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Children, Volume 9, Issue 1 (January 2022) – 119 articles

Cover Story (view full-size image): In recent decades, concern for the quality of psychoeducational practices for students with autism spectrum disorders has led to the study of the scope of evidence-based educational methods disseminated among teachers. The purpose of this study was to identify to what extent social communication evidence-based practices for these students were provided in teacher education and in-service training programs in a sample of special education teachers. Our results indicate the imperative need for a review of university training and professional development programs. View this paper
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Article
Prevalence of Overweight and Obesity and Associated Diet-Related Behaviours and Habits in a Representative Sample of Adolescents in Greece
Children 2022, 9(1), 119; https://doi.org/10.3390/children9010119 - 17 Jan 2022
Viewed by 803
Abstract
Excessive body weight during adolescence represents a significant public health problem worldwide. Identifying factors associated with its development is crucial. We estimated the prevalence of overweight and obesity in a representative sample of 11, 13 and, 15-year-olds living in Greece and explored the [...] Read more.
Excessive body weight during adolescence represents a significant public health problem worldwide. Identifying factors associated with its development is crucial. We estimated the prevalence of overweight and obesity in a representative sample of 11, 13 and, 15-year-olds living in Greece and explored the association with diet-related behaviours and habits. Self-reported data on weight, height, diet-related behaviours and habits were used from 3816 students (1898 boys, 1918 girls) participants in the Greek arm of the international Health Behaviour in School-Aged Children (HBSC) study during 2018. Overweight and obesity were defined using the 2007 WHO growth charts classification. Prevalence of overweight was 19.4% in the total sample, 24.1% for boys and 14.7% for girls, and prevalence of obesity was 5.3% in the total sample, 7.3% for boys and 3.4% for girls, respectively. In the total sample, overweight (including obesity) was positively associated with male gender, low family affluence, skipping breakfast, and being on a diet, and inversely associated with age and being physically active. Eating rarely with the family was positively associated with overweight only among boys and eating snacks/meals in front of screens only among girls. No association was noted for eating in fast-food restaurants, consuming vegetables, fruits, sweets, and sugar-sweetened beverages. Full article
(This article belongs to the Special Issue Childhood and Adolescent Obesity and Weight Management Update)
Review
New Insights from Metabolomics in Pediatric Renal Diseases
Children 2022, 9(1), 118; https://doi.org/10.3390/children9010118 - 17 Jan 2022
Viewed by 429
Abstract
Renal diseases in childhood form a spectrum of different conditions with potential long-term consequences. Given that, a great effort has been made by researchers to identify candidate biomarkers that are able to influence diagnosis and prognosis, in particular by using omics techniques (e.g., [...] Read more.
Renal diseases in childhood form a spectrum of different conditions with potential long-term consequences. Given that, a great effort has been made by researchers to identify candidate biomarkers that are able to influence diagnosis and prognosis, in particular by using omics techniques (e.g., metabolomics, lipidomics, genomics, and transcriptomics). Over the past decades, metabolomics has added a promising number of ‘new’ biomarkers to the ‘old’ group through better physiopathological knowledge, paving the way for insightful perspectives on the management of different renal diseases. We aimed to summarize the most recent omics evidence in the main renal pediatric diseases (including acute renal injury, kidney transplantation, chronic kidney disease, renal dysplasia, vesicoureteral reflux, and lithiasis) in this narrative review. Full article
(This article belongs to the Special Issue Advances in Pediatric Renal Diseases)
Article
Improving Body Representation and Motor Skills with a Preschool Education Program: A Preliminary Study
Children 2022, 9(1), 117; https://doi.org/10.3390/children9010117 - 17 Jan 2022
Viewed by 529
Abstract
Background: Body representation is described as a fundamental ability to build efficient motor skills. However, no structured and evidence-based program on body representation currently exists. This study assesses the effectiveness of a school-based body representation program (ENCOR: EN for ‘Enfant’ and COR for [...] Read more.
Background: Body representation is described as a fundamental ability to build efficient motor skills. However, no structured and evidence-based program on body representation currently exists. This study assesses the effectiveness of a school-based body representation program (ENCOR: EN for ‘Enfant’ and COR for ‘Corps’ in French) on body representation abilities and motor skills in preschool children. ENCOR focus on body representation abilities as a foundational ability for motor skills. It was designed with teachers and occupational therapists to be autonomously achieved by teachers. Methods: Twenty-three children aged 5–6 years were included and provided with education interventions (control versus ENCOR). Results: Body representation accuracy and precision in localization increased by about 20% and 37%, respectively, in the intervention program compared to the control intervention. In the body part naming task, participants performed fewer of the most frequent errors (i.e., from 198 to 116 left-right discrimination errors). As expected, performance in the body representation tasks and the motor skills tasks were correlated at baseline. We show that motor skills improved after the ENCOR training. Conclusions: Given the need for evidence-based programs in schools, this program could efficiently help implementing body representation education on a large scale. Future studies should evaluate the effectiveness of the program on other cognitive abilities and academic outcomes. Full article
(This article belongs to the Special Issue Child Psychology: Typical and Atypical Development)
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Article
The Association between Participation in Fights and Bullying and the Perception of School, Teachers, and Peers among School-Age Children in Serbia
Children 2022, 9(1), 116; https://doi.org/10.3390/children9010116 - 17 Jan 2022
Viewed by 428
Abstract
Participating in physical fighting and bullying can be a cause of severe injury and death among school-age children. Research evidence can support school and health actors’ efforts to improve school-age children’s development and health capacity for life. The study aims to assess the [...] Read more.
Participating in physical fighting and bullying can be a cause of severe injury and death among school-age children. Research evidence can support school and health actors’ efforts to improve school-age children’s development and health capacity for life. The study aims to assess the prevalence of school-age children’s participation in fights and bullying in Serbia, and to examine the relevance of students’ socio-demographic characteristics and perceptions of school and relations with other students and professors for participation in fights and bullying. A secondary analysis is also performed on the original data of the 2017 HBSC study, which was conducted on 3267 students in a nationally representative sample of primary and high schools in Serbia. We sought to investigate the relationship between eight socio-demographic characteristics and nine school-related perceptions, with two outcome variables: taking part in fights and taking part in bullying, examined by using univariate and multivariate logistic regression. The main results show that 50.8% of boys and 17.1% of girls have taken part in fights, while 17.7% boys and 10.4% of girls have taken part in bullying. Students who felt a large and very large burden of school obligations were 1.43 times more likely to participate in bullying at least once, while they were 1.38 and 2.12 times more likely to participate in multiple fights and 4.04, 1.24, and 2.78 times more likely to participate multiple times in bullying. Multiple participation in fights and in bullying is significantly negatively associated with female gender, younger age years, good and very good perception of family financial status and quality of life, and positive perceptions of school and relations they have with other students and professors. Fights among school-age children are significantly positively associated with living with relatives/legal guardians and poor quality of life. In conclusion, the prevalence of participating in at least one fight/bullying is higher than in multiple fights/bullying. These associations suggest a necessity to enhance the monitoring and control of peer behavior among school-age children. The findings of the study imply key enablers of protection, such as building relationships based on team spirit and work, friendly behavior, empathy, and help, which should be included in the value system of school and family activities in programs to combat fights and bullying in school-age children. Full article
Article
Sugar Content and Sources in Commercial Infant Cereals in Spain
Children 2022, 9(1), 115; https://doi.org/10.3390/children9010115 - 17 Jan 2022
Viewed by 377
Abstract
Instant infant cereals reconstituted with infant formula are the first complementary food for most Spanish infants. The main aim is to provide information on sugars in the formulation of infant cereals. Product information was collected from department stores, supermarkets, and pharmacies and completed [...] Read more.
Instant infant cereals reconstituted with infant formula are the first complementary food for most Spanish infants. The main aim is to provide information on sugars in the formulation of infant cereals. Product information was collected from department stores, supermarkets, and pharmacies and completed with data from brand websites. A portion of the samples was selected for total sugars determination using the HPLC and Luff-Schoorl methods. The information regarding a total of 120 milk-free instant infant cereals marketed in Spain from 12 companies was summarized. The mean of total sugars was 23 ± 9 g/100 g (25–42%), providing 24% of the calories. Most of porridges are prepared with partially hydrolyzed flours providing free sugars (glucose and maltose). The most commonly added sugar is sucrose. A total of 43.3% of products contain added sucrose, and 16.7% contain fruits. Infant cereals analyzed with added sugars can have a sugar content similar to that found in products without added sugars. Consistent differences were found in sugars content between assayed methods and this label information. Although the European legislation of infant cereals establishes values for added sugars, the labeling reflects the content of total sugars, but not that of added sugars. Full article
(This article belongs to the Special Issue New Research in Childhood Nutrition)
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Article
Loss of Health Promoting Bacteria in the Gastrointestinal Microbiome of PICU Infants with Bronchiolitis: A Single-Center Feasibility Study
Children 2022, 9(1), 114; https://doi.org/10.3390/children9010114 - 17 Jan 2022
Viewed by 615
Abstract
The feasibility of gastrointestinal (GI) microbiome work in a pediatric intensive care unit (PICU) to determine the GI microbiota composition of infants as compared to control infants from the same hospital was investigated. In a single-site observational study at an urban quaternary care [...] Read more.
The feasibility of gastrointestinal (GI) microbiome work in a pediatric intensive care unit (PICU) to determine the GI microbiota composition of infants as compared to control infants from the same hospital was investigated. In a single-site observational study at an urban quaternary care children’s hospital in Western Michigan, subjects less than 6 months of age, admitted to the PICU with severe respiratory syncytial virus (RSV) bronchiolitis, were compared to similarly aged control subjects undergoing procedural sedation in the outpatient department. GI microbiome samples were collected at admission (n = 20) and 72 h (n = 19) or at time of sedation (n = 10). GI bacteria were analyzed by sequencing the V4 region of the 16S rRNA gene. Alpha and beta diversity were calculated. Mechanical ventilation was required for the majority (n = 14) of study patients, and antibiotics were given at baseline (n = 8) and 72 h (n = 9). Control subjects’ bacterial communities contained more Porphyromonas, and Prevotella (p = 0.004) than those of PICU infants. The ratio of Prevotella to Bacteroides was greater in the control than the RSV infants (mean ± SD—1.27 ± 0.85 vs. 0.61 ± 0.75: p = 0.03). Bacterial communities of PICU infants were less diverse than those of controls with a loss of potentially protective populations. Full article
(This article belongs to the Special Issue Advances in Pediatric Critical Care)
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The Social Networks and Social Support of Siblings of Children with Cancer
Children 2022, 9(1), 113; https://doi.org/10.3390/children9010113 - 15 Jan 2022
Viewed by 535
Abstract
Siblings of children with cancer need support to ameliorate the challenges they encounter; however, little is known about what types and sources of support exist for siblings. This study addresses this gap in our understanding of the social networks and sources of support [...] Read more.
Siblings of children with cancer need support to ameliorate the challenges they encounter; however, little is known about what types and sources of support exist for siblings. This study addresses this gap in our understanding of the social networks and sources of support for adolescents with a brother or sister who has cancer. Additionally, we describe how the support siblings receive addresses what they feel are the hardest aspects of being a sibling of a child with cancer. During semi-structured interviews, siblings (ages 12–17) constructed ecomaps describing their support networks. Data were coded for support type (emotional, instrumental, informational, validation, companionship) and support provider (e.g., mother, teacher, friend). Network characteristics and patterns of support were explored. Support network size ranged from 3 to 10 individuals (M = 6 ± 1.9); siblings most frequently reported mothers as sources of support (n = 22, 91.7%), followed by fathers (n = 19, 79.2%), close friends (n = 19, 79.2%) and siblings (with or without cancer) (n = 17, 70.8%). Friends and brothers or sisters most often provided validation and companionship while instrumental and informational supports came from parents. This study provides foundational knowledge about siblings’ support networks, which can be utilized to design interventions that improve support for siblings of children with cancer. Full article
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Review
Emerging Links between Microbiome Composition and Skin Immunology in Diaper Dermatitis: A Narrative Review
Children 2022, 9(1), 112; https://doi.org/10.3390/children9010112 - 15 Jan 2022
Viewed by 814
Abstract
Diaper dermatitis is a common type of irritant contact dermatitis occurring in infants and toddlers. Its occurrence is triggered by an unfavorable environment under the diaper, damage to skin integrity by fecal enzyme degradation, overhydration and disruption of the lipid bilayer structure facilitating [...] Read more.
Diaper dermatitis is a common type of irritant contact dermatitis occurring in infants and toddlers. Its occurrence is triggered by an unfavorable environment under the diaper, damage to skin integrity by fecal enzyme degradation, overhydration and disruption of the lipid bilayer structure facilitating the entry of irritants and microorganisms. In diaper dermatitis development, the central proinflammatory cytokines are IL-1α, IL-8 and TNF-α. The initial release of IL-1α and TNF-α starts a further cascade of pro-inflammatory chemo- and cytokines, resulting in inflammation and erythema of the skin. A recently recognized factor in diaper dermatitis is the composition of the skin microbiome; common pathogenic strains Candida albicans and Staphylococcus aureus are associated with skin irritation. The resulting impaired microbiome composition produces a local inflammatory response and may thus worsen the initial dermatitis clinical presentation and subsequent healing. Introduction of probiotics is an attractive treatment for microbiome modulation, which has shown success in other skin conditions in adults and children. Probiotics are thought to work as a protective shield against irritants, maintain low skin pH, secrete beneficial metabolites, and block pathogen invasion. There is preliminary evidence that certain probiotics given orally or topically could be used as a gentle intervention in diaper dermatitis. Full article
(This article belongs to the Section Pediatric Dermatology)
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How Do Children with Autism Spectrum Disorder and Children with Developmental Delays Differ on the Child Behavior Checklist 1.5–5 DSM-Oriented Scales?
Children 2022, 9(1), 111; https://doi.org/10.3390/children9010111 - 14 Jan 2022
Viewed by 431
Abstract
The Child Behavior Checklist 1.5–5 (CBCL 1.5–5) is applied to identify emotional and behavioral problems on children with developmental disabilities (e.g., autism spectrum disorder [ASD] and developmental delays [DD]). To understand whether there are variations between these two groups on CBCL DSM-oriented scales, [...] Read more.
The Child Behavior Checklist 1.5–5 (CBCL 1.5–5) is applied to identify emotional and behavioral problems on children with developmental disabilities (e.g., autism spectrum disorder [ASD] and developmental delays [DD]). To understand whether there are variations between these two groups on CBCL DSM-oriented scales, we took two invariance analyses on 443 children (228 children with ASD). The first analysis used measurement invariance and multiple-group factor analysis on the test structure. The second analysis used item-level analysis, i.e., differential item functioning (DIF), to discover whether group memberships responded differently on some items even though underlying trait levels were the same. It was discovered that, on the test structure, the Anxiety Problems scale did not achieve metric invariance. The other scales achieved metric invariance; DIF analyses further revealed that there were items that functioned differently across subscales. These DIF items were mostly about children’s reactions to the surrounding environment. Our findings provide implications for clinicians to use CBCL DSM-oriented scales on differentiating children with ASD and children with DD. In addition, researchers need to be mindful about how items were responded differently, even though there were no mean differences on the surface. Full article
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Article
Can Body Mass Index Affect Height Growth at Menarche among Girls Receiving Treatment for Early Puberty? A Retrospective Study in Korean Girls
Children 2022, 9(1), 110; https://doi.org/10.3390/children9010110 - 14 Jan 2022
Viewed by 338
Abstract
Gonadotropin-releasing hormone agonist (GnRHa) therapy is used to control puberty progression and it preserves height potential in patients with idiopathic central precocious puberty (ICPP). This study evaluated the correlation between weight and height gain at menarche following GnRHa treatment among girls with ICPP [...] Read more.
Gonadotropin-releasing hormone agonist (GnRHa) therapy is used to control puberty progression and it preserves height potential in patients with idiopathic central precocious puberty (ICPP). This study evaluated the correlation between weight and height gain at menarche following GnRHa treatment among girls with ICPP and relatively central early puberty (EP). We investigated height/weight trends and changes in height from diagnosis to menarche in girls with ICPP and EP treated with GnRHa. The mean difference in height (Δheight) from treatment cessation to menarche was 9.79 ± 3.53 cm. Girls were divided into girls with Δheight ≥ 9.79 cm (Group 1) and girls with Δheight < 9.79 cm (Group 2). Although near adult height was significantly higher in Group 1, the mean body mass index (BMI) and weight were significantly lower at diagnosis, treatment discontinuation, and menarche. The BMI and weight at the three time points were negatively correlated with height. Girls with higher BMI at all three time points had slower growth rates during the study period. Considering that BMI and body weight were closely related to Δheight, proper management of BMI and body weight of girls receiving early puberty treatment might contribute to growth during and after GnRHa treatment. Full article
(This article belongs to the Section Integrative Pediatrics)
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Article
Positive Associations between Body Mass Index and Hematological Parameters, Including RBCs, WBCs, and Platelet Counts, in Korean Children and Adolescents
Children 2022, 9(1), 109; https://doi.org/10.3390/children9010109 - 14 Jan 2022
Viewed by 291
Abstract
We conducted this study to investigate the associations between hematological parameters and obesity in children and adolescents. The levels of hematological parameters (including white blood cells [WBCs], red blood cells [RBCs], hemoglobin [Hb], hematocrit [Hct], and platelets) of 7997 participants (4259 boys and [...] Read more.
We conducted this study to investigate the associations between hematological parameters and obesity in children and adolescents. The levels of hematological parameters (including white blood cells [WBCs], red blood cells [RBCs], hemoglobin [Hb], hematocrit [Hct], and platelets) of 7997 participants (4259 boys and 3738 girls) aged 10–18 years were recorded. The parameters were compared among participants with normal weight, overweight, and obesity. Significantly higher mean levels of WBCs (7.16 vs. 6.16 × 103/mm3, p < 0.001), RBCs (4.90 vs. 4.82 × 106/mm3, p < 0.001), Hb (14.07 vs. 13.99 g/dL, p < 0.05), Hct (42.31 vs. 41.91%, p < 0.001), and platelets (311.87 vs. 282.66 × 103/mm3, p < 0.001) were found in the obese than normal weight group, respectively, after adjusting for body mass index (BMI) and sex. BMI SDS had significant positive associations with the levels of WBCs (β = 0.275, p < 0.001), RBCs (β = 0.028, p < 0.001), Hb (β = 0.034, p < 0.001), Hct (β = 0.152, p < 0.001), and platelets (β = 8.372, p < 0.001) after adjusting for age, sex, and socioeconomic factors in a multiple linear regression analysis. A higher BMI was associated with elevated WBC, RBC, Hb, Hct, and platelet counts in children and adolescents. Because higher levels of hematological parameters are potential risk factors for obesity-related diseases, hematological parameters should be evaluated in obese children and adolescents. Full article
(This article belongs to the Special Issue Body Composition in Children)
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Article
Spanish Physical Education Teachers’ Perceptions about Their Preparation for Inclusive Education
Children 2022, 9(1), 108; https://doi.org/10.3390/children9010108 - 14 Jan 2022
Viewed by 631
Abstract
The prevailing rights and quality of life approaches call for the inclusion of people with diversity and/or disabilities in society, including their participation in the educational system. Therefore, different institutions are urging countries to take action to ensure that students with disabilities receive [...] Read more.
The prevailing rights and quality of life approaches call for the inclusion of people with diversity and/or disabilities in society, including their participation in the educational system. Therefore, different institutions are urging countries to take action to ensure that students with disabilities receive the accommodations and supports they need within the framework of inclusive education. The idiosyncrasies of physical education (PE) classes can be an opportunity to encourage the participation and inclusion of these students. Thus, this study aims to evaluate the PE teachers’ perception about their preparation to address inclusive education. The study involved 260 Spanish primary and secondary PE teachers who answered a sociodemographic questionnaire, three dichotomic questions about their initial and ongoing preparation and the Evaluation of Teacher Training for Inclusion Questionnaire (CEFI-R). PE teachers believe that they have not received the necessary initial preparation and they consider it important to assist in ongoing courses to address their students’ diverse needs. PE teachers are aware of the importance of inclusive education and perceive greater difficulties in secondary education. PE teachers also showed a good predisposition to teach students with special educational support needs, especially found in primary school teachers through the CEFI-R Dimension 1, with statistically significant differences. Full article
Article
Experimental Study on the Mechanical Behavior of Orthodontic Arches Exposed to the Environment in the Oral Cavity
Children 2022, 9(1), 107; https://doi.org/10.3390/children9010107 - 14 Jan 2022
Viewed by 296
Abstract
Background. The arches used in orthodontic therapy are subject to increasing physical and chemical stresses. Purpose of the study: This in vitro experimental study aims to highlight and compare the main mechanical properties of orthodontic arches. Materials and Methods: We used 40 springs, [...] Read more.
Background. The arches used in orthodontic therapy are subject to increasing physical and chemical stresses. Purpose of the study: This in vitro experimental study aims to highlight and compare the main mechanical properties of orthodontic arches. Materials and Methods: We used 40 springs, 2 materials, 20 of Ni-Cr and 20 of Co-Cr, of different diameters, 0.7 mm 0.8 mm and 1.2 mm, subjected to the environment of artificial saliva and artificial saliva with cola for one month and two months, respectively. Five springs of each material were tested at different times: T0, before application in the oral cavity, then at time T1, T2, T3, T4. Three lengths of the lever arm were considered for bending forces acting on the springs (dental wires). These lengths were 15, 10 and 5 mm. The wires were tested under the action of bending forces on a Hans Schmidt HV 500N stand, obtaining the characteristics of the wires: deformation-force-time. Results: Graphical determinations show that the degree of deformation of the wires is influenced by the applied force, diameter and obviously by the immersion time, respectively by the type of solution in which the springs were immersed. Conclusions: The final degree of bending is higher for Co-Cr arcs than for Ni-Cr at all three dimensions. Full article
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Article
The Incidence and Causes of Unplanned Reoperations as a Quality Indicator in Pediatric Surgery
Children 2022, 9(1), 106; https://doi.org/10.3390/children9010106 - 13 Jan 2022
Cited by 1 | Viewed by 359
Abstract
Background: Unplanned return to the operating room (uROR) within the 30-day postoperative period can be used as a quality indicator in pediatric surgery. The aim of this study was to investigate and evaluate uROR as a quality indicator. Methods: The case records of [...] Read more.
Background: Unplanned return to the operating room (uROR) within the 30-day postoperative period can be used as a quality indicator in pediatric surgery. The aim of this study was to investigate and evaluate uROR as a quality indicator. Methods: The case records of pediatric patients who underwent reoperation within the 30-day period after primary surgery, from 1 January 2018 to 31 December 2020 were retrospectively reviewed. The primary outcome of the study was the rate of uROR as a quality indicator in pediatric surgery. Secondary outcomes were indications for primary and secondary surgery, types and management of complications, factors that led to uROR, length of hospital stay, duration of surgery and anesthesia, and starting time of surgery. Results: A total of 3982 surgical procedures, under general anesthesia, were performed during the three-year study period (2018, n = 1432; 2019, n = 1435; 2020, n = 1115). Elective and emergency surgeries were performed in 3032 (76.1%) and 950 (23.9%) patients, respectively. During the study period 19 (0.5%) pediatric patients, with the median age of 11 years (IQR 3, 16), underwent uROR within the 30-day postoperative period. The uROR incidence was 6 (0.4%), 6 (0.4%), and 7 (0.6%) for years 2018, 2019, and 2020, respectively (p = 0.697). The incidence of uROR was significantly higher in males (n = 14; 73.7%) than in females (n = 5; 26.3%) (p = 0.002). The share of unplanned reoperations in studied period was 4.5 times higher in primarily emergency surgeries compared to primarily elective surgeries (p < 0.001). The difference in incidence was 0.9% (95% CI, 0.4–1.4). Out of children that underwent uROR within the 30-day period after elective procedures, 50% had American Society of Anesthesiologists (ASA) score three or higher (p = 0.016). The most common procedure which led to uROR was appendectomy (n = 5, 26.3%) while the errors in surgical technique were the most common cause for uROR (n = 11, 57.9%). Conclusion: Unplanned reoperations within the 30-day period after the initial surgical procedure can be a good quality indicator in pediatric surgery. Risk factors associated with uROR are emergency surgery, male gender, and ASA score ≥3 in elective pediatric surgery. Full article
(This article belongs to the Section Pediatric Surgery)
Article
Burden of Traumatic Brain Injuries in Children and Adolescents in Europe: Hospital Discharges, Deaths and Years of Life Lost
Children 2022, 9(1), 105; https://doi.org/10.3390/children9010105 - 13 Jan 2022
Viewed by 378
Abstract
Children and adolescents are at high risk of traumatic brain injuries (TBI). To identify those most at risk across Europe, a comprehensive epidemiological study on the burden of TBI is needed. Our aim was to estimate the burden of TBI in the pediatric [...] Read more.
Children and adolescents are at high risk of traumatic brain injuries (TBI). To identify those most at risk across Europe, a comprehensive epidemiological study on the burden of TBI is needed. Our aim was to estimate the burden of TBI in the pediatric and adolescent population of Europe by calculating rates of hospital-based incidence, death and years of life lost (YLL) due to TBI in 33 countries of Europe in 2014 (most recent available data). We conducted a cross-sectional observational, population-based study. All cases with TBI in the age range 0 to 19, registered in the causes of death databases or hospital discharge databases of 33 European countries were included. Crude and age-standardized rates of hospital discharges, deaths and YLLs due to TBI; and pooled estimates for all countries combined were calculated. TBI caused 2303 deaths (71% in boys), 154,282 YLLs (68% in boys) and 441,368 hospital discharges (61% in boys) in the population of 0–19 year-olds. We estimated pooled age-standardized rates of death (2.8, 95% CI: 2.4–3.3), YLLs (184.4, 95% CI: 151.6–217.2) and hospital discharges (344.6, 95% CI: 250.3–438.9) for the analyzed countries in 2014. The population of 15–19 year-olds had the highest rates of deaths and YLLs, and the population of 0–4 year-olds had the highest rate of hospital discharges. Detailed estimates of hospital discharge, death and YLL rates based on high-quality, standardized data may be used to develop health policies, aid decision-making and plan prevention. Full article
(This article belongs to the Section Global and Public Health)
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The Moderating Role of Surgency, Behavioral Inhibition, Negative Emotionality and Effortful Control in the Relationship between Parenting Style and Children’s Reactive and Proactive Aggression
Children 2022, 9(1), 104; https://doi.org/10.3390/children9010104 - 13 Jan 2022
Viewed by 548
Abstract
The principal aim of this study is to explore the moderating role of temperament in the relationship between parenting style and the reactive and proactive aggressive behavior of 8-year-old children. The participants are 279 children (154 boys and 125 girls). To measure reactive [...] Read more.
The principal aim of this study is to explore the moderating role of temperament in the relationship between parenting style and the reactive and proactive aggressive behavior of 8-year-old children. The participants are 279 children (154 boys and 125 girls). To measure reactive and proactive aggression, children completed the reactive and proactive questionnaire (RPQ). Child temperament and parenting styles were evaluated by both parents using the temperament in middle childhood questionnaire (TMCQ) and the parenting styles and dimensions questionnaire (PSDQ). The results revealed that boys with high surgency levels and authoritarian fathers displayed more reactive aggression, whereas behaviorally inhibited boys with mothers who scored low for authoritarian parenting displayed less reactive aggression. Finally, girls with high levels of effortful control and mothers who scored low for authoritative parenting displayed more proactive aggression. The results highlight the value of studying the moderating role of temperament in the relationship between children’s aggressive behavior and both mothers’ and fathers’ parenting styles, and underscores the importance of doing so separately for boys and girls. Full article
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Depressive Symptoms, Alcohol Beliefs and Heavy Episodic Drinking in Adolescents
Children 2022, 9(1), 103; https://doi.org/10.3390/children9010103 - 13 Jan 2022
Viewed by 383
Abstract
Adolescents who engage in heavy episodic drinking (HED—i.e., 5+ drinks on a single occasion) increase risks for psychopathology, alcohol dependence, and similar negative consequences in adulthood. We explored associations among depressive symptoms, positive alcohol beliefs, and progression of heavy episodic drinking (HED) in [...] Read more.
Adolescents who engage in heavy episodic drinking (HED—i.e., 5+ drinks on a single occasion) increase risks for psychopathology, alcohol dependence, and similar negative consequences in adulthood. We explored associations among depressive symptoms, positive alcohol beliefs, and progression of heavy episodic drinking (HED) in 3021 German adolescents (M(SD) age at baseline = 12.4 (1.0)) followed for 30 months in 4 waves, using a conditional parallel process linear growth model, with full information maximum likelihood estimation. By wave 4, 40.3% of participants had engaged in HED more than once; 16.4% had done so ≥5 times. Depressive symptoms were indirectly related to baseline values of HED (through positive beliefs and wave 1 drinking frequency and quantity) and to the rate of growth in HED (through positive beliefs and wave 1 quantity). Adolescents with higher levels of depressive symptoms and positive alcohol beliefs drink more frequently and at greater quantities, which is associated with initiating HED at a higher level and escalating HED more rapidly than peers with similar depressive symptoms who lack those beliefs. This suggests that, to the extent that positive alcohol beliefs can be tempered through public health campaigns, education and/or counseling, HED among depressed adolescents might be reduced. Full article
(This article belongs to the Special Issue New Frontiers in Adolescent Health and Development)
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Review
Current Knowledge of Selected Cardiovascular Biomarkers in Pediatrics: Kidney Injury Molecule-1, Salusin-α and -β, Uromodulin, and Adropin
Children 2022, 9(1), 102; https://doi.org/10.3390/children9010102 - 13 Jan 2022
Viewed by 366
Abstract
Cardiovascular diseases are the leading cause of morbidity and mortality in the modern world. Their common denominator is atherosclerosis, a process beginning in childhood. In pediatrics, the aim of preventive measures is to recognize children and adolescents at risk for accelerated atherosclerosis and [...] Read more.
Cardiovascular diseases are the leading cause of morbidity and mortality in the modern world. Their common denominator is atherosclerosis, a process beginning in childhood. In pediatrics, the aim of preventive measures is to recognize children and adolescents at risk for accelerated atherosclerosis and possible premature cardiovascular events in adulthood. Several diagnostic procedures and biomarkers are available for cardiovascular risk assessment in adults. However, reliable markers in pediatrics are still insufficiently studied. In this contribution, we discuss five potential biomarkers of particular interest: kidney injury molecule-1, salusin-α and -β, uromodulin, and adropin. Studies regarding the pediatric population are scarce, but they support the evidence from studies in the adult population. These markers might entail both a prognostic and a therapeutic interest. Full article
(This article belongs to the Special Issue Cardiovascular Disease in Children)
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Article
Colectomy Followed by J-Pouch Reconstruction to Correct Total Colonic Aganglionosis
Children 2022, 9(1), 101; https://doi.org/10.3390/children9010101 - 12 Jan 2022
Viewed by 409
Abstract
Background: Patients suffering from complete colonic aganglionosis (TCA) require the best surgical care possible. Only a few studies reported J-Pouch repair as the primary reconstructive surgery in TCA patients. This study adds to the current literature a thorough clinical and functional outcomes group. [...] Read more.
Background: Patients suffering from complete colonic aganglionosis (TCA) require the best surgical care possible. Only a few studies reported J-Pouch repair as the primary reconstructive surgery in TCA patients. This study adds to the current literature a thorough clinical and functional outcomes group. Methods: Between 2011 and 2021, medical records of Hirschsprung disease (HD) patients who underwent J-Pouch reconstruction during infancy (n = 12) were reviewed. In close follow-up, bowel function and satisfaction with operation results were evaluated. The median age at the time of J-Pouch reconstruction was 16 months, and covering ileostomies were closed four months later. There were no postoperative problems. After the final repair, Pouch-related problems (PRP) occurred in 27% of the children and were treated conservatively. There was no histological evidence of pouchitis in any of the individuals. The median 24-h stooling frequency was 4–5 at the latest follow-up 51 months following enterostomy closure. Conclusions: The current study’s findings support the existing literature and advocate for J-pouch repair in TCA patients. However, more research will be needed to determine the best time to undergo pouch surgery and ileostomy closure in TCA patients. Full article
(This article belongs to the Special Issue Abdominal Surgery in Pediatrics)
Case Report
Bilateral Multiple Tarsal Coalitions (Talonavicular and Talocalcaneal Coalitions) with Recurrent Ankle Sprain in an Adolescent
Children 2022, 9(1), 100; https://doi.org/10.3390/children9010100 - 12 Jan 2022
Viewed by 280
Abstract
Tarsal coalition is defined as an abnormal bony, cartilaginous, or fibrous union of two or more tarsal bones. The incidence of tarsal coalition is approximately 2% in the general population. Talocalcaneal and calcaneonavicular coalitions are the most common. The talonavicular coalition is a [...] Read more.
Tarsal coalition is defined as an abnormal bony, cartilaginous, or fibrous union of two or more tarsal bones. The incidence of tarsal coalition is approximately 2% in the general population. Talocalcaneal and calcaneonavicular coalitions are the most common. The talonavicular coalition is a rare entity with an incidence of approximately 1.3% among patients with tarsal coalitions. We present a case of a 12-year-old girl who had talonavicular and talocalcaneal coalitions associated with a recurrent ankle sprain. The talonavicular coalition was asymptomatic, and the talocalcaneal coalition was the cause of ankle pain and recurrent sprain. Surgical resection of the talocalcaneal coalition led to successful clinical and functional outcomes. In conclusion, the possibility of multiple tarsal coalitions should be considered in tarsal coalition patients, and the talocalcaneal coalition should be considered as a differential diagnosis in an adolescent patient with a recurrent ankle sprain. Full article
(This article belongs to the Section Pediatric Orthopedics)
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Article
Lack of Maternal Social Capital Increases the Likelihood of Harsh Parenting
Children 2022, 9(1), 99; https://doi.org/10.3390/children9010099 - 11 Jan 2022
Viewed by 327
Abstract
Does low maternal social capital increase the likelihood of parents using harsh parenting behaviors? We analyzed random digit dial telephone survey data from 661 female primary caregivers across Colorado. Positive reports of the use of either physically or psychologically harsh parenting methods were [...] Read more.
Does low maternal social capital increase the likelihood of parents using harsh parenting behaviors? We analyzed random digit dial telephone survey data from 661 female primary caregivers across Colorado. Positive reports of the use of either physically or psychologically harsh parenting methods were classified as harsh parenting. Absence of social capital was assessed within the family and the community; lack of social capital within the family was measured in terms of an absence of support from a partner and an additional caregiver. Absence of social capital within the community was measured as lack of interpersonal resources from neighbors and religious activities. Nearly 30% admitted to one or more physically harsh parenting behaviors in the prior year, and 85.8% reported at least one psychologically harsh parenting behavior. Lower levels of neighborhood connectedness were associated with physically harsh parenting (odds ratio = 1.50). Conflict between partners (odd ratio = 2.50) and the absence of an additional caregiver (odds ratio = 1.88) increased psychologically harsh parenting. One practical implication is that mental health and medical providers should help new parents value, access, or develop social networks within the community to prevent children from experiencing harsh parenting. Full article
(This article belongs to the Section Global and Public Health)
Article
Parental Disease Specific Knowledge and Its Impact on Health-Related Quality of Life
Children 2022, 9(1), 98; https://doi.org/10.3390/children9010098 - 11 Jan 2022
Viewed by 299
Abstract
Objective: Structured education programs have been shown to improve somatic outcome and health-related quality of life (HRQOL) in a variety of chronic childhood diseases. Similar data are scarce in paediatric liver transplantation (pLTx). The purpose of this study was to examine the relationship [...] Read more.
Objective: Structured education programs have been shown to improve somatic outcome and health-related quality of life (HRQOL) in a variety of chronic childhood diseases. Similar data are scarce in paediatric liver transplantation (pLTx). The purpose of this study was to examine the relationship of parental disease-specific knowledge and psychosocial disease outcome in patients after pLTx. Methods: Parents of 113 children (chronic liver disease n = 25, after pLTx n = 88) completed the transplant module of the HRQOL questionnaire PedsQL, the “Ulm quality of life inventory for parents of children with chronic diseases” ULQUI, and a tailor-made questionnaire to test disease-specific knowledge. Results: Parental knowledge was highest on the topic of “liver transplantation” and lowest in “basic background knowledge” (76% and 56% correct answers respectively). Knowledge performance was only marginally associated with HRQOL scores, with better knowledge being related to worse HRQOL outcomes. In contrast, self-estimation of knowledge performance showed significant positive correlations with both PedsQL and ULQUI results. Conclusion: Patient HRQOL and parental emotional wellbeing after pLTx are associated with positive self-estimation of parental disease-specific knowledge. Objective disease-specific knowledge has little impact on HRQOL. Parental education programs need to overcome language barriers and address self-efficacy in order to improve HRQOL after pLTx. Full article
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Review
Microcephaly in Neurometabolic Diseases
Children 2022, 9(1), 97; https://doi.org/10.3390/children9010097 - 11 Jan 2022
Cited by 1 | Viewed by 619
Abstract
Neurometabolic disorders are an important group of diseases that mostly occur in neonates and infants. They are mainly due to the lack or dysfunction of an enzyme or cofactors necessary for a specific biochemical reaction, which leads to a deficiency of essential metabolites [...] Read more.
Neurometabolic disorders are an important group of diseases that mostly occur in neonates and infants. They are mainly due to the lack or dysfunction of an enzyme or cofactors necessary for a specific biochemical reaction, which leads to a deficiency of essential metabolites in the brain. This, in turn, can cause certain neurometabolic diseases. Disruption of metabolic pathways, and the inhibition at earlier stages, may lead to the storage of reaction intermediates, which are often toxic to the developing brain. Symptoms are caused by the progressive deterioration of mental, motor, and perceptual functions. The authors review the diseases with microcephaly, which may be one of the most visible signs of neurometabolic disorders. Full article
Article
Orofacial Muscle Weakening in Facioscapulohumeral Muscular Dystrophy (FSHD) Patients
Children 2022, 9(1), 96; https://doi.org/10.3390/children9010096 - 11 Jan 2022
Viewed by 547
Abstract
Background: Facioscapulohumeral muscular dystrophy is the third most commonly found type of muscular dystrophy. The aim of this study was to correlate the D4Z4 repeat array fragment size to the orofacial muscle weakening exhibited in a group of patients with a genetically supported [...] Read more.
Background: Facioscapulohumeral muscular dystrophy is the third most commonly found type of muscular dystrophy. The aim of this study was to correlate the D4Z4 repeat array fragment size to the orofacial muscle weakening exhibited in a group of patients with a genetically supported diagnosis of FSHD. Methods: Molecular genetic analysis was performed for 52 patients (27 female and 25 male) from a group that consisted of 36 patients with autosomal dominant pedigrees and 16 patients with either sporadic or unknown family status. The patients were tested with the southern blotting technique, using EcoRI/Avrll double digestion, and fragments were detected by a p13E-11 telomeric probe. Spearman’s correlation was used to compare the fragment size with the degree of muscle weakening found in the forehead, periocular and perioral muscles. Results: A positive non-significant correlation between the DNA fragment size and severity of muscle weakness was found for the forehead (r = 0.27; p = 0187), the periocular (r = 0.24; p = 0.232) and the left and right perioral (r = 0.29; p = 0.122), (r = 0.32; p = 0.085) muscles. Conclusions: Although FSHD patients exhibited a decrease in muscular activity related to the forehead, perioral, and periocular muscles the genotype–phenotype associations confirmed a weak to moderate non-significant correlation between repeat size and the severity of muscle weakness. Orofacial muscle weakening and its association with a D4Z4 contraction alone may not have the significance to serve as a prognostic biomarker, due to the weak to moderate association. Further studies with larger sample sizes are needed to determine the degree of genetic involvement in the facial growth in FSHD patients. Full article
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Article
To Mask or Not to Mask—Evaluation of Cognitive Performance in Children Wearing Face Masks during School Lessons (MasKids)
Children 2022, 9(1), 95; https://doi.org/10.3390/children9010095 - 11 Jan 2022
Cited by 1 | Viewed by 3230
Abstract
In the current SARS-CoV-2 pandemic, wearing a face mask is mandatory again during school lessons. There are no controlled studies in children to date indicating an effect on cognitive performance from wearing face masks. In a randomized controlled trial, we analysed the influence [...] Read more.
In the current SARS-CoV-2 pandemic, wearing a face mask is mandatory again during school lessons. There are no controlled studies in children to date indicating an effect on cognitive performance from wearing face masks. In a randomized controlled trial, we analysed the influence of face masks on cognitive performance of pupils during regular school lessons. Pupils (n = 133, fifth to seventh grade) were randomized by alternating allocation into control (with masks, n = 65) and intervention groups (without mask, n = 68). After two school lessons with (control) and without (intervention) face masks in class, all pupils performed digital tests for cognitive performance regarding attention and executive functions (switch, Corsi block-tapping, 2-back and flanker task). Overall, there were no significant differences in cognitive performance between both groups, masks vs. no masks. Wearing face masks has no significant influence on attention and executive functions of pupils and can still be recommended during school lessons. Full article
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Article
Enteral Sodium Chloride Supplementation and Fluid Balance in Children Receiving Diuretics
Children 2022, 9(1), 94; https://doi.org/10.3390/children9010094 - 11 Jan 2022
Viewed by 289
Abstract
The use of sodium chloride (NaCl) supplementation in children being prescribed diuretics is controversial due to concerns that supplementation could lead to fluid retention. This is a single-center retrospective study in which fluid balance and diuretic dosing was examined in children prescribed enteral [...] Read more.
The use of sodium chloride (NaCl) supplementation in children being prescribed diuretics is controversial due to concerns that supplementation could lead to fluid retention. This is a single-center retrospective study in which fluid balance and diuretic dosing was examined in children prescribed enteral NaCl supplements for hyponatremia while receiving loop diuretics. The aim of this study was to determine whether significant fluid retention occurred with the addition of NaCl. Fifty-five patients with 68 events were studied. The median age was 5.2 months, and 82% were hospitalized for cardiac disease. Daily fluid balance the seven days prior to NaCl supplementation was lower than the seven days after, with measurement of: median 17 mL/kg/day (7–26) vs. 22 mL/kg/day (13–35) (p = 0.0003). There was no change in patient weight after supplementation (p = 0.63). There was no difference in the median loop diuretic dose before and after supplementation, with the diuretic dose in furosemide equivalents of 3.2 mL/kg/day (2.3–4.4) vs. 3.2 mL/kg/day (2.2–4.7) (p = 0.50). There was no difference in the proportion of patients receiving thiazide diuretics after supplementation (56% before vs. 50% after (p = 0.10)). NaCl supplementation in children receiving loop diuretics increased calculated fluid balance, but weight was unchanged, and this was not associated with an increase in diuretic needs, suggesting clinicians did not consider the increase in fluid balance to be clinically significant. Full article
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Article
Performance of the EQ-5D-Y Interviewer Administered Version in Young Children
Children 2022, 9(1), 93; https://doi.org/10.3390/children9010093 - 10 Jan 2022
Viewed by 297
Abstract
(1) Background: An estimated 78% of South African children aged 9–10 years have not mastered basic reading, therefore potentially excluding them from self-reporting on health-related outcome measures. Thus, the aim of this study was to compare the performance of the EQ-5D-Y-3L self-complete to [...] Read more.
(1) Background: An estimated 78% of South African children aged 9–10 years have not mastered basic reading, therefore potentially excluding them from self-reporting on health-related outcome measures. Thus, the aim of this study was to compare the performance of the EQ-5D-Y-3L self-complete to the newly developed interviewer-administered version in children 8–10 years. (2) Methods: Children (n = 207) with chronic respiratory illnesses, functional disabilities, orthopaedic conditions and from the general population completed the EQ-5D-Y-3L self-complete and interviewer-administered versions, Moods and Feelings Questionnaire (MFQ) and Faces Pain Scale-Revised (FPS-R). A functional independence measure (WeeFIM) was completed by the researcher. (3) Results: The 8-year-olds had significantly higher missing responses (x2 = 14.23, p < 0.001) on the self-complete version. Known-group and concurrent validity were comparable across dimensions, utility and VAS scores for the two versions. The dimensions showed low to moderate convergent validity with similar items on the MFQ, FPS-R and WeeFIM with significantly higher correlations between the interviewer-administered dimensions of Mobility and WeeFIM mobility total (z = 1.91, p = 0.028) and Looking After Myself and WeeFIM self-care total (z = 3.24, p = 0.001). Children preferred the interviewer-administered version (60%) (x2 = 21.87, p < 0.001) with 22% of the reasons attributed to literacy level. (4) Conclusions: The EQ-5D-Y-3L interviewer-administered version is valid and reliable in children aged 8–10 years. The results were comparable to the self-complete version indicating that versions can be used interchangeably. Full article
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Case Report
Cognitive Behavioural Therapy for an Adolescent with Anorexia Nervosa
Children 2022, 9(1), 92; https://doi.org/10.3390/children9010092 - 10 Jan 2022
Viewed by 728
Abstract
Introduction: The treatment of anorexia nervosa remains a matter of much debate. Though cognitive behavioural therapy would seem to offer good results, there is still no resounding evidence pointing to a single treatment of choice. The case presented in this paper examines the [...] Read more.
Introduction: The treatment of anorexia nervosa remains a matter of much debate. Though cognitive behavioural therapy would seem to offer good results, there is still no resounding evidence pointing to a single treatment of choice. The case presented in this paper examines the treatment with CBT of a patient presenting anorexia nervosa. Evaluation/diagnosis: An adolescent girl, 17 years of age, voluntarily attends psychological therapy to address eating behaviour problems. After administering the EAT-26, EDI-2, and BSQ standardised screening tests, as well as a clinical interview for assessment, a psychopathological profile is obtained, providing a diagnosis of anorexia nervosa, restricting subtype. Therapeutic goals: The therapeutic goals set were to reach a healthy weight for the patient’s age and height (specified as a minimum BMI of 18.5) and change the structure of thoughts, feelings, and behaviour that was justifying and maintaining the disorder. Treatment: Treatment lasted for 33 sessions and used cognitive behavioural techniques, such as cognitive restructuring, response cost, and positive reinforcement, in addition to family intervention techniques. Nutrition therapy was also carried out in parallel to the treatment sessions. Results: Following eight months of weekly sessions, the patient reached the target weight and changed attitudes towards food and body image, replacing them with healthy thoughts and behaviours. Follow-up made one and two years after the end of the treatment saw that these results were maintained. Discussion and conclusions: In this case, CBT proved effective in achieving the patient’s physical and psychological recovery. Therefore, this case contributes to the evidence of the efficacy of this therapeutic approach in certain cases of ED. Full article
(This article belongs to the Special Issue Eating Disorders and Obesity in Children and Adolescents)
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Review
Questionnaires Assessing Adolescents’ Self-Concept, Self-Perception, Physical Activity and Lifestyle: A Systematic Review
Children 2022, 9(1), 91; https://doi.org/10.3390/children9010091 - 10 Jan 2022
Cited by 1 | Viewed by 703
Abstract
Introduction: Adolescence is considered a fundamental time to promote change. During this time, young people consolidate their social and individual identity. By influencing positive changes, chronic diseases can be avoided, delayed or modified in the future. The use of valid and reliable questionnaires [...] Read more.
Introduction: Adolescence is considered a fundamental time to promote change. During this time, young people consolidate their social and individual identity. By influencing positive changes, chronic diseases can be avoided, delayed or modified in the future. The use of valid and reliable questionnaires is an optimal resource for gathering information and thus useful for this study. Objectives: The objectives of the study were to: (1). identify the questionnaires that assess self-esteem/self-concept, self-perception, physical exercise and lifestyle of adolescents; (2). analyse the psychometric measures of the questionnaires used to assess the self-esteem/self-concept, self-perception, physical exercise and lifestyle of adolescents; and (3). determine which questionnaires are the most reliable and valid for assessing the self-esteem/self-concept, self-perception, physical exercise and lifestyle of adolescents. Method: A bibliographic search was carried out in the following databases: Virtual Health Library, Cochrane, Medline, Cuiden, Scielo, Dialnet, PubMed and Ministry of Health, Consumption and Social Welfare following the PICO method. The recommendations of the PRISMA statement were followed. Results: A total of 71 scientific articles were collected. Within the self-perception/self-concept questionnaires, the Rosenberg Self-Esteem Scale stands out for being an optimal and widely used resource in adolescents. Regarding the questionnaires that evaluate self-perception, the General Health Questionnaire is the most used; it is used in numerous national health surveys in different countries. The Physical Activity Questionnaire for Adolescents ranks first with respect to the rest of the tools. It is a widely used resource internationally and provides enough information on the physical activity carried out by the subject in a given week. Although there are several questionnaires that measure lifestyle, the Health Behavior in School-aged Children instrument was selected. This instrument is at the European level and involves the collaboration of 48 countries and allows us to compare the lifestyle habits of adolescents from different countries. Discussion: The questionnaire that stands out in the assessment of self-esteem/self-concept is the Rosenberg Self-Esteem Scale. The General Health Questionnaire has been selected as the best tool for assessing self-perception. To measure physical exercise, the Physical Activity Questionnaire for Adolescents is identified as the ideal instrument because it is widely used and can be completed quickly. Regarding lifestyle, the Health Behavior in School aged Children is shown to be an effective instrument in assessing lifestyle. Full article
(This article belongs to the Special Issue Children's Body Image, Physical Activity and Health)
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Article
Early Developmental Signs in Children with Autism Spectrum Disorder: Results from the Japan Environment and Children’s Study
Children 2022, 9(1), 90; https://doi.org/10.3390/children9010090 - 10 Jan 2022
Viewed by 449
Abstract
Autism spectrum disorder (ASD) is a developmental disability in early childhood. Early identification and intervention in children with ASD are essential for children and their families. This study aimed to identify the earliest signs of ASD. Using a large cohort including data from [...] Read more.
Autism spectrum disorder (ASD) is a developmental disability in early childhood. Early identification and intervention in children with ASD are essential for children and their families. This study aimed to identify the earliest signs of ASD. Using a large cohort including data from 104,062 fetal records in the Japan Environment and Children’s Study, we examined the Ages and Stages Questionnaires® (ASQ-3TM) scores of children with and without ASD. The ASQ-3 comprises five domains: communication, gross motor, fine motor, problem solving, and personal-social. The ASQ-3 scores were obtained at ages 6 months, 1 year, and 3 years. There were 64,501 children with available ASQ-3 data. The number of children diagnosed with ASD was 188 (0.29%) at 3 years of age. The highest relative risk (RR) for any domain below the monitoring score at 6 months was in the communication (RR 1.90, 95% CI 1.29–2.78, p = 0.0041), followed by fine motor (RR 1.50, 95% CI 1.28–1.76, p < 0.0001) domain. A low ASQ-3 score in the communication domain at 6 months was related to an ASD diagnosis at 3 years of age. The ASQ-3 score at 6 months can contribute to the early identification of and intervention for ASD. Full article
(This article belongs to the Section Child Neurology)
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