Next Issue
Volume 7, December
Previous Issue
Volume 7, October

Children, Volume 7, Issue 11 (November 2020) – 57 articles

Cover Story (view full-size image): Brief synopsis: Physical activity (PA) has many health benefits, but most adolescents are insufficiently active. The GoActive study evaluated the effectiveness of a co-designed multicomponent school-based PA promotion program in 13-14-year-olds. The main evaluation showed no evidence for an effect and this study explores some of the reasons behind this. We present mixed-method data from adolescents, mentors, facilitators, and teachers. The paper details adolescent participation and interaction with GoActive, dose of intervention, the extent to which GoActive was implemented as planned, and implementation challenges. Exploring implementation in this way allowed us to better understand the study results, highlight the voices of all actors, and the impact of school context in running GoActive. View this paper
  • Issues are regarded as officially published after their release is announced to the table of contents alert mailing list.
  • You may sign up for e-mail alerts to receive table of contents of newly released issues.
  • PDF is the official format for papers published in both, html and pdf forms. To view the papers in pdf format, click on the "PDF Full-text" link, and use the free Adobe Readerexternal link to open them.
Order results
Result details
Select all
Export citation of selected articles as:
Open AccessReview
Fundamental Motor Skills Intervention for Children with Autism Spectrum Disorder: A 10-Year Narrative Review
Children 2020, 7(11), 250; https://doi.org/10.3390/children7110250 - 23 Nov 2020
Viewed by 435
Abstract
In the past decade, converging evidence has suggested that motor impairment is one of the most consistent markers, alongside sociocommunicative difficulties, for autism spectrum disorder (ASD). Indeed, widespread anomalies of movement have been described in the ASD context. These motor abnormalities could have [...] Read more.
In the past decade, converging evidence has suggested that motor impairment is one of the most consistent markers, alongside sociocommunicative difficulties, for autism spectrum disorder (ASD). Indeed, widespread anomalies of movement have been described in the ASD context. These motor abnormalities could have critical implications for subsequent cognitive and social development. Nevertheless, this area of development is particularly underexamined in the autism-related context, and early intervention programs commonly focus on the core symptoms of the condition. In the present work, we review and discuss the findings from recent studies that investigated the effect of interventions regarding fundamental motor skills in autistic children. Although the limited nature of the literature prevents researchers from drawing definitive conclusions, the results from the studies discussed here demonstrated potentially significant improvements in the motor abilities of autistic children after the interventions. Only a subset of the reviewed studies explored possible changes in the sociocommunicative domain after the motor skills improvements, and they had not concordant, although promising, conclusions. Overall, in consideration of the well-documented motor impairment people with the condition, the present findings highlight the importance of including motor skills training within the rehabilitation programs designed for autistic children. Furthermore, this narrative review encourages future interventional trials to consider motor skills as a possible target for reducing activity limitations and participation restrictions of autistic children. Full article
Show Figures

Figure 1

Open AccessArticle
Is It Possible for Children in Duchenne Muscular Dystrophy to Preserve Cardiac Function with Medical Assistance?
Children 2020, 7(11), 249; https://doi.org/10.3390/children7110249 - 22 Nov 2020
Viewed by 383
Abstract
In patients with Duchenne muscular dystrophy (DMD), death secondary to cardiac or respiratory failure typically occurs in the second or third decade without treatment. Although cardiac dysfunction is treated with standard heart-failure strategies, it remains insufficient in DMD children. The purpose of this [...] Read more.
In patients with Duchenne muscular dystrophy (DMD), death secondary to cardiac or respiratory failure typically occurs in the second or third decade without treatment. Although cardiac dysfunction is treated with standard heart-failure strategies, it remains insufficient in DMD children. The purpose of this study was to evaluate the efficiency of cardiac medication and noninvasive ventilator support in DMD cardiomyopathy children with analyzing echocardiographic data. Forty-eight DMD children patients were included and divided into 2 groups by left ventricular (LV) ejection fraction (EF) at the time of initial treatment. Group 1: LV EF ≥ 45% and Group 2: LV EF < 45%. p-values were calculated using a Linear mixed model to estimate the association between cardiac medications and echocardiographic measurements. Before and after cardiac medications, the change values were significantly different in interventricular septal thickness at end diastole (IVSd), interventricular septal thickness at end systole (IVSs), left ventricular internal diameter end systole (LVIDs), left ventricular posterior wall thickness end diastole (LVPWd), ejection fraction (EF), fractional shortening (FS), deceleration time (DT), DT slope, Lat A’ and Lat E/E’ (p < 0.05). Group 2 patients revealed to take more kinds of cardiac medications than Group 1 (p < 0.05) including ACEIs, beta-blocker, and inotropics, then LV EF was better preserved in Group 2 than Group 1. It is certainly helpful to take individualized medical combination therapy including inotropic agents for cardiomyopathy in DMD children patients with EF < 45%. Full article
(This article belongs to the collection Development of Medicines for Paediatric and Rare Diseases)
Show Figures

Figure 1

Open AccessArticle
Modified Constraint-Induced Movement Therapy at Home—Is It Possible? Families and Children’s Experience
Children 2020, 7(11), 248; https://doi.org/10.3390/children7110248 - 22 Nov 2020
Viewed by 578
Abstract
Modified constraint-induced movement therapy (mCIMT) is efficient at improving upper limb non-use. The experiences of families and children with mCIMT could allow researchers to understand how it influences their day-to-day life and to improve the function of the affected upper limb without altering [...] Read more.
Modified constraint-induced movement therapy (mCIMT) is efficient at improving upper limb non-use. The experiences of families and children with mCIMT could allow researchers to understand how it influences their day-to-day life and to improve the function of the affected upper limb without altering family life and avoiding frustration. In this qualitative study, we aimed to collect the experiences of parents and their children (aged 4–8 years) who did mCIMT at home regarding the application of low-intensity modified constraint-induced movement therapy to improve the affected upper limb functionality in infantile hemiplegia with moderate manual ability. Individual semi-structured interviews were performed to obtain insights into their experience with mCIMT. The experiences of parents and children were described in thematic sections. Eight children with hemiplegia (six years, standard deviation, SD: 1.77) and their parents were asked about their experiences after applying 50 h of mCIMT at home. Three main themes emerged from the children’s interview data: (1) the experience of wearing the containment in the modified constraint-induced movement therapy (CIMT) intervention, (2) the reaction to performing the therapy at home with his/her family, and (3) learning of the affected upper limb. In the parents’ interview data, there were two main themes: (1) the difficulty of executing an intensive therapy protocol (mCIMT: 50 h) at home and (2) the feeling of not wanting to finish the intervention. The experiences of the parents and their children regarding mCIMT allowed us to understand the facilitators and barriers that affect the execution of mCIMT at home, and this understanding allows us to improve its future application. Full article
(This article belongs to the Special Issue Parenting in Face of Health Challenges: Research and Interventions)
Show Figures

Figure 1

Open AccessArticle
Risk and Resilience Factors Impacting Treatment Compliance and Functional Impairment among Adolescents Participating in an Outpatient Interdisciplinary Pediatric Chronic Pain Management Program
Children 2020, 7(11), 247; https://doi.org/10.3390/children7110247 - 22 Nov 2020
Viewed by 304
Abstract
Recurrent pain is a common experience in childhood and adolescence and can result in significant disability in youth, including poor quality of life, school absences, and reduced social activities. Evidence has linked adolescent risk and resilience factors with treatment outcomes. However, less research [...] Read more.
Recurrent pain is a common experience in childhood and adolescence and can result in significant disability in youth, including poor quality of life, school absences, and reduced social activities. Evidence has linked adolescent risk and resilience factors with treatment outcomes. However, less research has focused on examining risk and resilience factors that may influence or predict adolescents’ compliance to treatment within an interdisciplinary pediatric chronic pain management program. Participants included 64 adolescents (M = 15.00 ± 1.69 years); 85.9% female, 84.4% Caucasian who presented to an initial evaluation in an interdisciplinary pediatric pain management program with their caregiver. Youth completed a series of questionnaires at the initial evaluation targeting pain acceptance, self-efficacy, pain catastrophizing, parental responses, pain intensity, and functional disability. Treatment compliance was measured at 3 and 6 months post-intake. Findings indicated that higher levels of adolescent-reported self-efficacy predict decreased treatment session attendance, whereas lower levels of acceptance and parental encouragement/monitoring of symptoms predict increased treatment compliance overall. Several adolescent-reported risk factors were associated with increased functional impairment among this sample. Results highlight the unique importance of risk and resilience factors within the developmental context of adolescence, while also emphasizing the need for further investigation of other relevant influences towards treatment compliance and functional impairment. Full article
(This article belongs to the Special Issue Pediatric Pain Management)
Open AccessArticle
The Intergenerational Transmission of Chronic Pain from Parents to Survivors of Childhood Cancer
Children 2020, 7(11), 246; https://doi.org/10.3390/children7110246 - 21 Nov 2020
Viewed by 479
Abstract
Background: Among youth with chronic non-cancer pain, 50% have parents with chronic pain. These youth report significantly more pain interference and posttraumatic stress symptoms (PTSS), and worse health-related quality of life (HRQL) than youth whose parents do not have chronic pain. Additionally, parent [...] Read more.
Background: Among youth with chronic non-cancer pain, 50% have parents with chronic pain. These youth report significantly more pain interference and posttraumatic stress symptoms (PTSS), and worse health-related quality of life (HRQL) than youth whose parents do not have chronic pain. Additionally, parent chronic pain is linked to increased child anxiety and depressive symptoms. Survivors of childhood cancer (SCCs) are at risk of pain and negative psychosocial outcomes and therefore may be especially vulnerable if their parents have chronic pain. Thus, the aims of the current study were to (1) identify rates of chronic pain among parents of SCCs, (2) test group differences in psychological symptoms in parents with chronic pain versus without, and (3) test group differences in pain interference, HRQL, anxiety, depression, and PTSS in SCCs with parents with chronic pain versus without. Methods: 122 SCCs (Mean age = 15.8, SD = 4.8, 45.7% male, Mean age at diagnosis = 5.9, SD = 4.7) and their parents were recruited from across Canada to complete online questionnaires. Parents were asked if they have had pain for at least three consecutive months and completed the brief symptom inventory (BSI) as a measure of psychological symptomatology. Survivors completed the pain questionnaire, patient reported outcomes measurement information system (PROMIS)—pain interference, anxiety, and depression measures, child posttraumatic stress scale, posttraumatic stress disorder checklist for the Diagnostic and Statistical Manual of Mental Disorders, and the pediatric quality of life inventory. Results: Forty-three (39%) parents of SCCs reported having chronic pain. Of the 29 survivors who had chronic pain, 14 (48%) also had parents with chronic pain. Parents with chronic pain reported significantly higher scores on the BSI than parents without chronic pain, F(1, 116) = 5.07, p = 0.026. SCCs with parents with versus without chronic pain reported significantly higher PTSS F(1, 105) = 10.53, p = 0.002 and depressive symptoms F(1, 102) = 6.68, p = 0.011. No significant differences were found across the other variables tested. Conclusions: Findings suggest that survivors’ parents’ own pain is prevalent and is related to survivors’ increased depressive symptoms and PTSS, but not anxiety, pain interference, or HRQL. Future research should explore whether parents may benefit from psychological intervention after their child has been diagnosed with cancer and how this could improve outcomes for their child. Full article
(This article belongs to the Special Issue Pediatric Pain Management)
Show Figures

Figure 1

Open AccessReview
Treatment of Complex Regional Pain Syndrome in Children and Adolescents: A Structured Literature Scoping Review
Children 2020, 7(11), 245; https://doi.org/10.3390/children7110245 - 20 Nov 2020
Viewed by 348
Abstract
Background: Complex regional pain syndrome (CRPS) is characterized by chronic, spontaneous and provoked pain of the distal extremities whose severity is disproportionate to the triggering event. Diagnosis and treatment are still debated and multidisciplinary. The purpose of this systematic review is to analyze [...] Read more.
Background: Complex regional pain syndrome (CRPS) is characterized by chronic, spontaneous and provoked pain of the distal extremities whose severity is disproportionate to the triggering event. Diagnosis and treatment are still debated and multidisciplinary. The purpose of this systematic review is to analyze the available literature to provide an update on the latest evidence related to the treatment of CRPS in growing age. Methods: Data extraction was performed independently by three reviewers based on predefined criteria and the methodologic quality of included studies was quantified by the Newcastle–Ottawa Quality Assessment Scale Cohort Studies. Results: At the end of the first screening, following the previously described selection criteria, we selected n = 103 articles eligible for full-text reading. Ultimately, after full-text reading and a reference list check, we selected n = 6. The articles focused on physical (PT), associated with cognitive behavioral (CBT) and pharmacological (PhT) treatments. The combination of PT + CBT shows the most efficacy as suggested, but a commonly accepted protocol has not been developed. Conclusions: Physical therapy in association with occupational and cognitive behavioral treatment is the recommended option in the management of pediatric CPRS. Pharmacological therapy should be reserved for refractory and selected patients. The design and development of a standard protocol are strongly suggested. Full article
(This article belongs to the Special Issue Bone Development and Disease in Infants)
Show Figures

Figure 1

Open AccessArticle
A Complementary Sensory Tool for Children with Autism Spectrum Disorders
Children 2020, 7(11), 244; https://doi.org/10.3390/children7110244 - 20 Nov 2020
Viewed by 1280
Abstract
Background: Sensory integration (SI) issues are widely described in people with autism spectrum disorder (ASD), impacting in their daily life and occupations. To improve their quality of life and occupational performance, we need to improve clinical and educational evaluation and intervention processes. We [...] Read more.
Background: Sensory integration (SI) issues are widely described in people with autism spectrum disorder (ASD), impacting in their daily life and occupations. To improve their quality of life and occupational performance, we need to improve clinical and educational evaluation and intervention processes. We aim to develop a tool for measuring SI issues for Spanish children and adolescents with ASD diagnosis, to be used as a complementary tool to complete the Rivière’s Autism Spectrum Inventory, a widely used instrument in Spanish speaking places to describe the severity of ASD symptoms, recently updated with a new sensory scale with three dimensions. Methods: 458 Spanish participants complemented the new questionnaire, initially formed by 73 items with a 1–5 Likert scale. Results: The instrument finally was composed of 41 items grouped in three factors: modulation disorders (13 items), discrimination disorders (13 items), and sensory-based motor disorders (15 items). The goodness-of-fit indices from factor analyses, reliability, and the analysis of the questionnaire’s classification capability offered good values. Conclusions: The new questionnaire shows good psychometric properties and seems to be a good complementary tool to complete new the sensory scale in the Rivière’s Autism Spectrum Inventory. Full article
(This article belongs to the Special Issue New Research in Children with Neurodevelopmental Disorders)
Show Figures

Graphical abstract

Open AccessReview
Bringing It All Together: A Review of the Challenges in Measuring Children’s Satisfaction as a Key Component of Acute Pain Management
Children 2020, 7(11), 243; https://doi.org/10.3390/children7110243 - 20 Nov 2020
Viewed by 314
Abstract
In 2008, the Pediatric Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (PedIMMPACT) published a consensus statement that recognized the dearth of research surrounding the topic of children’s satisfaction with acute pain management. This review of published literature will summarize what [...] Read more.
In 2008, the Pediatric Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (PedIMMPACT) published a consensus statement that recognized the dearth of research surrounding the topic of children’s satisfaction with acute pain management. This review of published literature will summarize what is known about the topic of children’s satisfaction with pain management, identify current gaps in the knowledge, and provide direction for future research in this critical area. Including children in the decision-making process as soon as they are developmentally able is a concept that is the fundamental basis for seeking assent and more active roles within healthcare decisions for children. It is the responsibility of adults to provide them with increasing opportunities for self-evaluation and more independent management of their healthcare, encouraging the development of children into adults. As clinicians and researchers, it is our prerogative to support the maturation of children by building effective methods to communicate their satisfaction with acute pain treatment and healthcare. Children’s satisfaction with acute pain management is not well studied and further research is needed for the development of inclusive, developmentally appropriate measures of satisfaction for our pediatric patients. Full article
(This article belongs to the Special Issue Pediatric Pain Management)
Open AccessFeature PaperReview
Hot Topics in Safety for Pediatric Anesthesia
Children 2020, 7(11), 242; https://doi.org/10.3390/children7110242 - 20 Nov 2020
Viewed by 597
Abstract
Anesthesiology is one of the leading medical specialties in patient safety. Pediatric anesthesiology is inherently higher risk than adult anesthesia due to differences in the physiology in children. In this review, we aimed to describe the highest yield safety topics for pediatric anesthesia [...] Read more.
Anesthesiology is one of the leading medical specialties in patient safety. Pediatric anesthesiology is inherently higher risk than adult anesthesia due to differences in the physiology in children. In this review, we aimed to describe the highest yield safety topics for pediatric anesthesia and efforts to ameliorate risk. Conclusions: Pediatric anesthesiology has made great strides in patient perioperative safety with initiatives including the creation of a specialty society, quality and safety committees, large multi-institutional research efforts, and quality improvement initiatives. Common pediatric peri-operative events are now monitored with multi-institution and organization collaborative efforts, such as Wake Up Safe. Full article
(This article belongs to the Special Issue Pediatric Anesthesia)
Open AccessArticle
Association of Vitamin D Status and Physical Activity with Lipid Profile in Korean Children and Adolescents: A Population-Based Study
Children 2020, 7(11), 241; https://doi.org/10.3390/children7110241 - 19 Nov 2020
Viewed by 324
Abstract
Dyslipidemia is one of the important influencing factors of cardiovascular health in the youth, and thus, assessment of its etiology is important. We aimed to investigate the association of dyslipidemia with vitamin D and physical activity in Korean children and adolescents. Data of [...] Read more.
Dyslipidemia is one of the important influencing factors of cardiovascular health in the youth, and thus, assessment of its etiology is important. We aimed to investigate the association of dyslipidemia with vitamin D and physical activity in Korean children and adolescents. Data of 3183 subjects aged 12–18 years in the Korea National Health and Nutrition Examination Survey were analyzed. Participants were divided into subgroups according to sex, body mass index, 25-hydroxyvitamin D levels, and lipid profile. The mean 25-hydroxyvitamin D level was 16.15 ng/mL, which was below normal. In total, 79.3% of the subjects had vitamin D deficiency. Females had lower vitamin D levels and a higher incidence of dyslipidemia compared to males. Vitamin D deficiency was significantly associated with high density lipoprotein cholesterol (HDL-C) levels. The low HDL-C group consisted of a higher proportion of subjects with vitamin D deficiency and low physical activity. This study suggests that vitamin D deficiency is prevalent in Korean children and adolescents. Vitamin D deficiency and low physical activity are related with low HDL-C levels. Maintaining sufficient vitamin D levels and physical activity may help prevent dyslipidemia. Full article
(This article belongs to the Special Issue New Research in Childhood Nutrition)
Show Figures

Figure 1

Open AccessArticle
Exploring the Mediating Roles of State and Trait Anxiety on the Relationship between Middle Adolescents’ Cyberbullying and Depression
Children 2020, 7(11), 240; https://doi.org/10.3390/children7110240 - 19 Nov 2020
Viewed by 503
Abstract
Cyberbullying is a global problem with significant negative implications, especially among more vulnerable populations, such as adolescents. Previous research suggested that cyberbullying is significantly associated with depression, and anxiety seems to partially or fully mediate this relationship. We aimed to investigate the prevalence [...] Read more.
Cyberbullying is a global problem with significant negative implications, especially among more vulnerable populations, such as adolescents. Previous research suggested that cyberbullying is significantly associated with depression, and anxiety seems to partially or fully mediate this relationship. We aimed to investigate the prevalence and the relationships between cyberbullying status (i.e., cyberbully, cyber victim, double role, or non-cyber), gender, and age. We also explored the mediating roles of state and trait anxiety on the relationship between adolescents’ cyberbullying victimization, cyber-aggressiveness, and depression. Our sample consisted of 501 middle adolescents aged from 12 to 15 years (M = 14.00; SD = 0.80; 51.1% males). The results suggested no significant associations between participants’ status, gender, or age. Mediation analyses suggested that the relationship between cyber-victimization, cyber-aggressiveness, and depression was mediated by state anxiety and not trait anxiety. We discuss the implications of the current findings in understanding cyberbullying’s psychological consequences and their relevant practical implications for prevention and intervention programs. Full article
(This article belongs to the Section Global and Public Health)
Open AccessReview
Tackling Childhood Stunting in the Eastern Mediterranean Region in the Context of COVID-19
Children 2020, 7(11), 239; https://doi.org/10.3390/children7110239 - 19 Nov 2020
Viewed by 478
Abstract
Over 20 million children under 5 years old in the WHO Eastern Mediterranean Region have stunted growth, as a result of chronic malnutrition, with damaging long-term consequences for individuals and societies. This review extracted and analyzed data from the UNICEF, WHO and the [...] Read more.
Over 20 million children under 5 years old in the WHO Eastern Mediterranean Region have stunted growth, as a result of chronic malnutrition, with damaging long-term consequences for individuals and societies. This review extracted and analyzed data from the UNICEF, WHO and the World Bank malnutrition estimates to present an overall picture of childhood stunting in the region. The number of children under 5 in the region who are affected by stunting has dropped from 24.5 million (40%) in 1990 to 20.6 million (24.2%) in 2019. The reduction rate since the 2012 baseline is only about two fifths of that required and much more rapid progress will be needed to reach the internationally agreed targets by 2025 and 2030. Prevalence is highest in low-income countries and those with a lower Human Development Index. The COVID-19 pandemic threatens to undermine efforts to reduce stunting, through its impact on access and affordability of safe and nutritious foods and access to important health services. Priority areas for action to tackle stunting as part of a comprehensive, multisectoral nutrition strategy are proposed. In light of the threat that COVID-19 will exacerbate the already heavy burden of malnutrition in the Eastern Mediterranean Region, implementation of such strategies is more important than ever. Full article
(This article belongs to the Section Global and Public Health)
Show Figures

Figure 1

Open AccessReview
Examining the Relationship between Cost and Quality of Care in the Neonatal Intensive Care Unit and Beyond
Children 2020, 7(11), 238; https://doi.org/10.3390/children7110238 - 19 Nov 2020
Viewed by 305
Abstract
There is tremendous variation in costs of delivering health care, whether by country, hospital, or patient. However, the questions remain: what costs are reasonable? How does spending affect patient outcomes? We look to explore the relationship between cost and quality of care in [...] Read more.
There is tremendous variation in costs of delivering health care, whether by country, hospital, or patient. However, the questions remain: what costs are reasonable? How does spending affect patient outcomes? We look to explore the relationship between cost and quality of care in adult, pediatric and neonatal literature. Health care stewardship initiatives attempt to address the issue of lowering costs while maintaining the same quality of care; but how do we define and deliver high value care to our patients? Ultimately, these questions remain challenging to tackle due to the heterogeneous definitions of cost and quality. Further standardization of these terms, as well as studying the variations of both costs and quality, may benefit future research on value in health care. Full article
(This article belongs to the Special Issue Neonatal Health Care)
Show Figures

Figure 1

Open AccessCase Report
Restoration of an Upper Anterior Tooth in an Adolescent with Autism Spectrum Disorder—A Student Case Report
Children 2020, 7(11), 237; https://doi.org/10.3390/children7110237 - 19 Nov 2020
Cited by 1 | Viewed by 675
Abstract
Background: Patients with autism spectrum disorder (ASD) or other mental or physical limitations experience an imbalance in the frequency of dental treatment as compared with the general patient population, in part, due to inadequate pre-graduate training of future dentists. Case presentation: This case [...] Read more.
Background: Patients with autism spectrum disorder (ASD) or other mental or physical limitations experience an imbalance in the frequency of dental treatment as compared with the general patient population, in part, due to inadequate pre-graduate training of future dentists. Case presentation: This case report describes a successful anterior tooth restoration, in awake state, in a 15-year-old boy with early childhood autism. The procedure was carried out independently by students of dentistry within the scope of their integrated clinical training semesters. Desensitization sessions were used as a preparatory measure and elements of behavioral facilitation (tell-show-feel-feel-do) were applied during the treatment. Conclusions: To avoid discrimination of this group of patients in the provision and quality of dental care, a structured approach to the transfer of theoretical and practical knowledge in the field of special care dentistry is indispensable. To this end, treatment strategies for special care patients should be taught to pre-graduate dental students as a fundamental part of their university curriculum. Full article
(This article belongs to the Special Issue Advance in Pediatric Dentistry)
Show Figures

Figure 1

Open AccessArticle
Child Pain Intensity and Parental Attitudes toward Complementary and Alternative Medicine Predict Post-Tonsillectomy Analgesic Use
Children 2020, 7(11), 236; https://doi.org/10.3390/children7110236 - 19 Nov 2020
Viewed by 349
Abstract
Parental attitudes regarding pain interventions and perceptions of their child’s pain intensity likely influence the decision to administer postoperative analgesics. Our study examined the impact of daily fluctuations in child pain intensity and parental attitudes regarding complementary and alternative medicine (CAM) on analgesic [...] Read more.
Parental attitudes regarding pain interventions and perceptions of their child’s pain intensity likely influence the decision to administer postoperative analgesics. Our study examined the impact of daily fluctuations in child pain intensity and parental attitudes regarding complementary and alternative medicine (CAM) on analgesic administration following pediatric tonsillectomy. Parents of children undergoing tonsillectomy (n = 33) completed a survey assessing CAM attitudes and a 7-day postoperative electronic daily diary to record their child’s daily pain intensity and analgesic medications (acetaminophen, ibuprofen, or oxycodone). Generalized linear mixed models with Poisson distributions evaluated the effects of within-person (child’s daily pain intensity) and between-person (average postoperative pain, parental CAM attitudes) components on the number of medication doses administered. Higher daily pain intensity was associated with more oxycodone doses administered on a given day, but not acetaminophen or ibuprofen. Positive parental CAM attitudes were associated with less oxycodone use, beyond the variations accounted for by the child’s daily pain intensity and average postoperative pain. Both parental CAM attitudes and their child’s daily pain intensity were independently associated with parental decisions to administer opioids following tonsillectomy. Understanding factors influencing individual variability in analgesic use could help optimize children’s postoperative pain management. Full article
(This article belongs to the Special Issue Pediatric Pain Management)
Show Figures

Figure 1

Open AccessArticle
Predicting Quality of Life among Mothers in an Online Health Community for Children with Type 1 Diabetes
Children 2020, 7(11), 235; https://doi.org/10.3390/children7110235 - 18 Nov 2020
Viewed by 307
Abstract
Quality of life of parents of children with chronic disease is important for disease self-management. This study aimed to identify predictors of quality of life among mothers of children with type 1 diabetes. A cross-sectional study was conducted. A total of 208 mothers [...] Read more.
Quality of life of parents of children with chronic disease is important for disease self-management. This study aimed to identify predictors of quality of life among mothers of children with type 1 diabetes. A cross-sectional study was conducted. A total of 208 mothers of children with type 1 diabetes were recruited from an online health community. Online health community collective empowerment and social support, diabetes self-efficacy, diabetes-related burden, and quality of life were measured. A multiple regression analysis was conducted to determine predictive factors for quality of life. Multiple regression analysis showed that diabetes-related burden and the child’s age were predictors of quality of life, and total variance explained by the model was 64.1% using two factors. In mothers of younger children, it is important to reduce the diabetes-related burden. Factors that increase the diabetes-related burden should be identified, and strategies to reduce the diabetes-related burden must be established. Full article
(This article belongs to the Special Issue Parenting in Face of Health Challenges: Research and Interventions)
Open AccessArticle
Febrile Seizures and Respiratory Viruses Determined by Multiplex Polymerase Chain Reaction Test and Clinical Diagnosis
Children 2020, 7(11), 234; https://doi.org/10.3390/children7110234 - 17 Nov 2020
Viewed by 299
Abstract
Febrile seizure (FS) is a common benign seizure disorder of young children. Although upper respiratory tract infection is the cause of fever in most episodes of FS, studies to identify respiratory viruses using a multiplex polymerase chain reaction (mPCR) test have rarely been [...] Read more.
Febrile seizure (FS) is a common benign seizure disorder of young children. Although upper respiratory tract infection is the cause of fever in most episodes of FS, studies to identify respiratory viruses using a multiplex polymerase chain reaction (mPCR) test have rarely been performed for children with FS. Medical records of children presenting with FS between January 2015 and December 2019 were retrospectively reviewed. Respiratory viruses identified by a rapid influenza detection test and mPCR test were investigated, and their seasonal distribution and the association between viral identification and seizure characteristics were determined. A total of 607 episodes of FS were analyzed: 81.1% of cases were generalized tonic–clonic seizures, 81.5% occurred within 24 h after fever onset, and 87.3% continued for ≤5 min. Complex FS occurred in 17.5% of FS episodes, and epilepsy was diagnosed in 2.5% of tracked cases. Of the 138 mPCR tests performed in 235 hospitalized episodes of FS, 112 (81.2%) tested positive for respiratory viruses: rhinovirus, enterovirus, adenovirus, and influenza virus were most frequently identified. The identified respiratory viruses showed similar seasonal distributions as were observed in community-acquired respiratory tract infections. The identification of a specific respiratory virus was not significantly associated with seizure characteristics or the development of complex FS. In conclusion, respiratory viruses, showing similar seasonal distributions with community-acquired respiratory tract infections and no significant association with the severity and outcomes of FS, should not be rigorously tested for in children with FS. Full article
(This article belongs to the Section Child Neurology)
Show Figures

Figure 1

Open AccessFeature PaperArticle
Pediatric Anesthesia Specialty Societies and Multi-Institutional Collaborations
Children 2020, 7(11), 233; https://doi.org/10.3390/children7110233 - 17 Nov 2020
Cited by 1 | Viewed by 440
Abstract
Pediatric anesthesiology is a subspecialty of anesthesiology that deals with the high-risk pediatric population. The specialty has made significant advancement in large collaborative efforts to study and increase patient safety, including the creation of international societies, a dedicated journal, special committees and interest [...] Read more.
Pediatric anesthesiology is a subspecialty of anesthesiology that deals with the high-risk pediatric population. The specialty has made significant advancement in large collaborative efforts to study and increase patient safety, including the creation of international societies, a dedicated journal, special committees and interest groups, and multi-institution databases for research and quality improvement. Readily available resources were created to help with the education of future pediatric anesthesiologists as well as continuing medical education. Conclusions: Specialty societies and collaborations in pediatric anesthesia are crucial for continuous improvement in the care of children. They promote research, education, quality improvement, and advocacy at the local, national, and international level. Full article
(This article belongs to the Special Issue Pediatric Anesthesia)
Open AccessArticle
Examining Factors of Accelerometer-Measured Sedentary Time in a Sample of Rural Canadian Children
Children 2020, 7(11), 232; https://doi.org/10.3390/children7110232 - 17 Nov 2020
Cited by 1 | Viewed by 346
Abstract
The aim of this study was to examine potential child-level and day-level factors of accelerometer-measured sedentary time in a sample of rural Canadian children. Children (n = 86) from rural Northwestern Ontario participated in this study. Children’s sedentary times were identified and [...] Read more.
The aim of this study was to examine potential child-level and day-level factors of accelerometer-measured sedentary time in a sample of rural Canadian children. Children (n = 86) from rural Northwestern Ontario participated in this study. Children’s sedentary times were identified and logged using an accelerometer. Child-level data (socio-demographic, household, and environment) came from surveys of children and their parents and a passively logging global positioning unit. Day-level data on day type (weekday/weekend) and weather (temperature, precipitation) were based on the dates of data collection and meteorological data came from the closest Environment Canada weather station. Cross-classified regression models were used to assess the relationship between child-level and day-level correlates of sedentary time. Boys were less sedentary than girls (b = −30.53 p = 0.01). For each one-year age increase, children’s sedentary time increased (b = 12.79 p < 0.01). This study indicates a difference in sedentary time based on a child’s age and gender. However, family, environmental, and weather characteristics did not influence sedentary time in this sample. Health practitioners who deliver care for northern rural youth can provide targeted health advice regarding sedentary time and consider gender and age to be risk factors for these behaviors. Full article
Open AccessArticle
Reach, Recruitment, Dose, and Intervention Fidelity of the GoActive School-Based Physical Activity Intervention in the UK: A Mixed-Methods Process Evaluation
Children 2020, 7(11), 231; https://doi.org/10.3390/children7110231 - 17 Nov 2020
Viewed by 486
Abstract
School-based multi-component physical activity (PA) promotion is advocated; however, research has indicated that a multi-component approach may not always be effective at increasing adolescent PA. Evaluation of the GoActive 12-week multi-component school-based intervention showed no effect on adolescent PA. A mixed-methods process evaluation [...] Read more.
School-based multi-component physical activity (PA) promotion is advocated; however, research has indicated that a multi-component approach may not always be effective at increasing adolescent PA. Evaluation of the GoActive 12-week multi-component school-based intervention showed no effect on adolescent PA. A mixed-methods process evaluation was embedded to facilitate greater understanding of the results, to elicit subgroup perceptions, and to provide insight into contextual factors influencing intervention implementation. This paper presents the reach, recruitment, dose, and fidelity of GoActive, and identifies challenges to implementation. The process evaluation employed questionnaires (1543 Year 9s), individual interviews (16 Year 9s; 7 facilitators; 9 contact teachers), focus groups (48 Year 9s; 58 mentors), alongside GoActive website analytics and researcher observations. GoActive sessions reached 39.4% of Year 9s. Intervention satisfaction was relatively high for mentors (87.3%) and facilitators (85.7%), but lower for Year 9s (59.5%) and teachers (50%). Intervention fidelity was mixed within and between schools. Mentorship was the most implemented component. Factors potentially contributing to low implementation included ambiguity of the roles subgroups played within intervention delivery, Year 9 engagement, institutional support, and further school-level constraints. Multiple challenges and varying contextual considerations hindered the implementation of GoActive in multiple school sites. Methods to overcome contextual challenges to implementation warrant in-depth consideration and innovative approaches. Full article
Show Figures

Figure 1

Open AccessArticle
The Nutritional Profile of Food Advertising for School-Aged Children via Television: A Longitudinal Approach
Children 2020, 7(11), 230; https://doi.org/10.3390/children7110230 - 17 Nov 2020
Viewed by 355
Abstract
The prevalence of childhood obesity continues to increase. Screen time, one of the most documented reasons for the obesogenic environment, enhances childhood obesity, since advertisements for unhealthy food products are still broadcast on channels for children. This is presently one of the main [...] Read more.
The prevalence of childhood obesity continues to increase. Screen time, one of the most documented reasons for the obesogenic environment, enhances childhood obesity, since advertisements for unhealthy food products are still broadcast on channels for children. This is presently one of the main challenges for the government in Spain, since the current laws and obligations are not updated. This study aims to analyze food advertising aimed at children on Spanish television in 2013 and 2018 on children’s and general channels to test the effect of laws and obligations over time. In total, we viewed 512 h of the most viewed channels, two children’s and two general channels, during the week and on weekends during specific periods of 2013 and 2018. Food advertising was categorized as core, non-core, and other food advertisement (CFA, NCFA, and OFA, respectively) according to the nutritional profile. A total of 2935 adverts were analyzed, 1263 in 2013 and 1672 in 2018. A higher proportion of NCFAs were broadcast on children’s channels than in prior years, rising from 52.2% to 69.8% (p < 0.001). Nowadays, the risk of watching NCFAs on children’s channels compared to general channels turns out to be higher (Odds ratio > 2.5; p < 0.001), due to exposure to adverts for high-sugar and high-fat foods such as cakes, muffins, cookies, and fried and frozen meals rich in fat. In conclusion, the trends of nutritional profiles in food advertising on television are worsening over time, since the prevalence of NCFAs was higher in 2018 than in 2013. Currently, CFAs are not mainly broadcast on children’s channels, confirming high-risk exposure to non-core food advertising by watching them. Thus, food advertising laws and obligations should be adapted to increase compliance. Full article
(This article belongs to the Special Issue New Research in Childhood Nutrition)
Show Figures

Figure 1

Open AccessArticle
Pain during Cast Wedging of Forearm Shaft and Distal Forearm Fractures in Children Aged 3 to 12 Years—A Prospective, Observational Study
Children 2020, 7(11), 229; https://doi.org/10.3390/children7110229 - 16 Nov 2020
Viewed by 286
Abstract
Background: Although fracture displacement in children is easily treated by cast wedging, no data on pain associated with the procedure are available. We hypothesized that there is no clinically relevant difference in pain before and after cast wedging in children between 3 and [...] Read more.
Background: Although fracture displacement in children is easily treated by cast wedging, no data on pain associated with the procedure are available. We hypothesized that there is no clinically relevant difference in pain before and after cast wedging in children between 3 and 12 years of age. Patients and Methods: This international, multicenter, prospective, observational study included 68 children (39 male, 29 female) aged 3 to 12 years (median age 8 years) with forearm fractures. Cast wedging was performed 5 to 10 days after the injury. Before starting the procedure, we administered a single oral dose of sodium metamizole (10 mg/kg body weight), and the children inhaled a nitrous oxide/oxygen mixture (50%/50%) during the wedging procedure. Pain was rated on a visual analog scale (VAS) 5 to 10 min before incision of the cast as well as 3 to 5 min and 30 min (maximum remembered pain) after inhalation stop. The degree of bending was judged either by the surgeon or was determined on the basis of first signs of pain expressed by the patient. We assessed the effectiveness of the procedure by obtaining X-ray images in two planes after 3 to 9 days. Results: Among the 68 patients, median VAS score before cast wedging was 0. This increased to a score of 1 (p = 0.015) at 3 to 5 min after the procedure. Median VAS score for the maximum remembered pain measured after 30 min was 0. Median differences in angulation between proximal and distal bone fragments before and after the intervention were 0° (p < 0.0001) in the a.p. view and 8.4° (p < 0.0001) in the lateral view. Conclusion: Cast wedging improved the position of forearm fracture fragments at the expense of minimal short-term pain. Full article
(This article belongs to the Section Pediatric Surgery)
Show Figures

Figure 1

Open AccessArticle
Esophageal Atresia: Nutritional Status and Energy Metabolism to Maximize Growth Outcome
Children 2020, 7(11), 228; https://doi.org/10.3390/children7110228 - 14 Nov 2020
Viewed by 376
Abstract
Background: Long-term negative sequelae of esophageal atresia (EA) may induce poor growth and impaired nutritional status in childhood. We describe the nutritional profile and energy metabolism of children with repaired EA to identify malnutrition risk factors and optimize growth management. Methods: Twenty-one children [...] Read more.
Background: Long-term negative sequelae of esophageal atresia (EA) may induce poor growth and impaired nutritional status in childhood. We describe the nutritional profile and energy metabolism of children with repaired EA to identify malnutrition risk factors and optimize growth management. Methods: Twenty-one children (>4 years) were included, and anthropometric measurements, nutritional assessment, and energy metabolism were considered. The subjects were defined as undernourished if they met BMI < −2 standard deviation (SD). To grade undernutrition, we defined the prevalence of underweight, stunting, and wasting (cut-off level of <−2 SD). Medical records were reviewed for the type of EA and surgery and perinatal data. Results: Malnutrition was detected in 28.6% of children. Underweight was detected in 23.8% of patients (all with undernutrition p < 0.01). Wasting was noted in 28.6% of patients, of these 5 children were undernourished (p < 0.001) and stunting was noticed in only one patient with malnutrition (p = 0.5). Resting expenditure energy (REE) was lower in undernourished subjects compared to subjects with adequate nutritional status (p < 0.001). Malnutrition was associated to: type of EA (p = 0.003, particularly type A and C); intervention including deferred anastomosis due to long-gap repair (p = 0.04) with/or without jejunostomy (p = 0.02), gastric pull-up (p = 0.04), primary anastomosis (p = 0.04), pyloromyotomy in long-gap (p < 0.01); small for gestational age condition (p = 0.001). Conclusions: undernutrition risk factors, beyond the type of malformation, surgery, and perinatal factors, must be early considered to personalize nutritional programming. Energy metabolism is important to monitor the nutritional requirements. The management of nutritional issues is surely a contributory factor able to counteract the poor growth of children with EA. Full article
(This article belongs to the Special Issue Pediatric Gastroenterology and Nutrition)
Open AccessArticle
Congenital Osseous Torticollis that Mimics Congenital Muscular Torticollis: A Retrospective Observational Study
Children 2020, 7(11), 227; https://doi.org/10.3390/children7110227 - 13 Nov 2020
Viewed by 312
Abstract
It may be difficult to diagnose congenital osseous torticollis based on physical examinations or plain X-rays, especially when children have no other accompanying congenital defects. This study reports the children with torticollis caused by the vertebral anomaly with the symptom of abnormal head [...] Read more.
It may be difficult to diagnose congenital osseous torticollis based on physical examinations or plain X-rays, especially when children have no other accompanying congenital defects. This study reports the children with torticollis caused by the vertebral anomaly with the symptom of abnormal head and neck posture only. We retrospectively reviewed the records of 1015 patients diagnosed with congenital torticollis in a single tertiary hospital (Incheon St. Mary’s Hospital, Korea) who were referred from a primary local clinic. We included those with deficits in passive range of motion (PROM) of neck. Ultrasonography of the sternocleidomastoid (SCM) muscles, ophthalmologic and neurologic examinations, and cervical X-rays were performed for all patients. If bony malalignment was suspected from X-ray, three-dimensional volume-rendered computed tomography (3D-CT) was performed. Ten patients were diagnosed with osseous torticollis with no defect other than bony anomalies. Although X-ray images were acquired for all patients, vertebral anomalies were definitely confirmed in three cases (30.0%) only, and the others (70.0%) were confirmed by CT. The most common type of vertebral anomaly was single-level fusion. Identifying congenital vertebral anomalies is challenging especially when the degree of invasion is only one level. Although abnormal findings on X-rays may be subtle, a careful examination must be performed to avoid misdiagnosis. Full article
Show Figures

Figure 1

Open AccessArticle
Screening of Sensitive Items on Gross Motor Development in Toddlers Aged 24~36 Months and Analysis of the Factors Influencing the Passing Rate
Children 2020, 7(11), 226; https://doi.org/10.3390/children7110226 - 13 Nov 2020
Viewed by 321
Abstract
Background: To save assessment time and improve the efficiency, it is necessary to find sensitive indicators from the test items of gross motor development in the C-LAP system for children aged 24~36 months and analyze the influencing factors of the passing rate of [...] Read more.
Background: To save assessment time and improve the efficiency, it is necessary to find sensitive indicators from the test items of gross motor development in the C-LAP system for children aged 24~36 months and analyze the influencing factors of the passing rate of these indicators. Methods: This retrospective study was conducted among 1354 toddlers (3058 person-times) aged 24 to 36 months in Beijing, Shanghai, Guangdong between January 2013 and December 2019. A linear regression model and Cox regression model were performed to screen sensitive indicators and explore their influencing factors, respectively. Results: “Walk backwards”, “Stand from supine position” and “Hop with one foot at least twice” are the three sensitive indicators for evaluating the development of gross motor function in 24~36 month old children. The child’s physiological age at first measurement and region are the two common independent factors influencing the passing rate of the three items, while paternal age and education may influence one or two of them. Conclusions: “Walk backwards”, “Stand from supine position” and “Hop with one foot at least twice” are sensitive indicators for the effective evaluation of the development of gross motor function in 24~36 month old children, and their passing rates are influenced by some demographic variables. Full article
(This article belongs to the Section Global and Public Health)
Show Figures

Figure 1

Open AccessArticle
Identifying Loss of Control Eating within Childhood Obesity: The Importance of Family Environment and Child Psychological Distress
Children 2020, 7(11), 225; https://doi.org/10.3390/children7110225 - 11 Nov 2020
Viewed by 431
Abstract
This study aims to examine the differences in family environment, psychological distress, and disordered eating symptomatology between children classified by weight status with or without loss of control (LOC) eating and to test a model of the role of emotional regulation of LOC [...] Read more.
This study aims to examine the differences in family environment, psychological distress, and disordered eating symptomatology between children classified by weight status with or without loss of control (LOC) eating and to test a model of the role of emotional regulation of LOC eating based on a dysfunctional family environment. A cross-sectional study was conducted among 239 families. The assessment measured family expressed emotion, family adaptability and cohesion, child levels of depression and anxiety, body esteem, and disordered eating attitudes. The assessment was carried out in primary care centers and primary schools. Child body mass index (BMI) was associated with higher expressed emotion, psychological distress, and disordered eating symptomatology. Children with obesity and LOC presented higher BMI, poorer body esteem, and more disordered eating attitudes than children without LOC. Children with overweight/obesity, both with or without LOC, exhibited higher psychological distress and emotional overinvolvement than normal-weight children. A partial mediation of depression or anxiety and disordered eating attitudes between expressed emotion and LOC was found. Findings support that children with overweight/obesity show more family and psychological distress. Body esteem issues and disordered eating attitudes could alert the presence of LOC in children with obesity. The function of LOC might be to cope with psychological distress that may appear in a dysfunctional family environment. Full article
(This article belongs to the Special Issue Research Status of Eating Disorders in Children and Adolescents)
Show Figures

Figure 1

Open AccessReview
Fundamental Movement Skills and Accelerometer-Measured Physical Activity Levels during Early Childhood: A Systematic Review
Children 2020, 7(11), 224; https://doi.org/10.3390/children7110224 - 11 Nov 2020
Cited by 1 | Viewed by 577
Abstract
Early childhood is a key period for children to begin developing and practicing fundamental movement skills (FMS), while aiming to perform sufficient physical activity (PA). This study reviews the current evidence for the levels of achievement in FMS and PA measured using accelerometers [...] Read more.
Early childhood is a key period for children to begin developing and practicing fundamental movement skills (FMS), while aiming to perform sufficient physical activity (PA). This study reviews the current evidence for the levels of achievement in FMS and PA measured using accelerometers among 4–5-year-old children and examines differences by gender. This review was conducted using the PRISMA framework. Keyword searches were conducted in Pubmed, Medline, Google Scholar and SPORTDiscus. Inclusion criteria included age: 4–5 years old; FMS measurement: Test of Gross Motor Development 2 and 3; PA measurement: objective methods; balance measurement: static single limb; study design: cross-sectional observational/descriptive, randomised control trials, intervention studies; language: English. Twenty-eight articles from twenty-one countries met the inclusion criteria and were split into either FMS and PA articles (n = 10) or balance articles (n = 18). Three articles showed children achieving 60 min of moderate to vigorous PA per day, two articles demonstrated significant differences between girls’ and boys’ performance of locomotor skills and five reported locomotor skills to be more proficient than object control skills at this age for both genders. Balance was measured in time (n = 12), points score (n = 3) or biomechanical variables (n = 3), displaying heterogeneity of not only measurement but also outcomes within these data, with static single limb balance held between 6.67 to 87.6 s within the articles. Four articles reported girls to have better balance than boys. There is little conclusive evidence of the current levels for FMS, PA and balance achievement in young children 4–5 years of age. The academic literature consistently reports low levels of FMS competence and mixed evidence for PA levels. Inconsistencies lie in balance measurement methodology, with broad-ranging outcomes of both low and high achievement at 4–5 years old. Further research is required to focus on increasing practice opportunities for children to improve their FMS, increase PA levels and establish sufficient balance ability. Consistent and comparable outcomes during early childhood through more homogenous methodologies are warranted. Full article
Show Figures

Figure 1

Open AccessEditorial
The Brightest Rainbow Follows the Darkest Storm
Children 2020, 7(11), 223; https://doi.org/10.3390/children7110223 - 10 Nov 2020
Viewed by 292
Abstract
A parent’s perspective on pulmonary vein stenosis through the experience of two children with the disease. Full article
Open AccessArticle
Progress in the Management of Paediatric-Onset Multiple Sclerosis
Children 2020, 7(11), 222; https://doi.org/10.3390/children7110222 - 09 Nov 2020
Viewed by 514
Abstract
Considerable progress has been made in the understanding and treatment of paediatric-onset multiple sclerosis (POMS); how this has translated into more effective care is less well understood. Here, we evaluate how recent advances have affected patient management and outcomes with a retrospective review [...] Read more.
Considerable progress has been made in the understanding and treatment of paediatric-onset multiple sclerosis (POMS); how this has translated into more effective care is less well understood. Here, we evaluate how recent advances have affected patient management and outcomes with a retrospective review of POMS patients managed at two paediatric neuroimmunology centres. Two cohorts, seen within a decade, were compared to investigate associations between management approaches and outcomes. Demographic, clinical and neurocognitive data were extracted from case notes and analysed. Of 51 patients, 24 were seen during the period 2007–2010 and 27 during the period 2015–2016. Median age at onset was 13.7 years; time from symptom onset to diagnosis was 9 months. Disease-modifying therapies were commenced in 19 earlier-cohort and 24 later-cohort patients. Median time from diagnosis to treatment was 9 months for earlier vs. 3.5 months in later patients (p = 0.013). A wider variety of treatments were used in the later cohort (four medications earlier vs. seven in the later and two clinical trials), with increased quality of life and neurocognitive monitoring (8% vs. 48% completed PedsQL quality of life inventory; 58% vs. 89% completed neurocognitive assessment). In both cohorts, patients were responsive to disease-modifying therapy (mean annualised relapse rate pre-treatment 2.7 vs. 1.7, mean post-treatment 0.74 vs. 0.37 in earlier vs. later cohorts). In conclusion, over the years, POMS patients were treated sooner with a wider variety of medications and monitored more comprehensively. However, this hugely uncontrolled cohort did not allow us to identify key determinants for the improvements observed. Full article
(This article belongs to the Section Child Neurology)
Show Figures

Figure 1

Open AccessArticle
Association between Self-Reported Sleep Duration and Dietary Nutrients in Korean Adolescents: A Population-Based Study
Children 2020, 7(11), 221; https://doi.org/10.3390/children7110221 - 08 Nov 2020
Viewed by 366
Abstract
(1) Background: Adolescence is a transient period from childhood to adulthood, which is characterized by rapid physical growth and psychological changes, including sleep. Because the relationship between insufficient sleep and obesity has been observed in children and adults, the potential links between sleep, [...] Read more.
(1) Background: Adolescence is a transient period from childhood to adulthood, which is characterized by rapid physical growth and psychological changes, including sleep. Because the relationship between insufficient sleep and obesity has been observed in children and adults, the potential links between sleep, dietary intake, and nutrition have received increased attention. We aimed to examine the association of sleep duration with dietary nutrients intake in South Korean adolescents; (2) Methods: This population-based, cross-sectional study analyzed the data obtained from the Korea National Health and Nutrition Examination Survey between 2013 and 2015. Data related to 1422 adolescents aged 12–18 years (741 males and 681 females) were included in the analysis. Sleep duration was assessed using a self-reported questionnaire. Nutrient intake, including daily total energy intake, was assessed with a 24-h dietary recall questionnaire; (3) Results: Most males (84.4%) and females (86.4%) reported < 9 h of sleep per night. Short sleep duration was inversely associated with body mass index and obesity in both sexes. We found that higher intake of fiber and lower intake of sodium were associated with longer sleep duration (P < 0.05). When comparing the intake above and below the estimated average requirements (EAR), the difference in sleep duration was significant in the group that consumed vitamins B1 and C below EAR; (4) Conclusions: The findings of this study indicate that sleep duration can be associated with intake of some nutrients, which may also be associated with obesity in adolescents. Therefore, it is possible to prevent obesity and its complications by controlling the sleep duration and intake of nutrients of adolescents. Full article
(This article belongs to the Special Issue Factors Affecting the Quality of Sleep in Children)
Show Figures

Figure 1

Previous Issue
Next Issue
Back to TopTop