using IBM SPSS Statistics 25 and illustrated using Microsoft Office Excel/Word 2021. Patients with peripheral vestibular dysfunction had significantly higher Cobb angle values when compared to patients with a negative result in an instrumental test for peripheral vestibular dysfunction. Motion sickness was considerably more associated with peripheral vestibular dysfunction, and a positive Fukuda stepping test was associated with a positive history of motion sickness. Adolescent idiopathic scoliosis with higher Cobb angles is related to positive motion sickness history as part of peripheral vestibular dysfunction. Conservative treatment for scoliosis could incorporate sensory integration techniques, and a positive history of motion sickness could be an indicator of a higher risk of progression in adolescent idiopathic scoliosis. Full article
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10 pages, 243 KiB  
Article
Understanding the Multiple Influences on Black Parents’ School Involvement: A Longitudinal Perspective
by Adrian Gale, Ed-Dee Williams, Donte Boyd and Husain Lateef
Children 2024, 11(6), 722; https://doi.org/10.3390/children11060722 - 13 Jun 2024
Viewed by 299
Abstract
This study explores longitudinal influences of various factors on Black parents’ involvement in their children’s education. Guided by Hoover-Dempsey & Sandler’s Model of Parent Involvement, this research examines whether parents’ school climate perceptions, attitudes about involvement, self-efficacy, and children’s academic performance predict parent [...] Read more.
This study explores longitudinal influences of various factors on Black parents’ involvement in their children’s education. Guided by Hoover-Dempsey & Sandler’s Model of Parent Involvement, this research examines whether parents’ school climate perceptions, attitudes about involvement, self-efficacy, and children’s academic performance predict parent involvement over time. Utilizing data from the Maryland Adolescence in Context Study with a sample of 560 Black parents, we found that positive school climate perceptions and favorable attitudes towards involvement significantly predict increased parent involvement in later years. The results underscore the importance of supportive school environments and parent attitudes in fostering their involvement. Full article
(This article belongs to the Section Global Pediatric Health)
18 pages, 1200 KiB  
Article
Sex Differences in White Matter Diffusivity in Children with Developmental Dyslexia
by Gehna Gupta, C. Nikki Arrington and Robin Morris
Children 2024, 11(6), 721; https://doi.org/10.3390/children11060721 - 13 Jun 2024
Viewed by 479
Abstract
Despite the high prevalence of developmental dyslexia in the U.S. population, research remains limited and possibly biased due to the overrepresentation of males in most dyslexic samples. Studying biological sex differences in the context of developmental dyslexia can help provide a more complete [...] Read more.
Despite the high prevalence of developmental dyslexia in the U.S. population, research remains limited and possibly biased due to the overrepresentation of males in most dyslexic samples. Studying biological sex differences in the context of developmental dyslexia can help provide a more complete understanding of the neurological markers that underly this disorder. The current study aimed to explore sex differences in white matter diffusivity in typical and dyslexic samples in third and fourth graders. Participants were asked to complete behavioral/cognitive assessments at baseline followed by MRI scanning and diffusion-weighted imaging sequences. A series of ANOVAs were conducted for comparing group membership (developmental dyslexia or typically developing), gender status (F/M), and white matter diffusivity in the tracts of interest. The Results indicated significant differences in fractional anisotropy in the left hemisphere components of the inferior and superior (parietal and temporal) longitudinal fasciculi. While males with dyslexia had lower fractional anisotropy in these tracts compared to control males, no such differences were found in females. The results of the current study may suggest that females may use a more bilateral/alternative reading network. Full article
(This article belongs to the Special Issue Neurodevelopmental Disorders in Pediatrics)
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