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Children, Volume 11, Issue 6 (June 2024) – 120 articles

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11 pages, 221 KiB  
Article
Antibiotic Exposure of Critically Ill Children at a Tertiary Care Paediatric Intensive Care Unit in Switzerland
by Anica Fenner, Melanie Huber, Verena Gotta, Vera Jaeggi, Luregn J. Schlapbach and Philipp Baumann
Children 2024, 11(6), 731; https://doi.org/10.3390/children11060731 (registering DOI) - 15 Jun 2024
Abstract
Antibiotic overtreatment fosters multidrug-resistance that threatens healthcare systems worldwide as it increases patient morbidity and mortality. Contemporary data on antibiotic usage on tertiary care paediatric intensive care units for in- and external benchmarking are scarce. This was a single-centre retrospective quality control study [...] Read more.
Antibiotic overtreatment fosters multidrug-resistance that threatens healthcare systems worldwide as it increases patient morbidity and mortality. Contemporary data on antibiotic usage on tertiary care paediatric intensive care units for in- and external benchmarking are scarce. This was a single-centre retrospective quality control study including all patients with antibiotic treatment during their hospitalization at a paediatric intensive care unit in the time period 2019–2021. Antibiotic treatment was calculated as days of therapy (DOT) per 100 patient days (DOT/100pd). Further, the variables PIM II score, length of stay in intensive care (LOS), gender, age, treatment year, reason for intensive care unit admission, and death were assessed. Two thousand and forty-one cases with a median age of 10 months [IQR 0–64] were included; 53.4% were male, and 4.5% of the included patients died. Median LOS was 2.73 days [0.07–5.90], and PIM II score was 1.98% [0.02–4.86]. Overall, the antibiotic exposure of critically ill children and adolescents was 59.8 DOT/100pd. During the study period, the antibiotic usage continuously increased (2019: 55.2 DOT/100pd; 2020: 59.8 DOT/100pd (+8.2%); 2021: 64.5 DOT/100pd (+8.0%)). The highest antibiotic exposure was found in the youngest patients (0–1 month old (72.7 DOT/100pd)), in patients who had a LOS of >2–7 days (65.1 DOT/100pd), those who had a renal diagnosis (98 DOT/100pd), and in case of death (91.5 DOT/100pd). Critically ill paediatric patients were moderately exposed to antibiotics compared to data from the previously published literature. The current underreporting of antimicrobial prescription data in this cohort calls for future studies for better internal and external benchmarking. Full article
10 pages, 326 KiB  
Article
Self-Assessed Educational Needs of Chinese Pediatric Clinicians Regarding Pediatric Palliative Care: A Cross-Sectional Investigation
by Xiaoxia Lu, Yanmei Wang, Jingke Li, Yue-Cune Chang and Niang-Huei Peng
Children 2024, 11(6), 730; https://doi.org/10.3390/children11060730 (registering DOI) - 14 Jun 2024
Abstract
Background: An important first step in enhancing professional palliative care training is to investigate the educational needs of pediatric clinicians in this field. The aims of this research were to analyze the extent of end-of-life care experience of Chinese pediatric clinicians and [...] Read more.
Background: An important first step in enhancing professional palliative care training is to investigate the educational needs of pediatric clinicians in this field. The aims of this research were to analyze the extent of end-of-life care experience of Chinese pediatric clinicians and identify the differing educational needs of physicians and nurses as well as associated impact factors. Methods: A cross-sectional descriptive survey via a structural questionnaire was used in this research. Results: In total, 187 clinicians, comprising 52 physicians and 135 nurses, participated in this study. The topics “pain management”, “symptom management”, and “discussing the prognosis with family members” were the most expressed educational needs among both physicians and nurses. Compared to nurses, physicians placed greater emphasis on the importance of “communication” and “pain and symptom management” (p < 0.05). Clinicians with more extensive end-of-life care experience more strongly felt the importance of learning about pain management and communication regarding end-of-life care (p < 0.05). Conclusions: Research showed that the education currently provided to pediatric clinicians does not meet their distinctive needs. Future palliative care education must be a continuing multi-level, interdisciplinary program and different education should be provided to physicians and nurses based on their respective needs. Full article
52 pages, 1014 KiB  
Systematic Review
Vulnerability in Children with Celiac Disease: Findings from a Scoping Review
by Lúcia Macedo, Marta Catarino, Constança Festas and Paulo Alves
Children 2024, 11(6), 729; https://doi.org/10.3390/children11060729 - 14 Jun 2024
Viewed by 85
Abstract
(1) Background: The scientific literature highlights that children diagnosed with celiac disease (CD) are at a heightened risk of experiencing physical, psychological, and social challenges, impacting their overall healthy childhood development. However, there remains a lack of a clear understanding regarding the factors [...] Read more.
(1) Background: The scientific literature highlights that children diagnosed with celiac disease (CD) are at a heightened risk of experiencing physical, psychological, and social challenges, impacting their overall healthy childhood development. However, there remains a lack of a clear understanding regarding the factors that contribute to this vulnerability. The purpose of this study is to analyze and map the evidence on the sociopsychosomatic vulnerability of these children and identify gaps in this topic. (2) Methods: Following Joanna Briggs Institute’s guidelines for scoping reviews, we executed a detailed search of key electronic databases and explored the grey literature to capture a broad spectrum of studies. Our focus was on identifying research that looked into the multiple dimensions of vulnerability—physical, psychological, and social—in children with CD. We included a diverse range of study designs as well as systematic reviews, ensuring a comprehensive analysis. The selection process was stringent, utilizing clearly defined inclusion and exclusion criteria. (3) Results: We identified 61 studies that met our inclusion criteria. The review highlighted significant adverse health outcomes in children with CD and elucidated various individual and environmental determinants that influenced these vulnerabilities. It also underscored the lack of assessment tools to evaluate the risk of health problems in this population. (4) Conclusions: The findings underscore a critical need for further research to deepen our understanding of the vulnerabilities associated with CD in children. Developing targeted assessment tools will be crucial in stratifying health risks and enhancing care strategies for this vulnerable population. Full article
(This article belongs to the Section Pediatric Nursing)
8 pages, 239 KiB  
Article
Evaluation of Sleep Quality in Asthmatic Children with the Paediatric Sleep Questionnaire (PSQ)
by Mehmet Yaşar Özkars, Seda Çevik, Serap Ata, Alican Sarısaltık and Uğur Altaş
Children 2024, 11(6), 728; https://doi.org/10.3390/children11060728 - 14 Jun 2024
Viewed by 132
Abstract
Considering the high prevalence of sleep-related breathing disorders (SRBD) in asthmatic patients, we aimed to compare asthmatic children and healthy children in terms of SRBD according to Paediatric Sleep Questionnaire (PSQ) scores. A questionnaire covering sociodemographic characteristics of the patients and the PSQ, [...] Read more.
Considering the high prevalence of sleep-related breathing disorders (SRBD) in asthmatic patients, we aimed to compare asthmatic children and healthy children in terms of SRBD according to Paediatric Sleep Questionnaire (PSQ) scores. A questionnaire covering sociodemographic characteristics of the patients and the PSQ, which evaluates sleep quality and consists of 22 questions, was administered. During the data collection process, 180 patients in the patient group and 170 patients in the control group were included. The patient group showed statistically significantly higher total scores and subscale scores for snoring, sleepiness, and inattention compared to the control group. Statistically significant correlations were found between the sleepiness subscale and body mass index z score in a negative direction and between age at presentation and duration of asthma in a positive direction. Our findings endorse employing the PSQ as a screening instrument in the outpatient environment to ensure timely referral of asthma patients to a sleep specialist for SRBD evaluation. Considering the widespread occurrence of snoring and asthma, this tool could aid in identifying patients with an elevated risk of SRBD and expedite the scheduling of nocturnal polysomnography for these children. Full article
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12 pages, 1350 KiB  
Article
Characterization of Primary IGF-1 Deficiency in a Cohort of Canadian Children with Short Stature Using a Novel Algorithm Tailored to Electronic Medical Records
by Rinila Haridas, Carly Baxter, Saunya Dover, Ellen B. Goldbloom, Ivan Terekhov and Marie-Eve Robinson
Children 2024, 11(6), 727; https://doi.org/10.3390/children11060727 - 14 Jun 2024
Viewed by 163
Abstract
(1) Background: Severe primary insulin-like growth factor-I deficiency (SPIGFD) is a rare disorder causing short stature in children due to low insulin-like growth factor 1 (IGF-1) levels. Given the sparsity of reported cases of SPIGFD worldwide, the condition may be underdiagnosed, potentially preventing [...] Read more.
(1) Background: Severe primary insulin-like growth factor-I deficiency (SPIGFD) is a rare disorder causing short stature in children due to low insulin-like growth factor 1 (IGF-1) levels. Given the sparsity of reported cases of SPIGFD worldwide, the condition may be underdiagnosed, potentially preventing affected children from receiving therapy with recombinant human IGF-1 (rhIGF-1). Our objective was to determine the prevalence of SPIGFD among children with short stature at a large pediatric tertiary care center through the use of a novel electronic medical record (EMR) algorithm. (2) Methods: We queried our EMR using an algorithm that detected all children seen at our center between 1 November 2013 and 31 August 2021 with short stature and low IGF-1. We then conducted chart reviews, applying established diagnostic criteria for those identified with potential SPIGFD. (3) Results: From a cohort of 4863 children with short stature, our algorithm identified 30 (0.6%) patients with potential SPIGFD. Using chart reviews, we determined that none of these patients had SPIGFD. (4) Conclusions: Our algorithm can be used in other EMRs to identify which patients are likely to have SPIGFD and thus benefit from treatment with rhIGF-1. This model can be replicated for other rare diseases. Full article
(This article belongs to the Special Issue Pediatric Growth and Skeletal Disorders)
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18 pages, 317 KiB  
Article
Lifestyle Habits Related to Internet Use in Adolescents: Relationships between Wellness, Happiness, and Mental Health
by Sigita Lesinskienė, Rokas Šambaras, Agnė Butvilaitė, Justina Andruškevič, Margarita Kubilevičiūtė, Urtė Stanelytė, Severija Skabeikaitė, Izabelė Jūraitytė, Ieva Ridzvanavičiūtė, Kamilė Pociūtė and Natalja Istomina
Children 2024, 11(6), 726; https://doi.org/10.3390/children11060726 - 14 Jun 2024
Viewed by 230
Abstract
Background: Studies in recent years have shown a significant increase in problematic internet use. Prolonged internet usage negatively impacts various aspects of adolescents’ lifestyles. Methods: The survey was conducted in three Lithuanian cities—Vilnius, Klaipėda, and Molėtai—between October and December of 2023. The survey [...] Read more.
Background: Studies in recent years have shown a significant increase in problematic internet use. Prolonged internet usage negatively impacts various aspects of adolescents’ lifestyles. Methods: The survey was conducted in three Lithuanian cities—Vilnius, Klaipėda, and Molėtai—between October and December of 2023. The survey involved students between the ages of 12 and 16. The participants completed a questionnaire that included questions about wellness and happiness, the Internet Addiction Test (IAT), and the Strengths and Difficulties Questionnaire (SDQ). Our study aimed to investigate problematic internet use among Lithuanian adolescents and its relationships with wellness, happiness, and mental health. Results: This study included 1412 adolescents, with a mean age of 14.41 ± 1.20, with the sample composed of 52.3% boys. Boys indicated that they felt healthier and happier than girls (69.4% vs. 47.4%; 51.4% vs. 29.6%), p < 0.001. A total of 20.8% of students had IAT scores that reflect a normal level of internet usage. For IAT, the average score of girls was statistically significantly higher than that of boys (41.87 ± 12.24 vs. 39.96 ± 12.37), p < 0.001. The IAT score was higher in the group of students who felt less happy and healthy, had more frequent headaches or abdominal pain, and had problems with sleep, p < 0.001. A statistically significant, positive weak correlation was found between students’ IAT scores and SDQ internalizing and SDQ externalizing scores (r = 0.366; r = 0.385, p < 0.001). Conclusions: Prolonged internet use is arising as a serious problem among adolescents. Negative feelings, unhappiness, and poor emotion regulation have an association with internet addiction. Also, the female gender may be more associated with possible internet addiction. The results of this study can serve as initial steps toward developing preventive interventions. Full article
(This article belongs to the Special Issue Physical Activity and Lifestyle Habits in Children and Adolescents)
10 pages, 1391 KiB  
Article
Relationship between Baseline Serum Potassium and 1-Year Readmission in Pediatric Patients with Heart Failure: A Retrospective Cohort Study
by Yong Han, Yuqin Huang, Danyan Su, Dongli Liu, Cheng Chen and Yusheng Pang
Children 2024, 11(6), 725; https://doi.org/10.3390/children11060725 - 14 Jun 2024
Viewed by 206
Abstract
Pediatric heart failure (HF) is associated with high readmission rates, but the optimal serum potassium range for this population remains unclear. In this single-center retrospective cohort study, 180 pediatric patients hospitalized for HF between January 2016 and January 2022 were stratified into low-potassium [...] Read more.
Pediatric heart failure (HF) is associated with high readmission rates, but the optimal serum potassium range for this population remains unclear. In this single-center retrospective cohort study, 180 pediatric patients hospitalized for HF between January 2016 and January 2022 were stratified into low-potassium (<3.7 mmol/L), middle-potassium (3.7–4.7 mmol/L), and high-potassium (≥4.7 mmol/L) groups based on the distribution of potassium levels in the study population. The primary outcome was readmission for HF within 1 year of discharge. Cox regression and restricted cubic spline models were used to assess the association between potassium levels and 1-year HF readmission rates. Notably, 38.9% of patients underwent 1 or more 1-year readmissions for HF within 1 year. The high-potassium group had a significantly higher readmission frequency than the middle-potassium group. In multivariate Cox regression models, potassium levels of ≥4.7 mmol/L were independently associated with increased 1-year readmission risk. A J-shaped relationship was observed between baseline potassium levels and 1-year readmission risk, with the lowest risk at 4.1 mmol/L. In pediatric patients with HF, a serum potassium level ≥ 4.7 mmol/L was independently associated with increased 1-year readmission risk. Maintaining potassium levels within a narrow range may improve outcomes in this population. Full article
(This article belongs to the Special Issue Heart Failure in Children and Adolescents)
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11 pages, 484 KiB  
Article
Validity of the BOT-2 Short Form for Korean School-Age Children: A Preliminary Study
by Deukgeun Yoon, Dabin Choi, Misun Kim, Seokyeon Ji, Yoo-Sook Joung and Eun Young Kim
Children 2024, 11(6), 724; https://doi.org/10.3390/children11060724 - 13 Jun 2024
Viewed by 125
Abstract
The Bruininks–Oseretsky Test of Motor Proficiency Second Edition (BOT-2) is the most common motor assessment in Korea. The BOT-2–Short Form (SF) is preferred over the complete form (CF) in settings with limited time. The present study aimed to assess the validity of the [...] Read more.
The Bruininks–Oseretsky Test of Motor Proficiency Second Edition (BOT-2) is the most common motor assessment in Korea. The BOT-2–Short Form (SF) is preferred over the complete form (CF) in settings with limited time. The present study aimed to assess the validity of the BOT-2 SF in Korean school-age children. First, we verified that the BOT-2 SF reflects developmental changes in motor skills. Second, we compared the BOT-2 SF scores to those of the BOT-2 CF. A total of 283 Korean school-age children performed the BOT-2. The differences in the BOT-2 SF point according to age group (7 years, 8–9 years, and 10–12 years) were analyzed. A correlation analysis of the standard scores between the BOT-2 SF and CF was conducted. The sensitivity and specificity of the BOT-2 SF were calculated in reference to its CF. Overall, the BOT-2 SF point scores increased with age. The correlation between the total scores of the BOT-2 SF and CF was strong. The BOT-2 SF had a sensitivity of 83% and specificity of 92%. This study has demonstrated the validity of the BOT-2 SF in Korean school-age children. The BOT2 SF can be useful in screening Korean school-age children with motor skills problems. Full article
(This article belongs to the Special Issue Motor Development in Children)
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13 pages, 982 KiB  
Article
Incidence and Importance of Peripheral Vestibular Dysfunction in Adolescent Idiopathic Scoliosis
by Liliana Vlădăreanu, Mădălina Gabriela Iliescu, Iulia Tania Andronache and Elena Danteș
Children 2024, 11(6), 723; https://doi.org/10.3390/children11060723 - 13 Jun 2024
Viewed by 135
Abstract
Adolescent idiopathic scoliosis (AIS) is a common form of scoliosis. As the name suggests, etiopathogenesis is not clearly defined, so treatment is still anchored in the musculoskeletal theory and correction/prevention of high Cobb angle values. This study aimed to determine whether there is [...] Read more.
Adolescent idiopathic scoliosis (AIS) is a common form of scoliosis. As the name suggests, etiopathogenesis is not clearly defined, so treatment is still anchored in the musculoskeletal theory and correction/prevention of high Cobb angle values. This study aimed to determine whether there is any connection between developing scoliotic curvature and a positive history of motion sickness as a symptom of a peripheral vestibular dysfunction/deficit, and if vestibular rehabilitation exercises could be integrated into the treatment plan. The study was conducted over 12 months on a selected population of 159 patients to evaluate or treat scoliotic curvatures in a private clinic. The collected data were analyzed using IBM SPSS Statistics 25 and illustrated using Microsoft Office Excel/Word 2021. Patients with peripheral vestibular dysfunction had significantly higher Cobb angle values when compared to patients with a negative result in an instrumental test for peripheral vestibular dysfunction. Motion sickness was considerably more associated with peripheral vestibular dysfunction, and a positive Fukuda stepping test was associated with a positive history of motion sickness. Adolescent idiopathic scoliosis with higher Cobb angles is related to positive motion sickness history as part of peripheral vestibular dysfunction. Conservative treatment for scoliosis could incorporate sensory integration techniques, and a positive history of motion sickness could be an indicator of a higher risk of progression in adolescent idiopathic scoliosis. Full article
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10 pages, 243 KiB  
Article
Understanding the Multiple Influences on Black Parents’ School Involvement: A Longitudinal Perspective
by Adrian Gale, Ed-Dee Williams, Donte Boyd and Husain Lateef
Children 2024, 11(6), 722; https://doi.org/10.3390/children11060722 - 13 Jun 2024
Viewed by 174
Abstract
This study explores longitudinal influences of various factors on Black parents’ involvement in their children’s education. Guided by Hoover-Dempsey & Sandler’s Model of Parent Involvement, this research examines whether parents’ school climate perceptions, attitudes about involvement, self-efficacy, and children’s academic performance predict parent [...] Read more.
This study explores longitudinal influences of various factors on Black parents’ involvement in their children’s education. Guided by Hoover-Dempsey & Sandler’s Model of Parent Involvement, this research examines whether parents’ school climate perceptions, attitudes about involvement, self-efficacy, and children’s academic performance predict parent involvement over time. Utilizing data from the Maryland Adolescence in Context Study with a sample of 560 Black parents, we found that positive school climate perceptions and favorable attitudes towards involvement significantly predict increased parent involvement in later years. The results underscore the importance of supportive school environments and parent attitudes in fostering their involvement. Full article
(This article belongs to the Section Global and Public Health)
18 pages, 1200 KiB  
Article
Sex Differences in White Matter Diffusivity in Children with Developmental Dyslexia
by Gehna Gupta, C. Nikki Arrington and Robin Morris
Children 2024, 11(6), 721; https://doi.org/10.3390/children11060721 - 13 Jun 2024
Viewed by 202
Abstract
Despite the high prevalence of developmental dyslexia in the U.S. population, research remains limited and possibly biased due to the overrepresentation of males in most dyslexic samples. Studying biological sex differences in the context of developmental dyslexia can help provide a more complete [...] Read more.
Despite the high prevalence of developmental dyslexia in the U.S. population, research remains limited and possibly biased due to the overrepresentation of males in most dyslexic samples. Studying biological sex differences in the context of developmental dyslexia can help provide a more complete understanding of the neurological markers that underly this disorder. The current study aimed to explore sex differences in white matter diffusivity in typical and dyslexic samples in third and fourth graders. Participants were asked to complete behavioral/cognitive assessments at baseline followed by MRI scanning and diffusion-weighted imaging sequences. A series of ANOVAs were conducted for comparing group membership (developmental dyslexia or typically developing), gender status (F/M), and white matter diffusivity in the tracts of interest. The Results indicated significant differences in fractional anisotropy in the left hemisphere components of the inferior and superior (parietal and temporal) longitudinal fasciculi. While males with dyslexia had lower fractional anisotropy in these tracts compared to control males, no such differences were found in females. The results of the current study may suggest that females may use a more bilateral/alternative reading network. Full article
(This article belongs to the Special Issue Neurodevelopmental Disorders in Pediatrics)
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11 pages, 3351 KiB  
Review
Maxillary Hypoplasia and Non-Invasive Ventilation: Literature Review and Proposed New Treatment Protocol
by Maria Costanza Meazzini, Mattia Moretti, Gabriele Canzi, Davide Sozzi, Giorgio Novelli and Fabio Mazzoleni
Children 2024, 11(6), 720; https://doi.org/10.3390/children11060720 - 13 Jun 2024
Viewed by 139
Abstract
The impact of non-invasive ventilation (NIV) on pediatric maxillary growth is a subject of ongoing research considering its increased use in the pediatric population due to technological advancements and broader indications. This review examines the existing literature, encompassing original articles, case reports, and [...] Read more.
The impact of non-invasive ventilation (NIV) on pediatric maxillary growth is a subject of ongoing research considering its increased use in the pediatric population due to technological advancements and broader indications. This review examines the existing literature, encompassing original articles, case reports, and reviews, to evaluate the effects of NIV on maxillary development and explore potential treatment options. Although the majority of studies agree on the adverse effects of prolonged NIV on maxillary development, techniques for its correction remain understudied. Introducing a novel treatment protocol, we addressed the challenge of correcting severe midfacial hypoplasia in a child with congenital central hypoventilation syndrome (CCHS) undergoing NIV therapy, thus sidestepping the necessity for osteotomies. This proposed protocol holds promise in correcting the adverse impact of NIV on maxillary growth, emphasizing the need for further exploration into innovative treatment modalities. Full article
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15 pages, 670 KiB  
Article
Proprioception, Emotion and Social Responsiveness in Children with Developmental Disorders: An Exploratory Study in Autism Spectrum Disorder, Cerebral Palsy and Different Neurodevelopmental Situations
by Inmaculada Riquelme, Samar M. Hatem, Álvaro Sabater-Gárriz, Elisabeth Martín-Jiménez and Pedro Montoya
Children 2024, 11(6), 719; https://doi.org/10.3390/children11060719 - 13 Jun 2024
Viewed by 179
Abstract
Proprioception has long been linked with emotional dysregulation in neurotypical adults. Neuropediatric disorders such as autism spectrum disorder (ASD) and cerebral palsy (CP) are distinct entities and yet both present with deficits and challenges in sensory processing and the regulation of emotions. This [...] Read more.
Proprioception has long been linked with emotional dysregulation in neurotypical adults. Neuropediatric disorders such as autism spectrum disorder (ASD) and cerebral palsy (CP) are distinct entities and yet both present with deficits and challenges in sensory processing and the regulation of emotions. This study aimed to explore the relationship between proprioception and emotional–social performance in children and to compare proprioception and emotional–social performance in different underlying neurodevelopmental conditions. For this purpose, this cross-sectional study included 42 children with ASD, 34 children with CP and 50 typically developing peers. Proprioceptive acuity, proprioceptive reactive behavior as well as emotion regulation and social responsiveness were assessed. The results show a significant correlation between proprioceptive deficits and emotional difficulties in this pediatric sample, with distinct proprioceptive impairment patterns according to the underlying neurological disorder. Children with CP showed significant emotional knowledge deficits, while children with ASD predominantly showed challenges in social responsiveness. These data thus suggest a differentiated impact of proprioception on emotional–social performance in neurodevelopmental disorders and highlight proprioception as a potential therapeutic target for balancing emotion regulation in children with neurodevelopmental conditions. Full article
(This article belongs to the Special Issue Neurodevelopmental Disorders in Pediatrics)
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8 pages, 448 KiB  
Brief Report
Does the ST2 Level in Pediatric Heart Failure Patients Correlate with Cardiovascular Events and Mortality?
by Ayse Sulu, Gulcan Uner, Pelin Kosger and Birsen Ucar
Children 2024, 11(6), 718; https://doi.org/10.3390/children11060718 - 13 Jun 2024
Viewed by 135
Abstract
Introduction: The suppression of tumorigenicity 2 (ST2) is a receptor member belonging to the interleukin-1 (IL-1) family. The ligand and soluble versions are its two isoforms. The IL-33-ST2L ligand complex’s development provides protection against heart fibrosis and hypertrophy. Investigations on heart failure in [...] Read more.
Introduction: The suppression of tumorigenicity 2 (ST2) is a receptor member belonging to the interleukin-1 (IL-1) family. The ligand and soluble versions are its two isoforms. The IL-33-ST2L ligand complex’s development provides protection against heart fibrosis and hypertrophy. Investigations on heart failure in adults have demonstrated that it does not change by age, body mass index (BMI), creatinine, hemoglobin, and albumin levels, in contrast to NT pro BNP. In adult heart failure patients, it has been demonstrated to be an independent predictor of mortality and cardiovascular events. The most recent guideline recommends using it as class 2b in the diagnosis of adult heart failure. Studies on ST2 in children are rare. The purpose of this study is to assess the prognostic value of ST2 for cardiovascular events in young individuals suffering from heart failure. Method: This study included pediatric patients (0–18 years old) with congenital heart disease or cardiomyopathy who needed medical care, as well as surgical or interventional treatment. Height, weight, gender, saturation, heart failure classification (Ross or NYHA), medications, the electrocardiogram, echocardiography, pro BNP, and sST2 values of the patients, as well as any hospitalization, lower respiratory tract infection, organ dysfunction, or need for angiography or surgery during follow-up data on arrhythmia and death were gathered during a 1-year follow-up. The SPSS software version 25 application was used to carry out the statistical analysis. Results: This study included 59 patients, of whom 27 (46.6%) were male. The average age of the patients was 55.5 months (1–228 months) and the average body weight was 16 kg (2.6–90 kg). Major cardiovascular events occurred in 45 of 59 patients (76.3%). Twenty-four patients experienced one MACE, while twenty-one patients experienced multiple MACEs. Pro BNP and sST2 levels were similar in the groups that developed MACE compared to those that did not. Pro BNP was discovered to be significantly higher in patients with hospitalization, growth retardation, lower respiratory tract infection, and organ failure, however, when assessing each situation (p = 0.001, p = 0.011, p = 0.001, p = 0.007, respectively). Soluble ST2 was found to be higher in patients with growth retardation than in those without (p = 0.037). Although the soluble ST2 level failed to demonstrate a correlation with pro BNP, it did show a positive correlation (r = 0.437) with the Ross score. When compared to other groups, it was discovered to be higher in patients with valvular insufficiency type heart disease. Conclusions: In this study, higher sST2 levels were discovered, particularly in the group with valve insufficiency and children with growth retardation. It was associated with the Ross score, but not with the pro BNP level. Although it increases in correlation with clinical heart failure, its predictive value for MACE is low. Similarly, pro BNP is not proven to be predictive; nonetheless, its high levels in patients with hospitalization, growth retardation, lower respiratory tract infection, and organ failure demonstrate that pro BNP may increase for a variety of causes. Long-term studies with more patients are needed for ST2 to be suitable for clinical use in pediatric patients. Full article
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15 pages, 1722 KiB  
Article
Exploring the Relationship between Wind Patterns and Hospital Admissions Due to Respiratory Symptoms in Children
by Despoina Boura, Marios Spanakis, George Markakis, George Notas, Christos Lionis, Nikolaos Tzanakis and Emmanouil Paraskakis
Children 2024, 11(6), 717; https://doi.org/10.3390/children11060717 - 12 Jun 2024
Viewed by 346
Abstract
Respiratory disorders significantly impact adolescents' health, often resulting in hospital admissions. Meteorological elements such as wind patterns have emerged as potential contributors to respiratory symptoms. However, it remains uncertain whether fluctuations in wind characteristics over extended periods have a tangible impact on respiratory [...] Read more.
Respiratory disorders significantly impact adolescents' health, often resulting in hospital admissions. Meteorological elements such as wind patterns have emerged as potential contributors to respiratory symptoms. However, it remains uncertain whether fluctuations in wind characteristics over extended periods have a tangible impact on respiratory health, particularly in regions characterized by distinct annual wind patterns. Crete is situated in the central-eastern Mediterranean Sea and frequently faces southerly winds carrying Sahara Desert sand from Africa and northerly winds from the Aegean Sea. This retrospective study analyzes long-term wind direction data and their relationship to respiratory symptoms observed in children up to 14 years old admitted at the University Hospital of Heraklion between 2002 and 2010. Symptoms such as headache, dyspnea, dry cough, dizziness, tachypnea, throat ache, and earache were predominantly reported during the presence of southern winds. Fever, productive cough, and chest pain were more frequently reported during northern winds. Cough was the most common symptom regardless of the wind pattern. Southern winds were significantly associated with higher probabilities of productive or non-productive cough, headache, dyspnea, tachypnea, dizziness, earache, and throat ache. Northern winds were related to a higher incidence of productive cough. Rhinitis, asthma, allergies, pharyngitis, and sinusitis were related to southern winds, while bronchiolitis and pneumonia were associated with northern winds. These findings underscore the critical role of local climatic factors, emphasizing their potential impact on exacerbating respiratory conditions in children. Moreover, they point out the need for further research to elucidate the underlying mechanisms and develop targeted interventions for at-risk populations. Full article
13 pages, 735 KiB  
Brief Report
A Psychometric Examination of the Abbreviated Version of the Parenting Styles Scale Using a Sample of Chilean Adolescents
by José Luis Gálvez-Nieto, Karina Polanco-Levicán, Sonia Salvo-Garrido and María Pía Godoy-Bello
Children 2024, 11(6), 716; https://doi.org/10.3390/children11060716 - 12 Jun 2024
Viewed by 180
Abstract
Parenting styles have been related to a series of variables that contribute positively to adulthood. The maternal and paternal parenting styles scale is a measure that presents a multidimensional structure of six correlated factors. However, the version available for Chile is extensive, with [...] Read more.
Parenting styles have been related to a series of variables that contribute positively to adulthood. The maternal and paternal parenting styles scale is a measure that presents a multidimensional structure of six correlated factors. However, the version available for Chile is extensive, with 82 items measuring this latent trait. Therefore, the aim of this study was to examine the psychometric properties of the reliability and validity of the abbreviated version of the maternal and paternal parenting styles scale using a sample of Chilean adolescents. The sample consisted of 2131 students of both the male and female sexes (51% males and 49% females) with a mean age of 15.85 years (SD = 1.37). The results of the exploratory and confirmatory factor analyses supported the six-factor correlated model, showing robust psychometric indices for both modelling approaches. In relation to the factorial invariance models, the results show factorial equivalence at the scalar invariance level for the variables of sex, age, academic achievement, and type of school. The scale showed adequate levels of reliability. This study concludes that the abbreviated version of the maternal and paternal parenting styles scale is a reliable and valid instrument for its application in Chilean adolescents. Full article
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12 pages, 303 KiB  
Article
Development of Basic Motor Skills from 3 to 10 Years of Age: Comparison by Sex and Age Range in Chilean Children
by Juan Hurtado-Almonacid, Tomás Reyes-Amigo, Rodrigo Yáñez-Sepúlveda, Guillermo Cortés-Roco, Cristian Oñate-Navarrete, Jorge Olivares-Arancibia and Jacqueline Páez-Herrera
Children 2024, 11(6), 715; https://doi.org/10.3390/children11060715 - 11 Jun 2024
Viewed by 324
Abstract
Basic motor skills are recognized as fundamental movements that allow children to interact with their environment and are identified as the basic structure on which more complex movements are built. Objective: to identify the level of motor development of children from 3 to [...] Read more.
Basic motor skills are recognized as fundamental movements that allow children to interact with their environment and are identified as the basic structure on which more complex movements are built. Objective: to identify the level of motor development of children from 3 to 10 years of age according to sex and age group. Methodology. We studied a sample with a total of 328 participants (girls = 170; boys = 158) at preschool (n = 154) and school levels (n = 174). The ages of the students ranged from 3 to 10 years, with a mean of 5.94 years (±2.53). TGMD2 was applied to identify motor development. Results: boys and girls present low levels of physical activity, with most of them in the very poor, poor, and low-average categories (n = 182, 55.5%). Levels of motor development in locomotion, manipulation, and general development by age show significant differences (p = 0.000). However, levels of development by sex are not significant in manipulation, locomotion, and gross motor skills tests, respectively (p = 0.150, p = 0.208, and p = 0.210), and in relation to chronological age and motor development age show significant differences (p = 0.000). Full article
(This article belongs to the Special Issue Motor Development in Children)
14 pages, 619 KiB  
Article
The Role of Social Problem-Solving and Prosocial Behavior in First Aid Willingness among Adolescents in Hungary
by Zsolt Katona, Klára Tarkó, Zita Petrovszki, Ferenc Győri, Beáta Vári, Balázs Polcsik and Tamás Berki
Children 2024, 11(6), 714; https://doi.org/10.3390/children11060714 - 10 Jun 2024
Viewed by 266
Abstract
First aid is a key factor in preventing further deterioration in an accident, saving lives, or improving treatment in emergencies. However, the reasons behind the willingness to provide first aid are still unclear. Therefore, this study aimed to investigate the role of social [...] Read more.
First aid is a key factor in preventing further deterioration in an accident, saving lives, or improving treatment in emergencies. However, the reasons behind the willingness to provide first aid are still unclear. Therefore, this study aimed to investigate the role of social problem-solving and prosocial behavior in the dimension of first aid willingness. Self-administered questionnaires were used to evaluate the dimensions of first aid willingness (first aid willingness for peers, first aid willingness for strangers, knowledge, and negative emotions), social problem solving (positive problem orientation, negative problem orientation, rational problem solving, avoidance style, and impulsivity/carelessness) and prosocial behavior. A total of 497 school-aged students between the ages of 12 and 15 years (201 boys and 296 girls) participated in this study. Our results showed that positive problem orientation (p < 0.05) and rational problem solving (p < 0.001) are significant factors in determining first aid willingness for both peers and strangers. On the other hand, avoidance style orientation (p < 0.05) has a negative influence on the willingness to provide first aid to peers and strangers. Negative problem orientation (p < 0.001) only predicted negative emotions related to emergencies. Furthermore, prosocial behavior (p < 0.001) was more strongly associated with first aid willingness than social problem solving. Our study suggested that improving social competence could be a key factor in increasing first aid provision in real time, which could save lives in emergencies. Full article
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18 pages, 452 KiB  
Systematic Review
The Emotional Impact of Family Involvement during Homework in Children with Neurodevelopmental Disorders: A Systematic Review
by Amanda Abín, Tania Pasarín-Lavín, Débora Areces, Celestino Rodríguez and José Carlos Núñez
Children 2024, 11(6), 713; https://doi.org/10.3390/children11060713 - 10 Jun 2024
Viewed by 310
Abstract
Neurodevelopmental disorders can be studied from two distinct perspectives: an internal approach, which examines the causes and consequences of these disorders; and a contextual approach, which considers the role of the family in the lives of children and adolescents. Research has demonstrated that [...] Read more.
Neurodevelopmental disorders can be studied from two distinct perspectives: an internal approach, which examines the causes and consequences of these disorders; and a contextual approach, which considers the role of the family in the lives of children and adolescents. Research has demonstrated that the most significant form of family involvement in families raising a child with NDD is through homework. This involvement has been shown to have an emotional impact on children with neurodevelopmental disorders such as ADHD or dyslexia. The objective of this study is to review published articles on homework and neurodevelopmental disorders, with particular attention to the role of the family and the emotional health of children and families. Method: The review followed the PRISMA guidelines. The final sample consisted of 11 articles, with samples ranging from less than 30 participants to more than 100 at the international level. Results: The results demonstrate the complex methodological and bibliometric picture of the final sample, as well as the many emotional and contextual variables that influence the relationship between homework and neurodevelopmental disorders. Conclusions: Future research should consider how emotional health affects the engagement of families with children with neurodevelopmental disorders. Full article
(This article belongs to the Special Issue Neurological Diseases in Children and Adolescents: 2nd Edition)
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9 pages, 747 KiB  
Brief Report
Does the esv3587290 Copy Number Variation in the VANGL1 Gene Differ as a Genetic Factor for Developing Nephritis in Mexican Childhood-Onset Systemic Lupus Erythematosus Patients?
by Miguel Angel Alcántara-Ortigoza, Ana Luisa Rodríguez-Lozano, Bernardette Estandía-Ortega, Ariadna González-del Angel, Luisa Díaz-García, Francisco Eduardo Rivas-Larrauri and Ruth Guadalupe Nájera-Velázquez
Children 2024, 11(6), 712; https://doi.org/10.3390/children11060712 - 10 Jun 2024
Viewed by 346
Abstract
A ~3-kb deletion-type DNA copy number variation (CNV, esv3587290) located at intron 7 of the VANGL1 gene (1p13.1, MIM*610132) has been proposed as a genetic factor in lupus nephritis (LN) development in adult systemic lupus erythematosus (SLE) patients across European-descent populations, but its [...] Read more.
A ~3-kb deletion-type DNA copy number variation (CNV, esv3587290) located at intron 7 of the VANGL1 gene (1p13.1, MIM*610132) has been proposed as a genetic factor in lupus nephritis (LN) development in adult systemic lupus erythematosus (SLE) patients across European-descent populations, but its replication in other ethnicities has been inconsistent and its association with LN in childhood-onset SLE (cSLE) remains unknown. Here, we performed an exploratory association study in a sample of 66 unrelated cSLE Mexican patients (11 males, 55 females; ages 7.8 to 18.6 years). Two stratified groups were compared: cSLE patients with (N = 39) or without (N = 27) LN, as diagnosed by renal biopsy (N = 17), proteinuria (N = 33), urinary protein–creatinine ratio > 0.2 (N = 34), and erythrocyturia and/or granular casts in urinary sediment (N = 16). For esv3587290 CNV genotyping, we performed an end-point PCR assay with breakpoint confirmation using Sanger sequencing. We also determined the allelic frequencies of the esv3587290 CNV in 181 deidentified ethnically matched individuals (reference group). The obtained genotypes were tested for Hardy–Weinberg equilibrium (HWE) using the χ2 test. Associations between LN and esv3587290 CNV were tested by calculating the odds ratio (OR) and using Pearson’s χ2 tests, with a 95% confidence interval and p ≤ 0.05. The esv3587290 CNV allele (OR 0.108, 95% CI 0.034–0.33, p = 0.0003) and the heterozygous genotype (OR 0.04, 95% CI 0.119–0.9811, p = 0.002) showed a significant protective effect against LN development. Finally, we characterized the precise breakpoint of the esv3587290 CNV to be NG_016548.1(NM_138959.3):c.1314+1339_1315-897del in our population. This report supports the notion that a broad genetic heterogeneity underlies the susceptibility for developing LN. Full article
(This article belongs to the Special Issue Diagnosis, Treatment and Care of Pediatric Rheumatology)
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12 pages, 853 KiB  
Article
Feasibility of Achieving Nutritional Adequacy in Critically Ill Children with Critical Neurological Illnesses (CNIs)?—A Quaternary Hospital Experience
by Marwa Mansour, Nicole Knebusch, Jennifer Daughtry, Thomas P. Fogarty, Fong Wilson Lam, Renan A. Orellana, Yi-Chen Lai, Jennifer Erklauer and Jorge A. Coss-Bu
Children 2024, 11(6), 711; https://doi.org/10.3390/children11060711 - 9 Jun 2024
Viewed by 294
Abstract
The literature on the nutritional needs and outcomes of critically ill children is scarce, especially on those with critical neurological illnesses (CNIs). Current evidence shows a lower mortality in patients who achieve two-thirds of their nutritional needs during the first week of pediatric [...] Read more.
The literature on the nutritional needs and outcomes of critically ill children is scarce, especially on those with critical neurological illnesses (CNIs). Current evidence shows a lower mortality in patients who achieve two-thirds of their nutritional needs during the first week of pediatric intensive care unit (PICU) admission. We hypothesized that achieving 60% of the recommended dietary intake during the first week of a PICU stay is not feasible in patients with CNI. We designed an observational retrospective cohort study where we included all index admissions to the PICU in our institution of children (1 month to 18 years) with CNI from January 2018 to June 2021. We collected patient demographics, anthropometric measures, and caloric and protein intake (enteral and parenteral) information during the first week of PICU admission. Goal adequacy for calories and protein was defined as [(intake/recommended) × 100] ≥ 60%. A total of 1112 patients were included in the nutrition assessment, 12% of whom were underweight (weight for age z score < −2). Of this group, 180 met the criteria for nutrition support evaluation. On the third day of admission, 50% of the patients < 2 years achieved caloric and protein goal adequacy, compared to 25% of patients > 2 years, with p-values of 0.0003 and 0.0004, respectively. Among the underweight patients, 60% achieved both caloric and protein goal adequacy by day 3 vs. 30% of non-underweight patients with p-values of 0.0006 and 0.002, respectively. The results show that achieving 60% of the recommended dietary intake by days 5 and 7 of admission was feasible in more than half of the patients in this cohort. Additionally, children who were evaluated by a clinical dietician during the first 48 h of PICU admission reached higher nutrition adequacy. Full article
(This article belongs to the Special Issue Metabolic and Nutritional Diseases in Children)
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11 pages, 335 KiB  
Article
Parent–Child Associations in Accelerometer-Measured Physical Activity and Sedentary Behaviour: The FAMIPASS Study
by Dagmar Sigmundová, Jaroslava Voráčová, Jan Dygrýn, Michal Vorlíček and Erik Sigmund
Children 2024, 11(6), 710; https://doi.org/10.3390/children11060710 - 8 Jun 2024
Viewed by 374
Abstract
Parent–child patterns in objectively measured movement behaviours were the highlight of this study. A total of 381 families (337 mothers, 256 fathers, 190 daughters, and 191 sons) from 36 randomly selected schools and kindergartens provided valid accelerometer data. Sedentary behaviour and physical activity [...] Read more.
Parent–child patterns in objectively measured movement behaviours were the highlight of this study. A total of 381 families (337 mothers, 256 fathers, 190 daughters, and 191 sons) from 36 randomly selected schools and kindergartens provided valid accelerometer data. Sedentary behaviour and physical activity (PA) were assessed using ActiGraph accelerometers. Spearman’s rho was used to evaluate parent–child associations, while logistic regression analysis (the backward LR method) was used to recognize factors related to children’s achievement of PA recommendations. Results indicated that girls engaged more in light PA, while boys showed higher levels of moderate and vigorous PA. Mothers spent less time sitting and more time in light PA compared to fathers, resulting in higher total PA levels. Father–son pairs showed a stronger association in total PA than mother–son pairs. Children aged 6–10 years and those with mothers who engaged in more vigorous PA were more likely to meet PA recommendations compared to younger children and those with less active mothers. Full article
(This article belongs to the Section Global and Public Health)
12 pages, 1191 KiB  
Article
An In-Depth Look at Nutrition Support and Adequacy for Critically Ill Children with Organ Dysfunction
by Nicole Knebusch, Paola Hong-Zhu, Marwa Mansour, Jennifer N. Daughtry, Thomas P. Fogarty, Fernando Stein and Jorge A. Coss-Bu
Children 2024, 11(6), 709; https://doi.org/10.3390/children11060709 - 8 Jun 2024
Viewed by 386
Abstract
Patients admitted to a pediatric intensive care unit (PICU) need individualized nutrition support that is tailored to their particular disease severity, nutritional status, and therapeutic interventions. We aim to evaluate how calories and proteins are provided during the first seven days of hospitalization [...] Read more.
Patients admitted to a pediatric intensive care unit (PICU) need individualized nutrition support that is tailored to their particular disease severity, nutritional status, and therapeutic interventions. We aim to evaluate how calories and proteins are provided during the first seven days of hospitalization for children in critical condition with organ dysfunction (OD). A single-center retrospective cohort study of children aged 2–18 years, mechanically ventilated > 48 h, and admitted > 7 days to a PICU from 2016 to 2017 was carried out. Nutrition support included enteral and parenteral nutrition. We calculated scores for the Pediatric Sequential Organ Failure Assessment (pSOFA) on days 1 and 3 of admission, with OD defined as a score > 5. Of 4199 patient admissions, 164 children were included. The prevalence of OD for days 1 and 3 was 79.3% and 78.7%, respectively. On day 3, when pSOFA scores trended upward, decreased, or remained unchanged, median (IQR) caloric intake was 0 (0–15), 9.2 (0–25), and 22 (1–43) kcal/kg/day, respectively (p = 0.0032); when pSOFA scores trended upward, decreased, or remained unchanged, protein intake was 0 (0–0.64), 0.44 (0–1.25), and 0.66 (0.04–1.67) g/kg/day, respectively (p = 0.0023). Organ dysfunction was prevalent through the first 72 h of a PICU stay. When the pSOFA scores trended downward or remained unchanged, caloric and protein intakes were higher than those that trended upward. Full article
(This article belongs to the Special Issue Metabolic and Nutritional Diseases in Children)
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10 pages, 204 KiB  
Article
Key Informant Views of the Determinants of Child Labour Maltreatment
by Md. Abdul Ahad, Yvonne Karen Parry, Eileen Willis and Shahid Ullah
Children 2024, 11(6), 708; https://doi.org/10.3390/children11060708 - 8 Jun 2024
Viewed by 343
Abstract
(1) Background: The maltreatment of child labourers is a major public health concern. There is a dearth of research in Bangladesh on the intentional maltreatment of child labourers. This study explored the risk factors for the maltreatment of child labourers in rural Bangladesh [...] Read more.
(1) Background: The maltreatment of child labourers is a major public health concern. There is a dearth of research in Bangladesh on the intentional maltreatment of child labourers. This study explored the risk factors for the maltreatment of child labourers in rural Bangladesh based on the knowledge and understanding of experts; (2) Methods: Seventeen interviews were conducted with experts who were sampled using a purposeful approach. A thematic analysis was performed to analyse data using NVivo; (3) Results: Child labourers were exposed to maltreatment due to their demographic, their young age, dropping out of school, health complications, and excessive dependency on employers. Socio-cultural adversities such as corporal punishment practices, social stratification, and family disorganization pose risks of experiencing maltreatment. Economic poverty is also a factor. Child labourers were found to be victimized if they worked in violence prone sectors. Significantly, the unregulated market structure and the lack of monitoring has also led to the exploitation of children in the workplace. Gaps in public policies were also identified as risk factor for the maltreatment of child labourers; (4) Conclusion: There is a need for adequate evidence-based research on the determinants of the maltreatment of child labourers to formulate adequate policy. Full article
(This article belongs to the Section Global and Public Health)
13 pages, 431 KiB  
Review
Wheat-Related Disorders in Children: A 360-Degree View
by Michele Fingerle, Sebastiano Salaorni, Angelo Pietrobelli, Giorgio Piacentini, Claudia Banzato and Luca Pecoraro
Children 2024, 11(6), 707; https://doi.org/10.3390/children11060707 - 7 Jun 2024
Viewed by 279
Abstract
Immunological illnesses related to wheat represent an epidemiologically relevant phenomenon at a pediatric age. The term “Wheat-related disorders” involves a spectrum of diseases: celiac disease, IgE-mediated wheat allergy, non-IgE mediated wheat allergy, wheat-related eosinophilic esophagitis, and non-celiac gluten sensitivity. Their pathogenesis is different. [...] Read more.
Immunological illnesses related to wheat represent an epidemiologically relevant phenomenon at a pediatric age. The term “Wheat-related disorders” involves a spectrum of diseases: celiac disease, IgE-mediated wheat allergy, non-IgE mediated wheat allergy, wheat-related eosinophilic esophagitis, and non-celiac gluten sensitivity. Their pathogenesis is different. At the same time, wheat represents their common point. This article aims to the state-of-the-art and new clinical evidence in pediatric age. Full article
17 pages, 698 KiB  
Systematic Review
Interventions through Art Therapy and Music Therapy in Autism Spectrum Disorder, ADHD, Language Disorders, and Learning Disabilities in Pediatric-Aged Children: A Systematic Review
by Victoria Martínez-Vérez, Paula Gil-Ruíz and Sara Domínguez-Lloria
Children 2024, 11(6), 706; https://doi.org/10.3390/children11060706 - 7 Jun 2024
Viewed by 300
Abstract
Traditional pharmacological treatments, although effective, often carry potential side effects, which positions art therapy and music therapy as promising non-pharmacological alternatives to alleviate symptoms and improve social, cognitive, and emotional skills without the associated risks. Through a review in the SCOPUS and WOS [...] Read more.
Traditional pharmacological treatments, although effective, often carry potential side effects, which positions art therapy and music therapy as promising non-pharmacological alternatives to alleviate symptoms and improve social, cognitive, and emotional skills without the associated risks. Through a review in the SCOPUS and WOS databases following the PRISMA protocol, a total of 80 articles were analyzed through a series of determined categories and subcategories of analysis. The aim of this study is to evaluate and synthesize the existing evidence on the efficacy and applicability of art therapy and music therapy in the treatment of children with autism spectrum disorder (ASD), hyperactivity disorder (HSDD), developmental language disorders, and language learning difficulties, identifying best practices and key areas for future research. Among the main findings is that art therapy and music therapy have a significant impact on symptomatology, behavior, and communication as well as social, cognitive, and emotional skills in the pediatric populations studied. These therapies are highly valued by the participants with a large majority recognizing their adaptability to different educational and clinical contexts. It is concluded that these therapies have a high potential as viable alternatives or complements to traditional pharmacological treatments, justifying their application and further study in broader therapeutic contexts. Full article
15 pages, 517 KiB  
Review
Lethal Complications and Complex Genotypes in Shwachman Diamond Syndrome: Report of a Family with Recurrent Neonatal Deaths and a Case-Based Brief Review of the Literature
by Danai Veltra, Nikolaos M. Marinakis, Ioannis Kotsios, Polyxeni Delaporta, Kyriaki Kekou, Konstantina Kosma, Joanne Traeger-Synodinos and Christalena Sofocleous
Children 2024, 11(6), 705; https://doi.org/10.3390/children11060705 - 7 Jun 2024
Viewed by 263
Abstract
Shwachman Diamond Syndrome (SDS) is a multi-system disease characterized by exocrine pancreatic insufficiency with malabsorption, infantile neutropenia and aplastic anemia. Life-threatening complications include progression to acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS), critical deep-tissue infections and asphyxiating thoracic dystrophy. In most patients, [...] Read more.
Shwachman Diamond Syndrome (SDS) is a multi-system disease characterized by exocrine pancreatic insufficiency with malabsorption, infantile neutropenia and aplastic anemia. Life-threatening complications include progression to acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS), critical deep-tissue infections and asphyxiating thoracic dystrophy. In most patients, SDS results from biallelic pathogenic variants in the SBDS gene, different combinations of which contribute to heterogenous clinical presentations. Null variants are not well tolerated, supporting the theory that the loss of SBDS expression is likely lethal in both mice and humans. A novel complex genotype (SBDS:c.[242C>G;258+2T>C];[460-1G>A]/WFS1:c.[2327A>T];[1371G>T]) was detected in a family with recurrent neonatal deaths. A female neonate died three hours after birth with hemolytic anemia, and a male neonate with severe anemia, thrombocytopenia and neutropenia succumbed on day 40 after Staphylococcus epidermidis infection. A subsequent review of the literature focused on fatal complications, complex SBDS genotypes and/or unusual clinical presentations and disclosed rare cases, of which some had unexpected combinations of genetic and clinical findings. The impact of pathogenic variants and associated phenotypes is discussed in the context of data sharing towards expanding scientific expert networks, consolidating knowledge and advancing an understanding of novel underlying genotypes and complex phenotypes, facilitating informed clinical decisions and disease management. Full article
38 pages, 1852 KiB  
Article
Beyond Language Scores: How Language Exposure Informs Assessment of Nonword Repetition, Vocabulary and Narrative Macrostructure in Bilingual Turkish/Swedish Children with and without Developmental Language Disorder
by Linnéa Öberg and Ute Bohnacker
Children 2024, 11(6), 704; https://doi.org/10.3390/children11060704 - 7 Jun 2024
Viewed by 252
Abstract
As in many other countries, baseline data concerning the linguistic development of bilingual children in Sweden are lacking, and suitable methods for identifying developmental language disorder (DLD) in bilinguals are lacking as well. This study presents reference data from 108 typically developing (TD) [...] Read more.
As in many other countries, baseline data concerning the linguistic development of bilingual children in Sweden are lacking, and suitable methods for identifying developmental language disorder (DLD) in bilinguals are lacking as well. This study presents reference data from 108 typically developing (TD) Turkish/Swedish-speaking children aged 4;0–8;1, for a range of language tasks developed specifically for the assessment of bilinguals (LITMUS test battery, COST Action IS0804). We report on different types of nonword repetition (NWR) tasks (language-specific and language-independent), receptive and expressive vocabulary (Cross-Linguistic Lexical Tasks, CLTs), and narrative macrostructure comprehension and production (Multilingual Assessment Instrument for Narratives, MAIN) in Turkish, the children’s home language, and in Swedish, the language of schooling and society. Performance was investigated in relation to age, language exposure, type of task, and (for NWR and narratives) vocabulary size. There was a positive development with age for all tasks, but effects of language exposure and vocabulary size differed between tasks. Six bilingual Turkish/Swedish children with DLD were individually compared to the TD children. TD/DLD performance overlapped substantially, particularly for NWR, and more so for the production than the comprehension tasks. Surprisingly, the discriminatory potential was poor for both language-specific and language-independent NWR. DLD case studies underscored the importance of interpreting language scores in relation to exposure history, and the need for an increased emphasis on functional language skills as reported by parents and teachers when assessing and diagnosing DLD in bilinguals. Full article
(This article belongs to the Special Issue Developmental Language Disorder in Children and Adolescents)
11 pages, 2846 KiB  
Article
Safety and Tolerability of Continuous Inhaled Iloprost Therapy for Severe Pulmonary Hypertension in Neonates and Infants
by Amit V. Krishnan, Victoria Freniere, Rakesh Sahni, Diana P. Vargas Chaves, Sankaran S. Krishnan, Dimitrios Savva and Usha S. Krishnan
Children 2024, 11(6), 703; https://doi.org/10.3390/children11060703 - 7 Jun 2024
Viewed by 287
Abstract
This is a single-center retrospective study to assess the safety and tolerability of continuous inhaled iloprost use as rescue therapy for refractory pulmonary hypertension (PH) in critically ill neonates and infants. A retrospective chart review was performed on 58 infants and data were [...] Read more.
This is a single-center retrospective study to assess the safety and tolerability of continuous inhaled iloprost use as rescue therapy for refractory pulmonary hypertension (PH) in critically ill neonates and infants. A retrospective chart review was performed on 58 infants and data were collected at baseline, 1, 6, 12, 24, 48 and 72 h of iloprost initiation. Primary outcomes were change in heart rate (HR), fraction of inspired oxygen (FiO2), mean airway pressures (MAP), blood pressure (BP) and oxygenation index (OI). Secondary outcomes were need for extracorporeal membrane oxygenation (ECMO) and death. 51 patients treated for >6 h were analyzed in 2 age groups, neonate (≤28 days: n = 32) and infant (29–365 days: n = 19). FiO2 (p < 0.001) and OI (p = 0.01) decreased, while there were no significant changes in MAP, BP and HR. Of the fifteen patients placed on ECMO, seven were bridged off ECMO on iloprost and eight died. Twenty-four out of fifty-one patients (47%) recovered without requiring ECMO, while twelve (23%) died. Iloprost as add-on therapy for refractory PH in critically ill infants in the NICU has an acceptable tolerability and safety profile. Large prospective multicenter studies using iloprost in the neonatal ICU are necessary to validate these results. Full article
(This article belongs to the Special Issue Pediatric Intensive Care – Practice and Research)
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5 pages, 195 KiB  
Editorial
Advancing Physical Literacy Research in Children
by Elizabeth J. Durden-Myers
Children 2024, 11(6), 702; https://doi.org/10.3390/children11060702 - 7 Jun 2024
Viewed by 353
Abstract
The collection of papers in this Special Issue serves to extend the literature and evidence base for physical literacy (PL) research within child and youth populations. Currently, child and youth populations are increasingly sedentary, resulting in them spending less time engaging in daily [...] Read more.
The collection of papers in this Special Issue serves to extend the literature and evidence base for physical literacy (PL) research within child and youth populations. Currently, child and youth populations are increasingly sedentary, resulting in them spending less time engaging in daily physical activity (PA). Physical literacy serves as an attractive concept to help reframe and address physical inactivity and poor health and wellbeing, utilising a different and integrated approach to physical activity, health and wellbeing promotion. The studies presented in this Special Issue respond to previous calls in PL research for further empirical evidence, clarity around PL assessment, the utility of physical literacy with diverse populations including indigenous children and those with disabilities, the application of PL within early years, parental engagement and the role of physical education in the promotion of PL. These studies shed new light on the frontiers of PL research within child and youth populations. Full article
(This article belongs to the Special Issue Developing Physical Literacy in Children)
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