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Children
Volume 11
Issue 8
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Children, Volume 11, Issue 8 (August 2024) – 149 articles

Cover Story (view full-size image): Autism spectrum disorder (ASD) is a highly heterogeneous neurodevelopmental disorder. In recent years, there has been an increase in studies on the implications of the gut microbiota (GM) on the behavior of children with ASD given that dysbiosis in the GM may trigger the onset, development, and progression of ASD through the microbiota–gut–brain axis. The aim of the present study was to perform a systematic review of articles using AI to analyze the GM in individuals with ASD. Conclusions: The bacteria Bifidobacterium is the most relevant biomarker with regard to ASD. Although AI provides a very promising approach to data analysis, caution is needed to avoid the over-interpretation of preliminary findings. Thus, more work is required to bridge the gap between AI in mental health research and clinical care in ASD. View this paper
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13 pages, 703 KiB  
Article
EuroQol Toddler and Infant Populations (EQ-TIPS): Age-Related Differences in Performance
by Janine Verstraete, Razia Amien and Lasse Herdien
Children 2024, 11(8), 1034; https://doi.org/10.3390/children11081034 - 22 Aug 2024
Viewed by 716
Abstract
Objectives: The EQ-TIPS was developed to measure the Health-Related Quality of Life in infants/toddlers. Considering the rapid development in this period, this study aimed to investigate age-related variations in EQ-TIPS performance. Methods: Data from 551 infants/toddlers living with a health condition were analysed. [...] Read more.
Objectives: The EQ-TIPS was developed to measure the Health-Related Quality of Life in infants/toddlers. Considering the rapid development in this period, this study aimed to investigate age-related variations in EQ-TIPS performance. Methods: Data from 551 infants/toddlers living with a health condition were analysed. Infants/toddlers were grouped by age: 0–6 months (n = 100), 6–12 months (n = 95), 12–24 months (n = 147), and 36–48 months (n = 97). Differences in item responses and item correlations across age groups were calculated by Kruskal–Wallis and Spearman’s correlations, respectively. Results: The report of problems was significantly higher for movement, play, and communication in the 36–48-month group compared to the 0–6-month group. There were strong correlations (r > 0.50) across all age groups between play and movement and communication and social interaction/play; neither pain nor eating showed a clear pattern of association. Conclusions: There is an age-related difference in the reporting of items linked to developmental milestones (movement, play, and communication) with most problems reported in the 36–48-month group when deviation from peers and continued dependence on caregivers is notable. Consideration should be given to including broader examples of play in the EQ-TIPS. Redefining the items to represent social communication and/or (social) emotion, rather than communication and social interaction, may be warranted. Future research should explore the psychometric performance of items to further inform item inclusion and/or revision. Full article
(This article belongs to the Section Pediatric Neonatology)
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9 pages, 244 KiB  
Article
Quality of Life in Children with Neurofibromatosis Type 1: Agreement between Parents and Patients, and the Role of Disease Severity and Visibility
by Nicola Davide Cavallo, Paola Maietta, Silverio Perrotta, Pasquale Moretta, Marco Carotenuto, Maria Esposito, Gabriella Santangelo and Claudia Santoro
Children 2024, 11(8), 1033; https://doi.org/10.3390/children11081033 - 22 Aug 2024
Viewed by 854
Abstract
Background: Neurofibromatosis type 1 (NF1) is a genetic disorder that affects multiple systems in the body, often leading to physical disfigurements and a wide range of clinical symptoms. This study aims to investigate the relationship between NF1 severity and visibility and the quality [...] Read more.
Background: Neurofibromatosis type 1 (NF1) is a genetic disorder that affects multiple systems in the body, often leading to physical disfigurements and a wide range of clinical symptoms. This study aims to investigate the relationship between NF1 severity and visibility and the quality of life (QoL) in children. Methods: The Pediatric Quality of Life Inventory (PedsQL) and a modified version of the Ablon scale were used to assess QoL and NF1 severity and visibility, respectively. Self-reported and parent-reported QoL scores were compared, and the associations between NF1 severity/visibility and QoL were explored. Results: Thirty-eight pediatric NF1 patients and their parents were enrolled. QoL scores did not differ significantly between patient self-reports and parent reports. However, correlational analyses revealed that higher NF1 severity was associated with lower physical QoL in patients, and greater NF1 visibility was linked to lower physical and social QoL. For parents, higher NF1 severity correlated with lower school functioning, whereas NF1 visibility did not show a significant correlation with QoL. Conclusion: The severity and visibility of NF1 have distinct impacts on various aspects of QoL in children, highlighting the need for tailored interventions that address both physical and psychological challenges. These findings underscore the importance of comprehensive care approaches in managing NF1 in pediatric populations. Full article
14 pages, 297 KiB  
Article
Relationship of Social–Emotional Learning, Resilience, Psychological Well-Being, and Depressive Symptoms with Physical Activity in School-Aged Children
by Evan Belaire, Fawzi Mualla, Lucas Ball, Iris Ma, Debra Berkey and Weiyun Chen
Children 2024, 11(8), 1032; https://doi.org/10.3390/children11081032 - 22 Aug 2024
Viewed by 1191
Abstract
Background: This study investigated the association of psychological well-being (PWB), resilience, depressive symptoms, and social–emotional learning (SEL) with physical activity (PA) in school-aged children. The objective was to understand how these psychosocial factors influence PA levels and identify gender-specific differences in these relationships. [...] Read more.
Background: This study investigated the association of psychological well-being (PWB), resilience, depressive symptoms, and social–emotional learning (SEL) with physical activity (PA) in school-aged children. The objective was to understand how these psychosocial factors influence PA levels and identify gender-specific differences in these relationships. Methods: This cross-sectional study involved 534 fourth grade and sixth grade students from eight schools in the Midwest region of the United States, with data collected through a Qualtrics survey. Multiple linear regression models were used to analyze the data, with gender-specific analyses conducted to identify differences between boys and girls. Results: The models indicated that all psychosocial factors taken together are significantly associated with PA (F = 26.937, p < 0.001). Of the factors, PWB and resilience were associated with higher PA individually for the total sample (β = 0.383, p = 0.001; β = 0.146, p = 0.005). A gender-specific analysis revealed that all factors collectively were significantly associated with PA in boys and girls (F = 15.846, p < 0.001; F = 6.869, p < 0.001). Individually, PWB and resilience were significantly associated with PA in boys (β = 0.358, p = 0.001; β = 0.171, p = 0.013), while only PWB was significantly associated with PA in girls (β = −0.355, p = 0.001). Conclusions: This study highlights the necessity of promoting resilience and psychological well-being through structured physical activities, aiming to reduce the risk of obesity and improve mental health among children. Future research should consider longitudinal designs and objective measures to further elucidate these relationships and inform effective educational strategies. Full article
(This article belongs to the Special Issue Promoting Physical Activity in the School Setting)
20 pages, 330 KiB  
Article
An Eye-Tracking Study on Six Early Social-Emotional Abilities in Children Aged 1 to 3 Years
by Thalia Cavadini, Elliot Riviere and Edouard Gentaz
Children 2024, 11(8), 1031; https://doi.org/10.3390/children11081031 - 22 Aug 2024
Viewed by 722
Abstract
Background: The experimental evaluation of young children’s socio-emotional abilities is limited by the lack of existing specific measures to assess this population and by the relative difficulty for researchers to adapt measures designed for the general population. Methods: This study examined six early [...] Read more.
Background: The experimental evaluation of young children’s socio-emotional abilities is limited by the lack of existing specific measures to assess this population and by the relative difficulty for researchers to adapt measures designed for the general population. Methods: This study examined six early social-emotional abilities in 86 typically developing children aged 1 to 3 years using an eye-tracking-based experimental paradigm that combined visual preference tasks adapted from pre-existing infant studies. Objectives: The aim of this study is to obtain developmental norms in six early social-emotional abilities in typical children aged 1 to 3 years that would be promising for an understanding of disorders of mental development. These developmental standards are essential to enable comparative assessments with children with atypical development, such as children with Profound Intellectual and Multiple Disabilities (PIMD). Results: The participants had greater spontaneous visual preferences for biological (vs. non-biological) motion, socially salient (vs. non-social) stimuli, the eye (vs. mouth) area of emotional expressions, angry (vs. happy) faces, and objects of joint attention (vs. non-looked-at ones). Interestingly, although the prosocial (vs. antisocial) scene of the socio-moral task was preferred, both the helper and hinderer characters were equally gazed at. Finally, correlational analyses revealed that performance was neither related to participants’ age nor to each other (dismissing the hypothesis of a common underpinning process). Conclusion: Our revised experimental paradigm is possible in infants aged 1 to 3 years and thus provides additional scientific proof on the direct assessment of these six socio-emotional abilities in this population. Full article
(This article belongs to the Section Pediatric Mental Health)
24 pages, 786 KiB  
Review
Relationship between Infant Feeding and the Microbiome: Implications for Allergies and Food Intolerances
by Lourdes Herrera-Quintana, Héctor Vázquez-Lorente, Daniel Hinojosa-Nogueira and Julio Plaza-Diaz
Children 2024, 11(8), 1030; https://doi.org/10.3390/children11081030 - 22 Aug 2024
Cited by 1 | Viewed by 2413
Abstract
Childhood is a critical period for immune system development, which is greatly influenced by the gut microbiome. Likewise, a number of factors affect the gut microbiome composition and diversity, including breastfeeding, formula feeding, and solid foods introduction. In this regard, several studies have [...] Read more.
Childhood is a critical period for immune system development, which is greatly influenced by the gut microbiome. Likewise, a number of factors affect the gut microbiome composition and diversity, including breastfeeding, formula feeding, and solid foods introduction. In this regard, several studies have previously demonstrated that breastfeeding promotes a favorable microbiome. In contrast, formula feeding and the early incorporation of certain solid foods may adversely affect microbiome development. Additionally, there is increasing evidence that disruptions in the early microbiome can lead to allergic conditions and food intolerances. Thus, developing strategies to promote optimal infant nutrition requires an understanding of the relationship between infant nutrition and long-term health. The present review aims to examine the relationship between infant feeding practices and the microbiome, as well as its implications on allergies and food intolerances in infants. Moreover, this study synthesizes existing evidence on how different eating habits influence the microbiome. It highlights their implications for the prevention of allergies and food intolerances. In conclusion, introducing allergenic solid foods before six months, alongside breastfeeding, may significantly reduce allergies and food intolerances risks, being also associated with variations in gut microbiome and related complications. Full article
(This article belongs to the Special Issue Infant and Early Childhood Nutrition)
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8 pages, 218 KiB  
Article
Obstructive Sleep Apnea Is Associated with Worsened Hospital Outcomes in Children Hospitalized with Asthma
by Jasmine Khatana, Aravind Thavamani, Krishna Kishore Umapathi, Senthilkumar Sankararaman and Aparna Roy
Children 2024, 11(8), 1029; https://doi.org/10.3390/children11081029 - 22 Aug 2024
Viewed by 586
Abstract
Background: Studies have shown a bidirectional relationship between asthma and obstructive sleep apnea (OSA). However, there is a paucity of national-level data evaluating the impact of OSA on hospital outcomes in pediatric hospitalizations for asthma. Methods: We analyzed the National Inpatient Sample and [...] Read more.
Background: Studies have shown a bidirectional relationship between asthma and obstructive sleep apnea (OSA). However, there is a paucity of national-level data evaluating the impact of OSA on hospital outcomes in pediatric hospitalizations for asthma. Methods: We analyzed the National Inpatient Sample and Kids Inpatient Database to include all pediatric hospitalizations with a primary diagnosis of asthma between 2003–2016. Using ICD codes, the pediatric asthma cohort was divided into two groups: those with and those without a concomitant diagnosis of OSA. The primary outcomes were in-hospital mortality and the need for mechanical ventilation. The secondary outcomes were the lengths of each hospital stay and total hospitalization charges. Results: We analyzed 1,606,248 hospitalizations during the 14-year study period. The overall prevalence rate of OSA was 0.7%. Patients with asthma and OSA were significantly older (8.2 versus 5.9 years) and were more often male, p < 0.001. The OSA group had several increased comorbidities. The overall mortality rate was 0.03%, and multivariate regression analysis showed that OSA was associated with 4.3 times higher odds of in-hospital mortality (95% CI: 2.4 to 7.6, p < 0.001). Furthermore, OSA was associated with a 5.2 times greater need for mechanical ventilation (95% CI: 4.8 to 5.5, p < 0.001). Linear regression analyses demonstrated that OSA independently contributed an additional 0.82 days to the hospital stay length (95% CI: 0.79 to 0.86, p < 0.001) and an extra 10,479 USD (95% CI: 10,110 to 10,848, p < 0.001) in hospitalization charges. Conclusion: OSA in children admitted with asthma is associated with poor hospital outcomes such as increased mortality risk, the need for mechanical ventilation, and increased healthcare utilization. Full article
(This article belongs to the Section Pediatric Pulmonary and Sleep Medicine)
8 pages, 585 KiB  
Article
The Relationship between Maternal Smoking and Infant Birth Weight: Improving Accuracy through Urine Cotinine Analysis and Effective Medical Record Strategies
by Danica Vojisavljevic, Donna Rudd, Roger Smith and Yogavijayan Kandasamy
Children 2024, 11(8), 1028; https://doi.org/10.3390/children11081028 - 22 Aug 2024
Viewed by 856
Abstract
Objective: We conducted a study to determine if antenatally collected maternal urine cotinine (a metabolite of nicotine) measurements can be used to assess the neonatal impact of nicotine exposure during pregnancy. This was a prospective longitudinal cohort of mother–infant dyads. Only term singleton [...] Read more.
Objective: We conducted a study to determine if antenatally collected maternal urine cotinine (a metabolite of nicotine) measurements can be used to assess the neonatal impact of nicotine exposure during pregnancy. This was a prospective longitudinal cohort of mother–infant dyads. Only term singleton pregnancies were included. The primary outcome measure was the correlation between maternal urine cotinine and infant birth weight. Methods: We analysed data from 238 mother–neonate dyads. Smoking habits were recorded during routine prenatal check-ups and urine samples were collected to measure cotinine and creatinine levels. Results: Urine cotinine was detected in 50.4% (120/238) of women from the whole cohort, but only 16% (38/238) self-reported as smokers (chi-square 39.7, p < 0.0001), and these women had significantly smaller babies (p = 0.010). There was a significant negative correlation between maternal urine cotinine and birth weight (Spearman’s coefficient = −0.0226, p = 0.013). Female babies born to women with nicotine in their urine were significantly smaller (p = 0.001). Conclusions: Infant birth weight significantly reduced in mothers with exposure to nicotine during pregnancy. The number of women exposed to nicotine during late pregnancy (measured in urine) was markedly higher than self-reported and national smoking percentages, suggesting an urgent need for an improvement in medical record reporting on smoking habits to better assess neonatal outcomes. Full article
(This article belongs to the Section Pediatric Neonatology)
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17 pages, 895 KiB  
Article
The Effect of Screen Habits and Alternative Activities on Tactile Exploration Skills in 6- to 36-Month-Old Toddlers
by Estelle Gillioz, Edouard Gentaz and Fleur Lejeune
Children 2024, 11(8), 1027; https://doi.org/10.3390/children11081027 - 22 Aug 2024
Viewed by 910
Abstract
Background/Objectives: With the rising ubiquity of digital media and screens in everyday life, toddlers are increasingly exposed to different screens from an early age (i.e., television, computer, tablet, phone). However, few studies have examined the effect of these screens on toddlers’ perceptual development. [...] Read more.
Background/Objectives: With the rising ubiquity of digital media and screens in everyday life, toddlers are increasingly exposed to different screens from an early age (i.e., television, computer, tablet, phone). However, few studies have examined the effect of these screens on toddlers’ perceptual development. Since tactile exploration skills are necessary for environmental discovery and overall development, the current research investigates the links between screen-use habits and the tactile exploration skills (with visual control) of 6- to 36-month-old toddlers. Methods: The study involved observing the interactions of 135 toddlers with various objects and assessing the complexity of their visuo-tactile exploration strategies through two original experimental tasks. Data concerning screen habits and other relevant factors, such as socio-economic level, were collected using a parental questionnaire. Results: Toddlers with greater screen exposure time demonstrated weaker tactile exploration skills and employed less age-appropriate exploration strategies. Socio-economic factors and parental engagement in alternative activities significantly influenced these developmental outcomes. Conclusions: These findings emphasize the importance of reducing screen time and promoting interactive co-viewing and alternative activities to mitigate the negative effects of screen exposure. Further longitudinal research is needed to determine the long-term impacts of early screen exposure on tactile exploration and overall psychological development. Full article
(This article belongs to the Section Pediatric Mental Health)
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9 pages, 1030 KiB  
Article
Investigation of the Diagnostic Value of Cerebrospinal Fluid and Serum sTREM-1 Levels in Neonatal Meningitis
by Salih Çağrı Çakır, Bayram Ali Dorum, Hilal Özkan, Nilgün Köksal, Fatma Kocael, Ferah Budak, Mustafa Hacımustafaoğlu, Solmaz Çelebi, Muhammed Ali Kızmaz, Cansu Sivrikaya Yıldırım and Kevser Üstün Elmas
Children 2024, 11(8), 1026; https://doi.org/10.3390/children11081026 - 22 Aug 2024
Viewed by 637
Abstract
Background: The aim of this study is to investigate the diagnostic value of cerebrospinal fluid (CSF) and serum levels of the soluble form of triggering receptor-1 expressed on myeloid cells (sTREM-1) in neonatal meningitis. Methods: Serum sTREM-1 levels were measured in all neonatal [...] Read more.
Background: The aim of this study is to investigate the diagnostic value of cerebrospinal fluid (CSF) and serum levels of the soluble form of triggering receptor-1 expressed on myeloid cells (sTREM-1) in neonatal meningitis. Methods: Serum sTREM-1 levels were measured in all neonatal sepsis patients at the start of antibiotic therapy and the 48th hour of treatment. At the beginning of antibiotic therapy, CSF samples were collected for sTREM-1 measurements. Control CSF samples were also collected from the patients with meningitis at the 48th hour of treatment. Results: A total of 77 preterm (50) and term (27) patients with neonatal sepsis were included in the study. There was no significant difference between the CSF sTREM-1 levels of patients with and without meningitis. The CSF sTREM-1 levels of preterm infants with meningitis decreased significantly after treatment (p = 0.038). Although the CSF/serum sTREM-1 ratios tended to increase in babies with meningitis, no significant difference was found between the groups. CSF/serum sTREM-1 ratios (mean ± SD) were 1.42 ± 0.91 and 1.14 ± 0.85 in preterm babies with and without meningitis and 1.15 ± 0.97 and 0.97 ± 0.55 in term babies with and without meningitis, respectively. Conclusions: Serum and CSF sTREM-1 levels increase in patients with neonatal sepsis. CSF s-TREM-1 levels decrease after treatment in preterm infants with meningitis. Full article
(This article belongs to the Section Pediatric Neonatology)
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14 pages, 2167 KiB  
Article
Exploring Pediatric Vertebral, Sacral, and Pelvic Osteosarcomas through the NCDB: Demographics, Treatment Utilization, and Survival Outcomes
by Pemla Jagtiani, Mert Karabacak, Matthew T. Carr, Zeynep Bahadir, Peter F. Morgenstern and Konstantinos Margetis
Children 2024, 11(8), 1025; https://doi.org/10.3390/children11081025 - 21 Aug 2024
Viewed by 701
Abstract
Background and Objectives: Retrieve data from the National Cancer Database (NCDB) to examine information on the epidemiological prevalence, treatment strategies, and survival outcomes of pediatric vertebral, sacral and pelvic osteosarcomas. Methods: We reviewed NCDB data from 2008 to 2018, concentrating on vertebral, sacral, [...] Read more.
Background and Objectives: Retrieve data from the National Cancer Database (NCDB) to examine information on the epidemiological prevalence, treatment strategies, and survival outcomes of pediatric vertebral, sacral and pelvic osteosarcomas. Methods: We reviewed NCDB data from 2008 to 2018, concentrating on vertebral, sacral, and pelvic osteosarcomas in children 0 to 21 years. Our analysis involved logistic and Poisson regression, Kaplan-Meier survival estimates, and Cox proportional hazards models. Results: The study population included 207 patients. For vertebral osteosarcomas, 62.5% of patients were female, and 78.1% were white. Regional lymph node involvement predicted 80 times higher mortality hazard (p = 0.021). Distant metastasis predicted 25 times higher mortality hazard (p = 0.027). For sacral and pelvic osteosarcomas, 58.3% of patients were male, and 72% were white. Patients with residual tumor were 4 times more likely to have prolonged LOS (p = 0.031). No residual tumor (HR = 0.53, p = 0.03) and radiotherapy receipt (HR = 0.46, p = 0.034) were associated with lower mortality hazards. Distant metastasis predicted 3 times higher mortality hazard (p < 0.001). Hispanic ethnicity was linked to lower resection odds (OR = 0.342, p = 0.043), possibly due to language barriers affecting patient understanding and care decisions. Conclusions: In conclusion, our examination of NCDB offers a thorough exploration of demographics, treatment patterns, and results, highlighting the importance of personalized approaches to enhance patient outcomes. Full article
(This article belongs to the Special Issue Diagnosis and Surgical Care of Pediatric Cancers)
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12 pages, 758 KiB  
Article
Long-Term Socioeconomic and Neurologic Outcome for Individuals with Childhood-Onset Multiple Sclerosis
by Moritz Tacke, Iris Hannibal, Katharina Vill, Michaela V. Bonfert, Wolfgang Müller-Felber and Astrid Blaschek
Children 2024, 11(8), 1024; https://doi.org/10.3390/children11081024 - 21 Aug 2024
Viewed by 533
Abstract
Intorduction: Most studies on the progression of childhood-onset multiple sclerosis (MS) involve relatively short follow-up periods, focusing primarily on neurological outcomes and disability progression. The influence of these and other factors on the health-related quality of life is not known. To gain a [...] Read more.
Intorduction: Most studies on the progression of childhood-onset multiple sclerosis (MS) involve relatively short follow-up periods, focusing primarily on neurological outcomes and disability progression. The influence of these and other factors on the health-related quality of life is not known. To gain a comprehensive understanding of early-onset MS, it is crucial to evaluate the effects of treatment and the disease on quality of life. Method: This pilot project aimed to evaluate the feasibility of using an online survey tool for long-term follow-up data collection from patients with childhood-onset MS. An anonymized, monocentric, prospective survey was conducted on a convenience cohort of patients treated at a certified centre for neuromuscular diseases in childhood between 2007 and 2019. Results: A total of 27 patients completed the survey. There were no mandatory items, therefore some patients chose not to answer all the questions in the questionnaire. Patients exhibited promising educational achievements, low neurological disease burden, and high resilience. However, anxiety, depression, and pain significantly impacted their perceived health status. Conclusion:This single-centre study has yielded new insights into childhood-onset MS. To enable more accurate comparisons across different centres and countries, it is essential to establish a minimum data set and questionnaire subset for patients with paediatric-onset MS transitioning into adulthood. Full article
(This article belongs to the Special Issue Recent Advances in Pediatric-Onset Multiple Sclerosis)
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10 pages, 219 KiB  
Article
Assessment of Visual Attention in Teams with or without Dedicated Team Leaders: A Neonatal Simulation-Based Pilot Randomised Cross-Over Trial Utilising Low-Cost Eye-Tracking Technology
by Prakash Kannan Loganathan, Anip Garg, Robert McNicol, Conor Wall, Matthew Pointon, Peter McMeekin, Alan Godfrey, Michael Wagner and Charles Christoph Roehr
Children 2024, 11(8), 1023; https://doi.org/10.3390/children11081023 - 21 Aug 2024
Viewed by 666
Abstract
Background: Eye-tracking technology could be used to study human factors during teamwork. Objectives: This work aimed to compare the visual attention (VA) of a team member acting as both a team leader and managing the airway, compared to a team member performing the [...] Read more.
Background: Eye-tracking technology could be used to study human factors during teamwork. Objectives: This work aimed to compare the visual attention (VA) of a team member acting as both a team leader and managing the airway, compared to a team member performing the focused task of managing the airway in the presence of a dedicated team leader. This work also aimed to report differences in team performance, behavioural skills, and workload between the two groups using validated tools. Methods: We conducted a simulation-based, pilot randomised controlled study. The participants included were volunteer paediatric trainees, nurse practitioners, and neonatal nurses. Three teams consisting of four team members were formed. Each team participated in two identical neonatal resuscitation simulation scenarios in a random order, once with and once without a team leader. Using a commercially available eye-tracking device, we analysed VA regarding attention to (1) a manikin, (2) a colleague, and (3) a monitor. Only the trainee who was the airway operator would wear eye-tracking glasses in both simulations. Results: In total, 6 simulation scenarios and 24 individual role allocations were analysed. Participants in a no-team-leader capacity had a greater number of total fixations on manikin and monitors, though this was not significant. There were no significant differences in team performance, behavioural skills, and individual workload. Physical demand was reported as significantly higher by participants in the group without a team leader. During debriefing, all the teams expressed their preference for having a dedicated team leader. Conclusion: In our pilot study using low-cost technology, we could not demonstrate the difference in VA with the presence of a team leader. Full article
(This article belongs to the Special Issue New Insights in Neonatal Resuscitation)
23 pages, 1478 KiB  
Article
Perinatal Predictors and Mediators of Attachment Patterns in Preschool Children: Exploration of Children’s Contributions in Interactions with Mothers
by Stefan Kurbatfinski, Jennifer Woo, Henry Ntanda, Gerald Giesbrecht and Nicole Letourneau
Children 2024, 11(8), 1022; https://doi.org/10.3390/children11081022 - 21 Aug 2024
Viewed by 757
Abstract
Insecure and disorganized attachment patterns in children are linked to poor health outcomes over the lifespan. Attachment patterns may be predicted by variables that influence the quality of children’s interactions with their primary caregivers/parents (usually mothers) such as prenatal and postnatal exposures and [...] Read more.
Insecure and disorganized attachment patterns in children are linked to poor health outcomes over the lifespan. Attachment patterns may be predicted by variables that influence the quality of children’s interactions with their primary caregivers/parents (usually mothers) such as prenatal and postnatal exposures and the children’s own behaviours in interactions. The purposes of this exploratory study were to examine: (1) prenatal predictors of children’s attachment patterns, and (2) postnatal mediators and moderators of associations between prenatal predictors and children’s attachment patterns, with adjustment for relevant covariates. Mother–child dyads (n = 214) from the longitudinal Alberta Pregnancy Outcomes and Nutrition (APrON) cohort were studied using valid and reliable measures. Hayes’ mediation analysis was employed to determine direct and indirect effects. Mothers’ prenatal cortisol levels directly predicted disorganized (versus organized) child attachment in unadjusted models. Children’s passivity (in adjusted models) and compulsivity (in unadjusted and adjusted models) in parent-child interactions mediated the pathway between mothers’ prenatal cortisol levels and children’s disorganized attachment patterns. Serial mediation analyses revealed that mothers’ cortisol levels predicted their children’s cortisol levels, which predicted children’s compulsivity, and, ultimately, disorganized attachment in both unadjusted and adjusted models. No predictors were correlated with children’s insecure (versus secure) attachment. This exploratory research suggests that prenatal exposure to mothers’ cortisol levels and children’s behavioural contributions to parent–child interaction quality should be considered in the genesis of children’s attachment patterns, especially disorganization. Interventions focused on parent-child interactions could also focus on addressing children’s behavioral contributions. Full article
(This article belongs to the Collection Emotional and Behavioral Problems in Children and Adolescents: Assessment and Intervention)
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12 pages, 221 KiB  
Article
Postoperative Recovery in the Youngest: Beyond Technology
by Carina Sjöberg, Mona Ringdal and Pether Jildenstål
Children 2024, 11(8), 1021; https://doi.org/10.3390/children11081021 - 21 Aug 2024
Viewed by 568
Abstract
Background: Measuring and interpreting vital signs in pediatric patients recovering from anaesthesia, particularly those up to 36 months old, is challenging. Nurses’ decision-making regarding the level of monitoring must balance patient safety with individualized care. This study aimed to explore the perceptions of [...] Read more.
Background: Measuring and interpreting vital signs in pediatric patients recovering from anaesthesia, particularly those up to 36 months old, is challenging. Nurses’ decision-making regarding the level of monitoring must balance patient safety with individualized care. This study aimed to explore the perceptions of critical care nurses and registered nurse anesthetists regarding their experiences and actions when making decisions about vital sign monitoring for children in post-anesthesia care units (PACUs). Methods: A qualitative study utilizing the critical incident technique was conducted. Interviews were performed with a purposeful sample of 17 critical care nurses and registered nurse anaesthetists from two hospitals. Results: Nurses reported that the rationale for decisions concerning the need for vital sign monitoring in children was both adequate and inadequate. Actions were taken to adjust the monitoring of vital signs, optimizing conditions for assessment and ensuring the child’s safe recovery. Conclusions: The complexity of accurately monitoring children makes it challenging for nurses in the PACU to adhere to guidelines. Evidence-based care and safety are compromised when technology has limitations and is not adapted for paediatric use, leading to a greater reliance on experience and clinical assessment. This reliance on experience is crucial for reliable assessment but also entails accepting greater risks. Full article
12 pages, 280 KiB  
Article
Socioeconomic Status and Rate of Poverty in Overweight and Obesity among Spanish Children and Adolescents
by Alejandra Gallego, Jorge Olivares-Arancibia, Rodrigo Yáñez-Sepúlveda, Héctor Gutiérrez-Espinoza and José Francisco López-Gil
Children 2024, 11(8), 1020; https://doi.org/10.3390/children11081020 - 21 Aug 2024
Viewed by 701
Abstract
Background: This study aimed to analyze the relationship between socioeconomic status (SES), poverty rate, and the prevalence of overweight/obesity or obesity in children and adolescents aged 2–14. Methods: Parents or guardians reported the weight and height of participants, used to calculate body mass [...] Read more.
Background: This study aimed to analyze the relationship between socioeconomic status (SES), poverty rate, and the prevalence of overweight/obesity or obesity in children and adolescents aged 2–14. Methods: Parents or guardians reported the weight and height of participants, used to calculate body mass index (BMI) and BMI z-scores according to the International Obesity Task Force standards. Participants were categorized into “overweight/obesity” and “no overweight/obesity” and further into “obesity” and “no obesity”. The rate of poverty rate was determined using data from the National Statistics Institute of Spain, defining it as the percentage of people with income below 60% of the national median. SES was based on the head of household’s occupation and categorized into low, medium, and high levels. Results: Adjusted multilevel models showed participants with medium or high SES had lower odds of overweight/obesity compared to those with low SES (medium SES: odds ratio [OR]: 0.63, 95% confidence interval [CI]: 0.54–0.73; high SES: OR: 0.59, 95% CI: 0.49–0.70). Participants in the high-poverty group had higher odds of having overweight/obesity (OR: 1.40, 95% CI: 1.13–1.74) compared to the low-poverty group. Conclusions: The study highlights significant socioeconomic disparities in childhood overweight/obesity, emphasizing the potential impact of SES and poverty on health outcomes in Spanish children and adolescents. Full article
(This article belongs to the Special Issue Dietary Habits, Social Determinants of Health and Obesity Risk in Children and Adolescents)
18 pages, 11951 KiB  
Review
The Management of Necrotizing Gingivitis in Paediatric Patients: A Scoping Review and Two Case Reports
by Massimiliano Ciribè, Erika Cirillo, Paolo Giacomo Arduino, Alessandra Putrino, Martina Caputo, Simona Zaami, Gaia Bompiani and Angela Galeotti
Children 2024, 11(8), 1019; https://doi.org/10.3390/children11081019 - 21 Aug 2024
Viewed by 957
Abstract
Necrotizing gingivitis (NG) is an acute inflammatory process with an estimated prevalence of less than 1%. The treatment of choice is usually antibiotics in addition to periodontal treatment. This scoping review aims to detail extent and type of proof related to NG in [...] Read more.
Necrotizing gingivitis (NG) is an acute inflammatory process with an estimated prevalence of less than 1%. The treatment of choice is usually antibiotics in addition to periodontal treatment. This scoping review aims to detail extent and type of proof related to NG in paediatric patient; moreover, a decision tree protocol was developed to define NG management in paediatric patients based on the presence or absence of systemic compromission. In addition, we also propose the use of ozone treatment as an adjuvant therapy. Seven papers (3 case reports, 2 guidelines, and 2 reviews) were selected for evaluation by reading the full texts. This review outlines the lack of research on the treatment of NG in paediatric patients; we, however, demonstrate the efficacy of the decision tree protocol by describing two case reports in which patients were treated with antibiotics according to the presence or absence of systemic involvement through the implementation of an individualized therapeutic approach, with periodontal ozone therapy. Moreover, the supportive use of this molecule in the management of NG can be a valuable tool in the healing of gingival tissues. Full article
(This article belongs to the Special Issue Oral Epidemiology and Pathology in Children)
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14 pages, 692 KiB  
Article
Iron and Vitamin A Status of Children Aged 0 to 36 Months in Thulamela Municipality, Vhembe District, South Africa
by Anzani Mugware, Selekane Ananias Motadi, Alphonce Bere and Lindelani Fhumudzani Mushaphi
Children 2024, 11(8), 1018; https://doi.org/10.3390/children11081018 - 20 Aug 2024
Viewed by 777
Abstract
Objective: The present study assessed the iron and Vitamin A status of children aged 0 to 36 months in Thulamela municipality, Vhembe District. Methods: A cross-sectional study was conducted among 250 children aged 0 to 36 months attending well-baby clinic services with their [...] Read more.
Objective: The present study assessed the iron and Vitamin A status of children aged 0 to 36 months in Thulamela municipality, Vhembe District. Methods: A cross-sectional study was conducted among 250 children aged 0 to 36 months attending well-baby clinic services with their mothers. Convenience sampling was used to select study participants, and simple random sampling was used to choose clinics. Data were gathered via a questionnaire administered by the researcher and field workers from August to September 2019. Standard techniques were used to measure body weight and height. In addition, serum retinol, haemoglobin, iron, ferritin, transferrin saturation, and transferrin levels were also assessed. Information on dietary diversity was gathered through a 24 h dietary recall. Results: The prevalence of underweight, wasting, and stunting was 3.6%, 2%, and 9.2%, respectively. Using serum retinol <10 µg/dL, 22% of children had vitamin A deficiency. The prevalence of anaemia was 53.6%, while 13.1% of children had iron deficiency anaemia when using serum ferritin of less than 12 μg/dL. Most children (90.8%) had an inadequate dietary diversity score, while 9.2% had sufficient dietary diversity. The most consumed food groups were grains, roots and tubers, vitamin A rich fruits and vegetable, and flesh foods. A higher percentage (44%) of children with low iron ferritin were underweight compared to those with normal iron ferritin (df = 1, p-value = 0.007). Conclusion: Iron, anaemia, and vitamin A deficiencies, accompanied by a high prevalence of stunting, were common among children in Thulamela Municipality. Thus, improving nutritional status in this area is a critical need. Full article
(This article belongs to the Special Issue Infant and Early Childhood Nutrition)
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22 pages, 536 KiB  
Systematic Review
Exploring the Benefits of Dog-Assisted Therapy for the Treatment of Complex Trauma in Children: A Systematic Review
by Rebekah L. Chapman, Caitlin Baselmans, Tiffani J. Howell, Carol Ronken and David Butler
Children 2024, 11(8), 1017; https://doi.org/10.3390/children11081017 - 20 Aug 2024
Viewed by 1454
Abstract
Background: The manifestation of complex trauma results from exposure to severe and repetitive stressors occurring within the caregiver system. Frequently associated with child maltreatment, complex trauma can lead to impairments in multiple domains, including attachment, affect and behavioural regulation, and cognition. Treatments, including [...] Read more.
Background: The manifestation of complex trauma results from exposure to severe and repetitive stressors occurring within the caregiver system. Frequently associated with child maltreatment, complex trauma can lead to impairments in multiple domains, including attachment, affect and behavioural regulation, and cognition. Treatments, including Trauma-Focused Cognitive Behavioural Therapy, have been shown to be efficacious, but high attrition rates point to the need for complementary methods that boost client retention and treatment efficacy. This systematic review examines whether dog-assisted therapy has beneficial impacts on the treatment of complex trauma and whether it can decrease treatment attrition among children presenting with complex trauma exposure. Methods: We followed PRISMA guidelines to locate relevant research reports. Seven published research reports matched the inclusion criteria. Results: Dog-assisted therapy may increase the efficacy of standard interventions for complex trauma, although only one study formally assessed treatment retention. Across most studies, there is an overall lack of detailed information on the nature of therapeutic activities involving the dog and how these activities may complement or enhance therapy as usual. Studies were of varying methodological quality, impacting the reliability of findings. Conclusions: Future studies should aim to better describe and justify dog-assisted therapy techniques and evaluate these in comparison with standard evidence-based approaches to the treatment of childhood complex trauma. Full article
(This article belongs to the Special Issue The Impact of Animals on Children’s Health, Development and Wellbeing)
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24 pages, 278 KiB  
Article
Family Dynamics, Socioeconomic Hardships, and Health Risk Behaviours of Bulgarian Adolescents during the COVID-19 Pandemic
by Elitsa Dimitrova and Anna Alexandrova-Karamanova
Children 2024, 11(8), 1016; https://doi.org/10.3390/children11081016 - 20 Aug 2024
Viewed by 1211
Abstract
Background/Objectives: This study aims to explore family dynamics and the economic hardships experienced by families during the COVID-19 pandemic and their associations with adolescents’ health risk behaviours (HRBs). Methods: Based on a representative study of adolescents aged 11–16 conducted in Bulgaria during the [...] Read more.
Background/Objectives: This study aims to explore family dynamics and the economic hardships experienced by families during the COVID-19 pandemic and their associations with adolescents’ health risk behaviours (HRBs). Methods: Based on a representative study of adolescents aged 11–16 conducted in Bulgaria during the COVID-19 pandemic and HBSC data from the pre-pandemic period, logistic regression models were applied, assessing cigarette smoking, vaping, alcohol use, drunkenness, and cannabis use. The independent variables included demographics, Family Affluence Scale (FAS III), family structure, ease of communication with parents, and the authors’ developed questions on parents’ income and economic status change, family conflicts, and missing contact with extended family due to the pandemic. Results: Material status of the family showed increasing differentials in adolescents’ HRBs during the pandemic. Parental unemployment, income reduction, and temporary lay-offs were associated with a higher risk of substance use. Family conflicts, missing contact with extended family, and difficulties in communication with the mother were related to a higher risk of substance use. Communication with the father was significantly associated with alcohol use and drunkenness. Boys had lower odds of vaping and higher odds of alcohol use, drunkenness, and cannabis use. Higher age and minority status were associated with an increase in adolescents’ HRBs. Conclusions: This study highlights the need for special family-focused interventions in times of health and economic crises. Full article
(This article belongs to the Special Issue Parenting and Child/Adolescent Development: Current Updates and Global Perspectives)
19 pages, 1399 KiB  
Review
Adverse Childhood Experiences and Risk of Abnormal Body Mass Index: A Global Systematic Review and Meta-Analysis
by Sohrab Amiri, Nailah Mahmood, Rahemeen Yusuf, Nadirah Ghenimi, Syed Fahad Javaid and Moien AB Khan
Children 2024, 11(8), 1015; https://doi.org/10.3390/children11081015 - 20 Aug 2024
Viewed by 876
Abstract
(1) Objectives: The impact of abnormal body mass index (BMI) on health is extensive, and various risk factors contribute to its effects. This study aimed to examine the association between adverse childhood experiences (ACEs) and BMI categories, including underweight, overweight, obesity, severe obesity, [...] Read more.
(1) Objectives: The impact of abnormal body mass index (BMI) on health is extensive, and various risk factors contribute to its effects. This study aimed to examine the association between adverse childhood experiences (ACEs) and BMI categories, including underweight, overweight, obesity, severe obesity, and morbid obesity; (2) Methods: Three databases were searched: Web of Science, PubMed, and Scopus. Manual searches were conducted using Google Scholar and ResearchGate. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to assess the association between ACEs and BMI. A random-effects model was used to combine the ORs and CIs across studies; (3) Results: This meta-analysis included 71 studies. The pooled ORs for the relationship between ACEs and obesity was 1.42 (95% CI: 1.24–1.63, Z = 4.96, p < 0.001), indicating a significant association. ACEs showed a positive association with overweight (OR = 1.16, 95% CI: 1.06–1.27, Z = 3.24, p = 0.001). Specifically, ACEs ≥ 4 were strongly associated with obesity (OR = 2.06, 95% CI: 1.27–3.36, Z = 2.90, p = 0.004). Sexual abuse was also found to be significantly associated with obesity (OR = 1.46, 95% CI: 1.29–1.65, Z = 5.98, p < 0.001); (4) Conclusion: This study finds that individuals who have experienced ACEs are more likely to have a higher BMI in adulthood. Therefore, ACEs should be considered a factor associated with abnormal BMI. Full article
(This article belongs to the Special Issue Children and Adolescent Mental Health Problems and Prevention)
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11 pages, 230 KiB  
Article
Awareness about Neonatal Lactose Intolerance among Chinese Neonatologists in Outpatient Settings: A Multi-Center Survey
by Zhengli Wang, Liting Liu, Chao Yu, Wenyan Tang, Xiangping Ding, Xiangwen Hu and Yuan Shi
Children 2024, 11(8), 1014; https://doi.org/10.3390/children11081014 - 20 Aug 2024
Viewed by 657
Abstract
Background: This study aimed to identify the specific areas of knowledge gaps regarding lactose intolerance among neonatologists in Chinese outpatient settings as well as to assess the availability of lactose intolerance testing in hospitals. Methods: A total of 278 neonatologists in outpatient settings [...] Read more.
Background: This study aimed to identify the specific areas of knowledge gaps regarding lactose intolerance among neonatologists in Chinese outpatient settings as well as to assess the availability of lactose intolerance testing in hospitals. Methods: A total of 278 neonatologists in outpatient settings from 144 hospitals were surveyed. To explore the awareness level, diagnosis, and treatment of neonatal lactose intolerance among neonatologists in outpatient settings, a multicenter cross-sectional survey was designed. Descriptive analysis based on frequency and percent distribution was performed for all variables. Results: Most respondents were senior doctors (256, 92.09%) from general hospitals and maternity/maternal and child health hospitals, had over 10 years of experience, and were dominantly associate chief physicians and chief physicians (211, 75.90%). A significant proportion of the participants (236, 84.89%) believed that neonatal lactose intolerance tends to be overlooked during clinical practice. When the most common symptoms of neonatal lactose intolerance were surveyed, diarrhea was selected by 142 (51.08%) respondents, followed by bloating and milk regurgitation or emesis (71, 25.54%). Other symptoms included unexplained crying (36, 12.85%), stool with milk flap or foam (15, 5.40%), and increased venting (14, 5.04%). Furthermore, the survey results indicated that the most common method for diagnosing neonatal lactose intolerance in the respondents’ hospitals was qualitative test for urinary galactose (78, 28.06%). Of the respondents, 137 (49.28%) stated that their hospital could not test for lactose intolerance. For treating lactose intolerance, the neonatologists primarily opted for exogenous lactase rather than lactose-free formula milk. Conclusions: This study sheds light on Chinese neonatologists’ awareness of neonatal lactose intolerance, revealing some knowledge gaps. The expeditious popularization and conduct of lactose intolerance-related examinations in hospitals will have a positive stimulative effect on the management of lactose intolerance in newborns. Full article
(This article belongs to the Section Pediatric Neonatology)
21 pages, 2935 KiB  
Article
Midpalatal Suture Maturation in Relation to Age, Sex, and Facial Skeletal Growth Patterns: A CBCT Study
by Felice Festa, Mario Festa, Silvia Medori, Giada Perrella, Pasquale Valentini, Giorgio Bolino and Monica Macrì
Children 2024, 11(8), 1013; https://doi.org/10.3390/children11081013 - 20 Aug 2024
Viewed by 765
Abstract
Background. The evaluation of midpalatal suture maturation is essential to undertake the most predictable maxillary expansion approach. Several factors, such as age, gender, and facial growth patterns, seem to be involved in midpalatal suture staging and, consequently, in its opening; however, the link [...] Read more.
Background. The evaluation of midpalatal suture maturation is essential to undertake the most predictable maxillary expansion approach. Several factors, such as age, gender, and facial growth patterns, seem to be involved in midpalatal suture staging and, consequently, in its opening; however, the link between these variables and the stages of midpalatal suture development remains poorly understood. Our study aimed to analyse the midpalatal suture maturation in relation to age, sex, and skeletal growth patterns by CBCT. Methods. We enrolled 263 patients (119 males and 144 females) aged from 8 to 20 years. The midpalatal suture maturation was defined according to Angelieri et al.’s classification using a low-dose CBCT. The chi-square test and linear regression were applied to investigate the suture stages by age, sex, and vertical and sagittal growth patterns. Results. Stage A was present in 8- and 9-year-olds with a larger prevalence in boys, while the prevalence of stage E increased progressively with age. Stage D was the most prevalent in our sample. The statistical analysis described that stage A was more likely in the youngest subjects, and stage E in the oldest participants. The males tended to have lower maturation stages. Moreover, the hypodivergent and normodivergent subjects tended to have higher maturation stages, while Class III was more likely in subjects in stages D or E. Conclusions. A total of 127 patients were in stages A, B, and C, showing an unfused suture. In young individuals, the opening of the midpalatal suture leads to a proper facial growth development by correcting the transverse superior hypoplasia. The midpalatal sutural maturation classification was related to age, sex, and divergence. Full article
(This article belongs to the Special Issue New Research Progress of Clinical Pediatric Dentistry)
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16 pages, 264 KiB  
Review
Prospective Genetic Screening in Multiple Endocrine Neoplasia Syndromes
by Diana Paun, Dana Tilici, Sorin Paun and Alexandra Mirica
Children 2024, 11(8), 1012; https://doi.org/10.3390/children11081012 - 20 Aug 2024
Viewed by 702
Abstract
Multiple endocrine neoplasia syndromes are a rare but potentially fatal pathology due to the lack of early diagnosis. We have performed a narrative review of the medical literature, summarizing the main clinical concepts useful in current clinical practice, showing the importance of screening [...] Read more.
Multiple endocrine neoplasia syndromes are a rare but potentially fatal pathology due to the lack of early diagnosis. We have performed a narrative review of the medical literature, summarizing the main clinical concepts useful in current clinical practice, showing the importance of screening and early diagnosis during childhood. Full article
(This article belongs to the Special Issue Human Genetics and Bioinformatics in Pediatric Diseases)
10 pages, 1036 KiB  
Case Report
Severe Post-Viral Polymyositis after COVID-19 in Childhood: A Case Report and Literature Review
by Jurgita Marciulynaite, Rima Sileikiene and Ausra Snipaitiene
Children 2024, 11(8), 1011; https://doi.org/10.3390/children11081011 - 20 Aug 2024
Viewed by 1470
Abstract
Polymyositis is a rarely reported complication of COVID-19 illness, especially in children. Molecular mimicry may be a cause of hyperactivated autoimmunity, leading to various clinical manifestations, including myopathies. Symptoms vary from mild muscle weakness to severe rhabdomyolysis. We review the literature on post-COVID [...] Read more.
Polymyositis is a rarely reported complication of COVID-19 illness, especially in children. Molecular mimicry may be a cause of hyperactivated autoimmunity, leading to various clinical manifestations, including myopathies. Symptoms vary from mild muscle weakness to severe rhabdomyolysis. We review the literature on post-COVID myositis and report a case of severe polymyositis in a 7-year-old boy, following undefined viral infection 3 weeks before the onset of muscle pain. Patient’s condition deteriorated from physical activity-associated pain in the lower limbs to severe muscle weakness leading to dysphagia and mechanical ventilation. As antibodies against SARS-CoV-2 were detected and other possible conditions causing myositis were excluded, the diagnosis of post-COVID polymyositis was considered as the most likely. The patient was treated with high doses of methylprednisolone and cyclophosphamide, resulting in improvement. Although COVID-19 is becoming a seasonal disease, the infection itself and post-viral disorders, such as polymyositis, are still of great interest and require better investigation to ensure appropriate management for each individual. Our experience suggests that aggressive immunosuppressive therapy might be a solution for severe post-COVID-related diseases. This literature review is provided in addition to the case report presented at the 29th European Paediatric Rheumatology Congress; the abstract is available online in the Proceedings of the 29th European Paediatric Rheumatology Congress. Full article
(This article belongs to the Special Issue COVID-19 and Pediatric Emergency Medicine)
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9 pages, 1077 KiB  
Case Report
Cytomegalovirus, a “Friend” of SARS-CoV-2: A Case Report
by Nicoleta-Ana Tomşa, Lorena Elena Meliţ, Gabriela Bucur, Anca-Meda Văsieșiu and Cristina Oana Mărginean
Children 2024, 11(8), 1010; https://doi.org/10.3390/children11081010 - 19 Aug 2024
Viewed by 807
Abstract
Introduction: Cytomegalovirus (CMV) infection is present in a latent state in 70–90% of the immunocompetent population, and its reactivation might be triggered by inflammatory conditions such as post-COVID multisystem inflammatory syndrome (MIS-C) or by immunosuppression induced by steroids. The aim of this paper [...] Read more.
Introduction: Cytomegalovirus (CMV) infection is present in a latent state in 70–90% of the immunocompetent population, and its reactivation might be triggered by inflammatory conditions such as post-COVID multisystem inflammatory syndrome (MIS-C) or by immunosuppression induced by steroids. The aim of this paper was to highlight the unexpected complications associated with SARS-CoV-2 infection that require a complex clinical approach for accurate diagnosis. Materials and Methods: We present the case of a 4-year-old male patient who, during an initially favorable course of PIMS, experienced symptoms of respiratory failure. Results: The patient initially presented with clinical and paraclinical signs of PIMS with cardiac involvement, for which high-dose corticosteroid therapy was initiated, followed by gradual tapering, along with immunoglobulins, anticoagulants, antiplatelet agents, and symptomatic treatment. After 10 days of favorable progress, the patient’s general condition deteriorated, showing tachypnea, desaturation, and a ground-glass appearance on thoracic CT. Negative inflammatory markers and favorable cardiac lesion evolution ruled out MIS-C relapse. The presence of anti-CMV IgM antibodies and viral DNA in the blood confirmed acute CMV infection, likely triggered by prior severe-acute-respiratory-syndrome-related coronavirus 2 (SARS-CoV-2) infection and secondary immunosuppression due to steroids. Non-specific immunomodulatory treatment was initiated but led to worsening of pulmonary lesions, prompting the initiation of specific antiviral treatment with ganciclovir, resulting in rapid clinical and imaging improvement. Conclusions: CMV infection can be reactivated by immunosuppression induced by corticosteroid therapy for MIS-C and may require specific etiological treatment. Full article
(This article belongs to the Section Pediatric Allergy and Immunology)
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10 pages, 225 KiB  
Article
Simethicone Medication Should Be Avoided in Infants Receiving Oral Lactase Treatment
by Ekin Say Yildirim, Adem Aydin, Tolga Ince, Zeynep Varol, Belgin Ünal and And Demir
Children 2024, 11(8), 1009; https://doi.org/10.3390/children11081009 - 17 Aug 2024
Viewed by 812
Abstract
Objective: In this retrospective study, we assessed the efficacy of oral lactase in infants with lactose intolerance in terms of sex, birth weight, and interference by other medications. Methods: The study was conducted on patients aged 0–6 months who had been diagnosed with [...] Read more.
Objective: In this retrospective study, we assessed the efficacy of oral lactase in infants with lactose intolerance in terms of sex, birth weight, and interference by other medications. Methods: The study was conducted on patients aged 0–6 months who had been diagnosed with lactose intolerance on admission to the Department of Social Pediatrics at Dokuz Eylul University. Demographic data, the onset of symptoms, and medications used were recorded. Results: We found that 86.7% of the infants responded to lactase, with no significant differences based on sex, birth weight, or age at symptom presentation. We observed, however, that the efficacy of treatment did improve over time, thereby deriving benefits from intestinal development and adaptation. Interestingly, the response to lactase was reduced in infants receiving concomitant simethicone for colic symptoms, suggesting a potential drug interaction, while probiotics had no impact on treatment outcomes. Conclusions: We advise against using additional medications with oral lactase, pointing out a possible interaction with simethicone that might decrease the effectiveness of treatment. Full article
(This article belongs to the Special Issue Advances in Gastrointestinal Diseases in Children and Adolescents)
20 pages, 253 KiB  
Article
Exploring Stress and Coping in Caregivers of Children with Pulmonary Vein Stenosis: A Mixed-Method Study
by Mark Fuller, Jr., Christina Ireland, Rachel Zmora and Kathy Jenkins
Children 2024, 11(8), 1008; https://doi.org/10.3390/children11081008 - 17 Aug 2024
Viewed by 677
Abstract
(1) Background: This mixed-method study aims to identify and describe factors associated with acute and long-term parenting stressors and coping strategies in caregivers of children with intraluminal pulmonary vein stenosis (PVS). (2) Methods: Parents of children with severe PVS were recruited from a [...] Read more.
(1) Background: This mixed-method study aims to identify and describe factors associated with acute and long-term parenting stressors and coping strategies in caregivers of children with intraluminal pulmonary vein stenosis (PVS). (2) Methods: Parents of children with severe PVS were recruited from a large quaternary hospital to complete a survey that included demographics, the Pediatric Inventory for Parents (PIP), and the Coping Health Inventory for Parents (CHIP). We determined the Social Vulnerability Index (SVI) based on self-reported home address. A subset of caregivers completed a 60 min semi-structured interview via Zoom exploring the impact their child’s diagnosis had on their family; experience managing stress in the hospital and at home; current resources and processes for coping; and potential recommendations for hospitals to build resilience and coping. We used multivariable linear regression to examine the association between SVI and parental stress and coping while adjusting for possible confounders. Thematic analysis identified themes related to stress and coping. Finally, we assessed instances of convergence and difference between the qualitative and quantitative results. (3) Results: Participants included 32 caregivers who were 91% female with a mean age of 39 years. The children of participants were 66% female, with a mean age of five years. The parents reported a high amount of stress with an average PIP score of 120, nearly 46 points higher than similar studies in the congenital heart community. We observed no significant associations between SVI and either parental stress or coping in adjusted models. We identified 13 themes, including medical care, hospital, family, support systems, and home medical routine or support. (4) Conclusions: Our study found high levels of illness-related parental stress among caregivers of children with PVS. Stress evolved over time from what caregivers described as ‘survival mode’ to a future-oriented outlook. Currently, caregivers rely heavily on support networks that are not available to all caregivers or may experience strain over time. Caregivers indicated that communication and parental role functioning were coping strategies that could be better supported by providers and health systems. Full article
(This article belongs to the Section Pediatric Pulmonary and Sleep Medicine)
10 pages, 687 KiB  
Article
Visual Performance of Children with Amblyopia after 6 Weeks of Home-Based Dichoptic Visual Training
by David P. Piñero, Amparo Gil-Casas, Francisco J. Hurtado-Ceña and Ainhoa Molina-Martin
Children 2024, 11(8), 1007; https://doi.org/10.3390/children11081007 - 17 Aug 2024
Viewed by 676
Abstract
Objectives: This study was aimed at analyzing the efficacy on the improvement of the visual function of a dichoptic online cloud-based platform for the treatment of amblyopia in anisometropic children. Methods: A quasi-experimental (pretest–post-test) study was conducted in 23 subjects with ages from [...] Read more.
Objectives: This study was aimed at analyzing the efficacy on the improvement of the visual function of a dichoptic online cloud-based platform for the treatment of amblyopia in anisometropic children. Methods: A quasi-experimental (pretest–post-test) study was conducted in 23 subjects with ages from 5 to 15 years old with anisometropic amblyopia combined with additional presence (2 subjects) or not (21 subjects) of microtropia. A total of 30 home-based training sessions of 30 min per session with Bynocs® platform were prescribed for 6 weeks. Results: Amblyopic eye logMAR visual acuity (VA) significantly improved from 0.28 ± 0.24 to 0.13 ± 0.20 after the 6-week treatment (p < 0.001). At baseline, 60.9% of participants had VA in amblyopic eye of 0.20 logMAR or worse, whereas this percentage decreased to 21.7% after treatment. Binocular function (BF) significantly improved from 2.82 ± 1.11 to 2.32 ± 0.94 (p < 0.001). Mean compliance was 92%, 87% and 93% at 2, 4 and 6 weeks of treatment, respectively. Conclusions: In conclusion, home-based dichoptic training with the digital platform evaluated is an effective method to improve amblyopic VA and stereoacuity in children with anisometropic amblyopia combined or not with microtropia. Full article
(This article belongs to the Section Pediatric Ophthalmology)
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23 pages, 1337 KiB  
Article
Exploring the Effectiveness and Challenges of Community Rehabilitation Service Programs for Children with Developmental Delays: A Qualitative Study from the Perspective of Early Intervention Service Providers in Taiwan
by Shu-Jou Sun, Wei-Lin Wang, Wei-Lun Huang and Wei-Sho Ho
Children 2024, 11(8), 999; https://doi.org/10.3390/children11080999 - 16 Aug 2024
Viewed by 661
Abstract
This qualitative study aimed to investigate the effectiveness of community rehabilitation programs for children with developmental delays from the perspective of early intervention service providers in Taiwan. Adopting a single-case experimental design (ABM design), this study examined the immediate and sustained effects of [...] Read more.
This qualitative study aimed to investigate the effectiveness of community rehabilitation programs for children with developmental delays from the perspective of early intervention service providers in Taiwan. Adopting a single-case experimental design (ABM design), this study examined the immediate and sustained effects of interventions on individualized goals during baseline, intervention, and maintenance phases. Additionally, data from interviews with parents, special education teachers, and other participants were collected to understand the challenges and improvement strategies of community rehabilitation programs. Results revealed that community rehabilitation programs for children with developmental delays exhibited both immediate and sustained effectiveness. Challenges faced by parents and professionals differed, with parents having less contact and communication with administrative systems, while professionals experienced more pronounced implementation difficulties during interventions. Moreover, strategies for improving community rehabilitation programs for children with developmental delays should vary for parents and professionals to address inconsistencies in attitudes and strategies among parents and administrative obstacles encountered by professionals. Full article
(This article belongs to the Special Issue Early Intervention, Inclusive Education, and Children Development)
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15 pages, 468 KiB  
Article
Health-Related Quality of Life and Mental Health of Parents of Children with Pediatric Abdominal Tumors
by Kira Zierke, Michael Boettcher, Paulina Behrendt, Safiullah Najem, Holger Zapf, Konrad Reinshagen, Wilhelm Wößmann and Johannes Boettcher
Children 2024, 11(8), 998; https://doi.org/10.3390/children11080998 - 16 Aug 2024
Viewed by 598
Abstract
Background: Abdominal tumors rarely occur in childhood but are associated with great psychological stress for patients and their families. Parents playing a central role in their children’s treatment may experience adverse effects on their Health-Related Quality of Life (HRQoL) and mental health due [...] Read more.
Background: Abdominal tumors rarely occur in childhood but are associated with great psychological stress for patients and their families. Parents playing a central role in their children’s treatment may experience adverse effects on their Health-Related Quality of Life (HRQoL) and mental health due to the children’s illness and required treatment. Given the limited knowledge of the psychosocial burden of parents with children suffering from solid abdominal tumors, this study aims to assess their HRQoL and mental health along with the impact of various psychosocial factors. Methods: A cross-sectional cohort study was carried out involving 54 parents of children with solid abdominal tumors who had surgery at the University Medical Center Hamburg-Eppendorf in Germany. The results were compared with 46 parents of children undergoing routine surgeries without a prior tumor diagnosis, and with normative values. Data were obtained using standardized questionnaires. Results: Parents of the index group showed significantly worse HRQoL and limited mental health. Furthermore, they showed significantly higher parental burden in several subscales and less social support in comparison with the control group. Conclusions: Considering the lower parental HRQoL and the central role parents play in their children’s lives, it is crucial to include prevention and intervention measures for parents as part of a multimodal treatment regime for children with solid pediatric abdominal tumors. Full article
(This article belongs to the Section Pediatric Mental Health)
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