Children

11 pages, 239 KiB

Open AccessArticle

Exploring the Association between Socioeconomic Environment, Eating Habits and Level of Nutrition in Children of High School Age: A Part of National Survey

by Mladen Grujicic, Marija Sekulic, Jovana Radovanovic, Viktor Selakovic, Jagoda Gavrilovic, Vladan Markovic, Marija Sorak, Marko Spasic, Rada Vucic, Snezana Sretenovic, Olivera Radmanovic, Zlata Rajkovic Pavlovic, Katarina Nikic Djuricic, Jovica Tomovic, Milena Maricic and Snezana Radovanovic

Children 2024, 11(9), 1074; https://doi.org/10.3390/children11091074 (registering DOI) - 31 Aug 2024

Abstract

Background/Objectives: One of the raising public health problems in the adolescent population is obesity, which has reached epidemic proportions worldwide. The aim of this work is to determine the prevalence of obesity in the population of children of secondary school, age 15 to [...] Read more.

Background/Objectives: One of the raising public health problems in the adolescent population is obesity, which has reached epidemic proportions worldwide. The aim of this work is to determine the prevalence of obesity in the population of children of secondary school, age 15 to 19 years in Serbia and the determinate connection with demographic and socio-economic characteristics of the respondents and their eating habits and physical activity. Methods: The research is part of the fourth National Population Health Survey conducted in 2019, which was conducted by the Republic Institute of Statistics, in cooperation with the Institute of Public Health of Serbia and the Ministry of Health of the Republic of Serbia. As a research instrument, questionnaires were used in accordance with the methodology of the European Health Survey. For the purposes of this research, data on the adult population aged 15–19 and over were used. Results: The association of overweight with demographic and socioeconomic characteristics was examined using binary regression. In the univariate model, male gender (OR = 1.95), younger age (OR = 1.57) and Region of Vojvodina (OR = 2.47) stood out as significant predictors of overweight, which was confirmed by the multivariate model. Conclusions: The results of our study emphasize that the prevalence of obesity in the population of high school youth is at a significant level and that a lot more needs to be done to promote healthy lifestyles and raise awareness of their benefits on health status. Full article

11 pages, 642 KiB

Open AccessArticle

Audiophonologopedic Telerehabilitation: Advantages and Disadvantages from User Perspectives

by Maria Lauriello, Anna Maria Angelone, Sara Iannotti, Eleonora Nardecchia, Benedetta Scopano, Alessandra Fioretti, Irene Ciancarelli and Alberto Eibenstein

Children 2024, 11(9), 1073; https://doi.org/10.3390/children11091073 (registering DOI) - 31 Aug 2024

Abstract

Introduction: Technological advancements and the COVID-19 pandemic have highlighted the importance of digital tools for patient care and rehabilitation. This study explores user perspectives on telerehabilitation, comparing it to traditional methods and identifying criteria for determining its suitability for different patients and clinical [...] Read more.

Introduction: Technological advancements and the COVID-19 pandemic have highlighted the importance of digital tools for patient care and rehabilitation. This study explores user perspectives on telerehabilitation, comparing it to traditional methods and identifying criteria for determining its suitability for different patients and clinical conditions. Methods: This study was carried out during the period of May–September 2021. Questionnaires were administered to 48 users in rehabilitation for audiophonologopedic and neurodevelopmental disorders in three rehabilitation centres in central Italy. Results: The user responses predominantly emphasize the benefits of time saving (68.75%) and cost-efficiency (37.5%), specifically regarding time saving due to travel and expenses incurred to go to where the therapy is carried out. The disadvantages include increased distraction (60.42%) in following the instructions remotely and logistic problems (39.58%). Patients with hearing loss were subjected to a larger number of telerehabilitation sessions, positively rating this alternative method. Patients with speech and language delay and autism spectrum disorder (ASD) prefer traditional treatment. Discussion: This study reveals a favourable perception of telerehabilitation as a therapy approach to be regarded as a supplement or temporary option to the irreplaceable face-to-face one. More research, as well as a larger sample sizes, will be useful to increase the significance of the correlations reported in this study. Full article

(This article belongs to the Special Issue Diagnosis and Management of Pediatric Ear and Vestibular Disorders)

22 pages, 2562 KiB

Open AccessArticle

Long-Term Mandatory Homeschooling during COVID-19 Had Compounding Mental Health Effects on Parents and Children

by Lucretia V. M. Groff, Mariam M. Elgendi, Sherry H. Stewart and Storm Hélène Deacon

Children 2024, 11(9), 1072; https://doi.org/10.3390/children11091072 (registering DOI) - 31 Aug 2024

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Abstract

Background/Objectives: Most studies have linked mandatory homeschooling during COVID-19 to mental health harm in parents and children, while a minority have found non-significant or beneficial effects. Past studies have not measured mandatory homeschooling continuously over an extended period; consequently, they could not capture [...] Read more.

Background/Objectives: Most studies have linked mandatory homeschooling during COVID-19 to mental health harm in parents and children, while a minority have found non-significant or beneficial effects. Past studies have not measured mandatory homeschooling continuously over an extended period; consequently, they could not capture compounding mental health effects, which may explain conflicting results. We asked whether children’s cumulative time spent homeschooled during COVID-19 school closure mandates caused compounding harm for parent and child mental health, and whether parent employment, child internet access and educational support from schools (live and pre-recorded online classes, home learning packs) impacted this relationship. We aimed to identify the families at greatest risk of mental health harm during mandatory homeschooling and the educational support that may have mitigated this risk. Methods: Couples completed retrospective, cross-sectional survey questionnaires assessing parent depression, anxiety and stress, child internalizing and externalizing symptoms, and the family’s homeschooling experience. Data were analyzed using mediation analysis total effects, ordinary least squares regression and simple slopes analysis. Results: Both parents and children experienced compounding mental health harm during mandatory homeschooling. Live online classes protected parents and children, while home learning packs protected children. Unexpectedly, reliable internet access and the employment of both parents placed children at greater risk. Conclusions: Findings suggest that long-term mandatory homeschooling during COVID-19 placed families at greater risk of mental health harm. To protect family mental health during homeschooling mandates, schools should provide children with evidence-based educational support. Full article

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

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15 pages, 648 KiB

Open AccessArticle

The Assessment of Postural–Motor, Coordination, and Reflex Functions in Children and Adolescents with a History of Premature Verticalization and Ontogeny Disorders in Their First Year of Life

by Mieczysław Maciak, Kamil Koszela, Anna Beniuk and Marta Woldańska-Okońska

Children 2024, 11(9), 1071; https://doi.org/10.3390/children11091071 (registering DOI) - 31 Aug 2024

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Abstract

(1) Background: Contracting diseases or being exposed to adverse environmental factors in the first year of life may impair the development of body posture and motor coordination. The purpose of this study was to evaluate the correlation between data on the speed of [...] Read more.

(1) Background: Contracting diseases or being exposed to adverse environmental factors in the first year of life may impair the development of body posture and motor coordination. The purpose of this study was to evaluate the correlation between data on the speed of passive verticalization, the number of risk factors and the quality of development in the first year of life, and the results of the functional examination of these individuals in adolescence. (2) Methods: Two groups of 60 volunteers, aged 9–14 years, were examined by performing functional tests and the retrospective analysis of their development up to the age of 1 year. The first group consisted of patients diagnosed with postural defects. The control group consisted of healthy people of the same age who volunteered for this study. (3) Results: Statistical analysis showed statistically significant differences between groups in terms of posture (p = 0.001), motor coordination (p = 0.001), and accumulated primitive reflexes (p = 0.001), as well as a high correlation between these disorders and the quality of development in the first year of life. In the first group, for the ages of 3–6 months (r = 0.96; p = 0.001), 6–9 months (r = 0.871; p = 0.001), and 9–12 months (r = 0.806; p = 0.001), no significant correlations were found with the age of 0–3 months. In the second group, the results were as follows: 0–3 months (r = 0.748; p = 0.001), 3–6 months (r = 0.862 p = 0.001), 6–9 months (r = 0.698; p = 0.001), and 9–12 months (r = 0.740; p = 0.001). In the group of adolescents with posture defects, we observed an earlier time of passive verticalization and sitting, as well as more frequent use of loungers, seats, and walkers (p = 0.026). (4) Conclusions: The analysis of this study’s data indicates that the development of body posture and motor coordination may be impaired due to accelerated and passive verticalization in the first year of life. Full article

(This article belongs to the Section Pediatric Neurology & Neurodevelopmental Disorders)

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30 pages, 831 KiB

Open AccessReview

A Scoping Review to Identify Community- and Societal-Level Strategies Evaluated from 2013 to 2023 for Their Potential Impact on Child Well-Being in the United States

by Katie A. Ports, Whitney L. Rostad, Peter Coyne, Jadyn Dunning, Andrea E. Gonzalez and Adam Troy

Children 2024, 11(9), 1070; https://doi.org/10.3390/children11091070 (registering DOI) - 31 Aug 2024

Viewed by 101

Abstract

There is increased recognition for solutions that address the social determinants of health (SDOHs)—the context in which families are raising children. Unfortunately, implementing solutions that address inequities in the SDOHs has proven to be difficult. Many child and family serving systems and communities [...] Read more.

There is increased recognition for solutions that address the social determinants of health (SDOHs)—the context in which families are raising children. Unfortunately, implementing solutions that address inequities in the SDOHs has proven to be difficult. Many child and family serving systems and communities do not know where to start or do not have the capacity to identify and implement upstream SDOH strategies. As such, we conducted a scoping review to assess the status of evidence connecting strategies that address the SDOHs and child well-being. A total of 29,079 records were identified using natural language processing with 341 records meeting inclusion criteria (e.g., outcomes focused on child well-being, interventions happening at a population level, and evaluations of prevention strategies in the United States). Records were coded, and the findings are presented by the SDOH domain, such as strategies that addressed economic stability (n = 94), education access and quality (n = 17), food security (n = 106), healthcare access and quality (n = 96), neighborhood and built environment (n = 7), and social and community context (n = 12). This review provides an overview of the associations between population-level SDOH strategies and the impact—good and bad—on child well-being and may be a useful resource for communities and practitioners when considering equitable solutions that promote thriving childhoods. Full article

(This article belongs to the Special Issue Physical, Psychological and Social Health in Childhood: The Role of Health Determinants)

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22 pages, 3654 KiB

Open AccessArticle

Surface and Mineral Changes of Primary Enamel after Laser Diode Irradiation and Application of Remineralization Agents: A Comparative In Vitro Study

by Mihaela-Valentina Cîrdei, Mădălin-Marius Margan, Roxana Margan, Alexandra Ban-Cucerzan, Ion Petre, Iosif Hulka, Razvan Mihai Horhat and Darinca Carmen Todea

Children 2024, 11(9), 1069; https://doi.org/10.3390/children11091069 - 30 Aug 2024

Viewed by 144

Abstract

Objectives: The purpose of this study is to evaluate the remineralization potential of primary teeth enamel after being exposed to different laser diode therapies. Methods: Ninety-six vestibular primary teeth enamel samples were divided into eight groups (n = 12) with varying treatments: [...] Read more.

Objectives: The purpose of this study is to evaluate the remineralization potential of primary teeth enamel after being exposed to different laser diode therapies. Methods: Ninety-six vestibular primary teeth enamel samples were divided into eight groups (n = 12) with varying treatments: control (G1), CPP-ACP-fluoride varnish (G2), diode lasers at 980 nm (G3), 808 nm (G4), 450 nm (G5), 980 nm + CPP-ACP-fluoride varnish (G6), 808 nm + CPP-ACP-fluoride varnish (G7), and 450 nm + CPP-ACP-fluoride varnish (G8). Each sample was assessed using a DIAGNOdent^® (KaVo Dental, Biberach, Germany), at baseline, post-treatment, and post-pH cycle remineralization. SEM imaging was performed before and after treatment and following the pH cycle. Results: The results indicated that the 980 nm and 808 nm diode lasers, both alone and in combination with CPP-ACP-fluoride varnish, either maintained or increased the calcium (Ca) weight percentage (Wt%) in the enamel. The 980 nm diode laser combined with CPP-ACP-fluoride varnish (G6) showed a significant increase in Ca Wt%, suggesting a strong remineralization effect. Similarly, the 808 nm diode laser alone (G4) also promoted a substantial increase in Ca Wt%. In contrast, the 450 nm diode laser, whether applied alone or in combination with CPP-ACP-fluoride varnish, resulted in a lower Ca Wt% and an increase in phosphorus (P) Wt%. Most groups, except for the CPP-ACP-fluoride varnish alone (G2), demonstrated an increase in P Wt%, indicating a complex interaction between laser therapy and enamel remineralization. Conclusions: The combined use of laser therapy with CPP-ACP-fluoride varnish significantly enhanced the remineralization of temporary teeth enamel. The 980 nm diode laser + CPP-ACP-fluoride varnish showed the most pronounced improvement in remineralization, while the 808 nm diode laser alone also effectively increased calcium solubility. These findings suggest that higher-wavelength diode lasers, particularly when combined with remineralizing agents, can effectively enhance the mineral content of primary teeth and promote enamel remineralization. Full article

(This article belongs to the Special Issue Public Health and Preventive Medicine for Children)

25 pages, 2894 KiB

Open AccessArticle

Online Age Verification: Government Legislation, Supplier Responsibilization, and Public Perceptions

by Chelsea Jarvie and Karen Renaud

Children 2024, 11(9), 1068; https://doi.org/10.3390/children11091068 - 30 Aug 2024

Viewed by 170

Abstract

There are widespread concerns about the online harms to children operating online. As such, governments have enacted laws to require online service providers to deploy age verification to prevent such harms. We investigate the following three research questions regarding this topic: (1) To [...] Read more.

There are widespread concerns about the online harms to children operating online. As such, governments have enacted laws to require online service providers to deploy age verification to prevent such harms. We investigate the following three research questions regarding this topic: (1) To what extent have different governments legislated age verification controls? (2) Do governments embrace a responsibilization strategy when it comes to online age verification? and (3) How does the UK public feel about online age verification legislation? We find that governments are applying a responsibilization strategy, which has led to widespread deployment of privacy-invasive or ineffective age verification. The former violates the privacy of underage users, with the latter undermining the overarching aims of the legislation. We have also found general disengagement and a lack of trust in the government amongst the public with regards to new online age verification laws within the UK. To conclude, despite governments globally looking to put more robust online age verification mechanisms in place, there remains a general lack of privacy preservation and affordable technological solutions. Moreover, the overarching aims of the online safety and age verification legislative changes may not be satisfied due to the general public stakeholder group’s disengagement and lack of trust in their government. Full article

(This article belongs to the Section Global Pediatric Health)

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12 pages, 464 KiB

Open AccessArticle

A Simple MRI Score Predicts Pathological General Movements in Very Preterm Infants with Brain Injury—Retrospective Cohort Study

by Monia Vanessa Dewan, Pia Deborah Weber, Ursula Felderhoff-Mueser, Britta Maria Huening and Anne-Kathrin Dathe

Children 2024, 11(9), 1067; https://doi.org/10.3390/children11091067 - 30 Aug 2024

Viewed by 264

Abstract

Background/Objectives: Very preterm infants are at increased risk of brain injury and impaired brain development. The Total Abnormality Score and biometric parameters, such as biparietal width, interhemispheric distance and transcerebellar diameter, are simple measures to evaluate brain injury, development and growth using cerebral [...] Read more.

Background/Objectives: Very preterm infants are at increased risk of brain injury and impaired brain development. The Total Abnormality Score and biometric parameters, such as biparietal width, interhemispheric distance and transcerebellar diameter, are simple measures to evaluate brain injury, development and growth using cerebral magnetic resonance imaging data at term-equivalent age. The aim of this study was to evaluate the association between the Total Abnormality Score and biometric parameters with general movements in very preterm infants with brain injury. Methods: This single-center retrospective cohort study included 70 very preterm infants (≤32 weeks’ gestation and/or <1500 g birth weight) born between January 2017 and June 2021 in a level-three neonatal intensive care unit with brain injury—identified using cerebral magnetic resonance imaging data at term-equivalent age. General movements analysis was carried out at corrected age of 8–16 weeks. Binary logistic regression and Spearman correlation were used to examine the associations between the Total Abnormality Score and biometric parameters with general movements. Results: There was a significant association between the Total Abnormality Score and the absence of fidgety movements [OR: 1.19, 95% CI = 1.38–1.03] as well as a significant association between the transcerebellar diameter and fidgety movements (Spearman ρ = −0.269, p < 0.05). Conclusions: Among very preterm infants with brain injury, the Total Abnormality Score can be used to predict the absence of fidgety movements and may be an easily accessible tool for identifying high-risk very preterm infants and planning early interventions accordingly. Full article

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27 pages, 842 KiB

Open AccessSystematic Review

Multistakeholder Perspectives on the Determinants of Family Fundamental Movement Skills Practice: A Qualitative Systematic Review

by Robert J. Flynn, Andy Pringle and Clare M. P. Roscoe

Children 2024, 11(9), 1066; https://doi.org/10.3390/children11091066 - 30 Aug 2024

Viewed by 158

Abstract

Background: Childhood obesity is a significant public health crisis that is exposing children to associated morbidities and premature mortality. However, parents can positively influence physical activity trajectories and improve health outcomes by nurturing fundamental movement skills (FMS) in children. This is the first [...] Read more.

Background: Childhood obesity is a significant public health crisis that is exposing children to associated morbidities and premature mortality. However, parents can positively influence physical activity trajectories and improve health outcomes by nurturing fundamental movement skills (FMS) in children. This is the first study to explore the determinants of family FMS practice via a systematic synthesis of qualitative evidence. Methods: Keyword searches were completed in SPORTDiscus, PubMed, Scopus, Web of Science, and Embase. Studies that offered perspectives relating to influences on the FMS of 2–6-year-old children in the family context via qualitative approaches, including visual methodologies that provided an important voice to children, were included. A thematic analysis was used to establish key themes. Results: The emergent themes included parent knowledge and beliefs, self-efficacy of parents to teach, and the home environment. Parents often undervalued FMS and lacked the self-efficacy to teach due to poor understanding, conflicting priorities, and multifaceted societal influences. Children preferred autonomous play and socialisation but were negatively influenced by technology and restrictive household rules. Conclusions: Greater knowledge exchange between stakeholders is necessary to empower parents and enhance FMS application at home. More community initiatives could facilitate greater access to outdoor spaces, facilities, and equipment, which may improve family engagement with FMS. Full article

(This article belongs to the Special Issue Physical, Psychological and Social Health in Childhood: The Role of Health Determinants)

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20 pages, 2458 KiB

Open AccessArticle

Road Fatalities in Children Aged 0–17: Epidemiological Data and Forensic Aspects on a Series of Cases in a Single-Centre in Romania

by Ştefania Ungureanu, Veronica Ciocan, Camelia-Oana Mureșan, Emanuela Stan, Georgiana-Denisa Gavriliţă, Alexandra Sirmon, Cristian Pop and Alexandra Enache

Children 2024, 11(9), 1065; https://doi.org/10.3390/children11091065 - 30 Aug 2024

Viewed by 164

Abstract

Introduction: Road Traffic Accidents (RTAs) are the leading cause of premature death in young people aged 5–29. Globally, 186,300 children aged 9 years and under die from RTAs each year. Romania had the highest mortality rate in children aged 0 to 14 for [...] Read more.

Introduction: Road Traffic Accidents (RTAs) are the leading cause of premature death in young people aged 5–29. Globally, 186,300 children aged 9 years and under die from RTAs each year. Romania had the highest mortality rate in children aged 0 to 14 for 2018–2020. This study aimed to assess the involvement of children aged 0–17 years in fatal RTAs by analyzing medico-legal autopsy records in a 5-year period at Timisoara Institute of Legal Medicine (TILM), Romania. Materials and Methods: A retrospective analysis of medico-legal autopsy records of road fatalities in children aged 0–17 years, from TILM in a 5-year period (2017–2021), was conducted. Results: Of all medico-legal autopsies in the 5-year period, 23 cases (5.8%) involved road fatalities in children aged 17 and under. Preschoolers accounted for 10 cases, followed by the age group 15–17 years (n = 9). Most children sustained fatal injuries as passengers (n = 13), followed by child pedestrians (n = 7). This research follows four representative cases, each being a different type of child road fatality regarding the type of road user, the age of the victim, and the involvement of other risk factors. Conclusions: Our findings emphasize the tragedy of road fatalities in children and the need to determine risk factors and prevention strategies to reduce the enormous global crisis involving these vulnerable victims. Full article

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16 pages, 3071 KiB

Open AccessArticle

Management of Bilateral Congenital and Juvenile Cataracts in a Low-Income Country: Patient Identification, Treatment Outcomes, and Follow Up

by Broder Poschkamp, Serge Dinkulu, Thomas Stahnke, Clara Böckermann, Edith Mukwanseke, Christiane Paschke, Adrian Hopkins, Rainald Duerksen, Ellen Catrin Steinau, Andreas Stahl, Andreas Götz, Rudolf Guthoff and Ngoy-Janvier Kilangalanga

Children 2024, 11(9), 1064; https://doi.org/10.3390/children11091064 - 30 Aug 2024

Viewed by 174

Abstract

Background: Childhood blindness remains a neglected issue in eye care within low-income countries, with congenital and juvenile cataracts being the most common treatable causes. This study aims to investigate the factors influencing the management of congenital and juvenile bilateral cataracts, provide data on [...] Read more.

Background: Childhood blindness remains a neglected issue in eye care within low-income countries, with congenital and juvenile cataracts being the most common treatable causes. This study aims to investigate the factors influencing the management of congenital and juvenile bilateral cataracts, provide data on general outcomes and postoperative findings, and discuss treatment in a low-income country context. Methods: In this prospective study, data from clinical care were continuously entered into a database, and one follow-up examination of a cohort of 91 patients with congenital and juvenile bilateral cataracts in Kinshasa, Democratic Republic of the Congo, was conducted. Multiple factors that affect the first clinical presentation, the clinical management, and outcome were investigated. Results: Most patients (88.5%) who received medical treatment were identified by cataract finders. A patient’s presentation time was independent of the parent’s education, social status, income, and sex of the child. The median age at first presentation was 5.8 years (ranging from 0 days to 17.3 years). The best visual acuity outcomes were achieved by patients who underwent surgery during early childhood. According to WHO grades and on an eye level basis, 51.1% (93 out of 182 eyes) showed improvement, while 34.6% (63 eyes) had unchanged results post-surgery. Among the cases without improvement, 76.2% were blind prior to surgery. Postoperative findings were observed in 56% of the patients, with secondary cataracts being the most common, affecting 26.37% of the operated eyes. Conclusions: Optimal management of childhood cataracts involves early identification, efficient hospital infrastructure, high-quality medical care, and long-term follow up. In sub-Saharan Africa, this approach must be adapted to the context of available resources, which differs significantly from those in high- and middle-income countries. Full article

(This article belongs to the Section Pediatric Ophthalmology)

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9 pages, 1405 KiB

Open AccessArticle

Genome-Wide Mapping of Consanguineous Families Confirms Previously Implicated Gene Loci and Suggests New Loci in Specific Language Impairment (SLI)

by Adnan Yousaf, Huma Hafeez, Muhammad Asim Raza Basra, Mabel L. Rice, Muhammad Hashim Raza and Muhammad Imran Shabbir

Children 2024, 11(9), 1063; https://doi.org/10.3390/children11091063 - 30 Aug 2024

Viewed by 142

Abstract

Specific language impairment (SLI) is a developmental disorder with substantial genetic contributions. A genome-wide linkage analysis and homozygosity mapping were performed in five consanguineous families from Pakistan. The highest LOD scores of 2.49 at 12p11.22-q11.21 in family PKSLI-31 and 1.92 at 6p in [...] Read more.

Specific language impairment (SLI) is a developmental disorder with substantial genetic contributions. A genome-wide linkage analysis and homozygosity mapping were performed in five consanguineous families from Pakistan. The highest LOD scores of 2.49 at 12p11.22-q11.21 in family PKSLI-31 and 1.92 at 6p in family PKSLI-20 were observed. Homozygosity mapping showed a loss of heterozygosity on 1q25.3-q32.2 and 2q36.3-q37.3 in PKSLI-20. A loss of heterozygosity mapped, in PKSLI-31 and PKSLI-34 flanks, NFXL1 and CNTNAP2, which are genes previously identified in SLI. Our findings report novel SLI loci and corroborate previously reported SLI loci, indicating the utility of a family-based approach. Full article

(This article belongs to the Special Issue Language Acquisition and Language Impairment in Children with and without Neurodevelopmental Disorders)

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14 pages, 799 KiB

Open AccessArticle

The Impact of Parental Involvement on the Educational Development of Students with Autism Spectrum Disorder

by José Fernández Cerero, Marta Montenegro Rueda and Eloy López Meneses

Children 2024, 11(9), 1062; https://doi.org/10.3390/children11091062 - 30 Aug 2024

Viewed by 226

Abstract

Background/Objectives: Parental involvement is vital for the academic success and overall development of students, particularly those with Autism Spectrum Disorder (ASD), who face unique educational challenges. This study investigates the influence of parental involvement on the academic performance and school adjustment of students [...] Read more.

Background/Objectives: Parental involvement is vital for the academic success and overall development of students, particularly those with Autism Spectrum Disorder (ASD), who face unique educational challenges. This study investigates the influence of parental involvement on the academic performance and school adjustment of students with ASD, focusing on the interplay of cultural identity and first language in their educational and social growth. The research also seeks to identify the challenges parents face and the strategies they use to support their children. Method: Employing a qualitative, interpretive approach, this study involved 42 parents of secondary school students with ASD in Seville, Spain. Data collection included in-depth interviews and focus group discussions, allowing for a comprehensive understanding of parental experiences. Results: The study found that active parental involvement greatly enhances students’ academic performance and emotional well-being. Key strategies include creating structured home environments, utilizing assistive technologies, and fostering open communication with school staff. However, parents reported significant challenges, including limited school resources, communication barriers with educators, and a lack of ASD-specific training for teachers and parents. These challenges often hinder their ability to fully support their children’s education. Conclusions: Active parental involvement is crucial for the educational success of students with ASD. The findings highlight the need for improved communication between schools and families, increased resources, and targeted ASD training for both teachers and parents. Additionally, the study advocates for greater investment in assistive technologies to better support students with ASD. Addressing these needs could significantly improve the educational experiences and outcomes for these students. Full article

(This article belongs to the Section Pediatric Neurology & Neurodevelopmental Disorders)

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12 pages, 235 KiB

Open AccessArticle

Vitamin D Deficiency—A Public Health Issue in Children

by Alexandru Herdea, Harun Marie, Adelina Ionescu, Diana-Mihaela Sandu, Sara-Teodora Pribeagu and Alexandru Ulici

Children 2024, 11(9), 1061; https://doi.org/10.3390/children11091061 - 30 Aug 2024

Viewed by 198

Abstract

Background: 25-hydroxyvitamin D [25(OH)D] deficiency is a global health concern, particularly in pediatric populations, with implications for musculoskeletal health and overall well-being. This study aimed to evaluate serum 25(OH)D levels in a pediatric population and assess the prevalence of deficiency and insufficiency. Methods: [...] Read more.

Background: 25-hydroxyvitamin D [25(OH)D] deficiency is a global health concern, particularly in pediatric populations, with implications for musculoskeletal health and overall well-being. This study aimed to evaluate serum 25(OH)D levels in a pediatric population and assess the prevalence of deficiency and insufficiency. Methods: A retrospective analysis was conducted on data from 741 pediatric patients (2–17 years old) who visited an urban hospital for children for acute respiratory and gastrointestinal conditions in the span of 2 years. Serum 25(OH)D levels were measured using chemiluminescent microparticle immunoassay. Statistical analyses were performed to assess the prevalence of deficiency and insufficiency, seasonal variations, and correlations with age and daylight exposure. Results: Of the 739 pediatric patients analyzed, a substantial proportion exhibited insufficient (31.80%) or deficient (36.54%) serum 25(OH)D levels. While younger age groups generally had higher mean 25(OH)D levels, a negative correlation was observed between 25(OH)D levels and age. Sunlight exposure variations did not significantly impact serum 25(OH)D levels. Despite diverse daylight exposure patterns, there were no significant differences between longer and shorter daylight periods. Conclusions: This study highlights the high prevalence of 25(OH)D deficiency and insufficiency in the pediatric population, emphasizing the need for public health monitoring and targeted supplementation strategies. Findings underscore the importance of regular consultations with healthcare providers to ensure optimal 25(OH)D levels in children, with potential implications for revising current sufficiency thresholds. Addressing 25(OH)D deficiency is crucial for promoting musculoskeletal health and overall well-being in children. Full article

(This article belongs to the Section Global Pediatric Health)

8 pages, 550 KiB

Open AccessCase Report

Pediatric Post-Pump Chorea: Case Report and Implications for Differential Diagnosis

by Elisa Rossi, Concetta Strano, Ilaria Cortesia, Francesca Torta, Mirella Davitto Bava, Irene Tardivo and Marco Spada

Children 2024, 11(9), 1060; https://doi.org/10.3390/children11091060 - 29 Aug 2024

Viewed by 246

Abstract

Background: Chorea is a neurological disorder characterized by random, fluid movements that may affect the limbs, trunk, neck, or face. In children, Sydenham’s chorea (SC) is the most common cause of acute chorea, mainly following group A beta-hemolytic streptococcal (GABHS) infection. Other autoimmune [...] Read more.

Background: Chorea is a neurological disorder characterized by random, fluid movements that may affect the limbs, trunk, neck, or face. In children, Sydenham’s chorea (SC) is the most common cause of acute chorea, mainly following group A beta-hemolytic streptococcal (GABHS) infection. Other autoimmune and metabolic disorders may also cause chorea. Case presentation: We report the case of a 6-year-old girl who developed chorea following cardiac surgery for mitral insufficiency. One week after discharge, the patient presented with right-sided hyposthenia, slower speech, mild dysarthria, and sialorrhea. Brain MRI and intracranial MRI angiography revealed a small vascular lesion consistent with a microembolic event. Extensive diagnostic investigations, including serum panels for autoimmune encephalitis, neurotropic viruses, and metabolic disorders, were negative. Conclusions: Considering the patient’s history, clinical course, and the exclusion of other potential causes, a diagnosis of post-pump chorea was made. This case underlines the importance of a thorough differential diagnosis in pediatric chorea and highlights post-pump chorea as a significant postoperative complication in pediatric cardiac surgery. The patient’s motor symptoms improved with symptomatic treatment, and follow-up showed good recovery without neurological sequelae. Full article

(This article belongs to the Special Issue Pediatric Emergency Medicine)

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10 pages, 246 KiB

Open AccessArticle

Transanal Endorectal Pull-Through for Hirschsprung’s Disease: Complications and Lessons from Our Practice and the Literature

by Andrzej Gołębiewski, Stefan Anzelewicz, Daria Sosińska and Monika Osajca-Kanyion

Children 2024, 11(9), 1059; https://doi.org/10.3390/children11091059 - 29 Aug 2024

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Abstract

Background/Objectives: Hirschsprung’s disease (HD) is a congenital disorder characterised by the absence of ganglion cells in the distal bowel, resulting in functional obstruction. The transanal endorectal pull-through (TEPT) procedure, a minimally invasive approach, aims to treat HD by removing the aganglionic segment. This [...] Read more.

Background/Objectives: Hirschsprung’s disease (HD) is a congenital disorder characterised by the absence of ganglion cells in the distal bowel, resulting in functional obstruction. The transanal endorectal pull-through (TEPT) procedure, a minimally invasive approach, aims to treat HD by removing the aganglionic segment. This study assessed the feasibility, safety, and efficacy of single-stage TEPT in paediatric patients, focusing on postoperative complications, bowel function, and quality of life. Methods: A retrospective cohort study was conducted on 150 children who underwent single-stage TEPT from January 2005 to December 2023 at the Medical University of Gdansk. Data were collected from medical records, including demographics, preoperative assessments, surgical details, postoperative management, and follow-up outcomes. Statistical analyses were performed using Microsoft Excel 365 and the programming language Python 3.12. The mean age at surgery was 13 months, with a male-to-female ratio of 2.75:1. The mean operative time was 129 min, and the mean hospital stay was seven days. Results: Postoperative complications included anastomotic leak (4%), wound infections (15%), and enterocolitis (26%). Redo surgeries were required in 18% of cases due to persistent constipation and obstructive symptoms. This article includes a comprehensive review of the literature. Conclusions: TEPT demonstrates a favourable safety profile and efficacy in treating HD, though significant concerns include complications such as enterocolitis and the need for additional surgeries. Surgical expertise and thorough preoperative and postoperative management are crucial to optimising patient outcomes. Full article

(This article belongs to the Special Issue Selected Papers from the OASIS (Holistic Care in Hirschsprung’s Disease) Meeting)

22 pages, 783 KiB

Open AccessArticle

Cultural Adaptation of Child Discipline Measures for Puerto Rican Mothers: Enhancing the Cultural Sensitivity of Parenting Assessments

by Jahaira Capellán, Hugh F. Crean, Susan W. Groth, Maria Quiñones-Cordero, José G. Pérez-Ramos and Hyekyun Rhee

Children 2024, 11(9), 1058; https://doi.org/10.3390/children11091058 - 29 Aug 2024

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Abstract

Background/Objectives: Puerto Ricans (PRs) face significant challenges in accessing essential parenting resources and support due to language barriers and lack of culturally appropriate healthcare services, perpetuating health disparities. Cultural adaptation of psychosocial measurement tools is crucial for promoting health equity and improving health [...] Read more.

Background/Objectives: Puerto Ricans (PRs) face significant challenges in accessing essential parenting resources and support due to language barriers and lack of culturally appropriate healthcare services, perpetuating health disparities. Cultural adaptation of psychosocial measurement tools is crucial for promoting health equity and improving health outcomes. This study describes the cultural adaptation of two parenting discipline assessment measures for use with Spanish-speaking PR mothers of 2–4-year-old children. Methods: We used a community-engaged, mixed-methods approach to measurement adaptation that involved independent translations (n = 2), back-translations (n = 2), and an adaptation committee (n = 6, including all translators) who reviewed, appraised, and modified survey versions. We conducted cognitive interviews (n = 20) to pretest the semi-finalized Spanish measures and assess mothers’ understanding of survey items. Results: Mothers had a mean age of 28.6 years. Most were married/cohabitating (70%), had a high school diploma or GED (90%), and a household income of less than $40,000 (68%). Indexed children’s mean age was 2.9 years, with most identified by mothers as female (60%). Feedback from the adaptation committee and pretesting participants led to specific changes like rephrasing culturally specific terms and adjusting examples to better fit the daily experiences of PR mothers. Most mothers found the Spanish version of the measures to be clear and culturally relevant. This cultural adaptation process addressed translation inconsistencies and design issues, and better captured culturally relevant discipline practices. Conclusions: Engaging communities in measurement adaptations ensures culturally and linguistically tailored measures that respect participant preferences, strengthen partnerships, and enable interventions to address health disparities, thereby promoting child health. Full article

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17 pages, 1663 KiB

Open AccessArticle

Differential Impact of WM Load on Attention in Young Adults Versus Children and Adolescents

by Hyojin Park and So-Yeon Kim

Children 2024, 11(9), 1057; https://doi.org/10.3390/children11091057 - 29 Aug 2024

Viewed by 189

Abstract

Background: This study aimed to examine how concurrent working memory (WM) loads affect selective attention, and to explore developmental differences between young adults and children/adolescents aged 10 to 14 years. Methods: We employed a modified Stroop task with verbal or spatial WM [...] Read more.

Background: This study aimed to examine how concurrent working memory (WM) loads affect selective attention, and to explore developmental differences between young adults and children/adolescents aged 10 to 14 years. Methods: We employed a modified Stroop task with verbal or spatial WM loads to assess their impact on attention. Results: In adults, we found increased Stroop effects when WM load overlapped with target processing and decreased Stroop effects when WM load overlapped with distractor processing. Conversely, in children/adolescents, WM loads did not significantly impact target or distractor processing, indicating no change in Stroop effects under dual-task conditions. Interestingly, results from the correlational analyses revealed that as participants’ ages increase, the interference effect under the WM load that shares resources with distractor processing in the attention task decreases. Conclusions: Our findings suggest that the interaction between attention and WM differs across developmental stages. While adults showed distinctive effects of concurrent WM loads on attention processing depending on the cognitive resources utilized, children/adolescents failed to show the interaction between the two cognitive systems. Furthermore, a significant relationship between age and the effects of WM load on attention was observed, providing insights into the development of the interaction between WM and attention. Full article

(This article belongs to the Special Issue Cognitive Development in Children)

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12 pages, 889 KiB

Open AccessReview

The Role of Diet and Physical Activity in Obesity and Overweight in Children with Down Syndrome in Developed Countries

by Paola Belleri, Giorgia Mazzuca, Angelo Pietrobelli, Nicola Zampieri, Giorgio Piacentini, Marco Zaffanello and Luca Pecoraro

Children 2024, 11(9), 1056; https://doi.org/10.3390/children11091056 - 29 Aug 2024

Viewed by 256

Abstract

Down’s syndrome (DS), or Trisomy 21, represents the most common chromosomal abnormality in live births, characterized by an extra chromosome 21. Children affected by Down’s syndrome are more susceptible to the development of obesity and of becoming overweight compared with other children. Furthermore, [...] Read more.

Down’s syndrome (DS), or Trisomy 21, represents the most common chromosomal abnormality in live births, characterized by an extra chromosome 21. Children affected by Down’s syndrome are more susceptible to the development of obesity and of becoming overweight compared with other children. Furthermore, they seem to present a more unfavorable lipid profile than the non-DS obese pediatric population. Diet and physical activity are closely related to the development of overweight and obesity, and they can be assessed using questionnaires such as the Mediterranean Diet Quality Index in children and adolescents (KIDMED) and the Godin–Shephard Leisure-Time Physical Activity Questionnaire. This review aims to undertake a comprehensive analysis of the intricate interplay between diet and physical activity in children affected by Down’s syndrome. Specifically, it seeks to deepen understanding regarding the question of how diet and exercise can influence and prevent the development of overweight and obesity in that special pediatric population. Full article

(This article belongs to the Special Issue Infant and Early Childhood Nutrition)

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10 pages, 233 KiB

Open AccessArticle

Children with Cerebral Palsy and Their Parents Have Different Experiences of Pain Management: A Qualitative Study

by Elisabeth Rønning Rinde, Agneta Anderzén-Carlsson, Reidun Birgitta Jahnsen and Randi Dovland Andersen

Children 2024, 11(9), 1055; https://doi.org/10.3390/children11091055 - 29 Aug 2024

Viewed by 339

Abstract

Aim: The aim of this study is to explore and compare experiences of pain management strategies for children with CP from the perspectives of children themselves and their parents. Methods: A secondary inductive analysis of previously collected qualitative data was performed. [...] Read more.

Aim: The aim of this study is to explore and compare experiences of pain management strategies for children with CP from the perspectives of children themselves and their parents. Methods: A secondary inductive analysis of previously collected qualitative data was performed. Fourteen children with CP and one parent of each child were interviewed separately about the management of the child’s pain. A dyadic data analysis was used to compare parents’ and children’s perspectives. Findings: The main thematic categories of pain management identified were self-care, psychological strategies, physical interventions and professional treatment. Experiences described by the child and parent differed within all participating dyads but to different degrees. On a group level, children described more use of psychological strategies than parents did. Parents described more professional treatment strategies. Conclusions: Parents and children described different experiences of pain management strategies, and both perspectives are needed to understand the child’s situation. Full article

(This article belongs to the Special Issue Lifestyle Interventions in Recurrent and Chronic Pain Management in Children and Adolescents)

12 pages, 1291 KiB

Open AccessArticle

Dronabinol Is Not a Game Changer in Pediatric Palliative Care: Results from a Retrospective Study

by Holger Hauch, Annika Lisakowski, Julia Wager and Boris Zernikow

Children 2024, 11(9), 1054; https://doi.org/10.3390/children11091054 - 28 Aug 2024

Viewed by 266

Abstract

Background/Objectives: Patients with life-limiting conditions (LLCs) often suffer from restlessness, spasticity, pain, and seizures. Dronabinol (DRB) may have a relieving effect; however, data on the effectiveness of DRB in children with LLCs are limited to outpatients. The aim of this study was to [...] Read more.

Background/Objectives: Patients with life-limiting conditions (LLCs) often suffer from restlessness, spasticity, pain, and seizures. Dronabinol (DRB) may have a relieving effect; however, data on the effectiveness of DRB in children with LLCs are limited to outpatients. The aim of this study was to assess the efficacy and safety of DRB. Methods: Retrospective analysis of inpatients. Results: From 2011 to 2021, 1219 patients were admitted. Of these, 63 patients (63.5% male, age: 10.4 (SD = 6.3) years) were treated with DRB; 96.8% had a neurological disease, and 26 patients were started on DRB (group A), while 37 were admitted with existing DRB (group B). The effective doses were 0.21 (SD = 0.11) in group A and 0.48 (SD = 0.5) mg/kg/BW/day in group B (p = 0.01). Subjective response rates to DRB in both groups (good/moderate effect) were 9.5%/38.1% for spasticity and 1.6%/25.4% for restlessness. However, no reduction in seizures, restlessness, or demand medication was observed in 24 h protocols when patients started DRB in group A. Three patients experienced severe side effects (e.g., respiratory depression). Other side effects included fatigue (22.2%) and behavioral problems (14.3%). Conclusions: Subjective positive effects could not be confirmed by more objective data. Side effects can be severe. Thus, DRB should be started in a well-monitored setting and only with clear indications. Full article

(This article belongs to the Special Issue Palliative and End-of-Life Care in Pediatrics)

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18 pages, 1438 KiB

Open AccessArticle

Exploring the Unmet Needs of Teachers of Young Children with ADHD Symptoms: A Qualitative Study

by Reem Aldabbagh, David Daley, Kapil Sayal and Cris Glazebrook

Children 2024, 11(9), 1053; https://doi.org/10.3390/children11091053 - 28 Aug 2024

Viewed by 260

Abstract

Background/Objectives: Children with Attention and Hyperactivity Deficit Disorder (ADHD) and those at risk of ADHD typically exhibit challenging behaviours that may disrupt the classroom environment and be frustrating for teachers. This study aimed to explore teachers’ experiences and emotions regarding teaching children with [...] Read more.

Background/Objectives: Children with Attention and Hyperactivity Deficit Disorder (ADHD) and those at risk of ADHD typically exhibit challenging behaviours that may disrupt the classroom environment and be frustrating for teachers. This study aimed to explore teachers’ experiences and emotions regarding teaching children with high levels of ADHD symptoms and their perceptions of what might help to meet their unmet support needs. Methods: Semi-structured interviews were conducted with 17 primary educational practitioners for children aged between four and eight years in the UK. Interview scripts were analysed using reflexive thematic analysis. Six main themes and 8 subthemes were developed. These included: (1) ADHD behaviours can disrupt the learning environment; (2) teachers face practical demands on their expertise and particular skills; (3) managing ADHD behaviours can be overwhelming for teachers; (4) teachers and children may treat children with ADHD negatively, which can impact on children’s emotions and lead to labelling; (5) existing support for teachers is limited; and (6) teachers need more specific training about ADHD. Results: The analysis revealed that teachers working with children with externalising behaviours such as ADHD can feel overwhelmed. Conclusions: The findings from this study suggest that teachers require more training in managing externalising behaviour in the classroom. Full article

(This article belongs to the Topic Diversity, Educational Inclusion, Emotional Intelligence, Coping, and Other Factors That Influence Psychological Health and Well-Being)

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19 pages, 2511 KiB

Open AccessArticle

Tracking Listening Skill Development in Infants and Children with Hearing Loss: A Normative Dataset for the Functional Listening Index—Paediatric (FLI-P^®)

by Robert S. C. Cowan, Aleisha Davis, Pia Watkins, Katie Neal, Ruth Brookman, Mark Seeto and Janette Oliver

Children 2024, 11(9), 1052; https://doi.org/10.3390/children11091052 - 28 Aug 2024

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Abstract

Background: Longitudinal studies highlight the importance of early intervention and timely device fitting for language development in children with congenital or early acquired hearing loss. Due to the variability in hearing loss, comorbidities, family circumstances, and service access, individualised monitoring of listening development [...] Read more.

Background: Longitudinal studies highlight the importance of early intervention and timely device fitting for language development in children with congenital or early acquired hearing loss. Due to the variability in hearing loss, comorbidities, family circumstances, and service access, individualised monitoring of listening development is essential to inform decision-making. The Functional Listening Index—Paediatric (FLI-P), a 64-item hierarchical checklist of listening skills, has been validated for children with hearing loss aged 0–6 years. This study aimed to develop benchmarks for the FLI-P in typically hearing children, allowing for comparison with individual children with hearing loss. Methods: FLI-P scores were obtained from parents/caregivers of 561 typically hearing children aged 0–72 months. Each child’s FLI-P score was categorised into a 6-month age block, with a minimum of 36 data points per block. Quantile regression was employed to establish percentiles of FLI-P scores by age. Results: FLI-P scores were successfully recorded for all 561 children. Regression analysis determined that the 16th and 84th percentiles of FLI-P scores corresponded to approximately ±1 standard deviation from the median score for each age group. A graphical representation of these percentile trajectories was created to facilitate comparison between children with hearing loss and the normative data. Conclusion: A normative dataset of FLI-P scores from typically hearing children has been established, allowing for comparisons with the scores and developmental trajectories of individual children with hearing loss. The study demonstrates how FLI-P can guide early intervention decisions and effectively monitor progress. Full article

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9 pages, 702 KiB

Open AccessArticle

Experience with Pediatric Chronic Immune Thrombocytopenia over 30 Years in the Era before Eltrombopag

by Begum S. Koc, Gul Nihal Ozdemir, Javid Alakbarli, Hilmi Apak and Tiraje Celkan

Children 2024, 11(9), 1051; https://doi.org/10.3390/children11091051 - 28 Aug 2024

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Abstract

Background: There is limited information on the natural course of chronic ITP in children. We aimed to evaluate the clinical and demographic characteristics of children with chronic ITP in the era before the availability of eltrombopag. Methods: A total of 86 children with [...] Read more.

Background: There is limited information on the natural course of chronic ITP in children. We aimed to evaluate the clinical and demographic characteristics of children with chronic ITP in the era before the availability of eltrombopag. Methods: A total of 86 children with chronic ITP between 1978–2014 were included. Demographic findings, laboratory results, clinical signs, bleeding scores, response time and time of complete remission were recorded. Results: The male/female ratio was 1.09, and median follow-up time was 3 years (range: 1.5–17 years). The median age at diagnosis of chronic ITP was 7 years (range: 2–17), and the median initial platelet count was 10 × 10⁹/L (range: 1–66 × 10⁹/L). Petechiae/ecchymoses were the most common clinical sign (86%) and followed by mucosal bleeding (39.5%). Severe bleeding was seen in 5% of the patients. None of them had intracranial hemorrhage. Twenty patients underwent splenectomy, and the rate of complete remission was 70%. Spontaneous complete remission was seen in 29% of the patients, and the median time to spontaneous complete remission was 3 years. Conclusions: Our study showed that almost one-third of patients with chronic ITP experienced spontaneous complete remission in an average of 3 years, and splenectomy provided satisfactory results in severe cases. This study demonstrates the natural history of chronic ITP in childhood before the era of eltrombopag. Full article

(This article belongs to the Special Issue Pediatric Blood Diseases and Blood Transfusion Treatment)

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14 pages, 499 KiB

Open AccessArticle

Risk Factors and 20-Year Time-Trend in Childhood Overweight and Obesity in Switzerland: A Repeated Cross-Sectional Study

by Robin Berli, Chantal Sempach and Isabelle Herter-Aeberli

Children 2024, 11(9), 1050; https://doi.org/10.3390/children11091050 - 28 Aug 2024

Viewed by 213

Abstract

Background/Objective: Even though global childhood obesity rates keep increasing, stabilization has been shown over the past decade in several countries, including Switzerland. We aimed to investigate the trends in childhood overweight and obesity over the past 21 years in Switzerland and to [...] Read more.

Background/Objective: Even though global childhood obesity rates keep increasing, stabilization has been shown over the past decade in several countries, including Switzerland. We aimed to investigate the trends in childhood overweight and obesity over the past 21 years in Switzerland and to identify the associated risk factors. Methods: Using cluster sampling, we recruited a national sample of 6–12-year-old children in Switzerland (n = 1245). We conducted anthropometric measurements and assessed risk factors using a self-administered questionnaire. We investigated the time trend by including data from four comparable previous surveys conducted since 2002. Results: We found a prevalence of overweight, including obesity, of 16.1 (14.1–18.2)%, with a significantly higher proportion in boys (18.6 (15.5–21.6)%) compared to girls (13.7 (11.0–16.4)%). We found a small but significant reduction in the prevalence of overweight including obesity over time (p = 0.005), but not of obesity alone (p = 0.099). The most important risk factors for obesity were parental education, parental origin, media consumption, as well as several dietary factors. Conclusions: Despite a slight decreasing trend in childhood overweight in Switzerland, it remains a public health concern. Prevention programs should focus on migrant families and those with low education and emphasize the risks of sedentary behavior and the importance of a healthy diet. Full article

(This article belongs to the Special Issue Identification of Factors Associated with Obesity in Children)

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8 pages, 651 KiB

Open AccessBrief Report

Visual Acuity Thresholds in Preterm Newborns: An Experimental Study

by Ruth Batista Bezerra Fagundes, Pedro Ykaro Fialho Silva, Mirella Telles Salgueiro Barboni, Gentil Gomes da Fonseca Filho, Valeria Azevedo de Almeida, Ingrid Guerra Azevedo and Silvana Alves Pereira

Children 2024, 11(9), 1049; https://doi.org/10.3390/children11091049 - 28 Aug 2024

Viewed by 213

Abstract

Purpose: Visual acuity plays a role in mediating neurological development in infants by enabling the differentiation of shapes and discriminating objects. Given the rapid structural development of the brain in the first days of life, this aspect is particularly significant for preterm infants, [...] Read more.

Purpose: Visual acuity plays a role in mediating neurological development in infants by enabling the differentiation of shapes and discriminating objects. Given the rapid structural development of the brain in the first days of life, this aspect is particularly significant for preterm infants, who typically experience this developmental phase while hospitalized in the neonatal intensive care unit (NICU). Therefore, this study aimed to assess visual acuity thresholds in preterm infants during hospitalization and to evaluate possible correlations between visual acuity and clinical parameters. Methods: A cross-sectional study was conducted in an NICU in Northeast Brazil. The visual acuity thresholds were tested using the Teller Acuity Cards II, comprised of 17 gray cards, with one 4 mm diameter peephole at the center and presented with about 35% reflectance. Preterm infants were positioned supine, at 30° elevation on the laps of their caregivers. The evaluator presented both sides of the cards and observed the eye fixation and reactions on both sides. Results: A total of 42 preterm infants with corrected gestational age between 30 to 36 weeks and 6 days were included. Visual acuity ranged from 0.23 to 0.64 cycle per degree. The mean visual acuity threshold was 0.32 cycles per degree for preterm infants at around 32 weeks of corrected gestational age. The visual acuity was not correlated with gestational age (p = 0.18), and neither were birth weight (p = 0.83) or duration of respiratory support (p = 0.98). However, days of phototherapy were inversely correlated with visual acuity (p = 0.04). Conclusions: Despite the challenges of hospitalization, it was possible to carry out a psychophysical test to assess visual acuity in preterm infants. The visual acuity showed no correlation with clinical parameters such as gestational age, birth weight, and duration of respiratory support. However, there was an inverse correlation between the number of days in phototherapy and visual acuity. Understanding the visual acuity levels in preterm infants during their NICU stay can contribute to tailoring interventions and care strategies that specifically address their visual developmental needs. This knowledge may guide healthcare professionals in optimizing the NICU environment to provide appropriate visual stimuli that support neurological development. Full article

(This article belongs to the Section Pediatric Emergency Medicine & Intensive Care Medicine)

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23 pages, 2440 KiB

Open AccessReview

Unraveling Childhood Obesity: A Grounded Theory Approach to Psychological, Social, Parental, and Biological Factors

by Georgia Karakitsiou, Spyridon Plakias, Foteini Christidi and Anna Tsiakiri

Children 2024, 11(9), 1048; https://doi.org/10.3390/children11091048 - 28 Aug 2024

Viewed by 520

Abstract

Childhood obesity is a major medical and public health issue of global interest, which is influenced by a diverse array of factors and carries significant medical and psychosocial implications. Despite the extensive studies that have been conducted to explore the specific issue, the [...] Read more.

Childhood obesity is a major medical and public health issue of global interest, which is influenced by a diverse array of factors and carries significant medical and psychosocial implications. Despite the extensive studies that have been conducted to explore the specific issue, the impact of several factors that influence, generate, worsen, and make chronic the phenomenon needs further exploration. This study aimed to construct a grounded theory that includes and connects the psychological, social, parental, and biological factors affecting childhood obesity. Key psychological factors include mental health issues such as depression and emotional eating, while social factors encompass socioeconomic status and cultural influences. Parental factors involve parenting styles and feeding practices, and biological factors relate to genetic predispositions and prenatal conditions. These factors interact in complex ways, highlighting the multifactorial nature of childhood obesity. The study employed a qualitative grounded theory approach, using research articles to achieve a thorough understanding. Qualitative analysis of the articles was conducted using Atlas.ti 24.0 software. Twenty-five research articles were required to reach theoretical saturation. The analysis resulted in 336 codes that were grouped into seven broad categories and twenty-four different subcategories. Through the construction of the theoretical framework, it was recognized that obesity in minors is a complex and multifactorial issue and that the network of causes and influencing factors covers a broad spectrum ranging from the individual to the family, and subsequently to society at large, which interact with each other. Full article

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31 pages, 947 KiB

Open AccessReview

Navigating the Challenges and Resilience in the Aftermath of the COVID-19 Pandemic in Adolescents with Chronic Diseases: A Scoping Review

by Giovanna Cristina Machado-Kayzuka, Isabela Helena Seccarecio, Milena de Lucca, Rhyquelle Rhibna Neris, Ana Carolina Andrade Biaggi Leite, Willyane de Andrade Alvarenga, Paula Saud De Bortoli, Manoela Henriques Pinto and Lucila Castanheira Nascimento

Children 2024, 11(9), 1047; https://doi.org/10.3390/children11091047 - 27 Aug 2024

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Abstract

Background/Objectives: The COVID-19 pandemic has profoundly affected the lives of adolescents worldwide, especially those living with chronic diseases. This study aims to explore the impact of the COVID-19 pandemic on the daily lives of adolescents with chronic diseases. Methods: This is a scoping [...] Read more.

Background/Objectives: The COVID-19 pandemic has profoundly affected the lives of adolescents worldwide, especially those living with chronic diseases. This study aims to explore the impact of the COVID-19 pandemic on the daily lives of adolescents with chronic diseases. Methods: This is a scoping review that follows the guidelines proposed by JBI. Eligibility criteria include articles focusing on adolescents aged 10 to 19 during the COVID-19 pandemic, regardless of chronic diseases. Searches were performed in PUBMED, LILACS, CINAHL, SCOPUS, grey literature, and manual searches in March 2024. Results: This review is composed of 35 articles. The analysis revealed two main categories: (1) Adolescents facing social isolation, school closure, and new family interactions, striving to reinvent themselves, and (2) Chasing the best decision: following up the chronic disease while fighting the COVID-19 pandemic. These categories encompass subcategories highlighting changes in social and family interactions and lifestyle habits. The findings suggest a multifaceted interaction of factors influencing adolescents’ well-being, including improved family bonding, heightened disease management, and increased stress and strains on resources. Conclusions: This review emphasizes the importance of long-term follow-up and social inclusion efforts for adolescents with chronic diseases and their families, addressing their unique needs during public health crises. Full article

(This article belongs to the Special Issue Innovations in the Family Care of Children with Chronic Illnesses)

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21 pages, 621 KiB

Open AccessReview

Advances in Juvenile Dermatomyositis: Pathophysiology, Diagnosis, Treatment and Interstitial Lung Diseases—A Narrative Review

by Ichiro Kobayashi

Children 2024, 11(9), 1046; https://doi.org/10.3390/children11091046 - 27 Aug 2024

Viewed by 271

Abstract

Juvenile idiopathic inflammatory myopathy (JIIM) is a rare systemic autoimmune disease characterized by skeletal muscle weakness with or without a skin rash. Juvenile dermatomyositis (JDM) is the most common subtype of JIIM, accounting for 80% of JIIM. Recent studies identified several myositis-specific autoantibodies [...] Read more.

Juvenile idiopathic inflammatory myopathy (JIIM) is a rare systemic autoimmune disease characterized by skeletal muscle weakness with or without a skin rash. Juvenile dermatomyositis (JDM) is the most common subtype of JIIM, accounting for 80% of JIIM. Recent studies identified several myositis-specific autoantibodies (MSAs) and myositis-associated autoantibodies (MAAs). Each MSA or MAA is associated with distinct clinical features and outcomes, although there are several differences in the prevalence of MSA/MAA and autoantibody–phenotype relationships between age and ethnic groups. Histopathological studies have revealed critical roles of type I interferons and vasculopathy in the development of JDM. Serological classification mostly corresponds to clinicopathological classification. Novel therapeutic agents, such as biologics and Janus kinase inhibitors (JAKi), have been developed; however, to date, there is a lack of high-level evidence. As advances in treatment have reduced the mortality rate of JIIM, recent studies have focused on medium- and long-term outcomes. However, rapidly progressive interstitial lung disease (RP-ILD) remains a major cause of death in anti-melanoma differentiation gene 5 autoantibody-positive JDM. Early diagnosis and intervention using a multi-drug regimen is critical for the treatment of RP-ILD. Rituximab and JAKi may reduce mortality in patients with JDM-associated RP-ILD refractory to conventional therapy. Full article

(This article belongs to the Special Issue Childhood Arthritis and Rheumatology Research for Dreams Come True Remission)

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22 pages, 1274 KiB

Open AccessArticle

The Study of Environmental Exposure of Mothers and Infants Impacted by Large-Scale Agriculture (SEMILLA): Description of the Aims and Methods of a Community-Based Birth Cohort Study

by Alexis J. Handal, Fadya Orozco, Stephanie Montenegro, Nataly Cadena, Fabián Muñoz, Eileen Ramírez del Rio and Niko Kaciroti

Children 2024, 11(9), 1045; https://doi.org/10.3390/children11091045 - 27 Aug 2024

Viewed by 283

Abstract

Background/Objectives: Women of childbearing age not only reside in agricultural communities but also form an integral part of the agricultural labor force. Limited research investigates the impact of prenatal fungicide exposure on infant health, specifically ethylenebisdithiocarbamates and their toxic by-product, ethylenethiourea (ETU), particularly [...] Read more.

Background/Objectives: Women of childbearing age not only reside in agricultural communities but also form an integral part of the agricultural labor force. Limited research investigates the impact of prenatal fungicide exposure on infant health, specifically ethylenebisdithiocarbamates and their toxic by-product, ethylenethiourea (ETU), particularly in occupational settings. This paper describes the background, aims, protocol, and baseline sample characteristics for the SEMILLA study, which investigates prenatal ETU exposure, neonatal thyroid function, infant growth, and neurobehavioral development in an agricultural region of Ecuador. Methods: This cohort study follows pregnant women and their infants up to 18 months of age, incorporating urinary biomarkers and survey data on ETU exposure and infant growth and neurodevelopmental measures. Data collection includes detailed questionnaires, scales, and physical examinations on maternal and infant health and development, as well as environmental factors. Descriptive statistics on key characteristics of the study population at baseline are presented. Results: SEMILLA enrolled 409 participants (72% enrollment rate): 111 agricultural workers (mostly floricultural), 149 non-agricultural workers, and 149 non-workers. Baseline characteristics show comparability between work sector groups, with some economic differences. Conclusions: SEMILLA will provide key evidence on prenatal fungicide exposure and infant development and encompass comprehensive multistage data collection procedures in pregnancy and infancy, focusing on structural and social determinants of health as well as individual-level chemical exposures. The community-based approach has proven essential, even amid challenges like the COVID-19 pandemic. The medium-term objective is to inform sustainable interventions promoting maternal and child health, with a long-term goal to reduce community exposures and improve worker health policies, particularly for women and pregnant workers. Full article

(This article belongs to the Section Global Pediatric Health)

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Children, Volume 11, Issue 9 (September 2024) – 40 articles

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