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Children, Volume 10, Issue 1 (January 2023) – 173 articles

Cover Story (view full-size image): The COVID-19 pandemic has placed far-reaching demands on healthcare systems and healthcare institutions worldwide. While the initial focus was on the care of people infected with the severe acute respiratory syndrome coronavirus 2, the treatment of other diseases receded into the background and underwent various changes. Since people with chronic health conditions are particularly dependent on stable and well-adjusted medical care, it is necessary to take a closer look at their healthcare situation: How have families with children with chronic health conditions experienced access to healthcare during the COVID-19 pandemic? As part of the KICK-COVID project (www.kick-covid.de), our study addresses this question for parents of children with three exemplary chronic health conditions (type 1 diabetes, obesity, or juvenile idiopathic arthritis) in Germany. View this paper
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8 pages, 245 KiB  
Article
Lung Ultrasound Role in Diagnosis of Neonatal Respiratory Disorders: A Prospective Cross-Sectional Study
by Rania Ismail, Nehal M. El Raggal, Laila A. Hegazy, Hossam M. Sakr, Osama A. Eldafrawy and Yasmin A. Farid
Children 2023, 10(1), 173; https://doi.org/10.3390/children10010173 - 16 Jan 2023
Cited by 4 | Viewed by 2417
Abstract
Lung ultrasound (LUS) has become one of the most exciting applications in neonatal point-of-care ultrasound (POCUS), yet still lacks routine clinical use. This study assesses the utility of LUS for neonatal respiratory disorders (NRDs) diagnosis and follow-up compared to chest X-ray (CXR). A [...] Read more.
Lung ultrasound (LUS) has become one of the most exciting applications in neonatal point-of-care ultrasound (POCUS), yet still lacks routine clinical use. This study assesses the utility of LUS for neonatal respiratory disorders (NRDs) diagnosis and follow-up compared to chest X-ray (CXR). A prospective cross-sectional study was conducted on 100 neonates having NRDs with a gestational age ≥28 weeks, excluding those having multiple congenital anomalies, chromosomal aberrations, hydrops fetalis and/or heart failure. CXR and LUS were done on admission for diagnosis and were repeated after 7 days, or if needed earlier within the 7 days. The diagnosis of NRDs by CXR and LUS on admission and after 7 days was comparable (p > 0.05). LUS diagnosis sensitivity and specificity for respiratory distress syndrome, pneumonia, meconium aspiration syndrome, pneumothorax and pulmonary atelectasis were 94.7/100%, 97.5/95%, 92.3/100%, 90.9/98.9% and 100/97.8%, respectively. The total agreement between LUS and CXR was 98.5% with 95% CI (0.88 to 0.92). LUS and CXR had considerable agreement in the diagnosis of NRDs. Being a reliable bedside modality of diagnosis and safer than CXR, LUS may be considered an alternative method for the diagnosis of neonates with NRDs. Full article
(This article belongs to the Special Issue Advances in Healthcare for Neonates)
12 pages, 1189 KiB  
Article
Analysis of Clinical Symptoms and Biochemical Parameters in Odontogenic Cellulitis of the Head and Neck Region in Children
by Adrianna Słotwińska-Pawlaczyk, Bogusława Orzechowska-Wylęgała, Katarzyna Latusek and Anna Maria Roszkowska
Children 2023, 10(1), 172; https://doi.org/10.3390/children10010172 - 16 Jan 2023
Cited by 3 | Viewed by 1933
Abstract
Many cases of cellulitis in the head and neck region among hospitalized pediatric patients are related to odontogenic infections. C-reactive protein (CRP), white blood cell (WBC) count, neutrophils to lymphocytes ratio (NLR), D-dimer, and prealbumin can be used to assess the severity of [...] Read more.
Many cases of cellulitis in the head and neck region among hospitalized pediatric patients are related to odontogenic infections. C-reactive protein (CRP), white blood cell (WBC) count, neutrophils to lymphocytes ratio (NLR), D-dimer, and prealbumin can be used to assess the severity of odontogenic inflammation. The aim of the study is to evaluate the biochemical parameters as a predictor factor of the severity of odontogenic cellulitis in children. This study was conducted from 2020 to 2021 on patients admitted to the Department of Pediatric Otolaryngology and Pediatric Head and Neck Surgery of the Upper Silesian Children’s Health Center in Katowice. We included 40 patients aged 2–16 in the study, who were divided into two groups: research (SS-Study subject) (n = 20) and control (CS-Control subject) (n = 20). The patients underwent an interview and physical examination to assess the presence of intraoral and extraoral swelling and the presence of trismus. The patients who qualified for the study had blood taken to determine the level of CRP, WBCs, NLR, D-dimers, and prealbumin. Differences in biochemical test results in the SS and CS were statistically significant (p < 0.05). In the SS group, the mean values of biochemical parameters exceeded the clinical norm. A statistically significant positive relationship was found between CRP and extraoral swelling. The NLR correlates significantly with extraoral swelling and the length of hospitalization. D-dimer statistically correlated with trismus, extraoral swelling, and the number of anatomical spaces involved. The NLR and CRP ratio can be considered a prognostic marker of the course of infection and hospitalization time. Full article
(This article belongs to the Special Issue Oral Health Behaviours and Their Predictors in Children)
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18 pages, 1680 KiB  
Article
The Psychosocial Effect of Parental Cancer: Qualitative Interviews with Patients’ Dependent Children
by Elise S. Alexander, Moira O’Connor and Georgia K. B. Halkett
Children 2023, 10(1), 171; https://doi.org/10.3390/children10010171 - 15 Jan 2023
Cited by 5 | Viewed by 3543
Abstract
Background: Children living with parental cancer are at an increased risk for various psychosocial, emotional, and behavioural problems. However, research regarding how children are affected by their parent’s diagnosis is still developing and patients’ children are typically invisible in clinical practice. This study [...] Read more.
Background: Children living with parental cancer are at an increased risk for various psychosocial, emotional, and behavioural problems. However, research regarding how children are affected by their parent’s diagnosis is still developing and patients’ children are typically invisible in clinical practice. This study aimed to investigate how children are affected by their parent’s cancer diagnosis, from children’s perspectives. Methods: Informed by methods of grounded theory and embedded within a social constructivist framework, twelve children (ranging from 5 to 17 years) living with a parent with cancer were interviewed using a semi-structured format assisted by a novel approach derived from play- and art-based developmental literature. Results: Findings indicate that patients’ children are constantly worried and distressed, and there are barriers that can be overcome to mitigate this. Four overarching themes were identified: (I) Feeling worried and distressed; (II) Comprehending their parent’s cancer diagnosis; (III) Being disconnected from their supports; and (IV) Needing someone to talk to. Conclusions: Children experience considerable levels of ongoing worry and distress when a parent is diagnosed with cancer and have difficulties comprehending and articulating this. They also feel a level of disconnection from their usual support systems (e.g., parents) and are limited regarding who they can seek out and talk to. Mitigating children’s ongoing worries and distress by promoting the availability and accessibility of parents and other supports to children, and reducing communication barriers between children and adults, should be a primary focus of psycho-oncology research and practice. Full article
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11 pages, 1276 KiB  
Article
The Preventable Effect of Taekwondo Sport among Cadets and Junior’ Bone Mineral Density: DEXA Assessment
by Hadeel Ali Ghazzawi, Adam Tawfiq Amawi, Hamza Alduraidi, Malik Juweid, Hussam H. Alhawari, Mousa A. Al-Abbadi, Ali M. Alabbadi and Lana Salah Subhi AlNemer
Children 2023, 10(1), 170; https://doi.org/10.3390/children10010170 - 15 Jan 2023
Cited by 3 | Viewed by 2449
Abstract
Athletes competing in Taekwondo (TKD), the weight-category sport, tend to rapidly lose weight to achieve the desired body weight for better competitive results. Little is known about the effect of rapid weight reduction on bone mass density (BMD), especially during childhood and adolescence. [...] Read more.
Athletes competing in Taekwondo (TKD), the weight-category sport, tend to rapidly lose weight to achieve the desired body weight for better competitive results. Little is known about the effect of rapid weight reduction on bone mass density (BMD), especially during childhood and adolescence. The current study aimed to investigate the impact of rapid weight loss on BMD among cadets and juniors TKD athletes. A descriptive case series study design was conducted and collected from 28 males and females aged 12–17 years old, with mean age 14.4 ± 1.7. Dual-energy X-ray absorptiometry (DEXA) was used for both BMD and body composition assessment, and laboratory tests were also performed for the total calcium (Ca), TSH, free T4 (FT4), and 25-OH-vitamin D. Results showed normal levels of Ca (82.1%), TSH (96.4%), and FT4 (96.4%), whilst 85.7% had vitamin D deficiency. DEXA results showed that within male athletes, juniors had a wider range of BMD than cadets, while within females, results did not vary, with no statistical difference between both males and females. Our results suggested that children and adolescents’ BMD was positively related to TKD sport regardless of the abnormal weight loss strategies used, as evidenced by laboratory results. Children and adolescents should be conscious and practice TKD sport adopting healthy weight loss behaviors. Full article
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8 pages, 792 KiB  
Article
Evaluating Emotional Outcomes of Medical Students in Pediatric Emergency Medicine Telesimulation
by Osamu Nomura, Momoka Sunohara, Ichiro Watanabe and Taichi Itoh
Children 2023, 10(1), 169; https://doi.org/10.3390/children10010169 - 15 Jan 2023
Cited by 2 | Viewed by 1711
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has challenged the feasibility of traditional in-person simulation-based clinical training due to the public health recommendation on social distancing. During the pandemic, telesimulation training was implemented to avoid multiple students and faculties gathering in confined spaces. While [...] Read more.
The coronavirus disease 2019 (COVID-19) pandemic has challenged the feasibility of traditional in-person simulation-based clinical training due to the public health recommendation on social distancing. During the pandemic, telesimulation training was implemented to avoid multiple students and faculties gathering in confined spaces. While medical trainees’ perceived emotions have been acknowledged as a critical outcome of the in-person simulation-based training, the impact of telesimulation on trainees’ emotions has been unexamined. We conducted an educational team-based simulation study with a pediatric case of septic shock. Seventeen and twenty-four medical students participated in the telesimulation training and in-person simulation training, respectively. The institutional pandemic social restrictions at the time of each training session determined the participant assignment to either the telesimulation training or in-person simulation training. All participants responded to the Japanese version of the Medical Emotion Scale, which includes 20 items rated on a five-point Likert-type scale before, during, and after the simulation sessions. The measured emotions were categized into four emotion groups according to two dimensions: positive or negative and activating or deactivating emotions. The one-way analysis of variance between the telesimulation and in-person simulation training revealed no significant differences in the emotions perceived by the participants before, during, and after the simulation training sessions. The perceived emotions of medical students were comparable between the telesimulation and in-person simulation training. Further longitudinal studies with larger samples and multiple variables are needed to generalize the effectiveness of telesimulation. Full article
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8 pages, 2129 KiB  
Article
Concentric Circles: A New Ultrasonographic Sign for the Diagnosis of Normal Infantile Hip Development
by Nikolaos Laliotis, Chrysanthos Chrysanthou and Panagiotis Konstandinidis
Children 2023, 10(1), 168; https://doi.org/10.3390/children10010168 - 15 Jan 2023
Cited by 1 | Viewed by 1565
Abstract
Ultrasound (US) of the infant hip is used to diagnose developmental dysplasia of the hip (DDH). We present a new sonographic sign that describes the periphery of the femoral head and the acetabulum as two concentric circles.During 2008–2019, 3650 infants were referred for [...] Read more.
Ultrasound (US) of the infant hip is used to diagnose developmental dysplasia of the hip (DDH). We present a new sonographic sign that describes the periphery of the femoral head and the acetabulum as two concentric circles.During 2008–2019, 3650 infants were referred for diagnosis of DDH. All underwent a clinical and US examination. We recorded the femoral head as the inner circle, within a fixed external circle, which was identified as the acetabulum. We analysed the clinical signs and risk factors. The US sign of two concentric circles was normal in 3522 infants and was classified as normal hip development. The alpha angle was >60° in 3449 (95%) infants. For the remaining 73 (5%) infants, the alpha angle was 50–60° and underwent further follow-up examination until the alpha angle was normalised. In 128 babies (3.5%), we detected the disruption of the concentric circle sign; the femoral head was found outside the acetabulum, which appeared with an upward sloping roof and the alpha angle was <50°. These infants had DDH and received appropriate treatment. Infants with a concentric circle sign and normal alpha angle are normal, whereas those with a disrupted sign are considered as having DDH. Full article
(This article belongs to the Special Issue Orthopedics and Trauma in Children)
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10 pages, 1633 KiB  
Article
Effect of Diurnal Variation of Heart Rate and Respiratory Rate on Activation of Rapid Response System and Clinical Outcome in Hospitalized Children
by Lia Kim, Kyoung Sung Yun, June Dong Park and Bongjin Lee
Children 2023, 10(1), 167; https://doi.org/10.3390/children10010167 - 14 Jan 2023
Cited by 1 | Viewed by 1670
Abstract
Heart rate and respiratory rate display circadian variation. Pediatric single-parameter rapid response system is activated when heart rate or respiratory rate deviate from age-specific criteria, though activation criteria do not differentiate between daytime and nighttime, and unnecessary activation has been reported due to [...] Read more.
Heart rate and respiratory rate display circadian variation. Pediatric single-parameter rapid response system is activated when heart rate or respiratory rate deviate from age-specific criteria, though activation criteria do not differentiate between daytime and nighttime, and unnecessary activation has been reported due to nighttime bradycardia. We evaluated the relationship between rapid response system activation and the patient’s clinical outcome by separately applying the criteria to daytime and nighttime in patients < 18. The observation period was divided into daytime and nighttime (8:00–20:00, and 20:00 to 8:00), according to which measured heart rate and respiratory rate were divided and rapid response system activation criteria were applied. We classified lower nighttime than daytime values into the ‘decreased group’, and the higher ones into the ‘increased group’, to analyze their effect on cardiopulmonary resuscitation occurrence or intensive care unit transfer. Nighttime heart rate and respiratory rate were lower than the daytime ones in both groups (both p values < 0.001), with no significant association with cardiopulmonary resuscitation occurrence or intensive care unit transfer in either group. Heart rate and respiratory rate tend to be lower at nighttime; however, their effect on the patient’s clinical outcome is not significant. Full article
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10 pages, 242 KiB  
Article
Retrospectively Assessed Muscle Tone and Skin Colour following Airway Suctioning in Video-Recorded Infants Receiving Delivery Room Positive Pressure Ventilation
by Gazmend Berisha, Anne Marthe Boldingh, Britt Nakstad, Elin Wahl Blakstad, Arild Erland Rønnestad and Anne Lee Solevåg
Children 2023, 10(1), 166; https://doi.org/10.3390/children10010166 - 14 Jan 2023
Cited by 1 | Viewed by 1662
Abstract
Background: Recently, the International Liaison Committee on Resuscitation published a systematic review that concluded that routine suctioning of clear amniotic fluid in the delivery room might be associated with lower oxygen saturation (SpO2) and 10 min Apgar score. The aim of [...] Read more.
Background: Recently, the International Liaison Committee on Resuscitation published a systematic review that concluded that routine suctioning of clear amniotic fluid in the delivery room might be associated with lower oxygen saturation (SpO2) and 10 min Apgar score. The aim of this study was to examine the effect of delivery room airway suctioning on the clinical appearance, including muscle tone and skin colour, of video-recorded term and preterm infants born through mainly clear amniotic fluid. Methods: This was a single-centre observational study using transcribed video recordings of neonatal stabilizations. All infants who received delivery room positive pressure ventilation (PPV) from August 2014 to November 2016 were included. The primary outcome was the effect of airway suctioning on muscle tone and skin colour (rated 0–2 according to the Apgar score), while the secondary outcome was the fraction of infants for whom airway suction preceded the initiation of PPV as a surrogate for “routine” airway suctioning. Results: Airway suctioning was performed in 159 out of 302 video recordings and stimulated a vigorous cry in 47 (29.6%) infants, resulting in improvements in muscle tone (p = 0.09) and skin colour (p < 0.001). In 43 (27.0%) infants, airway suctioning preceded the initiation of PPV. Conclusions: In this single-centre observational study, airway suctioning stimulated a vigorous cry with resulting improvements in muscle tone and skin colour. Airway suctioning was often performed prior to the initiation of PPV, indicating a practice of routine suctioning and guideline non-compliance. Full article
(This article belongs to the Special Issue Stabilization and Resuscitation of Newborns: 2nd Edition)
13 pages, 463 KiB  
Article
Parent Perspectives of Ear Health and the Relationship with Children’s Speech and Language in the Longitudinal Study of Indigenous Children
by Anita Morrow, Neil Orr, Kai Nash, Harvey Coates, Cara Cross, John Robert Evans, Hasantha Gunasekera, Samantha Harkus, Linda Harrison, Sharynne McLeod, Catherine McMahon, Katie Neal, Andrea Salins and Rona Macniven
Children 2023, 10(1), 165; https://doi.org/10.3390/children10010165 - 14 Jan 2023
Cited by 1 | Viewed by 2477
Abstract
Health and well-being are holistic concepts that are perceived to be inseparable for Aboriginal and Torres Strait Islander peoples. We examined relationships between parent-reported ear symptoms for 787 Indigenous children at two time points (age 2–3 years, age 4–5 years) and two parent-reported [...] Read more.
Health and well-being are holistic concepts that are perceived to be inseparable for Aboriginal and Torres Strait Islander peoples. We examined relationships between parent-reported ear symptoms for 787 Indigenous children at two time points (age 2–3 years, age 4–5 years) and two parent-reported speech and language outcomes one year later (age 5–6 years). Most parents (80.2%) reported no concern about their child’s expressive language and (93.8%) receptive language. Binary logistic regression models examined ear health as a predictor of children’s expressive and receptive speech and language adjusting for sociodemographic and health covariates. For children without parent-reported ear symptoms, there were lower odds of parental concern about expressive speech and language (aOR = 0.45; 95% CI 0.21–0.99) and receptive language (aOR = 0.24; 95% CI 0.09–0.62). Parents were less likely to have concerns about the child’s expressive speech and language if their child was female, lived in urban or regional areas, had excellent or very good global health, or had no disability when aged 2–5 years. Since parent-reported ear health and speech and language concerns were related, Aboriginal and Torres Strait Islander children could benefit from culturally safe, strength-based, and family-centered integrated speech, language, and ear health services. Full article
(This article belongs to the Special Issue Cognitive and Linguistic Development in Children and Adolescents)
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15 pages, 2540 KiB  
Article
The Development and Usability of a Mobile App for Parents of Children with ADHD
by Costina-Ruxandra Păsărelu, Reka Kertesz and Anca Dobrean
Children 2023, 10(1), 164; https://doi.org/10.3390/children10010164 - 14 Jan 2023
Cited by 6 | Viewed by 2805
Abstract
Background: Attention-Deficit/ Hyperactivity Disorder (ADHD) is one of the most prevalent mental health problems in children. Behavioral parent training (BPT) is the first-line treatment recommended by clinical guidelines; however, parental dropout is high. Mobile apps could be used as an adjunct to BPT [...] Read more.
Background: Attention-Deficit/ Hyperactivity Disorder (ADHD) is one of the most prevalent mental health problems in children. Behavioral parent training (BPT) is the first-line treatment recommended by clinical guidelines; however, parental dropout is high. Mobile apps could be used as an adjunct to BPT in order to increase treatment adherence, homework compliance, and parental engagement. In this paper, we describe the development process of a mobile app for parents of children with ADHD. Methods: We conducted a study to investigate parents’ perceived usability of the ADHD Coping Card. Results: The mobile app developed has a high usability. Future improvements in the app were suggested by parents. Conclusions: Given the increasing importance of digital mental health interventions in psychotherapy, it is important that future research is conducted with a higher number of participants to investigate the key factors implicated in choosing such an intervention in the future, both by parents and by mental health specialists. A mobile app can be used as an add-on in psychotherapy with parents of children with ADHD. Digital health interventions could help surpass gaps in treatment access for child mental health problems. Full article
(This article belongs to the Special Issue Child and Adolescent Psychiatry and Mental Health)
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11 pages, 839 KiB  
Article
Levels of Physical Activity, Family Functioning and Self-Concept in Elementary and High School Education Students: A Structural Equation Model
by Félix Zurita-Ortega, José Manuel Alonso-Vargas, Pilar Puertas-Molero, Gabriel González-Valero, José Luis Ubago-Jiménez and Eduardo Melguizo-Ibáñez
Children 2023, 10(1), 163; https://doi.org/10.3390/children10010163 - 14 Jan 2023
Cited by 1 | Viewed by 1906
Abstract
In the adolescent population there is great concern about low levels of physical activity and low levels of family awareness of the benefits of physical exercise on physical and mental health. This study aims to determine the influence of physical activity levels, family [...] Read more.
In the adolescent population there is great concern about low levels of physical activity and low levels of family awareness of the benefits of physical exercise on physical and mental health. This study aims to determine the influence of physical activity levels, family functioning and self-concept in primary and secondary school students, as well as to develop a structural equation model as a function of weekly physical activity time. A descriptive, cross-sectional, comparative study was conducted on whether students engage in more than three hours of physical activity per week. To collect the data, instruments validated by the scientific community were used, such as the Adaptability, Partnership, Growth, Affection, and Resolve family questionnaire (APGAR) and the self-concept questionnaire form 5. The results show that those students who engage in more than 3 h of physical activity per week have higher levels of family functioning than those who do not meet this sport criterion. In addition, physically active students show higher scores on all dimensions of self-concept than those who practice less than 3 h of physical activity per week. Finally, as a conclusion, it can be affirmed that the amount of physical activity practice brings benefits to student’s mental health. Full article
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12 pages, 6712 KiB  
Article
Allogeneic Mesenchymal Stromal Cells as a Global Pediatric Prospective Approach in the Treatment of Respiratory Failure Associated with Surfactant Protein C Dysfunction
by Gloria Pelizzo, Maria Antonietta Avanzini, Stefania Croce, Anna Mandelli, Elisa Lenta, Andrea Farolfi, Chiara Valsecchi, Salvatore Zirpoli, Giulia Lanfranchi, Eleonora Durante, Elena Zoia, Gianvincenzo Zuccotti and Valeria Calcaterra
Children 2023, 10(1), 162; https://doi.org/10.3390/children10010162 - 14 Jan 2023
Cited by 1 | Viewed by 1549
Abstract
Mesenchymal stromal cells (MSCs) have been proposed as a new therapeutic strategy to treat congenital and acquired respiratory system diseases. We describe a case report of an 18-month-old male patient with progressive chronic respiratory failure, associated with mutations of the surfactant protein C [...] Read more.
Mesenchymal stromal cells (MSCs) have been proposed as a new therapeutic strategy to treat congenital and acquired respiratory system diseases. We describe a case report of an 18-month-old male patient with progressive chronic respiratory failure, associated with mutations of the surfactant protein C gene (SFTPC) due to c.289G > T variant p.Gly97Ser (rs927644577) and c.176A > G variant (p.His59Arg), submitted to repeated intravenous infusions of allogeneic bone marrow (BM) MSCs. The clinical condition of the patient was monitored. Immunologic studies before and during MSC treatment were performed. No adverse events related to the MSC infusions were recorded. Throughout the MSC treatment period, the patient showed a growth recovery. Starting the second infusion, the patient experienced an improvement in his respiratory condition, with progressive adaptation to mechanical ventilation. After the third infusion, five hours/die of spontaneous breathing was shown, and after infusion IV, spontaneous ventilation for 24/24 h was recorded. A gradual decrease of lymphocytes and cell subpopulations was observed. No variations in the in vitro T cell response to PHA were determined by MSC treatment as well as for the in vitro B cell response. A decrease in IFN-γ, TNF-α, and IL-10 levels was also detected. Even though we cannot exclude an improvement of pulmonary function due to the physiological maturation, the well-known action of MSCs in the repair of lung tissue, together with the sequence of events observed in our patient, may support the therapeutic role of MSCs in this clinical condition. However, further investigations are necessary to confirm the result and long-term follow-up will be mandatory to confirm the benefits on the pulmonary condition. Full article
(This article belongs to the Special Issue Lung Function, Respiratory and Asthma Disease in Children)
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8 pages, 874 KiB  
Article
Delta Neutrophil Index Does Not Differentiate Bacterial Infection without Bacteremia from Viral Infection in Pediatric Febrile Patients
by Maro Kim, Jin Hee Lee, Young Ho Kwak, Hyun Kyung Kim, Hyuksool Kwon, Dongbum Suh, Do Kyun Kim, Ha Ni Lee, Jin Hee Kim, Jie Hee Jue and Soyun Hwang
Children 2023, 10(1), 161; https://doi.org/10.3390/children10010161 - 14 Jan 2023
Cited by 1 | Viewed by 1402
Abstract
Introduction: We sought to determine whether the delta neutrophil index (DNI), a marker that is reported to be used to predict the diagnosis, prognosis, and disease severity of bacteremia and sepsis, is useful in differentiating bacterial infection without bacteremia (BIWB) from viral infections [...] Read more.
Introduction: We sought to determine whether the delta neutrophil index (DNI), a marker that is reported to be used to predict the diagnosis, prognosis, and disease severity of bacteremia and sepsis, is useful in differentiating bacterial infection without bacteremia (BIWB) from viral infections (VI) in pediatric febrile patients in the emergency department (ED). Method: We conducted a retrospective analysis of febrile patients’ medical records from the pediatric ED of the teaching hospital. The patients with BIWB and those with VI were identified with a review of medical records. The primary outcome was the diagnostic performance of DNI in differentiating BIWB from VI. The secondary outcome was a comparison of the diagnostic performances of DNI, CRP, WBC, and neutrophil count between the two groups. Results: A total of 151 (26.3%) patients were in the BIWB group, and 423 (73.7%) were in the VI group. There was no significant difference in DNI between the two groups (3.51 ± 6.90 vs. 3.07 ± 5.82, mean ± SD, BIWB vs. VI). However, CRP levels were significantly higher in the BIWB group than in the VI group (4.56 ± 5.45 vs. 1.39 ± 2.12, mean ± SD, BIWB vs. VI, p < 0.05). The AUROCs of DNI, WBC count, neutrophil levels, RDW, and CRP levels were 0.5016, 0.5531, 0.5631, 0.5131, and 0.7389, respectively, and only CRP levels were helpful in differentiating BIWB from VI. Conclusion: In the absence of bacteremia, DNI would not be helpful in differentiating BIWB from VI in pediatric febrile patients. Full article
(This article belongs to the Section Pediatric Infectious Diseases)
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13 pages, 919 KiB  
Article
Impact of Delayed Time to Antibiotics in Medical and Surgical Necrotizing Enterocolitis
by Katherine E. Chetta, Katherine G. Vincent, Bresney Fanning, Ashley B. Klumb, Justin A. Chetta, Allison M. Rohrer, Leslie H. Spence and Jeanne G. Hill
Children 2023, 10(1), 160; https://doi.org/10.3390/children10010160 - 14 Jan 2023
Cited by 4 | Viewed by 2630
Abstract
This study investigated whether delayed receipt of antibiotics in infants with necrotizing enterocolitis (NEC) is associated with disease severity. In this retrospective, single-center cohort study of infants diagnosed with NEC over 4 years, we compared the timing of antibiotic administration in infants (time [...] Read more.
This study investigated whether delayed receipt of antibiotics in infants with necrotizing enterocolitis (NEC) is associated with disease severity. In this retrospective, single-center cohort study of infants diagnosed with NEC over 4 years, we compared the timing of antibiotic administration in infants (time order placed to time of receipt) in medical and surgical NEC. Cases were independently reviewed, then various clinical factors were compared. Of 46 suspected cases, 25 were confirmed by a panel of radiologists with good interrater reliability (ICC 0.657; p < 0.001). Delays in antibiotic receipt were 1.7× greater in surgical than medical NEC cases (p = 0.049). Every hour after order entry increased the adjusted odds of surgical NEC by 2.4 (1.08–5.23; p = 0.032). Delayed antibiotic receipt was more common in infants with surgical than medical NEC. Larger studies will be needed to investigate if optimizing antibiotic expediency could improve intestinal outcomes. Full article
(This article belongs to the Special Issue Practical Issues in Treatment of Preterm Infants)
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13 pages, 431 KiB  
Article
Change in Prevalence of Hypertension among Korean Children and Adolescents during the Coronavirus Disease 2019 (COVID-19) Outbreak: A Population-Based Study
by Kyungchul Song, Se Yong Jung, Juyeon Yang, Hye Sun Lee, Ho-Seong Kim and Hyun Wook Chae
Children 2023, 10(1), 159; https://doi.org/10.3390/children10010159 - 14 Jan 2023
Cited by 6 | Viewed by 1884
Abstract
During the coronavirus disease 2019 (COVID-19) outbreak, the prevalence of obesity increased globally; this may be associated with hypertension incidence. However, investigations on the changes in the prevalence of hypertension among children and adolescents are limited. This cross-sectional study investigated the prevalence of [...] Read more.
During the coronavirus disease 2019 (COVID-19) outbreak, the prevalence of obesity increased globally; this may be associated with hypertension incidence. However, investigations on the changes in the prevalence of hypertension among children and adolescents are limited. This cross-sectional study investigated the prevalence of hypertension among 1428 youths aged 10–18 years using data from the Korea National Health and Nutrition Examination Survey 2018–2020. We assessed the prevalence of hypertension according to sex, age, body mass index (BMI), and residential district. The prevalence of hypertension increased from 7.1% to 12.5% in all participants. In the sex-specific analysis, the prevalence was found to be increased in boys. In the age-specific analysis, the prevalence was found to be increased in youths aged 13–15 years. In the BMI-specific analysis, an increase in the prevalence was prominent in the normal BMI group. In the residential district-specific analysis, the prevalence of hypertension among youth increased in urban areas. Our results show that the prevalence of hypertension increased among Korean children and adolescents during the COVID-19 outbreak. These findings suggest the importance of close monitoring of hypertension among youth during the COVID-19 pandemic. Full article
(This article belongs to the Special Issue Cardiovascular Disease in Children)
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11 pages, 1070 KiB  
Article
Gentle Touch and Sucrose for Pain Relief during Suctioning in Preterm Newborns—A Randomized Clinical Trial
by Nayara Rodrigues Gomes de Oliveira, Cibelle Kayenne Martins Roberto Formiga, Bruna Abreu Ramos, Rafaela Noleto dos Santos, Nayara Nubia de Sousa Moreira, Patricia Gonçalves Evangelista Marçal and Waldemar Naves do Amaral
Children 2023, 10(1), 158; https://doi.org/10.3390/children10010158 - 13 Jan 2023
Cited by 2 | Viewed by 2001
Abstract
Pain management is challenging in neonatal care. We aimed to compare the effects of gentle touch and sucrose on pain relief during suctioning in premature newborns (PTNB). This crossover randomized clinical trial enrolled PTNBs with low birth weight, hemodynamically stable, and requiring suctioning [...] Read more.
Pain management is challenging in neonatal care. We aimed to compare the effects of gentle touch and sucrose on pain relief during suctioning in premature newborns (PTNB). This crossover randomized clinical trial enrolled PTNBs with low birth weight, hemodynamically stable, and requiring suctioning during hospitalization in the neonatal intensive care unit. PTNBs underwent three different suctioning procedures. The first was performed without intervention (baseline). Right after, PTNBs were randomly allocated (sucrose and gentle touch or vice versa) to the next two suctioning procedures. Two validated scales assessed pain: the Neonatal Infant Pain Scale (NIPS) and the Premature Infant Pain Profile-Revised (PIPP-R). We evaluated 50 PTNBs (mean of 28 weeks) with a mean low birth weight of 1050 g; most were under continuous positive airway pressure 37 (74%) and mechanical ventilation 41 (82%). Gentle touch was efficacious for pain relief since NIPS (p = 0.010) compared to baseline. Sucrose was also effective in reducing pain NIPS and PIPP-R (p < 0.001). Although the two interventions reduced pain, no difference was observed between gentle touch and sucrose. Full article
(This article belongs to the Special Issue Practical Issues in Treatment of Preterm Infants)
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10 pages, 1085 KiB  
Article
How Football Players’ Age Affect Passing Patterns of Play According to Field Location
by Nuno Coito, Hugo Folgado, Diogo Monteiro and Bruno Travassos
Children 2023, 10(1), 157; https://doi.org/10.3390/children10010157 - 13 Jan 2023
Viewed by 2069
Abstract
This study aimed to characterize the passing patterns that support collective tactical behaviour in football players of different ages (U15, U17, and U19) in different field zones. Two hundred and twenty-eight male players, divided into U15, U17, and U19, participated in the study. [...] Read more.
This study aimed to characterize the passing patterns that support collective tactical behaviour in football players of different ages (U15, U17, and U19) in different field zones. Two hundred and twenty-eight male players, divided into U15, U17, and U19, participated in the study. Cluster analysis was used to group the passes into three sizes (short, medium, and long). The chi-square test was used to analyse the effect of player age on game-passing patterns in each field zone. The results revealed that long and medium passes were used more in areas close to the goals and short passes in the middle area of the field, concerning all ages (p < 0.001). Furthermore, the analysis of the relative distance between the ball carrier and the receiver indicated that older players (U17 and U19) used more distant players to pass the ball in medium and long passes. These results can help coaches design small-sided games according to the players’ ages and adjust to the field’s space and the numerical relationship, thus creating a greater transfer from training to competition. Full article
(This article belongs to the Special Issue Sports Science in Children)
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9 pages, 7966 KiB  
Case Report
A Rare Complication of Thoracic Spine Surgery: Pediatric Horner’s Syndrome after Posterior Vertebral Column Resection—A Case Report
by Pawel Grabala, Kinga Danowska-Idziok and Ilkka J. Helenius
Children 2023, 10(1), 156; https://doi.org/10.3390/children10010156 - 13 Jan 2023
Cited by 1 | Viewed by 1782
Abstract
Background: Horner’s syndrome (HS) classically consists of the symptom triad of miosis, ptosis, and anhidrosis. It is caused by impairment of a certain pathway in the sympathetic nervous system. It may also appear as part of the clinical signs of other diseases and [...] Read more.
Background: Horner’s syndrome (HS) classically consists of the symptom triad of miosis, ptosis, and anhidrosis. It is caused by impairment of a certain pathway in the sympathetic nervous system. It may also appear as part of the clinical signs of other diseases and syndromes, including Pancoast tumors, intradural and/or epidural tumors, thoracic outlet syndrome, syringomyelia, brachial plexus injury, and aortic dissection. Here, we report a very rare complication of vertebral column resection in children, and we present the clinical findings of a case of Horner’s syndrome with a current literature review. Case presentation: A five-year-old child with severe congenital kyphoscoliosis qualified for surgical treatment of the spinal deformity via a posterior approach, with three-column osteotomy and fusion. Results: After successful surgery, the patient presented with HS due to distraction of the sympathetic nerve trunk and, thus, innervation to the left eye. At the 4-year follow-up, the child had fully recovered. Conclusions: Pediatric HS after posterior instrumented scoliosis correction surgery with posterior vertebral column resection of the thoracic spine is very rare. This is the first reported case of HS after posterior vertebral column resection and spinal fusion for congenital kyphoscoliosis without the use of epidural analgesia. Symptom resolution may be variable and, in some cases, delayed. Full article
(This article belongs to the Special Issue Advance in Pediatric Surgery)
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11 pages, 502 KiB  
Perspective
Disabilities in Early Childhood: A Global Health Perspective
by Bolajoko O. Olusanya, Claudine Storbeck, Vivian G. Cheung and Mijna Hadders-Algra
Children 2023, 10(1), 155; https://doi.org/10.3390/children10010155 - 12 Jan 2023
Cited by 1 | Viewed by 4328
Abstract
Prior to the launch of the United Nations’ Sustainable Development Goals (SDGs) in 2015, childhood disability was rarely considered an important subject in global health. The SDGs till 2030 now require that children under 5 years who are at risk of not benefitting [...] Read more.
Prior to the launch of the United Nations’ Sustainable Development Goals (SDGs) in 2015, childhood disability was rarely considered an important subject in global health. The SDGs till 2030 now require that children under 5 years who are at risk of not benefitting from inclusive quality education are identified, monitored, and promptly supported. A new tool for identifying children who are not developmentally on track has been developed by UNICEF but has limited sensitivity for detecting children with disabilities due to reliance on parental assessment of child behavior in certain everyday situations. In this paper, we identified conditions that are commonly associated with developmental disabilities based on the International Classification of Diseases (ICD) codes and clarified the concept of “developmentally on track” as it relates to children with developmental disabilities and developmental delays. We summarized the latest evidence on the global burden of developmental disabilities in children under 5 years based on the diagnostic and functional approaches for measuring disabilities at the population level. We highlighted the global health context for addressing the needs of children with developmental disabilities and provided an overview of the opportunities and the role of pediatric caregivers in supporting children with developmental disabilities. Full article
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12 pages, 641 KiB  
Article
Adapting the Motivated Strategies for Learning Questionnaire to the Japanese Problem-Based Learning Context: A Validation Study
by Osamu Nomura, Yuki Soma, Hiroshi Kijima and Yasushi Matsuyama
Children 2023, 10(1), 154; https://doi.org/10.3390/children10010154 - 12 Jan 2023
Cited by 1 | Viewed by 2256
Abstract
The COVID-19 pandemic has greatly changed medical education, and medical trainees’ self-regulation has become more emphasized. In Japan, the concept of self-regulated learning has not been fully applied in health profession education due to a lack of effective measurement tools. We aimed to [...] Read more.
The COVID-19 pandemic has greatly changed medical education, and medical trainees’ self-regulation has become more emphasized. In Japan, the concept of self-regulated learning has not been fully applied in health profession education due to a lack of effective measurement tools. We aimed to validate the translated Japanese version of the Motivated Strategies for Learning Questionnaire in the context of Problem-Based Learning (J-MSLQ-PBL). The questionnaire employs a seven-point Likert-type scale with 81 items and is categorized into two sections: motivation and learning strategies. An exploratory factor analysis (EFA) was conducted by using Promax rotation to examine the factor structure of the scale, using the collected data from 112 Japanese medical students. Factor extraction was based on a scree plot investigation, and an item was accepted when the factor loading was ≥0.40. In the motivation section, the extracted factors from the EFA were well aligned with the subscales of the original MSLQ, including “Self-Efficacy for Learning and Performance”, “Task Value”, “Self-Efficacy for Learning and Performance”, “Test Anxiety”, “Extrinsic Goal Orientation”, and “Intrinsic Goal Orientation”. In the learning strategies, the extracted factors poorly matched the structure of the original subscales. This discrepancy could be explained by insufficient translation, the limited sample size from a single medical school, or cross-cultural differences in learning strategies between Western and Japanese medical students. Only the motivation part of the J-MSLQ-PBL should be implemented to measure the competency elements of self-regulated learning in Japan. Full article
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13 pages, 984 KiB  
Article
The Effectiveness of Computer Aided Video Modeling in Teaching Basic Basketball Movements to Individuals with Down Syndrome
by Aslan Aydogan and Mukaddes Sakalli Demirok
Children 2023, 10(1), 153; https://doi.org/10.3390/children10010153 - 12 Jan 2023
Cited by 2 | Viewed by 1781
Abstract
In this study, the effectiveness of the video modeling method in teaching basic basketball skills to students with Down syndrome was examined. Four students with Down syndrome, who were studying at the disability free living center in Dolayaba, participated in this study. The [...] Read more.
In this study, the effectiveness of the video modeling method in teaching basic basketball skills to students with Down syndrome was examined. Four students with Down syndrome, who were studying at the disability free living center in Dolayaba, participated in this study. The ages of the students diagnosed with Down syndrome were as follows: two of them were 13, the others were 14 and 16. In the study, the effectiveness of video modeling in teaching basic basketball skills was evaluated using the multiple probe model, one of the single-subject research methods. The experimental process of the study consisted of collecting baseline data, daily, conducting instructional sessions, maintenance and generalization stages. The findings of the study showed that video modeling was effective in teaching basic basketball skills to students with Down syndrome and that they maintained the skills in interpersonal and environmental differences after the end of the instruction. When the opinions of the basketball teacher and the students were evaluated, it was determined that the students’ self-confidence and peer relations were strengthened thanks to their active participation in the lessons. The students were not bored because they stated that they found the lessons interesting and fun. Full article
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17 pages, 3328 KiB  
Review
Common Errors in the Management of Idiopathic Clubfeet Using the Ponseti Method: A Review of the Literature
by Sean B. Youn, Ashish S. Ranade, Anil Agarwal and Mohan V. Belthur
Children 2023, 10(1), 152; https://doi.org/10.3390/children10010152 - 12 Jan 2023
Cited by 1 | Viewed by 3075
Abstract
Congenital talipes equinovarus is one of the most prevalent birth defects, affecting approximately 0.6 to 1.5 children per 1000 live births. Currently, the Ponseti method is the gold-standard treatment for idiopathic clubfeet, with good results reported globally. This literature review focuses on common [...] Read more.
Congenital talipes equinovarus is one of the most prevalent birth defects, affecting approximately 0.6 to 1.5 children per 1000 live births. Currently, the Ponseti method is the gold-standard treatment for idiopathic clubfeet, with good results reported globally. This literature review focuses on common errors encountered during different stages of the management of idiopathic clubfeet, namely diagnosis, manipulation, serial casting, Achilles tenotomy, and bracing. The purpose is to update clinicians and provide broad guidelines that can be followed to avoid and manage these errors to optimize short- and long-term outcomes of treatment of idiopathic clubfeet using the Ponseti method. A literature search was performed using the following keywords: “Idiopathic Clubfoot” (All Fields) AND “Management” OR “Outcomes” (All Fields). Databases searched included PubMed, EMBASE, Cochrane Library, Google Scholar, and SCOPUS (age range: 0–12 months). A full-text review of these articles was then performed looking for “complications” or “errors” reported during the treatment process. A total of 61 articles were included in the final review: 28 from PubMed, 8 from EMBASE, 17 from Google Scholar, 2 from Cochrane Library, and 6 from SCOPUS. We then grouped the errors encountered during the treatment process under the different stages of the treatment protocol (diagnosis, manipulation and casting, tenotomy, and bracing) to facilitate discussion and highlight solutions. While the Ponseti method is currently the gold standard in clubfoot treatment, its precise and intensive nature can present clinicians, health care providers, and patients with potential problems if proper diligence and attention to detail is lacking. The purpose of this paper is to highlight common mistakes made throughout the Ponseti treatment protocol from diagnosis to bracing to optimize care for these patients. Full article
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21 pages, 1045 KiB  
Article
Regional Differences in Chinese Female Demand for Childcare Services of 0–3 Years: The Moderating and Mediating Effects of Family Childcare Context
by Chuanfang Chen, Huimin Hu and Renbing Shi
Children 2023, 10(1), 151; https://doi.org/10.3390/children10010151 - 12 Jan 2023
Cited by 1 | Viewed by 2574
Abstract
There are multiple reasons to consider the use of formal childcare: parental employment, child development, fertility choices, elderly health, generational relations, etc. This study explores the relationship between regional differences (urban/rural; eastern/central/western) and demand for childcare services (quantity, price, quality) from birth to [...] Read more.
There are multiple reasons to consider the use of formal childcare: parental employment, child development, fertility choices, elderly health, generational relations, etc. This study explores the relationship between regional differences (urban/rural; eastern/central/western) and demand for childcare services (quantity, price, quality) from birth to three years of age, moderated and mediated by the family childcare contexts among Chinese women. Altogether, 1770 mothers of children aged 0–3 were selected from a national survey and analyzed. There are three major findings: (1) Urban mothers show a willingness to spend on the higher monetary cost of center-based childcare compared to rural mothers, as a result of more severe work–child conflicts faced by urban women. Urban–rural gaps in individual and household income also contribute to the differences in affordability. (2) Mothers in eastern China have a more substantial need to place their infants or toddlers in nurseries before the age of three than their counterparts in central and western China, primarily due to a lack of grandparental and paternal childcare support and an expectation of higher quality programs. (3) There is no significant regional disparity in terms of care-related or education-related quality preferences. The paper proposes regional prioritized strategies and targeted services to address the “3A” problems of childcare provision. Full article
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9 pages, 360 KiB  
Article
A Link between Parental Psychopathology and Preschool Depression: Take Care of Parents to Take Care of Children
by Melania Martucci, Franca Aceti, Nicoletta Giacchetti, Veronica Scarselli and Carla Sogos
Children 2023, 10(1), 150; https://doi.org/10.3390/children10010150 - 12 Jan 2023
Cited by 2 | Viewed by 2003
Abstract
There is a lot of evidence in the literature showing that early-onset depression determines an emotional and cognitive vulnerability for psychiatric disorders in subsequent years. AIMS: The first aim of this outcome research was to analyze the impact of parental support treatment in [...] Read more.
There is a lot of evidence in the literature showing that early-onset depression determines an emotional and cognitive vulnerability for psychiatric disorders in subsequent years. AIMS: The first aim of this outcome research was to analyze the impact of parental support treatment in a sample of depressed preschool children divided into two groups of comparison (under-reactive and over-reactive) through evolution in the Clinical Global Impression (CGI). The second aim was to analyze the correlation between the presence of parental psychopathology and the severity of children’s disorders. METHODS: Our clinical sample consisted of 32 preschool-age children with a final diagnosis of MDD. The children’s assessment included a psychiatric assessment to establish a diagnosis of MDD, confirmed by means of a semi-structured interview, which was administered again one month after the end of parental treatment. All the parents began a six-month parent training treatment conducted by experienced child psychiatrists, whereas children were not treated. During this period, the Clinical Global Impression Scale (CGI) was filled out monthly in order to observe the evolution of the children’s disorders. Results: Post-hoc tests showed a significant difference from before the treatment to after the treatment only in the over-reactive group (p = 0.00). Regarding parental psychiatric disorders, in the over-reactive group, only 3 children had no parents with psychopathology. In the under-reactive group, no child lacked a parent with psychopathology. Conclusion: Parent training treatment seems to be a valid intervention to improve preschool depression, especially in over-reactive groups, and to prevent dysfunctional parental styles connected to parental psychopathology. Full article
(This article belongs to the Special Issue Updates on Perinatal Depression and Child Developmental Disorders)
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18 pages, 1018 KiB  
Review
Diagnosis and Management of Cancer Treatment-Related Cardiac Dysfunction and Heart Failure in Children
by Mohamed Hegazy, Stephanie Ghaleb and Bibhuti B Das
Children 2023, 10(1), 149; https://doi.org/10.3390/children10010149 - 12 Jan 2023
Cited by 5 | Viewed by 3353
Abstract
It is disheartening for parents to discover that their children have long-term cardiac dysfunction after being cured of life-threatening childhood cancers. As the number of childhood cancer survivors increases, early and late oncology-therapy-related cardiovascular complications continues to rise. It is essential to understand [...] Read more.
It is disheartening for parents to discover that their children have long-term cardiac dysfunction after being cured of life-threatening childhood cancers. As the number of childhood cancer survivors increases, early and late oncology-therapy-related cardiovascular complications continues to rise. It is essential to understand that cardiotoxicity in childhood cancer survivors is persistent and progressive. A child’s cancer experience extends throughout his lifetime, and ongoing care for long-term survivors is recognized as an essential part of the cancer care continuum. Initially, there was a lack of recognition of late cardiotoxicities related to cancer therapy. About 38 years ago, in 1984, pioneers like Dr. Lipshultz and others published anecdotal case reports of late cardiotoxicities in children and adolescents exposed to chemotherapy, including some who ended up with heart transplantation. At that time, cardiac tests for cancer survivors were denied by insurance companies because they did not meet appropriate use criteria. Since then, cardio-oncology has been an emerging field of cardiology that focuses on the early detection of cancer therapy-related cardiac dysfunction occurring during and after oncological treatment. The passionate pursuit of many healthcare professionals to make life better for childhood cancer survivors led to more than 10,000 peer-reviewed publications in the last 40 years. We synthesized the existing evidence-based practice and described our experiences in this review to share our current method of surveillance and management of cardiac dysfunction related to cancer therapy. This review aims to discuss the pathological basis of cancer therapy-related cardiac dysfunction and heart failure, how to stratify patients prone to cardiotoxicity by identifying modifiable risk factors, early detection of cardiac dysfunction, and prevention and management of heart failure during and after cancer therapy in children. We emphasize serial longitudinal follow-ups of childhood cancer survivors and targeted intervention for high-risk patients. We describe our experience with the new paradigm of cardio-oncology care, and collaboration between cardiologist and oncologist is needed to maximize cancer survival while minimizing late cardiotoxicity. Full article
(This article belongs to the Section Pediatric Cardiology)
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12 pages, 1388 KiB  
Study Protocol
Effect of Intermediate Airway Management on Ventilation Parameters in Simulated Pediatric Out-of-Hospital Cardiac Arrest: Protocol for a Multicenter, Randomized, Crossover Trial
by Loric Stuby, Elisa Mühlemann, Laurent Jampen, David Thurre, Johan N. Siebert and Laurent Suppan
Children 2023, 10(1), 148; https://doi.org/10.3390/children10010148 - 12 Jan 2023
Viewed by 2116
Abstract
Most pediatric out-of-hospital cardiac arrests (OHCAs) are caused by hypoxia, which is generally consecutive to respiratory failure. To restore oxygenation, prehospital providers usually first use basic airway management techniques, i.e., bag-valve-mask (BVM) devices. These devices present several drawbacks, most of which could be [...] Read more.
Most pediatric out-of-hospital cardiac arrests (OHCAs) are caused by hypoxia, which is generally consecutive to respiratory failure. To restore oxygenation, prehospital providers usually first use basic airway management techniques, i.e., bag-valve-mask (BVM) devices. These devices present several drawbacks, most of which could be avoided using supraglottic airway devices. These intermediate airway management (IAM) devices also present significant advantages over tracheal intubation: they are associated with higher success and lower complication rates in the prehospital setting. There are, however, few data regarding the effect of early IAM in pediatric OHCA. This paper details the protocol of a trial designed to evaluate the impact of this airway management strategy on ventilation parameters through a simulated, multicenter, randomized, crossover trial. The hypothesis underlying this study protocol is that early IAM without prior BVM ventilations could improve the ventilation parameters in comparison with the standard approach, which consists in BVM ventilations only. Full article
(This article belongs to the Special Issue Pediatric Airway Management: Advances and Future Challenges)
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10 pages, 1377 KiB  
Article
Drug Prescriptions Requiring Compounding at a Canadian University Affiliated Pediatric Hospital: A Cross-Sectional Study
by Émilie Kate Landry, Julie Autmizguine, Sophie Bérubé, Raphael Kraus, Marie-Élaine Métras, Denis Lebel and Catherine Litalien
Children 2023, 10(1), 147; https://doi.org/10.3390/children10010147 - 11 Jan 2023
Viewed by 1740
Abstract
Despite ongoing international efforts, many drugs administered to children must be compounded from dosage forms designed for adults because they remain unavailable in commercial formulations that suit their needs. Even though oral drug compounding is common in pediatrics, the extent of this practice [...] Read more.
Despite ongoing international efforts, many drugs administered to children must be compounded from dosage forms designed for adults because they remain unavailable in commercial formulations that suit their needs. Even though oral drug compounding is common in pediatrics, the extent of this practice has not been well described in recent years. This cross-sectional and retrospective study was conducted at a Canadian university-affiliated, 484-bed, tertiary care pediatric hospital and its rehabilitation centre on two randomly selected days. A total of 606 hospitalized children with 5465 prescriptions were included. Overall, compounded drugs for enteral administration (CDEA) represented 13% of all prescriptions (enteral and parenteral) and 23% of prescriptions for enteral administration. Of the 390 prescribed drugs, 122 required compounding. CDEA were mostly liquids (n = 478 [67%]) and mainly included drugs of the central nervous (35%), cardiovascular (21%), and gastro-intestinal (12%) systems. Nearly half (N = 298 [49%]) of children had at least one CDEA prescribed in their medical file. Many CDEA are available as commercial products in other jurisdictions. Collaboration is needed between all stakeholders to make these drugs available to Canadian children. Full article
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13 pages, 286 KiB  
Article
Validation of the Arabic Version of Strengths and Difficulties Questionnaire in Early Childhood Education in Qatar
by Maha Al-Hendawi
Children 2023, 10(1), 146; https://doi.org/10.3390/children10010146 - 11 Jan 2023
Viewed by 1395
Abstract
This study examined the validity of the Arabic version of the Strengths and Difficulties Questionnaire (SQD, teacher version) among a sample of young children in Qatar. Teachers rated 502 children aged four to five years from public preschools using the SDQ teacher version. [...] Read more.
This study examined the validity of the Arabic version of the Strengths and Difficulties Questionnaire (SQD, teacher version) among a sample of young children in Qatar. Teachers rated 502 children aged four to five years from public preschools using the SDQ teacher version. The factor structure of the SDQ was analyzed using exploratory and confirmatory factor analyses. I calculated Cronbach’s alpha coefficient and item–total correlations to determine the reliability of the five subscales and overall SDQ. The findings showed acceptable reliability, with the exception of the Peer Problems Scale. Common fit statistics—including the comparative fit index, non-normed fit index, and goodness-of-fit index—were used for the confirmatory factor analysis. In general, satisfactory psychometric characteristics were observed for the preschool SDQ, suggesting that the questionnaire could be administered to preschool-age children in Qatar. Full article
17 pages, 317 KiB  
Article
Early Years Physical Activity and Motor Skills Intervention—A Feasibility Study to Evaluate an Existing Training Programme for Early Years Educators
by Laura Basterfield, Theodora Machaira, Dan Jones, Tim Rapley, Vera Araujo-Soares, Neil Cameron and Liane B. Azevedo
Children 2023, 10(1), 145; https://doi.org/10.3390/children10010145 - 11 Jan 2023
Cited by 1 | Viewed by 2149
Abstract
A lack of fundamental motor skills (FMS) in the early years can lead to lower engagement with physical activity (PA), and track into adulthood. This study aimed to test the feasibility of an existing intervention for Early Years Educators (“Educators”) designed to increase [...] Read more.
A lack of fundamental motor skills (FMS) in the early years can lead to lower engagement with physical activity (PA), and track into adulthood. This study aimed to test the feasibility of an existing intervention for Early Years Educators (“Educators”) designed to increase knowledge, confidence and the ability to increase PA and FMS of children in a deprived area of England. Non-randomised design with wait-list control. Sixty-seven settings in Middlesbrough, North East England were invited. Recruitment target: 10 settings, 2 Educators per setting, four children per Educator. Intervention: one-day training course “Physical Literacy in the Early Years”, an age-appropriate theoretical and practical training course to support the development of physical literacy. Primary outcomes: recruitment, retention, acceptability of intervention and outcome measures. Secondary outcomes: change in Educators’ knowledge, intentions and behaviour, and change in children’s BMI z-score, PA and FMS. Eight settings were recruited; all Intervention Educators completed the training. Six settings participated at follow-up (four Intervention, two Control). The target for Educator recruitment was met (two per setting, total n = 16). Questionnaires were completed by 80% of Intervention Educators at baseline, 20% at follow-up. Control Educators completed zero questionnaires. No Educators took part in a process evaluation interview. Forty-eight children participated at baseline, 28 at follow-up. The intervention was deemed acceptable. The recruitment, retention and acceptability of measurements were insufficient to recommend proceeding. Additional qualitative work is needed to understand and surmount the challenges posed by the implementation of the trial. Full article
15 pages, 1466 KiB  
Article
Evaluating Changes in Perceived Enjoyment throughout a 12-Week School-Based Exergaming Intervention
by Lisa Röglin, Oliver Stoll, Kerstin Ketelhut, Anna Lisa Martin-Niedecken and Sascha Ketelhut
Children 2023, 10(1), 144; https://doi.org/10.3390/children10010144 - 11 Jan 2023
Cited by 4 | Viewed by 1866
Abstract
This study assessed whether a high-intensity exergame represents an enjoyable training tool for children in the elementary school setting. Furthermore, it evaluated whether gender, body mass index (BMI), waist-to-height ratio (WHtR), fitness level, weekly physical activity level, and general interest in sports moderate [...] Read more.
This study assessed whether a high-intensity exergame represents an enjoyable training tool for children in the elementary school setting. Furthermore, it evaluated whether gender, body mass index (BMI), waist-to-height ratio (WHtR), fitness level, weekly physical activity level, and general interest in sports moderate perceived enjoyment during the 12-week intervention. Thirty fifth- and sixth-grade students (10.5 ± 0.7 years; 50% girls) participated in this study. During baseline assessments, anthropometric measurements and a shuttle run test were conducted. Throughout the intervention period, the students participated in 15–20-min exergaming sessions (ES) in the ExerCube twice a week during school hours. Enjoyment was assessed after an ES in weeks 2 and 12. Additionally, enjoyment was evaluated after a physical education (PE) class in week 2. The results reveal no significant changes in enjoyment (p = 0.164) over time. The modest changes over time were significantly affected by BMI (p = 0.027), WHtR (p = 0.007), and weekly activity level (p = 0.016). Compared to the PE class, enjoyment was significantly higher during the ES (p < 0.001). None of the covariates showed a significant effect. Mean HR during the ES reached 87.1 ± 1.9% of students’ individual maximum HR. In conclusion, the ExerCube provides a promising tool for schools to promote enjoyable moderate-to-vigorous physical activity. Full article
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