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Comparison of Bioelectrical Impedance-Based Methods on Body Composition in Young Patients with Obesity -
Sensory Stimulation in the NICU Environment: Devices, Systems, and Procedures to Protect and Stimulate Premature Babies -
“Difficult to Sedate”: Successful Implementation of a Benzodiazepine-Sparing Analgosedation-Protocol in Mechanically Ventilated Children -
Molecular Mechanisms of Maternal Diabetes Effects on Fetal and Neonatal Surfactant
Journal Description
Children
Children
is an international, peer-reviewed, open access journal of pediatrics, focusing on the dissemination of clinical, epidemiological and translational science relevant to children’s health, published monthly online by MDPI.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, SCIE (Web of Science), PubMed, PMC, and many other databases.
- Journal Rank: JCR - Q2 (Pediatrics)
- Rapid Publication: manuscripts are peer-reviewed and a first decision provided to authors approximately 18.1 days after submission; acceptance to publication is undertaken in 2.8 days (median values for papers published in this journal in the first half of 2021).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
- Scope: Public Health and Epidemiology, Global Health, General Pediatrics, Pediatric Subspecialties, Pediatric Hospitalist Medicine
Impact Factor:
2.863 (2020)
;
5-Year Impact Factor:
3.091 (2020)
Latest Articles
Intergenerational Associations between Parents’ and Children’s Adverse Childhood Experience Scores
Children 2021, 8(9), 747; https://doi.org/10.3390/children8090747 - 29 Aug 2021
Abstract
Background: Adverse childhood experiences (ACEs) are stressful childhood events associated with behavioral, mental, and physical illness. Parent experiences of adversity may indicate a child’s adversity risk, but little evidence exists on intergenerational links between parents’ and children’s ACEs. This study examines these intergenerational
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Background: Adverse childhood experiences (ACEs) are stressful childhood events associated with behavioral, mental, and physical illness. Parent experiences of adversity may indicate a child’s adversity risk, but little evidence exists on intergenerational links between parents’ and children’s ACEs. This study examines these intergenerational ACE associations, as well as parent factors that mediate them. Methods: The Panel Study of Income Dynamics (PSID) 2013 Main Interview and the linked PSID Childhood Retrospective Circumstances Study collected parent and child ACE information. Parent scores on the Aggravation in Parenting Scale, Parent Disagreement Scale, and the Kessler-6 Scale of Emotional Distress were linked through the PSID 1997, 2002, and 2014 PSID Childhood Development Supplements. Multivariate linear and multinomial logistic regression models estimated adjusted associations between parent and child ACE scores. Results: Among 2205 parent-child dyads, children of parents with four or more ACEs had 3.25-fold (23.1% [95% CI 15.9–30.4] versus 7.1% [4.4–9.8], p-value 0.001) higher risk of experiencing four or more ACEs themselves, compared to children of parents without ACEs. Parent aggravation, disagreement, and emotional distress were partial mediators. Conclusions: Parents with higher ACE scores are far more likely to have children with higher ACEs. Addressing parenting stress, aggravation, and discord may interrupt intergenerational adversity cycles.
Full article
(This article belongs to the Special Issue Adverse Childhood Experiences: Prevention, Intervention, and Access to Care)
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Open AccessCase Report
Successful Liver Transplantation in Two Polish Brothers with Transaldolase Deficiency
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, , , , , , and
Children 2021, 8(9), 746; https://doi.org/10.3390/children8090746 - 29 Aug 2021
Abstract
Transaldolase deficiency (TALDO; OMIM 606003) is a rare inborn autosomal-recessive error of the pentose phosphate pathway. It is an early-onset multisystem disease with dysmorphic features, anaemia, coagulopathy, thrombocytopenia, tubulopathy, hepatosplenomegaly and end-stage liver disease. We present a case of two Polish brothers, born
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Transaldolase deficiency (TALDO; OMIM 606003) is a rare inborn autosomal-recessive error of the pentose phosphate pathway. It is an early-onset multisystem disease with dysmorphic features, anaemia, coagulopathy, thrombocytopenia, tubulopathy, hepatosplenomegaly and end-stage liver disease. We present a case of two Polish brothers, born to consanguineous parents, with early-onset TALDO. The dominant feature of disease was an early severe liver injury, with subsequent renal tubulopathy. Nodular liver fibrosis developed in the course of the underlying disease. The older brother presented stable liver function, however, he was qualified for deceased donor liver transplantation (DDLT) because of a liver tumour and suspicion of hepatocarcinoma. The boy was transplanted at the age of 14. The younger brother was qualified for DDLT due to end-stage liver disease and transplanted at the age of 11. Currently, both our patients are alive and in a good condition with normal graft function 23 and 20 months after DDLT respectively. Liver transplantation can be a therapeutic option in TALDO and should be considered in patients with coexisting severe chronic and end-stage liver disease. Long term follow-up is necessary to assess the impact of liver transplantation for quality of life, survival time and the course of the disease.
Full article
(This article belongs to the Special Issue Multidisciplinary Problems and Research in Pediatric Liver Transplantation)
Open AccessSystematic Review
Brain Sparing Effect on Neurodevelopment in Children with Intrauterine Growth Restriction: A Systematic Review
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, , , and
Children 2021, 8(9), 745; https://doi.org/10.3390/children8090745 - 28 Aug 2021
Abstract
Background: Fetal growth restriction (FGR) is a pregnancy complication. Multiple studies have connected FGR to poor cognitive development, behavior disorders, and academic difficulties during childhood. Brain sparing has traditionally been defined as an adaptive phenomenon in which the brain obtains the blood flow
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Background: Fetal growth restriction (FGR) is a pregnancy complication. Multiple studies have connected FGR to poor cognitive development, behavior disorders, and academic difficulties during childhood. Brain sparing has traditionally been defined as an adaptive phenomenon in which the brain obtains the blood flow that it needs. However, this adaptive phenomenon might not have a complete protective effect. This publication aims to systematically review the consequences of brain redistribution on neurodevelopment in children who presented with placental intrauterine growth restriction. Methods: We performed a systematic review according to PRISMA guidelines. It included studies on intrauterine growth restriction or small-for-gestational-age (SGA) fetuses, which middle cerebral artery was measured, and neurodevelopment assessed during childhood. PUBMED and EMBASE databases were searched for relevant published studies. Results: Of the 526 studies reviewed, only 12 were included. Brain sparing was associated with poor cognitive function and lower scores in IQ. Cerebral redistribution was related to better executive function and better behavior at 4 years old but not at 12 years old. Conclusions: We can assume that fetal brain sparing could not be a fully protective phenomenon. We could not find clinical differences in behavioral and executive functions because the results were heterogeneous. Some cognitive abilities could be affected in FGR brain sparing fetuses.
Full article
Open AccessArticle
When Parents Go Shopping: Perspectives on Gender-Typed Toys among Polish Mothers and Fathers from Big Cities
Children 2021, 8(9), 744; https://doi.org/10.3390/children8090744 - 28 Aug 2021
Abstract
Children learn to understand gender categories and roles typical for women and men from the earliest stages of their life. Toys, by which they are surrounded in everyday routine, may have a significant role in their knowledge of cultural norms and societal expectations,
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Children learn to understand gender categories and roles typical for women and men from the earliest stages of their life. Toys, by which they are surrounded in everyday routine, may have a significant role in their knowledge of cultural norms and societal expectations, but also might have a great impact on children’s health in the context of psychosocial development. Parental attitudes can also be an important moderator of the choice of gender-stereotyped toys. The aim of the study was to investigate parents’ perspectives on toys’ appropriateness for children according to gender, and to analyze parents’ knowledge about the labeling of toys in shops. In total, 526 parents from big cities participated in the study; to assess parental knowledge and perspectives on toys’ categorization, The World of Toys questionnaire was used. The results indicated that most parents from big cities observe that toys are arranged according to the child’s age and sex and the toys’ functionality. Moreover, in parents’ opinion, the compliance with the role of a woman or man affects categorization the most. Furthermore, both parents tended to attribute toys to both sexes more often than they believe the stores do. To conclude, despite the still visible division of toys in shops, Polish parents from big cities are more liberal and egalitarian than shops are when it comes to the perception of toys’ appropriateness, allowing children to play with most toys regardless of their sex.
Full article
(This article belongs to the Special Issue Parenting in Face of Health Challenges: Research and Interventions)
Open AccessArticle
Development and Implementation of a Low-Cost Tracking System after Newborn Hearing Screening in Upper Austria: Lessons Learned from the Perspective of an Early Intervention Provider
Children 2021, 8(9), 743; https://doi.org/10.3390/children8090743 - 28 Aug 2021
Abstract
More than one decade after the introduction of newborn hearing screening in Upper Austria, most children were still older than 6 months at enrolment in early intervention. In this study, under the guidance of health authorities, a revised screening and tracking protocol was
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More than one decade after the introduction of newborn hearing screening in Upper Austria, most children were still older than 6 months at enrolment in early intervention. In this study, under the guidance of health authorities, a revised screening and tracking protocol was developed by a network of early intervention providers and representatives of ENT, obstetrics, and pediatrics, including screening professionals and parents of children with hearing loss. Critical process indicators following internationally recommended benchmarks were defined and collected annually by the health authorities. Due to data protection issues, the data collection system was not personalized. Regular network meetings, case-oriented meetings, and screener training sessions were held. As a result, even without additional costs and within the legal constraints related to data protection in Austria, the proportion of children enrolled in early intervention before 6 months of age was significantly increased from 26% to 81% in two representative birth cohorts before and after the introduction of the new protocol, respectively. The coverage for bilateral screening increased from 91.4 to 97.6% of the total number of births.
Full article
(This article belongs to the Special Issue Advances in Newborn Screening)
Open AccessArticle
Fundamental Movement Skills and Physical Activity of 3–4-Year-Old Children within Early Childhood Centers in New Zealand
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Children 2021, 8(9), 742; https://doi.org/10.3390/children8090742 - 27 Aug 2021
Abstract
We sought to describe and explore relationships between fundamental movement skills (FMS) and level of physical activity (PA; light-, medium-, vigorous, and kCal/hour) in preschool children, aged 3–4-years-old, across four early childhood education (ECE) settings. Children’s FMS were assessed using the Test for
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We sought to describe and explore relationships between fundamental movement skills (FMS) and level of physical activity (PA; light-, medium-, vigorous, and kCal/hour) in preschool children, aged 3–4-years-old, across four early childhood education (ECE) settings. Children’s FMS were assessed using the Test for Gross Motor Development-2 (TGMD-2; n = 81) and PA via accelerometers (S = 53). Eighty-four children participated, with 50 in both assessments. The TGMD-2 showed as the children got older, their locomotor skills (p < 0.001, r = 0.512) and object control motor skills (p < 0.001, r = 0.383) improved. Accelerometry showed children were primarily inactive at ECE (78.3% of the time). There were significant correlations between kCal/hour and light (p < 0.001, r = −0.688), moderate (p < 0.001, r = 0.599) and vigorous (p < 0.001, rs = 0.707) activity, and between gross motor quotient and locomotor (p < 0.001, r = 0.798) and object control (p < 0.001, r = 0.367) skills. No correlation was observed between gross motor quotient and kCal/hour. To conclude, children in this cohort were primarily inactive during ECE center hours. Moreover, gross motor quotient was significantly correlated to locomotor and object control skills.
Full article
(This article belongs to the Special Issue Physical Activity and Nutrition Research)
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Open AccessArticle
Development of the Dutch Structure for Integrated Children’s Palliative Care
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, , , , and
Children 2021, 8(9), 741; https://doi.org/10.3390/children8090741 - 27 Aug 2021
Abstract
Children’s palliative care (CPC) is gaining attention worldwide, facilitated by the exchange of knowledge during regular specialised congresses. This article describes the developments in the Netherlands over the past 15 years. The Foundation for Children’s Palliative Expertise (PAL) was established as a nationwide
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Children’s palliative care (CPC) is gaining attention worldwide, facilitated by the exchange of knowledge during regular specialised congresses. This article describes the developments in the Netherlands over the past 15 years. The Foundation for Children’s Palliative Expertise (PAL) was established as a nationwide initiative committed to improving palliative care for children countrywide. This led to the development of the first hospital-based CPC team in 2012, which expanded to a total of seven teams adjacent to children’s university hospitals. Regional networks for CPC were developed in parallel to these teams from 2014 onwards. The networks are a collaboration of professionals from different disciplines and organisations, from hospital to homecare, and have covered the aspects of CPC nationally from 2019 onwards. They are connected through the Dutch Knowledge Centre for CPC. This centre was established in 2018 by the PAL Foundation in collaboration with the Dutch Association for Pediatrics. In 2013, the first evidence-based guideline, ‘palliative care for children’, provided access to knowledge for parents and healthcare providers, and in 2017, a format for an individual palliative care plan was established. Within the Knowledge Centre for CPC, a physician’s support centre for dilemma’s regarding the end of life of children was set up. The efforts to have children’s palliative care embedded in the regular Dutch health care insurance are ongoing.
Full article
(This article belongs to the Special Issue Palliative Care for Childhood Cancer)
Open AccessFeature PaperArticle
Hispanic Parents’ Views of Family Physical Activity: Results from a Multisite Focus Group Investigation
Children 2021, 8(9), 740; https://doi.org/10.3390/children8090740 - 27 Aug 2021
Abstract
Understanding parental views regarding family physical activity is essential to the development of family-focused physical activity interventions. Using a qualitative methodology with thematic analysis and a socio-demographic questionnaire, this study aimed to examine Mexican American and Puerto Rican parental views on child and
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Understanding parental views regarding family physical activity is essential to the development of family-focused physical activity interventions. Using a qualitative methodology with thematic analysis and a socio-demographic questionnaire, this study aimed to examine Mexican American and Puerto Rican parental views on child and family physical activity. Sixty-one parents (56 mothers, five fathers) from four sites (California, Illinois, Texas, and Puerto Rico) each participated in a single one-hour focus group session, which included an average of five parents. The findings of this study indicated that parents perceived themselves and their families to be physically active, while some parents believed their children were getting enough physical activity at school and afterschool programs. Walking, bicycling, and playing soccer were the most common physical activities that parents reported engaging in as a family. In addition, some parents shared their preference for exercising without their children. Time constraints along with unsafe neighborhood streets and parks were identified as the major barriers to being physically active as a family. Mothers reported that fathers’ involvement in physical activity and combining a healthy diet with exercise were useful strategies for physical activity promotion. This study provides valuable information regarding Hispanic parental views concerning family physical activity relevant to the design of culturally family-based physical activity interventions for this population.
Full article
Open AccessReview
Classification and Treatment of Pediatric Gliomas in the Molecular Era
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Children 2021, 8(9), 739; https://doi.org/10.3390/children8090739 - 27 Aug 2021
Abstract
The overall survival of pediatric gliomas varies over a wide spectrum depending on the tumor grade. Low-grade gliomas have an excellent long-term survival, with a possible burden of surgery, irradiation, and chemotherapy; in contrast, high-grade gliomas generally have a short-term, devastating lethal outcome.
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The overall survival of pediatric gliomas varies over a wide spectrum depending on the tumor grade. Low-grade gliomas have an excellent long-term survival, with a possible burden of surgery, irradiation, and chemotherapy; in contrast, high-grade gliomas generally have a short-term, devastating lethal outcome. Recent advances in understanding their molecular background will transform the classification and therapeutic approaches of pediatric gliomas. Molecularly targeted treatments may acquire a leading role in the primary treatment of low-grade gliomas and may provide alternative therapeutic strategies for high-grade glioma cases in the attempt to avoid the highly unsuccessful conventional therapeutic approaches. This review aims to overview this progress.
Full article
(This article belongs to the Special Issue Diagnosis, Treatment and Management of Pediatric Gliomas in the Molecular Era)
Open AccessEditorial
Information Provision and Preparatory Interventions: Shaping the Lens for Children’s Understanding and Response to Painful Contexts
Children 2021, 8(9), 738; https://doi.org/10.3390/children8090738 - 27 Aug 2021
Abstract
Any painful or medical experience that we face is viewed from the lens with which we understand and view the experience [...]
Full article
(This article belongs to the Special Issue Information Provision and Preparation in the Context of Children’s Pain)
Open AccessArticle
Social Anxiety in 15–19 Year Adolescents in Association with Their Subjective Evaluation of Mental and Physical Health
Children 2021, 8(9), 737; https://doi.org/10.3390/children8090737 - 26 Aug 2021
Abstract
Background: Studies show that social anxiety in adolescence have negative impact on quality of life. The study evaluates social anxiety links with mental and physical health factors in adolescents aged 15–19 years. Methods: The research was performed in 2018 in secondary schools in
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Background: Studies show that social anxiety in adolescence have negative impact on quality of life. The study evaluates social anxiety links with mental and physical health factors in adolescents aged 15–19 years. Methods: The research was performed in 2018 in secondary schools in Lithuania and included 1722 participants (46.1% males and 53.9% females). The social anxiety was assessed using Social Anxiety and Avoidance Scale for Adolescents. The main results were obtained using univariate and multivariate logistic regression analysis. Results: Total of 58.5% of adolescents were characterized by high social anxiety and 14.7% by high avoidance. Females more often were characterized by high anxiety compared to males. Multivariate logistic regression revealed that good mental health was a significant protective factor against high SA in adolescents. For females, high anxiety and avoidance were associated with living with both parents, for males, high anxiety was linked with mother’s university education. Very common stomach and abdominal pain in females as well as severe and very common stomach or abdominal pain in males, increase the risk of major social anxiety. Conclusions: High social anxiety were more prevalent between females than males and was linked with various well-being and health aspects in adolescents.
Full article
(This article belongs to the Section Child and Adolescent Psychiatry)
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Open AccessArticle
Enhanced Milieu Teaching with Phonological Emphasis: A Pilot Telepractice Parent Training Study for Toddlers with Clefts
Children 2021, 8(9), 736; https://doi.org/10.3390/children8090736 - 26 Aug 2021
Abstract
Objective: the purpose of this study was to evaluate the effects of training caregivers to use intervention strategies from the Enhanced Milieu Teaching with Phonological Emphasis (EMT + PE) program, delivered via telepractice, and to examine the effects on child speech and language
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Objective: the purpose of this study was to evaluate the effects of training caregivers to use intervention strategies from the Enhanced Milieu Teaching with Phonological Emphasis (EMT + PE) program, delivered via telepractice, and to examine the effects on child speech and language outcomes for children with repaired cleft lip +/- palate (CL/P). Design: A multiple baseline within subject design across parent behaviors was replicated across three participating dyads. A pre–post intervention comparison was provided with a non-cleft twin. Participants: Three mother-child dyads participated in this study. Children ranged in age from 21 to 27 months at the beginning of the study and all had a diagnosis of CL/P. A noncleft twin without CL/P was assessed pre- and post-intervention to provide a normative comparison. Results: Parents demonstrated a positive intervention effect by substantially increasing their use of EMT + PE intervention strategies during telepractice intervention sessions (Tau 0.675 to 1.1333). Following the conclusion of intervention, parents were able to maintain their use of strategies once direct coaching had been discontinued. Children demonstrated increased talking rate, improved speech production and expanded expressive vocabulary measures over the course of intervention. Speech and language development of a child without cleft palate was provided as a comparison. Conclusions: Parents were trained through telepractice to effectively deliver EMT + PE speech and language facilitation strategies that resulted in increased language and speech outcomes for their children with CL/P.
Full article
(This article belongs to the Special Issue Pediatric Speech and Language Intervention via Telepractice)
Open AccessArticle
Is Longstanding Congenital Muscular Torticollis Provoking Pelvic Malalignment Syndrome?
Children 2021, 8(9), 735; https://doi.org/10.3390/children8090735 - 26 Aug 2021
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It has been reported that congenital muscular torticollis (CMT) may result in secondary scoliosis over long-term follow-ups. However, there are few reports on whether CMT causes pelvic malalignment syndrome (PMS). This study aimed to investigate the relationship between CMT and PMS and to
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It has been reported that congenital muscular torticollis (CMT) may result in secondary scoliosis over long-term follow-ups. However, there are few reports on whether CMT causes pelvic malalignment syndrome (PMS). This study aimed to investigate the relationship between CMT and PMS and to determine the factors associated with the development of PMS in children with longstanding CMT. Medical records of 130 children with CMT who had long-term follow-up were reviewed retrospectively. The chi-squared test and logistic regression analysis were used to determine which initial clinical parameters contributed to the development of PMS. Among 130 children with CMT, 51 (39.2%) developed PMS with or without compensatory scoliosis during long-term follow-up, indicating a high prevalence of PMS in children with a CMT history. Initial clinical symptoms such as a limited range of motion of the neck or the presence of a neck mass could not predict the development of PMS. Even if the clinical symptoms are mild, long-term follow-up of children with CMT is essential to screen for PMS.
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Open AccessArticle
Overweight/Obese Schoolchildren with Low Muscle Strength Have a Lower Cardiorespiratory Capacity and Greater Cardiovascular Risk: Results of the School Health Survey of the Extreme South of Chile 2019
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, , , , and
Children 2021, 8(9), 734; https://doi.org/10.3390/children8090734 - 26 Aug 2021
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Objective: To compare cardiovascular risk and cardiorespiratory capacity in schoolchildren from a region in the extreme south of Chile according to nutritional status and muscular strength. Methods: An analytical cross-sectional study was performed on a sample of 594 schoolchildren from 5th to 8th
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Objective: To compare cardiovascular risk and cardiorespiratory capacity in schoolchildren from a region in the extreme south of Chile according to nutritional status and muscular strength. Methods: An analytical cross-sectional study was performed on a sample of 594 schoolchildren from 5th to 8th grade in the extreme south of Chile. Based on body mass index and lower limb muscle strength, participants were divided into four groups: high strength-normal weight, high strength-overweight/obese, low strength-normal weight, and low strength-overweight/obese. Then, waist-to-height ratio and cardiorespiratory capacity, measured with the 20 m shuttle run test, were assessed to determine their cardiovascular risk, comparing the four groups. Results: The overweight/obese group with high muscular strength presented better indicators in anthropometric variables (waist circumference and waist-to-height ratio) than their peers with low muscular strength. Additionally, the overweight/obese group with low muscular strength presented a lower cardiorespiratory capacity than their peers with high muscular strength. Both results were observed in boys and girls. Conclusion: The results of this study suggest that overweight/obese schoolchildren with high muscle strength present healthier anthropometric indicators and greater cardiorespiratory capacity than their peers with low muscle strength. These results confirm the relevance of measuring muscle strength in schoolchildren and its usefulness to assess functionality. These results encourage the scientific community to continue studying the role that muscle strength plays in modulating the effects of overweight and obesity on respiratory and cardiovascular conditions in childhood.
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Open AccessArticle
The Importance of Parents’ Income and Education Level in Relation to Their Preschool Children’s Activity Level at Leisure
Children 2021, 8(9), 733; https://doi.org/10.3390/children8090733 - 26 Aug 2021
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Previous research indicate that socioeconomic status positively corresponds with adults’ and adolescents’ physical activity levels. This study investigated the relationship between parents’ education and income, and preschool children’s physical activity level. A total of 244 Norwegian preschool children aged four to six and
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Previous research indicate that socioeconomic status positively corresponds with adults’ and adolescents’ physical activity levels. This study investigated the relationship between parents’ education and income, and preschool children’s physical activity level. A total of 244 Norwegian preschool children aged four to six and their parents were enrolled in the study. The children wore an Actigraph GT1M accelerometer for seven consecutive days to measure their physical activity level. Parents completed a questionnaire that provided information about their education level and income level. To examine the relationship between the parents’ education and income and their children’s physical activity level at leisure, the Kruskal-Wallis H test was conducted. The results revealed that neither mothers’ nor fathers’ education level or income, were associated with their children’s minutes in moderate to vigorous physical activity (MVPA) at leisure. The preschool curriculum of Norway may be one explanation why socioeconomic status was not linked to physical activity in this study. Another possibility is that this study was limited to full-time students with two parents. More research is needed to determine whether parent income or education is linked to physical activity among more diverse or older children in Norway.
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Open AccessArticle
Early Life Factors Associated with Preschool Wheezing in Preterm Infants
Children 2021, 8(9), 732; https://doi.org/10.3390/children8090732 - 26 Aug 2021
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Advanced neonatal care has increased the survival of neonates born prematurely, and prematurity is a well-known risk factor for asthma/wheezing disorders. Thus, this prospective study aimed to determine the early life factors associated with preschool wheezing in premature neonates. Preterm neonates born between
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Advanced neonatal care has increased the survival of neonates born prematurely, and prematurity is a well-known risk factor for asthma/wheezing disorders. Thus, this prospective study aimed to determine the early life factors associated with preschool wheezing in premature neonates. Preterm neonates born between 2012 and 2017 were recruited, excluding those with bacterial infection within 7 days of life, maternal sepsis, and maternal chorioamnionitis. Birth and admission history, comorbidities, and maternal history were documented. Respiratory problems were followed-up at the neonatal outpatient department. Patients were divided into wheezing and non-wheezing groups. Data were analyzed using the Mann–Whitney test and Fisher’s exact test, and multivariable logistic regression was used to define the risk factors of preschool wheezing/asthma. A total of 125 preterm infants were enrolled, including 19 in the wheezing group and 106 in the non-wheezing group. Patients in the wheezing group had longer duration of intubation (p = 0.025), higher rates for exclusive breast milk feeding (p = 0.012), and higher re-hospitalization rates for respiratory tract infections (p < 0.001), especially for respiratory syncytial virus (RSV) bronchiolitis (p = 0.045). The incidence of allergic rhinitis was also higher in the wheezing group (p = 0.005). After multivariable logistic regression, allergic rhinitis and re-hospitalization for respiratory tract infections were two significant risk factors for preschool wheezing/asthma in premature neonates. Close follow-up of premature infants at high risk for asthma susceptibility is recommended.
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Open AccessArticle
Does a Split-Week Gestational Age Model Provide Valuable Information on Neurodevelopmental Outcomes in Extremely Preterm Infants?
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Children 2021, 8(9), 731; https://doi.org/10.3390/children8090731 - 26 Aug 2021
Abstract
Our primary objective for this follow-up study was to compare the neurodevelopmental outcomes of a surviving cohort of infants using a split-week gestational model (early versus late) gestational age (GA) and the standard completed GA categorization. Neurodevelopmental outcomes using a split-week GA model
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Our primary objective for this follow-up study was to compare the neurodevelopmental outcomes of a surviving cohort of infants using a split-week gestational model (early versus late) gestational age (GA) and the standard completed GA categorization. Neurodevelopmental outcomes using a split-week GA model defined as early (X, 0–3) and late (X, 4–6), with X being 23–26 weeks GA, were compared to outcomes using completed weeks GA. In total, 1012 infants were included in the study. Statistically significant differences were noted in outcomes between the early and late split of the gestational week at 23 weeks (early vs. late), with 13.3% vs. 54.5% for no neurodevelopmental impairment, and 53.3% vs. 22.7% for significant impairment (p = 0.034), respectively. There were no differences seen in the split week model for 24, 25, and 26 weeks. A trend towards improved neurodevelopmental outcomes was seen with each increasing gestation week. The split-week model did not provide additional information for pregnancies and infants between 24 and 26 weeks gestation. It did, however, provide information for counsel for infants at 23 weeks gestation, showing benefits in the late versus early half of the week.
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(This article belongs to the Special Issue Health Care in Premature Infants)
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Open AccessArticle
Mapping the Field in Stress, Anxiety, and Postpartum Depression in Mothers of Preterm Infants in Neonatal Intensive Care
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Children 2021, 8(9), 730; https://doi.org/10.3390/children8090730 - 25 Aug 2021
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Objective: The main aim of this study was to describe and conduct a bibliometric analysis of the state of research on stress, anxiety, and postpartum depression in mothers of preterm infants in the Neonatal Intensive Care Unit. Background: Women affected by premature births
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Objective: The main aim of this study was to describe and conduct a bibliometric analysis of the state of research on stress, anxiety, and postpartum depression in mothers of preterm infants in the Neonatal Intensive Care Unit. Background: Women affected by premature births are particularly exposed to mental health difficulties in the postpartum period. The desire to comprehend and the growing interest in research on stress, anxiety, and postpartum depression in mothers of preterm infants in neonatal intensive care have led to a substantial rise in the number of documents in this field over the last years. Thus, it makes it vital to regularly review the state of knowledge on this phenomenon in order to identify progress and constraints, to stimulate reflection, and to encourage progress in future research. Method: This study examined 366 articles published in the Scopus database (1976–2020). Keyword analysis was also used to identify hot research trends to be developed in future studies. This study complies with the PRISMA-Scr guidelines for quality improvement research in the EQUATOR network. Results: Our results reveal that research in this field is in a period of high production and allows this flourishing body of work to be organized into different periods, highlighting the most important themes. In such a way, our research enriches the lively field by presenting a comprehensive understanding of the field. Discussion: The key contribution of this study is the development of a conceptual map of research on stress, anxiety, and postpartum depression in mothers of preterm infants in neonatal intensive care units.
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Open AccessCase Report
The Role of Elevated Wall Shear Stress in Progression of Pulmonary Vein Stenosis: Evidence from Two Case Studies
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Children 2021, 8(9), 729; https://doi.org/10.3390/children8090729 - 25 Aug 2021
Abstract
Pulmonary vein stenosis is a serious condition characterized by restriction or blockage due to fibrotic tissue ingrowth that develops in the pulmonary veins of infants or children. It is often progressive and can lead to severe pulmonary hypertension and death. Efforts to halt
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Pulmonary vein stenosis is a serious condition characterized by restriction or blockage due to fibrotic tissue ingrowth that develops in the pulmonary veins of infants or children. It is often progressive and can lead to severe pulmonary hypertension and death. Efforts to halt or reverse disease progression include surgery and catheter-based balloon dilation and stent implantation. Its cause and mechanism of progression are unknown. In this pilot study, we propose and explore the hypothesis that elevated wall shear stress at discrete pulmonary venous sites triggers stenosis. To assess this theory, we retrospectively analyzed cardiac catheterization, lung scan, and X-ray computed tomography data to estimate wall shear stress in the pulmonary veins at multiple time points during disease progression in two patients. Results are consistent with the existence of a level of elevated wall shear stress above which the disease is progressive and below which progression is halted. The analysis also suggests the possibility of predicting the target lumen size necessary in a given vein to reduce wall shear stress to normal levels and remove the trigger for stenosis progression.
Full article
(This article belongs to the Special Issue Pulmonary Vein Stenosis in Neonates and Infants: Etiology, Diagnosis and Management)
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Open AccessArticle
COVID-19 Associated Contact Restrictions in Germany: Marked Decline in Children’s Outpatient Visits for Infectious Diseases without Increasing Visits for Mental Health Disorders
Children 2021, 8(9), 728; https://doi.org/10.3390/children8090728 - 25 Aug 2021
Abstract
Children have a low risk for severe COVID-19 infections, but indirect consequences of the pandemic may affect their health. We evaluated nationwide data on children’s outpatient visits before and during the first wave of the COVID-19 pandemic in Germany. Data from the National
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Children have a low risk for severe COVID-19 infections, but indirect consequences of the pandemic may affect their health. We evaluated nationwide data on children’s outpatient visits before and during the first wave of the COVID-19 pandemic in Germany. Data from the National Association of Statutory Health Insurance Physicians for all children with statutory health insurance and at least one physician’s office visit between January 2019 and June 2020 were evaluated for total visits and selected diagnoses for the 2nd quarter of 2019 (8.29 million children, controls) and the 2nd quarter of 2020 (8.5 million, pandemic). Outpatient visits per child fell by 18% during the first wave of the pandemic. Outpatient visits associated with diagnosed infections fell markedly by 51%, particularly for children up to age 5 years for gastroenteritis (73%), otitis media (71%), and streptococcal angina (78%). Outpatient visits for diagnosed chronic physical disorders (diabetes, celiac disease, and hay fever) and mental and behavioral disorders showed little change. Reduced contact between children appears to markedly reduce infection transmission. Infection risks in educational settings should be attenuated after the pandemic through targeted education and counseling and appropriate relationship prevention measures to improve quality of life and opportunities for children and to reduce stress and lost work time for parents.
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(This article belongs to the Section Global and Public Health)
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