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Children, Volume 5, Issue 9 (September 2018) – 17 articles

Cover Story (view full-size image): Parenting a child with chronic pain can be extremely stressful, sometimes devastating, and has been associated with high rates of parental anxiety and depression. Mindfulness based interventions (MBIs) have emerged as a promising approach for improving the wellbeing of parents, including improvements in parental stress and mood, though few programs target parents of children with health conditions. Clinical and research initiatives need to assess ways to deliver MBIs to parents of children with health conditions, so these programs can be easily implemented into busy family life. View this paper.
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17 pages, 734 KiB  
Article
The Feasibility and Acceptability of The Girls Peer Activity (G-PACT) Peer-led Mentoring Intervention
by Michael B. Owen, Charlotte Kerner, Sarah L. Taylor, Robert J. Noonan, Lisa Newson, Maria-Christina Kosteli, Whitney B. Curry and Stuart J. Fairclough
Children 2018, 5(9), 128; https://doi.org/10.3390/children5090128 - 19 Sep 2018
Cited by 5 | Viewed by 4916
Abstract
Enjoyment of physical activity (PA) is positively correlated with PA engagement. The inclusion of peers has been found to increase the likelihood of PA enjoyment in youth. Peer-led strategies, incorporating peer networks in the intervention delivery, is relatively underused and consequently understudied in [...] Read more.
Enjoyment of physical activity (PA) is positively correlated with PA engagement. The inclusion of peers has been found to increase the likelihood of PA enjoyment in youth. Peer-led strategies, incorporating peer networks in the intervention delivery, is relatively underused and consequently understudied in school-based PA interventions. The purpose of this investigation was to evaluate the feasibility and acceptability of the novel Girls Peer Activity (G-PACT) peer-led mentoring intervention. Two-hundred and forty-nine Year 9 adolescent girls (13–14 years old) from three mixed-sex secondary schools located in West Lancashire, North-West England were invited to participate in the G-PACT project. The study employed a novel approach by using a three-tier model, including (Tier 1) Mentors (undergraduate students), (Tier 2) Leaders (Year 9 girls selected by teachers), and (Tier 3) Peers (whole Year 9 cohort). Mentors delivered a series of educational and leadership training to the Leaders in each respective school who then disseminated this information to their Peers and encouraged them to engage in more physical activities. Eight focus groups were conducted with Leaders (n = 40), 28 focus groups with Peers (n = 185), two focus groups with Mentors (n = 6), and three interviews with teachers (n = 4). Thematic analysis was used to analyze the pooled data and identify the key themes. The study found that the G-PACT intervention was feasible and acceptable for adolescent PA Leaders and their Mentors. The relationship between Leaders and their Peers required refinement to improve the communication processes to increase Peer engagement in the G-PACT project. Full article
(This article belongs to the Special Issue Physical Activity and Sedentary Behaviour in Children and Adolescents)
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4 pages, 468 KiB  
Case Report
Pediatric Pleomorphic Adenoma of the Parotid: Case Report, Review of Literature and Novel Therapeutic Targets
by Girish Gulab Meshram, Neeraj Kaur and Kanwaljeet Singh Hura
Children 2018, 5(9), 127; https://doi.org/10.3390/children5090127 - 18 Sep 2018
Cited by 3 | Viewed by 5066
Abstract
Salivary gland tumors are extremely rare and encompass a diverse group of histologies. Less than 5% of the affected population is pediatric. We present a case of 6-year-old child with pleomorphic adenoma of the parotid. The patient underwent a superficial parotidectomy. Recurrence was [...] Read more.
Salivary gland tumors are extremely rare and encompass a diverse group of histologies. Less than 5% of the affected population is pediatric. We present a case of 6-year-old child with pleomorphic adenoma of the parotid. The patient underwent a superficial parotidectomy. Recurrence was not observed in the six months of follow-up. Surgery is the mainstay of the management of benign salivary gland tumors. Although novel molecular agents are being explored, personalized therapy would be a challenge due to the rarity and vast genetic/histologic variations of salivary gland tumors. Full article
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13 pages, 707 KiB  
Review
Multidisciplinary Perioperative Care for Children with Neuromuscular Disorders
by J. Matthew Kynes, Martin Blakely, Kevin Furman, William B. Burnette and Katharina B. Modes
Children 2018, 5(9), 126; https://doi.org/10.3390/children5090126 - 12 Sep 2018
Cited by 12 | Viewed by 5024
Abstract
Children with neuromuscular diseases present unique challenges to providing safe and appropriate perioperative care. Given the spectrum of disease etiologies and manifestations, this is a population that often requires specialized multidisciplinary care from pediatricians, geneticists, neurologists, dieticians, and pulmonologists which must also be [...] Read more.
Children with neuromuscular diseases present unique challenges to providing safe and appropriate perioperative care. Given the spectrum of disease etiologies and manifestations, this is a population that often requires specialized multidisciplinary care from pediatricians, geneticists, neurologists, dieticians, and pulmonologists which must also be coordinated with surgeons and anesthesiologists when these patients present for surgery. Several of these diseases also have specific pharmacologic implications for anesthesia, most notably mitochondrial disease and muscular dystrophies, which put them at additional risk during the perioperative period particularly in patients presenting without a formal diagnosis. Techniques and strategies to fully evaluate and optimize these patients preoperatively, manage them safely intraoperatively, and return them to their baseline status postoperative are particularly important in this vulnerable group of patients. Utilizing a review of inherited neuromuscular conditions, generalized perioperative concerns, and specific complications related to anesthesia, this article provides an overview of pertinent considerations and recommends a framework for management of these patients. Full article
(This article belongs to the Section Pediatric Surgery)
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10 pages, 213 KiB  
Article
Causes of Morbidity and Mortality among Neonates and Children in Post-Conflict Burundi: A Cross-Sectional Retrospective Study
by Imelda K. Moise
Children 2018, 5(9), 125; https://doi.org/10.3390/children5090125 - 8 Sep 2018
Cited by 14 | Viewed by 5681
Abstract
The risk of a child dying before age five in Burundi is almost 1.6 times higher than that in the World Health Organization (WHO) African region. However, variations in the all-cause mortality rates across Burundi have not yet been measured directly at subnational [...] Read more.
The risk of a child dying before age five in Burundi is almost 1.6 times higher than that in the World Health Organization (WHO) African region. However, variations in the all-cause mortality rates across Burundi have not yet been measured directly at subnational levels, age group and by gender. The objective of this study was to describe the main causes of hospitalization and mortality in children during the neonatal period and at ages 1 to 59 months, for boys and girls, and to assess the total annual (2010) burden of under-five morbidity and mortality in hospitals using hospitalization records from 21 district hospitals. We found variation in the gender and regional distribution of the five leading causes of hospitalization and death of children under five. Although the five causes accounted for 89% (468/523) of all neonatal hospitalizations, three causes accounted for 93% (10,851/11,632) of all-cause hospitalizations for children ages 1 to 59 months (malaria, lung disease, and acute diarrhea), malaria accounted for 69% (1086/1566) of all deaths at ages 1 to 59 months. In Burundi, human malarial infections continue to be the main cause of hospitalization and mortality among under-five children. Full article
(This article belongs to the Special Issue 5th Anniversary Issue)
12 pages, 596 KiB  
Article
First Aid Practices and Health-Seeking Behaviors of Caregivers for Unintentional Childhood Injuries in Ujjain, India: A Community-Based Cross-Sectional Study
by Ashish Pathak, Nitin Agrawal, Love Mehra, Aditya Mathur and Vishal Diwan
Children 2018, 5(9), 124; https://doi.org/10.3390/children5090124 - 6 Sep 2018
Cited by 9 | Viewed by 6574
Abstract
Data on types of community first aid use and treatment provided post-injury from many low‒middle-income countries, including India, are lacking. This cross-sectional study was conducted among children aged one month to 18 years of age, in Ujjain, India, to understand types of first [...] Read more.
Data on types of community first aid use and treatment provided post-injury from many low‒middle-income countries, including India, are lacking. This cross-sectional study was conducted among children aged one month to 18 years of age, in Ujjain, India, to understand types of first aid given and health-seeking post-injury. A total of 1087 injuries in 1049 children were identified in the past year. A total of 729 (67%) injured children received first aid and 758 (70%) sought some form of health care. Children with burns received the most (86%) first aid, and most children (84%) with road traffic accidents (RTA) sought health care. Most children (52%) sought health care from a private health care facility; most children (65%) were transported to a health care facility within the golden hour. Motorbikes were the most preferred (50%) mode of transport. Only 1% of the injured used ambulance services. Commonly reported methods or substances for first aid included the use of coconut oil on wounds from falls (38%) and burns (44%), the use of antiseptic cream on wounds from RTA (31%), the application of turmeric for wounds from falls (16%), and rubbing of metal on a bitten area (47%). For most injuries, appropriate, locally available substances were used. Potentially harmful substances applied included lime, toothpaste, clay, and mud. The findings will help design community interventions to increase the provision of appropriate first aid for childhood injuries. Full article
(This article belongs to the Section Global Pediatric Health)
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2 pages, 160 KiB  
Correction
Correction: Esparham, A., et al., Pediatric Integrative Medicine: Vision for the Future. Children, 2018, 5, 111
by Anna Esparham, Sanghamitra M. Misra, Erica Sibinga, Timothy Culbert, Kathi Kemper, Hilary McClafferty, Sunita Vohra and Lawrence Rosen
Children 2018, 5(9), 123; https://doi.org/10.3390/children5090123 - 5 Sep 2018
Cited by 1 | Viewed by 3519
Abstract
The authors wish to make the following corrections to their paper [...] Full article
(This article belongs to the Special Issue Implementing Pediatric Integrative Medicine in Practice)
9 pages, 224 KiB  
Article
Integrative Pediatrics: Successful Implementation of Integrative Medicine in a German Hospital Setting—Concept and Realization
by Marion Eckert, Catharina Amarell, Dennis Anheyer, Holger Cramer and Gustav Dobos
Children 2018, 5(9), 122; https://doi.org/10.3390/children5090122 - 4 Sep 2018
Cited by 26 | Viewed by 6478
Abstract
Complementary and Alternative Medicine (CAM) has not been systematically institutionalized in pediatric hospital care in Germany so far. For the responsible implementation and systematic evaluation of CAM in pediatric care, a model project was initialized in three different pediatric hospitals in Germany, one [...] Read more.
Complementary and Alternative Medicine (CAM) has not been systematically institutionalized in pediatric hospital care in Germany so far. For the responsible implementation and systematic evaluation of CAM in pediatric care, a model project was initialized in three different pediatric hospitals in Germany, one of them being the “Kinderkrankenhaus St. Marien” in Landshut, Germany. During this project, a concept of the implementation process was developed based on clinical care, teaching, and scientific evaluation. A project group was formed in St. Marien, which included leaders of the hospital, physicians, nurses, and physiotherapists. Over a period of three years, pediatric treatment modalities of the CAM-spectrum were systematically integrated into routine pediatric care and a new integrative medicine department was established. CAM is now being applied in an inpatient as well as outpatient setting, in addition to conventional medical treatments. The modalities now applied include Traditional Chinese Medicine (TCM), relaxation, hypnosis, reflexology, wraps and poultices, aromatherapy, homeopathy, yoga, and herbal medicine. Studies were initiated in some areas. The process and concept leading up to this successful implementation will be described in this article. We show that with motivated team players and structured proceedings, implementation of integrative medicine in a children’s hospital can be successful. Full article
(This article belongs to the Special Issue Implementing Pediatric Integrative Medicine in Practice)
20 pages, 1258 KiB  
Article
Changes in Parent Psychological Flexibility after a One-Time Mindfulness-Based Intervention for Parents of Adolescents with Persistent Pain Conditions
by Danielle Ruskin, Lauren Campbell, Jennifer Stinson and Sara Ahola Kohut
Children 2018, 5(9), 121; https://doi.org/10.3390/children5090121 - 3 Sep 2018
Cited by 12 | Viewed by 5245
Abstract
Parenting a child with chronic pain can be stressful and impact parent functioning in a variety of areas. Several studies have examined mindfulness-based interventions (MBIs) for parents of children with different health and mental health conditions. However, no studies to date have examined [...] Read more.
Parenting a child with chronic pain can be stressful and impact parent functioning in a variety of areas. Several studies have examined mindfulness-based interventions (MBIs) for parents of children with different health and mental health conditions. However, no studies to date have examined MBIs for parents of children with pain conditions. This study aimed to: (1) determine the feasibility and acceptability of a one-time MBI workshop for parents (n = 34) of adolescents with painful conditions (chronic pain and inflammatory bowel disease) who were participating in a concurrent mindfulness group for adolescents with pain, and (2) examine changes in parent mindfulness and psychological flexibility following the intervention. A mixed-method design was used. In terms of feasibility and acceptability, high recruitment and retention rates were observed, and parents reported high satisfaction scores with the workshop. Changes pre to post intervention showed that dimensions of parent psychological flexibility, but not parent mindfulness, improved following participation in the workshop. Qualitative analyses based on parent responses on a questionnaire uncovered seven themes of parent “takeaways” following participation in the workshop: Mindfulness Skills, Not Alone, Psychological Flexibility, Parent–Child Interactions, Self-Efficacy, Optimism/Positivity/Hope, and Awareness of Values. Taken together, these findings suggest that a one-time MBI workshop offered to parents whose teen was participating in a concurrent mindfulness group for pain is a feasible and promising intervention for parents of children with pain conditions. Full article
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13 pages, 236 KiB  
Editorial
Delivering Pediatric Palliative Care: From Denial, Palliphobia, Pallilalia to Palliactive
by Stefan J. Friedrichsdorf and Eduardo Bruera
Children 2018, 5(9), 120; https://doi.org/10.3390/children5090120 - 31 Aug 2018
Cited by 42 | Viewed by 9084
Abstract
Among the over 21 million children with life-limiting conditions worldwide that would benefit annually from a pediatric palliative care (PPC) approach, more than eight million would need specialized PPC services. In the United States alone, more than 42,000 children die every year, half [...] Read more.
Among the over 21 million children with life-limiting conditions worldwide that would benefit annually from a pediatric palliative care (PPC) approach, more than eight million would need specialized PPC services. In the United States alone, more than 42,000 children die every year, half of them infants younger than one year. Advanced interdisciplinary pediatric palliative care for children with serious illnesses is now an expected standard of pediatric medicine. Unfortunately, in many institutions there remain significant barriers to achieving optimal care related to lack of formal education, reimbursement issues, the emotional impact of caring for a dying child, and most importantly, the lack of interdisciplinary PPC teams with sufficient staffing and funding. Data reveals the majority of distressing symptoms in children with serious illness (such as pain, dyspnea and nausea/vomiting) were not addressed during their end-of-life period, and when treated, therapy was commonly ineffective. Whenever possible, treatment should focus on continued efforts to control the underlying illness. At the same time, children and their families should have access to interdisciplinary care aimed at promoting optimal physical, psychological and spiritual wellbeing. Persistent myths and misconceptions have led to inadequate symptom control in children with life-limiting diseases. Pediatric Palliative Care advocates the provision of comfort care, pain, and symptom management concurrently with disease-directed treatments. Families no longer have to opt for one over the other. They can pursue both, and include integrative care to maximize the child’s quality of life. Since most of the sickest children with serious illness are being taken care of in a hospital, every children’s hospital is now expected to offer an interdisciplinary palliative care service as the standard of care. This article addresses common myths and misconceptions which may pose clinical obstacles to effective PPC delivery and discusses the four typical stages of pediatric palliative care program implementation. Full article
(This article belongs to the Special Issue Pediatric Palliative Care)
18 pages, 592 KiB  
Review
Genetic Predisposition to Neuroblastoma
by Erin K. Barr and Mark A. Applebaum
Children 2018, 5(9), 119; https://doi.org/10.3390/children5090119 - 31 Aug 2018
Cited by 54 | Viewed by 7150
Abstract
Neuroblastoma is the most common solid tumor in children under the age of one. It displays remarkable phenotypic heterogeneity, resulting in differences in outcomes that correlate with clinical and biologic features at diagnosis. While neuroblastoma accounts for approximately 5% of all cancer diagnoses [...] Read more.
Neuroblastoma is the most common solid tumor in children under the age of one. It displays remarkable phenotypic heterogeneity, resulting in differences in outcomes that correlate with clinical and biologic features at diagnosis. While neuroblastoma accounts for approximately 5% of all cancer diagnoses in pediatrics, it disproportionately results in about 9% of all childhood deaths. Research advances over the decades have led to an improved understanding of neuroblastoma biology. However, the initiating events that lead to the development of neuroblastoma remain to be fully elucidated. It has only been recently that advances in genetics and genomics have allowed researchers to unravel the predisposing factors enabling the development of neuroblastoma and fully appreciate the interplay between the genetics of tumor and host. In this review, we outline the current understanding of familial neuroblastoma and highlight germline variations that predispose children to sporadic disease. We also discuss promising future directions in neuroblastoma genomic research and potential clinical applications for these advances. Full article
(This article belongs to the Special Issue Recent Advances in Diagnosis and Treatment of Neuroblastoma)
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9 pages, 591 KiB  
Article
Youth Physical Activity Patterns During School and Out-of-School Time
by Pedro F. Saint-Maurice, Yang Bai, Spyridoula Vazou and Gregory Welk
Children 2018, 5(9), 118; https://doi.org/10.3390/children5090118 - 30 Aug 2018
Cited by 31 | Viewed by 5315
Abstract
This study describes age, sex, and season patterns in children’s physical activity behaviors during discrete time periods, both in school and at home. Participants were 135 elementary, 67 middle, and 89 high-school students (128 boys and 163 girls) involved in a larger school [...] Read more.
This study describes age, sex, and season patterns in children’s physical activity behaviors during discrete time periods, both in school and at home. Participants were 135 elementary, 67 middle, and 89 high-school students (128 boys and 163 girls) involved in a larger school activity monitoring project. We examined time spent in moderate-to-vigorous physical activity (MVPA) at recess, physical education (PE), lunch, commuting to/from school, before-school, after-school, evening, and weekend segments. Differences in MVPA by age, sex, and season were examined using a three-way analysis of variance and separately for each individual segment. Moderate-to-vigorous physical activity levels varied by context and were higher during recess (15.4 ± 8.5 min) while at school, and on Saturdays (97.4 ± 89.5 min) when youth were out-of-school. Elementary children were more active than their older counterparts only during lunch time, after-school, and Sunday (p < 0.05). Boys were consistently more active than girls at all segments. Participants were only more active during non-winter than winter months during PE (p = 0.006), after-school (p < 0.001), and Sunday (p = 0.008) segments. These findings showed that activity levels in youth vary during the day and season. The segments reflect discrete time periods that can potentially be targeted and evaluated to promote physical activity in this population. Full article
(This article belongs to the Special Issue Physical Activity and Sedentary Behaviour in Children and Adolescents)
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9 pages, 193 KiB  
Article
Teachers’ Strategies in Combating Diseases in Preschools’ Environments
by Emmanuel Obeng-Gyasi, Melissa A. Weinstein, Jessica R. Hauser and Cecilia S. Obeng
Children 2018, 5(9), 117; https://doi.org/10.3390/children5090117 - 30 Aug 2018
Cited by 5 | Viewed by 4528
Abstract
Scholarship on child health indicates that the early years of life are vital for all aspects of health and development. In particular, a solid health foundation predicts good life outcomes; therefore, systematic strategies for combating diseases are needed to ensure optimal health of [...] Read more.
Scholarship on child health indicates that the early years of life are vital for all aspects of health and development. In particular, a solid health foundation predicts good life outcomes; therefore, systematic strategies for combating diseases are needed to ensure optimal health of young children in early care environments. This study examined strategies used by 48 preschool teachers from 10 pre-schools in the US Midwest in order to combat diseases. The following results emerged: Participants noted that children should not attend childcare if they are vomiting, have a fever or have diarrhea. They should be symptom-free for at least one day before returning to school. It is recommended that children be sent home if they have any disease deemed to have adverse effects on their health during the school day. Participants noted further that children must not share hats in their childcare environments to avoid transfer of head lice. Since no strategies were mentioned to help children cope with emotional distress and illness, it is recommended that teachers develop strategies that will address emotional childhood diseases in order to help all children. Full article
9 pages, 445 KiB  
Article
Weight Loss Medications in Young Adults after Bariatric Surgery for Weight Regain or Inadequate Weight Loss: A Multi-Center Study
by Alexander T. Toth, Gricelda Gomez, Alpana P. Shukla, Janey S. Pratt, Hellas Cena, Ginevra Biino, Louis J. Aronne and Fatima Cody Stanford
Children 2018, 5(9), 116; https://doi.org/10.3390/children5090116 - 29 Aug 2018
Cited by 40 | Viewed by 6457
Abstract
This paper presents a retrospective cohort study of weight loss medications in young adults aged 21 to 30 following Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) between November 2000 and June 2014. Data were collected from patients who used topiramate, phentermine, and/or [...] Read more.
This paper presents a retrospective cohort study of weight loss medications in young adults aged 21 to 30 following Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) between November 2000 and June 2014. Data were collected from patients who used topiramate, phentermine, and/or metformin postoperatively. Percentage of patients achieving ≥5%, ≥10%, or ≥15% weight loss on medications was determined and percent weight change on each medication was compared to percent weight change of the rest of the cohort. Our results showed that 54.1% of study patients lost ≥5% of their postsurgical weight; 34.3% and 22.9% lost ≥10% and ≥15%, respectively. RYGB had higher median percent weight loss (−8.1%) than SG (−3.3%) (p = 0.0515). No difference was found in median percent weight loss with medications started at weight plateau (−6.0%) versus after weight regain (−5.4%) (p = 0.5304). Patients taking medications at weight loss plateau lost 41.2% of total body weight from before surgery versus 27.1% after weight regain (p = 0.076). Median percent weight change on metformin was −2.9% compared to the rest of the cohort at −7.7% (p = 0.0241). No difference from the rest of the cohort was found for phentermine (p = 0.2018) or topiramate (p = 0.3187). Topiramate, phentermine, and metformin are promising weight loss medications for 21 to 30 year olds. RYGB patients achieve more weight loss on medications but both RYGB and SG benefit. Median total body weight loss from pre-surgical weight may be higher in patients that start medication at postsurgical nadir weight. Participants on metformin lost significantly smaller percentages of weight on medications, which could be the result of underlying medical conditions. Full article
(This article belongs to the Special Issue Obesity and Metabolic Dysregulation in Childhood)
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12 pages, 250 KiB  
Article
Can the Mindful Awareness and Resilience Skills for Adolescents (MARS-A) Program Be Provided Online? Voices from the Youth
by Nicholas Chadi, Elli Weisbaum, Catherine Malboeuf-Hurtubise, Sara Ahola Kohut, Christine Viner, Miriam Kaufman, Jake Locke and Dzung X. Vo
Children 2018, 5(9), 115; https://doi.org/10.3390/children5090115 - 28 Aug 2018
Cited by 15 | Viewed by 6437
Abstract
Mindfulness-based interventions (MBIs) have been shown to improve health and well-being in adolescents with chronic illnesses. Because they are most often delivered in person in a group setting, there are several barriers that limit access to MBIs for youth with limited mobility or [...] Read more.
Mindfulness-based interventions (MBIs) have been shown to improve health and well-being in adolescents with chronic illnesses. Because they are most often delivered in person in a group setting, there are several barriers that limit access to MBIs for youth with limited mobility or who cannot access in-person MBIs in their communities. The objective of this study was to determine if eHealth is a viable platform to increase accessibility to MBIs for teens with chronic illnesses. This study reports the qualitative results of a mixed method randomized trial describing the experience of the Mindful Awareness and Resilience Skills for Adolescents (MARS-A) program, an eight-week MBI, delivered either in person or via eHealth. Participants were adolescents between the ages of 13 and 18 with a chronic illness recruited at a tertiary pediatric hospital in Toronto, Canada. Individual semi-structured post-participation audio-video interviews were conducted by a research assistant. A multiple-pass inductive process was used to review interview transcripts and interpret emergent themes from the participants’ lived experiences. Fifteen participants (8 online and 7 in person) completed post-participation interviews. Four distinct themes emerged from participants in both groups: Creation of a safe space, fostering peer support and connection, integration of mindfulness skills into daily life, and improved well-being through the application of mindfulness. Direct quotations representative of those four themes are reported. Results from this study suggest that eHealth delivery of an adapted MBI for adolescents with chronic illnesses may be an acceptable and feasible mode of delivery for MBIs in this population. EHealth should be considered in future studies of MBIs for adolescents with chronic illnesses as a promising avenue to increase access to MBIs for youth who might not be able to access in-person programs. Full article
(This article belongs to the Special Issue Implementing Pediatric Integrative Medicine in Practice)
7 pages, 763 KiB  
Review
High-Risk Neuroblastoma Treatment Review
by Valeria Smith and Jennifer Foster
Children 2018, 5(9), 114; https://doi.org/10.3390/children5090114 - 28 Aug 2018
Cited by 167 | Viewed by 16906
Abstract
Neuroblastoma is the most common extracranial solid tumor in children. One subset, high-risk neuroblastoma, is very difficult to treat and requires multi-modal therapy. Intensification of therapy has vastly improved survival rates, and research is focused on novel treatments to further improve survival rates. [...] Read more.
Neuroblastoma is the most common extracranial solid tumor in children. One subset, high-risk neuroblastoma, is very difficult to treat and requires multi-modal therapy. Intensification of therapy has vastly improved survival rates, and research is focused on novel treatments to further improve survival rates. The current treatment schema is divided into three stages—induction, consolidation, and maintenance. This review serves as an overview of the current treatment for high-risk neuroblastoma and a glimpse at current research for future therapy. Full article
(This article belongs to the Special Issue Recent Advances in Diagnosis and Treatment of Neuroblastoma)
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11 pages, 229 KiB  
Review
Chronic Pediatric Pain in Low- and Middle-Income Countries
by Camila B. Walters, J. Matthew Kynes, Jenna Sobey, Tsitsi Chimhundu-Sithole and K. A. Kelly McQueen
Children 2018, 5(9), 113; https://doi.org/10.3390/children5090113 - 27 Aug 2018
Cited by 21 | Viewed by 5088
Abstract
Chronic pain is a serious health concern and potentially debilitating condition, leading to anxiety, depression, reduced productivity and functionality, and poor quality of life. This condition can be even more detrimental and incapacitating in the pediatric patient population. In low- and middle-income countries [...] Read more.
Chronic pain is a serious health concern and potentially debilitating condition, leading to anxiety, depression, reduced productivity and functionality, and poor quality of life. This condition can be even more detrimental and incapacitating in the pediatric patient population. In low- and middle-income countries (LMICs), pain services are often inadequate or unavailable, leaving most of the world’s pediatric population with chronic pain untreated. Many of these children in LMICs are suffering without treatment, and often die in pain. Awareness and advocacy for this population must be prioritized. We reviewed the available literature on the chronic pediatric pain burden in LMICs, barriers to treatments, and current efforts to treat these patients. Full article
(This article belongs to the Section Global Pediatric Health)
9 pages, 194 KiB  
Review
Depression in Children and Adolescents with Autism Spectrum Disorder
by Melissa DeFilippis
Children 2018, 5(9), 112; https://doi.org/10.3390/children5090112 - 21 Aug 2018
Cited by 78 | Viewed by 17245
Abstract
Autism spectrum disorder (ASD) has a high rate of psychiatric comorbidity. The prevalence of comorbid depression seems to correlate with higher functioning forms of ASD and increasing age. Adolescence is a time when youth struggle with identity and interpersonal relationships, and a diagnosis [...] Read more.
Autism spectrum disorder (ASD) has a high rate of psychiatric comorbidity. The prevalence of comorbid depression seems to correlate with higher functioning forms of ASD and increasing age. Adolescence is a time when youth struggle with identity and interpersonal relationships, and a diagnosis of ASD further complicates this process. Adolescents with ASD may be more aware of the social communication deficits that come with the diagnosis than children with ASD, and it is theorized that higher functioning adolescents may experience this more acutely. While this may be true, the lack of reliable rating and diagnostic scales for depression in individuals with ASD makes it difficult to accurately measure rates of depression among individuals with more severe verbal deficits. While some research has focused on the prevalence of comorbid depression in children and adolescents with ASD and on the associated risk factors, there is very little evidence guiding treatment, including no empirical studies on psychopharmacology for depression in this population. Available evidence exists only in psychosocial approaches to treatment at this time and is mostly limited to adult studies. Current evidence will be presented in this review, including prevalence rates of depression in youth with ASD, various risk and protective factors, the use of diagnostic rating scales, and treatment studies. The lack of evidence supporting various treatment approaches will be highlighted, including challenges specific to the treatment of depression in ASD, which are not addressed in the current treatment studies in typically developing youth with depression. Full article
(This article belongs to the Special Issue 5th Anniversary Issue)
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