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Children
Volume 11
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Children, Volume 11, Issue 11 (November 2024) – 137 articles

Cover Story (view full-size image): This survey–study explored treatment patterns, barriers, and preferences among school-aged students (n = 332) using the Remote Electrical Neuromodulation (REN) wearable device, an FDA-cleared device for acute and/or preventive treatment of migraine for ages 8+. Following REN prescription, the portion of students who avoid treatment at school was reduced by half. Most common treatment barriers were the need to leave class to go to the nurse and stigma. Top reasons for preferring to treat with REN at school address these barriers, with no need to attend the nurse’s office and discrete treatment. The study underscores challenges of migraine management at school, highlighting REN’s role in empowering students to manage their migraine independently and discreetly to avoid class and social disruption, advocating for REN as a first-line treatment. View this paper
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13 pages, 677 KiB  
Review
Media Device Use and Vision Disorders in the Pediatric Age: The State of the Art
by Elena Bozzola, Mariangela Irrera, Romie Hellmann, Salvatore Crugliano and Michele Fortunato
Children 2024, 11(11), 1408; https://doi.org/10.3390/children11111408 - 20 Nov 2024
Viewed by 584
Abstract
Introduction. Evidence is consistent with increased screen viewing time among children and adolescents, and anticipation at the age at which children interact with media devices. Incorrect use of technology, as well as overuse, may lead to serious consequences. This study aims to revise [...] Read more.
Introduction. Evidence is consistent with increased screen viewing time among children and adolescents, and anticipation at the age at which children interact with media devices. Incorrect use of technology, as well as overuse, may lead to serious consequences. This study aims to revise scientific international literature and to describe the potential eye risks correlated to screen viewing time in the pediatric age. Materials and Methods. A review of the literature was performed according to the PRISMA 2020 guidelines, using the search terms “media device” and “eye” with the filter “age 0–18”. Results. Analyzing the international literature, we found 26 articles. Pre-myopia, myopia, digital eye strain, and acute acquired comitant esotropia were listed as potential and time-related consequences associated with the incorrect use of media devices among children and adolescents. Discussion. Family education on media device exposure and potential risk for children and adolescents’ sight in case of prolonged digital/screen exposure is required. During pediatric check controls, a dialogue with families on prolonged media device use at a close distance should be undertaken. Pediatricians and ophthalmologists should consider screen viewing time in case of ocular problems. Full article
(This article belongs to the Special Issue Visual Deficits and Eye Care in Children)
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16 pages, 302 KiB  
Review
Affective Touch in Preterm Infant Development: Neurobiological Mechanisms and Implications for Child–Caregiver Attachment and Neonatal Care
by Valentina Lucia La Rosa, Alessandra Geraci, Alice Iacono and Elena Commodari
Children 2024, 11(11), 1407; https://doi.org/10.3390/children11111407 - 20 Nov 2024
Viewed by 832
Abstract
Background/Objectives: Affective touch is crucial in infant development, particularly in regulating emotional, cognitive, and physiological processes. Preterm infants are often deprived of essential tactile stimulation owing to their early exposure to the external environment, which may affect long-term developmental outcomes. This review aimed [...] Read more.
Background/Objectives: Affective touch is crucial in infant development, particularly in regulating emotional, cognitive, and physiological processes. Preterm infants are often deprived of essential tactile stimulation owing to their early exposure to the external environment, which may affect long-term developmental outcomes. This review aimed to examine the neurobiological mechanisms of affective touch and highlight effective interventions, such as skin-to-skin contact (SSC) and kangaroo care (KC), to promote development in preterm infants. Methods: This review summarizes recent studies in the literature on affective touch, the role of C-tactile fibers, and the effects of tactile interventions in neonatal care. Studies were selected based on their relevance to the care and development of preterm infants, with a focus on physiological and neurodevelopmental outcomes. Key interventions, including SSC and massage therapy, are discussed in relation to their effectiveness in the neonatal intensive care unit (NICU). Results: The results suggest that affective touch, mainly through activation of tactile C-fibers, improves caregiver–infant bonding, reduces stress responses, and supports neurodevelopment in preterm infants. Interventions such as SSC and KC have also been shown to improve physiological regulation in these infants, including heart rate, breathing, and temperature control while promoting emotional regulation and cognitive development. Conclusions: Affective touch is a key component of early development, particularly in preterm infants admitted to the NICU. Integrating tactile interventions such as SSC and KC into neonatal care practices may significantly improve long-term developmental outcomes. Future research should explore the epigenetic mechanisms underlying affective touch and further refine tactile interventions to optimize neonatal care. Full article
(This article belongs to the Special Issue Children with Specific Neurodevelopmental Disorders: Assessment and Intervention)
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2 pages, 132 KiB  
Correction
Correction: Asonitou, K.; Koutsouki, D. PASS Theory and Movement Disorders: Methodology for Assessment and Intervention. Children 2024, 11, 1192
by Katerina Asonitou and Dimitra Koutsouki
Children 2024, 11(11), 1406; https://doi.org/10.3390/children11111406 - 20 Nov 2024
Viewed by 276
Abstract
In the original publication [...] Full article
9 pages, 1432 KiB  
Article
Management of Hirschsprung’s Disease: A Survey with Brazilian Pediatric Surgeons
by Cesar Saul Quevedo Penaloza, Alana Carnevale Barreto, Erika Veruska Paiva Ortolan, Augusto Zani and Pedro Luiz Toledo de Arruda Lourenção
Children 2024, 11(11), 1405; https://doi.org/10.3390/children11111405 - 20 Nov 2024
Viewed by 487
Abstract
Background: Hirschsprung’s disease (HD) is a congenital malformation of the enteric nervous system clinically manifested by intestinal obstruction in the neonatal period or severe constipation in childhood. Several surveys on HD have been conducted to evaluate experiences in its management around the world. [...] Read more.
Background: Hirschsprung’s disease (HD) is a congenital malformation of the enteric nervous system clinically manifested by intestinal obstruction in the neonatal period or severe constipation in childhood. Several surveys on HD have been conducted to evaluate experiences in its management around the world. For the first time in Brazil, we analyze and report the management patterns of HD among pediatric surgeons in Brazil. Methods: A validated questionnaire was disseminated in print at the Congress of Pediatric Surgery in São Paulo-Brazil, and an online version was sent to all the active members of the Brazilian and Paulista Institute of Pediatric Surgery. Results: In total, 361 pediatric surgeons answered the survey. Of these, 329 completed all questions (response rate: 91%). Most Brazilian services treat fewer than 10 cases of HD annually. The preferred diagnostic method was rectal biopsy. For newborns (NBs) and infants, open biopsy was the most commonly used technique. For NBs with HD clinically stable 50% of specialists chose immediate surgery. In NBs and infants with classic HD, the Soave technique (69%) is the most common surgical intervention, and the transanal route (80%) is the preferred surgical approach. In children over 3 years of age with classic HD, the most-used technique is the Duhamel method (54%), with the open approach being the most common (52%). Conclusions: Our study in Brazil found that HD patient management aligns with scientific evidence and international guidelines. Full article
(This article belongs to the Special Issue Colorectal Problems in Children: From Diagnosis to Treatment and Novelties)
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16 pages, 2713 KiB  
Review
Aquatic Therapy in Children and Adolescents with Disabilities: A Scoping Review
by Anna Ogonowska-Slodownik, Oliwia Jakobowicz, Lyndsay Alexander, Andresa R. Marinho-Buzelli, Catherine Devion and Natalia Morgulec-Adamowicz
Children 2024, 11(11), 1404; https://doi.org/10.3390/children11111404 - 20 Nov 2024
Viewed by 1083
Abstract
Globally, around 1 in 10 children aged 0–17 years have moderate-to-severe disabilities. The aquatic environment provides hydrostatic and hydrodynamic characteristics that make exercise and therapy feasible for children and adolescents with disabilities. The objective of this scoping review is to understand the extent [...] Read more.
Globally, around 1 in 10 children aged 0–17 years have moderate-to-severe disabilities. The aquatic environment provides hydrostatic and hydrodynamic characteristics that make exercise and therapy feasible for children and adolescents with disabilities. The objective of this scoping review is to understand the extent and type of evidence in relation to the use of aquatic therapy in children and adolescents with disabilities. The eligibility criteria were as follows: participants—children and/or adolescents with disabilities aged from 6 to 18 years old; concept—aquatic therapy interventions; context—any available setting. The databases searched included MEDLINE, CINAHL, EMBASE, PsycINFO, AMED, Eric, Scopus, Web of Science, Epistemonikos, and one register, Cochrane Central Register of Controlled Trials. In total, 52 reports met the inclusion criteria. Most of the studies included children/adolescents with autism spectrum disorder (ASD; 46.7%)—442 participants in 21 studies in total. The majority of interventions were based on aquatic exercise (35%). Most often, interventions were conducted for 8 weeks, with 2 sessions a week lasting 60 min. The most common type of intervention for children and adolescents with ASD and Down syndrome was swimming. Participants with attention deficit hyperactivity disorder, neuromuscular disorders, and cerebral palsy were more often treated with aquatic exercises. This scoping review could guide practitioners, clinicians, and researchers on what type, setting, and content of aquatic therapy interventions, including exercise types, intervention duration, number of sessions, frequency, facility, and provider, are used with children and adolescents with disabilities. Full article
(This article belongs to the Special Issue Advances in Rehabilitation of Children with Disabilities: 2nd Edition)
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7 pages, 209 KiB  
Editorial
Physical Activity and Lifestyle Behaviors in Children and Adolescents
by Alexandre Aparecido de Almeida and Matias Noll
Children 2024, 11(11), 1403; https://doi.org/10.3390/children11111403 - 20 Nov 2024
Viewed by 742
Abstract
A sedentary lifestyle, unfavorable body composition, and low muscle strength are strong predictors of morbidity and mortality and an independent determinant contributing to the development of many chronic diseases [...] Full article
(This article belongs to the Special Issue Physical Activity and Lifestyle Habits in Children and Adolescents)
9 pages, 720 KiB  
Article
Survival Analysis of Prefabricated Zirconia Crowns with and Without Pulpotomy in Primary Teeth: A Retrospective Cohort Study
by Murad Alrashdi
Children 2024, 11(11), 1402; https://doi.org/10.3390/children11111402 - 19 Nov 2024
Viewed by 550
Abstract
Background: Prefabricated Zirconia Crowns (PZCs) are increasingly preferred for restoring primary teeth due to their esthetic appeal and retention. However, their rigid, unmodifiable design requires precise tooth preparation, often leading to aggressive reduction and potential pulp exposure. Pulpotomy, a standard treatment for reversible [...] Read more.
Background: Prefabricated Zirconia Crowns (PZCs) are increasingly preferred for restoring primary teeth due to their esthetic appeal and retention. However, their rigid, unmodifiable design requires precise tooth preparation, often leading to aggressive reduction and potential pulp exposure. Pulpotomy, a standard treatment for reversible pulpitis and mechanical pulp exposure, is sometimes employed before PZCs. While pulpotomy is not routinely performed, its use raises important considerations about the interplay between restorative procedures and pulp therapy in pediatric dentistry, particularly regarding the long-term restoration outcomes of PZCs. Purpose: This study aimed to investigate the impact of pulpotomy on the success rate of PZCs. Methods: We examined 81 anterior upper primary teeth treated with PZCs in children aged 2–5 years over a two-year period. Cases were divided into groups with and without pulpotomy. Follow-ups occurred at 6-month intervals, assessing clinical and radiographic outcomes. Analyses were performed using SPSS 25.0 software. The statistical significance was p < 0.05. Results: A total of 81 anterior primary teeth were included. Chi-square analysis showed no association between pulp therapy and PZC success (χ2 = 0.051, p = 0.822). The Kaplan–Meier survival analysis revealed comparable survival curves and the log-rank test showed no statistically significant difference in survival time between pulpotomy-treated and untreated groups (χ2 = 0.051, p = 0.821). Conclusions: Pulpotomy did not significantly affect the success rate of PZCs within 2 years. Full article
(This article belongs to the Special Issue Research on Clinical Pediatric Dentistry)
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21 pages, 1111 KiB  
Review
Perspectives and Challenges of Telemedicine and Artificial Intelligence in Pediatric Dermatology
by Daniele Zama, Andrea Borghesi, Alice Ranieri, Elisa Manieri, Luca Pierantoni, Laura Andreozzi, Arianna Dondi, Iria Neri, Marcello Lanari and Roberta Calegari
Children 2024, 11(11), 1401; https://doi.org/10.3390/children11111401 - 19 Nov 2024
Viewed by 707
Abstract
Background: Pediatric dermatology represents one of the most underserved subspecialties in pediatrics. Artificial intelligence (AI) and telemedicine have become considerable in dermatology, reaching diagnostic accuracy comparable to or exceeding that of in-person visits. This work aims to review the current state of telemedicine [...] Read more.
Background: Pediatric dermatology represents one of the most underserved subspecialties in pediatrics. Artificial intelligence (AI) and telemedicine have become considerable in dermatology, reaching diagnostic accuracy comparable to or exceeding that of in-person visits. This work aims to review the current state of telemedicine and AI in pediatric dermatology, suggesting potential ways to address existing issues and challenges. Methods: We conducted a literature review including only articles published in the last 15 years. A total of 458 studies were identified, of which only 76 were included. Results: Most of the studies on telemedicine evaluate accuracy focused on concordance, which ranges from 70% to 89% for the most common pediatric skin diseases. Telemedicine showed the potential to manage chronic dermatological conditions in children, as well as decrease waiting times, and represents the chance for unprivileged populations to overcome barriers limiting access to medical care. The main limitations of telemedicine consist of the language barrier and the need for adequate technologies and acceptable image-quality video, which can be overcome by AI. AI-driven apps and platforms can facilitate remote consultations between pediatric dermatologists and patients or their caregivers. However, the integration of AI into clinical practice faces some challenges ranging from technical to ethical and regulatory. It is crucial to ensure that the development, deployment, and utilization of AI systems conform to the seven fundamental requirements for trustworthy AI. Conclusion: This study supplies a detailed discussion of open challenges with a particular focus on equity and ethical considerations and defining possible concrete directions. Full article
(This article belongs to the Section Pediatric Dermatology)
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15 pages, 260 KiB  
Article
A Nutrition Education Intervention Positively Affects the Diet–Health-Related Practices and Nutritional Status of Mothers and Children in a Pulse-Growing Community in Halaba, South Ethiopia
by Getahun Ersino Lombamo, Carol J. Henry and Gordon A. Zello
Children 2024, 11(11), 1400; https://doi.org/10.3390/children11111400 - 19 Nov 2024
Viewed by 467
Abstract
Objective: We conducted a six-month nutrition education intervention focused on the consumption of pulses and other foods to assess the effect on knowledge, attitude and practice (KAP) as well as the nutritional status of children and mothers from two pulse-growing communities in Halaba, [...] Read more.
Objective: We conducted a six-month nutrition education intervention focused on the consumption of pulses and other foods to assess the effect on knowledge, attitude and practice (KAP) as well as the nutritional status of children and mothers from two pulse-growing communities in Halaba, south Ethiopia. Methods: About 200 mother–child pairs in each of two purposively selected communities participated in this intervention study. A six-month nutrition education programme, involving interactive monthly community meetings and home visits, was offered to one of the two communities and the other served as a control/comparison. This study incorporated the use of Health Belief Model constructs to assess the KAP/perceptions of mothers surrounding pulse and other food consumptions, as well as nutrition-related issues before and after the intervention. Objective measures included dietary diversity scores (DDSs), one-day weighed dietary intakes and nutritional status measures based on anthropometric information. Demographics and socioeconomic information were also collected at baseline and endline. Results: Significant improvements (p < 0.05) were found in the intervention group on the KAP and perceptions of pulse nutrition benefits among mothers, DDSs and pulse and animal source food consumption indexes for mothers and children and the mean body-mass-index-for-age Z-score and wasting among children. Conclusions: Community-based nutrition education interventions involving monthly interactive community meetings and home visits in pulse-growing communities from a resource-poor country like Ethiopia can be effective in improving mothers’ knowledge of pulse nutrition and consumption frequency, leading to improvements in the DDSs of children and mothers while decreasing child underweight and wasting. Full article
(This article belongs to the Section Global Pediatric Health)
11 pages, 694 KiB  
Article
Investigation of the Etiology of Molar Incisor Hypomineralization in Children Residing in Konya Province and Surrounding Areas, Türkiye
by Aslı Seloğlu and Firdevs Kahvecioğlu
Children 2024, 11(11), 1399; https://doi.org/10.3390/children11111399 - 19 Nov 2024
Viewed by 486
Abstract
Background: According to the literature, hypomineralization of molars and incisors is a multifactorial condition that depends on both genetic and environmental factors. This study aims to diagnose Molar Incisor Hypomineralization (MIH) cases with a new index that better defines the defect and to [...] Read more.
Background: According to the literature, hypomineralization of molars and incisors is a multifactorial condition that depends on both genetic and environmental factors. This study aims to diagnose Molar Incisor Hypomineralization (MIH) cases with a new index that better defines the defect and to contribute to the literature by identifying possible etiological factors. Methods: This research was conducted with children aged 8–11 years old and their parents from Konya province and surrounding provinces. While children who were diagnosed with MIH as a result of the examination constituted the study group, children with no findings of MIH during intraoral examination were included in the control group. Between February and October 2020, 104 patients for the study group and 104 patients for the control group were reached, and a survey was administered to a total of 208 parents. Results: Asthma, pneumonia, lower respiratory tract infections, diarrhea, a fever, and febrile convulsions between the ages of 0–4 have been found to be related to MIH (p < 0.05). Conclusions: The association between medical diseases in children and enamel defect formation draws attention to the importance of pediatricians in the early diagnosis of MIH cases. Pediatricians can be very helpful in informing parents of children with health problems about possible dental defects and referring them to a pediatric dentist. Full article
(This article belongs to the Section Pediatric Dentistry & Oral Medicine)
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13 pages, 425 KiB  
Article
Executive Functions and Special Educational Needs and Their Relationship with School-Age Learning Difficulties
by Juan Manuel Núñez, Ana Soto-Rubio and Marián Pérez-Marín
Children 2024, 11(11), 1398; https://doi.org/10.3390/children11111398 - 19 Nov 2024
Viewed by 612
Abstract
Background/Objectives: The relationship between executive functions, special educational needs (SEN), and learning difficulties in school-aged children is critical for developing effective educational interventions. This study explores the connection between executive functions and SEN in primary school students, examining differences in executive function profiles [...] Read more.
Background/Objectives: The relationship between executive functions, special educational needs (SEN), and learning difficulties in school-aged children is critical for developing effective educational interventions. This study explores the connection between executive functions and SEN in primary school students, examining differences in executive function profiles between those with and without SEN and their impact on learning difficulties. Methods: In total, 123 primary school students aged 6 to 12 and their teachers and parents participated in this study. The Behavior Rating Inventory of Executive Function (BRIEF-2) and the Prediscal test were used to assess difficulties in reading and mathematics, and sociodemographic and clinical data were collected through ad hoc records. Results: The results indicated that students with SEN exhibited significantly more affected executive function profiles compared to their peers without SEN in both family and school contexts, highlighting areas such as cognitive flexibility, initiative, working memory, planning and organisation, task supervision, and material organisation. Additionally, significant negative correlations were found between executive functions and performance in reading and mathematics, suggesting that deficits in executive functions are strongly associated with SEN. Conclusions: These findings underscore the critical role of executive functions in understanding and addressing SEN and learning difficulties, emphasising the need for comprehensive assessment programmes and early intervention targeting executive function deficits to support the academic and overall development of students with SEN. Full article
(This article belongs to the Special Issue Cognitive Development in Children)
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12 pages, 1034 KiB  
Review
Diagnosis and Treatment of Infantile Hemangioma from the Primary Care Paediatricians to the Specialist: A Narrative Review
by Francesco Bellinato, Maria Marocchi, Luca Pecoraro, Marco Zaffanello, Micol Del Giglio, Giampiero Girolomoni, Giorgio Piacentini and Erika Rigotti
Children 2024, 11(11), 1397; https://doi.org/10.3390/children11111397 - 18 Nov 2024
Viewed by 783
Abstract
Infantile haemangiomas (IHs) affect 3–10% of infants, 10% of whom need topical or systemic beta-blocker therapy. Propranolol is the first choice for IHs with a high risk of complications. Since more than half of IHs leave a permanent mark, to reduce outcomes, it [...] Read more.
Infantile haemangiomas (IHs) affect 3–10% of infants, 10% of whom need topical or systemic beta-blocker therapy. Propranolol is the first choice for IHs with a high risk of complications. Since more than half of IHs leave a permanent mark, to reduce outcomes, it is essential to start oral propranolol (2–3 mg/kg/day in 2 doses/day) within the 5th month of life (i.e., during the proliferative phase) and to complete the therapy cycle for at least 6 months. This review aims to summarise the epidemiology, clinical presentation, diagnosis, and treatment of IHs and to highlight the importance of proper referral to specialised hub centres. Patients with vascular anomalies, particularly those suspected of having IH, should be referred to a specialised centre for accurate diagnosis, management by a multidisciplinary team, and timely treatment. IHs may pose life-threatening, functional, and aesthetic risks or may ulcerate. Segmental infantile haemangioma of the face/neck and the lumbosacral regions can be associated with various malformations. To ensure timely specialist evaluation and treatment to reduce the potential risk of complications, it is essential to identify high-risk IHs rapidly. The Infantile Haemangioma Referral Score (IHReS) scale is an important tool to assist primary care paediatricians and general dermatologists. Full article
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13 pages, 892 KiB  
Article
Voices of Hope: Leveraging Think-Aloud Cognitive Interviews to Develop a Hope Assessment Tool for Young People Living with Chronic Health Conditions
by Emily von Scheven, Mitchell Braun, Bhupinder Nahal, Emily R. Perito, Paul Brakeman, William Daniel Soulsby, Laura Quill, Addison Cuneo and Linda S. Franck
Children 2024, 11(11), 1396; https://doi.org/10.3390/children11111396 - 18 Nov 2024
Viewed by 571
Abstract
Background/Objectives: Hope is a universal, multidimensional, and nuanced concept that may have specific meaning for young people living with chronic health conditions anticipated to last into adulthood. We previously identified definitions of hope for youth living with chronic health conditions derived from young [...] Read more.
Background/Objectives: Hope is a universal, multidimensional, and nuanced concept that may have specific meaning for young people living with chronic health conditions anticipated to last into adulthood. We previously identified definitions of hope for youth living with chronic health conditions derived from young people’s and their caregivers’ own words. Here, we aimed to develop a hope assessment tool to facilitate the future evaluation of interventions to support wellness and health for young people growing up with chronic health conditions; Methods: We developed Likert-type scale questions using the young people’s and caregivers’ definitions of hope and applied the think-aloud cognitive interview method to assess understanding and to inform sequential iteration. Interviews were recorded and insights from participant interviews were analyzed thematically. Results: In total, 11 youth (age 12–16 years) with various chronic health conditions completed surveys and interviews over three iteration cycles. Responses to the six-point Likert-scale questions ranged from 1 (none of the time) to 6 (all of the time) (median 5). All of the young people (n = 11) reported that they do things they enjoy, either all of the time or most of the time. In contrast, only 36% felt energetic, either all or most of the time. Three themes were identified: my body and hope; my identity, self-image, and hope; and my world and hope. Conclusions: In addition to gaining important feedback that allowed us to improve item word choice to maximize assessment tool understanding, we gained valuable insights into the multidimensional construct of hope. Thematic analysis revealed the importance of physical symptoms and identity to the meaning of hope in the context of a young person’s life. Our new hope assessment tool derived from the young people’s own definition of hope has face and content validity for use in clinical and research settings to evaluate hope among pediatric patients living with chronic health conditions. Full article
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9 pages, 1991 KiB  
Case Report
Broadening the PHIP-Associated Neurodevelopmental Phenotype
by Giulia Pascolini, Giovanni Luca Scaglione, Balasubramanian Chandramouli, Daniele Castiglia, Giovanni Di Zenzo and Biagio Didona
Children 2024, 11(11), 1395; https://doi.org/10.3390/children11111395 - 17 Nov 2024
Viewed by 534
Abstract
Background: Monoallelic damaging variants in PHIP (MIM*612870), encoding the Pleckstrin Homology Domain Interacting Protein, have been associated with a novel neurodevelopmental disorder, also termed Chung–Jansen syndrome (CHUJANS, MIM#617991). Most of the described individuals show developmental delay (DD)/intellectual disability (ID), obesity/overweight, and variable congenital [...] Read more.
Background: Monoallelic damaging variants in PHIP (MIM*612870), encoding the Pleckstrin Homology Domain Interacting Protein, have been associated with a novel neurodevelopmental disorder, also termed Chung–Jansen syndrome (CHUJANS, MIM#617991). Most of the described individuals show developmental delay (DD)/intellectual disability (ID), obesity/overweight, and variable congenital anomalies, so the condition can be considered as an ID–overweight syndrome. Case Description: We evaluated a child presenting with DD/ID and a craniofacial phenotype reminiscent of a Pitt–Hopkins syndrome (PTHS)-like condition. We performed a clinical exome analysis on his biological sample, as well as an in silico prediction of the obtained data. At the same time, we interrogated the DeepGestalt technology powered by Face2Gene (F2G), using a frontal image of the proband, and clinically reviewed the earlier CHUJANS patients. In this child, we found a novel PHIP pathogenetic variant, which we corroborated through a protein modeling approach. The F2G platform supported the initial clinical hypothesis of a PTHS-like condition, while the clinical review highlighted the lack of the main frequent CHUJANS clinical features in this child. Conclusions: The unusual clinical presentation of this novel patient resembles a PTHS-like condition. However, a novel variant in PHIP has been unexpectedly detected, expanding the phenotypic spectrum of CHUJANS. Notably, PTHS (MIM#610954), which is a different ID syndrome caused by heterozygous variants in TCF4 (MIM*610954), is not classically considered in the differential diagnosis of CHUJANS nor has been cited in the previous studies. This could support other complex diagnoses and invite further patients’ descriptions. Full article
(This article belongs to the Special Issue Neurodevelopmental Disorders in Pediatrics)
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9 pages, 224 KiB  
Article
Incidence of and Risk Factors for Central Venous Catheter Thrombosis: Results from a Single-Center Pediatric Intensive Care Unit
by Maha Azzam, Yousef M. AlTalhi, Hani Alsawadi, Mohamed Humoodi, Abdullah Alzahrani, Amir Shehzad Hayat, Mohammed Bakhsh and Sara Osman
Children 2024, 11(11), 1394; https://doi.org/10.3390/children11111394 - 17 Nov 2024
Viewed by 781
Abstract
Background: Central Venous Catheter (CVC) is a necessary and important tool in managing acutely ill children and those needing complex care. CVC enables infusing venous medication, fluids, blood products, chemotherapy, total parental nutrition, and painless withdrawal of blood for laboratory testing when needed. [...] Read more.
Background: Central Venous Catheter (CVC) is a necessary and important tool in managing acutely ill children and those needing complex care. CVC enables infusing venous medication, fluids, blood products, chemotherapy, total parental nutrition, and painless withdrawal of blood for laboratory testing when needed. Objective: To identify the incidence and risk factors for Central Venous Catheter-Related Thrombosis (CVC-RT) among patients admitted to the Pediatric Intensive Unit. Method: This was a prospective, observational, single-center study that was conducted over 17 months from September 2019 to January 2021 at King Abdulaziz Medical City, Jeddah. Design: Prospective observational study. Setting: King Abdulaziz Medical City, a tertiary care center in the western region of Saudi Arabia. Patients: Pediatric patients aged 1 to 168 months who were admitted to the PICU and required central line insertion (whether inserted centrally or peripherally) for more than 48 hours were included. Screening for thrombosis was performed within day 4–7 post-line insertion and again on the 14th day. Results: A total of 255 patients were enrolled over 17 months. The incidence rate of CVC-RT was 5.4%. The type of CVC was significantly different between the two groups; in the no thrombosis group, 59.2% had a central line while in the CVC-RT groups, 51.9% had a PIC line (p = 0.027). In a multivariate regression analysis including patients’ clinical profile, high D-dimer as baseline and low platelets were both significant risk factors for CVC-RT [adjusted OR = 3.22, CI (1.25–8.28), p = 0.015 and adjusted OR = 7.38, CI (2.18–25.02), p = 0.001], respectively. Conclusions: The current study found that PIC line was associated with an increased risk of CVC-RT, which is congruent with the literature. As children with CVC can have multiple risk factors for developing CVC-RT, it is important to conduct further large prospective studies to identify such factors and decrease the incidence of CVC-RT. Full article
(This article belongs to the Section Pediatric Emergency Medicine & Intensive Care Medicine)
19 pages, 483 KiB  
Article
Night Sleep, Parental Bedtime Practices and Language Development in Low-Risk Preterm and Full-Term Late Talkers: A Longitudinal Study in the Third Year of Life
by Mariagrazia Zuccarini, Martina Riva, Arianna Aceti, Luigi Corvaglia, Anat Scher, Annalisa Guarini and Alessandra Sansavini
Children 2024, 11(11), 1393; https://doi.org/10.3390/children11111393 - 16 Nov 2024
Viewed by 1034
Abstract
Background: Studies on night sleep and parental bedtime practices and their associations with language development in populations at risk of language delay and neonatal conditions, such as late talkers and preterm children, are scarce. Objectives: Our objective was to longitudinally examine [...] Read more.
Background: Studies on night sleep and parental bedtime practices and their associations with language development in populations at risk of language delay and neonatal conditions, such as late talkers and preterm children, are scarce. Objectives: Our objective was to longitudinally examine the development of night sleep (total night sleep difficulties, settling, night waking, and co-sleeping), parental bedtime practices (total parental bedtime practices, active physical comforting, encouraging autonomy, and leaving to cry), and expressive language (word and sentence production), and their associations in low-risk preterm and full-term late talkers from 31 to 37 months of age. Methods: Parents of 38 late talkers, 19 low-risk preterm and 19 full-term children, completed the Italian versions of the Infant Sleep Questionnaire, the Parental Interactive Bedtime Behavior Scale, and the MacArthur-Bates Communicative Development Inventory Words and Sentences Long Form. Results: Late talkers’ night sleep difficulties, such as settling to sleep and night waking, decreased over time, with low-risk preterm late talkers experiencing more night waking and co-sleeping than full-term peers. Parents reported that instances of active physical comforting and leaving to cry also decreased, with parents of low-risk preterm late talkers reporting higher active physical comforting scores than parents of full-term peers. Improvements in parental practices of encouraging autonomy were significantly associated with increased sentence production from 31 to 37 months. Conclusions: Findings highlight the importance of monitoring night sleep in preterm and full-term late talkers. They also suggest that populations vulnerable to sleep and language delays may particularly benefit from targeted interventions promoting autonomy in their bedtime routines, which, in turn, could support their language development trajectories. Full article
(This article belongs to the Special Issue Early Interventions for Children with Language Developmental Disabilities)
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11 pages, 3317 KiB  
Article
Reimagining Kangaroo Care for Preterm Infants: A Novel Garment for Safe and Comfortable Bonding
by Alexandra McMillin, Aviva Presser Aiden, Jules P. Sherman, Ruth Ann Crystal and William D. Rhine
Children 2024, 11(11), 1392; https://doi.org/10.3390/children11111392 - 16 Nov 2024
Viewed by 790
Abstract
Background/Objectives: Kangaroo Care (KC) has been proven to enhance physiological stability, growth, and bonding in preterm, low-birthweight infants. Despite its benefits, KC is underutilized in Level IV Neonatal Intensive Care Units (NICUs) due to challenges in managing medical equipment. This study introduces the [...] Read more.
Background/Objectives: Kangaroo Care (KC) has been proven to enhance physiological stability, growth, and bonding in preterm, low-birthweight infants. Despite its benefits, KC is underutilized in Level IV Neonatal Intensive Care Units (NICUs) due to challenges in managing medical equipment. This study introduces the Kangarobe™, a novel garment designed to facilitate safe, comfortable, and efficient KC for medically fragile infants in high-acuity NICUs. Methods: From 2021 to 2023, a feasibility study was conducted involving 25 infant-parent dyads in a Level IV NICU. The Kangarobe™ was designed using human-centered design principles and tested on infants dependent on respiratory support. Surveys employing a 5-point Likert scale were administered to parents and nursing staff to assess safety, comfort, ease of use, and procedural access. Results: Survey results showed positive feedback from both parents and nursing staff, particularly in the areas of safety and comfort. For example, 72–80% of parents and nurses responded positively regarding ease and comfort. High level of agreement (76%) on the security of medical line management, with minimal negative feedback. In addition, parents using the Kangarobe™ held their infants for an average of 171 min per session, with a notable increase compared to the typical 75 min, indicating enhanced comfort and feasibility for extended KC sessions. The Kangarobe™ successfully enabled the secure management of medical lines and tubes, with the vertical access window improving procedural efficiency without interrupting KC. Conclusions: The Kangarobe™ demonstrates promise in addressing barriers to KC in high-acuity NICUs. By enhancing safety, comfort, and ease of use, it supports wider adoption of KC practices, potentially improving patient safety, staff efficiency, and family-centered care. Full article
(This article belongs to the Special Issue Providing Care for Preterm Infants)
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13 pages, 238 KiB  
Article
Nursing Students’ Volunteer Experiences of Interacting with Children Receiving Pediatric Palliative Care: A Qualitative Study
by Eunju Jin and Hyunju Kang
Children 2024, 11(11), 1391; https://doi.org/10.3390/children11111391 - 16 Nov 2024
Viewed by 541
Abstract
Background/Objectives: Pediatric palliative care refers to active, holistic care that provides support not only for families but also for the physical, psychological, social, and spiritual needs of pediatric patients with severe life-threatening diseases. Nursing students’ volunteer work for pediatric patients requiring palliative care [...] Read more.
Background/Objectives: Pediatric palliative care refers to active, holistic care that provides support not only for families but also for the physical, psychological, social, and spiritual needs of pediatric patients with severe life-threatening diseases. Nursing students’ volunteer work for pediatric patients requiring palliative care is a unique and special experience with which to understand them as prospective medical personnel and that allows them to directly experience and feel the needs and reality related to emotional support. This study aimed to explore the experiences of nursing students who volunteer in pediatric in palliative care settings. Methods: The participants, selected through purposive sampling, were 20 nursing undergraduate students who volunteered at a pediatric palliative care medical center or a private community organization providing a support program for pediatric patients receiving palliative care. Individual in-depth interviews were conducted, and data were analyzed using content analysis. Data were collected from 7 August to 27 November 2023. Results: Five major categories were derived: (1) meeting with children—the process of facing and overcoming challenges; (2) the journey of changing through interactions with children; (3) parting with the child—anticipation, shock, and remembering; (4) new insights into pediatric palliative care; (5) and growing as a nursing student. Conclusions: The volunteer activities enabled the nursing students to interact with pediatric patients undergoing palliative care outside the sphere of clinical education. It increased these students’ awareness of palliative care and provided an opportunity for self-reflection and growth. It also provided an opportunity to improve empathy and provide emotional support. Full article
(This article belongs to the Section Pediatric Nursing)
20 pages, 1199 KiB  
Article
Identifying Facilitators and Barriers to Neonatal Intensive Care Unit Visitation in Mothers of Low Socioeconomic Status: A Qualitative Investigation
by Dana B. McCarty, Renée M. Ferrari, Shelley Golden, Bharathi J. Zvara, Wylin D. Wilson and Meghan E. Shanahan
Children 2024, 11(11), 1390; https://doi.org/10.3390/children11111390 - 16 Nov 2024
Cited by 1 | Viewed by 701
Abstract
Background/Objectives: The experience of parenting in a highly medicalized, unnatural environment can result in impaired mother–infant bonding, but increased maternal presence at the infant’s bedside has been associated with improved infant and maternal outcomes. The primary objective of this study was to explore [...] Read more.
Background/Objectives: The experience of parenting in a highly medicalized, unnatural environment can result in impaired mother–infant bonding, but increased maternal presence at the infant’s bedside has been associated with improved infant and maternal outcomes. The primary objective of this study was to explore barriers and facilitators during the NICU Experience in regard to maternal presence in an NICU. Methods: We interviewed 12 mothers (7 Black, 5 white) of low socioeconomic status (SES) whose preterm infants (average birth gestational age of 27 weeks) were currently hospitalized in an NICU. We engaged the NICU Family Advisory Board in all steps of the research process. Results: Barriers and facilitators to maternal presence spanned all levels of the Socioecological Model; however, barriers were mostly at the societal, community, and institutional levels, while facilitators varied based on interpersonal and individual-level factors. Assets that mothers accessed to facilitate visits, such as free housing and shuttle services, were not available to all mothers based on individual circumstances (e.g., caregiving responsibilities). While a few mothers identified negative interactions with health care practitioners, these encounters were not attributed to racism or described as barriers to visitation. Conclusions: Hospitals can support families with infants in an NICU by providing free or inexpensive short-term sibling support, alleviating the burden of parking costs, and communicating early and frequently about available institutional resources during the hospital stay. Full article
(This article belongs to the Topic Risk and Protective Factors in Social Interactions: Behavioral and Neural Evidence)
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10 pages, 853 KiB  
Article
Hasn’t Child Abuse Been Overlooked? An Evaluation of Abused Children Who Visited the Emergency Department with Sentinel Injuries
by Han Bit Kim and Hyun Noh
Children 2024, 11(11), 1389; https://doi.org/10.3390/children11111389 - 15 Nov 2024
Viewed by 755
Abstract
Objective: Effective child abuse intervention requires understanding its prevalence. While obtaining a comprehensive national estimate of child abuse cases is challenging, sentinel injuries—minor yet unusual injuries like bruises or wounds in pre-cruising-age children—can provide an indicative measure. Using the National Emergency Department Information [...] Read more.
Objective: Effective child abuse intervention requires understanding its prevalence. While obtaining a comprehensive national estimate of child abuse cases is challenging, sentinel injuries—minor yet unusual injuries like bruises or wounds in pre-cruising-age children—can provide an indicative measure. Using the National Emergency Department Information System (NEDIS) data, this study aimed to gauge the prevalence of sentinel injuries using diagnostic codes in children under 12 months who visited emergency centers in South Korea and to evaluate the extent of child abuse screening in these cases. Methods: This cross-sectional study used diagnostic codes indicative of sentinel injuries previously defined using the Delphi method. This study, using NEDIS data, included children under 12 months who visited emergency centers nationwide from 2014 to 2021 for reasons of injury. Children injured in car accidents were excluded. Independent variables included patient demographics, the injury mechanism, intentionality, the route of arrival, the emergency center level, the triage level, and specialist consultation. Dependent variables were the presence of a sentinel injury code, and whether diagnostic tests for child abuse were conducted. Results: Based on NEDIS and national statistical data, the frequency from 2014 to 2021 averaged 2501 per 100,000 of the population. Of the 186,065 patients studied, 63,131 (33.9%) had a diagnostic code corresponding to a sentinel injury. The proportion of patients undergoing diagnostic tests for suspected child abuse was 36.9% for those with sentinel injuries and 43.8% for those with other codes. The percentage of children with sentinel injuries receiving diagnostic tests increased annually, from 32.4% in 2014 to 54.4% in 2021. By institution, the rates were 36.4% for regional emergency centers, 38.4% for local emergency centers, and 20.0% for local emergency institutions. Conclusions: A significant proportion of children presenting to emergency departments had sentinel injury codes. However, the rate of diagnostic tests conducted for suspected child abuse in these cases remains suboptimal. Although there has been an upward trend in testing rates in recent years, there is a pressing need for increased attention to and enhancement in screening for child abuse among children with sentinel injury codes. Full article
(This article belongs to the Special Issue Growing Up Unequal: Family Complexity, Child Maltreatment and Child Well-Being)
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10 pages, 665 KiB  
Article
Pain-Associated Diagnoses in Childhood Before the Diagnosis of Attention-Deficit/Hyperactivity Disorder: A Population-Based Study
by Eugene Merzon, Eli Magen, Yaniv Levy, Shai Ashkenazi, Iris Manor, Abraham Weizman, Beth Krone, Stephen V. Faraone, Ilan Green, Avivit Golan-Cohen, Shlomo Vinker and Ariel Israel
Children 2024, 11(11), 1388; https://doi.org/10.3390/children11111388 - 15 Nov 2024
Viewed by 641
Abstract
Background: Pediatric pain significantly affects children’s lives, leading to school absenteeism, impaired social interactions, and psychological distress. The perception of sensory signals as pain is influenced by the brain’s noradrenergic system, and recent evidence suggests that chronic pain may impact cognitive functioning and [...] Read more.
Background: Pediatric pain significantly affects children’s lives, leading to school absenteeism, impaired social interactions, and psychological distress. The perception of sensory signals as pain is influenced by the brain’s noradrenergic system, and recent evidence suggests that chronic pain may impact cognitive functioning and emotional regulation. Attention-Deficit/Hyperactivity Disorder (ADHD) is associated with alterations in the dopaminergic/noradrenergic systems, which could affect pain perception. Pain-associated conditions and frequent analgesic use in childhood may be linked to ADHD development and could serve as early indicators, yet data on this potential association remain limited. Study Aim: This population-based case-control study in Israel aimed to assess the prevalence of pain-related diagnoses prior to ADHD diagnosis in children aged 5 to 18. The study included children registered with Leumit Health Services (LHS) between 1 January 2006, and 30 June 2021. Children diagnosed with ADHD were compared to matched controls, selected based on age, gender, socioeconomic status, and other sociodemographic factors, who were never diagnosed with ADHD during the study period. Results: Children with ADHD (N = 18,756) and controls (N = 37,512) were precisely matched for sociodemographic characteristics. Individuals with ADHD exhibited significantly higher frequencies of diverse pain conditions, including those associated with illness [headache, earaches, and throat pain (odds ratios [OR] = 1.156 [95%CI 1.085, 1.232], 1.295 [95%CI 1.217, 1.377], and 1.080 [95%CI 1.019, 1.145], respectively; p < 0.01)] and injury [sprains and strains (OR = 1.233 [95% CI 1.104,1.376)]. Analgesics were more frequently purchased by individuals with ADHD, particularly paracetamol (OR = 1.194 [95%CI 1.152, 1.237], p < 0.001) and ibuprofen (OR = 1.366 [95%CI 1.318, 1.416], p = 0.001). Conclusions: This study highlights a potential connection between ADHD and pediatric pain. The elevated rates of pain diagnoses and analgesic usage among children with ADHD underscore the need for further research. Full article
(This article belongs to the Section Pediatric Neurology & Neurodevelopmental Disorders)
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10 pages, 241 KiB  
Review
Developmental Origins of Non-Communicable Chronic Diseases: Role of Fetal Undernutrition and Gut Dysbiosis in Infancy
by Manju Chandra
Children 2024, 11(11), 1387; https://doi.org/10.3390/children11111387 - 15 Nov 2024
Viewed by 532
Abstract
There is an increasing prevalence of non-communicable chronic diseases (NCCDs) like obesity, metabolic syndrome, type 2 diabetes mellitus (T2DM), hypertension, allergic asthma, and neuro-developmental/psychiatric problems in many parts of the world. A suboptimal lifestyle as an adult is often blamed for the occurrence [...] Read more.
There is an increasing prevalence of non-communicable chronic diseases (NCCDs) like obesity, metabolic syndrome, type 2 diabetes mellitus (T2DM), hypertension, allergic asthma, and neuro-developmental/psychiatric problems in many parts of the world. A suboptimal lifestyle as an adult is often blamed for the occurrence of NCCDs. This review discusses the developmental origin of health and disease theory and how suboptimal nutrition in intrauterine life and the establishment of a suboptimal gut microbiome during infancy can influence the predisposition to NCCDs. Full article
(This article belongs to the Section Pediatric Gastroenterology and Nutrition)
15 pages, 275 KiB  
Article
Is There an Association Between Cesarean Section Delivery with Specific Learning Disabilities (SLD) or/and Attention-Deficit/Hyperactivity Disorder (ADHD)? A Cross-Sectional Study in Greek Population
by Maria A. Makri, Dimitrios Chaniotis, Victoria G. Vivilaki and Effie G. Papageorgiou
Children 2024, 11(11), 1386; https://doi.org/10.3390/children11111386 - 14 Nov 2024
Viewed by 723
Abstract
Background/Objective: Learning difficulties (LDs) are lifelong neurodevelopmental disorders with multifactorial causes, including perinatal factors like mode of delivery. This study aims to explore whether cesarean section (CS) delivery is linked to the occurrence of specific learning disabilities (SLDs), attention-deficit/hyperactivity disorder (ADHD), or their [...] Read more.
Background/Objective: Learning difficulties (LDs) are lifelong neurodevelopmental disorders with multifactorial causes, including perinatal factors like mode of delivery. This study aims to explore whether cesarean section (CS) delivery is linked to the occurrence of specific learning disabilities (SLDs), attention-deficit/hyperactivity disorder (ADHD), or their comorbidity. Methods: An online questionnaire was distributed via Google Forms to Greek mothers and parents of children with and without diagnoses, shared through school-related groups and various Greek pages focused on child development, special education, and learning difficulties. Conducted over eight months (October 2023–May 2024), this cross-sectional study involved 256 children, 137 with LDs diagnoses, and 119 controls. Results: In total, 59.9% of CS-born children had a diagnosis, compared to 40.1% of those born vaginally (X²(1) = 4.19, p = 0.045). CS delivery was associated with a 68% increased likelihood of LDs (OR = 1.68, 95% CI [1.02, 2.76]), with higher risks for ADHD (OR = 2.25, 95% CI [1.06, 4.79]) and comorbid SLD/ADHD diagnoses (OR = 2.75, 95% CI [1.17, 6.46]). Stratified analyses showed birthweight and gestational age as effect modifiers rather than confounders. Key postnatal risk factors identified were family history (OR = 4.65, 95% CI [2.41, 8.94]) and language acquisition difficulties (OR = 5.28, 95% CI [1.36, 20.47]). Conclusions: The findings suggest a possible association between CS and LDs, along with a novel link between CS and increased comorbidities. These results underscore the need for further research and provide valuable insights into how CS delivery may influence the risk of LDs, depending on the type of diagnosis. Full article
(This article belongs to the Section Pediatric Neurology & Neurodevelopmental Disorders)
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9 pages, 558 KiB  
Article
Risk Factors for Postoperative Intra-Abdominal Abscess in Pediatric Perforated Appendicitis Following Laparoscopic Appendectomy: A Multicenter Analysis
by Joonhyuk Son, Ji-Won Han and Chaeyoun Oh
Children 2024, 11(11), 1385; https://doi.org/10.3390/children11111385 - 14 Nov 2024
Viewed by 688
Abstract
Background: Perforated appendicitis in children is a frequently encountered and significant surgical condition. The treatment of choice is laparoscopic appendectomy, but this carries a risk of postoperative intra-abdominal abscess (IAA). The purpose of this study was to determine risk factors linked to the [...] Read more.
Background: Perforated appendicitis in children is a frequently encountered and significant surgical condition. The treatment of choice is laparoscopic appendectomy, but this carries a risk of postoperative intra-abdominal abscess (IAA). The purpose of this study was to determine risk factors linked to the occurrence of IAA following laparoscopic surgery in pediatric perforated appendicitis. Methods: This retrospective cohort study analyzed 137 children with perforated appendicitis who received laparoscopic appendectomy at four tertiary hospitals between March 2018 and December 2022. Data on patient demographics, preoperative clinical characteristics, and surgical details were collected. Independent risk factors for IAA formation were determined using logistic regression analysis. Results: The overall incidence of postoperative IAA was 10.9%. Prolonged symptom duration and elevated CRP levels were associated with higher IAA rates. Patients who developed IAAs experienced prolonged postoperative fevers and longer hospital stays. Significant risk factors for IAA identified through multivariable analysis included a higher severity grade of appendicitis (≥Grade IV, OR 5.9, p = 0.034) and the presence of a free appendicolith during surgery (OR 5.549, p = 0.01). Of the patients who developed IAAs, nine (60%) improved with conservative treatment, while six (40%) required invasive procedures. Conclusions: A higher severity grade of appendicitis (≥Grade IV) and the presence of a free appendicolith are significant predictors of postoperative IAAs in pediatric perforated appendicitis. Recognizing these factors can help guide clinical management and postoperative care, potentially reducing the incidence of this complication. Full article
(This article belongs to the Special Issue Cutting-Edge Laparoscopic and Thoracoscopic Surgery in Children)
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11 pages, 261 KiB  
Article
High Serum Irisin Concentration Is Associated with More Disturbed Behavioural Eating Pattern in Adolescent Rhythmic Gymnasts
by Liina Remmel, Jaak Jürimäe, Anna-Liisa Tamm, Priit Purge and Vallo Tillmann
Children 2024, 11(11), 1384; https://doi.org/10.3390/children11111384 - 14 Nov 2024
Viewed by 520
Abstract
Background/Objectives: There are strict demands on body weight and shape in highly trained adolescent female athletes, and they are in the highest risk group for the development of eating disorders. This study aims to compare the behavioural eating patterns between highly trained [...] Read more.
Background/Objectives: There are strict demands on body weight and shape in highly trained adolescent female athletes, and they are in the highest risk group for the development of eating disorders. This study aims to compare the behavioural eating patterns between highly trained female adolescent athletes and untrained controls (UCs), and to describe the associations between behavioural eating patterns and different energy homeostasis hormones. Methods: A total of 33 rhythmic gymnasts (RGs), 20 swimmers (SWs), and 20 UCs (n = 20) that were 14 to 18 years old participated in this investigation. Anthropometric measurements, body composition, training volume, 3-consecutive-day energy intake, and different energy homeostasis hormones were measured. For the evaluation of the individual behavioural eating pattern, an eating disorders assessment scale (EDAS) questionnaire with different subscales was used. Results: The mean EDAS subscale of restrained eating score was significantly higher in the RG group compared to the UC group (17.2 ± 7.4 vs. 11.5 ± 5.8; p < 0.05). The EDAS total score (r = 0.380) and the subscale score of preoccupation with body image and body weight (r = 0.371) were both positively correlated (p < 0.05) with serum irisin concentrations in the RG group. Conclusions: In conclusion, female rhythmic gymnasts reported a more often restrained eating pattern than untrained controls, and their more disturbed behavioural eating pattern was associated with a higher serum irisin concentration. Full article
(This article belongs to the Special Issue Nutritional Status and Eating Patterns in Children and Adolescents: Prevalence, Screening and Prevention of Metabolic Disorders)
17 pages, 3244 KiB  
Article
Insights from Team Clinic: A Person-Centered Virtual Peer Group Care Model Adapted for Marginalized and Historically Excluded Youth with Type 1 Diabetes (T1D)
by Jaquelin Flores Garcia, Mark W. Reid, Alejandra Torres Sanchez, Valerie Ruelas, Sarah-Jeanne Salvy, Alex Thomas, Gary Ashwal, D. Steven Fox and Jennifer K. Raymond
Children 2024, 11(11), 1383; https://doi.org/10.3390/children11111383 - 14 Nov 2024
Viewed by 535
Abstract
Background: Despite advancements in T1D care regimens, racially and ethnically diverse youth with low income continue to experience worse health outcomes, more psychosocial challenges, and higher barriers to care. Alternative care models are needed to address the needs of this population. Methods: Team [...] Read more.
Background: Despite advancements in T1D care regimens, racially and ethnically diverse youth with low income continue to experience worse health outcomes, more psychosocial challenges, and higher barriers to care. Alternative care models are needed to address the needs of this population. Methods: Team Clinic is a person-centered virtual peer group (VPG) care model that was assessed in a 15-month, pragmatic randomized controlled trial. Youth (ages 10–17) and their families were assigned to study arms based on their clinician’s group (standard care or person-centered care, PCC) and then randomized to VPGs or no groups. Results: Data from 79 youth and their families were examined. While positive outcomes were seen across all study groups, youth that participated in Team Clinic (PCC + VPG) reported the largest increases in resilience at the end of the study (+7.42, to 51.63, p = 0.009). These participants also reported the lowest levels of depressive symptoms as assessed by PHQ-8 scores (−5.07, p = 0.002) at the end of the study. Conclusion: Team Clinic can serve as an alternative care model for racially and ethnically diverse youth with T1D and their families. VPGs can provide unique benefits, including an increase in resilience, a decrease in depressive symptoms, and a safe space for families to connect, learn, and receive support. Full article
(This article belongs to the Special Issue Innovative Psychosocial Interventions in Children and Adolescents Living with Type 1 Diabetes)
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10 pages, 837 KiB  
Article
Bladder and Bowel Dysfunction Rehabilitation in Children with Acquired Brain Injury
by Rita Chiminello, Chiara Pellegrino, Noemi Deanesi, Giulia Barone, Ida Barretta, Gaia Paolella, Maria Luisa Capitanucci, Antonio Maria Zaccara, Maria Laura Sollini, Giacomo Esposito, Donatella Lettori, Gessica Della Bella, Enrico Castelli and Giovanni Mosiello
Children 2024, 11(11), 1382; https://doi.org/10.3390/children11111382 - 14 Nov 2024
Viewed by 600
Abstract
Objective: To evaluate neurogenic bladder and bowel dysfunction (NBBD) in children with cerebral palsy (CP) and acquired brain injury (ABI), a condition considered less frequent in those patients than in children with spinal cord injury (SCI), and to study the relationship between NBBD [...] Read more.
Objective: To evaluate neurogenic bladder and bowel dysfunction (NBBD) in children with cerebral palsy (CP) and acquired brain injury (ABI), a condition considered less frequent in those patients than in children with spinal cord injury (SCI), and to study the relationship between NBBD and disability grade in this population. Study Design: We retrospectively reviewed the clinical data of all patients (aged 3–18 years old) admitted during a three-month observation in our neurorehabilitation department. Data collected were as follows: demographic parameters; disability status (Wee-FIM Scale, Gross Motor Function Classification System (GMFCS) and the Communication Function Classification System); and gastrointestinal and urological symptoms (diaries, Bristol scale, Pad Test and International Consultation on Incontinence Modular Questionnaire). Results: Sixty patients were enrolled (31 females, 29 males): 30 CP, 17 ABI, 3 SCI, and 10 others with neurological diseases. All presented urinary incontinence without gender differences. CP and ABI had major incidences of bowel dysfunction (50% and 64.7%, respectively) and SCI of urinary tract infections (66.6%) and enuresis (100%). A major incidence of symptoms was recorded in patients with higher GMFCS levels (level 3-4-5). Conclusions: NBBD has a high frequency in children with CP and ABI, as in SCI. More attention is needed from pediatricians and pediatric urologists for this clinical entity. Further studies are needed to better understand clinical relevance and, therefore, to establish specific management. Full article
(This article belongs to the Section Pediatric Nephrology & Urology)
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13 pages, 246 KiB  
Article
Refugee Caregivers’ Perceptions of Using Mindfulness-Based Interventions to Support Coping Skills in Children with Disability in Jordan
by Zeina Fayad, Hadeel R. Bakhsh and Rawan AlHeresh
Children 2024, 11(11), 1381; https://doi.org/10.3390/children11111381 - 13 Nov 2024
Viewed by 686
Abstract
Background: Refugee children with disabilities are vulnerable to developing dysfunctional coping skills due to barriers in accessing health care services, including occupational therapy (OT). This study investigated the perceptions of refugee caregivers regarding the use of mindfulness-based interventions (MBIs) as a treatment for [...] Read more.
Background: Refugee children with disabilities are vulnerable to developing dysfunctional coping skills due to barriers in accessing health care services, including occupational therapy (OT). This study investigated the perceptions of refugee caregivers regarding the use of mindfulness-based interventions (MBIs) as a treatment for coping skills among their children with disabilities. Methods: A qualitative survey was used to analyse the coping mechanisms and access to services among refugee children with disabilities, as well as their caregivers’ perceptions regarding the use of MBIs. The caregivers were recruited using convenience sampling from a database of individuals at the Al-Baqa’a refugee camp in Jordan via their community-based rehabilitation (CBR) centre. A demographic survey was sent to 156 refugees using WhatsApp. Refugees above the age of 18 years identifying as the caregivers of children with disabilities were eligible. Twenty-eight individuals completed the survey, and twenty-six were eligible. Open-ended questions asked about their child’s struggles, supports, barriers to support, and perceptions of MBIs. The data were collected via Google Sheets. Three researchers coded the responses using a descriptive coding method and line-by-line analysis. Results: Five themes were derived from the responses: “Daily Challenges”, “Support and Strategies”, “barriers to accessing support”, “MBIs: Caregiver Perceptions”, and “MBIs: Barriers”. The participants identified the behavioural, emotional, and cognitive challenges impacting their child’s participation. Financial and environmental constraints, stigma, and timing were the reported barriers to services. The participants felt positive about the potential of MBIs to support their children. Conclusions: Overall, this study obtained foundational data to establish accessible mental health programmes for refugees with disabilities. Further research is needed to transcend the barriers and maintain MBI programmes in the community and the home settings. Full article
(This article belongs to the Special Issue Behavioral and Mental Health Problems in Children: 2nd Edition)
16 pages, 304 KiB  
Article
Twelve-Year Changes in Pre-Schoolers’ Oral Health and Parental Involvement in Children’s Dental Care: Results from Two Repeated Cross-Sectional Surveys in Lithuania
by Apolinaras Zaborskis, Jaunė Razmienė, Augustė Razmaitė, Vilija Andruškevičienė, Julija Narbutaitė, Eglė Aida Bendoraitienė and Aistė Kavaliauskienė
Children 2024, 11(11), 1380; https://doi.org/10.3390/children11111380 - 13 Nov 2024
Viewed by 534
Abstract
Background and objectives: The role of parents and the family in promoting children’s oral health is increasingly acknowledged in the dental literature. This study aimed to investigate twelve-year changes in pre-schoolers’ oral health and parental involvement in children’s dental care using data from [...] Read more.
Background and objectives: The role of parents and the family in promoting children’s oral health is increasingly acknowledged in the dental literature. This study aimed to investigate twelve-year changes in pre-schoolers’ oral health and parental involvement in children’s dental care using data from two repeated cross-sectional surveys. The objectives were (1) to assess the temporal changes in children’s dental health status and oral health-related behaviours, (2) to examine temporal changes in parental attitudes toward their children’s oral health care, and (3) to analyze the associations between observed changes. Materials and methods: Two identical cross-sectional surveys were conducted in 2010/2011 (n = 294) and 2023 (n = 304). In both surveys, parents answered questions regarding their children’s oral health care and completed the 38-item ‘Parental Attitudes toward Children’s Oral Health’ (PACOH) scale, while the dental health of their 3–7-year-old children was clinically assessed. Changes in the examined characteristics were analyzed using general linear models. Results: Significant positive changes (p < 0.001) were observed when comparing the surveys: the dmf-t (decayed, missing, filled teeth) score for deciduous teeth decreased from 5.56 to 3.31; the Silness–Löe Plaque Index decreased from 1.45 to 1.15; the percentage of children brushing their teeth regularly increased from 33.0% to 55.3%; the percentage of parents assisting their child with tooth brushing increased from 19.2% to 85.1%; and regular visits to a children’s dentist increased from 36.4% to 85.1%. Moreover, the study revealed better parental attitudes toward their children’s oral health care, as reflected by a change in the total score of the PACOH scale from 112 to 122. Conclusions: It was concluded that changes in parental attitudes played a crucial role in driving positive trends in oral health-related behaviours, which likely contributed to the improvement of dental health in children. Therefore, understanding and influencing parental attitudes can be essential for promoting good oral health skills and good oral health in young children. Full article
(This article belongs to the Section Global Pediatric Health)
8 pages, 365 KiB  
Article
Hyperlactataemia Following Crystalloid Cardiopulmonary Bypass Priming in Paediatric Cardiac Surgery—Benign or Malignant? A Retrospective Study
by Philippa Jane Temple Bowers, Michael Daley, Nicole Yvette Renee Shrimpton, Adrian Mattke, Fumiaki Shikata, Kim Betts, Anthony Black, Supreet Prakash Marathe, Prem Venugopal and Nelson Alphonso
Children 2024, 11(11), 1379; https://doi.org/10.3390/children11111379 - 13 Nov 2024
Viewed by 434
Abstract
Background: Various mechanisms leading to early hyperlactataemia post-cardiac surgery have been postulated. Specifically, in the paediatric population, benign early hyperlactataemia may be associated with crystalloid priming in the cardiopulmonary bypass circuit. The aim of this study was to review paediatric patients who had [...] Read more.
Background: Various mechanisms leading to early hyperlactataemia post-cardiac surgery have been postulated. Specifically, in the paediatric population, benign early hyperlactataemia may be associated with crystalloid priming in the cardiopulmonary bypass circuit. The aim of this study was to review paediatric patients who had crystalloid prime and assess their outcomes. Methods: A retrospective review of paediatric patients who underwent cardiac surgery with crystalloid prime at our institution between November 2014 and May 2018 was performed. Data were collected from medical and laboratory records. Results: Among 569 patients, 237 (42%) received a crystalloid prime; 51 (22%) were excluded due to intraoperative hyperlactataemia. Of the remaining 186 patients, 98 (53%) developed hyperlactataemia postoperatively. Patients with hyperlactataemia had longer cardiopulmonary bypass and aortic cross-clamp times but similar Aristotle complexity scores. Patients with postoperative hyperlactataemia had higher peak VIS [median 8 (IQR 0–8) vs. 5 (IQR 0–8)] within the first 24 h (p = 0.002). However, there was no difference in the duration of ventilation between the two groups (p = 0.14). Yet only 58% of patients with hyperlactataemia were discharged from the ICU within 24 h, compared to 78% without hyperlactataemia. Conclusions: In this study population, transient postoperative hyperlactataemia in paediatric patients with crystalloid prime may not necessarily indicate tissue hypoxaemia. Despite a similar duration of ventilation in patients with and without hyperlactataemia, patients with hyperlactataemia had a longer duration of inotropes and ICU stay. Consideration should be given to discontinuing inotropes in patients with crystalloid prime and postoperative early hyperlactataemia once they are extubated. Full article
(This article belongs to the Section Pediatric Cardiology)
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