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Children, Volume 7, Issue 1 (January 2020) – 8 articles

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Cover Story (view full-size image) Adolescent/young-adult (AYA) cancer patients are a psychosocially at-risk group and experience [...] Read more.
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Open AccessArticle
Association of Adverse Childhood Experiences with Glycemic Control and Lipids in Children with Type 1 Diabetes
Children 2020, 7(1), 8; https://doi.org/10.3390/children7010008 - 18 Jan 2020
Viewed by 561
Abstract
Adverse childhood experiences (ACE) have been associated with a greater prevalence of risky behaviors and chronic health conditions, such as diabetes in adulthood. While adolescents with risk taking behaviors experience worsening of diabetic metabolic control, it is yet to be determined whether glycemic [...] Read more.
Adverse childhood experiences (ACE) have been associated with a greater prevalence of risky behaviors and chronic health conditions, such as diabetes in adulthood. While adolescents with risk taking behaviors experience worsening of diabetic metabolic control, it is yet to be determined whether glycemic management in children and adolescents is negatively and independently influenced by ACEs. This study examines the relationship between ACEs in children and adolescents with type 1 diabetes (T1DM) and glycemic control, BMI and lipids. For such children, we hypothesized that hemoglobin A1c (HbA1c) is positively correlated with ACE scores. Parents of children (age 2–18 years) with T1DM completed a validated ACE questionnaire. The associations between parent and child ACE score and HbA1c, lipids and BMI z-scores were assessed using linear regression. The prevalence of any ACE was 27.9% among children and 49.0% among parents. HbA1c was significantly higher in children who had exposure to three or more ACEs (β:0.63 (4.5 mmol/mol); p = 0.02), in those who had a parent exposed to four or more ACEs (β:0.87 (7.2 mmol/mol); p = 0.03), in children who had exposure to household incarceration (β:0.62 (4.4 mmol/mol); p = 0.05) and children who witnessed or had been victim of violence in the neighborhood (β:0.71 (5.4 mmol/mol); p = 0.02). ACEs were highly prevalent among children with T1DM and had a positive association with glycemic control. Full article
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Open AccessFeature PaperEditorial
Acknowledgement to Reviewers of Children in 2019
Children 2020, 7(1), 7; https://doi.org/10.3390/children7010007 - 16 Jan 2020
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Open AccessCase Report
Pancreatitis in A Patient with Cystic Fibrosis Taking Ivacaftor
Children 2020, 7(1), 6; https://doi.org/10.3390/children7010006 - 12 Jan 2020
Viewed by 611
Abstract
Pancreatitis is rare in pancreatic insufficient cystic fibrosis patients. While pancreatic insufficiency has been considered irreversible until now, in the current era of new therapies with modulators of the Cystic Fibrosis Transmembrane Regulator CFTR channel, there are reports of improvement of pancreatic exocrine [...] Read more.
Pancreatitis is rare in pancreatic insufficient cystic fibrosis patients. While pancreatic insufficiency has been considered irreversible until now, in the current era of new therapies with modulators of the Cystic Fibrosis Transmembrane Regulator CFTR channel, there are reports of improvement of pancreatic exocrine function. We describe the case of an adolescent with cystic fibrosis who developed pancreatitis after the partial recovery of pancreatic function while taking ivacaftor. This case adds to the limited body of evidence that CFTR modulators lead to the improvement of pancreatic exocrine function in cystic fibrosis. Full article
Open AccessReview
Infantile Spasms: An Update on Pre-Clinical Models and EEG Mechanisms
Children 2020, 7(1), 5; https://doi.org/10.3390/children7010005 - 06 Jan 2020
Viewed by 729
Abstract
Infantile spasms (IS) is an epileptic encephalopathy with unique clinical and electrographic features, which affects children in the middle of the first year of life. The pathophysiology of IS remains incompletely understood, despite the heterogeneity of IS etiologies, more than 200 of which [...] Read more.
Infantile spasms (IS) is an epileptic encephalopathy with unique clinical and electrographic features, which affects children in the middle of the first year of life. The pathophysiology of IS remains incompletely understood, despite the heterogeneity of IS etiologies, more than 200 of which are known. In particular, the neurobiological basis of why multiple etiologies converge to a relatively similar clinical presentation has defied explanation. Treatment options for this form of epilepsy, which has been described as “catastrophic” because of the poor cognitive, developmental, and epileptic prognosis, are limited and not fully effective. Until the pathophysiology of IS is better clarified, novel treatments will not be forthcoming, and preclinical (animal) models are essential for advancing this knowledge. Here, we review preclinical IS models, update information regarding already existing models, describe some novel models, and discuss exciting new data that promises to advance understanding of the cellular mechanisms underlying the specific EEG changes seen in IS—interictal hypsarrhythmia and ictal electrodecrement. Full article
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Open AccessArticle
Complementary Parent Components for Pediatric Pain Families: Innovations in Treatment
Children 2020, 7(1), 4; https://doi.org/10.3390/children7010004 - 01 Jan 2020
Viewed by 638
Abstract
For families with a child with chronic pain, the home environment is the context in which adaptive or maladaptive illness behaviors are developed. Supporting families to effectively cope with their child’s chronic pain is a critical need. This work analyzes intervention approaches from [...] Read more.
For families with a child with chronic pain, the home environment is the context in which adaptive or maladaptive illness behaviors are developed. Supporting families to effectively cope with their child’s chronic pain is a critical need. This work analyzes intervention approaches from emerging treatment programs to support families coping with pediatric pain that diverge from traditional treatment models by specifically targeting parents. Two novel parent intervention programs are presented that consider caregiver needs in both outpatient and inpatient pain treatment settings: Parents as Coping Coaches and Putting Parents FIRST. These programs are evaluated through comparing parental training components across different stages of treatment. Additionally, the efficacy of Putting Parents FIRST in promoting maintenance of children’s functional gains achieved in intensive interdisciplinary pain treatment is presented, and compared to previous results of the efficacy of Putting Parents FIRST. Specifically, outcomes of 36 children whose parents received the intervention in Putting Parents FIRST were compared to a matched control sample of children whose parents did not receive the parent intervention. Similar to the findings from Parents as Coping Coaches, results indicated that patients whose parents received the intervention maintained/improved program gains in disability, coping, and pain significantly more than patients whose parents did not receive the intervention. Implications for parent-focused intervention development efforts targeting parent and youth functioning in the context of pediatric chronic pain are considered. Full article
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Open AccessCommunication
Study Protocol of the Parents in Child Nutrition Informing Community (PICNIC) Peer Education Cohort Study to Improve Child Feeding and Dietary Intake of Children Aged Six Months to Three Years Old
Children 2020, 7(1), 3; https://doi.org/10.3390/children7010003 - 27 Dec 2019
Viewed by 833
Abstract
One in five Australian pre-schoolers are overweight or obese, meaning the first years of life are vital for obesity primary prevention. Parent child feeding practices impact on children’s dietary intake, which in turn impacts on their weight status. Parents’ child feeding beliefs are [...] Read more.
One in five Australian pre-schoolers are overweight or obese, meaning the first years of life are vital for obesity primary prevention. Parent child feeding practices impact on children’s dietary intake, which in turn impacts on their weight status. Parents’ child feeding beliefs are heavily influenced by parenting peers. The aim of this cohort study is to evaluate the impact of the Parents in Child Nutrition Informing Community (PICNIC) study on parents feeding practices and diet quality. The secondary outcomes are the perceptions of trained peer educators and education recipients based on their involvement in PICNIC. One hundred parents with a child aged 0–2 years at time of recruitment will participate in peer educator training, then disseminate nutrition and child feeding content to other parents over an intervention period of 12 months, supported by project-specific, evidence-based social media pages and website. An additional 100 new parents, recruited by peer educators, will participate in the study as nutrition education recipients. Both peer educators and education recipients will complete quantitative child feeding surveys before and during the 12 month intervention and a dietary intake survey at a time point 12 months post intervention. Following the intervention, 30 education recipients will be asked to participate in semi-structured phone interviews about their experiences with PICNIC. Peer educators will contribute as co-researchers and active participants in the evolution of the PICNIC model. This study will contribute to enhanced understanding of contemporary health literacy strategies for communicating nutrition and feeding messages to new parents and the impact of these strategies on parents feeding practices and children’s dietary intake in a community setting. Full article
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Open AccessArticle
The Role of Social Support in Adolescent/Young Adults Coping with Cancer Treatment
Children 2020, 7(1), 2; https://doi.org/10.3390/children7010002 - 23 Dec 2019
Viewed by 698
Abstract
Adolescents/young-adult (AYA) cancer patients are a psychosocially at-risk group as they are often less well-studied than other age cancer cohorts. Therefore, they experience disparities in access to developmentally informed treatment. Social support has been determined as an important aspect of AYAs’ cancer experience, [...] Read more.
Adolescents/young-adult (AYA) cancer patients are a psychosocially at-risk group as they are often less well-studied than other age cancer cohorts. Therefore, they experience disparities in access to developmentally informed treatment. Social support has been determined as an important aspect of AYAs’ cancer experience, but additional research was needed to describe specific behaviors AYAs found helpful and to explore how AYAs seek opportunities for additional support. As part of a larger qualitative study, study aims were to determine how AYAs (ages 15–26) cope during cancer treatment and examine how social support interacts with individual AYA coping. Participants included 10 AYA cancer patients undergoing treatment (mean age = 18.9 years) and 10 parents (mean age = 45.6 years). Descriptively, participants scored within the normal to high range on measures of hope, depression/anxiety/stress, quality of life, and social support. Participants completed semi-structured, audio-recorded interviews that were transcribed and coded as generated. Qualitative analysis was guided by principles of grounded theory and utilized the constant comparative approach. Themes within social support groups included presence, distraction, positive attitude, and maintaining AYA autonomy, communication, and advocacy. Results suggest social supports provide additional coping resources for AYAs with cancer through supplementing individual coping strategies. Future directions/implications for intervention/treatment are discussed. Full article
(This article belongs to the Special Issue Psychosocial Functioning in Childhood Cancer)
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Open AccessArticle
Pediatric Safety of Polysorbates in Drug Formulations
Children 2020, 7(1), 1; https://doi.org/10.3390/children7010001 - 20 Dec 2019
Viewed by 643
Abstract
Polysorbates 20 and 80 are the most frequently used excipients in biotherapeutics, the safety data for which have been well documented in adults. The polysorbate content in therapeutic formulations that are administered to children, however, has been less clearly regulated or defined with [...] Read more.
Polysorbates 20 and 80 are the most frequently used excipients in biotherapeutics, the safety data for which have been well documented in adults. The polysorbate content in therapeutic formulations that are administered to children, however, has been less clearly regulated or defined with regard to safety. In pediatric patients, excessive amounts of polysorbate in biotherapeutics have been linked to hypersensitivity and other toxicity-related effects. To determine safe levels of polysorbates for young patients, we have developed the progressive pediatric safety factor (PPSF), an age- and weight-based tool that estimates the amount of parenterally administered polysorbates 20 and 80 in formulations that will avoid excipient-related adverse events. Compared with existing modalities for calculating maximum acceptable doses of excipients for initial clinical trials in pediatrics, the PPSF is far more conservative, thus constituting an added margin of safety for excipient exposure in the most sensitive subpopulations—i.e., neonates and infants. Further, the PPSF may be applied to any relevant excipient, aiding pharmaceutical developers and regulatory authorities in conservatively estimating the safety assessment of a biotherapeutic’s formulation, based on excipient levels. Full article
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