Editor's Choice Articles

Editor’s Choice articles are based on recommendations by the scientific editors of MDPI journals from around the world. Editors select a small number of articles recently published in the journal that they believe will be particularly interesting to authors, or important in this field. The aim is to provide a snapshot of some of the most exciting work published in the various research areas of the journal.

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Article
Novel Neonatal Simulator Provides High-Fidelity Ventilation Training Comparable to Real-Life Newborn Ventilation
Children 2021, 8(10), 940; https://doi.org/10.3390/children8100940 - 19 Oct 2021
Cited by 4
Abstract
Face mask ventilation of apnoeic neonates is an essential skill. However, many non-paediatric healthcare personnel (HCP) in high-resource childbirth facilities receive little hands-on real-life practice. Simulation training aims to bridge this gap by enabling skill acquisition and maintenance. Success may rely on how [...] Read more.
Face mask ventilation of apnoeic neonates is an essential skill. However, many non-paediatric healthcare personnel (HCP) in high-resource childbirth facilities receive little hands-on real-life practice. Simulation training aims to bridge this gap by enabling skill acquisition and maintenance. Success may rely on how closely a simulator mimics the clinical conditions faced by HCPs during neonatal resuscitation. Using a novel, low-cost, high-fidelity simulator designed to train newborn ventilation skills, we compared objective measures of ventilation derived from the new manikin and from real newborns, both ventilated by the same group of experienced paediatricians. Simulated and clinical ventilation sequences were paired according to similar duration of ventilation required to achieve success. We found consistencies between manikin and neonatal positive pressure ventilation (PPV) in generated peak inflating pressure (PIP), mask leak and comparable expired tidal volume (eVT), but positive end-expiratory pressure (PEEP) was lower in manikin ventilation. Correlations between PIP, eVT and leak followed a consistent pattern for manikin and neonatal PPV, with a negative relationship between eVT and leak being the only significant correlation. Airway obstruction occurred with the same frequency in the manikin and newborns. These findings support the fidelity of the manikin in simulating clinical conditions encountered during real newborn ventilation. Two limitations of the simulator provide focus for further improvements. Full article
(This article belongs to the Special Issue Newborn Resuscitation: Advances in Training and Practice)
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Article
Healthy Habits and Emotional Balance in Women during the Postpartum Period: Differences between Term and Preterm Delivery
Children 2021, 8(10), 937; https://doi.org/10.3390/children8100937 - 18 Oct 2021
Cited by 5
Abstract
Breastfeeding could be considered as a vulnerable period, rising the risk to shift from optimism to pessimism. Preterm delivery is an event that increases postpartum maternal stress and depression, which can have a negative impact on breastfeeding and maternal–filial wellbeing. The adherence to [...] Read more.
Breastfeeding could be considered as a vulnerable period, rising the risk to shift from optimism to pessimism. Preterm delivery is an event that increases postpartum maternal stress and depression, which can have a negative impact on breastfeeding and maternal–filial wellbeing. The adherence to healthy habits may have a positive influence on this vulnerable population. We aimed to analyze the impact of prematurity on maternal psychological aspects during postpartum and to study if adherence to the Healthy Food Pyramid influences psychological variables. Fifty-five breastfeeding women being attended in the Hospital Clínico San Carlos (Madrid, Spain) were recruited during the first day postpartum. The medical data were collected from the obstetrical records. The women answered an auto-administered questionnaire with several sections: sociodemographic characteristics, Perceived Stress Scale (PSS), and Life Orientation Test (LOT), at 14 days and 6 months postpartum, Adherence to the Healthy Food Pyramid Questionnaire (AP-Q) at 28 days postpartum and the Edinburgh Postpartum Depression Scale (EPDS) at 6 months postpartum. The PSS and LOT scores were not statistically different in mothers with preterm compared to term delivery either at 14 days or at 6 months postpartum. Longitudinally, the PSS did not show significant differences, but the LOT score was lower at 6 months compared to 14 days postpartum (p-Value = 0.046). A higher EPDS score was significantly found in mothers with preterm delivery (9.0 ± 4.7) than those with a term delivery (5.4 ± 4.2; p-value = 0.040). A significant and positive correlation was observed between the AP-Q score and LOT both at 14 days and 6 months postpartum. Conclusively, maternal optimism decreases during the postpartum period, women with preterm delivery being at risk of postpartum depression. Furthermore, there is a relationship between optimism and adherence to healthy habits. Healthcare professional counseling is essential during the entire breastfeeding period, particularly in vulnerable mothers with preterm delivery. Full article
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Article
Dietary Sugar Intake and Its Association with Obesity in Children and Adolescents
Children 2021, 8(8), 676; https://doi.org/10.3390/children8080676 - 03 Aug 2021
Cited by 4
Abstract
Sugar intake has been associated with increased prevalence of childhood overweight/obesity; however, results remain controversial. The aim of this study was to examine the probability of overweight/obesity with higher sugar intakes, accounting for other dietary intakes. Data from 1165 children and adolescents aged [...] Read more.
Sugar intake has been associated with increased prevalence of childhood overweight/obesity; however, results remain controversial. The aim of this study was to examine the probability of overweight/obesity with higher sugar intakes, accounting for other dietary intakes. Data from 1165 children and adolescents aged ≥2–18 years (66.8% males) enrolled in the Hellenic National Nutrition and Health Survey (HNNHS) were used; specifically, 781 children aged 2–11 years and 384 adolescents 12–18 years. Total and added sugar intake were assessed using two 24 h recalls (24 hR). Foods were categorized into specific food groups to evaluate the main foods contributing to intakes. A significant proportion of children (18.7%) and adolescents (24.5%) exceeded the recommended cut-off of 10% of total energy intake from added sugars. Sweets (29.8%) and processed/refined grains and cereals (19.1%) were the main sources of added sugars in both age groups, while in adolescents, the third main contributor was sugar-sweetened beverages (20.6%). Being overweight or obese was 2.57 (p = 0.002) and 1.77 (p = 0.047) times more likely for intakes ≥10% of total energy from added sugars compared to less <10%, when accounting for food groups and macronutrient intakes, respectively. The predicted probability of becoming obese was also significant with higher total and added-sugar consumption. We conclude that high consumption of added sugars increased the probability for overweight/obesity among youth, irrespectively of other dietary or macronutrient intakes. Full article
(This article belongs to the Special Issue Body Composition in Children)
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Article
Effects on Recovery of Pediatric Patients Undergoing Total Intravenous Anesthesia with Propofol versus Ketofol for Short—Lasting Laparoscopic Procedures
Children 2021, 8(7), 610; https://doi.org/10.3390/children8070610 - 19 Jul 2021
Cited by 5
Abstract
Background: Combining ketamine and propofol (ketofol) was suggested as a new concept for sedation and general anesthesia in pediatric populations for various conditions. The aim of the present study was to determine the effect of total intravenous anesthesia (TIVA) with propofol and ketofol [...] Read more.
Background: Combining ketamine and propofol (ketofol) was suggested as a new concept for sedation and general anesthesia in pediatric populations for various conditions. The aim of the present study was to determine the effect of total intravenous anesthesia (TIVA) with propofol and ketofol on recovery after laparoscopic surgery in pediatric patients. Methods: Two hundred children with median age of 5 years who underwent laparoscopic surgery were randomized into two groups. Propofol 1% was used for induction and maintenance of anesthesia in group I, while ketamine-propofol combination (ketofol) was used in group II. Ketamine-propofol combination (ketofol) was prepared in the same applicator for group II. Ketofol ratios of 1:4 and 1:7 were used for induction and maintenance of anesthesia, respectively. A reduced McFarlan infusion dose was used in group I (1.2, 1.0, and 0.8 mL/kg/h for 15, 15, and 30 min, respectively), while a McFarlan infusion dose was used in group II (1.5, 1.3, and 1.1 mL/kg/h for 15, 15, and 30 min, respectively). Extubating time, duration of anesthesia, and length of stay in post-anesthesia care unit (PACU) were recorded. Results: Extubating time was significantly lower in the ketofol group than in the propofol group (240 s vs. 530 s; p < 0.00001). Significantly shorter duration of anesthesia (47 min vs. 60 min; p < 0.00001) as well as length of stay in the PACU (35 min vs. 100 min; p < 0.00001) were recorded in ketofol compared to the propofol group. Total fentanyl (100 µg (interquartile range, IQR 80, 125) vs. 50 µg (IQR 40, 60); p < 0.00001) and propofol (260 mg (IQR 200, 350) vs. 160 mg (IQR 120, 210); p < 0.00001) consumption per body weight were significantly lower in the ketofol group. Conclusions: TIVA with ketamine-propofol combination (ketofol) using a reduced McFarlan dose regimen shortened extubating time, duration of anesthesia, as well as length of stay in the PACU in pediatric anesthesia after laparoscopic surgery. Full article
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Article
Neonatal Multisystem Inflammatory Syndrome (MIS-N) Associated with Prenatal Maternal SARS-CoV-2: A Case Series
Children 2021, 8(7), 572; https://doi.org/10.3390/children8070572 - 02 Jul 2021
Cited by 13
Abstract
Multisystem inflammatory syndrome in children (MIS-C) is a post-infectious immune-mediated condition, seen 3–5 weeks after COVID-19. Maternal SARS-CoV-2 may potentially cause a similar hyperinflammatory syndrome in neonates due to transplacental transfer of antibodies. We reviewed the perinatal history, clinical features, and outcomes of [...] Read more.
Multisystem inflammatory syndrome in children (MIS-C) is a post-infectious immune-mediated condition, seen 3–5 weeks after COVID-19. Maternal SARS-CoV-2 may potentially cause a similar hyperinflammatory syndrome in neonates due to transplacental transfer of antibodies. We reviewed the perinatal history, clinical features, and outcomes of 20 neonates with features consistent with MIS-C related to maternal SARS-CoV-2 in Kolhapur, India, from 1 September 2020 to 30 April 2021. Anti-SARS-CoV-2 IgG and IgM antibodies were tested in all neonates. Fifteen singletons and five twins born to eighteen mothers with a history of COVID-19 disease or exposure during pregnancy presented with features consistent with MIS-C during the first 5 days after birth. Nineteen were positive for anti-SARS-CoV-2 IgG and all were negative for IgM antibodies. All mothers were asymptomatic and therefore not tested by RTPCR-SARS-CoV-2 at delivery. Eighteen neonates (90%) had cardiac involvement with prolonged QTc, 2:1 AV block, cardiogenic shock, or coronary dilatation. Other findings included respiratory failure (40%), fever (10%), feeding intolerance (30%), melena (10%), and renal failure (5%). All infants had elevated inflammatory biomarkers and received steroids and IVIG. Two infants died. We speculate that maternal SARS-CoV-2 and transplacental antibodies cause multisystem inflammatory syndrome in neonates (MIS-N). Immunomodulation may be beneficial in some cases, but further studies are needed. Full article
(This article belongs to the Special Issue Stabilization and Resuscitation of Newborns)
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Article
Somatotype, Accumulated Workload, and Fitness Parameters in Elite Youth Players: Associations with Playing Position
Children 2021, 8(5), 375; https://doi.org/10.3390/children8050375 - 10 May 2021
Cited by 6
Abstract
The purpose of this study was three-fold: (1) to describe anthropometric, maturation, and somatotype differences of players based on playing positions; (2) to analyze variations of accumulated load training (AcL) and fitness parameters between playing positions; and finally (3) to explain the variation [...] Read more.
The purpose of this study was three-fold: (1) to describe anthropometric, maturation, and somatotype differences of players based on playing positions; (2) to analyze variations of accumulated load training (AcL) and fitness parameters between playing positions; and finally (3) to explain the variation of maximal oxygen uptake (VO2max) and peak power (PP) through the AcL, body fat (BF), maturity, somatotype and fitness levels. Twenty-seven male youth soccer players under-16 were divided by the following positions participated in this study: six central midfielders, four wingers (WG), five forwards, eight defenders, and four goalkeepers (GK). They were evaluated on two occasions: pre-season and after-season. Height, sitting height, body mass, BF, girths, percentage of BF (BF%), lean body mass, maturity, somatotype, sprint test, change of direction test, Yo-Yo intermittent recovery test level 1, Wingate, PP, VO2max and fatigue index were assessed. Then, AcL was monitored during training sessions. The main results revealed significant differences between player positions for maturity offset (p = 0.001), for BF (p = 0.006), BF% (p = 0.015), and lean body mass kg (p = 0.003). Also, there were significant differences for AcL and fatigue index in pre-season between player positions (p < 0.05). In addition, there were some significant differences in pre- and after-season for VO2max and PP between player positions (p < 0.05). In conclusion, GK showed higher values in anthropometric, body composition variables and maturity offset compared to the other positions, while WG presented lower levels of BF. In pre-season, there were more differences by player positions for the different variables analyzed than after-season that reinforces the tactical role of the positions, and the emphasis in increased load in the beginning of the season. This study could be used by coaches, staff, and researchers as a reference for athletes of the same sex, age, and competitive level. Full article
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Article
Family Food Environment during the COVID-19 Pandemic: A Qualitative Study
Children 2021, 8(5), 354; https://doi.org/10.3390/children8050354 - 29 Apr 2021
Cited by 7
Abstract
Background: The COVID-19 pandemic, with its cyclical lockdown restrictions and school closures, has influenced family life. The home, work, and school environments have collided and merged to form a new normal for many families. This merging extends into the family food environment, and [...] Read more.
Background: The COVID-19 pandemic, with its cyclical lockdown restrictions and school closures, has influenced family life. The home, work, and school environments have collided and merged to form a new normal for many families. This merging extends into the family food environment, and little is known about how families are currently navigating this landscape. The objective of the present study was to describe families’ adaptations in the family food environment during the COVID-19 pandemic. Methods: Parents participated in one of 14 virtual focus groups (conducted in English and Spanish between December 2020 and February 2021). Reflexive thematic analysis was used to analyze the transcripts. Results: Forty-eight parents (81% Hispanic and SES diverse) participated. Five themes and one subtheme were identified around changes in eating habits and mealtime frequency, increases in snacking, family connectedness at mealtimes, and use of screens at meals. Conclusions: The COVID-19 pandemic has influenced the family food environment. Families shared how their eating habits have changed and that device usage increased at mealtimes. Some changes (e.g., weight gain) may have lasting health implications for both children and parents. Public health officials, pediatricians, and schools should work with families to resume healthy habits post pandemic. Full article
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Article
Validity of Appendicitis Inflammatory Response Score in Distinguishing Perforated from Non-Perforated Appendicitis in Children
Children 2021, 8(4), 309; https://doi.org/10.3390/children8040309 - 19 Apr 2021
Cited by 11
Abstract
Background: This prospective observational study aimed to evaluate the validity of appendicitis inflammatory response (AIR) score in differentiating advanced (perforated) from simple (non-perforated) appendicitis in pediatric patients. Methods: A single-center prospective cross-sectional study was conducted between 1 January 2019 until 1 May 2020 [...] Read more.
Background: This prospective observational study aimed to evaluate the validity of appendicitis inflammatory response (AIR) score in differentiating advanced (perforated) from simple (non-perforated) appendicitis in pediatric patients. Methods: A single-center prospective cross-sectional study was conducted between 1 January 2019 until 1 May 2020 including 184 pediatric patients who underwent appendectomy. Based on the intraoperative finding of advanced (n = 38) or simple (n = 146) appendicitis the patients were divided into two groups. Recipient-operator curve (ROC), with calculation of sensitivity and specificity of best cutoff and the area under the curve (AUC), were used to measure the diagnostic value and the potential for risk stratification of the AIR score, among the patients with simple or advanced acute appendicitis. Results: The median value of the AIR score in the perforated and non-perforated groups was 10 (interquartile range, IQR 9, 11), and was 7 (IQR 6, 9), respectively (p < 0.001). Based on the calculated value of AIR score, the patients were classified with a high precision into low, indeterminate and high risk groups for acute appendicitis (p < 0.001). A cutoff value of ≥9 was demonstrated to serve as a reliable indicator of perforated appendicitis with a sensitivity and a specificity of 89.5% and 71.9%, respectively (AUC = 0.80; 95% CI: 0.719–0.871; p < 0.001). Conclusions: Acute appendicitis can be detected with a high level of sensitivity and specificity using the AIR score. Also, the AIR score may differentiate perforated from non-perforated appendicitis in pediatric patients with a high level of accuracy. Full article
(This article belongs to the Special Issue Abdominal Surgery in Pediatrics)
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Article
Learning Curve for Laparoscopic Repair of Pediatric Inguinal Hernia Using Percutaneous Internal Ring Suturing
Children 2021, 8(4), 294; https://doi.org/10.3390/children8040294 - 11 Apr 2021
Cited by 8
Abstract
Background: Percutaneous internal ring suturing (PIRS) is a simple and popular technique for the treatment of inguinal hernia in children. The aim of this study was to analyze the learning curves during implementation of PIRS in our department. Methods: A total of 318 [...] Read more.
Background: Percutaneous internal ring suturing (PIRS) is a simple and popular technique for the treatment of inguinal hernia in children. The aim of this study was to analyze the learning curves during implementation of PIRS in our department. Methods: A total of 318 pediatric patients underwent hernia repair using the PIRS technique by three pediatric surgeons with different levels of experience in laparoscopic surgery. These patients were enrolled in a prospective cohort study during the period October 2015–January 2021. Surgical times, intraoperative and postoperative complications, in addition to outcomes of treatment were compared among the pediatric surgeons. Results: Regarding operative time a significant difference among the surgeons was found. Operative time significantly decreased after 25–30 procedures per surgeon. The surgeon with advanced experience in laparoscopic surgery had significantly less operative times for both unilateral (12 (interquartile range, IQR 10.5, 16.5) min vs. 21 (IQR 16.5, 28) min and 25 (IQR 21.5, 30) min; p = 0.002) and bilateral (19 (IQR 14, 21) min vs. 28 (IQR 25, 33) min and 31 (IQR 24, 36) min; p = 0.0001) hernia repair, compared to the other two surgeons. Perioperative complications, conversion, and ipsilateral recurrence rates were higher at the beginning, reaching the benchmarks when each surgeon performed at least 30 PIRS procedures. The most experienced surgeon had the lowest number of complications (1.4%) and needed a fewer number of cases to reach the plateau. The other two surgeons with less experience in laparoscopic surgery had higher rates of complications (4.4% and 5.4%) and needed a higher number of cases to reach the plateau (p = 0.190). Conclusions: A PIRS learning curve for perioperative and postoperative complications, recurrences, and conversion rates reached the plateau after each surgeon had performed at least 30 cases. After that number of cases PIRS is a safe and effective approach for pediatric hernia repair. A surgeon with an advanced level of experience in pediatric laparoscopic surgery adopted the technique more easily and had a significantly faster learning curve. Full article
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Communication
MAFLD in Obese Children: A Challenging Definition
Children 2021, 8(3), 247; https://doi.org/10.3390/children8030247 - 23 Mar 2021
Cited by 8
Abstract
Background: Recently, the new definition of Metabolic (dysfunction) associated fatty liver disease (MAFLD) has gained remarkable scientific interest. We aimed to evaluate the effectiveness of MAFLD definition in selecting obese children at higher cardiovascular risk. Methods: A total of 954 obese children and [...] Read more.
Background: Recently, the new definition of Metabolic (dysfunction) associated fatty liver disease (MAFLD) has gained remarkable scientific interest. We aimed to evaluate the effectiveness of MAFLD definition in selecting obese children at higher cardiovascular risk. Methods: A total of 954 obese children and adolescents was retrospectively enrolled. Clinical, biochemical, and metabolic evaluations were performed. Hepatic steatosis was assessed by liver ultrasound. According to the metabolic status, the population was divided in three groups. Group 1 included obese patients without both non-alcoholic fatty liver disease (NAFLD) and metabolic dysregulation; group 2 included patients with obesity and NAFLD (then encompassing one MAFLD criterion); group 3 included patients with obesity, NAFLD and evidence of metabolic dysregulation (then encompassing more than 1 MAFLD criteria). Results: Patients of Group 3 showed a worse cardiometabolic profile, as also proven by the higher percentage of prediabetes (defined as the presence of impaired fasting glucose or impaired glucose tolerance) compared to other groups (p = 0.001). Conclusions: MAFLD criteria in obese children seem to be less accurate in identifying patients having an intrinsic higher cardiometabolic risk. This suggests the need for a more accurate definition in the context of pediatric obesity. Full article
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Article
Musculoskeletal Pathology in Cerebral Palsy: A Classification System and Reliability Study
Children 2021, 8(3), 252; https://doi.org/10.3390/children8030252 - 23 Mar 2021
Cited by 7
Abstract
This article presents a classification of lower limb musculoskeletal pathology (MSP) for ambulant children with cerebral palsy (CP) to identify key features from infancy to adulthood. The classification aims to improve communication, and to guide referral for interventions, which if timed appropriately, may [...] Read more.
This article presents a classification of lower limb musculoskeletal pathology (MSP) for ambulant children with cerebral palsy (CP) to identify key features from infancy to adulthood. The classification aims to improve communication, and to guide referral for interventions, which if timed appropriately, may optimise long-term musculoskeletal health and function. Consensus was achieved by discussion between staff in a Motion Analysis Laboratory (MAL). A four-stage classification system was developed: Stage 1: Hypertonia: Abnormal postures are dynamic. Stage 2: Contracture: Fixed shortening of one or more muscle-tendon units. Stage 3: Bone and joint deformity: Torsional deformities and/or joint instability (e.g., hip displacement or pes valgus), usually accompanied by contractures. Stage 4: Decompensation: Severe pathology where restoration of optimal joint and muscle-tendon function is not possible. Reliability of the classification was tested using the presentation of 16 clinical cases to a group of experienced observers, on two occasions, two weeks apart. Reliability was found to be very good to excellent, with mean Fleiss’ kappa ranging from 0.72 to 0.84. Four-stages are proposed to classify lower limb MSP in children with CP. The classification was reliable in a group of clinicians who work together. We emphasise the features of decompensated MSP in the lower limb, which may not always benefit from reconstructive surgery and which can be avoided by timely intervention. Full article
(This article belongs to the Section Pediatric Surgery)
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Article
“You Can’t Go to the Park, You Can’t Go Here, You Can’t Go There”: Exploring Parental Experiences of COVID-19 and Its Impact on Their Children’s Movement Behaviours
Children 2021, 8(3), 219; https://doi.org/10.3390/children8030219 - 12 Mar 2021
Cited by 22
Abstract
The COVID-19 outbreak and related public health guidelines have changed the daily lives of Canadians and restricted opportunities for healthy movement behaviours for children. The purpose of this study was to explore how parents experienced the pandemic-related restrictions and how they impacted their [...] Read more.
The COVID-19 outbreak and related public health guidelines have changed the daily lives of Canadians and restricted opportunities for healthy movement behaviours for children. The purpose of this study was to explore how parents experienced the pandemic-related restrictions and how they impacted their children’s movement behaviours. Methods: Twenty-nine semi-structured one-on-one interviews were conducted (June–July 2020) with parents of children (5–11 years old) in Ontario and British Columbia. Interviews lasted between 24–104 min, were audio-recorded, transcribed verbatim, and thematically analyzed. Results: Findings emphasized various individual (e.g., motivation), interpersonal (e.g., parent work schedule), built (e.g., closure of parks) and natural environment (e.g., weather) factors related to children’s movement behaviours. The findings highlighted the loss of structured activities and destinations for children’s physical activity, and restricted opportunities for outdoor play exacerbated by shrinking childhood independent mobility. Conclusion: Families are adapting to many pandemic-related challenges including adhering to public health restrictions, parents juggling multiple roles, conducting work and school from home, as well as exacerbating factors like weather. It will be important to continue to encourage outdoor time, support policies and practice that facilitate independent mobility, and develop centralized resources that help families in the maintenance of healthy movement behaviours. Full article
(This article belongs to the Section Global and Public Health)
Article
Using Stakeholder Involvement, Expert Knowledge and Naturalistic Implementation to Co-Design a Complex Intervention to Support Children’s Inclusion and Participation in Schools: The CIRCLE Framework
Children 2021, 8(3), 217; https://doi.org/10.3390/children8030217 - 11 Mar 2021
Cited by 5
Abstract
Whist inclusion is recommended for most children most of the time it remains difficult to implement. In this paper, we present the process undertaken to review and redesign a pre-existing complex intervention (The CIRCLE Framework) which was designed to enhance teachers confidence and [...] Read more.
Whist inclusion is recommended for most children most of the time it remains difficult to implement. In this paper, we present the process undertaken to review and redesign a pre-existing complex intervention (The CIRCLE Framework) which was designed to enhance teachers confidence and competence in provision of universal first level supports for 5–12 year old children with additional support needs. The approach presented draws on the Medical Research Council guidance for the development of complex interventions. A series of ten co-design workshops with 70 stakeholders was completed, applying interactive and participatory methods. Analysing outputs of each workshop revealed recurring design ideas that became the main aspects of the new framework and associated manuals. Intervention content, theoretical frameworks, manuals to support use in practice and implementation strategies were developed. On completion, the updated intervention was extended up to 18 years of age and redistributed to all teachers in the participating local authority. We present the main conclusions and interpretations around the design and naturalistic implementation of the framework, and reflections on use in practice, including a detailed list of recommendations for implementation across schools and staff. Full article
(This article belongs to the Special Issue New Research in Children with Neurodevelopmental Disorders)
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Article
Online Videogames Use and Anxiety in Children during the COVID-19 Pandemic
Children 2021, 8(3), 205; https://doi.org/10.3390/children8030205 - 08 Mar 2021
Cited by 10
Abstract
Videogames use has constantly increased among children and adolescents, with uncertain consequences on their health. This study aimed to assess the prevalence of videogames use and addiction in a sample of Italian children during the COVID-19 pandemic and their association with anxiety symptoms. [...] Read more.
Videogames use has constantly increased among children and adolescents, with uncertain consequences on their health. This study aimed to assess the prevalence of videogames use and addiction in a sample of Italian children during the COVID-19 pandemic and their association with anxiety symptoms. One hundred and sixty-two children (M/F:78/84; age range: 8–10 years; average age 9.4 ± 0.7 years) completed the Videogame Addiction Scale for Children (VASC), the Test of Anxiety and Depression (TAD) and the Children’s Anxiety Meter—State (CAM-S). Demographic variables and data on the access to electronic tools and games preferences were also collected. Overall, 96.3% of the study participants stated to have access to one or more device. They reported a low risk of videogame addiction (VASC score (mean ± SD): 46.7 ± 15.4), a moderate level of trait anxiety (TAD score (mean ± SD): 135 ± 16.8) and a low state anxiety (CAM-S score (mean ± SD): 2.2 ± 2.1). Males reported to spend more time on videogames, to perceive higher self-control and to be more influenced by reinforcement mechanisms; females described higher levels of trait anxiety. In the regression analysis, state anxiety was a predictor of videogame use and addiction (p = 0.01). Further research is needed to confirm these data and to maximize the developmentally positive effects of videogames and preventing the negative consequences. Full article
(This article belongs to the Special Issue Recent Advances in Child and Adolescent Psychiatry)
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Article
Effects of the COVID-19 Lockdown on Portuguese Children’s Motor Competence
Children 2021, 8(3), 199; https://doi.org/10.3390/children8030199 - 07 Mar 2021
Cited by 11
Abstract
During long periods without school, children are more susceptible to unhealthy behaviors, such as an increase in sedentary behaviors, which has a negative impact on children’s motor competence (MC). The COVID-19 lockdown offered us a unique opportunity to test, in a quasi-experimental setting, [...] Read more.
During long periods without school, children are more susceptible to unhealthy behaviors, such as an increase in sedentary behaviors, which has a negative impact on children’s motor competence (MC). The COVID-19 lockdown offered us a unique opportunity to test, in a quasi-experimental setting, the impact of lockdown movement restrictions on children’s MC. We assessed the motor competence of 114 children aged 6–9 years using the motor competence assessment. All children were tested before and after the COVID-19 lockdown. Chi-square and 2 × 2 ANOVA (sex by moment) were used to further analyze the data. Regardless of sex, motor performances in all tests (except for jumping sideways in boys) were lower when compared with performances before lockdown. There was a marked decreasing trend in children’s levels of MC, shifting from an upper to a lower quartile in different tests. The results after the lockdown were always significantly inferior to the results before lockdown in all motor tests (except jumping sideways), in the three components of MC, and in global MC. Children’s global MC score decreased by an average of 13 points in boys and 16 points in girls. The imposed movement restrictions had a negative effect on children’s motor competence development. Full article
(This article belongs to the Special Issue Sports Science for Children)
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Article
High Acceptability of an Orally Dispersible Tablet Formulation by Children
Children 2021, 8(3), 194; https://doi.org/10.3390/children8030194 - 05 Mar 2021
Cited by 4
Abstract
There is a high unmet medical need for child-appropriate oral dosage forms. The acceptability of a novel placebo orally dispersible tablet formulation (pODT) was therefore evaluated. Monolithic tablets contain an inorganic calcium carbonate/calcium phosphate carrier material as the main excipient. They were assessed [...] Read more.
There is a high unmet medical need for child-appropriate oral dosage forms. The acceptability of a novel placebo orally dispersible tablet formulation (pODT) was therefore evaluated. Monolithic tablets contain an inorganic calcium carbonate/calcium phosphate carrier material as the main excipient. They were assessed in a cross-sectional acceptability study. The 40 child participants were between 2 to 5 years and 6 to 10 years old. One pODT with 5 mm diameter was administered to each participating child by placement on the tongue or into the buccal cavity. Parents were asked to complete a questionnaire together with the study personnel. The spontaneous reactions of the children were recorded. The ease of administration and children’s acceptance of the tablet was rated by research staff on a 4-point acceptability scale and by parents on a 5-point Likert scale. The older subjects answered how they had liked the pODT by pointing to the appropriate face of a Facial Hedonic Scale. pODT had very high acceptability as 93% of parents, and all questioned children reported the formulation to be acceptable or very acceptable. Staff reported administering pODT in these children without problems. None of the children showed distress on receipt of pODT. We conclude that the proposed child-friendly dosage form provides a convenient option for oral drug administration and is expected to enhance drug-adherence in pediatric patients. Full article
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Article
A Longitudinal Study of Subjective Daytime Sleepiness Changes in Elementary School Children Following a Temporary School Closure Due to COVID-19
Children 2021, 8(3), 183; https://doi.org/10.3390/children8030183 - 01 Mar 2021
Cited by 4
Abstract
Excessive daytime sleepiness is increasingly being recognized as a major global health concern. However, there have been few studies related to sleepiness and its associated factors in elementary school children. In Japan, all schools were closed from February to May 2020 to prevent [...] Read more.
Excessive daytime sleepiness is increasingly being recognized as a major global health concern. However, there have been few studies related to sleepiness and its associated factors in elementary school children. In Japan, all schools were closed from February to May 2020 to prevent coronavirus disease 2019 (COVID-19) outbreaks. The aim of this study was to identify changes in the subjective sleepiness of pupils during the 1.5-year period and to elucidate factors associated with changes in sleepiness. Questionnaire surveys about pupils’ sleep habits and the Japanese version of the Pediatric Daytime Sleepiness Scale (PDSS-J) were conducted longitudinally at one elementary school in June 2019, January 2020, and June 2020. The average ∆PDSS score was 0.94 ± 5.51 (mean ± standard deviation) from June 2019 to January 2020 and −1.65 ± 5.71 (t[498] = 6.13, p < 0.01) from January 2020 to June 2020. Univariate and multivariate logistic regression analyses revealed that decreasing social jetlag was associated with decreasing PDSS scores (OR = 0.77, 95% CI: 0.62–0.96, p = 0.02) during the school closure. A less restrictive school schedule secondary to a COVID-19-related school closure decreased sleepiness in children and was associated with decreasing social jetlag. Full article
(This article belongs to the Special Issue Factors Affecting the Quality of Sleep in Children)
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Article
Sleep and the General Behavior of Infants and Parents during the Closure of Schools as a Result of the COVID-19 Pandemic: Comparison with 2019 Data
Children 2021, 8(2), 168; https://doi.org/10.3390/children8020168 - 22 Feb 2021
Cited by 8
Abstract
This study compared cross-sectional data from online surveys describing the sleep behavior of infants and caregivers in March 2020 (the school closure period during the early stages of the COVID-19 pandemic; n = 295, 23.8 ± 3.8 months old) and March 2019 (before [...] Read more.
This study compared cross-sectional data from online surveys describing the sleep behavior of infants and caregivers in March 2020 (the school closure period during the early stages of the COVID-19 pandemic; n = 295, 23.8 ± 3.8 months old) and March 2019 (before the pandemic; n = 2017, 24.2 ± 3.8 months old). In comparing those two points in time, no significant differences were found in wake-up times (2019: 7:19 ± 0:46 am vs. 2020: 7:18 ± 0:47 am, p = 0.289), bedtimes (21:01 ± 0:48 pm vs. 21:04 ± 0:53 pm, p = 0.144), or nocturnal sleep times (593.7 ± 43.9 min vs. 588.1 ± 50.3 min, p = 0.613). Regarding the caregivers, in 2020, wake-up times (2019: 6:46 ± 0:50 am vs. 2020: 6:39 ± 0:50 am, p = 0.017) and bedtimes (22:53 ± 1:17 pm vs. 22:42 ± 1:04 pm, p = 0.016) became significantly earlier compared to 2019. Among infants staying at home, total sleep time and percentage of outdoor play decreased significantly, and media use increased significantly in 2020. Lower levels of exercise and more frequent media viewing may have caused prolonged sleep latency in these children. The percentage of caregivers responding with “negative childcare feelings” was significantly higher in the group with less than three nursery school attendance days. Caregivers and infants staying at home are a high-risk group during the pandemic. Full article
(This article belongs to the Special Issue Factors Affecting the Quality of Sleep in Children)
Article
Differences in Weight Status and Autonomous Motivation towards Sports among Children with Various Profiles of Motor Competence and Organized Sports Participation
Children 2021, 8(2), 156; https://doi.org/10.3390/children8020156 - 18 Feb 2021
Cited by 4
Abstract
This study aimed (1) to identify profiles in children based on actual motor competence (AMC), perceived motor competence (PMC), and organized sports participation (OSP), and (2) to examine differences among these profiles in weight status as well as autonomous motivation towards sports. Children’s [...] Read more.
This study aimed (1) to identify profiles in children based on actual motor competence (AMC), perceived motor competence (PMC), and organized sports participation (OSP), and (2) to examine differences among these profiles in weight status as well as autonomous motivation towards sports. Children’s (N = 206; 112 boys; Mage = 10.83 ± 0.92 years) AMC, PMC, OSP, weight status, and autonomous motivation towards sports were measured using validated assessment tools. Cluster analyses identified three profiles with completely convergent levels of AMC, PMC, and OSP and three profiles with partially convergent levels. Children in the convergent profiles with average to high levels of AMC, PMC, and OSP had the most optimal profile, as they combined a healthier weight status with elevated levels of autonomous motivation, while the opposite was true for children with low levels on all three cluster-variables. Partially convergent profiles showed that AMC and PMC appear crucial for weight status, as profiles with relatively low levels of AMC and PMC had the highest weight status, independent of their OSP levels. Overall, the findings highlight the importance of promoting AMC, PMC, and OSP simultaneously to help children in achieving a healthy weight status and being autonomously motivated towards OSP. Full article
(This article belongs to the Special Issue Sports Science for Children)
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Article
Differences on Motor Competence in 4-Year-Old Boys and Girls Regarding the Quarter of Birth: Is There a Relative Age Effect?
Children 2021, 8(2), 141; https://doi.org/10.3390/children8020141 - 13 Feb 2021
Cited by 9
Abstract
The aim of this study was to evaluate the differences on motor competence between boys and girls aged 4 years old and investigate the existence of Relative Age Effect on their motor competence. In total, 132 preschool children were evaluated, of whom 60 [...] Read more.
The aim of this study was to evaluate the differences on motor competence between boys and girls aged 4 years old and investigate the existence of Relative Age Effect on their motor competence. In total, 132 preschool children were evaluated, of whom 60 (45.50%) were girls and 72 (54.5%) were boys. The distribution of the participants was from quarter 1 [n = 28 (21.2%)], quarter 2 [n = 52 (39.4%)], quarter 3 [n = 24 (18.2%)], and quarter 4 [(n = 28 (21.2%)], respectively. The Movement Assessment Battery for Children-2 (MABC-2) was used to collect the data. The data show the main effects on quarter of birth factor in manual dexterity (MD; p < 0.001), in aiming and catching (A&C; p < 0.001), in balance (Bal; p < 0.001) and in total test score (TTS; p < 0.001). There are also statistical differences on gender factor in MD (p < 0.001) and in TTS (p = 0.031). A significant effect was also found in the interaction between two factors (gender and quarter of birth) in MD (p < 0.001), A&C (p < 0.001), and Bal (p < 0.001). There are differences in all the variables studied according to the quarter of birth and only in manual dexterity and in the total score if compared according to gender (the scores are higher in girls). Full article
(This article belongs to the Special Issue Physical Activity and Motor Competence in Preschool Children)
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Article
Dysregulation of Ki-67 Expression in T Cells of Children with Autism Spectrum Disorder
Children 2021, 8(2), 116; https://doi.org/10.3390/children8020116 - 06 Feb 2021
Cited by 5
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by behavioral abnormalities such as impairments in social function and deficits in communication. The etiology of autism is unknown in most cases, but many studies have pointed towards the immune system as a causative [...] Read more.
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by behavioral abnormalities such as impairments in social function and deficits in communication. The etiology of autism is unknown in most cases, but many studies have pointed towards the immune system as a causative agent in autism. Specific studies implicated lymphocytes, natural killer (NK) cells, monocytes, cytokines, and specific transcription factors in the development of ASD. The protein Ki-67 is n expressed in the proliferating cells and is used as a tool in several disorders. Ki-67 plays a crucial role in many neurological diseases. However, Ki-67 role in ASD is not fully understood. In this study, we investigated the possible role of Ki-67 expression in autistic children. We compared Ki-67 production in CD3+, CD4+, CD8+, CXCR4+, CXCR7+, CD45R+, HLA-DR+, GATA3+, Helios+, and FOXP3+ peripheral blood mononuclear cells (PBMCs) in autistic children to typically developing (TD) controls using immunofluorescence staining. We also determined Ki-67 mRNA levels in PBMCs using RT–PCR. The results revealed that autistic children had significantly increased numbers of CD3+Ki-67+, CD4+Ki-67+, CD8+Ki-67+, CXCR4+Ki-67+, CXCR7+Ki-67+, CD45R+Ki-67+, HLA-DR+Ki-67+, CXCR4+GATA3+, GATA3+Ki-67+ cells and decreased Helios+Ki-67+ and FOXP3+Ki-67+ cells compared with TD controls. In addition, the autistic children showed upregulation of Ki-67 mRNA levels compared with TD controls. Further studies need to be carried out to assess the exact role of Ki-67 and its therapeutic potential in ASD. Full article
(This article belongs to the Special Issue Autism and Children)
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Article
Relative Age Effect on Motor Competence in Children Aged 4–5 Years
Children 2021, 8(2), 115; https://doi.org/10.3390/children8020115 - 06 Feb 2021
Cited by 10
Abstract
The purpose of this study was to evaluate whether a Relative Age Effect (RAE) exists in motor competence of preschool children. The hypothesis was that motor competence, assessed by the Movement Assessment Battery for Children-2 (MABC-2), would be higher in preschool children born [...] Read more.
The purpose of this study was to evaluate whether a Relative Age Effect (RAE) exists in motor competence of preschool children. The hypothesis was that motor competence, assessed by the Movement Assessment Battery for Children-2 (MABC-2), would be higher in preschool children born in the first quarter of the year compared to those who were born in the last quarter of the same year. A total of 360 preschool children were evaluated of whom 208 (57.8%) were boys and 152 (42.8%) were girls, with a mean age of 4.52 years old (± 0.50). The distribution of the participants was 172 children aged 4 years old and 188 aged 5 years old. The data showed a main effect on the age factor in the total score of aiming and catching (p < 0.001) and in the total test score (p < 0.001), in the quarter of birth factor in all the dimensions studied (i.e., total score of manual dexterity (p < 0.001); total score of aiming and catching (p = 0.001); total score of balance (p < 0.001); total test score (p < 0.001)) and in the interaction between both factors (i.e., total score of manual dexterity (p = 0.005); total score of aiming and catching (p = 0.002); total score of balance (p < 0.001); total test score (p < 0.001)). Age and quarter of birth produce a RAE in 4 and 5-year-old preschool children’s motor competence. Full article
(This article belongs to the Special Issue Sports Science for Children)
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Article
The Impact of COVID-19 on the Interrelation of Physical Activity, Screen Time and Health-Related Quality of Life in Children and Adolescents in Germany: Results of the Motorik-Modul Study
Children 2021, 8(2), 98; https://doi.org/10.3390/children8020098 - 02 Feb 2021
Cited by 22
Abstract
Reduced physical activity (PA) and prolonged screen time (ST) negatively influence health-related quality of life (HRQoL), a protective factor against illness and mortality. Studies addressing the relationship between PA, ST, and mental health in youth are scarce, especially in times with high mental [...] Read more.
Reduced physical activity (PA) and prolonged screen time (ST) negatively influence health-related quality of life (HRQoL), a protective factor against illness and mortality. Studies addressing the relationship between PA, ST, and mental health in youth are scarce, especially in times with high mental health burdens like the COVID-19 pandemic. The purpose of this examination was to investigate whether PA, ST, and HRQoL before COVID-19 predict PA, ST, and HRQoL during the COVID-19 pandemic. Participants from the Motorik-Modul Study (MoMo; N = 1711; Mage = 10.36 (SD = 4.04) years, female = 49.8%; healthy weight = 76.8%) self-reported their PA and ST as well as HRQoL both before and during COVID-19. Relationships of all variables, from before to during COVID-19, were investigated through a path prediction model. Results showed all variables during COVID-19 were predicted by the respective levels before COVID-19, independent of gender and age. Cross-lags revealed a negative influence of before COVID-19 ST on during COVID-19 PA. HRQoL before COVID-19 was positively associated with during COVID-19 PA in children younger than 10 years and females, but not in adolescents and boys. As age- and gender-independent negative influence of before COVID-19 ST on during COVID-19 PA has been detected, health policy may be advised to focus on a general reduction in ST instead of PA enhancement to ensure high PA levels. Full article
(This article belongs to the Section Global and Public Health)
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The Impact of COVID-19 on the Adaptive Functioning, Behavioral Problems, and Repetitive Behaviors of Italian Children with Autism Spectrum Disorder: An Observational Study
Children 2021, 8(2), 96; https://doi.org/10.3390/children8020096 - 02 Feb 2021
Cited by 7
Abstract
Children with autism spectrum disorder (ASD) and their families have represented a fragile population on which the extreme circumstances of the COVID-19 outbreak may have doubly impaired. Interruption of therapeutical interventions delivered in-person and routine disruption constituted some of the main challenges they [...] Read more.
Children with autism spectrum disorder (ASD) and their families have represented a fragile population on which the extreme circumstances of the COVID-19 outbreak may have doubly impaired. Interruption of therapeutical interventions delivered in-person and routine disruption constituted some of the main challenges they had to face. This study investigated the impact of the COVID-19 lockdown on adaptive functioning, behavioral problems, and repetitive behaviors of children with ASD. In a sample of 85 Italian ASD children (mean age 7 years old; 68 males, 17 females), through a comparison with a baseline evaluation performed during the months preceding COVID-19, we evaluated whether after the compulsory home confinement any improvement or worsening was reported by parents of ASD individuals using standardized instruments (Adaptive Behavior Assessment System (Second Edition), Achenbach Child Behavior Checklist, Repetitive Behavior Scale-Revised). No significant worsening in the adaptive functioning, problematic, and repetitive behaviors emerged after the compulsory home confinement. Within the schooler children, clinical stability was found in reference to both adaptive skills and behavioral aspects, whereas within preschoolers, a significant improvement in adaptive skills emerged and was related to the subsistence of web-delivered intervention, parental work continuance, and online support during the lockdown. Full article
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Article
Adherence to 24-Hour Movement Guidelines among Spanish Adolescents: Differences between Boys and Girls
Children 2021, 8(2), 95; https://doi.org/10.3390/children8020095 - 01 Feb 2021
Cited by 4
Abstract
Background: The 24-Hour Movement Guidelines for adolescents recommend ≥60 min/day of moderate-to-vigorous physical activity (PA), ≤ 2 h/day of screen time, and 8–10 h/day of sleep. Since little information is available on the 24-Hour Movement Guidelines in Spanish adolescents, this study aims to [...] Read more.
Background: The 24-Hour Movement Guidelines for adolescents recommend ≥60 min/day of moderate-to-vigorous physical activity (PA), ≤ 2 h/day of screen time, and 8–10 h/day of sleep. Since little information is available on the 24-Hour Movement Guidelines in Spanish adolescents, this study aims to estimate the proportion of Spanish adolescents meeting individual and combinations of these 24-Hour Movement Guidelines. Moreover, another aim of this study is to examine gender differences in compliance with 24-Hour Movement Guidelines. Methods: A final sample of 1465 Spanish adolescents (44.50% girls; 13.08 ± 0.86) participated in this cross-sectional study. The 24-Hour Movement Guidelines were measured during weekdays and the weekend days by self-reported questionnaires. Results: Although most adolescents met sleep duration guidelines (81.3%), only 38% and 15.8% met physical activity and screen time guidelines, respectively. Only 5.4% of these adolescents met all three 24-Hour Movement Guidelines, whereas 10.2% of this sample did not meet any of these guidelines. Although boys reported greater compliance with physical activity recommendations and girls with screen time recommendations, no significant gender differences were found in the compliance of all three 24-Hour Movement Guidelines. Conclusion: Given that 94.4% of Spanish adolescents did not meet 24-Hour Movement Guidelines, promoting all these three movement behaviours in both boys and girls is an urgent public health priority. Full article
(This article belongs to the Section Global and Public Health)
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Article
How Living in Vulnerable Conditions Undermines Cognitive Development: Evidence from the Pediatric Population of Guatemala
Children 2021, 8(2), 90; https://doi.org/10.3390/children8020090 - 29 Jan 2021
Cited by 3
Abstract
Low-socioeconomic backgrounds represent a risk factor for children’s cognitive development and well-being. Evidence from many studies highlights that cognitive processes may be adversely affected by vulnerable contexts. The aim of this study was to determine if living in vulnerable conditions affects childhood cognitive [...] Read more.
Low-socioeconomic backgrounds represent a risk factor for children’s cognitive development and well-being. Evidence from many studies highlights that cognitive processes may be adversely affected by vulnerable contexts. The aim of this study was to determine if living in vulnerable conditions affects childhood cognitive development. To achieve this, we assessed the performance of a sample of 347 Guatemalan children and adolescents aged from 6 to 17 years (M = 10.8, SD = 3) in a series of 10 neuropsychological tasks recently standardized for the pediatric population of this country. Two-fifths of the sample (41.5%) could be considered to have vulnerable backgrounds, coming from families with low-socioeconomic status or having had a high exposure to violence. As expected, results showed lower scores in language and attention for the vulnerable group. However, contrary to expectations, consistent systematic differences were not found in the executive function tasks. Vulnerable children obtained lower scores in cognitive flexibility compared to the non-vulnerable group, but higher scores in inhibition and problem-solving tasks. These results suggest the importance of developing pediatric standards of cognitive performance that take environmental vulnerable conditions into consideration. These findings, one of the first obtained in the Guatemalan population, also provide relevant information for specific educational interventions and public health policies which will enhance vulnerable children and adolescent cognitive development. Full article
(This article belongs to the Special Issue Child Development in Latin America)
Article
Changes in Healthy Behaviors and Meeting 24-h Movement Guidelines in Spanish and Brazilian Preschoolers, Children and Adolescents during the COVID-19 Lockdown
Children 2021, 8(2), 83; https://doi.org/10.3390/children8020083 - 26 Jan 2021
Cited by 15
Abstract
Background: The aim of this study was to assess changes in physical activity, screen time and sleep duration of preschoolers, children and adolescents and the prevalence of meeting the 24-h movement guidelines during the lockdown caused by COVID-19 in a sample from Spain [...] Read more.
Background: The aim of this study was to assess changes in physical activity, screen time and sleep duration of preschoolers, children and adolescents and the prevalence of meeting the 24-h movement guidelines during the lockdown caused by COVID-19 in a sample from Spain and Brazil. Methods: A total of 1099 preschoolers, children and adolescents (aged 3–17 years) from Spain (12.1 ± 4.6 years) and Brazil (10.7 ± 4.3 years) were included. An online survey was created and distributed in each country using a snowball sampling strategy. This online survey was completed by parents (mother/father/responsible guardian). Results: The proportion of the sample who met the PA and ST recommendations decreased during the COVID-19 lockdown in both Spanish and Brazilian samples (p < 0.001), while sleep duration increased (p < 0.001). The proportion of the sample meeting the overall 24-h movement guidelines was very low before the lockdown (Spain 3.0%; Brazil 11.7%) and even worse during the lockdown (Spain 0.3%; Brazil 7.5%). Conclusions: The prevalence of preschoolers, children and adolescents in both the Spain and Brazil samples meeting the 24-h movement guidelines during COVID-19 restrictions was as low as previous studies in other countries. Efforts to protect and support healthy behaviors of young people during a period of pandemic restrictions need to be a priority. Full article
(This article belongs to the Section Global and Public Health)
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Consistency of a Nonword Repetition Task to Discriminate Children with and without Developmental Language Disorder in Catalan–Spanish and European Portuguese Speaking Children
Children 2021, 8(2), 85; https://doi.org/10.3390/children8020085 - 26 Jan 2021
Cited by 3
Abstract
Nonword repetition has been proposed as a diagnostic marker of developmental language disorder (DLD); however, the inconsistency in the ability of nonword repetition tasks (NRT) to identify children with DLD raises significant questions regarding its feasibility as a clinical tool. Research suggests that [...] Read more.
Nonword repetition has been proposed as a diagnostic marker of developmental language disorder (DLD); however, the inconsistency in the ability of nonword repetition tasks (NRT) to identify children with DLD raises significant questions regarding its feasibility as a clinical tool. Research suggests that some of the inconsistency across NRT may be due to differences in the nature of the nonword stimuli. In this study, we compared children’s performance on NRT between two cohorts: the children in the Catalan–Spanish cohort (CS) were bilingual, and the children in the European Portuguese cohort (EP) were monolingual. NRT performance was assessed in both Spanish and Catalan for the bilingual children from Catalonia-Spain and in Portuguese for the monolingual children from Portugal. Results show that although the absolute performance differed across the two cohorts, with NRT performance being lower for the CS, in both Catalan and Spanish, as compared to the EP cohort in both, the cut-points for the likelihood ratios (LH) were similar across the three languages and mirror those previously reported in previous studies. However, the absolute LH ratio values for this study were higher than those reported in prior research due in part to differences in wordlikeness and frequency of the stimuli in the current study. Taken together, the findings from this study show that an NRT consisting of 3-, 4-, and 5-syllable nonwords, which varies in wordlikeness ratings, when presented in a random order accurately identifies and correctly differentiates children with DLD from TD controls the child is bilingual or monolingual. Full article
Article
The Role of Preschool Hours in Achieving Physical Activity Recommendations for Preschoolers
Children 2021, 8(2), 82; https://doi.org/10.3390/children8020082 - 25 Jan 2021
Cited by 8
Abstract
Research on physical activity (PA) in different educational settings could elucidate which interventions promote a healthy school lifestyle in early childhood education (ECE). The aims of this study were: (a) to analyse the PA levels of preschoolers during school hours, as well as [...] Read more.
Research on physical activity (PA) in different educational settings could elucidate which interventions promote a healthy school lifestyle in early childhood education (ECE). The aims of this study were: (a) to analyse the PA levels of preschoolers during school hours, as well as the rate of compliance with specific recommendations on total PA (TPA) and moderate-vigorous PA (MVPA); (b) to examine the role of structured movement sessions and recess time in the MVPA levels during school hours; (c) to evaluate the sociodemographic correlates of preschoolers and the school environment on MVPA behaviour during school hours. PA was evaluated with Actigraph accelerometers. Our main findings were that: (a) preschoolers engaged in very little TPA and MVPA during school hours; (b) children showed significantly higher MVPA levels on days with versus without structured movement sessions, and the contribution of the structured sessions to MVPA was significantly higher than that of recess time; (c) gender and age were associated with PA, and a high density of young children on the playground was associated with high levels of vigorous PA, whereas in the classroom, high density was associated with more sedentary behaviour. Structured PA could reduce the gap in achieving international recommendations. Full article
(This article belongs to the Special Issue Physical Activity and Motor Competence in Preschool Children)
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Article
New Parents Experienced Lower Parenting Self-Efficacy during the COVID-19 Pandemic Lockdown
Children 2021, 8(2), 79; https://doi.org/10.3390/children8020079 - 24 Jan 2021
Cited by 6
Abstract
Background: The COVID-19 pandemic is a global issue which affects the entire population’s mental health. This study evaluates how restrictions to curtail this pandemic change parenting self-efficacy, depressive symptoms, couple satisfaction and health-related quality of life in parents after delivery of a [...] Read more.
Background: The COVID-19 pandemic is a global issue which affects the entire population’s mental health. This study evaluates how restrictions to curtail this pandemic change parenting self-efficacy, depressive symptoms, couple satisfaction and health-related quality of life in parents after delivery of a newborn. Methods: In this prospective single center evaluation of parental self-efficacy and quality of life, four validated questionnaires were used to repeatedly assess parenting self-efficacy (Tool to measure Parental Self-Efficacy, TOPSE), depressive symptoms (Edinburgh Postnatal Depression Scale, EPDS), couple satisfaction (Couple Satisfaction Index, CSI) and health-related quality of life (short form 12, SF12). Fifty-three parents of 50 infants answered a total number of 63 questionnaires during the lockdown period to limit the spread of COVID-19. These questionnaires were matched with 63 questionnaires of 58 other parents that had answered them before or after strong pandemic related measures. Results: Parents experienced lower parenting self-efficacy during the strict pandemic measures as compared to before and after (p = 0.04). In terms of age, socioeconomic, marital status and duration of hospitalization we detected no significant difference between both groups. On univariate linear regression, TOPSE scores were associated with gestational age (p = 0.044, parameter estimate: 1.67, 95% CI: 0.048 to 3.301), birth weight (p = 0.035, parameter estimate: 0.008, 95% CI: 0.001 to 0.015), number of newborns’ siblings (p = 0.0554, parameter estimate: 7.49, 95% CI: −0.174 to 15.145) and distance of home from hospital (p = 0.043, parameter estimate: −0.38, 95% CI: −0.745 to −0.011). Interestingly, there was a positive correlation between quality of life and TOPSE scores, suggesting that those who experience a higher self-efficacy also have a higher quality of life. Conclusions: When implementing a lock-down period psychological effects such as lower experience of parental self-efficacy have to be considered. Full article
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Article
Mealtime Environment and Control of Food Intake in Healthy Children and in Children with Gastrointestinal Diseases
Children 2021, 8(2), 77; https://doi.org/10.3390/children8020077 - 23 Jan 2021
Cited by 4
Abstract
Parental feeding practices and mealtime routine significantly influence a child’s eating behavior. The aim of this study was to investigate the mealtime environment in healthy children and children with gastrointestinal diseases. We conducted a cross-sectional case–control study among 787 healthy, typically developing children [...] Read more.
Parental feeding practices and mealtime routine significantly influence a child’s eating behavior. The aim of this study was to investigate the mealtime environment in healthy children and children with gastrointestinal diseases. We conducted a cross-sectional case–control study among 787 healthy, typically developing children and 141 children with gastrointestinal diseases, aged two to seven years. Parents were asked to provide data on demographics and describe their mealtime environment by answering to 24 closed-ended questions. It was found that the majority of the children had the same number of meals every day and at the same hour. Parents of both groups exerted considerable control on the child’s food intake by deciding both when and what their child eats. Almost one third of the parents also decided how much their child eats. The two groups differed significantly in nine of the 24 questions. The study showed that both groups provided structured and consistent mealtime environments. However, a significant proportion of children did not control how much they eat which might impede their ability to self-regulate eating. The presence of a gastrointestinal disease was found to be associated with reduced child autonomy, hampered hunger cues and frequent use of distractions during meals. Full article
(This article belongs to the Special Issue Eating Disorders and Obesity in Children and Adolescents)
Article
“Your Friends Do Matter”: Peer Group Talk in Adolescence and Gender Violence Victimization
Children 2021, 8(2), 65; https://doi.org/10.3390/children8020065 - 20 Jan 2021
Cited by 6
Abstract
Research on gender violence has identified as one main component leading to gender violence a dominant socialization process which associates attractiveness to men who show violent behaviors and attitudes, while egalitarian and non-violent men are emptied of attractiveness. This is known as coercive [...] Read more.
Research on gender violence has identified as one main component leading to gender violence a dominant socialization process which associates attractiveness to men who show violent behaviors and attitudes, while egalitarian and non-violent men are emptied of attractiveness. This is known as coercive dominant discourse. Starting from the evidence that the peer group is a main context of socialization in adolescence, quantitative data were collected from six classes of secondary education (14–15-year-old adolescents) to explore whether the coercive dominant discourse is displayed in social interactions in the peer group and, if so, how it influences attractiveness patterns and sexual-affective behavior in adolescence. The analyses reveal that the coercive dominant discourse is often reproduced in the peer group interactions, creating group pressure, and pushing some girls to violent relationships. Alternative ways of interaction are also reported, which allow a socialization leading to more freedom, less coercion, and more healthy relationships. Full article
(This article belongs to the Section Global and Public Health)
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Connection between Social Relationships and Basic Motor Competencies in Early Childhood
Children 2021, 8(1), 53; https://doi.org/10.3390/children8010053 - 17 Jan 2021
Cited by 5
Abstract
In preschool, children build new contacts and social relationships with other people. They learn to cooperate with their peers and communicate in groups. In addition to social relationships, basic motor competencies (in German: Motorische Basiskompetenzen (MOBAK)) are also seen as a central developmental [...] Read more.
In preschool, children build new contacts and social relationships with other people. They learn to cooperate with their peers and communicate in groups. In addition to social relationships, basic motor competencies (in German: Motorische Basiskompetenzen (MOBAK)) are also seen as a central developmental goal in early childhood and are necessary for participation in the culture of sports and movement. The aim of this paper is to describe the connection between social relationships and basic motor competencies in early childhood. In this present study, the motor competencies of N = 548 preschool children (51% girls, M = 68.0 months, SD = 6.8) were tested in the competence areas of self-movement and object movement. The children’s perceived social relationships were recorded from teacher and parent perspectives. The results clearly show a connection between social relationships and motor competencies in early childhood, with a stronger connection observed in boys. This finding is relevant both from a developmental and a health-oriented perspective, as it points to a link between physical and mental health, as well as technical and interdisciplinary competencies, in early childhood. Full article
(This article belongs to the Special Issue Physical Activity and Motor Competence in Preschool Children)
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Article
Motor Development among Spanish Preschool Children
Children 2021, 8(1), 41; https://doi.org/10.3390/children8010041 - 12 Jan 2021
Cited by 6
Abstract
The purpose of this study was to analyze motor development of Spanish preschoolers, taking into account sex and age, being an only child, prematurity, and the practice of extracurricular activities. The sample was composed of 300 preschoolers (132 girls, 168 boys) ages 3 [...] Read more.
The purpose of this study was to analyze motor development of Spanish preschoolers, taking into account sex and age, being an only child, prematurity, and the practice of extracurricular activities. The sample was composed of 300 preschoolers (132 girls, 168 boys) ages 3 to 6 years. Preschoolers were tested on 12 fundamental motor skills (locomotor and object control) through the Test of Gross Motor Development—Second Edition (TGMD-2). Nonparametric analysis indicated that there are differences between girls and boys in locomotor and object control skills in the age range of 3–4 years. However, boys and girls scored similarly at the age of 5 years in locomotor development. There were not differences between only children and those who are not only children. Similarly, prematurity was not associated with locomotor and object control development. Nevertheless, those preschoolers who practice extracurricular physical activities scored significantly higher in comparison with those children do not. Further research is needed to shed light on the differences between boys and girls in object control. It may be explained by the types of extracurricular activities. Full article
(This article belongs to the Special Issue Physical Activity and Motor Competence in Preschool Children)
Article
Safety and Effects of the Rapid Maxillary Expander on Temporomandibular Joint in Subjects Affected by Juvenile Idiopathic Arthritis: A Retrospective Study
Children 2021, 8(1), 33; https://doi.org/10.3390/children8010033 - 07 Jan 2021
Cited by 15
Abstract
Background: In Juvenile Idiopathic Arthritis (JIA) temporo-mandibular joints are often affected causing skeletal and dental malocclusions. The most frequent condition is mandibular hypoplasia, that may be associated with maxillary hypoplasia. The aim of this retrospective case control study is to investigate the effects [...] Read more.
Background: In Juvenile Idiopathic Arthritis (JIA) temporo-mandibular joints are often affected causing skeletal and dental malocclusions. The most frequent condition is mandibular hypoplasia, that may be associated with maxillary hypoplasia. The aim of this retrospective case control study is to investigate the effects and the safety of rapid maxillary expansion (RME) in growing patients affected by JIA. It was evaluated whether RME could be performed without complications on TMJs of JIA patients using DC/TMD protocol, and naso-maxillary transversal parameters were compared with the ones obtained on healthy patients. Methods: Twenty-five patients affected by JIA that ceased to manifest TMJ (Temporo-Mandibular Joint) symptoms in the previous year were treated with RME to solve the maxillary transverse hypoplasia. Postero-anterior cephalometric tracings were collected before and after treatment; linear measurements were obtained to study maxillary and nasal cavity modifications. Data were compared to those of a similar group of twenty-five healthy patients. Paired t-test and Independent t-test were used to evaluate changes before and after treatment in each group and to perform a comparison between the groups. Results: All patients demonstrated a statistically significant increase in nasal cavity width, maxillary width and upper and lower intermolar width. No patients presented a worsening of their TMJs condition. Intragroup comparisons revealed significant changes of cephalometric measurements, but no difference was found when comparing JIA and healthy patients. Conclusions: Growing patients with JIA that ceased to show signs of active TMJ involvement for at least one year could be safely treated with RME, expecting similar benefits to those of healthy patients. Dentists and rheumatologists should be informed of safety and potential benefits of palatal expansion in JIA patients in order to improve the outcome of orthodontic treatment and reduce the indication for more invasive procedures (i.e., Surgical Assisted Rapid Maxillary Expansion). Full article
(This article belongs to the Special Issue Dental Caries and Oral Health in Children)
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Article
Eating Behaviors in Relation to Child Weight Status and Maternal Education
Children 2021, 8(1), 32; https://doi.org/10.3390/children8010032 - 07 Jan 2021
Cited by 4
Abstract
Background: The eating behavior of children is important to maintain a healthy weight. This current study explored the differences in children’s eating behaviors and their relation to weight status and maternal education level, using the child eating behavior questionnaire (CEBQ). Methods: The study [...] Read more.
Background: The eating behavior of children is important to maintain a healthy weight. This current study explored the differences in children’s eating behaviors and their relation to weight status and maternal education level, using the child eating behavior questionnaire (CEBQ). Methods: The study recruited 169 participants aged between six and ten years. Multinomial logistic regression was conducted to examine the association between the CEBQ factors and children’s body weight status. The association between the CEBQ scores and maternal educational levels was examined using a one-way analysis of variance (ANOVA). Results: The multinomial logistic regression findings indicate that children in the obese group exhibited a significant increase in food responsiveness, enjoyment of food, emotional overeating, and a decrease in satiety responsiveness compared to normal weight children. The one-way ANOVA showed a significant difference in subscales under the food approach (food responsiveness, desire to drink, emotional overeating) and food avoidance (satiety responsiveness) based upon the child’s weight status. The three subscales under the food approach category were significantly dependent upon the maternal education but did not have a significant association with food avoidance. Conclusions: The results suggest that the increase in food responsiveness and emotional overeating in obese children is influenced by maternal education. Full article
(This article belongs to the Section Global and Public Health)
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Article
“Girls Aren’t Meant to Exercise”: Perceived Influences on Physical Activity among Adolescent Girls—The HERizon Project
Children 2021, 8(1), 31; https://doi.org/10.3390/children8010031 - 07 Jan 2021
Cited by 10
Abstract
Background. Adolescent girls are less active than boys, with approximately 10% of girls in Ireland and the United Kingdom meeting the minimum recommended daily physical activity (PA) guidelines. This study investigated factors perceived to influence PA among adolescent girls from low socioeconomic areas [...] Read more.
Background. Adolescent girls are less active than boys, with approximately 10% of girls in Ireland and the United Kingdom meeting the minimum recommended daily physical activity (PA) guidelines. This study investigated factors perceived to influence PA among adolescent girls from low socioeconomic areas in order to inform the design of a future intervention (The HERizon Project). Methods. A total of 48 adolescent girls (13–18 years) from low socioeconomic areas of the United Kingdom and Ireland participated in focus groups (n = 8), to explore perspectives of physical activity and the influence of gender within this. Focus groups were thematically analyzed and interpreted within a socioecological framework. Results. Most girls enjoyed PA and were aware of its benefits. They identified both barriers and facilitators to PA at intrapersonal (fear of judgement and changing priorities WITH age), interpersonal (changing social pressures and support from others) and organizational (delivery of PE) levels. Gender inequality was a multilevel factor, crossing all socioecological levels. Conclusion. Although many adolescent girls enjoy PA, their experiences appear to be limited by a fear of judgement and an overarching sense of gender inequality. Future interventions, such as the HERizon Project, should address influences at intrapersonal, interpersonal and organizational levels to promote positive PA experiences for adolescent girls. Full article
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Article
Improved Survival of Periviable Infants after Alteration of the Threshold of Viability by the Neonatal Resuscitation Program 2015
Children 2021, 8(1), 23; https://doi.org/10.3390/children8010023 - 04 Jan 2021
Cited by 7
Abstract
Periviable infants (PIs) born at 22–25 weeks gestational age (wGA) have a variable survival rate (49.7–86.2%) among hospitals. One factor involved in this difference may be the definition of the threshold of viability. The American Academy of Pediatrics revised the neonatal resuscitation program [...] Read more.
Periviable infants (PIs) born at 22–25 weeks gestational age (wGA) have a variable survival rate (49.7–86.2%) among hospitals. One factor involved in this difference may be the definition of the threshold of viability. The American Academy of Pediatrics revised the neonatal resuscitation program in late 2015 (NRP 2015) and altered the threshold of viability from 23 to 22 wGA. The impact on the survival of PIs after the guideline alteration has seldom been discussed. Since 2016, the unit of this study has implemented the renewed guideline for PIs. We retrospectively reviewed and analyzed the survival and clinical variables of PIs before and after implementation of the guideline, which included a 10-year cohort in a single center in Taiwan. There were 168 PIs enrolled between 2010 and 2019 (Epoch-I, 2010–2015; Epoch-II, 2016–2019), after excluding those with congenital anomalies and parent-decided comfort care. Compared to those in Epoch-I, the PIs in Epoch-II had significantly higher odds ratios (2.602) (95% confidence interval: 1.170–5.789; p = 0.019) for survival. Younger gestational age, small size for gestational age, cesarean delivery, low blood pH at birth, and surfactant therapeutic treatment were found to be significant risk factors associated with the survival of PIs (p < 0.05 for each). The altered threshold of viability by NRP 2015 may impact the survival of PIs. However, long-term follow-up for surviving PI is required in the future. Full article
(This article belongs to the Section Global and Public Health)
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Article
Longer Exposure to Left-to-Right Shunts Is a Risk Factor for Pulmonary Vein Stenosis in Patients with Trisomy 21
Children 2021, 8(1), 19; https://doi.org/10.3390/children8010019 - 01 Jan 2021
Cited by 10
Abstract
We conducted a study to determine whether patients born with Trisomy 21 and left-to-right shunts who develop pulmonary vein stenosis (PVS) have a longer exposure to shunt physiology compared to those who do not develop PVS. We included patients seen at Boston Children’s [...] Read more.
We conducted a study to determine whether patients born with Trisomy 21 and left-to-right shunts who develop pulmonary vein stenosis (PVS) have a longer exposure to shunt physiology compared to those who do not develop PVS. We included patients seen at Boston Children’s Hospital between 15 August 2006 and 31 August 2017 born with Trisomy 21 and left-to-right shunts who developed PVS within 24 months of age. We conducted a retrospective 3:1 matched case–control study. The primary predictor was length of exposure to shunt as defined as date of birth to the first echocardiogram showing mild or no shunt. Case patients with PVS were more likely to have a longer exposure to shunt than patients in the control group (6 vs. 3 months, p-value 0.002). Additionally, PVS patients were also more likely to have their initial repair ≥ 4 months of age (81% vs. 42%, p-value 0.003) and have a gestational age ≤ 35 weeks (48% vs. 13%, p-value 0.003). Time exposed to shunts may be an important modifiable risk factor for PVS in patients with Trisomy 21. Full article
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Article
Diminished Returns of Parental Education in Terms of Youth School Performance: Ruling out Regression toward the Mean
Children 2020, 7(7), 74; https://doi.org/10.3390/children7070074 - 07 Jul 2020
Cited by 13
Abstract
Background: Minorities’ Diminished Returns (MDRs) refer to systemically weaker effects of socioeconomic status (SES) indicators on various developmental, behavioral, and health outcomes of ethnic minorities compared to non-Hispanic (non-Latino) Whites. Similar MDRs also exist for the effects of parental education on the school [...] Read more.
Background: Minorities’ Diminished Returns (MDRs) refer to systemically weaker effects of socioeconomic status (SES) indicators on various developmental, behavioral, and health outcomes of ethnic minorities compared to non-Hispanic (non-Latino) Whites. Similar MDRs also exist for the effects of parental education on the school performance of ethnic minority youth. Aim: To assess whether regression toward the mean (RTM) has any role in explaining the diminished effects of parental education on the school performance of Black and Hispanic youth relative to non-Hispanic White youth. Materials and methods: Data for this cross-sectional study came from the Monitoring the Future survey (MTF, 2017), a nationally representative survey of American youth in 12th grade. The sample included 10,262 youth who were 12th graders (typically 17–18 years old). The independent variable was parental education with five categories: Some high school, High school graduate, Some college, College graduate, and Graduate school. The outcome was self-reported school performance measured as grade point average (GPA). Ethnicity was the effect modifier. Analysis of variance (ANOVA) and the Tukey Post Hoc test was used to analyze the data. Data visualization (line graphs) was used to visualize the shape of youth GPA as a function of parental education levels across ethnic groups. Results: While a perfect stepwise increase was seen in youth school performance as a result of parental education improvement, this pattern differed considerably across ethnic groups. Such a perfect stepwise increase in youth school performance as a result of the incremental increase in parental education was missing for Black and Hispanic youth. The shape of the association between parental education and youth school performance ruled out regression toward the mean (RTM) as an explanation for the observed diminished effects of parental education on the school performance of Black and Hispanic youth. Conclusion: Diminished returns of parental education on the school performance of Black and Hispanic youth cannot be explained by regression toward the mean. Other factors and contextual processes, such as segregation, discrimination, racism, and poor quality of schools in urban areas, should be investigated in future research. Full article
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Article
Family Socioeconomic Status and Exposure to Childhood Trauma: Racial Differences
Children 2020, 7(6), 57; https://doi.org/10.3390/children7060057 - 03 Jun 2020
Cited by 14
Abstract
Background: Minorities’ diminished returns (MDRs) refer to weaker effects of socioeconomic status (SES) indicators such as parental educational attainment and family income in generating tangible childhood outcomes for racial and ethnic minorities compared to the majority group, a pattern prevalent in the US. [...] Read more.
Background: Minorities’ diminished returns (MDRs) refer to weaker effects of socioeconomic status (SES) indicators such as parental educational attainment and family income in generating tangible childhood outcomes for racial and ethnic minorities compared to the majority group, a pattern prevalent in the US. Our existing knowledge is minimal, however, about diminished returns of family SES on reducing exposure to childhood trauma. Aim: To determine if there was a difference between non-Hispanic whites (NHW) and non-Hispanic blacks (NHB) in the effect of SES on exposure to childhood trauma among children ages 8–11 years old. Materials and methods: In this cross-sectional study, we analyzed data from 4696 NHW or NHB American 8–11-year-old children who were participants in the Adolescent Brain Cognitive Development (ABCD) Study. The independent variables were parental educational attainment and family income. The primary outcome was exposure to 1 or 2+ childhood traumas, measured by the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) semi-structured interview. Polynomial regression was used for data analysis. Results: Parental education and family income had statistically significant protective (negative) effects on childhood trauma, indicating children from high income and highly educated families were exposed to a lower level of childhood trauma. However, race/ethnicity showed statistically significant interactions with parental education and family income on exposure to childhood trauma, indicating weaker protective effects of parental education and family income on reducing exposure to trauma for NHB compared to NHW children. Race-specific models showed protective effects of parental education and family income on exposure to childhood trauma for NHW but not NHB children. Conclusion: The protective effects of parental education and family income against exposure to childhood trauma are systematically diminished for NHBs compared to NHWs. To minimize the racial/ethnic health gaps, diminished returns of parental education and family income should be addressed. There is a need for programs and interventions that equalize not only SES but also the marginal returns of SES for ethnic groups. Such efforts require addressing structural and societal barriers that hinder NHB families from translating their SES resources into tangible outcomes. There is a need for studies that can minimize MDRs for NHB families, such that SES can similarly secure tangible outcomes in the presence of SES resources. Full article
Article
Minorities’ Diminished Returns of Parental Educational Attainment on Adolescents’ Social, Emotional, and Behavioral Problems
Children 2020, 7(5), 49; https://doi.org/10.3390/children7050049 - 18 May 2020
Cited by 14
Abstract
Aim: To compare racial groups for the effect of parental educational attainment on adolescents’ social, emotional, and behavioral problems. Methods: In this cross-sectional study, 10,762 youth from the Adolescent Brain Cognitive Development (ABCD) study were included. The independent variable was parental educational attainment. [...] Read more.
Aim: To compare racial groups for the effect of parental educational attainment on adolescents’ social, emotional, and behavioral problems. Methods: In this cross-sectional study, 10,762 youth from the Adolescent Brain Cognitive Development (ABCD) study were included. The independent variable was parental educational attainment. The main outcomes were (1) anxious and depressed mood, (2) withdrawn and depressed affect, (3) somatic complaints, (4) social and interpersonal problems, (5) thought problems, (6) rule-breaking behaviors, (7) attention problems, and (8) violent and aggressive behaviors. These scores were generated based on parent-reported behavioral problems measured using the Child Behavior Checklist (CBCL). Race and ethnicity were the moderators. Linear regression was used to analyze the ABCD data. Results: Overall, high parental educational attainment was associated with lower scores across all domains. Race and ethnicity showed statistically significant interactions with parental educational attainment on adolescents’ fewer social, emotional, and behavioral problems (all domains), net of all confounders, indicating smaller tangible gains from their parental educational attainment for Black and Hispanic compared to non-Hispanic White adolescents. Conclusions: The protective effects of parental education against social, emotional, and behavioral problems are systematically diminished for Hispanic and Black than non-Hispanic White adolescents. Full article
Article
The Influence of Social Support on Physical Activity in Chinese Adolescents: The Mediating Role of Exercise Self-Efficacy
Children 2020, 7(3), 23; https://doi.org/10.3390/children7030023 - 20 Mar 2020
Cited by 15
Abstract
The purpose of this study was to examine the associations of social support and self-efficacy with physical Activity (PA) and the mediating effect of self-efficacy on the relationship between social support and PA in Chinese adolescents. Participants included a total of 2341 Chinese [...] Read more.
The purpose of this study was to examine the associations of social support and self-efficacy with physical Activity (PA) and the mediating effect of self-efficacy on the relationship between social support and PA in Chinese adolescents. Participants included a total of 2341 Chinese adolescents (aged 12.75 ± 1.46 years). Self-reported instruments, including the physical activity questionnaire for adolescents, the social support revalued scale and the exercise self-efficacy scale, were used to measure physical activity, social support and exercise self-efficacy. Results showed that social support (r = 0.29, p < 0.05) and exercise self-efficacy (r = 0.43, p < 0.05) were significant and positive predictors of PA among Chinese adolescents, and exercise self-efficacy was a significant mediator in the relationship between social support and PA (standardized effect size = 0.15, p < 0.001). Such findings were evident with similar patterns in both male and female adolescents. The findings of this study have indicated the importance of social support and exercise self-efficacy on PA promotion in adolescents, which will aid the development of effective interventions in this population. Full article
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Article
Effects of a Need-Supportive Motor Skill Intervention on Children’s Motor Skill Competence and Physical Activity
Children 2020, 7(3), 21; https://doi.org/10.3390/children7030021 - 17 Mar 2020
Cited by 17
Abstract
A need-supportive environment can provide various motivational benefits to impact children’s psychomotor developmental levels. However, very little is known about the effects of need-supportive motor skill intervention on children’s motor skill competence and physical activity by gender. Guided by self-determination theory (SDT), this [...] Read more.
A need-supportive environment can provide various motivational benefits to impact children’s psychomotor developmental levels. However, very little is known about the effects of need-supportive motor skill intervention on children’s motor skill competence and physical activity by gender. Guided by self-determination theory (SDT), this study aimed to (a) investigate the effect of a need-supportive fundamental movement skill (FMS) program on children’s FMS competence and moderate-to-vigorous physical activity (MVPA), and (b) explore potential gender differences in these effects. Thirty-six children (63.8% girls; Mage = 6.52 ± 0.97) participated and were divided into two groups: an intervention group (24 need-supportive FMS sessions over eight weeks) and a control group. A repeated-measures multivariate analysis of variance (MANOVA) was used to examine the influence of the motor skill intervention on FMS competence and MVPA over time by group (intervention, control) and gender (boys, girls). The results showed (a) significant group differences between the intervention and control group in FMS competence and MVPA (p < 0.001), (b) non-significant gender differences between boys and girls in FMS competence and MVPA (p = 0.85), and (c) non-significant interaction effects over time (p = 0.52). The findings highlight that a need-supportive FMS program may enhance FMS development and daily physical activity for both genders during the early school years. Full article
(This article belongs to the Section Global and Public Health)
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Article
The Profile, Health Seeking Behavior, Referral Patterns, and Outcome of Outborn Neonates Admitted to a District and Regional Hospital in the Upper West Region of Ghana: A Cross-Sectional Study
Children 2020, 7(2), 15; https://doi.org/10.3390/children7020015 - 18 Feb 2020
Cited by 3
Abstract
Neonatal mortality is the major contributor to under-five mortality rates in many low and middle income countries. We examined the health practices, care-seeking behavior, and referral of sick outborn neonates to a district and regional hospital in the Upper West Region of Ghana. [...] Read more.
Neonatal mortality is the major contributor to under-five mortality rates in many low and middle income countries. We examined the health practices, care-seeking behavior, and referral of sick outborn neonates to a district and regional hospital in the Upper West Region of Ghana. The study was a cross-sectional study conducted over an eight (8) month period in 2018. Data were obtained from caregiver interviews and case notes. Altogether, 153 outborn neonates were examined. Inappropriate practices including the use of enemas, cord care with cow dung, and herbal baths were found. Three babies treated this way died. The majority of caregivers sought care at a health facility. However, 67 (44%) sought care only after their babies were ill for ≥7 days, suggesting the influence of a period of confinement on health seeking. More than half, 94 (61.4%), of the facilities visited referred patients to destination hospitals without giving any treatment. Delayed care-seeking was associated with a low birth weight, using home remedies, and a maternal age of ≥30 years. Altogether, 12 neonates (7.8%) died, consisting of three males and nine females (p = 0.018). Socio-cultural factors strongly influence health seeking behavior and the health outcome of neonates in this setting. There appeared to be a limited repertoire of interventions for treating neonatal disease in primary care. Full article
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Communication
Study Protocol of the Parents in Child Nutrition Informing Community (PICNIC) Peer Education Cohort Study to Improve Child Feeding and Dietary Intake of Children Aged Six Months to Three Years Old
Children 2020, 7(1), 3; https://doi.org/10.3390/children7010003 - 27 Dec 2019
Cited by 5
Abstract
One in five Australian pre-schoolers are overweight or obese, meaning the first years of life are vital for obesity primary prevention. Parent child feeding practices impact on children’s dietary intake, which in turn impacts on their weight status. Parents’ child feeding beliefs are [...] Read more.
One in five Australian pre-schoolers are overweight or obese, meaning the first years of life are vital for obesity primary prevention. Parent child feeding practices impact on children’s dietary intake, which in turn impacts on their weight status. Parents’ child feeding beliefs are heavily influenced by parenting peers. The aim of this cohort study is to evaluate the impact of the Parents in Child Nutrition Informing Community (PICNIC) study on parents feeding practices and diet quality. The secondary outcomes are the perceptions of trained peer educators and education recipients based on their involvement in PICNIC. One hundred parents with a child aged 0–2 years at time of recruitment will participate in peer educator training, then disseminate nutrition and child feeding content to other parents over an intervention period of 12 months, supported by project-specific, evidence-based social media pages and website. An additional 100 new parents, recruited by peer educators, will participate in the study as nutrition education recipients. Both peer educators and education recipients will complete quantitative child feeding surveys before and during the 12 month intervention and a dietary intake survey at a time point 12 months post intervention. Following the intervention, 30 education recipients will be asked to participate in semi-structured phone interviews about their experiences with PICNIC. Peer educators will contribute as co-researchers and active participants in the evolution of the PICNIC model. This study will contribute to enhanced understanding of contemporary health literacy strategies for communicating nutrition and feeding messages to new parents and the impact of these strategies on parents feeding practices and children’s dietary intake in a community setting. Full article
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Article
The Role of Social Support in Adolescent/Young Adults Coping with Cancer Treatment
Children 2020, 7(1), 2; https://doi.org/10.3390/children7010002 - 23 Dec 2019
Cited by 11
Abstract
Adolescents/young-adult (AYA) cancer patients are a psychosocially at-risk group as they are often less well-studied than other age cancer cohorts. Therefore, they experience disparities in access to developmentally informed treatment. Social support has been determined as an important aspect of AYAs’ cancer experience, [...] Read more.
Adolescents/young-adult (AYA) cancer patients are a psychosocially at-risk group as they are often less well-studied than other age cancer cohorts. Therefore, they experience disparities in access to developmentally informed treatment. Social support has been determined as an important aspect of AYAs’ cancer experience, but additional research was needed to describe specific behaviors AYAs found helpful and to explore how AYAs seek opportunities for additional support. As part of a larger qualitative study, study aims were to determine how AYAs (ages 15–26) cope during cancer treatment and examine how social support interacts with individual AYA coping. Participants included 10 AYA cancer patients undergoing treatment (mean age = 18.9 years) and 10 parents (mean age = 45.6 years). Descriptively, participants scored within the normal to high range on measures of hope, depression/anxiety/stress, quality of life, and social support. Participants completed semi-structured, audio-recorded interviews that were transcribed and coded as generated. Qualitative analysis was guided by principles of grounded theory and utilized the constant comparative approach. Themes within social support groups included presence, distraction, positive attitude, and maintaining AYA autonomy, communication, and advocacy. Results suggest social supports provide additional coping resources for AYAs with cancer through supplementing individual coping strategies. Future directions/implications for intervention/treatment are discussed. Full article
(This article belongs to the Special Issue Psychosocial Functioning in Childhood Cancer)
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Article
NICU Admissions for Meconium Aspiration Syndrome before and after a National Resuscitation Program Suctioning Guideline Change
Children 2019, 6(5), 68; https://doi.org/10.3390/children6050068 - 07 May 2019
Cited by 20
Abstract
The Textbook of Neonatal Resuscitation, seventh edition, does not suggest routine endotracheal suctioning for non-vigorous infants born through meconium-stained amniotic fluid. We compared 301,150 infants at ≥35 weeks’ gestational age inborn at 311 Vermont Oxford Network member centers in the United States (U.S.) [...] Read more.
The Textbook of Neonatal Resuscitation, seventh edition, does not suggest routine endotracheal suctioning for non-vigorous infants born through meconium-stained amniotic fluid. We compared 301,150 infants at ≥35 weeks’ gestational age inborn at 311 Vermont Oxford Network member centers in the United States (U.S.) and admitted to neonatal intensive care units (NICU) who were born before (2013 to 2015) and after (2017) the guideline change. Logistic regression models adjusting for clustering of infants within centers were used to calculate risk ratios. NICU admissions for infants with a diagnosis of meconium aspiration syndrome (MAS) decreased from 1.8% to 1.5% (risk ratio: 0.82; 95% confidence interval: 0.68, 0.97) and delivery room endotracheal suctioning in this group decreased from 57.0% to 28.9% (0.51; 0.41, 0.62). Treatment with conventional or high frequency ventilation, inhaled nitric oxide, or extracorporeal membrane oxygenation remained unchanged 42.3% vs. 40.3% (0.95; 0.80, 1.13) among infants with MAS and 9.1% vs. 8.2% (0.91; 0.87, 0.95) among infants without MAS. The use of surfactant among infants with MAS increased from 24.6% to 30% (1.22; 1.02, 1.48). Mortality (2.6 to 2.9%, 1.12; 0.74, 1.69) and moderate/severe hypoxic-ischemic encephalopathy (5.4 to 6.8%, 1.24; 0.91, 1.69) increased slightly in 2017. Subgroup analyses of infants with 1 min Apgar scores of ≤3 found similar results. While NICU admissions for MAS and tracheal suctioning decreased after the introduction of the new guideline with no subsequent increase in severe respiratory distress among infants with and without a MAS diagnosis, limitations in our study preclude inferring that the new guideline is safe or effective. Full article
(This article belongs to the Special Issue Emerging Concepts in Neonatal Resuscitation)
Communication
Regulation of E-Cigarettes in the United States and Its Role in a Youth Epidemic
Children 2019, 6(3), 40; https://doi.org/10.3390/children6030040 - 04 Mar 2019
Cited by 17
Abstract
During the first decade of federal regulation of electronic nicotine delivery systems (ENDS), the e-cigarette industry has rapidly grown. Recently, the U.S. Surgeon General and Commissioner of the Food and Drug Administration each declared the rapid rise in rates of youth using these [...] Read more.
During the first decade of federal regulation of electronic nicotine delivery systems (ENDS), the e-cigarette industry has rapidly grown. Recently, the U.S. Surgeon General and Commissioner of the Food and Drug Administration each declared the rapid rise in rates of youth using these products to be an “epidemic.” While a foundational basis for regulating ENDS has been in effect since 2016, deferred enforcement has contributed to acute rise in use by youth. The Agency has undertaken several initiatives to address the problem and warned manufacturers that if current youth trends continue, it will be “game over.” Full article
(This article belongs to the Special Issue Tobacco and Nicotine Use and Exposure Among Children and Adolescents)
Article
Family Income at Birth and Risk of Attention Deficit Hyperactivity Disorder at Age 15: Racial Differences
Children 2019, 6(1), 10; https://doi.org/10.3390/children6010010 - 14 Jan 2019
Cited by 86
Abstract
Background: Socioeconomic status (SES) resources protect children and adults against the risk of medical and psychiatric conditions. According to the Minorities’ Diminished Returns theory, however, such protective effects are systemically weaker for the members of racial and ethnic minority groups compared to Whites. [...] Read more.
Background: Socioeconomic status (SES) resources protect children and adults against the risk of medical and psychiatric conditions. According to the Minorities’ Diminished Returns theory, however, such protective effects are systemically weaker for the members of racial and ethnic minority groups compared to Whites. Aims: Using a national data set with 15 years of follow up, we compared Black and White youth for the effects of family SES at birth on the risk of Attention Deficit Hyperactivity Disorder (ADHD) at age 15. Methods: The Fragile Families and Child Wellbeing Study (FFCWS, 1998–2016) is a longitudinal prospective study of urban youth from birth to age 15. This analysis included 2006 youth who were either White (n = 360) or Black (n = 1646). The independent variable was family income, the dependent variable was ADHD at age 15. Child gender, maternal age, and family type at birth were covariates, and race was the focal moderator. We ran logistic regressions in the overall sample and specific to race. Results: In the overall sample, high family income at birth was not associated with the risk of ADHD at age 15, independent of all covariates. Despite this relationship, we found a significant interaction between race and family income at birth on subsequent risk of ADHD, indicating a stronger effect for Whites compared to Blacks. In stratified models, we found a marginally significant protective effect of family SES against the risk of ADHD for White youths. For African American youth, on the other hand, family SES was shown to have a marginally significant risk for ADHD. Conclusions: The health gain that follows family income is smaller for Black than White families, which is in line with the Minorities’ Diminished Returns. The solution to health disparities is not simply policies that aim to reduce the racial gap in SES, because various racial health disparities in the United States are not due to differential access to resources but rather the impact of these resources on health outcomes. Public policies, therefore, should go beyond equalizing access to resources and also address the structural racism and discrimination that impact Blacks’ lives. Policies should fight racism and should help Black families to overcome barriers in their lives so they can gain health from their SES and social mobility. As racism is multi-level, multi-level interventions are needed to tackle diminished returns of SES. Full article
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