Children

20 pages, 612 KiB

Open AccessArticle

Characteristics of Anemia in Children Aged 6 Months to 5 Years Attending External Consultations at a Pediatric Hospital in Lisbon, Portugal

by Réka Maulide Cane, Sérgio Chicumbe, Youssouf Keita, Anaxore Casimiro, Bárbara Martins Saraiva, Joana Vasconcelos, Beatriz Luzio Vaz, Afonso Sousa, Mafalda Cabral, Francisco Branco Caetano, Luís Varandas and Isabel Craveiro

Children 2025, 12(7), 832; https://doi.org/10.3390/children12070832 - 24 Jun 2025

Abstract

Background/Objectives: Childhood anemia remains a serious public health issue, negatively affecting cognitive and psychomotor development, with repercussions on school performance and adult productivity. This study aimed to characterize the profile of children aged 6 months to 5 years diagnosed with or at risk [...] Read more.

Background/Objectives: Childhood anemia remains a serious public health issue, negatively affecting cognitive and psychomotor development, with repercussions on school performance and adult productivity. This study aimed to characterize the profile of children aged 6 months to 5 years diagnosed with or at risk of anemia who attended a pediatric hospital in Lisbon, Portugal. Methods: A hospital-based, cross-sectional descriptive study was conducted from September 2023 to September 2024. Descriptive statistics, including frequency distributions and cross-tabulations, summarized participant characteristics and key variables. Results: We observed that 33.3% (74/222) of the children were either anemic or at risk of anemia. Among these, 93.2% (69/74) were confirmed anemic or at risk based on hemoglobin levels. Five children (6.8%) had normal hemoglobin but abnormal red-cell indices, with microcytic (60.0%; 3/5) or normocytic (40.0%; 2/5) patterns. Anemia rates were higher in males (55.1%), children aged 24–59 months, those residing in the Metropolitan Lisbon Area (82.6%), children whose caregivers had only basic or secondary education (58.0%), and those whose mothers were born in foreign countries (48.4%). Microcytic red-cell indices were observed in 63.1% of cases. Serum iron results indicated that 32.0% were pre-anemic and 40.0% anemic. Ferritin levels showed iron-deficiency anemia in 22.2% of tested cases. In addition, 33.3% carried the sickle cell trait, and 35.0% had elevated C-reactive protein, suggesting anemia of inflammation. Conclusions: Anemia is a moderate public health issue, mainly affecting children with less-educated caregivers and migrant mothers. Targeted public health actions, including systematic screening, caregiver education, and multiculturally sensitive interventions, are crucial to address anemia. Full article

(This article belongs to the Section Pediatric Hematology & Oncology)

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12 pages, 847 KiB

Open AccessReview

The Impact of Physical Activity on Clinical Outcomes in Children with Cystic Fibrosis: A Narrative Review

by Chiara Rosolia Capasso, Antonio Luca Miniato, Paola Di Filippo, Armando Di Ludovico, Sabrina Di Pillo, Francesco Chiarelli, Giuseppe Francesco Sferrazza Papa and Marina Attanasi

Children 2025, 12(7), 831; https://doi.org/10.3390/children12070831 - 23 Jun 2025

Abstract

Background: Cystic fibrosis (CF) is a chronic genetic disease marked by progressive lung function decline and increased respiratory infections. Emerging evidence supports the role of physical exercise in improving lung function, aerobic capacity, and quality of life in pediatric CF patients. Methods: We [...] Read more.

Background: Cystic fibrosis (CF) is a chronic genetic disease marked by progressive lung function decline and increased respiratory infections. Emerging evidence supports the role of physical exercise in improving lung function, aerobic capacity, and quality of life in pediatric CF patients. Methods: We reviewed randomized clinical trials and observational studies from the last ten years, sourced from PubMed and Google Scholar. Included studies involved children and adolescents (0–18 years) with CF and assessed physical exercise as a primary intervention to improve lung function, aerobic fitness, quality of life, or hospitalization rates. Results: Aerobic training, particularly when combined with strength training, improves cardiorespiratory fitness and muscle strength without compromising nutritional status. High-Intensity Interval Training and Inspiratory Muscle Training show potential but need further validation. Supervised, personalized exercise programs are key to promoting adherence and optimizing outcomes. Conclusions: Exercise-based interventions in pediatric CF should evolve toward personalized, technology-enhanced, and sustainable models. Integrating wearable devices, adapting programs to individual needs, and leveraging early parental involvement may enhance engagement and outcomes, especially in the era of CFTR modulator therapies. Full article

(This article belongs to the Special Issue Lung Function and Respiratory Diseases in Children and Infants)

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15 pages, 337 KiB

Open AccessArticle

Effects of Integrated Neuromuscular Training on Physical Fitness in Badminton Athletes of Different Maturity Statuses

by Ming-Chia Weng, Xiang Dai, Chih-Hui Chiu, Chien-Chang Ho, Chia-Cheng Liu, Shuo-Min Hsu and Che-Hsiu Chen

Children 2025, 12(7), 830; https://doi.org/10.3390/children12070830 - 23 Jun 2025

Abstract

Background/Objectives: Dominant leg use in badminton may contribute to lower limb asymmetry, potentially affecting performance and injury risk. This study investigated the effects of a 12-week integrated neuromuscular training (NMT) program on sports performance. Methods: Twenty-four well-trained male badminton players (age: 13.5 ± [...] Read more.

Background/Objectives: Dominant leg use in badminton may contribute to lower limb asymmetry, potentially affecting performance and injury risk. This study investigated the effects of a 12-week integrated neuromuscular training (NMT) program on sports performance. Methods: Twenty-four well-trained male badminton players (age: 13.5 ± 1.15 years) were randomly assigned to groups based on maturation status (pre-peak height velocity [pre-PHV] and post-peak height velocity [post-PHV]; n = 12 each). All participants completed two NMT sessions weekly. Pre- and post-training assessments included a 20 m sprint, countermovement jump (CMJ), agility t-text, hexagon test, and Y-balance test. Results: Both groups improved significantly across most tests. The post-PHV group (ES: 0.70–1.35) showed greater improvements in sprinting, CMJ, and agility, while the pre-PHV group (ES: 0.39–1.23) improved more in balance and asymmetry. Conclusions: These results underscore the need for age- and maturity-specific training strategies to optimize performance and address asymmetries in youth athletes. Full article

(This article belongs to the Section Pediatric Orthopedics & Sports Medicine)

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14 pages, 237 KiB

Open AccessArticle

Child Maltreatment and the Mediating Effects of Bullying Victimization on School Engagement Among South Korean Youth in Orphanages and a National Sample

by Sunghwan Cho, Seon Kim, Hollee A. McGinnis and Traci L. Wike

Children 2025, 12(7), 829; https://doi.org/10.3390/children12070829 - 23 Jun 2025

Abstract

Background: Peer bullying is a global problem affecting youth around the world that can impact youth development including school engagement. The relationship between child maltreatment and school bullying victimization and perpetration is well known. However, few studies have explored the extent of bullying [...] Read more.

Background: Peer bullying is a global problem affecting youth around the world that can impact youth development including school engagement. The relationship between child maltreatment and school bullying victimization and perpetration is well known. However, few studies have explored the extent of bullying among vulnerable groups of adolescents. Youth in orphanage care may be at higher risk of both maltreatment and bullying because of the circumstances and stigma that brought them into care. This study aimed to examine peer bullying victimization among adolescents residing in orphanage care compared to a national sample of adolescents in South Korea, and to investigate the mediating effect of bullying victimization on the relationship between child maltreatment and school engagement. This comparison allowed for an examination of how caregiving contexts may differentially influence the impact of maltreatment and bullying on school engagement. Methods: Data from the national Korean Welfare Panel Study (KoWePS) 7th wave (n = 521) and a study of 153 South Korean adolescents in orphanage care were merged into one dataset (n = 675). Analysis included descriptive and bivariate statistics, two simple mediation analyses, and multiple regression analysis to verify mediation effects using PROCESS Macro. Results: Adolescents in orphanage care reported significantly higher bullying victimization and lower school engagement than the national sample. Negative correlations were identified between child maltreatment, bullying victimization, and school engagement among adolescents in orphanage care. Importantly, bullying victimization significantly mediated the relationship between child maltreatment and school engagement within this group. Conclusions: These findings highlight the complex relationship between maltreatment and bullying victimization, emphasizing the need for comprehensive interventions addressing both maltreatment and peer bullying to enhance school engagement among vulnerable youth. Full article

(This article belongs to the Section Pediatric Mental Health)

12 pages, 756 KiB

Open AccessArticle

Continuous Renal Replacement Therapy in Critically-Ill Term and Preterm Newborns: A Single-Center Study in Belgrade

by Snezana Rsovac, Katarina Milosevic, Brankica Spasojevic, Mirjana Cvetkovic, Gordana Milosevski Lomic, Biljana Medjo, Mina G. Cobeljic, Nadja Vukasinovic, Vesna Selakovic, Dusan Todorovic, Masa Petrovic, Davor Plavec and Jasna Kalanj

Children 2025, 12(7), 828; https://doi.org/10.3390/children12070828 - 23 Jun 2025

Abstract

Background/Objectives: Continuous renal replacement therapy (CRRT) is an important treatment method that is becoming a commonly-used procedure in neonatal intensive care units (NICUs), especially in critically-ill neonates. Methods: We conducted a retrospective study aimed to evaluate factors influencing the outcomes of CRRT in [...] Read more.

Background/Objectives: Continuous renal replacement therapy (CRRT) is an important treatment method that is becoming a commonly-used procedure in neonatal intensive care units (NICUs), especially in critically-ill neonates. Methods: We conducted a retrospective study aimed to evaluate factors influencing the outcomes of CRRT in neonates and preterm infants. The study analyzed data from 41 newborns treated with CRRT at our NICU over a ten-year period. Demographic, clinical, and laboratory parameters were assessed, including gestational age, birth weight, PRISM III score, and laboratory markers like urea, creatinine, and potassium levels, as well as characteristics of CRRT. Results: Our research found that the duration of CRRT, the presence of anuria, and higher potassium levels after initiation of CRRT were significant predictors of a poor outcome. Despite the lack of significant correlation between demographic characteristics, PRISM III score and the outcome, our findings highlight the importance of timely CRRT initiation and efficient management to improve survival. Conclusions: Our study identified several significant prognostic indicators in neonates undergoing renal replacement therapy. While these findings provide valuable insights, further research is needed to establish clear theoretical guidelines and improve clinical decision-making. Full article

(This article belongs to the Special Issue Providing Care for Preterm Infants)

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26 pages, 1204 KiB

Open AccessArticle

Rights-Based Priorities for Children with SEND in the Post-COVID-19 Era: A Multi-Method, Multi-Phased, Multi-Stakeholder Consensus Approach

by Emma Ashworth, Lucy Bray, Amel Alghrani, Seamus Byrne and Joanna Kirkby

Children 2025, 12(7), 827; https://doi.org/10.3390/children12070827 - 23 Jun 2025

Abstract

Background: The provision of education, health, and social care for children with special educational needs and disabilities (SEND) in England has long been criticised for its inequities and chronic underfunding. These systemic issues were further exacerbated by the onset of the COVID-19 pandemic [...] Read more.

Background: The provision of education, health, and social care for children with special educational needs and disabilities (SEND) in England has long been criticised for its inequities and chronic underfunding. These systemic issues were further exacerbated by the onset of the COVID-19 pandemic and the accompanying restrictions, which disrupted essential services and resulted in widespread unmet needs and infringements on the rights of many children with SEND. This study aimed to use a three-phase consensus-building approach with 1353 participants across five stakeholder groups to collaboratively develop evidence-informed priorities for policy and practice. The priorities sought to help address the longstanding disparities and respond to the intensified challenges brought about by the pandemic. Methods: A total of 55 children with SEND (aged 5–16), 893 parents/carers, and 307 professionals working in SEND-related services participated in the first phase through online surveys. This was followed by semi-structured interviews with four children and young people, ten parents/carers, and 15 professionals, allowing for deeper exploration of lived experiences and priorities. The data were analysed, synthesised, and structured into five overarching areas of priority. These were subsequently discussed and refined in a series of activity-based group workshops involving 20 children with SEND, 11 parents/carers, and 38 professionals. Results and Conclusions: The consensus-building process led to the identification of key priorities for both pandemic response and longer-term recovery, highlighting the responsibilities of central Government and statutory services to consider and meet the needs of children with SEND. These priorities are framed within a children’s rights context and considered against the rights and duties set out in the United Nations Convention on the Rights of the Child (1989). Priorities include protecting and promoting children with SEND’s rights to (1) play, socialise, and be part of a community, (2) receive support for their social and emotional wellbeing and mental health, (3) feel safe, belong, and learn in school, (4) access health social care services and therapies, and (5) receive support for their parents/carers and families. Together, they highlight the urgent need for structural reform to ensure that children with SEND receive the support they are entitled to—not only in times of crisis but as a matter of routine practice and policy. Full article

(This article belongs to the Section Global Pediatric Health)

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20 pages, 652 KiB

Open AccessArticle

Mindfulness-Based Intervention in Schools: Addressing Social Media Burnout and Enhancing Well-Being in Adolescents

by Süleyman Ünlü, Kıvanç Uzun and Gökmen Arslan

Children 2025, 12(7), 826; https://doi.org/10.3390/children12070826 - 23 Jun 2025

Abstract

Background: This study examined the effectiveness of a mindfulness-based psychoeducational intervention in addressing social media burnout and enhancing subjective well-being among adolescents. Methods: A total of 138 high school students in Türkiye were screened, and 32 were randomly assigned to either an experimental [...] Read more.

Background: This study examined the effectiveness of a mindfulness-based psychoeducational intervention in addressing social media burnout and enhancing subjective well-being among adolescents. Methods: A total of 138 high school students in Türkiye were screened, and 32 were randomly assigned to either an experimental group (n = 16) receiving a six-week intervention or a control group (n = 16) receiving no treatment. The intervention included weekly sessions focused on present-moment awareness, digital detox strategies, emotional regulation, and self-compassion. Data were collected using self-report scales measuring social media burnout and subjective well-being, and were analyzed using non-parametric statistical tests, including the Mann–Whitney U test and the Wilcoxon Signed-Rank test. Results: The results demonstrated significant improvements in the experimental group, including reduced burnout and enhanced well-being, with the effects sustained at a 30-day follow-up. Conclusions: These findings suggest that school-based mindfulness programs can serve as effective and scalable tools to foster psychological resilience and digital well-being in adolescents. Full article

(This article belongs to the Section Pediatric Mental Health)

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17 pages, 1028 KiB

Open AccessArticle

Parental Marital Quality and School Bullying Victimization: A Moderated Mediation Model of Parent–Child Attachment and Child Gender

by Guojie Peng, Qiwen Liang, Siying Li, Xin Li, Weiqi Mu and Mingjie Zhou

Children 2025, 12(7), 825; https://doi.org/10.3390/children12070825 - 23 Jun 2025

Abstract

Background/Objectives: School bullying is a significant issue that negatively impacts children’s well-being, emphasizing the need to identify family-related factors contributing to bullying victimization. This study explored the potential link between parental marital quality and school bullying victimization by employing a moderated mediation [...] Read more.

Background/Objectives: School bullying is a significant issue that negatively impacts children’s well-being, emphasizing the need to identify family-related factors contributing to bullying victimization. This study explored the potential link between parental marital quality and school bullying victimization by employing a moderated mediation model. Methods: Parent–child attachment, measured separately as father–child and mother–child attachment, was tested as a mediator, with child gender included as a moderator. Data were collected from both children and their mothers, comprising 358 mother–child pairs recruited from three primary schools in suburban Beijing, China. Results: Results revealed that greater parental marital quality was associated with a lower risk of bullying victimization, with father–child attachment mediating this relationship. Furthermore, child gender moderated the mediating effect of father–child attachment, such that the indirect pathway from parental marital quality to bullying victimization through father–child attachment was statistically significant for girls but not for boys. Conclusions: These findings highlight the importance of father–child attachment in preventing bullying victimization and suggest that gender-sensitive implications may be necessary. Full article

(This article belongs to the Special Issue Advances in Child–Parent Attachment and Children's Peer Relations)

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20 pages, 619 KiB

Open AccessArticle

Impact of Parental Knowledge on Prevention Risk of Caries in Seville Children Between 6 and 14 Years Old, Applying the CAMBRA Protocol

by Esther Pérez de Mora, José María Barrera-Mora, Marcela Arenas-González, Asunción Mendoza-Mendoza and David Ribas-Pérez

Children 2025, 12(7), 824; https://doi.org/10.3390/children12070824 - 23 Jun 2025

Abstract

Background/Objectives: To explore the association between parental knowledge on dental caries prevention and the risk of caries in pediatric patients aged 6 to 14 years who reside in the province of Seville, using the CAMBRA preventive protocol as an assessment tool. Methods [...] Read more.

Background/Objectives: To explore the association between parental knowledge on dental caries prevention and the risk of caries in pediatric patients aged 6 to 14 years who reside in the province of Seville, using the CAMBRA preventive protocol as an assessment tool. Methods: After the approval granted by the Ethics Committee, a descriptive and analytical observational study was conducted. Caries risk was established using the CAMBRA Questionnaire, pH measurement, and salivary flow rate. To assess the socioeconomic background of the patients and their hygiene and dietary habits, parents completed two surveys: the first about the quality of the patient’s diet, and the second directly related to the CAMBRA questionnaire used and validated by the University of Seville. Results: The final study sample consisted of 300 pediatric patients, aged 6 to 14 years, of whom 54% were boys and 46% were girls. The caries risk distribution was as follows: 33% low, 7% moderate, 48.6% high, and 11.3%. A total of 61.7% of the participants live in urban areas, while 38.3% are from peri-urban regions. There is a statistically significant association between socioeconomic status and family circumstances in children with a risk of caries. Furthermore, an association was established between caries risk, dietary habits, and oral hygiene. Conclusions: Parental knowledge about dental caries prevention and caries risk in children was found to have a strong association with reduced caries risk in children. Full article

(This article belongs to the Collection Advance in Pediatric Dentistry)

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17 pages, 266 KiB

Open AccessArticle

Sociodemographic Status, Dietary Intake, and Physical Activity in Relation to Body Mass Index Among Female Adolescents in Saudi Arabia

by Leila Arfaoui, Afnan Alghanmi, Ruba Alamri, Nouf Aljehani, Areej Alkhaldy and Mourad Assidi

Children 2025, 12(7), 823; https://doi.org/10.3390/children12070823 - 22 Jun 2025

Abstract

Background: Sociodemographic status, dietary intake, and physical activity have been linked to body mass index (BMI) among adolescents. However, there is a scarcity of research investigating these factors in relation to BMI standard deviation score (BMI_SDS) in Saudi Arabia. Therefore, we [...] Read more.

Background: Sociodemographic status, dietary intake, and physical activity have been linked to body mass index (BMI) among adolescents. However, there is a scarcity of research investigating these factors in relation to BMI standard deviation score (BMI_SDS) in Saudi Arabia. Therefore, we examined the roles of sociodemographic status, dietary habits, and physical activity in relation to body mass index among Saudi female adolescents aged 11–18 years attending public and private schools in the city of Jeddah. Methods: This school-based cross-sectional study was performed between February and April 2019 in Jeddah. A total of 920 female adolescent students were recruited from both public and private schools. Data was collected using questionnaires conducted via interview as well as anthropometric measurements. Results: About 37.4% (n = 344) of the participants were overweight or obese. The majority of the participants (61.6%, n = 567) had a healthy dietary intake score. More than half of the participants (52.6%, n = 484) had a low physical activity and screen time score, with 36.5% (n = 336) never engaging in ≥60 min of physical activity per day and 61.4% (n = 565) reporting a daily screen time of >4 h. Multivariate logistic regression analysis revealed that students aged over 16 years were less likely to have overweight/obesity compared to those aged <14 years (adjusted odds ratio “aOR” = 0.53; 95% CI: 0.35–0.79, p = 0.002). Participants enrolled in private schools were at higher risk of being overweight/obese compared to those enrolled in public schools (aOR = 1.55; 95% CI: 1.16–2.08, p = 0.003). Adolescent females with daily vegetable intake were less likely than those who never consumed vegetables to be overweight or obese (aOR = 0.47; 95% CI: 0.29–0.77, p = 0.002). However, no associations were found with the other sociodemographic, dietary intake, physical activity, and screen time exposure variables. Conclusions: This study shows a trend of elevated obesity prevalence among Saudi female adolescents in Jeddah, highlighting the need for gender-sensitive, school- and community-based interventions targeting diet, physical activity, and sedentary behavior. To obtain a more comprehensive understanding, studies involving nationally representative samples, encompassing all cities across Saudi Arabia and exploring broader aspects of nutrition and physical activity, are essential. Full article

(This article belongs to the Special Issue Nutritional Status and Eating Patterns in Children and Adolescents: Prevalence, Screening and Prevention of Metabolic Disorders)

15 pages, 218 KiB

Open AccessArticle

Patient-Reported Disease Presentation, Interventions, and Outcomes in United States Pregnancies Affected by Alloimmunization at Risk of Hemolytic Disease of the Fetus and Newborn

by Molly R. Sherwood, Bethany M. Weathersby, Marion E. Granger Howard and Kara B. Markham

Children 2025, 12(7), 822; https://doi.org/10.3390/children12070822 - 22 Jun 2025

Abstract

Background/Objectives: Pregnancies complicated by red cell alloimmunization can progress to hemolytic disease of the fetus and newborn (HDFN), requiring close monitoring and timely intervention to prevent fetal/neonatal morbidity and mortality. This study investigated disease presentation, interventions, and outcomes in respondents with a history [...] Read more.

Background/Objectives: Pregnancies complicated by red cell alloimmunization can progress to hemolytic disease of the fetus and newborn (HDFN), requiring close monitoring and timely intervention to prevent fetal/neonatal morbidity and mortality. This study investigated disease presentation, interventions, and outcomes in respondents with a history of alloimmunized pregnancy. Methods: This was a retrospective cross-sectional survey study administered online to alloimmunized patients between November 2022–February 2023. A total of 127 participants reported on 200 alloimmunized pregnancies. Distribution of pregnancy characteristics, antibodies and titers, monitoring, treatments and fetal outcomes were described and stratified where appropriate by fetal antigen status and disease severity. Outcomes and management practices in subsequent pregnancies following fetal loss to HDFN are reported. Results: Multiple antibodies were present in 42% of pregnancies with known antibody type (80/192). Titers reached critical levels (any titer for Anti-K; ≥16 for all other antibodies) in 71% (125/176) of pregnancies where titer was reported. Among fetal antigen positive pregnancies with critical titers, intrauterine transfusions were conducted in 40% (42/106), intravenous immunoglobulin was administered in 14% (15/106), plasmapheresis in 7% (7/106), and phenobarbital in 9% (9/106). Complications from transfusion were reported in 38% of pregnancies receiving intrauterine transfusion (17/45). Fetal death due to HDFN or complications from intrauterine transfusion was reported in 9% of antigen positive pregnancies with critical titers (10/106) and 16% of pregnancies receiving intrauterine transfusion (7/45). Conclusions: Disease presentation and severity complements previous research in this disease population, however, monitoring practices were diverse. Fetal death and intrauterine complication rates were higher than those previously reported in large international referral centers. Development of best practices and centralized referral centers may improve disease outcomes. Full article

(This article belongs to the Special Issue Genetics and Precision Medicine with Hematologic Diseases in Children)

16 pages, 978 KiB

Open AccessArticle

Sex-Specific Associations of Childhood BMI Patterns with Cardiometabolic Risk: An 11-Year Korean Longitudinal Study

by Hyo-Jin Kim, Sarang Jeong, Joo Hyun Lim and Dankyu Yoon

Children 2025, 12(7), 821; https://doi.org/10.3390/children12070821 - 21 Jun 2025

Abstract

Background/Objectives: Childhood overweight/obesity status is a critical risk factor for adverse cardiometabolic outcomes. We aimed to evaluate the sex-specific associations between a maintained childhood overweight status and late-adolescent cardiometabolic risk factors using data from a Korean longitudinal study. Methods: We used data [...] Read more.

Background/Objectives: Childhood overweight/obesity status is a critical risk factor for adverse cardiometabolic outcomes. We aimed to evaluate the sex-specific associations between a maintained childhood overweight status and late-adolescent cardiometabolic risk factors using data from a Korean longitudinal study. Methods: We used data from the Korean Children-Adolescents Study, a prospective cohort of children enrolled at age 7 and followed annually from 2005 to 2020. Among participants who were followed at least once, a total of 899 children (438 boys, 461 girls) with consistent body mass index (BMI) status at ages 7–9 and 10–12 were included in the analysis. Participants were categorized into two groups on the basis of BMI: normal weight maintenance and overweight maintenance. Multivariable linear regression was used to examine the associations between BMI patterns and cardiometabolic risk factors, with adjustments for covariates. Results: Among the 899 children (mean age: 7.1 ± 0.4 years, 48.7% boys), 12.8% of boys and 5.9% of girls were classified into the overweight maintenance group. Boys in the overweight maintenance group had significantly greater BMIs, waist circumferences (WC), body fat percentages, trunk fat mass, and aspartate aminotransferase and alanine aminotransferase levels at ages 15 and 18. Girls in the same group had elevated BMI, WC, body fat percentage, trunk fat mass, and blood pressure and experienced earlier pubertal onset. Conclusions: Maintaining an overweight status during childhood is associated with adverse cardiometabolic profiles in adolescence, with sex-specific differences. These findings highlight the importance of early, sex-specific interventions to prevent long-term health risks associated with childhood obesity. Full article

(This article belongs to the Section Pediatric Endocrinology & Diabetes)

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16 pages, 1474 KiB

Open AccessArticle

Effects of Video-Guided Active Breaks on Motor Competence of Schoolchildren with Special Education Needs

by Alejandra Robles-Campos, Daniel Reyes-Molina, Karen Kracht-Suazo, Igor Cigarroa, Jaime Cárcamo-Oyarzun, Nicolas Martinez-Lopez, Margarita Perez-Ruiz, Alberto Grao-Cruces, Jorge Mota, Alberto Ruiz-Ariza, Fernando Muñoz Hinrichsen, Guillermo García-Pérez-de-Sevilla, Carlos Celis-Morales and Rafael Zapata-Lamana

Children 2025, 12(7), 820; https://doi.org/10.3390/children12070820 - 21 Jun 2025

Abstract

Background: The development of motor competencies in childhood can enhance the trajectory of physical activity throughout life. However, few studies have examined the effects of physical activity programs on motor competencies in schoolchildren with special educational needs. Aim: Our aim was to analyze [...] Read more.

Background: The development of motor competencies in childhood can enhance the trajectory of physical activity throughout life. However, few studies have examined the effects of physical activity programs on motor competencies in schoolchildren with special educational needs. Aim: Our aim was to analyze the effects of a video-guided active break program on motor competencies in schoolchildren aged 6 to 10 years with special educational needs. Methods: A prespecified subanalysis of a multicenter randomized controlled trial was conducted with a sample of 161 schoolchildren (7.8 ± 1.1 years, 32% girls) with special educational needs from five public schools in Chile. Participants were assigned to a control group (CG, n = 85) with no active breaks or an experimental group (EG, n = 76) with active breaks. A 12-week video-guided active break program was implemented in the classroom twice daily, five days per week. The intervention was delivered via a web-based platform. Basic motor competencies were assessed using the MOBAK 1–2 and MOBAK 3–4 tests. Results: A significant time × group interaction was found for object control, F(1154) = 11.365, p < 0.001, η²_p = 0.011; jumping, F(1154) = 11.047, p = 0.001, η²_p = 0.067; and running, F(1154) = 4.881, p = 0.029, η²_p = 0.031. These results indicate that the experimental group showed significantly greater improvements in object control, jumping, and running abilities compared to the control group. Conclusions: The active break program significantly improved motor skills in schoolchildren with special educational needs. The program proved to be both feasible and effective in enhancing students’ motor competencies. School-based guided active break programs may play a role in promoting motor competencies among schoolchildren with special educational needs. Clinical Trial ID NCT06423404 Full article

(This article belongs to the Section Global Pediatric Health)

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10 pages, 2149 KiB

Open AccessArticle

A Prospective Study on the Systematic Application of the Safe Insertion Umbilical Venous Catheter (SIUVeC) Bundle

by Giovanni Barone, Gina Ancora, Mauro Pittiruti, Giorgia Prontera, Giovanni Vento and Vito D’Andrea

Children 2025, 12(7), 819; https://doi.org/10.3390/children12070819 - 21 Jun 2025

Abstract

Background/Objectives: Inserting umbilical venous catheters is a common procedure in neonatal intensive care units. However, this maneuver is potentially associated with early and late complications, some of which can be severe. Several strategies have been described in the literature to minimize the [...] Read more.

Background/Objectives: Inserting umbilical venous catheters is a common procedure in neonatal intensive care units. However, this maneuver is potentially associated with early and late complications, some of which can be severe. Several strategies have been described in the literature to minimize the risk of such complications. The recently described SIUVeC (Safe Insertion Umbilical Venous Catheter) protocol incorporates all the innovations suggested by the latest literature, with the intention of reducing the risk associated with this procedure. The purpose of this paper is to report the outcomes of the systematic implementation of this protocol. Methods: Infants were enrolled in this prospective study if they were eligible for umbilical venous catheter placement. Results: A total of 449 infants were enrolled in the study. In total, 407 (90.6%) catheters were successfully placed in the proper position, at the inferior cavo–atrial junction. A total of 89.9% of the catheters were removed electively, without any complications. Conclusions: The SIUVeC protocol demonstrates an effective strategy for the safe elective insertion of umbilical venous catheters. Full article

(This article belongs to the Special Issue Advances in Neonatal Resuscitation and Intensive Care)

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11 pages, 437 KiB

Open AccessArticle

Retrospective Analysis on the Impact of Triptorelin on Final Height of Girls with Precocious and Early Puberty: A Single-Center, Long-Term Study

by Georgia Sotiriou, Anastasios Serbis, Assimina Galli-Tsinopoulou and Athanasios Christoforidis

Children 2025, 12(7), 818; https://doi.org/10.3390/children12070818 - 21 Jun 2025

Abstract

Background/Objectives: To evaluate the effect of triptorelin on final height of girls with precocious or early puberty, compared to the untreated group, and to investigate factors that contribute to its maximum effectiveness in terms of final height. Methods: We collected for the last [...] Read more.

Background/Objectives: To evaluate the effect of triptorelin on final height of girls with precocious or early puberty, compared to the untreated group, and to investigate factors that contribute to its maximum effectiveness in terms of final height. Methods: We collected for the last two decades the data of patients evaluated in our Pediatric Endocrinology Clinic for precocious (PP) (thelarche before 8 years of age) or early puberty (EP) (thelarche before 9 years of age) during the last two decades. Our final set included 178 girls (85 with precocious and 93 with early puberty, of whom 85 received triptorelin). Final heights, measured and documented by health professionals, and the exact date of menarche were collected after telephone communication. Logistic regression analysis assessed the effect of various parameters on the response to treatment. Results: Τhe difference in mean standard deviation (ΔSDS) of final and midparental height did not show significant difference between treated and untreated girls (ΔHeight SDS (Final − Midparental): −0.20 ± 0.89 vs. −0.28 ± 0.83, p = 0.243). The results were similar when we compared the EP (−0.22 ± 0.71 vs. −0.17 ± 0.83, p = 0.778) and PP (−0.19 ± 1.04 vs. −0.39 ± 0.83, p = 0.315) subgroups. Menarche occurred earlier in the PP group compared to the EP group (10.68 ± 1.22 vs. 11.12 ± 0.90 years, p = 0.005) and in the untreated compared to the treated group (10.31 ± 0.91 vs. 11.57 ± 0.06 years, p < 0.001 for EP, 11.53 ± 0.90 vs. 9.86 ± 0.86 years, p < 0.001 for PP). Predictors of final height were height at diagnosis (positively correlated), midparental height, and bone age at diagnosis (negatively correlated). Conclusions: There was no significant difference in final height between treated and untreated girls. Triptorelin was effective in delaying the onset of menarche. Factors contributing to a better final height in treated girls were higher height at baseline, lower midparental height, and younger bone age. Full article

(This article belongs to the Section Pediatric Endocrinology & Diabetes)

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21 pages, 2641 KiB

Open AccessArticle

Cumulative Transcutaneous Spinal Stimulation with Locomotor Training Safely Improves Trunk Control in Children with Spinal Cord Injury: Pilot Study

by Liubov Amirova, Anastasia Keller, Goutam Singh, Molly King, Parth Parikh, Nicole Stepp, Beatrice Ugiliweneza, Yury Gerasimenko and Andrea L. Behrman

Children 2025, 12(7), 817; https://doi.org/10.3390/children12070817 - 21 Jun 2025

Abstract

Background/Objectives: Non-invasive spinal cord transcutaneous stimulation (scTS) has expanded the therapeutic landscape of spinal cord injury (SCI) rehabilitation, offering potential benefits beyond compensatory approaches to paralysis. Children with SCI are particularly susceptible to developing neuromuscular scoliosis due to trunk muscle paralysis and ongoing [...] Read more.

Background/Objectives: Non-invasive spinal cord transcutaneous stimulation (scTS) has expanded the therapeutic landscape of spinal cord injury (SCI) rehabilitation, offering potential benefits beyond compensatory approaches to paralysis. Children with SCI are particularly susceptible to developing neuromuscular scoliosis due to trunk muscle paralysis and ongoing skeletal growth, making targeted interventions crucial. As demonstrated in adults and pediatrics with SCI, the ability of scTS to acutely and safely enable an upright posture and trunk control could be leveraged as a therapeutic adjunct. Activity-based locomotor training (AB-LT) alone significantly improves trunk control in children with SCIs; combining it with scTS may enhance outcomes. This pilot study evaluated the safety, feasibility, and cumulative effects of AB-LT combined with scTS on trunk control in children with SCI. Methods: Three children with SCI completed 19 to 64 sessions of combined AB-LT and scTS. Adverse effects were monitored session to session, and trunk control was assessed pre- and post-intervention. Results: Across 130 interventions in three participants, 88.5% of sessions were free from adverse effects. Reported adverse events included autonomic dysreflexia (5.4%), skin redness at electrode sites (4.6%), and headaches (1.5%). No significant impact of scTS on fatigue or central hemodynamic parameters was observed. Post-intervention, all participants demonstrated improved trunk control during quiet and perturbed sitting. Conclusions: These findings provide the first evidence supporting the safety and feasibility of this combinatorial approach in pediatric SCI rehabilitation while emphasizing the importance of monitoring skin integrity and signs of autonomic dysreflexia. This intervention shows potential synergistic benefits, warranting further research to confirm efficacy and optimize therapeutic protocols. Full article

(This article belongs to the Special Issue Emerging Trends in Neuromodulation for Children with Neurological Conditions)

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18 pages, 2098 KiB

Open AccessArticle

Development and Validation of the Children’s Emotions Database (CED): Preschoolers’ Basic and Complex Facial Expressions

by Nadia Koltcheva and Ivo D. Popivanov

Children 2025, 12(7), 816; https://doi.org/10.3390/children12070816 - 21 Jun 2025

Abstract

Background. Emotions are a crucial part of our human nature. The recognition of emotions is an essential component of our social and emotional skills. Facial expressions serve as a key element in discerning others’ emotions. Different databases of images of facial emotion [...] Read more.

Background. Emotions are a crucial part of our human nature. The recognition of emotions is an essential component of our social and emotional skills. Facial expressions serve as a key element in discerning others’ emotions. Different databases of images of facial emotion expressions exist worldwide; however, most of them are limited to only adult faces and include only the six basic emotions, as well as neutral faces, ignoring more complex emotional expressions. Here, we present the Children’s Emotions Database (CED), a novel repository featuring both basic and complex facial expressions captured from preschool-aged children. The CED is one of the first databases to include complex emotional expressions in preschoolers. Our aim was to develop such a database that can be used further for research and applied purposes. Methods. Three 6-year-old children (one female) were photographed while showing different facial emotional expressions. The photos were taken under standardized conditions. The children were instructed to express each of the following basic emotions: happiness, pleasant surprise, sadness, fear, anger, disgust; a neutral face; and four complex emotions: pride, guilt, compassion, and shame; this resulted in a total of eleven expressions for each child. Two photos per child were reviewed and selected for validation. The photo validation was performed with a sample of 104 adult raters (94 females; aged 19–70 years; M = 29.9; SD = 11.40) and a limited sample of 32 children at preschool age (17 girls; aged 4–7 years; M = 6.5; SD = 0.81). The validation consisted of two tasks—free emotion labeling and emotion recognition (with predefined labels). Recognition accuracy for each expression was calculated. Results and Conclusions. While basic emotions and neutral expressions were recognized with high accuracy, complex emotions were less accurately identified, consistent with the existing literature on the developmental challenges in recognizing such emotions. The current work is a promising new database of preschoolers’ facial expressions consisting of both basic and complex emotions. This database offers a valuable resource for advancing research in emotional development, educational interventions, and clinical applications tailored to early childhood. Full article

(This article belongs to the Special Issue Social-Emotional Skills, Resilience, and Behavioral Problems in Children)

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15 pages, 1099 KiB

Open AccessReview

Gross Motor Performance, Participation and Quality of Life After Adapted Physical Activity Interventions in Pediatric Populations with Neuromotor Disability: A Systematic Review

by Silvia Faccioli, Avola Marianna, Mangano Giulia Rita Agata, Sghedoni Silvia and Sassi Silvia

Children 2025, 12(7), 815; https://doi.org/10.3390/children12070815 - 21 Jun 2025

Abstract

Background/Objectives: Physical activity is generally recommended, but youth with disabilities present increased sedentary behaviors. This is often due to limited or inaccessible exercise options. The aim of this systematic review was to report on the state of knowledge about the role of adapted [...] Read more.

Background/Objectives: Physical activity is generally recommended, but youth with disabilities present increased sedentary behaviors. This is often due to limited or inaccessible exercise options. The aim of this systematic review was to report on the state of knowledge about the role of adapted physical activity (APA) in improving gross motor performance (query 1), participation and QoL (query 2) of children and adolescents with neurological motor disability. Methods: Pubmed, Scopus and Cinahl databases were enquired in October 2023 and updated in May 2025. Inclusion criteria were the following: any type of physical activity; pediatric subjects with any neuromotor disease; and any type of outcome measure regarding gross motor performance, participation or QoL. The risk of bias (RoB) was assessed by means of ROB 2, Robins-I and JBI tools. Results were synthetized focusing on the outcome measures and the type of activity proposed. Results: Thirteen and seven studies were included relative to queries 1 and 2, respectively. They all were RCTs, and some presented randomization RoB. Several types of APA (e.g., resistance, high-intensity circuit, running, cycling, aquatic and dance training) and of outcome measures were enquired, mostly focusing on subjects with cerebral palsy or Down syndrome. An increased time of moderate-to-vigorous physical activity, improvement in timed functional tests, muscle strength and stability were observed. Conclusions: APA may improve functioning, social participation and promote active lifestyle in pediatric persons with neuromotor disabilities, without adverse effects. In the future, more specific indications based on the functioning profile are advisable to orient professionals to define individualized safe training programs. Full article

(This article belongs to the Special Issue Physical Activity in Children with Disabilities)

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12 pages, 419 KiB

Open AccessArticle

Motor Coordination in Schoolchildren Aged 6 to 11 in Northwestern Spain. A Cross-Sectional Study Based on Age and BMI

by Ricardo Fernández-Vázquez, Rubén Navarro-Patón, Martín Barcala-Furelos, Javier Cachón-Zagalaz and Marcos Mecías-Calvo

Children 2025, 12(7), 814; https://doi.org/10.3390/children12070814 - 21 Jun 2025

Abstract

Background/Objectives: A large percentage of schoolchildren are children with overweight or obese, and weight gain over time increases the risk of poor health later in life. Motor coordination may be a protective factor, enabling young people to participate in healthy physical activities. However, [...] Read more.

Background/Objectives: A large percentage of schoolchildren are children with overweight or obese, and weight gain over time increases the risk of poor health later in life. Motor coordination may be a protective factor, enabling young people to participate in healthy physical activities. However, it is unknown when the relationship between motor coordination and weight first emerges, nor whether it is evident across the body mass index (BMI) spectrum. The aim of this study was to explore what happens with coordination skills [i.e., locomotor coordination (LC), visuomotor coordination (VC), foot object control coordination (FOCC), hand object control coordination (HOCC), global motor coordination (GMC)] applying the 3JS battery, according to age (6 to 11 years) and BMI (normal weight, overweight or obesity) in a sample of 688 Primary Education participants (8.71 ± 1.66 years; 48.8% boys) from Galicia (Spain). Methods: To analyze the differences in the variables of the 3JS battery between age (6–11 years) and BMI (normal weight vs. overweight vs. obesity), they were evaluated using a multivariate analysis of covariance (MANCOVA), introducing the sex category (boy-girl) as a covariate to avoid possible confounding factors. Results: After the application of the 3JS Battery, statistically significant differences were observed depending on age [LC (p < 0.001); VC (p < 0.001); FOCC (p < 0.001); HOCC (p < 0.001); GMC (p < 0.001)] and BMI [LC (p < 0.001); VC (p = 0.008); HOCC (p < 0.001); GMC (p < 0.001)]. No statistically significant differences were found in the interactions between age and BMI (p > 0.05). Conclusions: Locomotor coordination increases progressively with age, both globally and in each of the manifestations, and this is greater the older the schoolchildren are. Schoolchildren with normal weight compared to schoolchildren with overweight or obesity have better global motor coordination, locomotor coordination, global control of objects, and control with the hand. Full article

(This article belongs to the Special Issue Motor Competence, Cognition, Movement Behaviors, and Physical Fitness in Children and Adolescents: New Theoretical and Statistical Approaches)

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