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Children, Volume 7, Issue 5 (May 2020) – 12 articles

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Cover Story (view full-size image) Pathogenic airway bacteria colonizing the neonatal airway increase the risk of childhood asthma, [...] Read more.
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Open AccessArticle
Minorities’ Diminished Returns of Parental Educational Attainment on Adolescents’ Social, Emotional, and Behavioral Problems
Children 2020, 7(5), 49; https://doi.org/10.3390/children7050049 - 18 May 2020
Cited by 2 | Viewed by 736
Abstract
Aim: To compare racial groups for the effect of parental educational attainment on adolescents’ social, emotional, and behavioral problems. Methods: In this cross-sectional study, 10,762 youth from the Adolescent Brain Cognitive Development (ABCD) study were included. The independent variable was parental educational attainment. [...] Read more.
Aim: To compare racial groups for the effect of parental educational attainment on adolescents’ social, emotional, and behavioral problems. Methods: In this cross-sectional study, 10,762 youth from the Adolescent Brain Cognitive Development (ABCD) study were included. The independent variable was parental educational attainment. The main outcomes were (1) anxious and depressed mood, (2) withdrawn and depressed affect, (3) somatic complaints, (4) social and interpersonal problems, (5) thought problems, (6) rule-breaking behaviors, (7) attention problems, and (8) violent and aggressive behaviors. These scores were generated based on parent-reported behavioral problems measured using the Child Behavior Checklist (CBCL). Race and ethnicity were the moderators. Linear regression was used to analyze the ABCD data. Results: Overall, high parental educational attainment was associated with lower scores across all domains. Race and ethnicity showed statistically significant interactions with parental educational attainment on adolescents’ fewer social, emotional, and behavioral problems (all domains), net of all confounders, indicating smaller tangible gains from their parental educational attainment for Black and Hispanic compared to non-Hispanic White adolescents. Conclusions: The protective effects of parental education against social, emotional, and behavioral problems are systematically diminished for Hispanic and Black than non-Hispanic White adolescents. Full article
Open AccessCommunication
Pragmatic Markers in the Management of Asthma: A Real-World-Based Approach
Children 2020, 7(5), 48; https://doi.org/10.3390/children7050048 - 18 May 2020
Viewed by 588
Abstract
Bronchial hyperreactivity, reversible airflow limitation and chronic airway inflammation characterize asthma pathophysiology. Personalized medicine, i.e., a tailored management approach, is appropriate for asthma management and is based on the identification of peculiar phenotypes and endotypes. Biomarkers are necessary for defining phenotypes and endotypes. [...] Read more.
Bronchial hyperreactivity, reversible airflow limitation and chronic airway inflammation characterize asthma pathophysiology. Personalized medicine, i.e., a tailored management approach, is appropriate for asthma management and is based on the identification of peculiar phenotypes and endotypes. Biomarkers are necessary for defining phenotypes and endotypes. Several biomarkers have been described in asthma, but most of them are experimental and/or not commonly available. The current paper will, therefore, present pragmatic biomarkers useful for asthma management that are available in daily clinical practice. In this regard, eosinophil assessment and serum allergen-specific IgE assay are the most reliable biomarkers. Lung function, mainly concerning forced expiratory flow at 25-755 of vital capacity (FEF25-75), and nasal cytology may be envisaged as ancillary biomarkers in asthma management. In conclusion, biomarkers have clinical relevance in asthma concerning both the endotype definition and the personalization of the therapy. Full article
(This article belongs to the Special Issue Pediatric Asthma)
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Open AccessReview
Culinary Education Programs for Children in Low-Income Households: A Scoping Review
Children 2020, 7(5), 47; https://doi.org/10.3390/children7050047 - 13 May 2020
Viewed by 684
Abstract
Child obesity in the United States is at an all-time high, particularly among underserved populations. Home-cooked meals are associated with lower rates of obesity. Helping children develop culinary skills has been associated with improved nutrition. The purpose of this study is to report [...] Read more.
Child obesity in the United States is at an all-time high, particularly among underserved populations. Home-cooked meals are associated with lower rates of obesity. Helping children develop culinary skills has been associated with improved nutrition. The purpose of this study is to report results from a scoping review of culinary education interventions with children from low-income families. Three databases and hand searches of relevant articles were examined. Retained articles met inclusionary criteria. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, as appropriate. A data extraction template was developed. Data were independently extracted and verified. Only nine out of 370 articles met the inclusionary criteria and were included in the review. Most interventions were school-based, used a quasi-experimental design, and recruited minority children. Children-only was the primary intervention focus. Primary outcomes were mostly psychosocial from child self-report. Most interventions focused on children only and were guided by Social Cognitive Theory. Most reported stakeholder involvement; however, type and degree varied. All had an in-person component; only one used technology. Few reported training program leaders. Culinary education programs for children from low-income families could benefit from a broader theoretical grounding, program leader training, and greater parental involvement. Full article
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Open AccessArticle
Parental Attachment Patterns in Mothers of Children with Anxiety Disorder
Children 2020, 7(5), 46; https://doi.org/10.3390/children7050046 - 11 May 2020
Viewed by 737
Abstract
Anxiety disorder on of the most common illnesses in the context of psychiatry. Potential causes include genetic and environmental factors, as well as the parental attachment of the individuals. The purpose of this study is to examine the relationship between parental attachment style [...] Read more.
Anxiety disorder on of the most common illnesses in the context of psychiatry. Potential causes include genetic and environmental factors, as well as the parental attachment of the individuals. The purpose of this study is to examine the relationship between parental attachment style and anxiety disorders for a group of children and their parents. Study data were collected from the mothers (N = 40) of children with an anxiety disorder who visited a child psychiatry outpatient clinic at a city hospital and a private institution in Kayseri (Turkey) in 2018. For the control group, 40 mothers of children without any mental illness were also included in the study. The purposive sampling method was used in the selection of the participants for both groups (experimental and control). Sociodemographic data sheet and parental bonding instrument (PBI) were utilized as the data collection instruments. Then, data were analyzed based on the descriptive analysis methodology that included mean scores, standard deviation, p-value, t-experimental, two-way ANOVA and Pearson correlation experiments by using SPSS v.22. The findings revealed that the mothers of the participants with a college degree in the experimental group had fewer perceptions of protection (t = 2.38, p < 0.01), but more perception of care from their mothers than fathers (t =−2.28, p < 0.05). In addition, although the perceived care of parents was found lower than the participants in the control group, the participants in both groups evaluated their parents analogously for overprotection. Findings showed that the mothers in the experimental group predominantly described their parents as neglecting. Full article
(This article belongs to the Section Global and Public Health)
Open AccessArticle
Season of Birth Impacts the Neonatal Nasopharyngeal Microbiota
Children 2020, 7(5), 45; https://doi.org/10.3390/children7050045 - 11 May 2020
Viewed by 778
Abstract
Objective: Pathogenic airway bacteria colonizing the neonatal airway increase the risk of childhood asthma, but little is known about the determinants of the establishment and dynamics of the airway microbiota in early life. We studied associations between perinatal risk factors and bacterial [...] Read more.
Objective: Pathogenic airway bacteria colonizing the neonatal airway increase the risk of childhood asthma, but little is known about the determinants of the establishment and dynamics of the airway microbiota in early life. We studied associations between perinatal risk factors and bacterial richness of the commensal milieu in the neonatal respiratory tract. Methods: Three hundred and twenty-eight children from the Copenhagen Prospective Studies on Asthma in the Childhood2000 (COPSAC2000) at-risk birth cohort were included in this study. The bacterial richness in each of the nasopharynxes of the 1-month old, asymptomatic neonates was analyzed by use of a culture-independent technique (T-RFLP). Information on perinatal risk factors included predisposition to asthma, allergy and eczema; social status of family; maternal exposures during pregnancy; mode of delivery; and postnatal exposures. The risk factor analysis was done by conventional statistics and partial least square discriminant analysis (PLSDA). Results: The nasopharyngeal bacterial community at 1-month displayed an average of 35 (IQR: 14–55, range 1–161) phylogenetically different bacteria groups. Season of birth was associated with nasopharyngeal bacterial richness at 1-month of age with a higher bacterial richness (p = 0.003) and more abundant specific bacterial profiles representing Gram-negative alpha-proteobacteria and Gram-positive Bacilli in the nasopharynx of summer-born children. Conclusion: Early postnatal bacterial colonization of the upper airways is significantly affected by birth season, emphasizing a future focus on the seasonality aspect in modelling the impact of early dynamic changes in airway bacterial communities in relation to later disease development. Full article
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Open AccessArticle
Parental Educational Attainment and Social Environment of Urban Public Schools in the U.S.: Blacks’ Diminished Returns
Children 2020, 7(5), 44; https://doi.org/10.3390/children7050044 - 10 May 2020
Cited by 3 | Viewed by 860
Abstract
Background: Recent research has documented marginalization-related diminished returns (MDRs) of socioeconomic status (SES), defined as weaker effects of SES indicators, such as parental educational attainment, on securing tangible outcomes for the members of socially marginalized (e.g., racial and ethnic minority) groups, compared to [...] Read more.
Background: Recent research has documented marginalization-related diminished returns (MDRs) of socioeconomic status (SES), defined as weaker effects of SES indicators, such as parental educational attainment, on securing tangible outcomes for the members of socially marginalized (e.g., racial and ethnic minority) groups, compared to privileged social groups (e.g., non-Hispanic Whites). Aims: To explore race/ethnic differences between non-Hispanic Blacks vs. non-Hispanic Whites who attend urban public schools on the effect of parental education on lower school environmental risk among American high schoolers. Methods: For this cross-sectional study, we borrowed the Education Longitudinal Study (ELS-2002) baseline data, a nationally representative study that enrolled 1706 10th grade youths who were attending urban public schools. From this number, 805 (47.2%) were non-Hispanic Black and 901 (52.8%) were non-Hispanic White youths. The dependent variable was the level of school social environmental risk measured using 18 items as self-reported, and was treated as a continuous variable. The independent variable was parental educational attainment, treated as a continuous measure. Gender, region, and parental marital status were the covariates. Race/ethnicity was the moderating variable. Linear regressions were applied to perform our data analysis. Results: Black students were found to attend schools with higher levels of social environmental risk. Youths with parents with a higher educational attainment were found to attend schools with a lower social environmental risk. We found a significant interaction between race (non-Hispanic Black vs. non-Hispanic White) and parental educational attainment on the level of school social environmental risk, suggesting that the protective effect of high parental education on reducing the school social environmental risk was smaller for non-Hispanic Black than for non-Hispanic White youths. Conclusions: Although high parental educational attainment is protective against social environmental risk for American youths, this protective effect is weaker for non-Hispanic Black than non-Hispanic White youths. The diminished returns of parental education in reducing school social environmental risk may explain why the effects of parental education on educational outcomes are smaller for non-Hispanic Black than non-Hispanic White youths (i.e., MDRs). The social environment indirectly generates racial youth educational disparities through deteriorating non-Hispanic Black youth educational outcomes across all SES levels. To prevent the confounding effects of private, suburban, rural, and Catholic schools, we limited this analysis to public urban schools. More research is needed on other settings. Full article
Open AccessArticle
The Measurement of Asthma and Allergic Rhinitis Control in Children and Adolescents
Children 2020, 7(5), 43; https://doi.org/10.3390/children7050043 - 07 May 2020
Viewed by 738
Abstract
Asthma and allergic rhinitis (AR) are frequently associated. The objective of the treatment of asthma and AR should be the control of symptoms and disease progression. Therefore, the combined measurement of disease control is desirable. In this regard, a questionnaire able to together [...] Read more.
Asthma and allergic rhinitis (AR) are frequently associated. The objective of the treatment of asthma and AR should be the control of symptoms and disease progression. Therefore, the combined measurement of disease control is desirable. In this regard, a questionnaire able to together assess asthma and AR control has been validated: the CARAT (Control of Allergic Rhinitis and Asthma Test). A further pediatric version (CARATkids) has been generated. The current real-world study used different disease control measures in children and adolescents with asthma and rhinitis. A total of 138 children and adolescents were recruited at three allergy centers. CARAT, CARATkids, ACT (Asthma Control Test), cACT (children ACT), GINA (Global Initiative for Asthma) disease control classification, VAS (Visual Analog Scale) for asthma and nasal symptoms, and lung function were used in all subjects. There was a predominance of males (67.4%) and asthma was well-controlled (according to GINA classification) in about half the subjects. In children, the median CARAT and cACT values were 5 and 22 respectively. In adolescents, the median CARAT and ACT values were 23 for both tests. There were significant differences between CARAT and ACT (p = 0.035) as well as between CARATkids and cACT (p = 0.0001). However, the tests’ outcomes were different as assessed in different domains. CARAT and CARATkids are disease-control measurements that give additional information to other tests, therefore, these different questionnaires to measure disease control complement each other. Full article
(This article belongs to the Special Issue Pediatric Asthma)
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Open AccessArticle
Readiness to Change among Adolescents with Chronic Pain and Their Parents: Is the German Version of the Pain Stages of Change Questionnaire a Useful Tool?
Children 2020, 7(5), 42; https://doi.org/10.3390/children7050042 - 02 May 2020
Viewed by 694
Abstract
The Pain Stages of Change Questionnaire (PSOCQ) measures patients’ willingness to engage in active self-management of their pain. The present study aimed to create validated German short versions of the PSOCQ for adolescents (PSOCQ-A) and their parents (PSOCQ-P). Additionally, an investigation of stages [...] Read more.
The Pain Stages of Change Questionnaire (PSOCQ) measures patients’ willingness to engage in active self-management of their pain. The present study aimed to create validated German short versions of the PSOCQ for adolescents (PSOCQ-A) and their parents (PSOCQ-P). Additionally, an investigation of stages of change regarding pain characteristics and treatment outcomes was undertaken. In Study 1, the data of adolescents aged 11 to 18 years and their parents were collected prior to intake (N = 501) and at admission (N = 240) to specialist inpatient pain treatment. Confirmatory factor analyses indicated a poor fit of the full PSOCQ measures prior to intake, but an acceptable fit at admission. Short PSOCQ-A and PSOCQ-P versions were identified. In Study 2, these results were cross-validated with data from an additional N = 150 patients and their parents, collected during and 3 months after interdisciplinary inpatient pain treatment. Model fits for both short versions were acceptable, although low internal consistency for the PSOCQ-A Precontemplation and Contemplation subscales was identified. During treatment, both patients’ and their parents’ readiness to change increased. Stage of change at discharge did not predict treatment non-response 3 months later. This study indicates that the PSOCQ is neither meaningful prior to admission nor predictive of non-response to treatment. While some value may exist in monitoring treatment progress, based on the results of this study, it is not recommended that the PSOCQ-A and PSOCQ-P be used as a measure of stage of change in German pediatric pain populations. Full article
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Open AccessArticle
Association between Active Travel to School and Depressive Symptoms among Early Adolescents
Children 2020, 7(5), 41; https://doi.org/10.3390/children7050041 - 02 May 2020
Viewed by 675
Abstract
Background: Although much evidence has demonstrated the positive relationship of active school travel (AST) and physical health, little is known about the relationship of AST and mental health indicators among early adolescents, especially in Chinese populations. Thus, this study aimed to investigate the [...] Read more.
Background: Although much evidence has demonstrated the positive relationship of active school travel (AST) and physical health, little is known about the relationship of AST and mental health indicators among early adolescents, especially in Chinese populations. Thus, this study aimed to investigate the relationship of AST with depressive symptoms and its sex as well as age difference among early adolescents from Shanghai urban areas, China. Methods: 6478 adolescents (mean age = 13.6) in urban area were recruited, of whom boys accounted for 46.2%. A self-reported questionnaire in Chinese was used to collect data on AST and depressive symptoms, and other control variables. Multivariable logistic regression analyses were used to explore the relationships of AST with depressive symptoms. Results: Of all included participants, 53.2% of adolescents reported being active in AST without sex difference. The prevalence of depressive symptoms was 19.2% without sex difference. AST was associated with reporting no depressive symptoms in adolescents (adjusted OR = 1.20, 95%CI: 1.06–1.36). However, the relationship was significant in boys (adjusted OR = 1.34, 95%CI: 1.11–1.60), in those who were grade 8 (adjusted OR = 1.25, 95%CI: 1.01–1.55) and 9 (adjusted OR = 1.29, 95%CI: 1.01–1.65) adolescents. Conclusions: AST may play an important role in preventing depressive symptoms among early adolescents. However, the relationship of AST with depressive symptoms differed by sex and age. More research is encouraged to explore the mechanism linking AST and depressive symptoms among adolescents, especially in different contexts. Full article
Open AccessArticle
Health Locus of Control in Parents of Children with Leukemia and Associations with Their Life Perceptions and Depression Symptomatology
Children 2020, 7(5), 40; https://doi.org/10.3390/children7050040 - 01 May 2020
Cited by 1 | Viewed by 704
Abstract
In childhood cancer, parents have an important role in the promotion of their children’s wellbeing and in their adoption of a locus of control style towards their children’s health. The current study aimed at identifying types of locus of control in parents of [...] Read more.
In childhood cancer, parents have an important role in the promotion of their children’s wellbeing and in their adoption of a locus of control style towards their children’s health. The current study aimed at identifying types of locus of control in parents of children with leukemia and the possible association with depressive symptomatology and current life perception. One hundred and four parents were recruited at the Hematology–Oncology Clinic of the Department of Woman’s and Child’s Health, University of Padua, one month after a leukemia diagnosis. Participants were Caucasian with a mean age of 37.28 years (SD = 5.89), mostly mothers (87.5%) and with a mean of 12.16 years of education (SD = 3.82). After signing the informed consent, they filled in the Ladder of Life, the Brief Symptom Inventory-18 and the Parental Health Locus of Control (PHLOC) questionnaires. Paired-samples t-test (t = −14.42; df = 103; p = 0.0001) showed that parents of children with leukemia were more inclined to have an external locus of control than an internal one. The hierarchical regression analysis model (R2 = 0.34; F = 4.32; p = 0.0001) identified health professional influence (ß = −0.28; p = 0.004), current life perception (ß = −0.3; p = 0.013) and future life perception (ß = −0.26; p = 0.012) as significant predictors of parental depression. Current life perception was best predicted (R2 = 0.25; F = 3.96; p = 0.01) by the parental influence locus of control style (ß = 0.25; p = 0.03). Improving trust in the medical staff care and strengthening the internal locus of control in parents could be a preventive program to cope with parental depression symptomatology. Full article
Open AccessReview
Grief and Bereavement in Parents After the Death of a Child in Low- and Middle-Income Countries
Children 2020, 7(5), 39; https://doi.org/10.3390/children7050039 - 01 May 2020
Viewed by 929
Abstract
While great strides have been made in improving childhood mortality, millions of children die each year with significant health-related suffering. More than 98% of these children live in low- and middle-income countries (LMICs). Efforts have been made to increase access to pediatric palliative [...] Read more.
While great strides have been made in improving childhood mortality, millions of children die each year with significant health-related suffering. More than 98% of these children live in low- and middle-income countries (LMICs). Efforts have been made to increase access to pediatric palliative care (PPC) services to address this suffering in LMICs through policy measures, educational initiatives, and access to essential medicines. However, a core component of high-quality PPC that has been relatively neglected in LMICs is grief and bereavement support for parents after the death of their child. This paper reviews the current literature on parental grief and bereavement in LMICs. This includes describing bereavement research in high-income countries (HICs), including its definition, adverse effect upon parents, and supportive interventions, followed by a review of the literature on health-related grief and bereavement in LMICs, specifically around: perinatal death, infant mortality, infectious disease, interventions used, and perceived need. More research is needed in grief and bereavement of parents in LMICs to provide them with the support they deserve within their specific cultural, social, and religious context. Additionally, these efforts in LMICs will help advance the field of parental grief and bereavement research as a whole. Full article
(This article belongs to the Special Issue Psychosocial Functioning in Childhood Cancer)
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Open AccessArticle
Domestic Risk Factors for Atopic and Non-Atopic Asthma in First Nations Children Living in Saskatchewan, Canada
Children 2020, 7(5), 38; https://doi.org/10.3390/children7050038 - 27 Apr 2020
Viewed by 796
Abstract
Both allergic and non-allergic asthma phenotypes are thought to vary by specific housing and other indoor environmental conditions. This study evaluated risk factors for allergic asthma phenotypes in First Nation children, an understudied Canadian population with recognized increased respiratory morbidity. We conducted a [...] Read more.
Both allergic and non-allergic asthma phenotypes are thought to vary by specific housing and other indoor environmental conditions. This study evaluated risk factors for allergic asthma phenotypes in First Nation children, an understudied Canadian population with recognized increased respiratory morbidity. We conducted a cross-sectional survey with a clinical component to assess the respiratory health of 351 school-age children living on two rural reserve communities. Asthma was defined as parental report of physician diagnosed asthma or a report of wheeze in the past 12 months. Atopy was determined by a ≥ 3-mm wheal response to any of six respiratory allergens upon skin prick testing (SPT). Important domestic and personal characteristics evaluated included damp housing conditions, household heating, respiratory infections and passive smoking exposure. Asthma and atopy prevalence were 17.4% and 17.1%, respectively. Of those with asthma, 21.1% were atopic. We performed multivariate multinomial logistic regression modelling with three outcomes: non-atopic asthma, atopic asthma and no asthma for 280 children who underwent SPT. After adjusting for potential confounders, children with atopic asthma were more likely to be obese and to live in homes with either damage due to dampness (p < 0.05) or signs of mildew/mold (p = 0.06). Both natural gas home heating and a history of respiratory related infections were associated with non-atopic asthma (p < 0.01). Domestic risk factors for asthma appear to vary by atopic status in First Nations children. Determining asthma phenotypes could be useful in environmental management of asthma in this population. Full article
(This article belongs to the Section Global and Public Health)
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