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Editor’s Choice Articles

Editor’s Choice articles are based on recommendations by the scientific editors of MDPI journals from around the world. Editors select a small number of articles recently published in the journal that they believe will be particularly interesting to readers, or important in the respective research area. The aim is to provide a snapshot of some of the most exciting work published in the various research areas of the journal.

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17 pages, 300 KiB  
Article
Nasal High-Frequency Oscillatory Ventilation Use in Romanian Neonatal Intensive Care Units—The Results of a Recent Survey
by Maria Livia Ognean, Anca Bivoleanu, Manuela Cucerea, Radu Galiș, Ioana Roșca, Monica Surdu, Silvia-Maria Stoicescu and Rangasamy Ramanathan
Children 2024, 11(7), 836; https://doi.org/10.3390/children11070836 - 9 Jul 2024
Cited by 1 | Viewed by 1258
Abstract
Background: Nasal high-frequency oscillatory ventilation (nHFOV) has emerged as an effective initial and rescue noninvasive respiratory support mode for preterm infants with respiratory distress syndrome (RDS); however, little is known about nHFOV use in Romanian neonatal intensive care units (NICUs). Objectives: We aimed [...] Read more.
Background: Nasal high-frequency oscillatory ventilation (nHFOV) has emerged as an effective initial and rescue noninvasive respiratory support mode for preterm infants with respiratory distress syndrome (RDS); however, little is known about nHFOV use in Romanian neonatal intensive care units (NICUs). Objectives: We aimed to identify the usage extent and clinical application of nHFOV in Romania. Methods: A structured web-based questionnaire was designed to find the rate of nHFOV use and knowledge of this new method of noninvasive respiratory support in Romanian level III NICUs. Using multiple-choice, open-ended, and yes/no questions, we collected information on the NICU’s size, noninvasive respiratory support modes used, nHFOV use, indications, settings, nasal interfaces, secondary effects, and equipment used. Descriptive statistics and comparisons were performed using IBM SPSS Statistics 26.0. Results: A total of 21/23 (91.3%) leaders from level III NICUs (median [IQR] number of beds of 10 [10–17.5]) responded to the survey. The most frequently used noninvasive ventilation modes were CPAP mode on mechanical ventilators (76.2%), followed by NIPPV (76.2%); heated, humidified high-flow nasal cannula (HHHFNC) (61.9%); and nHFOV (11/21 units; 52.4%). A total of 5/11 units reported frequent nHFOV use (in two or more newborns/month) in both term and preterm infants. The main indications reported for nHFOV use were CPAP failure (90.9%), hypercapnia (81.8%), and bronchopulmonary dysplasia (72.7%). Face/nasal masks and short binasal prongs are the most commonly used nasal interfaces (90.9% and 72.7%, respectively). Air leaks at the interface level (90.9%), thick secretions (81.8%), and airway obstruction (63.6%) were the most frequently mentioned adverse effects of nHFOV. Only three of the NICUs had a written protocol for nHFOV use. Most units not yet using nHFOV cited lack of equipment, experience, training, or insufficient information and evidence for the clinical use and outcome of nHFOV use in neonates as the main reasons for not implementing this noninvasive respiratory mode. Conclusions: Our survey showed that nHFOV is already used in more than half of the Romanian level III NICUs to support term and preterm infants with respiratory distress despite a lack of consensus regarding indications and settings during nHFOV. Full article
(This article belongs to the Special Issue Diagnosis and Management of Newborn Respiratory Distress Syndrome)
9 pages, 230 KiB  
Article
Different Eating Habits Are Observed in Overweight and Obese Children Than in Normal-Weight Peers
by Żaneta Malczyk, Agnieszka Pasztak-Opiłka and Agnieszka Zachurzok
Children 2024, 11(7), 834; https://doi.org/10.3390/children11070834 - 9 Jul 2024
Cited by 1 | Viewed by 1394
Abstract
Background: Obesity is diagnosed in 13.6% of early primary school children in Poland. Its presence at this age increases the risk of obesity occurrence in adulthood. Therefore, it is important to properly shape eating behaviors at the stage of childhood and identify incorrect [...] Read more.
Background: Obesity is diagnosed in 13.6% of early primary school children in Poland. Its presence at this age increases the risk of obesity occurrence in adulthood. Therefore, it is important to properly shape eating behaviors at the stage of childhood and identify incorrect eating styles. Methods: This study aimed to investigate whether overweight and obese children differ significantly from children with normal body weights in terms of their eating styles. For the materials and methods, 43 mothers of overweight or obese children aged 3–10 years and 88 mothers of normal-weight children aged 3–10 years completed a questionnaire related to sociodemographic factors and the Children’s Eating Behaviour Questionnaire. Results: The overweight and obese children, compared with normal-weight children, scored higher on the food responsiveness (p = 0.009) and emotional overeating (p = 0.013) scales and lower on the satiety responsiveness (p = 0.025) and slowness in eating scales (p < 0.0001). No significant difference was found for other subscales between the studied groups. In the group of overweight and obese children, the child’s age correlated negatively with enjoyment of food, as did the mother’s BMI with slowness in eating. Conclusions: The results indicate the presence of significant differences in eating styles between normal-weight children and overweight or obese children. Identifying families at high risk of inappropriate eating behaviors and educating them appropriately can reduce the risk of children becoming overweight or obese. Full article
(This article belongs to the Section Pediatric Endocrinology & Diabetes)
10 pages, 820 KiB  
Article
Incidence and Characteristics of Pediatric Patients with Acute Otitis Hospitalized in a Romanian Infectious Diseases Hospital
by Vlad Ștefan Pleșca, Anca Streinu-Cercel, Oana Săndulescu, Anca Cristina Drăgănescu, Răzvan Hainăroșie and Anca Doina Pleșca
Children 2024, 11(7), 832; https://doi.org/10.3390/children11070832 - 8 Jul 2024
Cited by 1 | Viewed by 997
Abstract
Background: Otic involvement is common in children during acute infectious diseases, and is an important cause of morbidity and health service utilization. Methods: We performed a retrospective analysis of pediatric cases hospitalized in the largest infectious disease hospital in Romania between 2018 and [...] Read more.
Background: Otic involvement is common in children during acute infectious diseases, and is an important cause of morbidity and health service utilization. Methods: We performed a retrospective analysis of pediatric cases hospitalized in the largest infectious disease hospital in Romania between 2018 and 2023, with the aim of quantifying the incidence and impact of acute otitis (AO) according to pediatric age subgroups. Results: A total of 1118 cases diagnosed with AO were eligible and included in the analysis. Acute congestive otitis media was the most common subtype, identified in 53.3% of cases, followed by acute purulent otitis media (APOM) in 26.7% of children. The majority of AO cases (69.9%) were diagnosed in the pre-pandemic period (2018–2019), and infants (10.6%), toddlers (49.4%), and preschoolers (29.2%) were the most affected age groups. A viral infection associated with the AO episode was documented in 49.6% of cases. Influenza viruses were most commonly reported (20.5%), followed by SARS-CoV-2 (5.8%), and adenovirus (4.9%). A total of 38 cases of AO were identified in children with measles. In 15.9% of APOM cases, Streptococcus pneumoniae was isolated by culture from otic secretions. The duration of hospitalization was longer in children with APOM and acute otitis externa compared to the other subtypes of AO (p < 0.001). Conclusions: Our study highlights the importance of ENT (ear, nose, and throat) monitoring in children hospitalized for acute infectious diseases, as the majority of AO cases occur in the context of a viral infection. These findings emphasize the necessity for tailored assessment and intervention in suspected cases of AO, especially in young children under 5 years of age. Full article
(This article belongs to the Special Issue Viral Respiratory Infections and Bacterial Superinfections in Children)
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11 pages, 2460 KiB  
Article
Do Gender and BMI Affect the Motor Skills of Five-Year-Old Preschoolers Differently?
by Marcos Mecías-Calvo, Fernando Carregal-San Emeterio and Rubén Navarro-Patón
Children 2024, 11(7), 829; https://doi.org/10.3390/children11070829 - 7 Jul 2024
Cited by 1 | Viewed by 1113
Abstract
Background/Objective: Weight gain is associated with numerous health complications and constitutes a serious public health problem. Motor competence (MC) can be a protective factor since children’s participation and practice in physical activities can improve their health. The objective of this study was to [...] Read more.
Background/Objective: Weight gain is associated with numerous health complications and constitutes a serious public health problem. Motor competence (MC) can be a protective factor since children’s participation and practice in physical activities can improve their health. The objective of this study was to investigate the impact of gender and BMI on MC [i.e., manual dexterity (MD), aiming and catching (A&C), balance (Bal), and total MC percentile (TP)] depending on gender (boy/girl) and BMI (normal weight, overweight or obesity). Methods: The MABC-2 battery was applied in a sample of 368 preschool children (5.69 ± 0.28 years of age; 54.9% girls). Results: Boys and girls showed statistically significant differences in MC components: boys had higher scores in A&C (p = 0.002), while girls excelled in MD (p < 0.001), Bal (p = 0.035); TP (p < 0.001), and BMI [Bal (p = 0.009); TP (p = 0.050)], with a higher percentile in those children with overweight in both cases. Statistically significant differences were also found in the interactions between gender*BMI [MD (p < 0.001) and TP (p < 0.001)]. Conclusions: The findings showed that there were notable variations in total percentile, balance, and manual dexterity between boys and girls. In addition, girls outperformed boys in all categories save aiming and catching. However, males who were overweight or obese earned greater percentiles in both balance and the MABC-2 battery’s total percentile. Full article
(This article belongs to the Special Issue Motor Competence and Physical Activity in School Children)
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19 pages, 3304 KiB  
Article
The Accuracy of Digital Impressions versus Conventional Impressions in Neonates with Cleft Lip and/or Palate: A Laboratory-Based Study
by Jyotsna Unnikrishnan, Mahmoud Bakr, Robert Love and Ghassan Idris
Children 2024, 11(7), 827; https://doi.org/10.3390/children11070827 - 6 Jul 2024
Cited by 2 | Viewed by 1340
Abstract
Cleft lip and palate (CL/P) are a common congenital craniofacial anomaly requiring precise impressions for effective treatment. Conventional impressions (CIs) pose challenges in neonates with CL/P due to their delicate oral anatomy. While digital impressions (DIs) are increasingly recognised for their potential benefits [...] Read more.
Cleft lip and palate (CL/P) are a common congenital craniofacial anomaly requiring precise impressions for effective treatment. Conventional impressions (CIs) pose challenges in neonates with CL/P due to their delicate oral anatomy. While digital impressions (DIs) are increasingly recognised for their potential benefits over conventional methods in dentistry, their accuracy and application in neonates with cleft lip and palate (CL/P) remain underexplored. This study aimed to assess the accuracy of DIs compared to CIs in neonates with CL/P, using alginate and putty materials as references. A laboratory-based case–control study was conducted, utilising soft acrylic models resembling neonatal mouths with CL/P. Alginate and putty impressions were obtained conventionally, while digital impressions were captured using an intraoral scanner (IOS). A total of 42 models were analysed, divided evenly into three groups, with each group comprising 14 models. Superimposition and surface discrepancy analyses were performed to evaluate impression accuracy. The results revealed no statistically significant differences between the digital and conventional impressions in their intra-arch measurements and surface discrepancies. The mean measurement values did not significantly differ among groups, with p values indicating no significant variations (p > 0.05), confirmed by an analysis of variance. High intra-examiner reliability with Intra Class Coefficient (ICC) values close to 1 indicated consistent measurements over time. The current study demonstrates that DIs are equally accurate as conventional alginate and putty impressions in neonates with cleft lip and palate, offering a viable and less invasive alternative for clinical practise. This advancement holds promise for improving the treatment planning process and enhancing patient comfort, particularly in vulnerable neonatal populations. Further research is warranted to explore the clinical implications and factors affecting DI accuracy in this population. Full article
(This article belongs to the Special Issue Congenital Cleft Lip and Palate: Diagnosis, Treatment and Management)
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9 pages, 222 KiB  
Article
Orofacial Clefts and Maternal Risk Factors: A Population-Based Case–Control Study
by Michele Santoro, Lorena Mezzasalma, Alessio Coi and Anna Pierini
Children 2024, 11(7), 819; https://doi.org/10.3390/children11070819 - 4 Jul 2024
Cited by 1 | Viewed by 977
Abstract
Background/Objectives: Orofacial clefts (OFCs) are some of the most common congenital anomalies worldwide. The aim of this case–control study was to evaluate the association of OFCs with selected maternal characteristics. Methods: Data on isolated non-syndromic cases of OFCs were extracted from the population-based [...] Read more.
Background/Objectives: Orofacial clefts (OFCs) are some of the most common congenital anomalies worldwide. The aim of this case–control study was to evaluate the association of OFCs with selected maternal characteristics. Methods: Data on isolated non-syndromic cases of OFCs were extracted from the population-based registry of congenital anomalies of Tuscany. A sample of live-born infants without any congenital anomaly was used as the control group. We investigated the association with sex and some maternal characteristics: age, body mass index, smoking, and education. Adjusted odds ratios (OR) were calculated using a logistic regression model. Analyses were performed for the total OFCs and separately for cleft lip (CL) and cleft palate (CP). Results: Data on 219 cases and 37,988 controls were analyzed. A higher proportion of males (57.9%) was observed, particularly for CL. A decreasing trend among the maternal age classes was observed (OR:0.81 (95%CI 0.70–0.94)). Underweight mothers had a higher prevalence of OFCs, in particular for CL (OR:1.88 (95%CI 1.08–3.26)). Conclusions: We found an association of OFCs with lower maternal age. The association with maternal age remains controversial and further epidemiological evidence is needed through multicenter studies. We observed that CL was more common in underweight mothers, suggesting actions of primary prevention. Full article
(This article belongs to the Special Issue Current Research on Cleft Lip in Children - 2nd Edition)
11 pages, 6142 KiB  
Article
Sclerostin and Wnt Signaling in Idiopathic Juvenile Osteoporosis Using High-Resolution Confocal Microscopy for Three-Dimensional Analyses
by Renata C. Pereira, Kathleen J. Noche, Barbara Gales, Zhangying Chen, Isidro B. Salusky and Lauren V. Albrecht
Children 2024, 11(7), 820; https://doi.org/10.3390/children11070820 - 4 Jul 2024
Cited by 1 | Viewed by 1311
Abstract
Background: Idiopathic juvenile osteoporosis (IJO) is a rare condition characterized by low bone mass that can increase the risk of fractures in children. Treatment options for these patients are limited as the molecular mechanisms of disease initiation and progression are incompletely understood. Sclerostin [...] Read more.
Background: Idiopathic juvenile osteoporosis (IJO) is a rare condition characterized by low bone mass that can increase the risk of fractures in children. Treatment options for these patients are limited as the molecular mechanisms of disease initiation and progression are incompletely understood. Sclerostin inhibits canonical Wnt signaling, which is important for the bone formation activity of osteoblasts, and elevated sclerostin has been implicated in adult osteoporosis. Objective: To evaluate the role of sclerostin in IJO, high-resolution confocal microscopy analyses were performed on bone biopsies collected from 13 pediatric patients. Methods: Bone biopsies were stained with sclerostin, and β-catenin antibodies showed elevated expression across osteocytes and increased sclerostin-positive osteocytes in 8 of the 13 total IJO patients (62%). Results: Skeletal sclerostin was associated with static and dynamic histomorphometric parameters. Further, colocalization analyses showed that bone sclerostin colocalized with phosphorylated β-catenin, a hallmark of Wnt signaling that indicates Wnt inhibition. In contrast, sclerostin-positive osteocytes were not colocalized with an “active” unphosphorylated form of β-catenin. Conclusions: These results support a model that altered levels of sclerostin and Wnt signaling activity occur in IJO patients. Full article
(This article belongs to the Special Issue Pediatric Growth and Skeletal Disorders)
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14 pages, 1608 KiB  
Article
Polypharmacy in Children with Medical Complexity: A Cross-Sectional Study in a Pediatric Palliative Care Center
by Anna Zanin, Fernando Baratiri, Barbara Roverato, Daniele Mengato, Lisa Pivato, Irene Avagnina, Irene Maghini, Antuan Divisic, Francesca Rusalen, Caterina Agosto, Francesca Venturini and Franca Benini
Children 2024, 11(7), 821; https://doi.org/10.3390/children11070821 - 4 Jul 2024
Cited by 2 | Viewed by 1494
Abstract
Background: Children with medical complexity (CMC) often require multiple medications, leading to polypharmacy, which seems to be linked to adverse effects, administration errors, and increased caregiver burden. This study aimed to describe the prevalence of polypharmacy, medication burden, off-label drug use, and associated [...] Read more.
Background: Children with medical complexity (CMC) often require multiple medications, leading to polypharmacy, which seems to be linked to adverse effects, administration errors, and increased caregiver burden. This study aimed to describe the prevalence of polypharmacy, medication burden, off-label drug use, and associated costs. Methods: Conducted at the Pediatric Palliative Care Center of Padua, Italy, from August to October 2021, this cross-sectional observational study included patients up to 23 years old with at least one prescribed drug. Data were collected from medical records and caregiver interviews. Drug costs were collected from the Italian Medicine Agency. Descriptive statistical analysis was performed. For comparisons among categorical variables, the Chi-square test was used, and for those among continuous variables, the ANOVA test was used. Results: This study analyzed treatment regimens of 169 patients with a median age of 12.5 years (0.3–23). Polypharmacy was present in 52.7% of patients, and medication burden was observed in 44.4%, both varying significantly by primary diagnosis (p < 0.001). The median daily cost per patient was EUR 2.2 (IQR 0.9–7.1), with significant variation among subgroups. Only 34.6% of prescriptions were off-label. Conclusions: polypharmacy and medication burden are frequent among our CMC population, with some differences according to primary diagnosis. Full article
(This article belongs to the Special Issue Recent Advances in Pediatric Palliative Home Care)
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15 pages, 693 KiB  
Review
Oral Health and Caries Prevention: How Tongue Hygiene Helps Maintain Balance of Microbiota and Overall Health in Pediatric Patients
by Giovanna Mosaico, Mara Pinna, Roberta Grassi, Germano Orrù, Andrea Scribante, Carolina Maiorani, Cinzia Casu, Gianna Maria Nardi and Andrea Butera
Children 2024, 11(7), 816; https://doi.org/10.3390/children11070816 - 3 Jul 2024
Cited by 2 | Viewed by 3367
Abstract
Background/Objectives: The tongue harbors about two-thirds of the microorganisms present in the mouth; the stable bacterial population consists mainly of aerobic and facultative anaerobic streptococci. These bacterial colonies, found more frequently on the tongue than on the outside of the hard part of [...] Read more.
Background/Objectives: The tongue harbors about two-thirds of the microorganisms present in the mouth; the stable bacterial population consists mainly of aerobic and facultative anaerobic streptococci. These bacterial colonies, found more frequently on the tongue than on the outside of the hard part of the dental enamel in children younger than 18 months, suggest that the tongue is a potential bacterial reservoir. The aim of this review is to examine the scientific literature to clarify whether the mechanical removal of bacterial biofilm on the tongue can have a positive effect on caries prevention, with the reduction in colony-forming unit (CFU) of salivary streptococcus and the whole-mouth plaque index (FMPS). Methods: An open literature search was conducted by using PubMed (MEDLINE), Cochrane Library and Google Scholar. The most studied age range was 9 to 12 years, with groups of children with no caries and groups with a minimum number of two teeth that were reconstructed, decayed and/or missing (DMFS/dmfs > 2) who experienced different tongue hygiene methods for the first time. Results: Four randomized trials met the search criteria and were included in this review. Conclusions: The results obtained suggest that specific tongue hygiene protocols, combined with a healthy diet and lifestyle, could be considered the gold standard to enable more effective primary prevention and improve the health of pediatric patients. This review improves the understanding of the impact of tongue hygiene in controlling the bacteria responsible for the onset of carious disease and its systemic correlates; however, further research with more data is needed to further confirm the findings of this research. Full article
(This article belongs to the Special Issue New Research Progress of Clinical Pediatric Dentistry)
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12 pages, 262 KiB  
Article
Assessing the Relationship between Body Image Satisfaction and Physical Activity in Italian Adolescents: A Cross-Sectional Investigation
by Sabrina Masotti, Tommaso Piva, Valentina Zerbini, Andrea Raisi, Erica Menegatti, Anselmo Pagani, Costanza Bigoni, Elena Ballarin, Federica De Luca, Luciana Zaccagni, Natascia Rinaldo, Stefania Toselli, Emanuela Gualdi-Russo, Antonio Argentoni, Arli Veli, Gianni Mazzoni and Simona Mandini
Children 2024, 11(7), 818; https://doi.org/10.3390/children11070818 - 3 Jul 2024
Cited by 3 | Viewed by 1464
Abstract
Background: Body image perception can significantly influence various aspects of adolescent lives. The study analyzed the relationship between body image satisfaction and sports participation in adolescents, examining various factors that contribute to body image concerns and their implications for sports engagement. Methods: A [...] Read more.
Background: Body image perception can significantly influence various aspects of adolescent lives. The study analyzed the relationship between body image satisfaction and sports participation in adolescents, examining various factors that contribute to body image concerns and their implications for sports engagement. Methods: A total of 237 schoolchildren were recruited from lower secondary Italian schools. Anthropometric characteristics were measured directly. Assessment of body image perception was performed using Body Silhouette Charts for preadolescent children. The Italian version of the International Physical Activity Questionnaire for Adolescents questionnaire was administered to assess physical activity (PA) levels at school and during leisure time in the last 7 days. Analysis of variance was used to test differences in PA levels, while multiple regression models were carried out to assess possible predictors of body dissatisfaction. Results: In total, 42.6% of children were not satisfied with their figure and 23.2% were very dissatisfied; among them, the vast majority would have liked to be thinner. The dissatisfaction and satisfaction were similar in boys and girls. The frequency of satisfaction with one’s body image was higher in children who practiced extracurricular sports compared to those who did not. The percentage of dissatisfaction with one’s body image was similar in the two groups, but the frequency of children being very dissatisfied was double in the group that does not practice extracurricular sport (31.2% vs. 17.7%). Body dissatisfaction increases with increasing body mass index in both genders but decreases in children involved in extracurricular sports. Conclusions: Encouraging teenagers to engage in regular physical activity should be a key component of therapies supporting positive body image. This study found a relationship between extracurricular sports and body image satisfaction, suggesting that physical activity protects teenagers’ body image satisfaction. Full article
(This article belongs to the Special Issue Health Benefits of Physical Activity for Children and Adolescents)
13 pages, 258 KiB  
Article
Investigating the Sociodemographic and Health Characteristics of Non-Sugar Sweeteners Consumption in Greek School-Aged Children: A Cross-Sectional Study
by Kyriaki Apergi, Olga Malisova, Antonis Vlassopoulos, Philippa Fidanoglou, Aikaterini Kandyliari and Maria Kapsokefalou
Children 2024, 11(7), 813; https://doi.org/10.3390/children11070813 - 2 Jul 2024
Cited by 1 | Viewed by 941
Abstract
Background/Objectives: The childhood consumption of non-sugar-sweetened (NSS) soft drinks is a growing concern due to its potential health implications. This study investigated demographic, anthropometric, and lifestyle factors influencing NSS soft drink consumption among children. Methods: A sample of 1304 children and their parents [...] Read more.
Background/Objectives: The childhood consumption of non-sugar-sweetened (NSS) soft drinks is a growing concern due to its potential health implications. This study investigated demographic, anthropometric, and lifestyle factors influencing NSS soft drink consumption among children. Methods: A sample of 1304 children and their parents were surveyed. Results: Analysis revealed that nearly 60% reported consuming NSS soft drinks at least once a week. Also, positive associations were found between NSS soft drink consumption and lower socioeconomic status, increased total beverage consumption, higher maternal BMI, and parental soft drink habits. However, upon employing multivariable models, only the association between total and NSS soft drinks consumption remained statistically significant (OR = 18.925, p < 0.05 for children; OR = 3.801, p < 0.05 for parents), highlighting the pivotal role of parental behavior in shaping children’s consumption patterns. Conclusions: These findings emphasize the importance of tracking parental habits, revealing a strong correlation between parental behavior and children’s soft drink consumption patterns. Understanding these factors is crucial for developing effective public health strategies for children, which should prioritize not only individual behaviors but also parental modeling and household dynamics. Full article
(This article belongs to the Special Issue Advances in the Management of Children and Adolescents with Obesity)
16 pages, 279 KiB  
Article
Machine Learning Approach for Predicting the Impact of Food Insecurity on Nutrient Consumption and Malnutrition in Children Aged 6 Months to 5 Years
by Radwan Qasrawi, Sabri Sgahir, Maysaa Nemer, Mousa Halaikah, Manal Badrasawi, Malak Amro, Stephanny Vicuna Polo, Diala Abu Al-Halawa, Doa’a Mujahed, Lara Nasreddine, Ibrahim Elmadfa, Siham Atari and Ayoub Al-Jawaldeh
Children 2024, 11(7), 810; https://doi.org/10.3390/children11070810 - 2 Jul 2024
Cited by 2 | Viewed by 1942
Abstract
Background: Food insecurity significantly impacts children’s health, affecting their development across cognitive, physical, and socio-emotional dimensions. This study explores the impact of food insecurity among children aged 6 months to 5 years, focusing on nutrient intake and its relationship with various forms of [...] Read more.
Background: Food insecurity significantly impacts children’s health, affecting their development across cognitive, physical, and socio-emotional dimensions. This study explores the impact of food insecurity among children aged 6 months to 5 years, focusing on nutrient intake and its relationship with various forms of malnutrition. Methods: Utilizing machine learning algorithms, this study analyzed data from 819 children in the West Bank to investigate sociodemographic and health factors associated with food insecurity and its effects on nutritional status. The average age of the children was 33 months, with 52% boys and 48% girls. Results: The analysis revealed that 18.1% of children faced food insecurity, with household education, family income, locality, district, and age emerging as significant determinants. Children from food-insecure environments exhibited lower average weight, height, and mid-upper arm circumference compared to their food-secure counterparts, indicating a direct correlation between food insecurity and reduced nutritional and growth metrics. Moreover, the machine learning models observed vitamin B1 as a key indicator of all forms of malnutrition, alongside vitamin K1, vitamin A, and zinc. Specific nutrients like choline in the “underweight” category and carbohydrates in the “wasting” category were identified as unique nutritional priorities. Conclusion: This study provides insights into the differential risks for growth issues among children, offering valuable information for targeted interventions and policymaking. Full article
(This article belongs to the Section Pediatric Gastroenterology and Nutrition)
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8 pages, 402 KiB  
Review
Chronic Kidney Disease and Growth Failure in Children
by Tommaso Todisco, Grazia Maria Ubertini, Carla Bizzarri, Sandro Loche and Marco Cappa
Children 2024, 11(7), 808; https://doi.org/10.3390/children11070808 - 1 Jul 2024
Cited by 1 | Viewed by 2481
Abstract
Chronic kidney disease (CKD) is a significant challenge for pediatric endocrinologists, as children with CKD may present a variety of endocrine complications. Growth failure is common in CKD, and its severity is correlated with the degree of renal insufficiency. Management strategies include addressing [...] Read more.
Chronic kidney disease (CKD) is a significant challenge for pediatric endocrinologists, as children with CKD may present a variety of endocrine complications. Growth failure is common in CKD, and its severity is correlated with the degree of renal insufficiency. Management strategies include addressing reversible comorbidities, optimizing nutrition, and ensuring metabolic control. Kidney replacement therapy, including transplantation, determines a significant improvement in growth. According to a recent Consensus Statement, children with CKD stage 3—or on dialysis older >6 months—are eligible for treatment with recombinant growth hormone (rGH) in the case of persistent growth failure. Treatment with rGH may be considered for those with height between the 3rd and 10th percentile and persistent growth deceleration. In children who received kidney transplantation but continue to experience growth failure, initiation of GH therapy is recommended one year post-transplantation if spontaneous catch-up growth does not occur and steroid-free immunosuppression is not an option. In children with CKD, due to nephropathic cystinosis and persistent growth failure, GH therapy should be considered at all stages of CKD. Potential adverse effects and benefits must be regularly assessed during therapy. Treatment with GH is safe in children with CKD. However, its general efficacy is still controversial. All possible problems with a negative impact on growth should be timely addressed and resolved, whenever possible with a personalized approach to the patient. GH therapy may be useful in promoting catch-up growth in children with residual growth potential. Future research should focus on refining effective therapeutic strategies and establishing consensus guidelines to optimize growth outcomes in this population. Full article
(This article belongs to the Special Issue New Research Progress on Endocrine Disorders in Infants, Children, and Adolescents)
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11 pages, 1356 KiB  
Review
A Systematic Review of Telehealth Utilization for Bowel Management Programs in Pediatric Colorectal Surgery
by Elizaveta Bokova, Ismael Elhalaby, Seth Saylors, Irene Isabel P. Lim and Rebecca M. Rentea
Children 2024, 11(7), 786; https://doi.org/10.3390/children11070786 - 27 Jun 2024
Cited by 1 | Viewed by 1939
Abstract
Recent advancements in pediatric surgery have embraced telehealth (TH) modalities, transitioning from traditional in-person consultations to virtual care. This shift has broadened access to healthcare, potentially enhancing affordability, patient and caregiver satisfaction, and clinical outcomes. In pediatric colorectal surgery, telehealth has been effectively [...] Read more.
Recent advancements in pediatric surgery have embraced telehealth (TH) modalities, transitioning from traditional in-person consultations to virtual care. This shift has broadened access to healthcare, potentially enhancing affordability, patient and caregiver satisfaction, and clinical outcomes. In pediatric colorectal surgery, telehealth has been effectively utilized to support Bowel Management Programs (BMPs) for children suffering from constipation and fecal incontinence. A systematic review was conducted to assess the effectiveness of virtual BMPs, analyzing studies from January 2010 to December 2023, sourced from MEDLINE (via PubMed), Embase, and the Cochrane Library, with five studies included. Remote BMPs, implemented through video or telephone consultations, reported satisfaction rates exceeding 75% among families, indicating a strong preference for virtual interactions over traditional visits. Significant findings from the studies include improvements in Vancouver and Baylor scores, reductions in the duration of multidisciplinary consultations, enhancements in pediatric quality of life and Cleveland scores, and decreased frequency of laxative treatments. The implementation of TH has facilitated patient-led care, enabling timely adjustments in treatment and efficient distribution of medical supplies. The findings suggest that virtual BMPs are a viable and effective alternative to conventional approaches, yielding high caregiver satisfaction and superior clinical outcomes while promoting patient independence. Full article
(This article belongs to the Section Pediatric Neonatology)
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9 pages, 256 KiB  
Article
The Relevance of β-Thalassemia Heterozygosity in Pediatric Clinical Practice: Croatian Experience
by Ana Dordevic, Milena Ugrin, Ines Mrakovcic Sutic, Jelena Roganovic and Sonja Pavlovic
Children 2024, 11(7), 785; https://doi.org/10.3390/children11070785 - 27 Jun 2024
Cited by 1 | Viewed by 1133
Abstract
(1) Background: Thalassemia syndromes are common monogenic disorders that represent a significant global health issue. No systematic epidemiological or molecular investigations on thalassemias in the Croatian population have been reported to date. (2) Methods: This prospective study included 70 children with a presumptive [...] Read more.
(1) Background: Thalassemia syndromes are common monogenic disorders that represent a significant global health issue. No systematic epidemiological or molecular investigations on thalassemias in the Croatian population have been reported to date. (2) Methods: This prospective study included 70 children with a presumptive diagnosis of thalassemia and their 42 first-degree relatives. Molecular characterization was performed using direct sequencing and gap-PCR methods. (3) Results: We identified 46 (30 children and 16 first-degree relatives) β-thalassemia heterozygous carriers from 24 unrelated families, carrying eight different mutations and one hemoglobin variant. Five variants account for approximately 85% of all affected β-globin alleles: Hb Lepore-Boston-Washington (32.6%), HBB:c.93-21G>A (19.6%), HBB:c.315+1G>A (13.1%), HBB:c.92+1G>A (10.9%), and HBB:c.92+6T>C (8.7%) variants. (4) Conclusions: β-thalassemia carriers need more detailed genetic profiling since genetic modifiers can significantly impact their phenotype. Our study provides important new insights into the relevance of β-thalassemia heterozygosity in pediatric clinical practice. Full article
(This article belongs to the Section Pediatric Hematology & Oncology)
18 pages, 616 KiB  
Article
“Preparation Is Key”: Parents’ and Nurses’ Perceptions of Combined Parent-Delivered Pain Management in Neonatal Care
by Martina Carlsen Misic, Emma Olsson, Ylva Thernström Blomqvist and Alexandra Ullsten
Children 2024, 11(7), 781; https://doi.org/10.3390/children11070781 - 27 Jun 2024
Cited by 1 | Viewed by 2318
Abstract
Background: There is a knowledge-to-practice gap regarding parent-delivered pain management, and few studies have investigated parents’ and nurses’ participation in and acceptance of combined parent-delivered pain-alleviating interventions such as skin-to-skin contact (SSC), breastfeeding, and parental musical presence. This study investigated parents’ and nurses’ [...] Read more.
Background: There is a knowledge-to-practice gap regarding parent-delivered pain management, and few studies have investigated parents’ and nurses’ participation in and acceptance of combined parent-delivered pain-alleviating interventions such as skin-to-skin contact (SSC), breastfeeding, and parental musical presence. This study investigated parents’ and nurses’ perceptions of and reflections on experiencing combined parent-delivered pain management. Methods: This qualitative study applies a collaborative participatory action research design using ethnographic data collection methods such as focus groups, video observations, and video-stimulated recall interviews with parents and nurses. Results: The results concern three main categories, i.e., preparation, participation, and closeness, as well as various sub-categories. Preparations were central to enabling combined parent-delivered pain management. Participation was facilitated by parental musical presence, in which parents shifted their attention toward their infant. Closeness and presence during neonatal care helped parents become active during their infant’s painful procedures. Parental lullaby singing created a calm and trusting atmosphere and after the procedure, both parents and nurses felt that they had successfully supported the infant through a potentially painful procedure. Conclusions: Mental and practical preparation is central to implementing combined parent-delivered pain management. When parents and nurses explored the interventions, they found the methods feasible, promoting self-efficacy and confidence in both parents and nurses. Full article
(This article belongs to the Special Issue Parental Involvement in Neonatal and Infant Pain Prevention and Management: Evidence, Opportunities and Challenges)
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17 pages, 774 KiB  
Article
Who Benefits Most from the Family Education and Support Program in Cape Verde? A Cluster Analysis
by Adriana Correia, Cátia Martins, Rita dos Santos, Victoria Hidalgo, Saúl Neves de Jesus and Cristina Nunes
Children 2024, 11(7), 782; https://doi.org/10.3390/children11070782 - 27 Jun 2024
Cited by 1 | Viewed by 1080
Abstract
Background/Objectives: Child parenting programs can enhance parental skills, prevent future issues in child development, and improve children’s quality of life. The present research aimed to study the changes promoted by the Family Education and Support Program (FAF) implemented in Cape Verde, regarding parental [...] Read more.
Background/Objectives: Child parenting programs can enhance parental skills, prevent future issues in child development, and improve children’s quality of life. The present research aimed to study the changes promoted by the Family Education and Support Program (FAF) implemented in Cape Verde, regarding parental educational practices, perceived parental efficacy, and attitudes and beliefs of Cape Verdean parents. Methods: To this end, 37 participants were evaluated through a pretest-postest design. The evaluated dimensions were perceived parental competence, parenting practices, Parental attitudes and beliefs, mental health and perceived child quality of life. Results: A cluster analysis was conducted, distinguishing two groups. Both groups benefited from the program. Cluster 1 reported more significant gains in dimensions of parental efficacy and satisfaction, inadequate expectations, affection and support, and reactivity, while cluster 2 showed a greater difference in regulation and reactivity. Conclusions: Overall, the FAF intervention contributed to an increase in positive parenting practices. By analyzing potential underlying profiles in the change process, this study suggests that there are participants who benefit more than others from the intervention, and this information may be relevant for professionals and researchers in the field. Full article
(This article belongs to the Special Issue Parenting and Child/Adolescent Development: Current Updates and Global Perspectives)
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13 pages, 243 KiB  
Article
Medical Complexity of Children with Special Healthcare Needs and Healthcare Experiences
by Hye-Jung Yun, M. L. Parker, Cynthia B. Wilson and Ming Cui
Children 2024, 11(7), 775; https://doi.org/10.3390/children11070775 - 27 Jun 2024
Cited by 1 | Viewed by 1213
Abstract
The rising prevalence of CSHCN has led to significant challenges for caregivers, particularly mothers, who face difficulties from caregiving demands and managing complex healthcare interactions. The objective of this study was to examine the association between the medical complexity of CSHCN and the [...] Read more.
The rising prevalence of CSHCN has led to significant challenges for caregivers, particularly mothers, who face difficulties from caregiving demands and managing complex healthcare interactions. The objective of this study was to examine the association between the medical complexity of CSHCN and the healthcare experiences of their mothers while exploring the influence of sociodemographic factors on these associations. The study utilized data from the 2016–2020 National Survey of Children’s Health (NSCH), involving 17,434 mothers of CSHCN. Mothers provided information on the medical complexity of CSHCN, healthcare experiences (care coordination, family-centered care, and shared decision-making), and sociodemographic information (race, community, insurance, child sex, age, and federal poverty level). Results from multiple regressions revealed that greater medical complexity was associated with more negative healthcare experiences. Minoritized mothers, those in rural areas, and families with lower income reported lower levels of family-centered care, indicating significant disparities. Additionally, the negative association between medical complexity and healthcare experiences was pronounced for White families and those with private insurance compared to minoritized families and those with public insurance. This study highlights the necessity for targeted interventions to improve care coordination, family-centered care, and shared decision-making, emphasizing the need for a comprehensive, family-centered approach to address healthcare disparities and promote health equity for CSHCN and their families. Full article
(This article belongs to the Special Issue Parenting in the Face of Health Challenges: Research and Interventions Update)
11 pages, 735 KiB  
Article
The Role of Parental Mediation and Age in the Associations between Cyberbullying Victimization and Bystanding and Children’s and Adolescents’ Depression
by Michelle F. Wright
Children 2024, 11(7), 777; https://doi.org/10.3390/children11070777 - 27 Jun 2024
Cited by 1 | Viewed by 1430
Abstract
Background/Objectives: The primary objective of this research was to assess age differences in the associations between cyberbullying victimization and bystanding and depression among 234 elementary school students (4th and 5th graders; 51% female), 363 middle school students (6th to 8th grades; 53% female), [...] Read more.
Background/Objectives: The primary objective of this research was to assess age differences in the associations between cyberbullying victimization and bystanding and depression among 234 elementary school students (4th and 5th graders; 51% female), 363 middle school students (6th to 8th grades; 53% female), and 341 high school students (9th to 12th grades; 51% female) as well as the moderating effect of parental mediation in these relationships. Methods: Participants completed self-report questionnaires on their cyberbullying victimization and bystanding, as well as depressive symptoms. Results: The findings revealed that high levels of instructive mediation buffered against depression associated with cyberbullying victimization and bystanding across all age groups, with the strongest effects found for middle school students. Lower levels of instructive mediation and higher levels of restrictive mediation increased the positive relationships between cyberbullying victimization and bystanding and depression. Co-viewing mediation did not moderate any of the associations. Conclusions: Parental mediation of technology use has the potential to alleviate the negative consequences associated with cyberbullying victimization and bystanding. The findings highlight the importance of tailoring prevention and intervention strategies to specific age groups and to parents. Full article
(This article belongs to the Special Issue New Challenges of Cyberbullying in Children and Adolescents)
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12 pages, 252 KiB  
Article
Understanding Adolescent Mental Health in the COVID-19 Era: A Psychodynamic Approach
by Aslı Akın and Lea Sarrar
Children 2024, 11(7), 772; https://doi.org/10.3390/children11070772 - 26 Jun 2024
Cited by 1 | Viewed by 1783
Abstract
Objective: This cross-sectional, case-control study aimed to explore the psychodynamic characteristics that influenced adolescents’ mental health during the COVID-19 pandemic. Methods: Personality structure impairments, psychodynamic conflicts, defense styles, and mental health issues were examined using the OPD-Structure- and Conflict-Questionnaires, the Defense Style Questionnaire, [...] Read more.
Objective: This cross-sectional, case-control study aimed to explore the psychodynamic characteristics that influenced adolescents’ mental health during the COVID-19 pandemic. Methods: Personality structure impairments, psychodynamic conflicts, defense styles, and mental health issues were examined using the OPD-Structure- and Conflict-Questionnaires, the Defense Style Questionnaire, and the Patient Health Questionnaire in adolescents before (n = 288) and after (n = 451) the COVID-19 pandemic in Germany. Results: Adolescents with mental health issues exhibited greater impairments in personality structure, more immature defense styles, and higher levels of psychodynamic conflicts both before and after the pandemic onset. Comparisons between pre-pandemic and pandemic samples indicated a lower level of the conflict of taking care of oneself versus being cared for in passive mode among adolescents during the pandemic. In-depth analysis of adolescents with mental health issues from the pandemic group revealed significant associations between personality structure impairments and a maladaptive defense style with somatoform, depressive, anxiety, eating, and alcohol use disorders. Conclusion: The findings provide clinically relevant insights into the psychodynamic factors that contributed to the psychological vulnerability of adolescents during the COVID-19 pandemic. These insights can guide the development of targeted psychodynamic interventions to support adolescents’ mental health in similar future crises. Full article
(This article belongs to the Special Issue Child and Adolescent Psychiatry: A Post-COVID Era?)
16 pages, 1251 KiB  
Article
Utility of the Post-Reflux Swallow-Induced Peristaltic Wave Index and Mean Nocturnal Baseline Impedance for the Diagnosis of Gastroesophageal Reflux Disease Phenotypes in Children
by Radu Samuel Pop, Daniela Pop, Lăcrămioara Eliza Chiperi, Vlad-Ionuț Nechita, Sorin Claudiu Man and Dan Lucian Dumitrașcu
Children 2024, 11(7), 773; https://doi.org/10.3390/children11070773 - 26 Jun 2024
Cited by 1 | Viewed by 1235
Abstract
(1) Objectives: Assessment of novel impedance parameters such as the post-reflux swallow-induced peristaltic wave (PSPW) index and mean nocturnal baseline impedance (MNBI) have been proposed to enhance the accuracy of gastroesophageal reflux disease (GERD) diagnosis. We aimed to evaluate the clinical value of [...] Read more.
(1) Objectives: Assessment of novel impedance parameters such as the post-reflux swallow-induced peristaltic wave (PSPW) index and mean nocturnal baseline impedance (MNBI) have been proposed to enhance the accuracy of gastroesophageal reflux disease (GERD) diagnosis. We aimed to evaluate the clinical value of MNBI and the PSPW index in discerning different phenotypes of GERD in children. (2) Methods: We conducted a prospective, observational study that included 49 children aged 5–18 years, referred for MII-pH monitoring due to negative endoscopy and persisting gastroesophageal reflux symptoms despite acid-suppressant treatment. The PSPW index and MNBI were assessed along with conventional metrics. (3) Results: Using a receiver operating characteristic (ROC) curve analysis, MNBI (AUC 0.864) and the PSPW index (AUC 0.83) had very good performance in differentiating between non-erosive reflux disease (NERD) and functional phenotypes. The PSPW index (AUC 0.87) discriminated better between functional heartburn (FH) and reflux hypersensitivity (RH) compared to the MNBI (AUC 0.712). A PSPW cut-off value of 65% provided a sensitivity of 76.9% and a specificity of 90% in distinguishing FH and RH. The PSPW index (AUC 0.87) proved to have better performance than the MNBI (AUC 0.802) in differentiating between FH and non-FH patients. MNBI diagnosed FH with a sensitivity of 84% and a specificity of 80.6% at a cut-off value of 2563 Ω. (4) Conclusions: The PSPW index and MNBI are useful to distinguish between GERD phenotypes in pediatric patients. Full article
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24 pages, 1105 KiB  
Review
Measurement Method Options to Investigate Digital Screen Technology Use by Children and Adolescents: A Narrative Review
by Amber Beynon, Danica Hendry, Charlotte Lund Rasmussen, Andrew L. Rohl, Rebecca Eynon, George Thomas, Sarah Stearne, Amity Campbell, Courtenay Harris, Juliana Zabatiero and Leon Straker
Children 2024, 11(7), 754; https://doi.org/10.3390/children11070754 - 21 Jun 2024
Cited by 1 | Viewed by 2036
Abstract
The role and potential impact of digital screen technology in the lives of children is heavily debated. Current evidence is limited by the weakness of measures typically used to characterise screen use, predominantly proxy- or self-reports with known inaccuracy and bias. However, robust [...] Read more.
The role and potential impact of digital screen technology in the lives of children is heavily debated. Current evidence is limited by the weakness of measures typically used to characterise screen use, predominantly proxy- or self-reports with known inaccuracy and bias. However, robust and detailed evidence is needed to provide practical trustworthy guidance to families and professionals working with families. The purpose of this paper is to support researchers to select measurement method(s) that will provide robust and detailed evidence. The paper outlines the challenges in measuring contemporary screen use by children, using a child–technology interaction model to organise considerations. A range of different methods used to measure digital screen technology use in children and adolescents (i.e., questionnaires, diaries, electronically prompted sampling, direct observation, fixed room cameras, wearable/portable cameras, audio recorders, screen-device onboard logging, remote digital trace logging and proximity logging) are described along with examples of their use and constructs typically measured as well as a summary of the advantages and disadvantages of each method. A checklist and worked examples are provided to support researchers determining the best methods or combination of methods for a research project. Full article
(This article belongs to the Special Issue Screen Time, Adverse Childhood Experiences and Childhood Mental Health on Child and Adolescent Development: Current Research and Future Directions)
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15 pages, 983 KiB  
Review
Macrophage Activation Syndrome in Children: Update on Diagnosis and Treatment
by Jin Lee, Kil Seong Bae, Jung Woo Rhim, Soo-Young Lee, Dae Chul Jeong and Jin Han Kang
Children 2024, 11(7), 755; https://doi.org/10.3390/children11070755 - 21 Jun 2024
Cited by 1 | Viewed by 2766
Abstract
Macrophage activation syndrome (MAS) is potentially fatal; so, early diagnosis and timely treatment are essential. However, detecting MAS is sometimes challenging because its principal features can be observed in other pediatric diseases that cause severe inflammation. Cytokine storm due to immune dysregulation represents [...] Read more.
Macrophage activation syndrome (MAS) is potentially fatal; so, early diagnosis and timely treatment are essential. However, detecting MAS is sometimes challenging because its principal features can be observed in other pediatric diseases that cause severe inflammation. Cytokine storm due to immune dysregulation represents the clinical and laboratory features of MAS that are included in the diagnostic criteria. Most cases of MAS occur as an underlying condition worsens and progresses. Therefore, a patient with autoimmune or autoinflammatory disease who shows unexplained clinical deterioration despite appropriate management should be considered at high risk for MAS (i.e., occult MAS). The basic principles of treatment are control of triggering factors, supportive care, and relief of hyperinflammation. Systemic steroids and cyclosporine A are frequently used as a first-line treatment. For the treatment of refractory MAS, cytokine-specific biologic agents such as anakinra have recently become preferred over traditional immunosuppressive agents such as etoposide. MAS might be underrecognized in pediatric patients with infectious and inflammatory diseases due to its diverse clinical presentations. Clinical suspicion of MAS is of the utmost importance for early recognition of the disease. Full article
(This article belongs to the Special Issue Diagnosis, Treatment and Care of Pediatric Rheumatology)
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11 pages, 237 KiB  
Article
Exploring the Role of ChatGPT-4, BingAI, and Gemini as Virtual Consultants to Educate Families about Retinopathy of Prematurity
by Ceren Durmaz Engin, Ezgi Karatas and Taylan Ozturk
Children 2024, 11(6), 750; https://doi.org/10.3390/children11060750 - 20 Jun 2024
Cited by 5 | Viewed by 1407
Abstract
Background: Large language models (LLMs) are becoming increasingly important as they are being used more frequently for providing medical information. Our aim is to evaluate the effectiveness of electronic artificial intelligence (AI) large language models (LLMs), such as ChatGPT-4, BingAI, and Gemini in [...] Read more.
Background: Large language models (LLMs) are becoming increasingly important as they are being used more frequently for providing medical information. Our aim is to evaluate the effectiveness of electronic artificial intelligence (AI) large language models (LLMs), such as ChatGPT-4, BingAI, and Gemini in responding to patient inquiries about retinopathy of prematurity (ROP). Methods: The answers of LLMs for fifty real-life patient inquiries were assessed using a 5-point Likert scale by three ophthalmologists. The models’ responses were also evaluated for reliability with the DISCERN instrument and the EQIP framework, and for readability using the Flesch Reading Ease (FRE), Flesch-Kincaid Grade Level (FKGL), and Coleman-Liau Index. Results: ChatGPT-4 outperformed BingAI and Gemini, scoring the highest with 5 points in 90% (45 out of 50) and achieving ratings of “agreed” or “strongly agreed” in 98% (49 out of 50) of responses. It led in accuracy and reliability with DISCERN and EQIP scores of 63 and 72.2, respectively. BingAI followed with scores of 53 and 61.1, while Gemini was noted for the best readability (FRE score of 39.1) but lower reliability scores. Statistically significant performance differences were observed particularly in the screening, diagnosis, and treatment categories. Conclusion: ChatGPT-4 excelled in providing detailed and reliable responses to ROP-related queries, although its texts were more complex. All models delivered generally accurate information as per DISCERN and EQIP assessments. Full article
(This article belongs to the Special Issue Recent Advances in Retinopathy of Prematurity)
11 pages, 1551 KiB  
Article
Application of Interferon-γ Release Assay in the Assessment of T-Cell Immunity to SARS-CoV-2 Antigens in the Cohort of Pediatric Patients with Juvenile Idiopathic Arthritis
by Katarzyna Kapten, Krzysztof Orczyk and Elzbieta Smolewska
Children 2024, 11(6), 736; https://doi.org/10.3390/children11060736 - 16 Jun 2024
Cited by 1 | Viewed by 1319
Abstract
Background: an accurate assessment of the immunity against SARS-CoV-2 can facilitate a better understanding and management of not only the recent coronavirus but similar pathogens as well. Objective: the aim of this study was to evaluate T-cell immunity with reference to antibody titers [...] Read more.
Background: an accurate assessment of the immunity against SARS-CoV-2 can facilitate a better understanding and management of not only the recent coronavirus but similar pathogens as well. Objective: the aim of this study was to evaluate T-cell immunity with reference to antibody titers in a group of pediatric patients with autoimmune arthritides utilizing the widely known Interferon-γ Release Assay (IGRA). Materials and Methods: This study was conducted in the cohort of 55 children suffering from Juvenile Idiopathic Arthritis (JIA). This research analyzed the SARS-CoV-2 T-cell response measured by a specific quantitative IGRA, followed by a serological ELISA test measuring the presence and quantity of IgG, IgM, and IgA antibodies in serum. Results: The cellular response to SARS-CoV-2 measured by the IGRA test significantly correlated with the antibody titers, IgA (p < 0.00003, R = 0.537), IgG (p < 0.0001, R = 0.668), and IgG nucleocapsid protein (NCP) (p < 0.003, R = 0.0399), with no correlation with IgM levels. The antibody levels in patients receiving biological agents were significantly lower compared to the rest of the cohort (p = 0.0369), while traditional disease-modifying antirheumatic drugs had no such effect. Limitations: the main limitation of the research is the small sample size, mostly due to the specific cohort of patients and the lack of a healthy control. Conclusions: IGRA appears to be a viable tool in the accurate evaluation of T-cell responses to SARS-CoV-2, and serodiagnostics alone is not always sufficient in the assessment of immune responses. Full article
(This article belongs to the Special Issue Diagnosis, Treatment and Care of Pediatric Rheumatology)
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12 pages, 233 KiB  
Article
Families of Children with Intellectual and Developmental Disabilities: Variables Associated with Family Quality of Life
by Ghaleb H. Alnahdi and Susanne Schwab
Children 2024, 11(6), 734; https://doi.org/10.3390/children11060734 - 15 Jun 2024
Cited by 1 | Viewed by 1703
Abstract
Families of children with intellectual and developmental disabilities often face unique challenges that significantly impact their quality of life. Understanding the predictors of family quality of life (FQOL) is crucial for developing effective support systems and interventions. Aim: This study investigated the predictors [...] Read more.
Families of children with intellectual and developmental disabilities often face unique challenges that significantly impact their quality of life. Understanding the predictors of family quality of life (FQOL) is crucial for developing effective support systems and interventions. Aim: This study investigated the predictors that might influence the perception of families having a member with a disability regarding their quality of life (FQOL). Method: The sample consisted of 320 family members from the Riyadh region of Saudi Arabia. Results: The overall results showed that participants’ satisfaction with FQOL was at a moderate level. Further results indicated that variables associated with severity, type of disability, and the mother’s age and education were significant predictors of the FQOL. Conclusions: These results emphasize the importance of considering the variables that impact FQOL, such as the severity and type of disability, and mother’s related variables, when directing support to families with a member with a disability. The recommendations and limitations of the study were discussed. Full article
(This article belongs to the Section Pediatric Mental Health)
8 pages, 239 KiB  
Article
Evaluation of Sleep Quality in Asthmatic Children with the Paediatric Sleep Questionnaire (PSQ)
by Mehmet Yaşar Özkars, Seda Çevik, Serap Ata, Alican Sarısaltık and Uğur Altaş
Children 2024, 11(6), 728; https://doi.org/10.3390/children11060728 - 14 Jun 2024
Cited by 3 | Viewed by 1132
Abstract
Considering the high prevalence of sleep-related breathing disorders (SRBD) in asthmatic patients, we aimed to compare asthmatic children and healthy children in terms of SRBD according to Paediatric Sleep Questionnaire (PSQ) scores. A questionnaire covering sociodemographic characteristics of the patients and the PSQ, [...] Read more.
Considering the high prevalence of sleep-related breathing disorders (SRBD) in asthmatic patients, we aimed to compare asthmatic children and healthy children in terms of SRBD according to Paediatric Sleep Questionnaire (PSQ) scores. A questionnaire covering sociodemographic characteristics of the patients and the PSQ, which evaluates sleep quality and consists of 22 questions, was administered. During the data collection process, 180 patients in the patient group and 170 patients in the control group were included. The patient group showed statistically significantly higher total scores and subscale scores for snoring, sleepiness, and inattention compared to the control group. Statistically significant correlations were found between the sleepiness subscale and body mass index z score in a negative direction and between age at presentation and duration of asthma in a positive direction. Our findings endorse employing the PSQ as a screening instrument in the outpatient environment to ensure timely referral of asthma patients to a sleep specialist for SRBD evaluation. Considering the widespread occurrence of snoring and asthma, this tool could aid in identifying patients with an elevated risk of SRBD and expedite the scheduling of nocturnal polysomnography for these children. Full article
(This article belongs to the Special Issue Sleep-Disordered Breathing and Allergy in Children: Current Research Insights and Future Directions)
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11 pages, 503 KiB  
Article
Validity of the BOT-2 Short Form for Korean School-Age Children: A Preliminary Study
by Deukgeun Yoon, Dabin Choi, Misun Kim, Seokyeon Ji, Yoo-Sook Joung and Eun Young Kim
Children 2024, 11(6), 724; https://doi.org/10.3390/children11060724 - 13 Jun 2024
Cited by 1 | Viewed by 1314
Abstract
The Bruininks–Oseretsky Test of Motor Proficiency Second Edition (BOT-2) is the most common motor assessment in Korea. The BOT-2–Short Form (SF) is preferred over the complete form (CF) in settings with limited time. The present study aimed to assess the validity of the [...] Read more.
The Bruininks–Oseretsky Test of Motor Proficiency Second Edition (BOT-2) is the most common motor assessment in Korea. The BOT-2–Short Form (SF) is preferred over the complete form (CF) in settings with limited time. The present study aimed to assess the validity of the BOT-2 SF in Korean school-age children. First, we verified that the BOT-2 SF reflects developmental changes in motor skills. Second, we compared the BOT-2 SF scores to those of the BOT-2 CF. A total of 283 Korean school-age children performed the BOT-2. The differences in the BOT-2 SF point according to age group (7 years, 8–9 years, and 10–12 years) were analyzed. A correlation analysis of the standard scores between the BOT-2 SF and CF was conducted. The sensitivity and specificity of the BOT-2 SF were calculated in reference to its CF. Overall, the BOT-2 SF point scores increased with age. The correlation between the total scores of the BOT-2 SF and CF was strong. The BOT-2 SF had a sensitivity of 83% and specificity of 92%. This study has demonstrated the validity of the BOT-2 SF in Korean school-age children. The BOT2 SF can be useful in screening Korean school-age children with motor skills problems. Full article
(This article belongs to the Special Issue Motor Development in Children)
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15 pages, 670 KiB  
Article
Proprioception, Emotion and Social Responsiveness in Children with Developmental Disorders: An Exploratory Study in Autism Spectrum Disorder, Cerebral Palsy and Different Neurodevelopmental Situations
by Inmaculada Riquelme, Samar M. Hatem, Álvaro Sabater-Gárriz, Elisabeth Martín-Jiménez and Pedro Montoya
Children 2024, 11(6), 719; https://doi.org/10.3390/children11060719 - 13 Jun 2024
Cited by 1 | Viewed by 1875
Abstract
Proprioception has long been linked with emotional dysregulation in neurotypical adults. Neuropediatric disorders such as autism spectrum disorder (ASD) and cerebral palsy (CP) are distinct entities and yet both present with deficits and challenges in sensory processing and the regulation of emotions. This [...] Read more.
Proprioception has long been linked with emotional dysregulation in neurotypical adults. Neuropediatric disorders such as autism spectrum disorder (ASD) and cerebral palsy (CP) are distinct entities and yet both present with deficits and challenges in sensory processing and the regulation of emotions. This study aimed to explore the relationship between proprioception and emotional–social performance in children and to compare proprioception and emotional–social performance in different underlying neurodevelopmental conditions. For this purpose, this cross-sectional study included 42 children with ASD, 34 children with CP and 50 typically developing peers. Proprioceptive acuity, proprioceptive reactive behavior as well as emotion regulation and social responsiveness were assessed. The results show a significant correlation between proprioceptive deficits and emotional difficulties in this pediatric sample, with distinct proprioceptive impairment patterns according to the underlying neurological disorder. Children with CP showed significant emotional knowledge deficits, while children with ASD predominantly showed challenges in social responsiveness. These data thus suggest a differentiated impact of proprioception on emotional–social performance in neurodevelopmental disorders and highlight proprioception as a potential therapeutic target for balancing emotion regulation in children with neurodevelopmental conditions. Full article
(This article belongs to the Special Issue Neurodevelopmental Disorders in Pediatrics)
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38 pages, 3176 KiB  
Article
Beyond Language Scores: How Language Exposure Informs Assessment of Nonword Repetition, Vocabulary and Narrative Macrostructure in Bilingual Turkish/Swedish Children with and without Developmental Language Disorder
by Linnéa Öberg and Ute Bohnacker
Children 2024, 11(6), 704; https://doi.org/10.3390/children11060704 - 7 Jun 2024
Cited by 1 | Viewed by 997
Abstract
As in many other countries, baseline data concerning the linguistic development of bilingual children in Sweden are lacking, and suitable methods for identifying developmental language disorder (DLD) in bilinguals are lacking as well. This study presents reference data from 108 typically developing (TD) [...] Read more.
As in many other countries, baseline data concerning the linguistic development of bilingual children in Sweden are lacking, and suitable methods for identifying developmental language disorder (DLD) in bilinguals are lacking as well. This study presents reference data from 108 typically developing (TD) Turkish/Swedish-speaking children aged 4;0–8;1, for a range of language tasks developed specifically for the assessment of bilinguals (LITMUS test battery, COST Action IS0804). We report on different types of nonword repetition (NWR) tasks (language-specific and language-independent), receptive and expressive vocabulary (Cross-Linguistic Lexical Tasks, CLTs), and narrative macrostructure comprehension and production (Multilingual Assessment Instrument for Narratives, MAIN) in Turkish, the children’s home language, and in Swedish, the language of schooling and society. Performance was investigated in relation to age, language exposure, type of task, and (for NWR and narratives) vocabulary size. There was a positive development with age for all tasks, but effects of language exposure and vocabulary size differed between tasks. Six bilingual Turkish/Swedish children with DLD were individually compared to the TD children. TD/DLD performance overlapped substantially, particularly for NWR, and more so for the production than the comprehension tasks. Surprisingly, the discriminatory potential was poor for both language-specific and language-independent NWR. DLD case studies underscored the importance of interpreting language scores in relation to exposure history, and the need for an increased emphasis on functional language skills as reported by parents and teachers when assessing and diagnosing DLD in bilinguals. Full article
(This article belongs to the Special Issue Developmental Language Disorder in Children and Adolescents)
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13 pages, 4427 KiB  
Article
Reconstructive Options for Pressure Ulcers in Pediatric Patients
by Dominika Krakowczyk, Jakub Opyrchał, Tomasz Koszutski, Krzysztof Dowgierd and Łukasz Krakowczyk
Children 2024, 11(6), 691; https://doi.org/10.3390/children11060691 - 5 Jun 2024
Cited by 2 | Viewed by 1878
Abstract
Background: Pressure ulcers pose significant challenges in terms of treatment, often exhibiting a low success rate and a propensity for recurrence. Children with neurological impairments such as myelomeningocele and those with spinal injuries are particularly vulnerable to developing pressure ulcers. Despite advancements, achieving [...] Read more.
Background: Pressure ulcers pose significant challenges in terms of treatment, often exhibiting a low success rate and a propensity for recurrence. Children with neurological impairments such as myelomeningocele and those with spinal injuries are particularly vulnerable to developing pressure ulcers. Despite advancements, achieving successful reconstruction remains a formidable task. Common sites prone to pressure ulcer formation include the sacral and ischial regions, as well as areas over bony prominences. Additionally, pressure ulcers attributable to medical devices facilitating ambulation are observed. While many pressure sores resolve spontaneously, conservative management may prove ineffective for some, especially in cases of stage 3 and 4 ulcers, necessitating surgical intervention. Various surgical techniques are employed for the treatment of decubitus ulcers, yet there exists no universally accepted gold standard for their management. This paper presents our institutional experience in this domain, highlighting differences in surgical approaches, treatment outcomes, complication rates, and long-term follow-up. Methods: This study involved a retrospective analysis of medical records from 11 children, ranging in age from 10 to 17 years, who presented with extensive pressure ulcers that were unresponsive to conservative treatment measures. Data collection spanned from February 2017 to June 2022. The pressure ulcers affected various anatomical regions, including the ischial area (5/11 patients), sacral region (3/11 patients), lower limb (1/11 patients), elbow (1/11 patients), and perineal area (1/11 patients). Surgical intervention was the chosen approach for all cases, employing techniques such as reconstructive surgery utilizing perforator, pediculated flaps, and locoregional flaps. Results: Eleven patients with sore ulcers (stage 3 and 4) were treated surgically. We present our experience of using surgical methods, including pedicled anterolateral flaps, pedicled gracilis musculocutaneous flaps, propeller flaps and locoregional flaps. In some cases, surgery was performed after 60 days of hospitalization or ten years after ulcer occurrence. We reviewed the length of hospital stay, surgical management and patient satisfaction. Patients were followed up to 5 years post-surgery. All flaps survived except for one flap where partial necrosis was observed. The recurrence rate was 9.01% (1/11). One patient underwent another surgery. The general outcome was satisfactory. Conclusions: Conclusions: Our findings underscore the efficacy of flap reconstruction surgical techniques in the management of pressure ulcers among pediatric patients. Based on our experience and the outcomes observed, we advocate for considering reconstructive surgery as a viable therapeutic option early in the treatment course, particularly for stage 3 and 4 ulcers. This approach not only addresses the immediate needs of patients but also holds promise for long-term wound healing and prevention of recurrence. Full article
(This article belongs to the Section Pediatric Surgery)
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10 pages, 608 KiB  
Article
The Impact of Time to Initiate Therapeutic Hypothermia on Short-Term Neurological Outcomes in Neonates with Hypoxic–Ischemic Encephalopathy
by Till Dresbach, Viktoria Rigoni, Anne Groteklaes, Thomas Hoehn, Anja Stein, Ursula Felderhoff-Mueser, Andreas Mueller and Hemmen Sabir
Children 2024, 11(6), 686; https://doi.org/10.3390/children11060686 - 4 Jun 2024
Cited by 1 | Viewed by 1450
Abstract
Background: Therapeutic hypothermia is the standard treatment for neonates with hypoxic–ischemic encephalopathy. Preclinical evidence indicates that the time to initiate therapeutic hypothermia correlates with its therapeutic success. This study aims to explore whether there is a correlation between the early initiation of therapeutic [...] Read more.
Background: Therapeutic hypothermia is the standard treatment for neonates with hypoxic–ischemic encephalopathy. Preclinical evidence indicates that the time to initiate therapeutic hypothermia correlates with its therapeutic success. This study aims to explore whether there is a correlation between the early initiation of therapeutic hypothermia and improved short-term neurological outcomes in cooled asphyxiated newborns. Methods: A retrospective analysis was conducted, involving 68 neonates from two different neonatal intensive care units. The impact of time to initiate treatment, time to reach the target temperature, and time between initiation and target temperature was correlated with short-term outcomes on MRI. Results: We did not find a significant difference between outcomes regarding the time to start treatment and the time to achieve the target temperature. Interestingly, neonates with a poor outcome were treated on average earlier than neonates with a favorable outcome but required more time to reach the target temperature. Additionally, the study results did not support the hypothesis that a shorter time to initiate treatment would lead to shorter times to achieve the target temperature. Conclusion: Based on our findings, it is recommended to prioritize a thorough evaluation of neonatal encephalopathy before initiating therapeutic hypothermia. Early initiation of treatment should be balanced with the time required for precise assessment to ensure better outcomes. Full article
(This article belongs to the Section Pediatric Neonatology)
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38 pages, 1732 KiB  
Review
Voice as a Biomarker of Pediatric Health: A Scoping Review
by Hannah Paige Rogers, Anne Hseu, Jung Kim, Elizabeth Silberholz, Stacy Jo, Anna Dorste and Kathy Jenkins
Children 2024, 11(6), 684; https://doi.org/10.3390/children11060684 - 4 Jun 2024
Cited by 2 | Viewed by 2143
Abstract
The human voice has the potential to serve as a valuable biomarker for the early detection, diagnosis, and monitoring of pediatric conditions. This scoping review synthesizes the current knowledge on the application of artificial intelligence (AI) in analyzing pediatric voice as a biomarker [...] Read more.
The human voice has the potential to serve as a valuable biomarker for the early detection, diagnosis, and monitoring of pediatric conditions. This scoping review synthesizes the current knowledge on the application of artificial intelligence (AI) in analyzing pediatric voice as a biomarker for health. The included studies featured voice recordings from pediatric populations aged 0–17 years, utilized feature extraction methods, and analyzed pathological biomarkers using AI models. Data from 62 studies were extracted, encompassing study and participant characteristics, recording sources, feature extraction methods, and AI models. Data from 39 models across 35 studies were evaluated for accuracy, sensitivity, and specificity. The review showed a global representation of pediatric voice studies, with a focus on developmental, respiratory, speech, and language conditions. The most frequently studied conditions were autism spectrum disorder, intellectual disabilities, asphyxia, and asthma. Mel-Frequency Cepstral Coefficients were the most utilized feature extraction method, while Support Vector Machines were the predominant AI model. The analysis of pediatric voice using AI demonstrates promise as a non-invasive, cost-effective biomarker for a broad spectrum of pediatric conditions. Further research is necessary to standardize the feature extraction methods and AI models utilized for the evaluation of pediatric voice as a biomarker for health. Standardization has significant potential to enhance the accuracy and applicability of these tools in clinical settings across a variety of conditions and voice recording types. Further development of this field has enormous potential for the creation of innovative diagnostic tools and interventions for pediatric populations globally. Full article
(This article belongs to the Section Pediatric Otolaryngology)
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21 pages, 882 KiB  
Article
Leveraging User-Friendly Mobile Medical Devices to Facilitate Early Hospital Discharges in a Pediatric Setting: A Randomized Trial Study Protocol
by Gianvincenzo Zuccotti, Marta Marsilio, Laura Fiori, Paola Erba, Francesca Destro, Costantino Zamana, Laura Folgori, Anna Mandelli, Davide Braghieri, Chiara Guglielmetti, Martina Pisarra, Letizia Magnani, Gabriele Infante, Dario Dilillo, Valentina Fabiano, Patrizia Carlucci, Elena Zoia, Gloria Pelizzo and Valeria Calcaterra
Children 2024, 11(6), 683; https://doi.org/10.3390/children11060683 - 4 Jun 2024
Cited by 2 | Viewed by 1420
Abstract
Background: Mobile technology is increasingly prevalent in healthcare, serving various purposes, including remote health monitoring and patient self-management, which could prove beneficial to early hospital discharges. Aims: This study investigates the transitional care program experience facilitating early discharges in a pediatric setting through [...] Read more.
Background: Mobile technology is increasingly prevalent in healthcare, serving various purposes, including remote health monitoring and patient self-management, which could prove beneficial to early hospital discharges. Aims: This study investigates the transitional care program experience facilitating early discharges in a pediatric setting through the use of an easy-to-use mobile medical device (TytoCare™, TytoCare Ltd., Natanya, Israel). Outcomes: This study aims to assess the effectiveness of telehomecare in achieving complete resolution of diseases without readmission, compare the length of stay between intervention and standard care groups, and gather user and professional experiences. Methods: A randomized open-label, controlled pilot study enrolled 102 children, randomly assigned to the telehomecare (TELE) group (n = 51, adopting early hospital discharge with continued home monitoring) or the standard-of-care (STAND) group (n = 51). Primary outcomes include complete disease resolution without readmission. Secondary objectives include recording a shorter length of stay in the intervention group. Surveys on user and professional experiences were conducted. A group of 51 children declining telemedicine services (NO-TELE) was also included. Results: In the TELE group, 100% of children achieved complete disease resolution without readmission, with a median duration of stay of 4 days, significantly shorter than the 7 days in the STAND group (p = 0.01). The telemedicine system demonstrated efficient performance and high satisfaction levels. The NO-TELE group showed no significant differences in demographics or digital technology competence. Perceived benefits of telemedicine included time and cost savings, reduced hospital stays, and technology utility and usability. Conclusions: This study demonstrates that user-friendly mobile medical devices effectively facilitate early hospital discharges in a pediatric setting. These devices serve as a bridge between home and hospital, optimizing care pathways. Full article
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18 pages, 9434 KiB  
Review
Meconium Aspiration Syndrome, Hypoxic-Ischemic Encephalopathy and Therapeutic Hypothermia—A Recipe for Severe Pulmonary Hypertension?
by Deepika Sankaran, Jessa Rose A. Li and Satyan Lakshminrusimha
Children 2024, 11(6), 673; https://doi.org/10.3390/children11060673 - 1 Jun 2024
Cited by 1 | Viewed by 3127
Abstract
Hypoxic-ischemic encephalopathy (HIE) is the leading cause of mortality among term newborns globally. Infants born through meconium-stained amniotic fluid are at risk of developing meconium aspiration syndrome (MAS) and HIE. Simultaneous occurrence of MAS and HIE is a perilous combination for newborns due [...] Read more.
Hypoxic-ischemic encephalopathy (HIE) is the leading cause of mortality among term newborns globally. Infants born through meconium-stained amniotic fluid are at risk of developing meconium aspiration syndrome (MAS) and HIE. Simultaneous occurrence of MAS and HIE is a perilous combination for newborns due to the risk of persistent pulmonary hypertension of the newborn (PPHN). Moreover, therapeutic hypothermia (TH), which is the current standard of care for the management of HIE, may increase pulmonary vascular resistance (PVR) and worsen PPHN. Infants with MAS and HIE require close cardiorespiratory and hemodynamic monitoring for PPHN. Therapeutic strategies, including oxygen supplementation, ventilation, use of surfactant, inhaled nitric oxide and other pulmonary vasodilators, and systemic vasopressors, play a critical role in the management of PPHN in MAS, HIE, and TH. While TH reduces death or disability in infants with HIE, infants with MAS and HIE undergoing TH need close hemodynamic monitoring for PPHN. Full article
(This article belongs to the Special Issue The Management of Pulmonary Hypertension in Infants and Children)
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11 pages, 2855 KiB  
Article
Study of Correlation between Fetal Bowel Dilation and Congenital Gastrointestinal Malformation
by Yi Jiang, Weipeng Wang, Weihua Pan, Wenjie Wu, Dan Zhu and Jun Wang
Children 2024, 11(6), 670; https://doi.org/10.3390/children11060670 - 31 May 2024
Cited by 1 | Viewed by 1390
Abstract
Background: Ultrasound serves as a valuable tool for the early detection of fetal bowel dilatation, yet the correlation between fetal bowel dilatation and gastrointestinal malformations remains to be further investigated. This study aims to explore the relationship by conducting a follow-up and analysis [...] Read more.
Background: Ultrasound serves as a valuable tool for the early detection of fetal bowel dilatation, yet the correlation between fetal bowel dilatation and gastrointestinal malformations remains to be further investigated. This study aims to explore the relationship by conducting a follow-up and analysis of fetuses with bowel dilation. Methods: A retrospective analysis was conducted on 113 fetuses with bowel dilatation at our center from July 2014 to December 2019. The location and degree of bowel dilatation were analyzed. ROC curves were constructed based on the diameter of the bowel and its ratio to fetal gestational age. Results: In total, 40 of 41 cases (97.6%) with upper gastrointestinal dilatation (double-bubble sign) and 46 of 72 cases (63.9%) with lower gastrointestinal dilatation were diagnosed with gastrointestinal malformations postnatally. The AUC of the dilatation diameter was 0.854 with a cutoff value of 18.05 mm in patients with lower gastrointestinal dilatation. The ratio of the diameter to gestational age (D/GA) showed a higher AUC of 0.906 with a cutoff value of 0.4931. Conclusions: The presence of the double-bubble sign in fetuses indicates a close association with duodenal obstruction. The risk of gastrointestinal malformations increases when the bowel diameter exceeds 18.05 mm, particularly when the D/GA surpasses 0.4931. Full article
(This article belongs to the Special Issue Adverse Neonatal Outcomes in Perinatal Periods: Risk Factors, Screening and Treatment)
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20 pages, 741 KiB  
Review
Management of Pediatric Solid Organ Injuries
by Bailey D. Lyttle, Regan F. Williams and Steven Stylianos
Children 2024, 11(6), 667; https://doi.org/10.3390/children11060667 - 30 May 2024
Cited by 1 | Viewed by 1258
Abstract
Solid organ injury (SOI) is common in children who experience abdominal trauma, and the management of such injuries has evolved significantly over the past several decades. In 2000, the American Pediatric Surgical Association (APSA) published the first societal guidelines for the management of [...] Read more.
Solid organ injury (SOI) is common in children who experience abdominal trauma, and the management of such injuries has evolved significantly over the past several decades. In 2000, the American Pediatric Surgical Association (APSA) published the first societal guidelines for the management of blunt spleen and/or liver injury (BLSI), advocating for optimized resource utilization while maintaining patient safety. Nonoperative management (NOM) has become the mainstay of treatment for SOI, and since the publication of the APSA guidelines, numerous groups have evaluated how invasive procedures, hospitalization, and activity restrictions may be safely minimized in children with SOI. Here, we review the current evidence-based management guidelines in place for the treatment of injuries to the spleen, liver, kidney, and pancreas in children, including initial evaluation, inpatient management, and long-term care, as well as gaps that exist in the current literature that may be targeted for further optimization of protocols for pediatric SOI. Full article
(This article belongs to the Special Issue Treatment of Childhood Fractures and Trauma)
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10 pages, 488 KiB  
Article
Psychometric Properties of the Revised Self-Efficacy for Diabetes Self-Management Scale among Spanish Children and Adolescents with Type 1 Diabetes
by Joaquín Villaécija, Bárbara Luque, Esther Cuadrado, Sebastián Vivas and Carmen Tabernero
Children 2024, 11(6), 662; https://doi.org/10.3390/children11060662 - 29 May 2024
Cited by 1 | Viewed by 1216
Abstract
A longitudinal design was used to examine the psychometric properties of the Self-Efficacy for Diabetes Self-Management (SEDM) for children and adolescents with a diagnosis of type 1 diabetes (T1D). The SEDM was adapted to Spanish and the best factorial solution was selected to [...] Read more.
A longitudinal design was used to examine the psychometric properties of the Self-Efficacy for Diabetes Self-Management (SEDM) for children and adolescents with a diagnosis of type 1 diabetes (T1D). The SEDM was adapted to Spanish and the best factorial solution was selected to test the invariance of the measures of age and gender. Individuals between the ages of 10 and 19 years old with a diagnosis of T1D completed a self-reported questionnaire (167 at Time 1 [mean age = 14.49, SD = 2.76; 56.9% boys] and 122 at Time 2 [mean age = 14.77, SD = 2.58; 56.6% boys]). Two unifactorial solutions were tested. The psychometric properties of the scale were validated. The proposed validation obtained excellent reliability indices (χ2 (26) = 25.59, p > 0.49, RMSEA = 0.00, 95% CI [0.00, 0.07], CFI = 1.00, GFI = 0.96, AGFI = 0.92, TLI = 1.00, and CMIN = 0.98), and it appeared to be invariant for gender and for age groups. The Cronbach’s α was 0.85. The test–retest reliability was high (r = 0.69 [p < 0.001]). Convergent, discriminant, and external validity were proven. The nine-item SEDM is a brief measure with satisfactory structural validity. From our knowledge, this study provides the first reliable tool to assess self-efficacy in the management of T1D for Spanish children and adolescents. Full article
(This article belongs to the Special Issue Advances in Childhood Diabetes)
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7 pages, 192 KiB  
Article
Evaluation of Adolescents’ Awareness of Seat Belt Use and the Relationship with Risky Behaviors
by Hatice Topal, Sadettin Burak Açıkel, Hülya Şirin, Emine Polat, Harun Terin, Mehmet Mustafa Yılmaz and Saliha Şenel
Children 2024, 11(6), 656; https://doi.org/10.3390/children11060656 - 28 May 2024
Cited by 1 | Viewed by 1027
Abstract
The one of the leading causes of adolescent morbidity and mortality worldwide is motor vehicle accidents (MVA). The use of seat belts significantly lowers MVA fatalities and injuries. The aim of this study is to investigate adolescent seat belt usage patterns and relation [...] Read more.
The one of the leading causes of adolescent morbidity and mortality worldwide is motor vehicle accidents (MVA). The use of seat belts significantly lowers MVA fatalities and injuries. The aim of this study is to investigate adolescent seat belt usage patterns and relation with risky behaviors. The study conducted at two medical institutions with non-immigrant and literate adolescents aged 12–18. Demographics, seat belt use, and risk-taking behavior were collected through questionnaires. 726 teenagers (422 girls and 304 boys) with an average age of 176.7 ± 23.37 months participated in the study. Parents’ educational levels and front-seat belt use have been found to be correlated. Comparatively to non-users, seat belt users demonstrated lower risk scores (total, traffic, substance, and social). The use of seat belts was significantly predicted by traffic risk, according to logistic regression. The frequency of seatbelt use was higher among participants from cities with higher socioeconomic status. As a result, it was found that adolescents who exhibited more risky behaviors had a lower frequency of seat belt use and seat belt use was associated with socioeconomic level and parental education level. It is thought that population-based studies to be conducted on this subject are important. Full article
(This article belongs to the Section Pediatric Mental Health)
29 pages, 4467 KiB  
Article
Impact of Interleukin-17 Receptor A Gene Variants on Asthma Susceptibility and Clinical Manifestations in Children and Adolescents
by Shymaa Ahmed Maher, Nouran B. AbdAllah, Essam Al Ageeli, Eman Riad, Shahad W. Kattan, Sherouk Abdelaal, Wagdy Abdelfatah, Gehan A. Ibrahim, Eman A. Toraih, Ghada A. Awadalla, Manal S. Fawzy and Ahmed Ibrahim
Children 2024, 11(6), 657; https://doi.org/10.3390/children11060657 - 28 May 2024
Cited by 2 | Viewed by 1201
Abstract
Several single nucleotide polymorphisms (SNPs) in multiple interleukin receptor genes could be associated with asthma risk and/or phenotype. Interleukin-17 (IL-17) has been implicated in tissue inflammation and autoimmune diseases. As no previous studies have uncovered the potential role of IL17 receptor A ( [...] Read more.
Several single nucleotide polymorphisms (SNPs) in multiple interleukin receptor genes could be associated with asthma risk and/or phenotype. Interleukin-17 (IL-17) has been implicated in tissue inflammation and autoimmune diseases. As no previous studies have uncovered the potential role of IL17 receptor A (RA) gene variants in asthma risk, we aimed to explore the association of four IL17RA SNPs (i.e., rs4819554A/G, rs879577C/T, rs41323645G/A, and rs4819555C/T) with asthma susceptibility/phenotype in our region. TaqMan allelic discrimination analysis was used to genotype 192 individuals. We found that the rs4819554 G/G genotype significantly reduced disease risk in the codominant (OR = 0.15, 95%CI = 0.05–0.45, p < 0.001), dominant (OR = 0.49, 95%CI = 0.26–0.93, p = 0.028), and recessive (OR = 0.18, 95%CI = 0.07–0.52, p < 0.001) models. Similarly, rs879577 showed reduced disease risk associated with the T allele across all genetic models. However, the A allele of rs41323645 was associated with increased disease risk in all models. The G/A and A/A genotypes have higher ORs of 2.47 (95%CI = 1.19–5.14) and 3.86 (95%CI = 1.62–9.18), respectively. Similar trends are observed in the dominant 2.89 (95%CI = 1.47–5.68, p = 0.002) and recessive 2.34 (95%CI = 1.10–4.98, p = 0.025) models. For the rs4819555 variant, although there was no significant association identified under any models, carriers of the rs4819554*A demonstrated an association with a positive family history of asthma (71.4% in carriers vs. 27% in non-carriers; p = 0.025) and the use of relievers for >2 weeks (52.2% of carriers vs. 28.8% of non-carriers; p = 0.047). Meanwhile, the rs4819555*C carriers displayed a significant divergence in the asthma phenotype, specifically atopic asthma (83.3% vs. 61.1%; p = 0.007), showed a higher prevalence of chest tightness (88.9% vs. 61.5%; p = 0.029), and were more likely to report comorbidities (57.7% vs. 16.7%, p = 0.003). The most frequent haplotype in the asthma group was ACAC, with a frequency of 22.87% vs. 1.36% in the controls (p < 0.001). In conclusion, the studied IL17RA variants could be essential in asthma susceptibility and phenotype in children and adolescents. Full article
(This article belongs to the Special Issue Molecular and Pathophysiological Mechanisms Underlying Asthma and Allergy in Children)
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13 pages, 1043 KiB  
Article
Sleep-Disordered Breathing and Associated Comorbidities among Preschool-Aged Children with Down Syndrome
by Tessa K. Kolstad, Lourdes M. DelRosso, Mary Anne Tablizo, Manisha Witmans, Yeilim Cho and Michelle Sobremonte-King
Children 2024, 11(6), 651; https://doi.org/10.3390/children11060651 - 28 May 2024
Cited by 1 | Viewed by 1435
Abstract
Children with Down syndrome (DS) are at high risk of sleep-disordered breathing (SDB). The American Academy of Pediatrics recommends a polysomnogram (PSG) in children with DS prior to the age of 4. This retrospective study examined the frequency of SDB, gas exchange abnormalities, [...] Read more.
Children with Down syndrome (DS) are at high risk of sleep-disordered breathing (SDB). The American Academy of Pediatrics recommends a polysomnogram (PSG) in children with DS prior to the age of 4. This retrospective study examined the frequency of SDB, gas exchange abnormalities, co-morbidities, and surgical management in children with DS aged 2–4 years old at Seattle Children’s Hospital from 2015–2021. A total of 153 children underwent PSG, with 75 meeting the inclusion criteria. The mean age was 3.03 years (SD 0.805), 56% were male, and 54.7% were Caucasian. Comorbidities included (n, %): cardiac (43, 57.3%), dysphagia or aspiration (24, 32.0%), prematurity (17, 22.7%), pulmonary (16, 21.3%), immune dysfunction (2, 2.7%), and hypothyroidism (23, 30.7%). PSG parameter data collected included (mean, SD): obstructive AHI (7.9, 9.4) and central AHI (2.4, 2.4). In total, 94.7% met the criteria for pediatric OSA, 9.5% met the criteria for central apnea, and 9.5% met the criteria for hypoventilation. Only one child met the criteria for hypoxemia. Overall, 60% had surgical intervention, with 88.9% of these being adenotonsillectomy. There was no statistically significant difference in the frequency of OSA at different ages. Children aged 2–4 years with DS have a high frequency of OSA. The most commonly encountered co-morbidities were cardiac and swallowing dysfunction. Among those with OSA, more than half underwent surgical intervention, with improvements in their obstructive apnea hypopnea index, total apnea hypopnea index, oxygen saturation nadir, oxygen desaturation index, total arousal index, and total sleep duration. This highlights the importance of early diagnosis and appropriate treatment. Our study also suggests that adenotonsillar hypertrophy is still a large contributor to upper airway obstruction in this age group. Full article
(This article belongs to the Section Pediatric Pulmonary and Sleep Medicine)
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17 pages, 1346 KiB  
Article
Effect of the Different Dietary Supplements on the Average Surface Roughness and Color Stability of Direct Restorative Materials Used in Pediatric Dentistry
by Nagehan Aktaş, Yasemin Akın, Cenkhan Bal, Mehmet Bani and Merve Bankoğlu Güngör
Children 2024, 11(6), 645; https://doi.org/10.3390/children11060645 - 27 May 2024
Cited by 1 | Viewed by 1664
Abstract
Increased surface roughness and discoloration of the direct restorative materials used in pediatric patients affect the longevity of restorations and impair children’s oral health. Many factors can alter these properties. One of these factors is the intake of dietary supplements. It is crucial [...] Read more.
Increased surface roughness and discoloration of the direct restorative materials used in pediatric patients affect the longevity of restorations and impair children’s oral health. Many factors can alter these properties. One of these factors is the intake of dietary supplements. It is crucial to predict the properties of restorative materials when exposed to dietary supplements to maintain the dental care of children. Thus, this study aimed to investigate the effect of various syrup-formed dietary supplements on the average surface roughness and color stability of current restorative materials used in pediatric dentistry. Seven different restorative materials (conventional glass ionomer [Fuji IX GP], resin-modified glass ionomer, [Fuji II LC], zirconia-reinforced glass ionomer [Zirconomer Improved], polyacid-modified composite resin [Dyract®XTRA], bulk-fill glass hybrid restorative [Equia Forte HT Fill], conventional resin composite [Charisma Smart], and resin composite with reactive glass fillers [Cention N]) were tested. The specimens prepared from each type of restorative material were divided into five subgroups according to dietary supplements (Sambucol Kids, Resverol, Imunol, Umca, and Microfer). These specimens were immersed daily in supplement solution over a period of 28 days. Surface roughness and color difference measurements were performed at baseline and at the 7th and 28th days. The color difference and Ra values showed that there was an interaction among the type of restorative material, type of dietary supplement, and immersion time factors (p < 0.05). Whereas lower Ra values were found in the composite resin group, the highest Ra values were found in the conventional glass ionomer group. All supplements caused increasing color difference values, and Resverol and Umca showed higher discoloration values above the clinically acceptable threshold. The intake of dietary supplement type, the immersion time of the dietary supplement, and the restorative material type affected the surface roughness and color stability of the tested direct restorative materials. All of the experimental groups showed higher Ra values than clinically acceptable surface roughness values (0.2 µm). The color difference values also increased with the immersion time. Full article
(This article belongs to the Special Issue New Technologies and Materials in Oral Health and Dental Care of Pediatric Dentistry)
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28 pages, 350 KiB  
Article
Clinical Symptomatology of Anxiety and Family Function in Adolescents—The Self-Esteem Mediator
by Ignatia Farmakopoulou, Maria Lekka and Evgenia Gkintoni
Children 2024, 11(3), 338; https://doi.org/10.3390/children11030338 - 12 Mar 2024
Cited by 8 | Viewed by 4522
Abstract
Background: Family, the child’s first environment, shapes their psycho-emotional balance. The literature links adolescent anxiety to family relationships, interactions, and dynamics. The self-esteem of adolescents appears to protect their mental health. Goal: This study examines whether family cohesion and adaptability affect adolescent anxiety [...] Read more.
Background: Family, the child’s first environment, shapes their psycho-emotional balance. The literature links adolescent anxiety to family relationships, interactions, and dynamics. The self-esteem of adolescents appears to protect their mental health. Goal: This study examines whether family cohesion and adaptability affect adolescent anxiety symptoms. It also examines whether teen self-esteem mediates this relationship. Method: This cross-sectional, descriptive study included 166 Attica youth aged 12–18 from schools and educational units. The adolescents completed Olson’s FACES-III cohesion and adaptability scale, Spielberger’s STAI-C, Rosenberg’s self-esteem scale, and a socio-demographic questionnaire. Results: Family cohesion, but not adaptability, was negatively correlated with state (rho = −0.25, p = 0.001) and trait (rho = −0.46, p < 0.001) anxiety in the adolescents. Teenagers from extreme families with the lowest cohesion and adaptability had higher trait anxiety (x2(2) = 6.91, p = 0.032) than those from moderately balanced/balanced families. Self-esteem mediated the relationship between the family cohesion functioning and adolescent’s state anxiety (p = 0.005) and trait anxiety (p = 0.011). Conclusions: The findings show that family dysfunction negatively impacts adolescent anxiety, as well as their self-esteem, which protects mental balance. Full article
(This article belongs to the Special Issue 2nd Edition: Children’s Mental Health, Parenting, Family and Groups’ Resilience in Crisis)
9 pages, 243 KiB  
Review
The Global Occurrences of Cleft Lip and Palate in Pediatric Patients and Their Association with Demographic Factors: A Narrative Review
by Farah Asnely Putri, Madhuri Pattamatta, Sheylla Edu September Anita and Tantry Maulina
Children 2024, 11(3), 322; https://doi.org/10.3390/children11030322 - 8 Mar 2024
Cited by 10 | Viewed by 5411
Abstract
Objective: Orofacial clefts are one of the most common abnormalities that occur in the orofacial area. Due to their high prevalence, special attention provided to risk factors and their possible involvement in the occurrence of orofacial clefts is of importance. The objective of [...] Read more.
Objective: Orofacial clefts are one of the most common abnormalities that occur in the orofacial area. Due to their high prevalence, special attention provided to risk factors and their possible involvement in the occurrence of orofacial clefts is of importance. The objective of this study was to review the current global occurrence of orofacial clefts and the possible linkage of previously investigated risk factors to the occurrence of orofacial clefts. Review: The risk factors of orofacial clefts can be classified into two groups, modifiable risk factors and non-modifiable risk factors. Due to the extent of elaboration of each risk factor in each group, this current narrative review is limited to several mostly investigated risk factors, which included a review of parental age, sexual disparities, educational attainment, and income. Studies indicate that Asians are more likely than other races to have orofacial clefts, with a higher incidence rate in men than in women. There is evidence that the age of the parents is associated with the chance of the occurrence of orofacial cleft. The prevention of orofacial clefts and the distribution of medical resources depend heavily on a thorough understanding of epidemiology on a global scale. Nevertheless, the earlier studies concentrated on more developed nations or areas, and registry data from low-income nations had significant gaps. The findings of this narrative review can be used as the scientific basis for further research within this area. Conclusion: The occurrence rate of orofacial clefts remains high in several regions. Possible associations between parental age, sexual disparities, educational attainment, and family income to the occurrence of orofacial clefts remain contradictory, indicating the importance of further research to obtain more insights. Full article
(This article belongs to the Special Issue Oral Epidemiology and Pathology in Children)
28 pages, 1737 KiB  
Review
Children’s Health, Wellbeing and Academic Outcomes over the Summer Holidays: A Scoping Review
by Emily Eglitis, Aaron Miatke, Rosa Virgara, Amanda Machell, Timothy Olds, Mandy Richardson and Carol Maher
Children 2024, 11(3), 287; https://doi.org/10.3390/children11030287 - 27 Feb 2024
Cited by 6 | Viewed by 4188
Abstract
Background: The school day provides a supportive and stimulating environment that may protect children and adolescents (5–18 years) from behaviours that are adverse for health and wellbeing. Objective: To review the literature regarding changes in children’s academic achievement or overall wellbeing during the [...] Read more.
Background: The school day provides a supportive and stimulating environment that may protect children and adolescents (5–18 years) from behaviours that are adverse for health and wellbeing. Objective: To review the literature regarding changes in children’s academic achievement or overall wellbeing during the extended school summer break and evaluate if the outcomes are different for children experiencing disadvantage. Methods: The peer-reviewed literature was searched across six electronic databases for studies tracking changes in any academic, health or wellbeing outcome in children over the summer holidays. Studies were screened in duplicate for inclusion. Data were extracted using a standardized data extraction form. Outcomes were coded as decline (suggestive or significant), increase (suggestive or significant) or mixed/neutral and then compared to the school year or according to disadvantaged. Results: Seventy-six studies (n = 14,230,846 participants) were included. Strong evidence was found of a decline in academic outcomes and increases in adiposity, sedentary behaviour and screen time. There was moderate evidence of declines in cardiovascular fitness and physical activity. These patterns were magnified for disadvantaged children. Limited data were available on muscular fitness, sleep, diet quality and social, emotional or mental wellbeing. A total of 80% of studies were from the United States. Most data were from children 12 years of age and younger. Conclusions: Over the summer break, children’s academic and health outcomes decline. Children experiencing disadvantage display magnified losses that warrant further investigation. The summer holidays present an opportunity to improve children’s health and wellbeing. Full article
(This article belongs to the Section Pediatric Mental Health)
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12 pages, 318 KiB  
Article
Role of Satisfaction with Life, Sex and Body Mass Index in Physical Literacy of Spanish Children
by Javier Urbano-Mairena, María Mendoza-Muñoz, Jorge Carlos-Vivas, Raquel Pastor-Cisneros, Antonio Castillo-Paredes, Miguel Rodal and Laura Muñoz-Bermejo
Children 2024, 11(2), 181; https://doi.org/10.3390/children11020181 - 1 Feb 2024
Cited by 6 | Viewed by 1766
Abstract
Physical activity (PL) is essential to achieve good health, prevent cardiovascular diseases, obesity and overweight, as well as to achieve a better quality of life. Therefore, PL could become the tool to increase the practice of physical activity among young people, thus increasing [...] Read more.
Physical activity (PL) is essential to achieve good health, prevent cardiovascular diseases, obesity and overweight, as well as to achieve a better quality of life. Therefore, PL could become the tool to increase the practice of physical activity among young people, thus increasing life satisfaction (LS) given its positive relationship with physical activity. A single-measure cross-sectional correlational study was carried out, involving 135 children aged 8–12 years from Extremadura. They were administered the SWLS questionnaire and the Canadian assessment of physical literacy (CAPL-2). Significantly higher levels of PL (p = 0.010) were found in normal-weight children compared to overweight and obese children, due to the physical competence domain score (p < 0.001). PL was directly related to SWLS (p < 0.001), but inversely related to BMI (p = 0.018). The daily physical activity behaviour domain was explained by SWLS (p < 0.001) and sex (p < 0.001). Physical competence was described by SWLS (p < 0.001) and BMI (p = 0.045). Finally, the motivation and confidence domain were only significantly associated with SWLS (p < 0.001). It was concluded that boys and girls of normal weight achieved higher levels of PL and LS than those with overweight and obesity, establishing a negative relationship of PL with BMI and positive with LS. Full article
(This article belongs to the Special Issue Developing Physical Literacy in Children)
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12 pages, 1189 KiB  
Article
COVID-19 Pediatric Follow-Up: Respiratory Long COVID-Associated Comorbidities and Lung Ultrasound Alterations in a Cohort of Italian Children
by Cristiana Indolfi, Angela Klain, Giulio Dinardo, Elisabetta D’Addio, Serena Ferrara, Fabio Decimo, Giorgio Ciprandi, Maria Angela Tosca and Michele Miraglia del Giudice
Children 2024, 11(2), 166; https://doi.org/10.3390/children11020166 - 27 Jan 2024
Cited by 7 | Viewed by 1606
Abstract
In children, the factors that influence COVID-19 disease and its medium- and long-term effects are little known. Our investigation sought to evaluate the presence of comorbidity factors associated with respiratory long COVID manifestations in children and to study ultrasound abnormalities following SARS-CoV-2 infection. [...] Read more.
In children, the factors that influence COVID-19 disease and its medium- and long-term effects are little known. Our investigation sought to evaluate the presence of comorbidity factors associated with respiratory long COVID manifestations in children and to study ultrasound abnormalities following SARS-CoV-2 infection. Children, who arrived at the ‘Respiratory Diseases of Pediatric Interest Unit’ at the Department of Woman, Child, and General and Specialized Surgery of the University of Campania ‘Luigi Vanvitelli’, were selected during the timeframe from September 2021 to October 2022. The children were diagnosed with a SARS-CoV-2 infection that occurred at least one month before the visit. All patients followed a COVID-19 follow-up protocol, developed by the Italian Society of Pediatric Respiratory Diseases (SIMRI), which included: collection of data regarding SARS-CoV-2 illness and history of known respiratory and allergic diseases; physical examination; BMI assessment; baseline spirometry and after bronchodilation test; six-minute walking test; and lung ultrasound (LUS). In a cohort of 104 participants with respiratory long COVID symptoms (64.7% male, average age 8.92 years), 46.1% had fever with other symptoms, and 1% required hospitalization. BMI analysis showed 58.4% of the cohort was overweight. The LUS was positive in 27.0% of cases. A significant BMI association was observed with COVID-19 symptoms and LUS score (p-value < 0.05). No associations were found with asthma or atopy. Full article
(This article belongs to the Section Pediatric Allergy and Immunology)
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14 pages, 496 KiB  
Review
Ensuring Optimal Outcomes for Preterm Infants after NICU Discharge: A Life Course Health Development Approach to High-Risk Infant Follow-Up
by Jonathan S. Litt, Neal Halfon, Michael E. Msall, Shirley Ann Russ and Susan R. Hintz
Children 2024, 11(2), 146; https://doi.org/10.3390/children11020146 - 24 Jan 2024
Cited by 6 | Viewed by 3489
Abstract
Children born prematurely (<37 weeks’ gestation) have an increased risk for chronic health problems and developmental challenges compared to their term-born peers. The threats to health and development posed by prematurity, the unintended effects of life-sustaining neonatal intensive care, the associated neonatal morbidities, [...] Read more.
Children born prematurely (<37 weeks’ gestation) have an increased risk for chronic health problems and developmental challenges compared to their term-born peers. The threats to health and development posed by prematurity, the unintended effects of life-sustaining neonatal intensive care, the associated neonatal morbidities, and the profound stressors to families affect well-being during infancy, childhood, adolescence, and beyond. Specialized clinical programs provide medical and developmental follow-up care for preterm infants after hospital discharge. High-risk infant follow-up, like most post-discharge health services, has many shortcomings, including unclear goals, inadequate support for infants, parents, and families, fragmented service provisions, poor coordination among providers, and an artificially foreshortened time horizon. There are well-documented inequities in care access and delivery. We propose applying a life course health development framework to clinical follow-up for children born prematurely that is contextually appropriate, developmentally responsive, and equitably deployed. The concepts of health development, unfolding, complexity, timing, plasticity, thriving, and harmony can be mapped to key components of follow-up care delivery to address pressing health challenges. This new approach envisions a more effective version of clinical follow-up to support the best possible functional outcomes and the opportunity for every premature infant to thrive within their family and community environments over their life course. Full article
(This article belongs to the Special Issue The Implications of Preterm Birth for Health and Wellbeing over the Life Course)
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18 pages, 358 KiB  
Article
Family Functioning, Maternal Depression, and Adolescent Cognitive Flexibility and Its Associations with Adolescent Depression: A Cross-Sectional Study
by Justyna Urbańska-Grosz, Emilia J. Sitek, Anna Pakalska, Bożena Pietraszczyk-Kędziora, Kalina Skwarska and Maciej Walkiewicz
Children 2024, 11(1), 131; https://doi.org/10.3390/children11010131 - 22 Jan 2024
Cited by 6 | Viewed by 3689
Abstract
Background: This study explores family functioning and its associations with adolescent major depressive disorder (MDD), comparing its dynamics with healthy counterparts. Family functioning (cohesion, flexibility, communication, and satisfaction), maternal depressive symptoms, postpartum depression history, parental divorce, parental alcohol abuse, and the adolescents’ cognitive [...] Read more.
Background: This study explores family functioning and its associations with adolescent major depressive disorder (MDD), comparing its dynamics with healthy counterparts. Family functioning (cohesion, flexibility, communication, and satisfaction), maternal depressive symptoms, postpartum depression history, parental divorce, parental alcohol abuse, and the adolescents’ cognitive flexibility, are examined. The research incorporates the perspectives of both adolescents and mothers. Methods: The sample includes 63 mother-teenager dyads in the clinical group and 43 in the control group. Instruments encompass the Family Adaptability and Cohesion Evaluation Scales (FACES IV), Children’s Depression Inventory (CDI-2), Beck Depression Inventory (BDI-II), The Brixton Spatial Anticipation Test, and structured interviews. Results: Families of adolescents with MDD exhibit lower flexibility, cohesion, communication, and overall satisfaction. Depressed adolescents display reduced cognitive flexibility. Discrepancies were observed between adolescents’ and mothers’ perspectives as associated with adolescents’ MDD. Teenagers emphasized the severity of maternal depressive symptoms, while mothers highlighted the importance of family cohesion and flexibility. Conclusions: This study emphasizes a holistic strategy in addressing adolescent depression, including family-based assessment and therapy. Screening for maternal depressive symptoms is identified as valuable. Cognitive flexibility also needs to be addressed during therapy for depression in adolescence. Full article
(This article belongs to the Special Issue Child and Adolescent Psychiatry and Mental Health Progress)
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11 pages, 227 KiB  
Article
Real-World Use of Dalbavancin for Treatment of Soft Tissue and Bone Infection in Children: Safe, Effective and Hospital-Time Sparing
by Désirée Caselli, Marcello Mariani, Claudia Colomba, Chiara Ferrecchi, Claudio Cafagno, Daniela Trotta, Ines Carloni, Daniela Dibello, Elio Castagnola and Maurizio Aricò
Children 2024, 11(1), 78; https://doi.org/10.3390/children11010078 - 9 Jan 2024
Cited by 8 | Viewed by 1954
Abstract
Acute bacterial skin and skin structure infections (ABSSSI) and osteoarticular infections compound the burden of morbidity, mortality and prolonged hospitalizations among gram-positive infections. Dalbavancin, a second-generation, intravenous lipoglycopeptide, due to its prolonged half-life, can be a valuable alternative in their treatment when administered [...] Read more.
Acute bacterial skin and skin structure infections (ABSSSI) and osteoarticular infections compound the burden of morbidity, mortality and prolonged hospitalizations among gram-positive infections. Dalbavancin, a second-generation, intravenous lipoglycopeptide, due to its prolonged half-life, can be a valuable alternative in their treatment when administered as inpatient treatment at the price of an extended hospital stay. Between October 2019 and September 2023, 31 children and adolescents were treated with dalbavancin because of bone and joint infections (n = 12 patients, 39%), ABSSSI (n = 13 patients, 42%), mainly for the limbs, facial cellulitis or complicated ABSSSI (n = 6 patients, 19%), at five Italian pediatric centers. Microbiological study provided gram-positive bacterial isolate in 16 cases, in 11 cases from a positive blood culture; 9 of them were MRSA. Twenty-five patients were initially treated with a different antibiotic therapy: beta-lactam-based in 18 patients (58%), glycopeptide-based in 15 patients (48%) and daptomycin in 6 (19%). The median time that elapsed between admission and start of dalbavancin was 18 days. A total of 61 doses of dalbavancin were administered to the 31 patients: 16 received a single dose while the remaining 15 patients received between two (n = 9) and nine doses. The frequency of administration was weekly in five cases or fortnightly in nine patients. Median length of stay in hospital was 16 days. Median time to discharge after the first dose of dalbavancin was 1 day. Treatment was very well-tolerated: of the 61 administered doses, only four doses, administered to four patients, were associated with an adverse event: drug extravasation during intravenous administration occurred in two patients, with no sequelae; however, in two patients the first administration was stopped soon after infusion start: in one (ID #11), due to headache and vomiting; in another (ID #12) due to a systemic reaction. In both patients, drug infusion was not repeated. None of the remaining 29 patients reported treatment failure (resistant or recurrent disease) or an adverse effect during a median follow-up time of two months. The use of dalbavancin was safe, feasible and also effective in shortening the hospital stay in children and adolescents. Full article
(This article belongs to the Section Pediatric Orthopedics & Sports Medicine)
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