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Children, Volume 11, Issue 7 (July 2024) – 99 articles

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12 pages, 428 KiB  
Article
Occurrence of Body Posture Abnormalities in Overweight and Obese Children Aged 5–6 Years—Pilot Study
by Alicja Bober, Aleksandra Kopaczyńska, Agnieszka Puk and Agnieszka Chwałczyńska
Children 2024, 11(7), 849; https://doi.org/10.3390/children11070849 - 12 Jul 2024
Viewed by 80
Abstract
Objectives: The study aimed to assess the occurrence of body posture disorders and their changes under the influence of a physioprophylactic program in children depending on body weight. Methods: In the examined children, the general and segmental body composition and body posture [...] Read more.
Objectives: The study aimed to assess the occurrence of body posture disorders and their changes under the influence of a physioprophylactic program in children depending on body weight. Methods: In the examined children, the general and segmental body composition and body posture were determined using a physiotherapeutic assessment based on the Kasperczyk method. Mass, overall, and segmental body composition were determined using the bioelectrical impedance method using a TANITA body composition analyzer. The study group of 76 children was divided due to body weight disorders into Group I (n = 51), in which BMI and fat mass values were within the normative limits for age and gender, and Group II (n = 19), comprising children whose body weight exceeded the norm and/or fat mass exceeded normative values. The examined children underwent a physioprophylactic. The program was conducted by qualified physiotherapists for 12 weeks, once a week for 30 min. The therapeutic program was focused on physioprevention of being overweight and the correction of body posture. Results: A distal distribution of fat mass was observed in the examined group. Asymmetry in the sagittal plane was found in 35% of children. No statistically significant differences were found in the presence of asymmetry in the sagittal plane between the groups. No statistically significant differences were found in the occurrence of posture irregularities between the groups. Conclusions: There were no changes in the weight and body posture of the examined children under the influence of the physiotherapy program. The lack of correlation in the examined group between body weight and posture irregularities in 5–6-year-olds may suggest the acquisition of posture defects as a consequence of the persistence of overweight or obesity. Full article
9 pages, 387 KiB  
Article
Impact of an Intervention Aimed at Improving Sleep Quality in Hospitalized Children
by Carolina Lechosa-Muñiz, Laura Ruiz-Azcona, Elena Pérez Belmonte, María Paz-Zulueta and María Jesús Cabero-Pérez
Children 2024, 11(7), 848; https://doi.org/10.3390/children11070848 - 12 Jul 2024
Viewed by 75
Abstract
Background: Hospitalized children need adequate sleep to favor early recovery. Methods: To study the sleep pattern of children admitted to a pediatric inpatient unit, a cross-sectional study was carried out at a reference hospital in northern Spain. The main study variables were medical [...] Read more.
Background: Hospitalized children need adequate sleep to favor early recovery. Methods: To study the sleep pattern of children admitted to a pediatric inpatient unit, a cross-sectional study was carried out at a reference hospital in northern Spain. The main study variables were medical specialty of admission, sleep-inducing treatment, hours of sleep at home and during admission, number of nocturnal awakenings, and reasons for awakening. Differences in the hours of sleep and nighttime awakenings between the initial period and at six months were calculated using the Student’s t-test. Results: We included 100 baseline patients and 100 post-intervention patients. Up to 4% of the baseline sample and 3% of the six-month sample had been prescribed a sleep-promoting drug. Regarding awakenings, 79% of the children in the baseline sample suffered awakenings, with a mean of 1.98 awakenings (range 1–13). At six months, the percentage of children who experienced awakenings decreased by 17%, with a mean of 1.34 (range 1–5). In the baseline sample, 48% were caused by nursing care, decreasing to 34% after the intervention. Conclusions: An educational intervention with the implementation of targeted evidence-based practices is a useful measure for improving the sleep pattern by decreasing the number of awakenings. Full article
(This article belongs to the Section Global Pediatric Health)
11 pages, 301 KiB  
Article
Assessment and Rehabilitation Intervention of Feeding and Swallowing Skills in Children with Down Syndrome Using the Global Intensive Feeding Therapy (GIFT)
by Silvia Franceschetti, Marco Tofani, Serena Mazzafoglia, Francesca Pizza, Eleonora Capuano, Massimiliano Raponi, Gessica Della Bella and Antonella Cerchiari
Children 2024, 11(7), 847; https://doi.org/10.3390/children11070847 - 12 Jul 2024
Viewed by 90
Abstract
Background: Children with Down syndrome (DS) experience more difficulties with oral motor skills, including chewing, drinking, and swallowing. The present study attempts to measure the preliminary effectiveness of Global Intensive Feeding Therapy (GIFT) in DS. GIFT is a new rehabilitation program addressing the [...] Read more.
Background: Children with Down syndrome (DS) experience more difficulties with oral motor skills, including chewing, drinking, and swallowing. The present study attempts to measure the preliminary effectiveness of Global Intensive Feeding Therapy (GIFT) in DS. GIFT is a new rehabilitation program addressing the specific difficulties and needs of each child, focusing on sensory and motor oral abilities. It follows an intensive schedule comprising 15 sessions over 5 consecutive days, with 3 sessions per day. The principles of GIFT are applied with specific objectives for DS. Methods: GIFT was preliminarily implemented among 20 children diagnosed with DS. To measure the efficacy of GIFT, the Karaduman Chewing Performance Scale (KCPS), the International Dysphagia Diet Standardization Initiative (IDDSI), and the Pediatric Screening–Priority Evaluation Dysphagia (PS–PED) were used. Data were analyzed using the Wilcoxon signed-rank test before (T0) and after intervention (T1) and at one-month follow-up (T2). The effect size was also measured for specific outcomes, using Kendall’s W. Results: Our findings revealed that children with DS showed no risk of dysphagia according to the PS–PED (mean score 2.80). Furthermore, statistically significant improvements in chewing performance were observed, as measured by the KCPS (p < 0.01), as well as in texture acceptance and modification, as measured by the IDDSI post-intervention (p < 0.01). For both the KCPS and IDDSI, a large effect size was found (Kendall’s W value > 0.8). Parents/caregivers continued using GIFT at home, and this allowed for a positive outcome at the one-month follow-up. Conclusions: GIFT proved to be effective in the rehabilitation of feeding and swallowing disorders in children with DS, as well as for food acceptance. Full article
18 pages, 1979 KiB  
Article
Development and Evaluation of the Abdominal Pain Knowledge Questionnaire (A-PKQ) for Children and Their Parents
by Verena Neß, Clarissa Humberg, Franka Lucius, Leandra Eidt, Thomas Berger, Martin Claßen, Nils Christian Syring, Jens Berrang, Christine Vietor, Stephan Buderus, Lisa-Marie Rau and Julia Wager
Children 2024, 11(7), 846; https://doi.org/10.3390/children11070846 - 12 Jul 2024
Viewed by 110
Abstract
Background: Abdominal pain is a common and often debilitating issue for children and adolescents. In many cases, it is not caused by a specific somatic condition but rather emerges from a complex interplay of bio-psycho-social factors, leading to functional abdominal pain (FAP). Given [...] Read more.
Background: Abdominal pain is a common and often debilitating issue for children and adolescents. In many cases, it is not caused by a specific somatic condition but rather emerges from a complex interplay of bio-psycho-social factors, leading to functional abdominal pain (FAP). Given the complex nature of FAP, understanding its origins and how to effectively manage this condition is crucial. Until now, however, no questionnaire exists that targets knowledge in this specific domain. To address this, the Abdominal Pain Knowledge Questionnaire (A-PKQ) was developed. Methods: Two versions were created (one for children and one for parents) and tested in four gastroenterology clinics and one specialized pain clinic in Germany between November 2021 and February 2024. Children between 8 and 17 years of age (N = 128) and their accompanying parents (N = 131) participated in the study. Rasch analysis was used to test the performance of both versions of the questionnaire. Results: The original questionnaires exhibited good model and item fit. Subsequently, both questionnaires were refined to improve usability, resulting in final versions containing 10 items each. These final versions also demonstrated good model and item fit, with items assessing a variety of relevant domains. Conclusion: The A-PKQ is an important contribution to improving assessment in clinical trials focused on pediatric functional abdominal pain. Full article
(This article belongs to the Section Pediatric Gastroenterology and Nutrition)
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15 pages, 459 KiB  
Article
Assessment of Adolescents in Child-to-Parent Violence: Invariance, Prevalence, and Reasons
by Luis Burgos-Benavides, M. Carmen Cano-Lozano, Andrés Ramírez, Samuel P. León, Venus Medina-Maldonado and Francisco Javier Rodríguez-Díaz
Children 2024, 11(7), 845; https://doi.org/10.3390/children11070845 - 12 Jul 2024
Viewed by 121
Abstract
Child-to-parent violence is a form of family violence where the children are the aggressors. Objective: This study first aimed to analyze the psychometric validity of the Child-to-Parent Violence Questionnaire (CPV-Q) among Ecuadorian adolescents. Second, the measurement invariance across the children’s sex was examined. [...] Read more.
Child-to-parent violence is a form of family violence where the children are the aggressors. Objective: This study first aimed to analyze the psychometric validity of the Child-to-Parent Violence Questionnaire (CPV-Q) among Ecuadorian adolescents. Second, the measurement invariance across the children’s sex was examined. Finally, the prevalence of child-to-parent violence (CPV) was also determined. Methods: A total of 2084 adolescents aged 12 to 18 years participated in this study. The participants were residents of two provinces in southern Ecuador. A higher percentage of participants were women. They lived mostly with their father and mother. The married marital status of the parents was the most frequently reported. Most of the fathers and mothers of the participants completed primary education. The sampling design was probabilistic, with proportional allocation by age and quotas according to the number of inhabitants per province. The sample size was determined by using a finite population formula. All the participants were randomly selected. The CPV-Q was used to assess child-to-parent violence. The items were adapted linguistically and tailored to the Ecuadorian context. Results: The questionnaire demonstrated excellent model fit and adequate reliability. Full measurement invariance was held for all scales except for the reasons subscale pertaining to fathers. Statistically significant differences were observed with respect to the sex of the aggressor, with control/domain behaviors toward both parents and psychological violence toward the mother being more frequent among daughters than sons. Similarly, reactive reasons were more frequent among daughters than sons. Conclusion: This study provides significant psychometric evidence on the CPV-Q in Ecuadorian adolescents along with data on the prevalence of violence against parents. Full article
(This article belongs to the Special Issue Children and Adolescent Mental Health Problems and Prevention)
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21 pages, 7914 KiB  
Review
The Etiology of Neuromuscular Hip Dysplasia and Implications for Management: A Narrative Review
by Ana Presedo, Erich Rutz, Jason J. Howard, Michael Wade Shrader and Freeman Miller
Children 2024, 11(7), 844; https://doi.org/10.3390/children11070844 - 11 Jul 2024
Viewed by 169
Abstract
This study summarizes the current knowledge of the etiology of hip dysplasia in children with neuromuscular disease and the implications for management. This article is based on a review of development of the hip joint from embryology through childhood growth. This knowledge is [...] Read more.
This study summarizes the current knowledge of the etiology of hip dysplasia in children with neuromuscular disease and the implications for management. This article is based on a review of development of the hip joint from embryology through childhood growth. This knowledge is then applied to selective case reviews to show how the understanding of these developmental principles can be used to plan specific treatments. The development of the hip joint is controlled by genetic shape determination, but the final adult shape is heavily dependent on the mechanical environment experienced by the hip joint during growth and development. Children with neuromuscular conditions show a high incidence of coxa valga, hip dysplasia, and subluxation. The etiology of hip pathology is influenced by factors including functional status, muscular tone, motor control, child’s age, and muscle strength. These factors in combination influence the development of high neck–shaft angle and acetabular dysplasia in many children. The hip joint reaction force (HJRF) direction and magnitude determine the location of the femoral head in the acetabulum, the acetabular development, and the shape of the femoral neck. The full range of motion is required to develop a round femoral head. Persistent abnormal direction and/or magnitude of HJRF related to the muscular tone can lead to a deformed femoral head and a dysplastic acetabulum. Predominating thigh position is the primary cause defining the direction of the HJRF, leading to subluxation in nonambulatory children. The magnitude and direction of the HJRF determine the acetabular shape. The age of the child when these pathomechanics occur acts as a factor increasing the risk of hip subluxation. Understanding the risk factors leading to hip pathology can help to define principles for the management of neurologic hip impairment. The type of neurologic impairment as defined by functional severity assessed by Gross Motor Function Classification System and muscle tone can help to predict the risk of hip joint deformity. A good understanding of the biomechanical mechanisms can be valuable for treatment planning. Full article
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12 pages, 437 KiB  
Review
An Updated Reappraisal of Dupilumab in Children and Adolescents with Severe Asthma
by Gian Luigi Marseglia, Amelia Licari, Maria Angela Tosca, Michele Miraglia del Giudice, Cristiana Indolfi and Giorgio Ciprandi
Children 2024, 11(7), 843; https://doi.org/10.3390/children11070843 - 11 Jul 2024
Viewed by 196
Abstract
Severe asthma (SA) is still a demanding challenge in clinical practice. Type 2 inflammation is the most common phenotype in children and adolescents with SA. As a result, anti-inflammatory drugs, mainly corticosteroids (CSs), represent the first choice to reduce type 2 inflammation. However, [...] Read more.
Severe asthma (SA) is still a demanding challenge in clinical practice. Type 2 inflammation is the most common phenotype in children and adolescents with SA. As a result, anti-inflammatory drugs, mainly corticosteroids (CSs), represent the first choice to reduce type 2 inflammation. However, SA patients may require high inhaled and oral CS doses to achieve and maintain asthma control. Some SA patients, despite the highest CS dosages, can even display uncontrolled asthma. Therefore, the biological era constituted a breakthrough in managing this condition. Dupilumab is a monoclonal antibody directed against the IL-4 receptor α-subunit (IL-4Rα), antagonizing against both IL-4 and IL-13, and has been approved for pediatric severe type 2 asthma. This review presents and discusses the most recent published studies on dupilumab in children and adolescents with SA. There is convincing evidence that dupilumab is a safe and effective option in managing SA as it can reduce asthma exacerbations, reduce CS use, and improve lung function, asthma control, and quality of life, also for caregivers. However, a thorough diagnostic pathway is mandatory, mainly concerning phenotyping. In fact, the ideal eligible candidate is a child or adolescent with a type 2 allergic phenotype. Full article
(This article belongs to the Section Pediatric Allergy and Immunology)
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12 pages, 306 KiB  
Article
The Effects of a School-Based Physical Activity Program on Physical Fitness in Egyptian Children: A Pilot Study from the DELICIOUS Project
by Osama Abdelkarim, Noha El-Gyar, Amira M. Shalaby and Mohamed Aly
Children 2024, 11(7), 842; https://doi.org/10.3390/children11070842 - 10 Jul 2024
Viewed by 132
Abstract
Background: Ensuring the physical fitness of Egyptian children is of paramount importance to their overall well-being, given the unique socio-cultural and educational barriers they face that may hinder their active participation. As part of the DELICIOUS project, the “Be Fit Program” aims to [...] Read more.
Background: Ensuring the physical fitness of Egyptian children is of paramount importance to their overall well-being, given the unique socio-cultural and educational barriers they face that may hinder their active participation. As part of the DELICIOUS project, the “Be Fit Program” aims to increase the level of physical fitness among Egyptian school-aged children. This study explores the effectiveness of a structured, six-week physical activity (PA) program in improving various facets of physical fitness in children, including body composition, speed, coordination, muscular strength, and cardiovascular endurance. With the increasing prevalence of sedentary lifestyles, such efforts are imperative to improve overall health outcomes. Methods: A cohort of 125 children, aged 8.50 to 12.25 y (mean age 10.19 ± 1.03 y), participated in the study. Their body composition, speed, coordination, strength, and aerobic fitness were assessed before and after the Be Fit Program using the revised International Physical Performance Test Profile. Paired t-tests were used to detect changes between the pre- and post-tests. Results: Following the six-week intervention, statistical analyses revealed significant improvements in coordination and lower body strength (p < 0.01). Aerobic endurance showed marginal improvements, approaching statistical significance (p = 0.06). Conversely, there were no statistically significant changes in body composition, speed, or upper body strength (p > 0.05). Conclusions: The study confirms that tailored, non-competitive physical activities can positively influence specific fitness components in Egyptian children. However, achieving holistic improvements across all targeted fitness domains may require further strategic adjustments or a longer program duration. This pilot study underscores the importance of culturally tailored, school-based PA programs and highlights the continued need for research and program refinement to comprehensively improve children’s fitness in the Egyptian context. Full article
(This article belongs to the Special Issue Childhood Physical Activity and Health)
9 pages, 3016 KiB  
Review
Identifying Language Development in Children with ADHD: Differential Challenges, Interventions, and Collaborative Strategies
by Dimitra V. Katsarou, Efthymia Efthymiou, Georgios A. Kougioumtzis, Maria Sofologi and Maria Theodoratou
Children 2024, 11(7), 841; https://doi.org/10.3390/children11070841 - 10 Jul 2024
Viewed by 201
Abstract
Attention Deficit Hyperactivity Disorder (ADHD) significantly influences children’s language acquisition and usage. This theoretical study explores the multifaceted impact of ADHD on language development, specifically focusing on reading and writing challenges. Existing research reveals that approximately 30% of children with ADHD show significant [...] Read more.
Attention Deficit Hyperactivity Disorder (ADHD) significantly influences children’s language acquisition and usage. This theoretical study explores the multifaceted impact of ADHD on language development, specifically focusing on reading and writing challenges. Existing research reveals that approximately 30% of children with ADHD show significant delays in reading proficiency. Additionally, about 40% of these children struggle with phonological processing, which directly impacts their reading and writing skills. Interventions targeting executive function training combined with phonics-based instruction have been shown to significantly improve language outcomes. This study introduces a comprehensive framework connecting these challenges to specific interventions and collaborative strategies, emphasizing the importance of a multi-disciplinary approach. This work provides perspectives on the specific connections between ADHD symptoms and language difficulties, offering detailed potential solutions based on empirical data. Moreover, it features the necessity of adopting integrated intervention strategies to advance academic outcomes and communicative competencies for children with ADHD, providing new understandings into effective educational practices. Full article
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8 pages, 196 KiB  
Article
Family and Peer Social Capital and Child Behavioral Outcomes in Japan
by Jared M. Poff, Jonathan A. Jarvis, Mikaela J. Dufur and Shana L. Pribesh
Children 2024, 11(7), 840; https://doi.org/10.3390/children11070840 - 10 Jul 2024
Viewed by 164
Abstract
Background/Objectives: Child problem behaviors have been linked to immediate and long-term negative outcomes. Research has found that family and peer social capital have a strong influence on child behavioral outcomes. However, most research about social capital and child behavior problems has been conducted [...] Read more.
Background/Objectives: Child problem behaviors have been linked to immediate and long-term negative outcomes. Research has found that family and peer social capital have a strong influence on child behavioral outcomes. However, most research about social capital and child behavior problems has been conducted in Western contexts. Social capital may influence child behavior problems differently in non-Western sociocultural environments due to different family and peer dynamics. Methods: Using a sample from the Japan Household Panel Survey and Japan Child Panel Survey (N = 182), we expand this literature on various forms of social capital to the Japanese context with data that were collected between 2009 and 2014. We examine the relationship of family and peer social capital with children internalizing and externalizing problem behaviors using OLS linear regression. Results: Our results differ from what is commonly found in Western contexts. Whereas family and peer social capital are typically associated with both internalizing and externalizing problem behaviors in Western countries, we find that greater family social capital is associated with decreased externalizing problem behaviors but not internalizing problem behaviors in Japan, and peer social capital has no association on either type of problem behaviors. Conclusions: Our findings emphasize the importance of considering social and cultural contexts when exploring how social capital might encourage prosocial child outcomes. Full article
9 pages, 613 KiB  
Article
Comparison of Metabolic Control in Children and Adolescents Treated with Insulin Pumps
by Agnieszka Lejk, Karolina Myśliwiec, Arkadiusz Michalak, Barbara Pernak, Wojciech Fendler and Małgorzata Myśliwiec
Children 2024, 11(7), 839; https://doi.org/10.3390/children11070839 - 10 Jul 2024
Viewed by 147
Abstract
Background: While insulin pumps remain the most common form of therapy for youths with type 1 diabetes (T1DM), they differ in the extent to which they utilize data from continuous glucose monitoring (CGM) and automate insulin delivery. Methods: The aim of the study [...] Read more.
Background: While insulin pumps remain the most common form of therapy for youths with type 1 diabetes (T1DM), they differ in the extent to which they utilize data from continuous glucose monitoring (CGM) and automate insulin delivery. Methods: The aim of the study was to compare metabolic control in patients using different models of insulin pumps. This retrospective single-center study randomly sampled 30 patients for each of the following treatments: Medtronic 720G without PLGS (predictive low glucose suspend), Medtronic 640G or 740G with PLGS and Medtronic 780G. In the whole study group, we used CGM systems to assess patients’ metabolic control, and we collected lipid profiles. In three groups of patients, we utilized CGM sensors (Guardian 3, Guardian 4, Libre 2 and Dexcom G6) to measure the following glycemic variability proxy values: time in range (TIR), time below 70 mg/dL (TBR), time above 180 mg/dL (TAR), coefficient of variation (CV) and mean sensor glucose. Results: Medtronic 640G or 740G and 780G users were more likely to achieve a target time in the target range 70–180 mg/dL (≥80%) [Medtronic 720G = 4 users (13.3%) vs. Medtronic 640G/740G = 10 users (33.3%) vs. Medtronic 780G = 13 users (43.3%); p = 0.0357)] or low glucose variability [Medtronic 720G = 9 users (30%) vs. Medtronic 640G/740G = 18 users (60%) vs. Medtronic 780G = 19 users (63.3%); p = 0.0175)]. Conclusions: Any integration between the insulin pump and CGM was associated with better glycemic control. More advanced technologies and artificial intelligence in diabetes help patients maintain better glycemia by eliminating various factors affecting postprandial glycemia. Full article
(This article belongs to the Special Issue Glycemic Control in Children and Adolescents with Type 1 Diabetes)
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25 pages, 1002 KiB  
Article
“It Seems Much More Enjoyable Now”: Parental Perception of Relational Change from Participating in Paediatric Autism Communication Therapy (PACT)
by Charlotte Engberg Conrad, Rikke Jørgensen, Cecilie Amstrup, Tine Ellitsgaard Gottschau, Per Hove Thomsen and Marlene Briciet Lauritsen
Children 2024, 11(7), 838; https://doi.org/10.3390/children11070838 - 10 Jul 2024
Viewed by 154
Abstract
Objectives: This qualitative study aims to examine parental experiences of feasibility and relational changes from participating in the Paediatric Autism Communication Therapy (PACT) intervention. Methods: Thirteen parents of children diagnosed with autism spectrum disorder (mean age 3.89 years) participated in semi-structured interviews. Thematic [...] Read more.
Objectives: This qualitative study aims to examine parental experiences of feasibility and relational changes from participating in the Paediatric Autism Communication Therapy (PACT) intervention. Methods: Thirteen parents of children diagnosed with autism spectrum disorder (mean age 3.89 years) participated in semi-structured interviews. Thematic analysis was performed, inspired by an abductive approach informed by the theories of the attachment system, the caregiving system and mentalisation. Results: Three overarching themes were identified: the struggle of fitting PACT into everyday life, the fruit of relational connection and the cascading relational effects of PACT. Parents were challenged regarding finding time for the intervention but adapted PACT to their individual needs and possibilities. All parents experienced relational improvement, and a cycle of positive relational change through PACT was identified. Conclusions: This study has several clinical implications. Therapists and clinics offering PACT interventions should encourage and support parents in their individual journey of implementing PACT into their everyday lives. Some of the parents described improvements in parental mentalisation, child attachment and mutual enjoyment in the parent–child relationship. Children with autism could benefit from parents increasing their sensitivity when caregiving, and clinicians may through interventions such as PACT facilitate this development. Full article
10 pages, 1437 KiB  
Article
Assessing Psychological Disorders in Turkish Adolescents with Transfusion-Dependent Thalassemia
by Aylin Yetim Şahin, Ibrahim Kandemir, Hüseyin Dağ, Emine Türkkan, Melike Tuğrul Aksakal, Memduh Sahin, Firdevs Baş and Zeynep Karakaş
Children 2024, 11(7), 837; https://doi.org/10.3390/children11070837 - 9 Jul 2024
Viewed by 235
Abstract
We investigated depression and anxiety levels and related psychological disorders in adolescents with transfusion-dependent thalassemia (TDT) in this study. The study was conducted in two pediatric hematology outpatient clinics and included adolescents with TDT (14.8 ± 2.4 years, n = 40) in the [...] Read more.
We investigated depression and anxiety levels and related psychological disorders in adolescents with transfusion-dependent thalassemia (TDT) in this study. The study was conducted in two pediatric hematology outpatient clinics and included adolescents with TDT (14.8 ± 2.4 years, n = 40) in the study and compared them with the healthy age-matched control group (14.3 ± 2.3 years, n = 62). The Turkish version of the Revised Child Anxiety and Depression Scale (RCADS) was used to determine depression, anxiety, and related psychologic disorders (obsession, panic disorder, social phobia). Depression, anxiety, obsession, panic disorder, and social phobia scores were significantly higher in the patient group compared with the control (all p < 0.05). Ferritin levels were positively correlated with total depression, general anxiety, separation anxiety, and social phobia scores, but transfusion frequency and young age were the confounding factors. Patients in early adolescence and those who require more frequent blood transfusions are at higher risk of developing psychological disorders; routine screening for mood disorders should be warranted. Serum ferritin level may be a good warning indicator for early recognition of psychologic disorders in TDT patients. Full article
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17 pages, 300 KiB  
Article
Nasal High-Frequency Oscillatory Ventilation Use in Romanian Neonatal Intensive Care Units—The Results of a Recent Survey
by Maria Livia Ognean, Anca Bivoleanu, Manuela Cucerea, Radu Galiș, Ioana Roșca, Monica Surdu, Silvia-Maria Stoicescu and Rangasamy Ramanathan
Children 2024, 11(7), 836; https://doi.org/10.3390/children11070836 - 9 Jul 2024
Viewed by 231
Abstract
Background: Nasal high-frequency oscillatory ventilation (nHFOV) has emerged as an effective initial and rescue noninvasive respiratory support mode for preterm infants with respiratory distress syndrome (RDS); however, little is known about nHFOV use in Romanian neonatal intensive care units (NICUs). Objectives: We aimed [...] Read more.
Background: Nasal high-frequency oscillatory ventilation (nHFOV) has emerged as an effective initial and rescue noninvasive respiratory support mode for preterm infants with respiratory distress syndrome (RDS); however, little is known about nHFOV use in Romanian neonatal intensive care units (NICUs). Objectives: We aimed to identify the usage extent and clinical application of nHFOV in Romania. Methods: A structured web-based questionnaire was designed to find the rate of nHFOV use and knowledge of this new method of noninvasive respiratory support in Romanian level III NICUs. Using multiple-choice, open-ended, and yes/no questions, we collected information on the NICU’s size, noninvasive respiratory support modes used, nHFOV use, indications, settings, nasal interfaces, secondary effects, and equipment used. Descriptive statistics and comparisons were performed using IBM SPSS Statistics 26.0. Results: A total of 21/23 (91.3%) leaders from level III NICUs (median [IQR] number of beds of 10 [10–17.5]) responded to the survey. The most frequently used noninvasive ventilation modes were CPAP mode on mechanical ventilators (76.2%), followed by NIPPV (76.2%); heated, humidified high-flow nasal cannula (HHHFNC) (61.9%); and nHFOV (11/21 units; 52.4%). A total of 5/11 units reported frequent nHFOV use (in two or more newborns/month) in both term and preterm infants. The main indications reported for nHFOV use were CPAP failure (90.9%), hypercapnia (81.8%), and bronchopulmonary dysplasia (72.7%). Face/nasal masks and short binasal prongs are the most commonly used nasal interfaces (90.9% and 72.7%, respectively). Air leaks at the interface level (90.9%), thick secretions (81.8%), and airway obstruction (63.6%) were the most frequently mentioned adverse effects of nHFOV. Only three of the NICUs had a written protocol for nHFOV use. Most units not yet using nHFOV cited lack of equipment, experience, training, or insufficient information and evidence for the clinical use and outcome of nHFOV use in neonates as the main reasons for not implementing this noninvasive respiratory mode. Conclusions: Our survey showed that nHFOV is already used in more than half of the Romanian level III NICUs to support term and preterm infants with respiratory distress despite a lack of consensus regarding indications and settings during nHFOV. Full article
(This article belongs to the Special Issue Diagnosis and Management of Newborn Respiratory Distress Syndrome)
14 pages, 307 KiB  
Article
Reliability of an “At-Home” Method for Monitoring Resting and Reactive Autonomic Nervous System Activity in Children: A Pilot Study
by Rachel Venn, Joseph M. Northey, Nenad Naumovski and Andrew McKune
Children 2024, 11(7), 835; https://doi.org/10.3390/children11070835 - 9 Jul 2024
Viewed by 318
Abstract
Background: Heart rate variability (HRV), an index of the functional status of the autonomic nervous system (ANS), provides an opportunity for early detection of ANS dysfunction. Lower resting, vagally related HRV parameters are associated with increased risk of physical and mental illness. External [...] Read more.
Background: Heart rate variability (HRV), an index of the functional status of the autonomic nervous system (ANS), provides an opportunity for early detection of ANS dysfunction. Lower resting, vagally related HRV parameters are associated with increased risk of physical and mental illness. External factors influencing the ANS, such as the testing environment, may impact the interpretation of HRV. This study’s main aim was to determine the reliability of HRV resting and reactivity tests performed at home with children aged 4–9 years. Methods: Fourteen healthy children (female n = 8) aged 6.8 ± 1.5 years participated. Two HRV tests were performed at home via online supervision 7 days apart using a Polar H10 heart rate monitor. The absolute and relative reliability of the pre-exercise resting (5 min) and sub-maximal exercise step test recovery (4 × 30 s segments) HRV time and frequency domains were calculated. Results: The Pearson correlation coefficients for day 1 versus day 7 for the vagal activity HRV domains (RMSSD log) at rest and in the first 30 s and 30–60 s of recovery indicated good-to-excellent relative reliability (r > 0.8, p < 0.01). Absolute reliability was moderate for the resting RMSSD log, with a coefficient of variation (CV) of 5.2% (90% CI: 3.9, 7.8%), high for the first 30 s of standing recovery, with a CV of 10.7% (90% CI: 8.2, 15.7%), and moderate for 30–60 s of recovery, with a CV of 8.7% (90% CI: 6.6, 12.9%). Conclusions: The findings of this pilot study indicate that the resting and exercise recovery HRV measures of vagal activity can be measured reliably at home in children. This represents a novel “at-home” protocol for monitoring ANS health and development in children. Full article
9 pages, 230 KiB  
Article
Different Eating Habits Are Observed in Overweight and Obese Children Than in Normal-Weight Peers
by Żaneta Malczyk, Agnieszka Pasztak-Opiłka and Agnieszka Zachurzok
Children 2024, 11(7), 834; https://doi.org/10.3390/children11070834 - 9 Jul 2024
Viewed by 393
Abstract
Background: Obesity is diagnosed in 13.6% of early primary school children in Poland. Its presence at this age increases the risk of obesity occurrence in adulthood. Therefore, it is important to properly shape eating behaviors at the stage of childhood and identify incorrect [...] Read more.
Background: Obesity is diagnosed in 13.6% of early primary school children in Poland. Its presence at this age increases the risk of obesity occurrence in adulthood. Therefore, it is important to properly shape eating behaviors at the stage of childhood and identify incorrect eating styles. Methods: This study aimed to investigate whether overweight and obese children differ significantly from children with normal body weights in terms of their eating styles. For the materials and methods, 43 mothers of overweight or obese children aged 3–10 years and 88 mothers of normal-weight children aged 3–10 years completed a questionnaire related to sociodemographic factors and the Children’s Eating Behaviour Questionnaire. Results: The overweight and obese children, compared with normal-weight children, scored higher on the food responsiveness (p = 0.009) and emotional overeating (p = 0.013) scales and lower on the satiety responsiveness (p = 0.025) and slowness in eating scales (p < 0.0001). No significant difference was found for other subscales between the studied groups. In the group of overweight and obese children, the child’s age correlated negatively with enjoyment of food, as did the mother’s BMI with slowness in eating. Conclusions: The results indicate the presence of significant differences in eating styles between normal-weight children and overweight or obese children. Identifying families at high risk of inappropriate eating behaviors and educating them appropriately can reduce the risk of children becoming overweight or obese. Full article
7 pages, 176 KiB  
Case Report
Continuous Infusion of Dexmedetomidine for Maintenance of Sedation in an Aggressive Adolescent with Autism Spectrum Disorder in the Emergency Department
by Giorgio Cozzi, Alessandro Zago, Federico Poropat, Ingrid Rabach, Egidio Barbi and Alessandro Amaddeo
Children 2024, 11(7), 833; https://doi.org/10.3390/children11070833 - 9 Jul 2024
Viewed by 271
Abstract
Background: The treatment of aggressive behavior and agitation in pediatric patients with autism spectrum disorder (ASD) in the emergency department is topical and challenging. Case Presentation: We described an adolescent with autism spectrum disorder treated ten times in the pediatric emergency department for [...] Read more.
Background: The treatment of aggressive behavior and agitation in pediatric patients with autism spectrum disorder (ASD) in the emergency department is topical and challenging. Case Presentation: We described an adolescent with autism spectrum disorder treated ten times in the pediatric emergency department for severe episodes of aggressiveness and agitation. After resolving the acute phase of these behavioural crises, sedation was maintained with a continuous infusion of dexmedetomidine to prevent the resurgence of agitation and to organize discharge properly, considering the family’s needs. The continuous infusion of dexmedetomidine allowed the patient to remain asleep most of the time during his stay at the emergency department. No adverse events were recorded. Conclusions: The continuous infusion of dexmedetomidine could represent a safe and valuable tool to facilitate the permanence of the patient in the PED. Full article
10 pages, 820 KiB  
Article
Incidence and Characteristics of Pediatric Patients with Acute Otitis Hospitalized in a Romanian Infectious Diseases Hospital
by Vlad Ștefan Pleșca, Anca Streinu-Cercel, Oana Săndulescu, Anca Cristina Drăgănescu, Răzvan Hainăroșie and Anca Doina Pleșca
Children 2024, 11(7), 832; https://doi.org/10.3390/children11070832 - 8 Jul 2024
Viewed by 354
Abstract
Background: Otic involvement is common in children during acute infectious diseases, and is an important cause of morbidity and health service utilization. Methods: We performed a retrospective analysis of pediatric cases hospitalized in the largest infectious disease hospital in Romania between 2018 and [...] Read more.
Background: Otic involvement is common in children during acute infectious diseases, and is an important cause of morbidity and health service utilization. Methods: We performed a retrospective analysis of pediatric cases hospitalized in the largest infectious disease hospital in Romania between 2018 and 2023, with the aim of quantifying the incidence and impact of acute otitis (AO) according to pediatric age subgroups. Results: A total of 1118 cases diagnosed with AO were eligible and included in the analysis. Acute congestive otitis media was the most common subtype, identified in 53.3% of cases, followed by acute purulent otitis media (APOM) in 26.7% of children. The majority of AO cases (69.9%) were diagnosed in the pre-pandemic period (2018–2019), and infants (10.6%), toddlers (49.4%), and preschoolers (29.2%) were the most affected age groups. A viral infection associated with the AO episode was documented in 49.6% of cases. Influenza viruses were most commonly reported (20.5%), followed by SARS-CoV-2 (5.8%), and adenovirus (4.9%). A total of 38 cases of AO were identified in children with measles. In 15.9% of APOM cases, Streptococcus pneumoniae was isolated by culture from otic secretions. The duration of hospitalization was longer in children with APOM and acute otitis externa compared to the other subtypes of AO (p < 0.001). Conclusions: Our study highlights the importance of ENT (ear, nose, and throat) monitoring in children hospitalized for acute infectious diseases, as the majority of AO cases occur in the context of a viral infection. These findings emphasize the necessity for tailored assessment and intervention in suspected cases of AO, especially in young children under 5 years of age. Full article
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9 pages, 576 KiB  
Case Report
Van Wyk–Grumbach Syndrome and Gonadectomy
by Abril Adriana Arellano-Llamas, Alvaro Hernandez-Caballero, Efren Delgado-Mendoza and Manuel Alejandro Catalan-Ruiz
Children 2024, 11(7), 831; https://doi.org/10.3390/children11070831 - 8 Jul 2024
Viewed by 353
Abstract
Van Wyk–Grumbach syndrome (VWGS) refers to the development of peripheral precocious puberty, long-standing hypothyroidism, and gonadal masses; when not diagnosed, an unnecessary gonadectomy may be performed. Herein, we present a case of a 10-year-old girl with Down’s syndrome, short stature, and vitiligo who [...] Read more.
Van Wyk–Grumbach syndrome (VWGS) refers to the development of peripheral precocious puberty, long-standing hypothyroidism, and gonadal masses; when not diagnosed, an unnecessary gonadectomy may be performed. Herein, we present a case of a 10-year-old girl with Down’s syndrome, short stature, and vitiligo who presented to our hospital with vaginal bleeding and a palpable pelvic mass. Upon ultrasound and topographical examination, bilateral ovarian masses with negative tumor markers were detected. After bilateral gonadectomy, endocrine studies revealed profound hypothyroidism and peripheral puberty that led to the VWGS syndrome diagnosis (TSH 367.3 mUI/mL, isolated menstruation, indetectable LH, and elevated estradiol). Levothyroxine treatment improved obesity and short stature, and sexual hormone replacement began at 13 years of age. The literature on Van Wyk–Grumbach syndrome shows that it presents most often in women, and classic hypothyroidism symptoms always precede the diagnosis. Approximately 11% of patients have Down’s syndrome, sometimes tumor markers are elevated, and some develop severe symptoms (myopathy, short stature, mental delay, ascites, pericardial effusion, Cullen’s sign, pituitary hyperplasia, and severe anemia) that respond to levothyroxine treatment. Conclusions: Children with peripheral precocious puberty and gonadal masses must be studied for hypothyroidism before any radical decision is made. Full article
(This article belongs to the Special Issue Endocrine Diseases in Pediatrics: Diagnosis and Treatment)
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9 pages, 408 KiB  
Article
The Influence of Children’s Discrimination Experiences on Parents’ Mental and Self-Rated Health: Results from the National Health Interview Survey
by Elizabeth Jelsma, Nema Kebbeh and Mahnoor Ahmad
Children 2024, 11(7), 830; https://doi.org/10.3390/children11070830 - 8 Jul 2024
Viewed by 351
Abstract
Background: This study assessed the associations between children’s experiences of discrimination based on race/ethnicity and sexual orientation/gender identity and their parents’ anxiety, depressive symptoms, and self-rated health. Methods: Our sample included 3910 parents with at least one child between 12 and 17 years [...] Read more.
Background: This study assessed the associations between children’s experiences of discrimination based on race/ethnicity and sexual orientation/gender identity and their parents’ anxiety, depressive symptoms, and self-rated health. Methods: Our sample included 3910 parents with at least one child between 12 and 17 years of age. Data were pooled from the 2021 and 2022 waves of the National Health Interview Survey. Path analysis with maximum likelihood (ML) estimation and bootstrapping were used to examine the indirect pathways from child-experienced discrimination to parental self-rated health through parental anxiety and depressive symptoms. Results: Child-experienced discrimination based on race/ethnicity was associated with worse parental self-rated health via pathways through higher parental anxiety (p = 0.003) and depressive symptoms (p < 0.001). Child-experienced discrimination based on sexual orientation/gender identity was also associated with worse parental self-rated health via pathways through higher parental anxiety (p = 0.002) and depressive symptoms (p = 0.001). Conclusions: The results show a strong association between children’s experiences of discrimination and parental self-rated health through pathways of poor parental mental health. Findings demonstrate the need to reduce discrimination directed at children and to facilitate mental health support for parents of children experiencing discrimination to improve family well-being. Full article
(This article belongs to the Special Issue Parents and Children Relationships: Protective and Risk Factors)
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11 pages, 2460 KiB  
Article
Do Gender and BMI Affect the Motor Skills of Five-Year-Old Preschoolers Differently?
by Marcos Mecías-Calvo, Fernando Carregal-San Emeterio and Rubén Navarro-Patón
Children 2024, 11(7), 829; https://doi.org/10.3390/children11070829 - 7 Jul 2024
Viewed by 361
Abstract
Background/Objective: Weight gain is associated with numerous health complications and constitutes a serious public health problem. Motor competence (MC) can be a protective factor since children’s participation and practice in physical activities can improve their health. The objective of this study was to [...] Read more.
Background/Objective: Weight gain is associated with numerous health complications and constitutes a serious public health problem. Motor competence (MC) can be a protective factor since children’s participation and practice in physical activities can improve their health. The objective of this study was to investigate the impact of gender and BMI on MC [i.e., manual dexterity (MD), aiming and catching (A&C), balance (Bal), and total MC percentile (TP)] depending on gender (boy/girl) and BMI (normal weight, overweight or obesity). Methods: The MABC-2 battery was applied in a sample of 368 preschool children (5.69 ± 0.28 years of age; 54.9% girls). Results: Boys and girls showed statistically significant differences in MC components: boys had higher scores in A&C (p = 0.002), while girls excelled in MD (p < 0.001), Bal (p = 0.035); TP (p < 0.001), and BMI [Bal (p = 0.009); TP (p = 0.050)], with a higher percentile in those children with overweight in both cases. Statistically significant differences were also found in the interactions between gender*BMI [MD (p < 0.001) and TP (p < 0.001)]. Conclusions: The findings showed that there were notable variations in total percentile, balance, and manual dexterity between boys and girls. In addition, girls outperformed boys in all categories save aiming and catching. However, males who were overweight or obese earned greater percentiles in both balance and the MABC-2 battery’s total percentile. Full article
(This article belongs to the Special Issue Motor Competence and Physical Activity in School Children)
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14 pages, 721 KiB  
Article
Impact of Outdoor Play Structures on Moderate to Vigorous Physical Activity in Children during Recess: A Comparative Study
by Maria Fernanda Fuentes Diaz, Martin Sénéchal and Danielle R. Bouchard
Children 2024, 11(7), 828; https://doi.org/10.3390/children11070828 - 7 Jul 2024
Viewed by 303
Abstract
Background/Objectives: It is believed that outdoor play structures lead to more physical activity for kids during school recess. However, the intensity of this activity remains unknown. This study explored whether access to outdoor play structures during recess interferes with children’s physical activity levels. [...] Read more.
Background/Objectives: It is believed that outdoor play structures lead to more physical activity for kids during school recess. However, the intensity of this activity remains unknown. This study explored whether access to outdoor play structures during recess interferes with children’s physical activity levels. Methods: Forty-one children (8–10 years old) accessed play structures during the afternoon recess but not in the morning for one entire week. To control for temperature differences, the same number of participants from another school who did not access playground structures were invited to participate. Moderate to Vigorous Physical Activity (MVPA) was determined using heart rate reserve. Heart rate was recorded using the Fitbit Inspire 2 (San Francisco, CA, USA) for at least three full school days. Wilcoxon signed-rank and Mann–Whitney U tests analyzed within- and between-group differences. Results: The findings show no difference in MVPA when accessing or not accessing outdoor play structures, both within groups [(n = 37) median (25th–75th) 16 min (7–30) vs. 14 min (5–22)] and between groups [(n = 22) 16 min (7–26)]. The weekly MVPA for all participants (n = 59) [172 min (117–282)] was the strongest variable associated with MVPA during recess [t(df) = 5.40 (38), 95% CI 0.04–0.09, p < 0.001]. Conclusion: accessibility to outdoor play structures does not increase MVPA during recess in children aged 8 to 10. Therefore, schools may need various options for children to play during recess, allowing them to accumulate MVPA. Full article
(This article belongs to the Section Global Pediatric Health)
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19 pages, 3304 KiB  
Article
The Accuracy of Digital Impressions versus Conventional Impressions in Neonates with Cleft Lip and/or Palate: A Laboratory-Based Study
by Jyotsna Unnikrishnan, Mahmoud Bakr, Robert Love and Ghassan Idris
Children 2024, 11(7), 827; https://doi.org/10.3390/children11070827 - 6 Jul 2024
Viewed by 432
Abstract
Cleft lip and palate (CL/P) are a common congenital craniofacial anomaly requiring precise impressions for effective treatment. Conventional impressions (CIs) pose challenges in neonates with CL/P due to their delicate oral anatomy. While digital impressions (DIs) are increasingly recognised for their potential benefits [...] Read more.
Cleft lip and palate (CL/P) are a common congenital craniofacial anomaly requiring precise impressions for effective treatment. Conventional impressions (CIs) pose challenges in neonates with CL/P due to their delicate oral anatomy. While digital impressions (DIs) are increasingly recognised for their potential benefits over conventional methods in dentistry, their accuracy and application in neonates with cleft lip and palate (CL/P) remain underexplored. This study aimed to assess the accuracy of DIs compared to CIs in neonates with CL/P, using alginate and putty materials as references. A laboratory-based case–control study was conducted, utilising soft acrylic models resembling neonatal mouths with CL/P. Alginate and putty impressions were obtained conventionally, while digital impressions were captured using an intraoral scanner (IOS). A total of 42 models were analysed, divided evenly into three groups, with each group comprising 14 models. Superimposition and surface discrepancy analyses were performed to evaluate impression accuracy. The results revealed no statistically significant differences between the digital and conventional impressions in their intra-arch measurements and surface discrepancies. The mean measurement values did not significantly differ among groups, with p values indicating no significant variations (p > 0.05), confirmed by an analysis of variance. High intra-examiner reliability with Intra Class Coefficient (ICC) values close to 1 indicated consistent measurements over time. The current study demonstrates that DIs are equally accurate as conventional alginate and putty impressions in neonates with cleft lip and palate, offering a viable and less invasive alternative for clinical practise. This advancement holds promise for improving the treatment planning process and enhancing patient comfort, particularly in vulnerable neonatal populations. Further research is warranted to explore the clinical implications and factors affecting DI accuracy in this population. Full article
(This article belongs to the Special Issue Congenital Cleft Lip and Palate: Diagnosis, Treatment and Management)
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11 pages, 236 KiB  
Article
A Semester of Hatha Yoga Has Comparable Effects to Physical Education for Children in Terms of Physical Activity and Psychosocial Indicators
by Claudio R. Nigg
Children 2024, 11(7), 826; https://doi.org/10.3390/children11070826 - 6 Jul 2024
Viewed by 241
Abstract
Background/Objectives: As research on yoga with school children is growing, this study investigated the effects a semester of yoga versus physical education on children’s physical activity and psychosocial indicators. Methods: Physical activity and psychosocial variables were assessed at Time 1 (January/February) and Time [...] Read more.
Background/Objectives: As research on yoga with school children is growing, this study investigated the effects a semester of yoga versus physical education on children’s physical activity and psychosocial indicators. Methods: Physical activity and psychosocial variables were assessed at Time 1 (January/February) and Time 2 (April/May) through self-report surveys (n = 157; 63% female, age: m = 10.38, sd = 0.81 years) for the intervention (Hatha yoga classes) and control groups (standard physical education classes). The intervention group was also observed regarding pedometer and System for Observing Fitness Instruction Time data. Results: The results revealed a trend towards an increase for the control and a decrease for the intervention group in stress levels. The pedometer results showed a trend towards an increasing number of steps/min. Skill practice had the greatest increase with time dedicated to that activity. The observation results revealed a significant difference in activity from Time 1 to Time 2. The major differences were decreases in sitting and being very active, and an increase in walking. Conclusions: Given the observation data and our study design limitations, the study results showed similarities between Hatha yoga and physical education in terms of increasing physical activity levels and psychosocial variables; thus, yoga may be a viable alternative to children’s physical education in this regard. Full article
(This article belongs to the Special Issue Health Benefits of Physical Activity for Children and Adolescents)
17 pages, 301 KiB  
Review
Object Exploration and Manipulation in Infants at Typical vs. Elevated Likelihood for ASD: A Review
by Valentina Focaroli, Fabrizio Taffoni, Andrea Velardi, Barbara Caravale and Flavio Keller
Children 2024, 11(7), 825; https://doi.org/10.3390/children11070825 - 5 Jul 2024
Viewed by 186
Abstract
The present review considers the growing body of literature on fine motor skills in infants at elevated genetic likelihood (EL) for autism spectrum disorder (ASD). This area of study aims to identify crucial motor markers associated with the disorder, facilitating earlier and more [...] Read more.
The present review considers the growing body of literature on fine motor skills in infants at elevated genetic likelihood (EL) for autism spectrum disorder (ASD). This area of study aims to identify crucial motor markers associated with the disorder, facilitating earlier and more accurate identification of ASD, using various experimental methodologies, including standardized assessments, observational measures, and technological tools. The reviewed evidence revealed distinct developmental trajectories in EL infants, marked by differences in fine motor skills and exploratory behaviors compared to typically developing infants. We discuss the developmental trajectory of fine motor skills in infants and their predictive value for later ASD diagnosis, highlighting the significance of fine motor skills as early indicators of ASD risk in infants and emphasizing the need for further research to elucidate their predictive value and underlying mechanisms. Full article
10 pages, 483 KiB  
Article
Three-Dimensional Anthropometric Analysis of the Effect of Lip Reconstructive Surgery on Children with Cleft Lip and Palate at Three Different Times
by Gabriela Mendonça Rando, Eloá Cristina Passucci Ambrosio, Paula Karine Jorge, Chiarella Sforza, Márcio Menezes, Ana Lúcia Pompeia Fraga de Almeida, Simone Soares, Gisele Silva Dalben, Cristiano Tonello, Cleide Felício Carvalho Carrara, Maria Aparecida Andrade Moreira Machado and Thais Marchini Oliveira
Children 2024, 11(7), 824; https://doi.org/10.3390/children11070824 - 5 Jul 2024
Viewed by 227
Abstract
Objectives: This investigation aimed to assess the optimal timing for lip repair in children with cleft lip and palate via 3D anthropometric analysis to evaluate their maxillofacial structures. Methods: The sample comprised 252 digitized dental models, divided into groups according to the following [...] Read more.
Objectives: This investigation aimed to assess the optimal timing for lip repair in children with cleft lip and palate via 3D anthropometric analysis to evaluate their maxillofacial structures. Methods: The sample comprised 252 digitized dental models, divided into groups according to the following timing of lip repair: G1 (n = 50): 3 months; G2 (n = 50): 5 and 6 months; G3 (n = 26): 8 and 10 months. Models were evaluated at two-time points: T1: before lip repair; T2: at 5 years of age. Linear measurements, area, and Atack index were analyzed. Results: At T1, the intergroup analysis revealed that G1 had statistically significant lower means of I-C′, I-C, C-C′, and the sum of the segment areas compared to G2 (p = 0.0140, p = 0.0082, p = 0.0004, p < 0.0001, respectively). In addition, there was a statistically significant difference when comparing the cleft area between G2 and G3 (p = 0.0346). At T2, the intergroup analysis revealed that G1 presented a statistically significant mean I-C′ compared to G3 (p = 0.0461). In the I-CC’ length analysis, G1 and G3 showed higher means when compared to G2 (p = 0.0039). The I-T′ measurement was statistically higher in G1 than in G2 (p = 0.0251). In the intergroup growth rate analysis, G1 and G2 showed statistically significant differences in the I-C′ measurement compared to G3 (p = 0.0003). In the analysis of the Atack index, there was a statistically significant difference between G1 and the other sample sets (p < 0.0001). Conclusion: Children who underwent surgery later showed better results in terms of the growth and development of the dental arches. Full article
(This article belongs to the Special Issue Current Research on Cleft Lip in Children - Volume 2)
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6 pages, 309 KiB  
Brief Report
Does Preterm Prolonged Rupture of Membranes Increase the Risk of Needing Invasive Respiratory Support? A Retrospective Single-Centre Study
by Eleanor Jeffreys, Ravindra Bhat, Anne Greenough and Theodore Dassios
Children 2024, 11(7), 823; https://doi.org/10.3390/children11070823 - 5 Jul 2024
Viewed by 212
Abstract
(1) Background: Preterm premature rupture of membranes (PPROM) has been associated with increased perinatal morbidity, but the effect of PPROM on respiratory disease has not been previously quantified. We hypothesised that PPROM would be associated with a higher incidence of invasive ventilation. (2) [...] Read more.
(1) Background: Preterm premature rupture of membranes (PPROM) has been associated with increased perinatal morbidity, but the effect of PPROM on respiratory disease has not been previously quantified. We hypothesised that PPROM would be associated with a higher incidence of invasive ventilation. (2) Methods: A retrospective cohort study at the Neonatal Unit at King’s College Hospital NHS Foundation Trust, London, UK, was conducted on infants born before 37 weeks of gestation. PPROM was defined as the rupture of membranes for >48 h. (3) Results: We reviewed 1901 infants (434 with PPROM) with a median (IQR) gestational age of 32.4 (28.7–35.0) weeks. The median (IQR) duration of rupture of membranes in the infants with PPROM was 129 (78–293) h. The incidence of invasive ventilation was 56% in the infants with PPROM and 46% in the infants without PPROM (p < 0.001). Following regression analysis, PPROM was significantly related to a higher incidence of invasive ventilation (odds ratio: 1.48; 95% CI: 1.13–1.92, adjusted p = 0.004) after adjusting for birth weight [odds ratio = 0.34; 95% CI: 0.33–0.43, adjusted p < 0.001], Apgar score at 10 min [odds ratio =0.61; 95% CI: 0.56–0.66, adjusted p < 0.001] and antenatal corticosteroid use (adjusted p = 0.939). (4) Conclusions: PPROM was associated with a 1.48-fold higher risk of needing invasive ventilation. Full article
(This article belongs to the Section Pediatric Neonatology)
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12 pages, 578 KiB  
Article
The Association of Social Media Use and Eating Behaviour of Belgian Adolescent Girls Diagnosed with Anorexia Nervosa—A Qualitative Approach
by Nathalie Praet, Jeff Stevens, Kristina Casteels and Jaan Toelen
Children 2024, 11(7), 822; https://doi.org/10.3390/children11070822 - 4 Jul 2024
Viewed by 434
Abstract
Background: Social media have become integral in adolescents’ lives, presenting both opportunities and risks, especially concerning psychiatric issues like eating disorders, prevalent in this vulnerable age group. Methods: This qualitative study employed semi-structured interviews with seven adolescent girls (aged 15–17) diagnosed with eating [...] Read more.
Background: Social media have become integral in adolescents’ lives, presenting both opportunities and risks, especially concerning psychiatric issues like eating disorders, prevalent in this vulnerable age group. Methods: This qualitative study employed semi-structured interviews with seven adolescent girls (aged 15–17) diagnosed with eating disorders. Interviews covered seven predefined topics, recorded and transcribed for thematic analysis. Results: Participants identified four key themes: exposure to selective content, biased interpretation, behavioural adaptation, and evolving perspectives during recovery. They highlighted social media’s role in exacerbating body dissatisfaction and altering behaviours related to eating disorders. Conclusions: This research underscores the critical need for awareness and guidance in adolescents’ social media use to mitigate negative impacts, emphasizing the potential link between exposure to specific content and cognitive-behavioural changes in those with eating disorders. Further investigation is warranted to deepen our comprehension of these dynamics. Full article
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14 pages, 1608 KiB  
Article
Polypharmacy in Children with Medical Complexity: A Cross-Sectional Study in a Pediatric Palliative Care Center
by Anna Zanin, Fernando Baratiri, Barbara Roverato, Daniele Mengato, Lisa Pivato, Irene Avagnina, Irene Maghini, Antuan Divisic, Francesca Rusalen, Caterina Agosto, Francesca Venturini and Franca Benini
Children 2024, 11(7), 821; https://doi.org/10.3390/children11070821 - 4 Jul 2024
Viewed by 398
Abstract
Background: Children with medical complexity (CMC) often require multiple medications, leading to polypharmacy, which seems to be linked to adverse effects, administration errors, and increased caregiver burden. This study aimed to describe the prevalence of polypharmacy, medication burden, off-label drug use, and associated [...] Read more.
Background: Children with medical complexity (CMC) often require multiple medications, leading to polypharmacy, which seems to be linked to adverse effects, administration errors, and increased caregiver burden. This study aimed to describe the prevalence of polypharmacy, medication burden, off-label drug use, and associated costs. Methods: Conducted at the Pediatric Palliative Care Center of Padua, Italy, from August to October 2021, this cross-sectional observational study included patients up to 23 years old with at least one prescribed drug. Data were collected from medical records and caregiver interviews. Drug costs were collected from the Italian Medicine Agency. Descriptive statistical analysis was performed. For comparisons among categorical variables, the Chi-square test was used, and for those among continuous variables, the ANOVA test was used. Results: This study analyzed treatment regimens of 169 patients with a median age of 12.5 years (0.3–23). Polypharmacy was present in 52.7% of patients, and medication burden was observed in 44.4%, both varying significantly by primary diagnosis (p < 0.001). The median daily cost per patient was EUR 2.2 (IQR 0.9–7.1), with significant variation among subgroups. Only 34.6% of prescriptions were off-label. Conclusions: polypharmacy and medication burden are frequent among our CMC population, with some differences according to primary diagnosis. Full article
(This article belongs to the Special Issue Recent Advances in Pediatric Palliative Home Care)
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11 pages, 6142 KiB  
Article
Sclerostin and Wnt Signaling in Idiopathic Juvenile Osteoporosis Using High-Resolution Confocal Microscopy for Three-Dimensional Analyses
by Renata C. Pereira, Kathleen J. Noche, Barbara Gales, Zhangying Chen, Isidro B. Salusky and Lauren V. Albrecht
Children 2024, 11(7), 820; https://doi.org/10.3390/children11070820 - 4 Jul 2024
Viewed by 306
Abstract
Background: Idiopathic juvenile osteoporosis (IJO) is a rare condition characterized by low bone mass that can increase the risk of fractures in children. Treatment options for these patients are limited as the molecular mechanisms of disease initiation and progression are incompletely understood. Sclerostin [...] Read more.
Background: Idiopathic juvenile osteoporosis (IJO) is a rare condition characterized by low bone mass that can increase the risk of fractures in children. Treatment options for these patients are limited as the molecular mechanisms of disease initiation and progression are incompletely understood. Sclerostin inhibits canonical Wnt signaling, which is important for the bone formation activity of osteoblasts, and elevated sclerostin has been implicated in adult osteoporosis. Objective: To evaluate the role of sclerostin in IJO, high-resolution confocal microscopy analyses were performed on bone biopsies collected from 13 pediatric patients. Methods: Bone biopsies were stained with sclerostin, and β-catenin antibodies showed elevated expression across osteocytes and increased sclerostin-positive osteocytes in 8 of the 13 total IJO patients (62%). Results: Skeletal sclerostin was associated with static and dynamic histomorphometric parameters. Further, colocalization analyses showed that bone sclerostin colocalized with phosphorylated β-catenin, a hallmark of Wnt signaling that indicates Wnt inhibition. In contrast, sclerostin-positive osteocytes were not colocalized with an “active” unphosphorylated form of β-catenin. Conclusions: These results support a model that altered levels of sclerostin and Wnt signaling activity occur in IJO patients. Full article
(This article belongs to the Special Issue Pediatric Growth and Skeletal Disorders)
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