Children

13 pages, 286 KiB

Open AccessArticle

Determinants of Creativity in Migrant versus Urban Children: A Case Study in China

by Yiqi Dai, Shunan Chen, Fengqian Mao and Junfang Xu

Children 2024, 11(7), 802; https://doi.org/10.3390/children11070802 (registering DOI) - 29 Jun 2024

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Objective: This study examines the current status and variations in creativity between migrant and urban children, exploring the influencing factors affecting creativity. Methods: We selected children from local households in Hangzhou City and non-local migrant households as participants. Their basic demographic information and [...] Read more.

Objective: This study examines the current status and variations in creativity between migrant and urban children, exploring the influencing factors affecting creativity. Methods: We selected children from local households in Hangzhou City and non-local migrant households as participants. Their basic demographic information and creative tendencies were assessed using the Children’s Basic Situation Questionnaire and Williams’ Creativity Tendency Measurement Scale, respectively. A multi-model regression analysis was conducted to analyze factors influencing creativity. Results: This study included 1047 children. Significant differences were observed between urban and migrant children regarding age, family type, number of siblings, parental education, parental presence at home, parental guidance in learning, experience of changing schools, having their own room, and academic performance. In addition, migrant children exhibited significantly lower creativity levels compared to urban children. The multi-model regression analysis showed that migrant status, a good parent–child relationship, having parents who often guide learning, having their own room, and excellent academic performance significantly influenced children’s creativity. Conclusions: Migrant children display lower levels of creativity than their urban counterparts, with notable differences across several factors. Full article

13 pages, 668 KiB

Open AccessSystematic Review

A Systematic Review on Ketamine and Esketamine for Treatment-Resistant Depression and Suicidality in Adolescents: A New Hope

by Simone Pardossi, Andrea Fagiolini, Simona Scheggi and Alessandro Cuomo

Children 2024, 11(7), 801; https://doi.org/10.3390/children11070801 (registering DOI) - 29 Jun 2024

Viewed by 92

Abstract

Treating depression in adolescents is a significant challenge, and major depressive disorder (MDD) with suicidal ideation and treatment-resistant depression (TRD) are common and potentially devastating to optimal psychological and physical development in this age group. Suicide is among the leading causes of youth [...] Read more.

Treating depression in adolescents is a significant challenge, and major depressive disorder (MDD) with suicidal ideation and treatment-resistant depression (TRD) are common and potentially devastating to optimal psychological and physical development in this age group. Suicide is among the leading causes of youth mortality, and TRD occurs in up to 40% of adolescents with MDD. TRD involves severe, persistent symptoms that are hard to treat, significantly reducing functioning and quality of life. We conducted a literature search focusing on key terms related to ketamine and esketamine for MDD with suicidal ideation and TRD in adolescents, aiming to review the potential utility of these molecules in adolescents for these conditions. Ketamine has shown efficacy in reducing depressive symptoms in adolescents with TRD. Esketamine has shown efficacy in reducing depressive symptoms and treating suicidal ideation in adolescents. Both ketamine and esketamine have demonstrated favorable safety and tolerability profiles. Using these drugs for serious conditions like adolescent MDD with suicidal thoughts and TRD can effectively treat symptoms, reduce self-harm and suicide risks, and provide a window for longer-term therapeutic interventions. The prompt and effective treatment of TRD could improve adolescents’ quality of life. However, more research is needed to optimize treatment protocols and evaluate long-term effects. Full article

11 pages, 962 KiB

Open AccessArticle

Agony of Choice: Caudal Block versus Ilioinguinal/Iliohypogastric Nerve Block in Unilateral Orchidopexy

by Aybike Hofmann, Bernhard Koller, Franziska Vauth, Pirmin I. Zöhrer, Gregor Badelt and Wolfgang H. Rösch

Children 2024, 11(7), 800; https://doi.org/10.3390/children11070800 (registering DOI) - 29 Jun 2024

Viewed by 88

Abstract

Objective: This prospective study aimed to compare the efficacy of caudal block (CB) and ilioinguinal/iliohypogastric nerve block (IINB) for providing additional analgesia during unilateral orchidopexy. Methods: Seventy-one boys aged <48 months, classified as ASA I/II, were assigned into CB (n = 37) [...] Read more.

Objective: This prospective study aimed to compare the efficacy of caudal block (CB) and ilioinguinal/iliohypogastric nerve block (IINB) for providing additional analgesia during unilateral orchidopexy. Methods: Seventy-one boys aged <48 months, classified as ASA I/II, were assigned into CB (n = 37) and IINB (n = 34) groups. Outcome measures included intra- and postoperative analgesic requirements, pain scores, and administration duration. Additional intraoperative analgesia was administered for a 10% increase in heart rate, while postoperative pain was assessed using the Children’s and Infants Postoperative Pain Scale (CHIPPS), with scores >4 prompting supplementary analgesia. Monitoring was extended for 24 h post-surgery. Results: CB significantly reduced the need for intraoperative (p < 0.001) and early postoperative (p = 0.008) analgesia compared to IINB. However, the CB group exhibited a slightly higher but non-significant analgesic requirement on the ward. No clinically relevant side effects were observed in either group. Conclusions: Both CB and IINB are effective and safe methods for providing regional analgesia during orchidopexy. CB demonstrates superior efficacy intraoperatively and in the early postoperative period, while IINB may offer advantages in the later recovery phase. However, additional analgesia is often required for orchidopexy, especially in outpatient settings. Full article

(This article belongs to the Special Issue State-of-Art in Pediatric Anesthesia)

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14 pages, 444 KiB

Open AccessArticle

Hemostatic Status of Neonates with Perinatal Hypoxia, Studied via NATEM in Cord Blood Samples

by Marina Tsaousi, Rozeta Sokou, Abraham Pouliakis, Marianna Politou, Nicoletta Iacovidou, Theodora Boutsikou, Alma Sulaj, Eleni Karapati, Andreas G. Tsantes, Argirios E. Tsantes, Serena Valsami and Zoi Iliodromiti

Children 2024, 11(7), 799; https://doi.org/10.3390/children11070799 (registering DOI) - 29 Jun 2024

Viewed by 80

Abstract

Background: Perinatal hypoxia may result in coagulation dysfunction. Diminished blood flow or oxygen to the fetus/neonate during the perinatal period can cause bone marrow and liver function impairment, leading to thrombocytopenia, impaired synthesis of clotting and fibrinolytic factors, and increased destruction of platelets [...] Read more.

Background: Perinatal hypoxia may result in coagulation dysfunction. Diminished blood flow or oxygen to the fetus/neonate during the perinatal period can cause bone marrow and liver function impairment, leading to thrombocytopenia, impaired synthesis of clotting and fibrinolytic factors, and increased destruction of platelets in the small blood vessels. The goal of the present study was to evaluate the hemostatic status of newborns with perinatal hypoxia via the non-activated thromboelastometry (NATEM) assay in cord blood samples. Methods: 134 hypoxic neonates born in our maternity unit over a 1.5-year period were enrolled in this observational cohort study, and 189 healthy neonates served as the control group. Participation in the study was voluntary and parents signed informed consent prior to recruitment. Demographic and clinical data were recorded on admission, and the NATEM method was performed on cord blood samples. The following NATEM values were evaluated: clotting time (CT), alpha angle (α-angle), clot formation time (CFT), clot amplitude at 5 and 10 min. (A5, A10), maximum clot firmness (MCF), clot lysis index at 60 min. after CT (LI60), and maximum clot elasticity (MCE). Statistical analysis was conducted utilizing the SAS for Windows 9.4 software platform. Results: Neonates with perinatal hypoxia exhibited decreased fibrinolytic potential in comparison to healthy neonates, as indicated by increased LI60, and this difference was statistically significant (LΙ60: 94 (92–96) Vs 93 (91–95), p value = 0.0001). There were no statistically significant differences noted among the remaining NATEM variables. Conclusion: Our findings indicate decreased fibrinolytic potential in hypoxic neonates in comparison to healthy neonates, suggesting that NATEM could serve as an effective tool for promptly identifying hemostasis dysfunction in this group of neonates. Full article

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11 pages, 512 KiB

Open AccessArticle

Two Physiotherapy Methods to Improve the Physical Condition of Children with Autism Spectrum Disorder

by Lina Draudvilienė, Justas Draudvila, Simona Stankevičiūtė and Laura Daniusevičiūtė-Brazaitė

Children 2024, 11(7), 798; https://doi.org/10.3390/children11070798 (registering DOI) - 28 Jun 2024

Viewed by 133

Abstract

This study presents two simple physiotherapy programs that were implemented for five weeks and showed positive changes in balance, coordination, and motor skills in kindergarteners with ASD. Physiotherapy programs in a gym and games on a smart board with balance plates and an [...] Read more.

This study presents two simple physiotherapy programs that were implemented for five weeks and showed positive changes in balance, coordination, and motor skills in kindergarteners with ASD. Physiotherapy programs in a gym and games on a smart board with balance plates and an unstable base were applied to improve the physical condition of children with ASD. Thirty children with ASD (4–6 years old) attending special needs kindergarten were enrolled in the study. Three tests were used to assess participants’ physical condition before and after the study: the modified Berg Balance Scale, the Imbalance Coordination Sample, and the Bruininks–Oseretsky Motor Proficiency Test (BOTMP). The resulting mean change, calculated from each group’s scores, shows that the participants who received physical therapy sessions at the smart board had the greatest change of 1.58 points. It shows that the opportunity to play games on a smart board motivates children with ASD to work harder; therefore, it is a simple and easy way to engage children in different types of physical exercise. A slightly smaller change of 1.51 was obtained in the group that received gym sessions. However, working in the gym was more psychologically challenging for the children with ASD due to their lack of desire and motivation. Both methods are relatively simple and easy to apply at home; therefore, parents can make a significant contribution to improving children’s physical condition and that can be an effective tool to assist these individuals with activities in daily life. Full article

(This article belongs to the Topic Influence of Physical Activity, Nutrition, Educators and Parents on Children's Health Development)

14 pages, 502 KiB

Open AccessArticle

Prenatal and Postnatal Diagnosis and Genetic Background of Corpus Callosum Malformations and Neonatal Follow-Up

by Virág Bartek, István Szabó, Ágnes Harmath, Gábor Rudas, Tidhar Steiner, Attila Fintha, Nándor Ács and Artúr Beke

Children 2024, 11(7), 797; https://doi.org/10.3390/children11070797 (registering DOI) - 28 Jun 2024

Viewed by 149

Abstract

Introduction: The corpus callosum is one of the five main cerebral commissures. It is key to combining sensory and motor functions. Its structure can be pathological (dysgenesis) or completely absent (agenesis). The corpus callosum dys- or agenesis is a rare disease (1:4000 live [...] Read more.

Introduction: The corpus callosum is one of the five main cerebral commissures. It is key to combining sensory and motor functions. Its structure can be pathological (dysgenesis) or completely absent (agenesis). The corpus callosum dys- or agenesis is a rare disease (1:4000 live births), but it can have serious mental effects. Methods: In our study, we processed the data of 64 pregnant women. They attended a prenatal diagnostic center and genetic counseling from 2005 to 2019 at the Department of Obstetrics and Gynecology at Semmelweis University. Results: The pregnancies had the following outcomes: 52 ended in delivery, 1 in spontaneous abortion, and 11 in termination of pregnancy (TOP) cases (n = 64). The average time of detection with imaging tests was 25.24 gestational weeks. In 16 cases, prenatal magnetic resonance imaging (MRI) was performed. If the abnormality was detected before the 20th week, a genetic test was performed on an amniotic fluid sample obtained from a genetic amniocentesis. Karyotyping and cytogenetic tests were performed in 15 of the investigated cases. Karyotyping gave normal results in three cases (46,XX or XY). In one of these cases, postnatally chromosomal microarray (CMA) was later performed, which confirmed Aicardi syndrome (3q21.3–21.1 microdeletion). In one case, postnatally, the test found Wiedemann–Rautenstrauch syndrome. In other cases, it found X ring, Di George syndrome, 46,XY,del(13q)(q13q22) and 46,XX,del(5p)(p13) (Cri-du-chat syndrome). Edwards syndrome was diagnosed in six cases, and Patau syndrome in one case. Conclusion: We found that corpus callosum abnormalities are often linked to chromosomal problems. We recommend that a cytogenetic test be performed in all cases to rule out inherited diseases. Also, the long-term outcome does not just depend on the disease's severity and the associated other conditions, and hence proper follow-up and early development are also key. For this reason, close teamwork between neonatology, developmental neurology, and pediatric surgery is vital. Full article

(This article belongs to the Special Issue New Trends in Perinatal and Pediatric Epidemiology)

26 pages, 487 KiB

Open AccessReview

Neurodevelopmental Disorders Associated with Gut Microbiome Dysbiosis in Children

by Alejandro Borrego-Ruiz and Juan J. Borrego

Children 2024, 11(7), 796; https://doi.org/10.3390/children11070796 (registering DOI) - 28 Jun 2024

Viewed by 75

Abstract

The formation of the human gut microbiome initiates in utero, and its maturation is established during the first 2–3 years of life. Numerous factors alter the composition of the gut microbiome and its functions, including mode of delivery, early onset of breastfeeding, exposure [...] Read more.

The formation of the human gut microbiome initiates in utero, and its maturation is established during the first 2–3 years of life. Numerous factors alter the composition of the gut microbiome and its functions, including mode of delivery, early onset of breastfeeding, exposure to antibiotics and chemicals, and maternal stress, among others. The gut microbiome–brain axis refers to the interconnection of biological networks that allow bidirectional communication between the gut microbiome and the brain, involving the nervous, endocrine, and immune systems. Evidence suggests that the gut microbiome and its metabolic byproducts are actively implicated in the regulation of the early brain development. Any disturbance during this stage may adversely affect brain functions, resulting in a variety of neurodevelopmental disorders (NDDs). In the present study, we reviewed recent evidence regarding the impact of the gut microbiome on early brain development, alongside its correlation with significant NDDs, such as autism spectrum disorder, attention-deficit/hyperactivity disorder, Tourette syndrome, cerebral palsy, fetal alcohol spectrum disorders, and genetic NDDs (Rett, Down, Angelman, and Turner syndromes). Understanding changes in the gut microbiome in NDDs may provide new chances for their treatment in the future. Full article

18 pages, 814 KiB

Open AccessArticle

Impact of Digital Media, School Problems, and Lifestyle Factors on Youth Psychosomatic Health: A Cross-Sectional Survey

by Verena Barbieri, Giuliano Piccoliori, Adolf Engl and Christian J. Josef Wiedermann

Children 2024, 11(7), 795; https://doi.org/10.3390/children11070795 (registering DOI) - 28 Jun 2024

Viewed by 102

Abstract

Background: Post-pandemic psychosomatic complaints in children and adolescents have been underreported. This study investigated psychosomatic complaints in children and adolescents in Northern Italy in 2023, with the aim of identifying changes in predictors and vulnerable subgroups. Methods: Cross-sectional data representative of scholars from [...] Read more.

Background: Post-pandemic psychosomatic complaints in children and adolescents have been underreported. This study investigated psychosomatic complaints in children and adolescents in Northern Italy in 2023, with the aim of identifying changes in predictors and vulnerable subgroups. Methods: Cross-sectional data representative of scholars from a northern Italian province were analyzed using the Health Behavior in School-aged Children (HBSC) checklist. The sum scores, count data, and dichotomized data were examined, and predictor effects were expressed using a linear regression model for the sum scores. Results: Data from 4525 participants (aged 7–19 years, 50.5% girls) were analyzed. Psychosomatic symptoms remained unchanged after the pandemic. Significant gender differences were noted, especially in older age groups, with girls reporting more complaints. Factors such as children’s health, digital media use, and school problems significantly influence psychosomatic outcomes. While migration background negatively affected girls’ psychosomatic well-being, boys showed improvement through sports. Conclusion: The psychosomatic well-being of children and adolescents did not improve after the pandemic. These findings indicate the need for targeted interventions, improved health literacy, and ongoing monitoring to support the mental well-being of this vulnerable population. Reducing screen time remains a critical strategy for enhancing youth well-being. Full article

(This article belongs to the Special Issue Children’s Self-Regulation and Health in the Context of Digital Technology Use)

15 pages, 484 KiB

Open AccessReview

Epidemiology of Endocrine Dysfunctions in Pediatric Patients with Previous Central Nervous System Infection: A Scoping Review of the Literature

by Giorgio Sodero, Clelia Cipolla, Laura Martino, Carolina Gentili, Claudia Rendeli and Danilo Buonsenso

Children 2024, 11(7), 794; https://doi.org/10.3390/children11070794 (registering DOI) - 28 Jun 2024

Viewed by 111

Abstract

Purpose The incidence of endocrine sequelae following central nervous system (CNS) infections in pediatric age is not known. We conducted this scoping review to assess the incidence of endocrinological alterations in patients with prior CNS infections in pediatric age. Methods Our screening process [...] Read more.

Purpose The incidence of endocrine sequelae following central nervous system (CNS) infections in pediatric age is not known. We conducted this scoping review to assess the incidence of endocrinological alterations in patients with prior CNS infections in pediatric age. Methods Our screening process included both randomized and non-randomized controlled trials. All types of observational studies, prospective and retrospective, have been included. Results Ten studies were included in our review. The cumulative number of patients in all of the studies was 211, the mean age of the population study was 4.9 (+/− 5 years). The included papers described the following acute CNS infections: meningitis (nine studies reported eighty-five cases) and encephalitis (three studies described sixty-five cases). Two case reports and one retrospective study reported hypopituitarism as a consequence of Mycobacterium tuberculosis CNS infection. In five studies the patients developed endocrine comorbidities at the time of infection. Another study analyzed 49 young adults who previously had tuberculous meningitis at a mean age of 5.9 +/− 5.0 years: seven patients had growth hormone deficiency, four of whom also had gonadotropin deficiency; the other three had gonadotropin deficiency, corticotropin deficiency, and mild hyperprolactinemia. Conclusion Standardized multidisciplinary follow-up and research of patients with prior CNS infection is crucial. Although pituitary reserve screening is not commonly performed in these patients, clinical and research centers should set up an endocrinological evaluation with monitoring of auxological parameters to detect the signs and symptoms of hypopituitarism early and to initiate the appropriate care in children with previous CNS infections. Full article

(This article belongs to the Special Issue Short- and Long-Term Outcomes of Central Nervous Systems in Pediatric Patients)

15 pages, 1811 KiB

Open AccessArticle

A Randomized Controlled Simulation Trial of a Neonatal Resuscitation Digital Game Simulator for Labour and Delivery Room Staff

by Christiane Bilodeau, Georg M. Schmölzer and Maria Cutumisu

Children 2024, 11(7), 793; https://doi.org/10.3390/children11070793 (registering DOI) - 28 Jun 2024

Viewed by 141

Abstract

Background: Healthcare providers (HCPs) working in labour and delivery rooms need to undergo regular refresher courses to maintain their neonatal resuscitation skills, which are shown to decline over time. However, due to their irregular schedules and limited time, HCPs encounter difficulties in readily [...] Read more.

Background: Healthcare providers (HCPs) working in labour and delivery rooms need to undergo regular refresher courses to maintain their neonatal resuscitation skills, which are shown to decline over time. However, due to their irregular schedules and limited time, HCPs encounter difficulties in readily accessing refresher programs. RETAIN is a digital game that simulates a delivery room to facilitate neonatal resuscitation training for HCPs. Objective: This study aims to ascertain whether participants enjoyed the RETAIN digital game simulator and whether it was at least as good as a video lecture at refreshing and maintaining participants’ neonatal resuscitation knowledge. Methods: In this randomized controlled simulation trial, n = 42 labour and delivery room HCPs were administered a pre-test of neonatal resuscitation knowledge using a manikin. Then, they were randomly assigned to a control or a treatment group. For 20–30 min, participants in the control group watched a neonatal resuscitation lecture video, while those in the treatment group played the RETAIN digital game simulator of neonatal resuscitation scenarios. Then, all participants were administered a post-test identical to the pre-test. Additionally, participants in the treatment group completed a survey of attitudes toward the RETAIN simulator that provided a measure of enjoyment of the RETAIN game simulator. After two months, participants were administered another post-test identical to the pre-test. Results: For the primary outcome (neonatal resuscitation performance), an analysis of variance revealed that participants significantly improved their neonatal resuscitation performance over the first two time points, with a significant decline to the third time point, the same pattern of results across conditions, and no differences between conditions. For the secondary outcome (attitudes toward RETAIN), participants in the treatment condition also reported favourable attitudes toward RETAIN. Conclusions: Labour and delivery room healthcare providers in both groups (RETAIN simulator or video lecture) significantly improved their neonatal resuscitation performance immediately following the intervention, with no group differences. The findings suggest that participants enjoyed interacting with the RETAIN digital game simulator, which provided a similar boost in performance right after use to the more traditional intervention. Full article

(This article belongs to the Special Issue New Insights in Neonatal Resuscitation)

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27 pages, 616 KiB

Open AccessReview

Cephalometric Evaluation of Children with Short Stature of Genetic Etiology: A Review

by George Paltoglou, Nickolas Ziakas, George P. Chrousos and Christos Yapijakis

Children 2024, 11(7), 792; https://doi.org/10.3390/children11070792 (registering DOI) - 28 Jun 2024

Viewed by 138

Abstract

Introduction: A plethora of biological molecules regulate chondrogenesis in the epiphyseal growth plate. Disruptions of the quantity and function of these molecules can manifest clinically as stature abnormalities of various etiologies. Traditionally, the growth hormone/insulin-like growth factor 1 (IGF1) axis represents the etiological [...] Read more.

Introduction: A plethora of biological molecules regulate chondrogenesis in the epiphyseal growth plate. Disruptions of the quantity and function of these molecules can manifest clinically as stature abnormalities of various etiologies. Traditionally, the growth hormone/insulin-like growth factor 1 (IGF1) axis represents the etiological centre of final stature attainment. Of note, little is known about the molecular events that dominate the growth of the craniofacial complex and its correlation with somatic stature. Aim: Given the paucity of relevant data, this review discusses available information regarding potential applications of lateral cephalometric radiography as a potential clinical indicator of genetic short stature in children. Materials and Methods: A literature search was conducted in the PubMed electronic database using the keywords: cephalometric analysis and short stature; cephalometric analysis and achondroplasia; cephalometric analysis and hypochondroplasia; cephalometric analysis and skeletal abnormalities; cephalometr* and SHOX; cephalometr* and CNP; cephalometr* and ACAN; cephalometr* and CNVs; cephalometr* and IHH; cephalometr* and FGFR3; cephalometr* and Noonan syndrome; cephalometr* and “Turner syndrome”; cephalometr* and achondroplasia. Results: In individuals with genetic syndromes causing short stature, linear growth of the craniofacial complex is confined, following the pattern of somatic short stature regardless of its aetiology. The angular and linear cephalometric measurements differ from the measurements of the average normal individuals and are suggestive of a posterior placement of the jaws and a vertical growth pattern of the face. Conclusions: The greater part of the existing literature regarding cephalometric measurements in short-statured children with genetic syndromes provides qualitative data. Furthermore, cephalometric data for individuals affected with specific rare genetic conditions causing short stature should be the focus of future studies. These quantitative data are required to potentially establish cut-off values for reference for genetic testing based on craniofacial phenotypes. Full article

(This article belongs to the Section Pediatric Endocrinology)

12 pages, 462 KiB

Open AccessArticle

Complications and Outcomes of Surgically Treated Pediatric Supracondylar Humerus Fractures

by Sebastian G. Hahn, Andrea Schuller, Lorenz Pichler, Anna Hohensteiner, Thomas Sator, Oskar Bamer, Britta Chocholka, Manuela Jaindl, Elisabeth Schwendenwein, Bikash Parajuli, Sanika Rapole, Thomas Tiefenboeck and Stephan Payr

Children 2024, 11(7), 791; https://doi.org/10.3390/children11070791 - 28 Jun 2024

Viewed by 142

Abstract

This study describes the outcome of supracondylar humerus fractures in children using crossed K-wires after closed or open reduction with the medial, lateral or bilateral approach. Patients treated between January 2000 and December 2019 were classified according to the Von Laer classification, complications [...] Read more.

This study describes the outcome of supracondylar humerus fractures in children using crossed K-wires after closed or open reduction with the medial, lateral or bilateral approach. Patients treated between January 2000 and December 2019 were classified according to the Von Laer classification, complications were classified according to the Sink classification and clinical outcomes were classified according to modified Flynn criteria. In total, 364 patients with a mean age of 5.23 ± 2.45 years were included. The majority were type IV fractures (156; 42.9%) and 94 (60.3%) needed an open reduction for which the medial approach (53; 56.4%) was predominantly used. Overall, of 50 complications (31 using closed reduction, 19 open reduction), 17/50 (34%) needed revision surgery. An excellent clinical outcome was achieved in 348/364 (95.6%) patients. The approach used for open reduction as such had no influence on the complication rate or clinical outcome. For severely displaced fractures, the data showed that an open approach for crossed K-wires tended to result in fewer complications and better clinical outcomes than a closed reduction. If an open reduction is indicated, the required approach (medial, lateral or bilateral) should be primarily selected according to the requirements of the fracture pattern and eventual cosmetic considerations. Full article

(This article belongs to the Special Issue Research in Paediatric Orthopaedic Surgery (Volume II))

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15 pages, 833 KiB

Open AccessArticle

Causal Factors Contributing to Youth Cyberbullying in the Deep South of Thailand

by Kasetchai Laeheem

Children 2024, 11(7), 790; https://doi.org/10.3390/children11070790 - 28 Jun 2024

Viewed by 137

Abstract

Background: Violence against each other via social media has increased and caused cyberbullying that can happen anytime through electronic communication tools that everyone can access easily. Cyberbullying is sending, posting, and sharing negative, harmful, and false information about another, causing embarrassment online on [...] Read more.

Background: Violence against each other via social media has increased and caused cyberbullying that can happen anytime through electronic communication tools that everyone can access easily. Cyberbullying is sending, posting, and sharing negative, harmful, and false information about another, causing embarrassment online on social media. Objectives: This study aims to investigate causal factors contributing to youth cyberbullying in Thailand’s deep south. Methods: A cross-sectional survey was conducted among 340 youths in Thailand’s deep south, consisting of 220 males and 120 females. The subjects were divided by age range: 22–23 years old (40.6%), 24–25 years old (26.8%), 18–19 years old (17.1%), and 18–19 years old (15.5%). The data were analyzed with structural equation modeling (SEM). Results: The results were that the model of the causal factors resulting in youth cyberbullying in the deep south of Thailand was consistent with the empirical data (the relative chi-square (χ²/df) was 1.77). The goodness-of-fit index (GFI) was 0.95. The root-mean-square error of approximate (RMSEA) was 0.049). Cyberbullying was positively influenced directly and indirectly by negative upbringing, the influence of personal violence, and the influence of media violence at a statistically significant level of 0.001, with total effect sizes of 1.13, 0.74, and 0.64, respectively. Additionally, cyberbullying was positively influenced directly by negative mental traits with a statistically significant level of 0.05 and a total effect size of 0.17. Conclusions: This study suggests that the results could be beneficial in concretely forming policies and strategies to prevent and mitigate the problem of youth cyberbullying. Full article

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13 pages, 543 KiB

Open AccessArticle

Consensus Guidelines for the Use of Vosoritide in Children with Achondroplasia in Australia

by Louise Tofts, Penny Ireland, Tracy Tate, Supriya Raj, Theresa Carroll, Craig F. Munns, Stephen Knipe, Katherine Langdon, Lesley McGregor, Fiona McKenzie, Andreas Zankl and Ravi Savarirayan

Children 2024, 11(7), 789; https://doi.org/10.3390/children11070789 - 28 Jun 2024

Viewed by 147

Abstract

Background: Achondroplasia, the most prevalent skeletal dysplasia, stems from a functional mutation in the fibroblast growth factor receptor 3 gene, leading to growth impairment. This condition presents multifaceted medical, functional and psychosocial challenges throughout childhood, adolescence and adulthood. Current management strategies aim to [...] Read more.

Background: Achondroplasia, the most prevalent skeletal dysplasia, stems from a functional mutation in the fibroblast growth factor receptor 3 gene, leading to growth impairment. This condition presents multifaceted medical, functional and psychosocial challenges throughout childhood, adolescence and adulthood. Current management strategies aim to minimise medical complications, optimise functional capabilities and provide comprehensive supportive care. Vosoritide (trade name: VOXZOGO^®, BioMarin Pharmaceuticals) is the first disease-modifying pharmaceutical treatment approved for the management of patients with achondroplasia and became available in Australia in May 2023. Methods: Standardised clinical guidelines for its optimal use are not yet widely available. To address this gap, a multidisciplinary Australian Vosoritide Working Group, comprising 12 experts with experience in achondroplasia management from across Australia, developed recommendations to guide the use of vosoritide in clinical practice. Results: The recommendations, which are expert opinions of the Australian Vosoritide Working Group, aim to (i) standardise the use of vosoritide across Australia, (ii) support the safe clinical rollout of vosoritide and (iii) support universal access. Conclusions: These recommendations have been developed for healthcare professionals and institutions that are engaged in using vosoritide in the management of achondroplasia and will be revised using a formal framework for clinical guideline development once more evidence is available. Full article

(This article belongs to the Special Issue Pediatric Growth and Skeletal Disorders)

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13 pages, 709 KiB

Open AccessArticle

Factors Predicting In-School and Electronic Bullying among High School Students in the United States: An Analysis of the 2021 Youth Risk Behavior Surveillance System

by Tran H. Nguyen, Gulzar H. Shah, Ravneet Kaur, Maham Muzamil, Osaremhen Ikhile and Elizabeth Ayangunna

Children 2024, 11(7), 788; https://doi.org/10.3390/children11070788 - 28 Jun 2024

Viewed by 191

Abstract

Background: Bullying is a global public health problem with severe adverse effects on behavioral health. Understanding the predictors of victimization by bullying is essential for public policy initiatives to respond to the problem effectively. In addition to traditional in-person bullying, electronic bullying has [...] Read more.

Background: Bullying is a global public health problem with severe adverse effects on behavioral health. Understanding the predictors of victimization by bullying is essential for public policy initiatives to respond to the problem effectively. In addition to traditional in-person bullying, electronic bullying has become more prevalent due to increasing social interaction and identity formation in virtual communities. This study aims to determine the predictors of in-school and electronic bullying. Methods: We employed multivariable logistic regression to analyze a nationally representative sample of 17,232 high school students in the United States, the 2021 Youth Risk Behavior Surveillance System national component. The survey was conducted during the COVID-19 pandemic, from September through December 2021. The factors examined included sociodemographic characteristics (age, gender, race), appearance (obesity), physically active lifestyles (being physically active, spending a long time on digital games), and risk-taking behavior (using marijuana). Results: Our results indicated that sociodemographic characteristics were strong predictors of being bullied in school and electronically. Being obese is more likely to result in bullying in school (AOR = 1.32, p = 0.003) and electronically (AOR = 1.30, p = 0.004). Adolescent students showing marijuana use had higher odds of being bullied in school (AOR = 2.15, p < 0.001) and electronically (AOR = 1.81, p < 0.001). While spending a long time on digital devices raises the risk of being electronically bullied (AOR = 1.25, p = 0.014), being physically active is not associated with being bullied. Neither of the two lifestyle factors was associated with in-school bullying. Conclusions: Interventions addressing violence among adolescents can benefit from empirical evidence of risk factors for bullying victimization in high school. Full article

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9 pages, 672 KiB

Open AccessArticle

Increased Semantic Memorization in Children with ADHD during a Paradigm of Motor Priming: Exploratory Findings

by Ana Moscoso, Clarisse Louisin, Simona Caldani, Mickael Worms Ehrminger, Mylene Fefeu, Eric Acquaviva, Richard Delorme and Maria Pia Bucci

Children 2024, 11(7), 787; https://doi.org/10.3390/children11070787 - 28 Jun 2024

Viewed by 184

Abstract

Aim: The aim was to evaluate the effect of body actions on learning process, particularly semantic memory capabilities in drug-naïve children with attention deficit hyperactivity disorder (ADHD). Method: Thirty children had to listen to a story which was repeated three times in a [...] Read more.

Aim: The aim was to evaluate the effect of body actions on learning process, particularly semantic memory capabilities in drug-naïve children with attention deficit hyperactivity disorder (ADHD). Method: Thirty children had to listen to a story which was repeated three times in a row and then a fourth time five minutes later. After each listen, the child was asked what she/he remembered from the story. The whole sample was split randomly into three subgroups of equal IQ (mean 102.2 ± 12.7), age (mean age 8 ± 0.6 years), sex (ratio female to male 1:5) and severity of ADHD symptoms (34.2 ± 7.4); a G1 “Freeze” subgroup, which implied listening to the story while sitting on a chair without moving; a G2 “Minimal” subgroup, which implied listening to the story while sitting on a chair but free movement was allowed; a G3 “Prescribed movement” subgroup, which implied listening to the story standing up, while copying the experimenter movements that mimicked the actions told in the story. Results: Although our sample was limited in size, interestingly, children in the G3 subgroup showed the highest short-term semantic memory retention compared to G1. In all subgroups, repetition allowed an increase in performance. Conclusions: Our exploratory findings stress the positive role of movement in children with ADHD to increase semantic memorization. Hyperactivity may counteract the deficit of memorization related to attention impairment in children with ADHD. Our results may encourage parents or teachers to allow children with ADHD to move around during short-term memory-retention tasks. Full article

(This article belongs to the Special Issue Updates on Child Neuropsychiatry)

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13 pages, 959 KiB

Open AccessReview

A Systematic Review of Telehealth Utilization for Bowel Management Programs in Pediatric Colorectal Surgery

by Elizaveta Bokova, Ismael Elhalaby, Seth Saylors, Irene Isabel P. Lim and Rebecca M. Rentea

Children 2024, 11(7), 786; https://doi.org/10.3390/children11070786 - 27 Jun 2024

Viewed by 331

Abstract

Recent advancements in pediatric surgery have embraced telehealth (TH) modalities, transitioning from traditional in-person consultations to virtual care. This shift has broadened access to healthcare, potentially enhancing affordability, patient and caregiver satisfaction, and clinical outcomes. In pediatric colorectal surgery, telehealth has been effectively [...] Read more.

Recent advancements in pediatric surgery have embraced telehealth (TH) modalities, transitioning from traditional in-person consultations to virtual care. This shift has broadened access to healthcare, potentially enhancing affordability, patient and caregiver satisfaction, and clinical outcomes. In pediatric colorectal surgery, telehealth has been effectively utilized to support Bowel Management Programs (BMPs) for children suffering from constipation and fecal incontinence. A systematic review was conducted to assess the effectiveness of virtual BMPs, analyzing studies from January 2010 to December 2023, sourced from MEDLINE (via PubMed), Embase, and the Cochrane Library, with five studies included. Remote BMPs, implemented through video or telephone consultations, reported satisfaction rates exceeding 75% among families, indicating a strong preference for virtual interactions over traditional visits. Significant findings from the studies include improvements in Vancouver and Baylor scores, reductions in the duration of multidisciplinary consultations, enhancements in pediatric quality of life and Cleveland scores, and decreased frequency of laxative treatments. The implementation of TH has facilitated patient-led care, enabling timely adjustments in treatment and efficient distribution of medical supplies. The findings suggest that virtual BMPs are a viable and effective alternative to conventional approaches, yielding high caregiver satisfaction and superior clinical outcomes while promoting patient independence. Full article

9 pages, 370 KiB

Open AccessArticle

The Relevance of β-Thalassemia Heterozygosity in Pediatric Clinical Practice: Croatian Experience

by Ana Dordevic, Milena Ugrin, Ines Mrakovcic Sutic, Jelena Roganovic and Sonja Pavlovic

Children 2024, 11(7), 785; https://doi.org/10.3390/children11070785 - 27 Jun 2024

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Abstract

(1) Background: Thalassemia syndromes are common monogenic disorders that represent a significant global health issue. No systematic epidemiological or molecular investigations on thalassemias in the Croatian population have been reported to date. (2) Methods: This prospective study included 70 children with a presumptive [...] Read more.

(1) Background: Thalassemia syndromes are common monogenic disorders that represent a significant global health issue. No systematic epidemiological or molecular investigations on thalassemias in the Croatian population have been reported to date. (2) Methods: This prospective study included 70 children with a presumptive diagnosis of thalassemia and their 42 first-degree relatives. Molecular characterization was performed using direct sequencing and gap-PCR methods. (3) Results: We identified 46 (30 children and 16 first-degree relatives) β-thalassemia heterozygous carriers from 24 unrelated families, carrying eight different mutations and one hemoglobin variant. Five variants account for approximately 85% of all affected β-globin alleles: Hb Lepore-Boston-Washington (32.6%), HBB:c.93-21G>A (19.6%), HBB:c.315+1G>A (13.1%), HBB:c.92+1G>A (10.9%), and HBB:c.92+6T>C (8.7%) variants. (4) Conclusions: β-thalassemia carriers need more detailed genetic profiling since genetic modifiers can significantly impact their phenotype. Our study provides important new insights into the relevance of β-thalassemia heterozygosity in pediatric clinical practice. Full article

(This article belongs to the Section Pediatric Hematology & Oncology)

15 pages, 306 KiB

Open AccessArticle

Diagnostics of Metabolic Bone Disease in Extremely Preterm Infants—Clinical Applicability of Bone Turnover Biochemical Markers and Quantitative Ultrasound

by Sandra Cerar, Lara Vurzer, Aneta Soltirovska Šalamon, Lilijana Kornhauser Cerar, Matevž Trdan, Domen Robek, Tina Perme, Ajda Biček, Adrijana Oblak, Janja Marc, Darko Černe, Vanja Erčulj and Štefan Grosek

Children 2024, 11(7), 784; https://doi.org/10.3390/children11070784 - 27 Jun 2024

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Abstract

Background: Significant improvement in neonatal care has enabled increasing survival of preterm infants. Metabolic bone disease of prematurity is often overlooked due to other comorbidities of preterm birth. The best approach is screening and prevention of the disease in high-risk infants such as [...] Read more.

Background: Significant improvement in neonatal care has enabled increasing survival of preterm infants. Metabolic bone disease of prematurity is often overlooked due to other comorbidities of preterm birth. The best approach is screening and prevention of the disease in high-risk infants such as preterm infants. Aim: We followed up the clinical, radiological, and serum biochemical markers of metabolic bone disease in extremely preterm infants (<28 weeks of gestation). The clinical applicability and validation of C-terminal telopeptide of type I collagen (CTX-I) as a novel bone turnover marker were assessed. Standard and novel biochemical bone turnover markers and quantitative ultrasound were compared. Method: Patients’ data were collected from medical records. Assessments of calcium, phosphate, alkaline phosphatase, bone-alkaline phosphatase, CTX-I, and quantitative ultrasound were prospectively performed twice in 42 extremely preterm infants at postmenstrual ages of 30–32 weeks and 36–40 weeks. Bone mineral density was measured by quantitative ultrasound. Conclusion: Phosphate, alkaline phosphatase, bone alkaline phosphatase, calcium, or ionized calcium are not related to gestational age, but bone mineral density, measured by quantitative ultrasound, is related. There is no correlation between standard and novel biochemical markers and quantitative ultrasound for the identification of metabolic bone disease. Full article

(This article belongs to the Special Issue Intensive Care for Critically Ill Neonates: Clinical Diagnosis and Treatment)

12 pages, 319 KiB

Open AccessArticle

Optimizing Newborn Outcomes in Cesarean Sections: A Comparative Analysis of Stress Indicators under General and Spinal Anesthesia

by Anna Uram-Benka, Izabella Fabri-Galambos, Marina Pandurov-Brlić, Goran Rakić, Nikola Bošković, Jasminka Uram-Dubovski, Jelena Antić and Dejan Dobrijević

Children 2024, 11(7), 783; https://doi.org/10.3390/children11070783 - 27 Jun 2024

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Abstract

Background and Objectives: The moment of birth represents a complex physiological process that is followed by adaptive changes in the vital systems of the newborn. Such reactions have their positive but also negative effects. The aim of this research was to determine the [...] Read more.

Background and Objectives: The moment of birth represents a complex physiological process that is followed by adaptive changes in the vital systems of the newborn. Such reactions have their positive but also negative effects. The aim of this research was to determine the difference in laboratory values of stress indicators in newborn children delivered by cesarean section (CS) with general and spinal anesthesia. We attempted to make a recommendation about the optimal type of anesthesia based on our results. Materials and Methods: The study was performed on 150 healthy term newborns delivered by urgent or planned CS. Samples for adrenocorticotropic hormone (ACTH), cortisol, triglycerides, and interleukin-6 (IL-6) were analyzed. Results: Leukocyte numbers, triglycerides, and blood sugar values were normal for the newborns’ age, with statistically significantly lower values of blood sugar and triglycerides in newborns delivered by CS in spinal anesthesia (p < 0.005) compared to general anesthesia. There were no significant differences in ACTH, cortisol, and IL-6 levels between those newborns delivered via CS after spinal or general anesthesia. Conclusions: In cases where vaginal delivery is not possible, when CS is indicated, the use of well-controlled spinal anesthesia is followed by lower degrees of metabolic, inflammatory, and stress responses and better vitality of the baby upon birth. Full article

17 pages, 611 KiB

Open AccessArticle

Who Benefits Most from the Family Education and Support Program in Cape Verde? A Cluster Analysis

by Adriana Correia, Cátia Martins, Rita dos Santos, Victoria Hidalgo, Saúl Neves de Jesus and Cristina Nunes

Children 2024, 11(7), 782; https://doi.org/10.3390/children11070782 - 27 Jun 2024

Viewed by 265

Abstract

Background/Objectives: Child parenting programs can enhance parental skills, prevent future issues in child development, and improve children’s quality of life. The present research aimed to study the changes promoted by the Family Education and Support Program (FAF) implemented in Cape Verde, regarding parental [...] Read more.

Background/Objectives: Child parenting programs can enhance parental skills, prevent future issues in child development, and improve children’s quality of life. The present research aimed to study the changes promoted by the Family Education and Support Program (FAF) implemented in Cape Verde, regarding parental educational practices, perceived parental efficacy, and attitudes and beliefs of Cape Verdean parents. Methods: To this end, 37 participants were evaluated through a pretest-postest design. The evaluated dimensions were perceived parental competence, parenting practices, Parental attitudes and beliefs, mental health and perceived child quality of life. Results: A cluster analysis was conducted, distinguishing two groups. Both groups benefited from the program. Cluster 1 reported more significant gains in dimensions of parental efficacy and satisfaction, inadequate expectations, affection and support, and reactivity, while cluster 2 showed a greater difference in regulation and reactivity. Conclusions: Overall, the FAF intervention contributed to an increase in positive parenting practices. By analyzing potential underlying profiles in the change process, this study suggests that there are participants who benefit more than others from the intervention, and this information may be relevant for professionals and researchers in the field. Full article

(This article belongs to the Special Issue Parenting and Child/Adolescent Development: Current Updates and Global Perspectives)

18 pages, 389 KiB

Open AccessArticle

“Preparation Is Key”: Parents’ and Nurses’ Perceptions of Combined Parent-Delivered Pain Management in Neonatal Care

by Martina Carlsen Misic, Emma Olsson, Ylva Thernström Blomqvist and Alexandra Ullsten

Children 2024, 11(7), 781; https://doi.org/10.3390/children11070781 - 27 Jun 2024

Viewed by 440

Abstract

Background: There is a knowledge-to-practice gap regarding parent-delivered pain management, and few studies have investigated parents’ and nurses’ participation in and acceptance of combined parent-delivered pain-alleviating interventions such as skin-to-skin contact (SSC), breastfeeding, and parental musical presence. This study investigated parents’ and nurses’ [...] Read more.

Background: There is a knowledge-to-practice gap regarding parent-delivered pain management, and few studies have investigated parents’ and nurses’ participation in and acceptance of combined parent-delivered pain-alleviating interventions such as skin-to-skin contact (SSC), breastfeeding, and parental musical presence. This study investigated parents’ and nurses’ perceptions of and reflections on experiencing combined parent-delivered pain management. Methods: This qualitative study applies a collaborative participatory action research design using ethnographic data collection methods such as focus groups, video observations, and video-stimulated recall interviews with parents and nurses. Results: The results concern three main categories, i.e., preparation, participation, and closeness, as well as various sub-categories. Preparations were central to enabling combined parent-delivered pain management. Participation was facilitated by parental musical presence, in which parents shifted their attention toward their infant. Closeness and presence during neonatal care helped parents become active during their infant’s painful procedures. Parental lullaby singing created a calm and trusting atmosphere and after the procedure, both parents and nurses felt that they had successfully supported the infant through a potentially painful procedure. Conclusions: Mental and practical preparation is central to implementing combined parent-delivered pain management. When parents and nurses explored the interventions, they found the methods feasible, promoting self-efficacy and confidence in both parents and nurses. Full article

(This article belongs to the Special Issue Parental Involvement in Neonatal and Infant Pain Prevention and Management: Evidence, Opportunities and Challenges)

8 pages, 666 KiB

Open AccessBrief Report

The Impact of Parents’ Subjective Preparedness on Their Children’s Post-Traumatic Symptoms Following Surgery

by Fortu Benarroch, Rony Kapel Lev-Ari and Amichai Ben-Ari

Children 2024, 11(7), 780; https://doi.org/10.3390/children11070780 - 27 Jun 2024

Viewed by 278

Abstract

The role of parental factors in the emergence of post-traumatic stress symptoms (PTSSs) following pediatric surgeries is well recognized, but the specific influence of parents’ subjective preparedness for their child’s surgery has not been explored. In a study involving 253 children hospitalized in [...] Read more.

The role of parental factors in the emergence of post-traumatic stress symptoms (PTSSs) following pediatric surgeries is well recognized, but the specific influence of parents’ subjective preparedness for their child’s surgery has not been explored. In a study involving 253 children hospitalized in a pediatric surgery ward, parents completed a demographic questionnaire during their child’s stay, which included the question, “As a parent, have you been prepared for the surgical intervention your child is undergoing?” Four months post-surgery, the same parents were interviewed using two questionnaires that evaluated their children’s post-traumatic symptoms. Our findings indicate that in emergency surgical settings, children whose parents felt prepared experienced significantly fewer PTSSs compared to children whose parents did not feel prepared. In contrast, for elective surgeries, parental subjective perception of preparedness did not significantly impact the children’s PTSSs. We conclude that for emergency surgical procedures, addressing parents’ subjective preparedness could be crucial. Further research is necessary to develop targeted interventions that leverage this insight to minimize the risk of PTSSs in children undergoing emergency surgeries. Full article

(This article belongs to the Special Issue Medical Trauma in Children)

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9 pages, 234 KiB

Open AccessArticle

The Impact of Dietary Habits on Sleep Deprivation and Glucose Control in School-Aged Children with Type 1 Diabetes: A Cross-Sectional Study

by Merve Askin Ceran, Muteber Gizem Keser, Murat Bektas, Nurhan Unusan and Beray Selver Eklioglu

Children 2024, 11(7), 779; https://doi.org/10.3390/children11070779 - 27 Jun 2024

Viewed by 256

Abstract

Diet plays a crucial role in managing type 1 diabetes (T1DM). Background/Objectives:This study aimed to determine the impact of nutritional habits on sleep deprivation and glucose control in school-aged children with T1DM. Methods: In this cross-sectional study, nutritional habits and sleep deprivation [...] Read more.

Diet plays a crucial role in managing type 1 diabetes (T1DM). Background/Objectives:This study aimed to determine the impact of nutritional habits on sleep deprivation and glucose control in school-aged children with T1DM. Methods: In this cross-sectional study, nutritional habits and sleep deprivation were assessed in 100 school-aged children with T1DM, aged 7–13 years. The Dietary Habits Index and the Sleep Deprivation Scale for Children and Adolescents were used to evaluate nutritional habits and the level of sleep deprivation. Patients’ sociodemographic and nutritional variables were collected through researcher-composed questionnaires. HbA1c levels over the past 6 months were obtained from the patient data system. Results: The study found a moderately strong positive correlation between the Dietary Habits Index score and HbA1c (p < 0.001), with 28% of the variation in HbA1c explained by changes in the Dietary Habits Index score. However, no correlation was found between the Dietary Habits Index score and the level of sleep deprivation. Conclusions: The nutritional habits of school-aged children with T1DM may affect glucose control and sleep deprivation. Therefore, it is important to educate children with T1DM on making healthy food choices to manage their condition effectively. Full article

(This article belongs to the Special Issue Glycemic Control in Children and Adolescents with Type 1 Diabetes)

7 pages, 2006 KiB

Open AccessCase Report

FLAIR Hyperintense Cortical Lesions in a 4-Year-Old Child with Myelin Oligodendrocyte Glycoprotein (MOG)-Associated Encephalitis and Seizures: A Case Report

by Luca Bernardi, Nicole Mussi, Roberto Grandinetti, Emanuela Turco, Benedetta Piccolo, Francesca Ormitti, Nicola Principi and Susanna Esposito

Children 2024, 11(7), 778; https://doi.org/10.3390/children11070778 - 27 Jun 2024

Viewed by 285

Abstract

Myelin oligodendrocyte glycoprotein (MOG)-IgG-associated disease (MOGAD) is a relatively uncommon autoantibody demyelinating disorder of the central nervous system (CNS) with heterogeneous clinical manifestations and magnetic resonance imaging (MRI) findings. In recent years, a rare MOGAD subtype characterized by distinct clinical and MRI findings [...] Read more.

Myelin oligodendrocyte glycoprotein (MOG)-IgG-associated disease (MOGAD) is a relatively uncommon autoantibody demyelinating disorder of the central nervous system (CNS) with heterogeneous clinical manifestations and magnetic resonance imaging (MRI) findings. In recent years, a rare MOGAD subtype characterized by distinct clinical and MRI findings has been described. Seizures and cortical hyperintensities best seen on MRI T2-weighted fluid-attenuated inversion recovery (FLAIR) sequences, associated with headache and cerebral spine fluid (CSF) pleocytosis, are the most important characteristics of this MOGAD entity that is named FLAMES (FLAIR hyperintense cortical lesions in MOG-associated encephalitis with seizures). Because of its rarity and the peculiarities of the brain damage and clinical manifestations, it can be under-recognized and confused with focal viral encephalitis, meningitis, subarachnoid hemorrhage, CNS vasculitis, or mitochondrial cytopathy. We described the case of a 4-year-old previously healthy girl who was admitted for focal-onset, tonic-clonic seizures, fever, and headache, combined with optic neuritis. MRI was characterized by FLAIR imaging showing hyperintense cortical lesions, and a mild leukocytosis in the CSF was detected. Efficacy and rapid response to steroid therapy was observed, and no recurrences of neurological problems or further seizures were reported in the following 12 months. This case report can help in understanding FLAMES characteristics in pediatrics in order to favor early diagnosis and prompt therapy. Full article

(This article belongs to the Special Issue Infectious Diseases in Children)

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11 pages, 735 KiB

Open AccessArticle

The Role of Parental Mediation and Age in the Associations between Cyberbullying Victimization and Bystanding and Children’s and Adolescents’ Depression

by Michelle F. Wright

Children 2024, 11(7), 777; https://doi.org/10.3390/children11070777 - 27 Jun 2024

Viewed by 249

Abstract

Background/Objectives: The primary objective of this research was to assess age differences in the associations between cyberbullying victimization and bystanding and depression among 234 elementary school students (4th and 5th graders; 51% female), 363 middle school students (6th to 8th grades; 53% female), [...] Read more.

Background/Objectives: The primary objective of this research was to assess age differences in the associations between cyberbullying victimization and bystanding and depression among 234 elementary school students (4th and 5th graders; 51% female), 363 middle school students (6th to 8th grades; 53% female), and 341 high school students (9th to 12th grades; 51% female) as well as the moderating effect of parental mediation in these relationships. Methods: Participants completed self-report questionnaires on their cyberbullying victimization and bystanding, as well as depressive symptoms. Results: The findings revealed that high levels of instructive mediation buffered against depression associated with cyberbullying victimization and bystanding across all age groups, with the strongest effects found for middle school students. Lower levels of instructive mediation and higher levels of restrictive mediation increased the positive relationships between cyberbullying victimization and bystanding and depression. Co-viewing mediation did not moderate any of the associations. Conclusions: Parental mediation of technology use has the potential to alleviate the negative consequences associated with cyberbullying victimization and bystanding. The findings highlight the importance of tailoring prevention and intervention strategies to specific age groups and to parents. Full article

(This article belongs to the Special Issue New Challenges of Cyberbullying in Children and Adolescents)

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11 pages, 741 KiB

Open AccessArticle

Management of Paediatric Cardiac Arrest due to Shockable Rhythm—A Simulation-Based Study at Children’s Hospitals in a German Federal State

by Nadine Mand, Marieke Hoffmann, Anja Schwalb, Andreas Leonhardt, Martin Sassen, Tina Stibane, Rolf Felix Maier and Carolin Donath

Children 2024, 11(7), 776; https://doi.org/10.3390/children11070776 - 27 Jun 2024

Viewed by 215

Abstract

(1) Background: To improve the quality of emergency care for children, the Hessian Ministry for Social Affairs and Integration offered paediatric simulation-based training (SBT) for all children’s hospitals in Hesse. We investigated the quality of paediatric life support (PLS) in simulated paediatric resuscitations [...] Read more.

(1) Background: To improve the quality of emergency care for children, the Hessian Ministry for Social Affairs and Integration offered paediatric simulation-based training (SBT) for all children’s hospitals in Hesse. We investigated the quality of paediatric life support (PLS) in simulated paediatric resuscitations before and after SBT. (2) Methods: In 2017, a standardised, high-fidelity, two-day in-house SBT was conducted in 11 children’s hospitals. Before and after SBT, interprofessional teams participated in two study scenarios (PRE and POST) that followed the same clinical course of apnoea and cardiac arrest with a shockable rhythm. The quality of PLS was assessed using a performance evaluation checklist. (3) Results: 179 nurses and physicians participated, forming 47 PRE and 46 POST interprofessional teams. Ventilation was always initiated. Before SBT, chest compressions (CC) were initiated by 87%, and defibrillation by 60% of teams. After SBT, all teams initiated CC (p = 0.012), and 80% defibrillated the patient (p = 0.028). The time to initiate CC decreased significantly (PRE 123 ± 11 s, POST 76 ± 85 s, p = 0.030). (4) Conclusions: The quality of PLS in simulated paediatric cardiac arrests with shockable rhythm was poor in Hessian children’s hospitals and improved significantly after SBT. To improve children’s outcomes, SBT should be mandatory for paediatric staff and concentrate on the management of shockable rhythms. Full article

(This article belongs to the Special Issue Research Progress of the Pediatric Cardiology: 3rd Edition)

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13 pages, 243 KiB

Open AccessArticle

Medical Complexity of Children with Special Healthcare Needs and Healthcare Experiences

by Hye-Jung Yun, M. L. Parker, Cynthia B. Wilson and Ming Cui

Children 2024, 11(7), 775; https://doi.org/10.3390/children11070775 - 27 Jun 2024

Viewed by 304

Abstract

The rising prevalence of CSHCN has led to significant challenges for caregivers, particularly mothers, who face difficulties from caregiving demands and managing complex healthcare interactions. The objective of this study was to examine the association between the medical complexity of CSHCN and the [...] Read more.

The rising prevalence of CSHCN has led to significant challenges for caregivers, particularly mothers, who face difficulties from caregiving demands and managing complex healthcare interactions. The objective of this study was to examine the association between the medical complexity of CSHCN and the healthcare experiences of their mothers while exploring the influence of sociodemographic factors on these associations. The study utilized data from the 2016–2020 National Survey of Children’s Health (NSCH), involving 17,434 mothers of CSHCN. Mothers provided information on the medical complexity of CSHCN, healthcare experiences (care coordination, family-centered care, and shared decision-making), and sociodemographic information (race, community, insurance, child sex, age, and federal poverty level). Results from multiple regressions revealed that greater medical complexity was associated with more negative healthcare experiences. Minoritized mothers, those in rural areas, and families with lower income reported lower levels of family-centered care, indicating significant disparities. Additionally, the negative association between medical complexity and healthcare experiences was pronounced for White families and those with private insurance compared to minoritized families and those with public insurance. This study highlights the necessity for targeted interventions to improve care coordination, family-centered care, and shared decision-making, emphasizing the need for a comprehensive, family-centered approach to address healthcare disparities and promote health equity for CSHCN and their families. Full article

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

1 pages, 134 KiB

Open AccessCorrection

Correction: Klain et al. The Prevention of House Dust Mite Allergies in Pediatric Asthma. Children 2024, 11, 469

by Angela Klain, Antonio Andrea Senatore, Amelia Licari, Francesca Galletta, Irene Bettini, Leonardo Tomei, Sara Manti, Francesca Mori, Michele Miraglia del Giudice and Cristiana Indolfi

Children 2024, 11(7), 774; https://doi.org/10.3390/children11070774 - 27 Jun 2024

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Abstract

There was an error in the original publication [...] Full article

17 pages, 503 KiB

Open AccessArticle

Utility of the Post-Reflux Swallow-Induced Peristaltic Wave Index and Mean Nocturnal Baseline Impedance for the Diagnosis of Gastroesophageal Reflux Disease Phenotypes in Children

by Radu Samuel Pop, Daniela Pop, Lăcrămioara Eliza Chiperi, Vlad-Ionuț Nechita, Sorin Claudiu Man and Dan Lucian Dumitrașcu

Children 2024, 11(7), 773; https://doi.org/10.3390/children11070773 - 26 Jun 2024

Viewed by 171

Abstract

Objectives: Assessment of novel impedance parameters such as the post-reflux swallow-induced peristaltic wave (PSPW) index and mean nocturnal baseline impedance (MNBI) have been proposed to enhance the accuracy of gastroesophageal reflux disease (GERD) diagnosis. We aimed to evaluate the clinical value [...] Read more.

Objectives: Assessment of novel impedance parameters such as the post-reflux swallow-induced peristaltic wave (PSPW) index and mean nocturnal baseline impedance (MNBI) have been proposed to enhance the accuracy of gastroesophageal reflux disease (GERD) diagnosis. We aimed to evaluate the clinical value of MNBI and the PSPW index in discerning different phenotypes of GERD in children. Methods: We conducted a prospective, observational study that included 49 children aged 5–18 years, referred for MII-pH monitoring due to negative endoscopy and persisting gastroesophageal reflux symptoms despite acid-suppressant treatment. The PSPW index and MNBI were assessed along with conventional metrics. Results: Using a receiver operating characteristic (ROC) curve analysis, MNBI (AUC 0.864) and the PSPW index (AUC 0.83) had very good performance in differentiating between non-erosive reflux disease (NERD) and functional phenotypes. The PSPW index (AUC 0.87) discriminated better between functional heartburn (FH) and reflux hypersensitivity (RH) compared to the MNBI (AUC 0.712). A PSPW cut-off value of 65% provided a sensitivity of 76.9% and a specificity of 90% in distinguishing FH and RH. The PSPW index (AUC 0.87) proved to have better performance than the MNBI (AUC 0.802) in differentiating between FH and non-FH patients. MNBI diagnosed FH with a sensitivity of 84% and a specificity of 80.6% at a cut-off value of 2563 Ω. Conclusions: The PSPW index and MNBI are useful to distinguish between GERD phenotypes in pediatric patients. Full article

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Children, Volume 11, Issue 7 (July 2024) – 52 articles

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