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 readers, or important in the respective research area. 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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7 pages, 192 KiB  
Article
Evaluation of Adolescents’ Awareness of Seat Belt Use and the Relationship with Risky Behaviors
by Hatice Topal, Sadettin Burak Açıkel, Hülya Şirin, Emine Polat, Harun Terin, Mehmet Mustafa Yılmaz and Saliha Şenel
Children 2024, 11(6), 656; https://doi.org/10.3390/children11060656 - 28 May 2024
Cited by 2 | Viewed by 1253
Abstract
The one of the leading causes of adolescent morbidity and mortality worldwide is motor vehicle accidents (MVA). The use of seat belts significantly lowers MVA fatalities and injuries. The aim of this study is to investigate adolescent seat belt usage patterns and relation [...] Read more.
The one of the leading causes of adolescent morbidity and mortality worldwide is motor vehicle accidents (MVA). The use of seat belts significantly lowers MVA fatalities and injuries. The aim of this study is to investigate adolescent seat belt usage patterns and relation with risky behaviors. The study conducted at two medical institutions with non-immigrant and literate adolescents aged 12–18. Demographics, seat belt use, and risk-taking behavior were collected through questionnaires. 726 teenagers (422 girls and 304 boys) with an average age of 176.7 ± 23.37 months participated in the study. Parents’ educational levels and front-seat belt use have been found to be correlated. Comparatively to non-users, seat belt users demonstrated lower risk scores (total, traffic, substance, and social). The use of seat belts was significantly predicted by traffic risk, according to logistic regression. The frequency of seatbelt use was higher among participants from cities with higher socioeconomic status. As a result, it was found that adolescents who exhibited more risky behaviors had a lower frequency of seat belt use and seat belt use was associated with socioeconomic level and parental education level. It is thought that population-based studies to be conducted on this subject are important. Full article
(This article belongs to the Section Pediatric Mental Health)
17 pages, 1346 KiB  
Article
Effect of the Different Dietary Supplements on the Average Surface Roughness and Color Stability of Direct Restorative Materials Used in Pediatric Dentistry
by Nagehan Aktaş, Yasemin Akın, Cenkhan Bal, Mehmet Bani and Merve Bankoğlu Güngör
Children 2024, 11(6), 645; https://doi.org/10.3390/children11060645 - 27 May 2024
Cited by 1 | Viewed by 2001
Abstract
Increased surface roughness and discoloration of the direct restorative materials used in pediatric patients affect the longevity of restorations and impair children’s oral health. Many factors can alter these properties. One of these factors is the intake of dietary supplements. It is crucial [...] Read more.
Increased surface roughness and discoloration of the direct restorative materials used in pediatric patients affect the longevity of restorations and impair children’s oral health. Many factors can alter these properties. One of these factors is the intake of dietary supplements. It is crucial to predict the properties of restorative materials when exposed to dietary supplements to maintain the dental care of children. Thus, this study aimed to investigate the effect of various syrup-formed dietary supplements on the average surface roughness and color stability of current restorative materials used in pediatric dentistry. Seven different restorative materials (conventional glass ionomer [Fuji IX GP], resin-modified glass ionomer, [Fuji II LC], zirconia-reinforced glass ionomer [Zirconomer Improved], polyacid-modified composite resin [Dyract®XTRA], bulk-fill glass hybrid restorative [Equia Forte HT Fill], conventional resin composite [Charisma Smart], and resin composite with reactive glass fillers [Cention N]) were tested. The specimens prepared from each type of restorative material were divided into five subgroups according to dietary supplements (Sambucol Kids, Resverol, Imunol, Umca, and Microfer). These specimens were immersed daily in supplement solution over a period of 28 days. Surface roughness and color difference measurements were performed at baseline and at the 7th and 28th days. The color difference and Ra values showed that there was an interaction among the type of restorative material, type of dietary supplement, and immersion time factors (p < 0.05). Whereas lower Ra values were found in the composite resin group, the highest Ra values were found in the conventional glass ionomer group. All supplements caused increasing color difference values, and Resverol and Umca showed higher discoloration values above the clinically acceptable threshold. The intake of dietary supplement type, the immersion time of the dietary supplement, and the restorative material type affected the surface roughness and color stability of the tested direct restorative materials. All of the experimental groups showed higher Ra values than clinically acceptable surface roughness values (0.2 µm). The color difference values also increased with the immersion time. Full article
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19 pages, 5012 KiB  
Review
Complete Transposition of the Great Arteries in the Pediatric Field: A Multimodality Imaging Approach
by Sara Moscatelli, Martina Avesani, Nunzia Borrelli, Jolanda Sabatino, Valeria Pergola, Isabella Leo, Claudia Montanaro, Francesca Valeria Contini, Gabriella Gaudieri, Jessica Ielapi, Raffaella Motta, Marco Alfonso Perrone and Giovanni Di Salvo
Children 2024, 11(6), 626; https://doi.org/10.3390/children11060626 - 23 May 2024
Cited by 7 | Viewed by 3290
Abstract
The complete transposition of the great arteries (C-TGA) is a congenital cardiac anomaly characterized by the reversal of the main arteries. Early detection and precise management are crucial for optimal outcomes. This review emphasizes the integral role of multimodal imaging, including fetal echocardiography, [...] Read more.
The complete transposition of the great arteries (C-TGA) is a congenital cardiac anomaly characterized by the reversal of the main arteries. Early detection and precise management are crucial for optimal outcomes. This review emphasizes the integral role of multimodal imaging, including fetal echocardiography, transthoracic echocardiography (TTE), cardiovascular magnetic resonance (CMR), and cardiac computed tomography (CCT) in the diagnosis, treatment planning, and long-term follow-up of C-TGA. Fetal echocardiography plays a pivotal role in prenatal detection, enabling early intervention strategies. Despite technological advances, the detection rate varies, highlighting the need for improved screening protocols. TTE remains the cornerstone for initial diagnosis, surgical preparation, and postoperative evaluation, providing essential information on cardiac anatomy, ventricular function, and the presence of associated defects. CMR and CCT offer additional value in C-TGA assessment. CMR, free from ionizing radiation, provides detailed anatomical and functional insights from fetal life into adulthood, becoming increasingly important in evaluating complex cardiac structures and post-surgical outcomes. CCT, with its high-resolution imaging, is indispensable in delineating coronary anatomy and vascular structures, particularly when CMR is contraindicated or inconclusive. This review advocates for a comprehensive imaging approach, integrating TTE, CMR, and CCT to enhance diagnostic accuracy, guide therapeutic interventions, and monitor postoperative conditions in C-TGA patients. Such a multimodal strategy is vital for advancing patient care and improving long-term prognoses in this complex congenital heart disease. Full article
(This article belongs to the Special Issue Beyond Congenital Heart Disease: Role of the Pediatric Cardiologist)
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11 pages, 1106 KiB  
Article
Bowel Management in Hirschsprung Disease—Pre-, Peri- and Postoperative Care for Primary Pull-Through
by Judith Lindert, Felix Schulze and Stefanie Märzheuser
Children 2024, 11(5), 588; https://doi.org/10.3390/children11050588 - 13 May 2024
Cited by 5 | Viewed by 2683
Abstract
(1) Background: Bowel management contributes throughout the pathway of care for children with Hirschsprung. Preoperative bowel management prepares the child and family for the pull-through surgery. Perioperative bowel management supports early recovery and tailored bowel management in the follow-up supports the achievement of [...] Read more.
(1) Background: Bowel management contributes throughout the pathway of care for children with Hirschsprung. Preoperative bowel management prepares the child and family for the pull-through surgery. Perioperative bowel management supports early recovery and tailored bowel management in the follow-up supports the achievement of social continence. (2) Methods: We conducted a cross-sectional assessment of our institutional bowel management program to illustrate the pre-, peri- and postoperative bowel management strategies. (3) Results: A total of 31 children underwent primary pull-through, 23 without a stoma and 8 with a stoma, at a median age of 9 months. All children without a stoma were prepared for surgery by using rectal irrigations. Children with a stoma were prepared for surgery with a transfer of stoma effluent. Transanal irrigation supported early recovery. (4) Conclusions: Bowel management is a key pillar of the management of children with Hirschsprung disease. Incorporating bowel management in the pathway of care facilitates primary pull-through and supports perioperative recovery. Full article
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19 pages, 2041 KiB  
Review
The Potential Impact of the Gut Microbiota on Neonatal Brain Development and Adverse Health Outcomes
by Maria Tzitiridou-Chatzopoulou, Jannis Kountouras and Georgia Zournatzidou
Children 2024, 11(5), 552; https://doi.org/10.3390/children11050552 - 5 May 2024
Cited by 5 | Viewed by 2669
Abstract
Over the past decade, microbiome research has significantly expanded in both scope and volume, leading to the development of new models and treatments targeting the gut–brain axis to mitigate the effects of various disorders. Related research suggests that interventions during the critical period [...] Read more.
Over the past decade, microbiome research has significantly expanded in both scope and volume, leading to the development of new models and treatments targeting the gut–brain axis to mitigate the effects of various disorders. Related research suggests that interventions during the critical period from birth to three years old may yield the greatest benefits. Investigating the substantial link between the gut and brain during this crucial developmental phase raises fundamental issues about the role of microorganisms in human health and brain development. This underscores the importance of focusing on the prevention rather than the treatment of neurodevelopmental and neuropsychiatric disorders. The present review examines the gut microbiota from birth to age 3, with a particular focus on its potential relationship with neurodevelopment. This review emphasizes the immunological mechanisms underlying this relationship. Additionally, the study investigates the impact of the microbiome on cognitive development and neurobehavioral issues such as anxiety and autism. Importantly, it highlights the need to integrate mechanistic studies of animal models with epidemiological research across diverse cultures to better understand the role of a healthy microbiome in early life and the implications of dysbiosis. Furthermore, this review summarizes factors contributing to the transmission of gut microbiome-targeted therapies and their effects on neurodevelopment. Recent studies on environmental toxins known to impact neurodevelopment are also reviewed, exploring whether the microbiota may mitigate or modulate these effects. Full article
(This article belongs to the Section Pediatric Neonatology)
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19 pages, 1446 KiB  
Article
Neuropsychological Symptoms and Quality of Life during the COVID-19 Pandemic in Children: A Survey in a Pediatric Population in the Abruzzo Region, Italy
by Chiara Marcotullio, Marina Attanasi, Annamaria Porreca, Paola Di Filippo, Sara Matricardi, Annamaria Venanzi, Marco Schiavo, Antonio Paone, Nadia Rossi, Francesco Chiarelli and Giovanni Prezioso
Children 2024, 11(5), 532; https://doi.org/10.3390/children11050532 - 28 Apr 2024
Cited by 4 | Viewed by 1617
Abstract
Background: The SARS-CoV-2 pandemic has significantly affected the pediatric population. Long-term sequelae (Long COVID-19) may particularly involve the central nervous system, with possible effects on psychological well-being and quality of life (QoL), aspects that were already influenced by the restrictive measures and general [...] Read more.
Background: The SARS-CoV-2 pandemic has significantly affected the pediatric population. Long-term sequelae (Long COVID-19) may particularly involve the central nervous system, with possible effects on psychological well-being and quality of life (QoL), aspects that were already influenced by the restrictive measures and general social impact of the pandemic. Methods: We conducted a cross-sectional survey that aims at investigating the neuropsychological effects and the QoL impairment of SARS-CoV-2 on a cohort of children and adolescents in the Abruzzo region (Italy). A questionnaire was submitted to caregivers with the help of the PEDIATOTEM platform. A control group of healthy subjects was also included to distinguish between the effects of infection from the general influence of the pandemic. Results: A total of 569 subjects responded: 396 COVID-19 patients (99 of whom had Long COVID-19) and 111 controls. After the pandemic, when compared with the COVID-19 group, the controls reported significantly increased appetite, sleeping habits, and time spent remotely with friends and a reduction in physical activity and time spent in person with friends. A significant higher rate of controls asked for psychological/medical support for emotional problems. On the other hand, the Long COVID-19 group showed more fatigue and emotional instability with respect to non-Long-COVID-19 subjects. No differences in QoL results (EuroQOL) were found between the COVID-19 patients and controls, while the Long-COVID-19 subgroup showed significantly higher rates of pain/discomfort and mood instability, as confirmed by the analysis of variation of responses from the pre-COVID-19 to the post-COVID-19 period. Conclusions: Among COVID-19 patients, neuropsychological and QoL impairment was more evident in the Long COVID-19 subgroup, although emotional and relational issues were also reported by uninfected patients, with a growing request for specialist support as a possible consequence of social restriction. Full article
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15 pages, 605 KiB  
Review
The Prevention of House Dust Mite Allergies in Pediatric Asthma
by Angela Klain, Antonio Andrea Senatore, Amelia Licari, Francesca Galletta, Irene Bettini, Leonardo Tomei, Sara Manti, Francesca Mori, Michele Miraglia del Giudice and Cristiana Indolfi
Children 2024, 11(4), 469; https://doi.org/10.3390/children11040469 - 15 Apr 2024
Cited by 7 | Viewed by 5368
Abstract
This review provides a concise overview of preventive measures against dust mite allergies in pediatric populations, emphasizing the need for a comprehensive and evolving approach. Dust mites, ubiquitous microscopic arachnids, pose a significant threat to children’s health, triggering allergies and asthma. Traditional preventive [...] Read more.
This review provides a concise overview of preventive measures against dust mite allergies in pediatric populations, emphasizing the need for a comprehensive and evolving approach. Dust mites, ubiquitous microscopic arachnids, pose a significant threat to children’s health, triggering allergies and asthma. Traditional preventive strategies such as regular cleaning, mattress covers, and humidity control are essential but warrant refinement. Empowering children through personalized hygiene education and exploring innovative bedding solutions showcase a forward-thinking paradigm. Collaboration with healthcare professionals and embracing technology-driven solutions ensures a holistic and adaptable approach to safeguarding pediatric health against dust mite-related ailments. This abstract underscores the importance of continually reassessing and innovating preventive measures to create resilient and health-conscious living environments for children. Full article
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19 pages, 1461 KiB  
Review
Risk Factors of Malnutrition among In-School Children and Adolescents in Developing Countries: A Scoping Review
by Mustapha Amoadu, Susanna Aba Abraham, Abdul Karim Adams, William Akoto-Buabeng, Paul Obeng and John Elvis Hagan, Jr.
Children 2024, 11(4), 476; https://doi.org/10.3390/children11040476 - 15 Apr 2024
Cited by 7 | Viewed by 12036
Abstract
Malnutrition among in-school children is a complex issue influenced by socio-economic, environmental, and health-related factors, posing significant challenges to their well-being and educational trajectories in developing countries. This review synthesized evidence on the multifaceted aspects of child malnutrition within the educational setting in [...] Read more.
Malnutrition among in-school children is a complex issue influenced by socio-economic, environmental, and health-related factors, posing significant challenges to their well-being and educational trajectories in developing countries. This review synthesized evidence on the multifaceted aspects of child malnutrition within the educational setting in developing countries. This review followed the six steps outlined by Arksey and O’Malley’s framework. Four main databases (PubMed, CENTRAL, JSTOR, and Scopus) were searched. Additional searches were conducted in WHO Library, ProQuest, HINARI, Google Scholar, and Google. Reference lists of eligible papers were checked. This review found that low family income, varying family sizes, parental employment status, and educational levels significantly impact malnutrition among in-school children and adolescents. Environmental elements, including rural/urban residence, household sanitation, and living conditions, also influence malnutrition. In addition, nutrition knowledge, dietary habits, nutrient deficiencies, physical activity, and prevalent health conditions compound the risk of malnutrition. This study underscores the extensive health impact of malnutrition on general health, specific nutrient deficiencies, fetal/maternal health concerns, and overall morbidity. Also, malnutrition affects school performance and attendance, impacting cognitive abilities, and academic achievements. Addressing these challenges requires comprehensive policy actions aligned with Sustainable Development Goals, emphasizing poverty alleviation, health literacy, and gender equity. Full article
(This article belongs to the Section Pediatric Gastroenterology and Nutrition)
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10 pages, 423 KiB  
Article
Childhood Obesity Trends among 8–11-Year-Olds: Insights from a School Sample in Vienna, Austria (2017–2023)
by Paula Moliterno, Victoria Donhauser and Kurt Widhalm
Children 2024, 11(4), 431; https://doi.org/10.3390/children11040431 - 3 Apr 2024
Cited by 5 | Viewed by 2122
Abstract
In Austria, childhood obesity is a public health concern. This study examined time trends in the percentage of obesity among a sample of schoolchildren from Vienna (2017–2023). The body mass index percentiles of 326 children [9.3 years old (95% CI 8.3–10.5, min–max 8.0–10.9] [...] Read more.
In Austria, childhood obesity is a public health concern. This study examined time trends in the percentage of obesity among a sample of schoolchildren from Vienna (2017–2023). The body mass index percentiles of 326 children [9.3 years old (95% CI 8.3–10.5, min–max 8.0–10.9] from the EDDY study were calculated for trend analyses. Trend analysis was performed using a logistic regression using overweight and obesity as dependent binary variables, and study year and age as independent continuous variables. The percentage change over time was calculated, including the first period of the COVID-19 pandemic. Obesity percentages increased from 23.5 (95% CI 15.1–31.9)% in 2017 to 25.0 (95% CI 12.2–37.8)% in 2023. From 2017 to 2023, while overweight/obesity percentages decreased by 25.9 (−59.5–15.6)%, obesity increased by 6.4 (−51.2–94.9)%. A non-significant trend (p ≥ 0.38) was observed. During the first period of the pandemic, the percentage changes in overweight/obesity and obesity were 68.4 (5.6–187.9)% and 29.2 (−37.3–166.8)%, respectively. The current percentage of obesity in this sample is high and peaked in 2020 during the pandemic. These findings emphasize the need for future investigations considering the representativeness of the school-aged population in Austria to gain a broader picture of overweight and obesity trends. Full article
(This article belongs to the Section Global Pediatric Health)
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16 pages, 558 KiB  
Review
Exploring Progesterone Deficiency in First-Trimester Miscarriage and the Impact of Hormone Therapy on Foetal Development: A Scoping Review
by Munkhtuya Bataa, Erini Abdelmessih and Fahad Hanna
Children 2024, 11(4), 422; https://doi.org/10.3390/children11040422 - 2 Apr 2024
Cited by 4 | Viewed by 3168
Abstract
Background and Objectives: Progesterone deficiency during pregnancy may lead to various complications, including first-trimester miscarriage, which is the most common pregnancy complication. However, progesterone therapy may play a role in pregnancy maintenance and foetal development. The aim of this scoping review is to [...] Read more.
Background and Objectives: Progesterone deficiency during pregnancy may lead to various complications, including first-trimester miscarriage, which is the most common pregnancy complication. However, progesterone therapy may play a role in pregnancy maintenance and foetal development. The aim of this scoping review is to present evidence on the link between progesterone deficiency and first-trimester miscarriage among pregnant women and assess the impact of progesterone therapy on foetal development. Methods: A comprehensive global systematic search of mainly primary research studies was conducted using several databases. Peer-reviewed studies published between 2010 and 2023 were included. The scoping review was conducted using the framework outlined by the Joanna Briggs Institute (JBI) and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses—Extension for Scoping Reviews (PRISMA-ScR) statement. Results: Twenty-three articles (which included 35,862 participants) were included in the analysis. Most studies were conducted in mid- to high-income countries. All 23 articles reported a significant positive relationship between progesterone deficiency and first-trimester miscarriage. Furthermore, the majority of studies reported a higher risk of miscarriage when lower levels of progesterone are combined with other declined hormones. While most studies reported that progesterone therapy may reduce the rate of first-trimester miscarriage among pregnant women, no evidence of health-related harm to offspring development was reported. Conclusions: The findings from this systematic–scoping review indicate possible benefits of progesterone replacement therapy in maintaining a healthy pregnancy and foetal development. Rigorous studies that include large sample sizes and systematic reviews are required to confirm these findings further. Full article
(This article belongs to the Special Issue Recent Advances in Maternal and Fetal Health)
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13 pages, 658 KiB  
Review
The Thousand Faces of Invasive Group A Streptococcal Infections: Update on Epidemiology, Symptoms, and Therapy
by Stefania Mercadante, Andrea Ficari, Lorenza Romani, Maia De Luca, Costanza Tripiciano, Sara Chiurchiù, Francesca Ippolita Calo Carducci, Laura Cursi, Martina Di Giuseppe, Andrzej Krzysztofiak, Stefania Bernardi and Laura Lancella
Children 2024, 11(4), 383; https://doi.org/10.3390/children11040383 - 22 Mar 2024
Cited by 7 | Viewed by 3395
Abstract
Invasive infections caused by Streptococcus pyogfenes (iGAS), commonly known as Group A Streptococcus, represent a significant public health concern due to their potential for rapid progression and life-threatening complications. Epidemiologically, invasive GAS infections exhibit a diverse global distribution, affecting individuals of all ages [...] Read more.
Invasive infections caused by Streptococcus pyogfenes (iGAS), commonly known as Group A Streptococcus, represent a significant public health concern due to their potential for rapid progression and life-threatening complications. Epidemiologically, invasive GAS infections exhibit a diverse global distribution, affecting individuals of all ages with varying predisposing factors. The pathogenesis of invasive GAS involves an array of virulence factors that contribute to tissue invasion, immune evasion, and systemic dissemination. In pediatrics, in the last few years, an increase in iGAS infections has been reported worldwide becoming a challenging disease to diagnose and treat promptly. This review highlights the current knowledge on pathogenesis, clinical presentations, and therapeutic approaches for iGAS in children. Full article
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26 pages, 618 KiB  
Review
The Relationship between Physical Activity, Physical Fitness, Cognition, and Academic Outcomes in School-Aged Latino Children: A Scoping Review
by J. P. Marrero-Rivera, Olivia Sobkowiak, Aimee Sgourakis Jenkins, Stefano J. Bagnato, Christopher E. Kline, Benjamin DH Gordon and Sharon E. Taverno Ross
Children 2024, 11(3), 363; https://doi.org/10.3390/children11030363 - 19 Mar 2024
Cited by 4 | Viewed by 3177
Abstract
This scoping review provides an overview of the relationship between physical activity, physical fitness, cognition, and academic outcomes in Latino school-aged children and identifies areas for future research. A primary search was conducted in PubMed, PsycINFO, Web of Science, and ERIC for original-research [...] Read more.
This scoping review provides an overview of the relationship between physical activity, physical fitness, cognition, and academic outcomes in Latino school-aged children and identifies areas for future research. A primary search was conducted in PubMed, PsycINFO, Web of Science, and ERIC for original-research articles meeting the inclusion criteria; the search results were uploaded into PICO Portal and assessed by two independent reviewers. Of the 488 initial search results, 50 articles were eligible for full-text review, and 38 were included in this review. Most studies were cross-sectional, conducted in the United States or Chile, and included children 5–18 years old. Overall, the majority of articles reported positive associations between physical activity or physical fitness and cognitive outcomes (n = 11/12; 91.7%), and physical activity or physical fitness and academic outcomes (n = 22/28; 78.6%). In sum, this review provided consistent evidence for higher amounts of physical activity and greater physical fitness to be associated with various positive cognitive and academic outcomes in a school-aged Latino population. This scoping review also elucidated a substantial gap in the research regarding study design, with a discernible lack of interventional efforts. Future studies should test physical activity interventional strategies to optimize cognitive and academic outcomes in school-aged Latino populations. Full article
(This article belongs to the Special Issue Health Benefits of Physical Activity for Children and Adolescents)
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28 pages, 350 KiB  
Article
Clinical Symptomatology of Anxiety and Family Function in Adolescents—The Self-Esteem Mediator
by Ignatia Farmakopoulou, Maria Lekka and Evgenia Gkintoni
Children 2024, 11(3), 338; https://doi.org/10.3390/children11030338 - 12 Mar 2024
Cited by 9 | Viewed by 6399
Abstract
Background: Family, the child’s first environment, shapes their psycho-emotional balance. The literature links adolescent anxiety to family relationships, interactions, and dynamics. The self-esteem of adolescents appears to protect their mental health. Goal: This study examines whether family cohesion and adaptability affect adolescent anxiety [...] Read more.
Background: Family, the child’s first environment, shapes their psycho-emotional balance. The literature links adolescent anxiety to family relationships, interactions, and dynamics. The self-esteem of adolescents appears to protect their mental health. Goal: This study examines whether family cohesion and adaptability affect adolescent anxiety symptoms. It also examines whether teen self-esteem mediates this relationship. Method: This cross-sectional, descriptive study included 166 Attica youth aged 12–18 from schools and educational units. The adolescents completed Olson’s FACES-III cohesion and adaptability scale, Spielberger’s STAI-C, Rosenberg’s self-esteem scale, and a socio-demographic questionnaire. Results: Family cohesion, but not adaptability, was negatively correlated with state (rho = −0.25, p = 0.001) and trait (rho = −0.46, p < 0.001) anxiety in the adolescents. Teenagers from extreme families with the lowest cohesion and adaptability had higher trait anxiety (x2(2) = 6.91, p = 0.032) than those from moderately balanced/balanced families. Self-esteem mediated the relationship between the family cohesion functioning and adolescent’s state anxiety (p = 0.005) and trait anxiety (p = 0.011). Conclusions: The findings show that family dysfunction negatively impacts adolescent anxiety, as well as their self-esteem, which protects mental balance. Full article
11 pages, 521 KiB  
Review
Melatonin Use in Pediatrics: A Clinical Review on Indications, Multisystem Effects, and Toxicity
by Pranita Shenoy, Adriana Etcheverry, Jalyn Ia, Manisha Witmans and Mary Anne Tablizo
Children 2024, 11(3), 323; https://doi.org/10.3390/children11030323 - 9 Mar 2024
Cited by 9 | Viewed by 7763
Abstract
Exogenous melatonin is typically used for sleep regulation in the context of insomnia either in healthy children or those with neurodevelopmental disabilities. It is also used for the management of circadian rhythm sleep disorders in pediatric and adolescent patients. There are also many [...] Read more.
Exogenous melatonin is typically used for sleep regulation in the context of insomnia either in healthy children or those with neurodevelopmental disabilities. It is also used for the management of circadian rhythm sleep disorders in pediatric and adolescent patients. There are also many other possible indications that we will discuss in this paper beyond the role of melatonin for sleep regulation, including its potential use for various areas of medicine such as inflammatory conditions. Since melatonin is unregulated in the United States, distributed over the counter and perceived to be natural and safe, it has become available in many forms in the last two decades. With increasing sleep disturbances and mental health problems after the COVID-19 pandemic, melatonin has become even more popular and studies have shown a dramatic increase in use as well as resulting side effects, including melatonin overdose. As melatonin is generally viewed by physicians as a benign medication, we hope to increase awareness of melatonin’s properties as well as negative side effects to optimize its use in the pediatric population. Full article
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14 pages, 448 KiB  
Article
Unilateral Sensorineural Hearing Loss in Children: Etiology, Audiological Characteristics, and Treatment
by Mirko Aldè, Diego Zanetti, Umberto Ambrosetti, Eleonora Monaco, Anna Maria Gasbarre, Lorenzo Pignataro, Giovanna Cantarella and Stefania Barozzi
Children 2024, 11(3), 324; https://doi.org/10.3390/children11030324 - 9 Mar 2024
Cited by 6 | Viewed by 3854
Abstract
The aim of this study was to evaluate audiological characteristics and parents’ opinions on hearing device use in children with unilateral sensorineural hearing loss (USNHL) who attended a tertiary-level audiologic center. The medical charts of 70 children aged 6 to 12 years with [...] Read more.
The aim of this study was to evaluate audiological characteristics and parents’ opinions on hearing device use in children with unilateral sensorineural hearing loss (USNHL) who attended a tertiary-level audiologic center. The medical charts of 70 children aged 6 to 12 years with USNHL were reviewed. In 51.4% of cases, the children were diagnosed with USNHL after the age of 2 years. The main causes of USNHL were congenital cytomegalovirus infection (21.4%) and unilateral cochlear nerve hypoplasia (12.9%). The percentage of patients wearing a hearing device was 45.7% (32/70); of these, 28 (87.5%) wore a conventional hearing aid, 2 (6.3%) a CROS device, and 2 (6.3%) a cochlear implant. Regarding the choice to use a hearing device, no significant differences were found between the subcategories of hearing loss degree (p = 0.55) and audiometric configuration (p = 0.54). Most parents of children with mild-to-severe USNHL observed improved attention (90.9%), and reduced fatigue and restlessness (86.4%) using the hearing aid. These children performed significantly better on all audiological tests (speech perception in quiet and in noise conditions, and sound localization) while wearing the hearing aid (p < 0.001). More efforts should be made to raise awareness among professionals and parents about the negative consequences of uncorrected USNHL. Full article
(This article belongs to the Special Issue Diagnosis and Management of Pediatric Ear and Vestibular Disorders)
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9 pages, 243 KiB  
Review
The Global Occurrences of Cleft Lip and Palate in Pediatric Patients and Their Association with Demographic Factors: A Narrative Review
by Farah Asnely Putri, Madhuri Pattamatta, Sheylla Edu September Anita and Tantry Maulina
Children 2024, 11(3), 322; https://doi.org/10.3390/children11030322 - 8 Mar 2024
Cited by 15 | Viewed by 7121
Abstract
Objective: Orofacial clefts are one of the most common abnormalities that occur in the orofacial area. Due to their high prevalence, special attention provided to risk factors and their possible involvement in the occurrence of orofacial clefts is of importance. The objective of [...] Read more.
Objective: Orofacial clefts are one of the most common abnormalities that occur in the orofacial area. Due to their high prevalence, special attention provided to risk factors and their possible involvement in the occurrence of orofacial clefts is of importance. The objective of this study was to review the current global occurrence of orofacial clefts and the possible linkage of previously investigated risk factors to the occurrence of orofacial clefts. Review: The risk factors of orofacial clefts can be classified into two groups, modifiable risk factors and non-modifiable risk factors. Due to the extent of elaboration of each risk factor in each group, this current narrative review is limited to several mostly investigated risk factors, which included a review of parental age, sexual disparities, educational attainment, and income. Studies indicate that Asians are more likely than other races to have orofacial clefts, with a higher incidence rate in men than in women. There is evidence that the age of the parents is associated with the chance of the occurrence of orofacial cleft. The prevention of orofacial clefts and the distribution of medical resources depend heavily on a thorough understanding of epidemiology on a global scale. Nevertheless, the earlier studies concentrated on more developed nations or areas, and registry data from low-income nations had significant gaps. The findings of this narrative review can be used as the scientific basis for further research within this area. Conclusion: The occurrence rate of orofacial clefts remains high in several regions. Possible associations between parental age, sexual disparities, educational attainment, and family income to the occurrence of orofacial clefts remain contradictory, indicating the importance of further research to obtain more insights. Full article
(This article belongs to the Special Issue Oral Epidemiology and Pathology in Children)
18 pages, 516 KiB  
Review
Trends in Physical Activity and Motor Development in Young People—Decline or Improvement? A Review
by Cristiana D’Anna, Pasqualina Forte and Elisa Pugliese
Children 2024, 11(3), 298; https://doi.org/10.3390/children11030298 - 1 Mar 2024
Cited by 8 | Viewed by 3859
Abstract
This paper aims to analyse studies and research conducted in EU and non-EU member states to identify and compare trends in physical activity and motor skills. Thus, a comparative overview of the state of the art in the two pre-pandemic decades that can [...] Read more.
This paper aims to analyse studies and research conducted in EU and non-EU member states to identify and compare trends in physical activity and motor skills. Thus, a comparative overview of the state of the art in the two pre-pandemic decades that can facilitate an understanding of the different territorial realities and training needs to be conducted, considering the different cultural situations. A scoping review was conducted by analysing a series of studies published between 1990 and 2022, including only those studies that collected data in the pre-pandemic period. The search was carried out on databases such as PubMed, Google Scholar, and ScienceDirect. The following keywords were used for the acquisition of relevant studies: children, decline, motor skills, physical activity, and young people. From the literature review emerged clearly in all the longitudinal surveys a negative trend of body mass index (BMI), which was increasing in all the countries analysed, and cardiorespiratory fitness, which, in close relation to the increase in overweight levels, was in decline. If an unambiguous trend could be declared for the variables just mentioned, it was not possible to declare the same trend for the other variables analysed, which showed discordant results between the different countries. Full article
(This article belongs to the Section Pediatric Orthopedics & Sports Medicine)
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28 pages, 1737 KiB  
Review
Children’s Health, Wellbeing and Academic Outcomes over the Summer Holidays: A Scoping Review
by Emily Eglitis, Aaron Miatke, Rosa Virgara, Amanda Machell, Timothy Olds, Mandy Richardson and Carol Maher
Children 2024, 11(3), 287; https://doi.org/10.3390/children11030287 - 27 Feb 2024
Cited by 7 | Viewed by 5217
Abstract
Background: The school day provides a supportive and stimulating environment that may protect children and adolescents (5–18 years) from behaviours that are adverse for health and wellbeing. Objective: To review the literature regarding changes in children’s academic achievement or overall wellbeing during the [...] Read more.
Background: The school day provides a supportive and stimulating environment that may protect children and adolescents (5–18 years) from behaviours that are adverse for health and wellbeing. Objective: To review the literature regarding changes in children’s academic achievement or overall wellbeing during the extended school summer break and evaluate if the outcomes are different for children experiencing disadvantage. Methods: The peer-reviewed literature was searched across six electronic databases for studies tracking changes in any academic, health or wellbeing outcome in children over the summer holidays. Studies were screened in duplicate for inclusion. Data were extracted using a standardized data extraction form. Outcomes were coded as decline (suggestive or significant), increase (suggestive or significant) or mixed/neutral and then compared to the school year or according to disadvantaged. Results: Seventy-six studies (n = 14,230,846 participants) were included. Strong evidence was found of a decline in academic outcomes and increases in adiposity, sedentary behaviour and screen time. There was moderate evidence of declines in cardiovascular fitness and physical activity. These patterns were magnified for disadvantaged children. Limited data were available on muscular fitness, sleep, diet quality and social, emotional or mental wellbeing. A total of 80% of studies were from the United States. Most data were from children 12 years of age and younger. Conclusions: Over the summer break, children’s academic and health outcomes decline. Children experiencing disadvantage display magnified losses that warrant further investigation. The summer holidays present an opportunity to improve children’s health and wellbeing. Full article
(This article belongs to the Section Pediatric Mental Health)
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18 pages, 343 KiB  
Review
Antimicrobial Stewardship in Pediatric Emergency Medicine: A Narrative Exploration of Antibiotic Overprescribing, Stewardship Interventions, and Performance Metrics
by Kevin Meesters and Danilo Buonsenso
Children 2024, 11(3), 276; https://doi.org/10.3390/children11030276 - 23 Feb 2024
Cited by 5 | Viewed by 3111
Abstract
Antibiotic overprescribing is prevalent in pediatric emergency medicine, influenced by clinician–caregiver dynamics and diagnostic uncertainties, and poses substantial risks such as increasing antibacterial resistance, adverse drug reactions, and increased healthcare expenditures. While antimicrobial stewardship programs have proven effective in optimizing antibiotic use within [...] Read more.
Antibiotic overprescribing is prevalent in pediatric emergency medicine, influenced by clinician–caregiver dynamics and diagnostic uncertainties, and poses substantial risks such as increasing antibacterial resistance, adverse drug reactions, and increased healthcare expenditures. While antimicrobial stewardship programs have proven effective in optimizing antibiotic use within inpatient healthcare settings, their implementation in pediatric emergency medicine presents specific challenges. Existing biomarkers like white blood cell count, C-reactive protein, procalcitonin, and presepsin have limitations in their ability to distinguish (serious) bacterial infections from other etiologies of fever. Furthermore, rapid antigen detection tests and guidelines aimed at guiding antibiotic prescriptions for children have not consistently reduced unnecessary antibiotic use. To improve antibiotic prescribing practices, potential strategies include the utilization of decision support tools, audit and feedback, establishing follow-up procedures, implementing safety netting systems, and delivering comprehensive training and supervision. Notably, host genome signatures have also gained attention for their potential to facilitate rapid and precise diagnoses of inflammatory syndromes. Standardized metrics are crucial for evaluating antimicrobial use within pediatric healthcare settings, enabling the establishment of benchmarks for assessing antibiotic utilization, quality enhancement initiatives, and research endeavors. Full article
(This article belongs to the Special Issue Pediatric Emergency Medicine)
12 pages, 454 KiB  
Article
Associations among Motor Competence, Physical Activity, Perceived Motor Competence, and Aerobic Fitness in 10–15-Year-Old Youth
by Dawn P. Coe, Emily M. Post, Eugene C. Fitzhugh, Jeffrey T. Fairbrother and E. Kipling Webster
Children 2024, 11(2), 260; https://doi.org/10.3390/children11020260 - 17 Feb 2024
Cited by 5 | Viewed by 2629
Abstract
(1) Background: The developmental model describes possible mechanisms that could impact the trajectory of children and adolescents’ health behaviors related to obesity; however, few data are available that support this model in the adolescent population. This study investigated the associations among motor competence [...] Read more.
(1) Background: The developmental model describes possible mechanisms that could impact the trajectory of children and adolescents’ health behaviors related to obesity; however, few data are available that support this model in the adolescent population. This study investigated the associations among motor competence (MC), moderate-to-vigorous physical activity (MVPA), perceived motor competence (PMC), and aerobic fitness in children and adolescents and the mediating and moderating effects of PMC, aerobic fitness, and weight status on the MC–MVPA relationship. (2) Methods: Participants included 47 adolescents (12.2 ± 1.6 y; 55% male) who completed the Bruininks–Oseretsky Test of Motor Proficiency, 2nd Edition (MC), Harter’s perceived self-competency questionnaire (PMC), and the PACER test (aerobic fitness) and whose MVPA was measured via accelerometry. The body mass index (BMI) was calculated from measured height and weight. (3) Results: There were positive correlations between MC and fitness [rs(47) = 0.469, p < 0.01], PMC and fitness [rs(47) = 0.682, p < 0.01], and PMC and MC [rs(47) = 0.416, p < 0.01]. There were no associations among MVPA and MC, PMC, or fitness (p > 0.05). There were inverse associations between BMI and both MVPA [rs(44) = −0.410, p < 0.01] and fitness [rs(47) = 0.295, p < 0.05]. The association between MC and MVPA was mediated by fitness (β = 0.3984; 95% CI (0.0564–0.7985)). (4) Conclusions: The associations among MC, PMC, and fitness highlight the critical role of MC in health and partially support the proposed developmental model concerning the relationships that exist among MC, MVPA, PMC, fitness, and BMI. Full article
(This article belongs to the Special Issue Motor Competence and Physical Activity in School Children)
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12 pages, 1517 KiB  
Article
Integrating Artificial Intelligence in Pediatric Healthcare: Parental Perceptions and Ethical Implications
by Elena Camelia Berghea, Marcela Daniela Ionescu, Radu Marian Gheorghiu, Iulia Florentina Tincu, Claudia Oana Cobilinschi, Mihai Craiu, Mihaela Bălgrădean and Florian Berghea
Children 2024, 11(2), 240; https://doi.org/10.3390/children11020240 - 14 Feb 2024
Cited by 6 | Viewed by 3507
Abstract
Background: Our study aimed to explore the way artificial intelligence (AI) utilization is perceived in pediatric medicine, examining its acceptance among patients (in this case represented by their adult parents), and identify the challenges it presents in order to understand the factors influencing [...] Read more.
Background: Our study aimed to explore the way artificial intelligence (AI) utilization is perceived in pediatric medicine, examining its acceptance among patients (in this case represented by their adult parents), and identify the challenges it presents in order to understand the factors influencing its adoption in clinical settings. Methods: A structured questionnaire was applied to caregivers (parents or grandparents) of children who presented in tertiary pediatric clinics. Results: The most significant differentiations were identified in relation to the level of education (e.g., aversion to AI involvement was 22.2% among those with postgraduate degrees, 43.9% among those with university degrees, and 54.5% among those who only completed high school). The greatest fear among respondents regarding the medical use of AI was related to the possibility of errors occurring (70.1%). Conclusions: The general attitude toward the use of AI can be considered positive, provided that it remains human-supervised, and that the technology used is explained in detail by the physician. However, there were large differences among groups (mainly defined by education level) in the way AI is perceived and accepted. Full article
(This article belongs to the Section Global Pediatric Health)
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12 pages, 442 KiB  
Article
Treating Children and Adolescents with Obesity: Predictors of Early Dropout in Pediatric Weight-Management Programs
by Giovanni Luppino, Malgorzata Wasniewska, Celeste Casto, Chiara Ferraloro, Alessandra Li Pomi, Giorgia Pepe, Letteria Anna Morabito, Angela Alibrandi, Domenico Corica and Tommaso Aversa
Children 2024, 11(2), 205; https://doi.org/10.3390/children11020205 - 5 Feb 2024
Cited by 4 | Viewed by 1974
Abstract
Background: Possible therapeutic failure of pediatric obesity is influenced by the high dropout rate. The aim of this study was to evaluate the rate of dropout and the rate of weight loss over the 24 months of follow-up. Methods: The retrospective, single-center study, [...] Read more.
Background: Possible therapeutic failure of pediatric obesity is influenced by the high dropout rate. The aim of this study was to evaluate the rate of dropout and the rate of weight loss over the 24 months of follow-up. Methods: The retrospective, single-center study, involved 489 patients followed for obesity in the period 2016–2020. Patients’ auxological data and blood samples were collected during the first (V1) and last visit (V2). Dropout was defined as a follow-up of less than 12 months and/or including less than one visit every 6 months. Patients were divided into two groups and compared: Group A of dropout (297 patients) and Group B of non-dropout (192 patients). Results: In the follow-up period, which had a mean duration of 24 months, the dropout rate was 60.7%. In Group A, the percentage of patients with BMI ≥ 3 SD at V2 was significantly higher than that in Group B. In Group B, the percentage of patients with pathological HOMA-IR and with fasting glucose >100 mg/dL was higher than group A. The probability of dropout was positively associated with pubertal stage and negatively with impaired fasting glycemia and pathological insulinemia at V1. Conclusion: The study demonstrated a high dropout rate during follow-up, mainly among adolescents and patients with no glucometabolic alterations. Full article
(This article belongs to the Special Issue Childhood and Adolescent Obesity and Weight Management: 3rd Edition)
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30 pages, 1478 KiB  
Review
Theoretical–Methodological Foundations for the Global Integration Method (Método de Integração Global—MIG) in the Treatment of Autism Spectrum Disorder
by Renato Guimarães Loffi, Thalita Karla Flores Cruz, Giulia Moreira Paiva, Deisiane Oliveira Souto, Simone Rosa Barreto, Patrícia Aparecida Neves Santana, Amanda Aparecida Alves Cunha Nascimento, Fabiana Rachel Martins Costa, Elisa Braz Cota and Vitor Geraldi Haase
Children 2024, 11(2), 191; https://doi.org/10.3390/children11020191 - 2 Feb 2024
Cited by 7 | Viewed by 4168
Abstract
Currently, there is no intervention model for autism spectrum disorder (ASD) that addresses all levels and factors of the International Classification of Functioning, Disability and Health (ICF, WHO). The most researched programs focus on naturalistic, developmental and behavioral approaches to socio-communication. Less attention [...] Read more.
Currently, there is no intervention model for autism spectrum disorder (ASD) that addresses all levels and factors of the International Classification of Functioning, Disability and Health (ICF, WHO). The most researched programs focus on naturalistic, developmental and behavioral approaches to socio-communication. Less attention has been paid to motor and environmental reactivity aspects (behavior/interest restriction and sensory reactivity). The evidence rationale for the Global Integration Method (MIG, “Método de Integração Global”), a model addressing sensorimotor reactivity in addition to socio-communication, is presented. MIG is an integrative, interdisciplinary, family-oriented intervention and naturalistic program that addresses all levels and moderating factors of ASD’s impact. MIG’s theoretical rationale is based on the predictive coding impairment and embodied cognition hypotheses. MIG incorporates both bottom-up (flexible therapeutic suit, social-motor synchronization) and top-down (schematic social information processing, narratives, imagery) strategies to promote the building and use of accurate, flexible and context-sensitive internal predictive models. MIG is based on the premises that predictive coding improves both socio-communication and environmental reactivity, and that the postural stabilization provided by the flexible therapeutic suit frees information processing resources for socio-cognitive learning. MIG builds on interdisciplinary, professionally and parentally mediated work based on behavioral principles of intensive training in a situated environment. Full article
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12 pages, 318 KiB  
Article
Role of Satisfaction with Life, Sex and Body Mass Index in Physical Literacy of Spanish Children
by Javier Urbano-Mairena, María Mendoza-Muñoz, Jorge Carlos-Vivas, Raquel Pastor-Cisneros, Antonio Castillo-Paredes, Miguel Rodal and Laura Muñoz-Bermejo
Children 2024, 11(2), 181; https://doi.org/10.3390/children11020181 - 1 Feb 2024
Cited by 7 | Viewed by 2218
Abstract
Physical activity (PL) is essential to achieve good health, prevent cardiovascular diseases, obesity and overweight, as well as to achieve a better quality of life. Therefore, PL could become the tool to increase the practice of physical activity among young people, thus increasing [...] Read more.
Physical activity (PL) is essential to achieve good health, prevent cardiovascular diseases, obesity and overweight, as well as to achieve a better quality of life. Therefore, PL could become the tool to increase the practice of physical activity among young people, thus increasing life satisfaction (LS) given its positive relationship with physical activity. A single-measure cross-sectional correlational study was carried out, involving 135 children aged 8–12 years from Extremadura. They were administered the SWLS questionnaire and the Canadian assessment of physical literacy (CAPL-2). Significantly higher levels of PL (p = 0.010) were found in normal-weight children compared to overweight and obese children, due to the physical competence domain score (p < 0.001). PL was directly related to SWLS (p < 0.001), but inversely related to BMI (p = 0.018). The daily physical activity behaviour domain was explained by SWLS (p < 0.001) and sex (p < 0.001). Physical competence was described by SWLS (p < 0.001) and BMI (p = 0.045). Finally, the motivation and confidence domain were only significantly associated with SWLS (p < 0.001). It was concluded that boys and girls of normal weight achieved higher levels of PL and LS than those with overweight and obesity, establishing a negative relationship of PL with BMI and positive with LS. Full article
(This article belongs to the Special Issue Developing Physical Literacy in Children)
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10 pages, 415 KiB  
Article
Early Assessment of Efficacy and Safety of Biologics in Pediatric Allergic Diseases: Preliminary Results from a Prospective Real-World Study
by Lucia Caminiti, Francesca Galletta, Simone Foti Randazzese, Paolo Barraco, Stefano Passanisi, Antonella Gambadauro, Giuseppe Crisafulli, Mariella Valenzise and Sara Manti
Children 2024, 11(2), 170; https://doi.org/10.3390/children11020170 - 28 Jan 2024
Cited by 5 | Viewed by 2406
Abstract
Background: Despite the increasing interest in biologics for the management of allergic diseases, sparse real-world data are still available in the pediatric population. This study aimed to evaluate the early real-life efficacy and safety of omalizumab for patients with moderate-to-severe asthma and chronic [...] Read more.
Background: Despite the increasing interest in biologics for the management of allergic diseases, sparse real-world data are still available in the pediatric population. This study aimed to evaluate the early real-life efficacy and safety of omalizumab for patients with moderate-to-severe asthma and chronic spontaneous urticaria (CSU), and Dupilumab for patients with moderate-to-severe atopic dermatitis (AD). Methods: A prospective study enrolling children aged 6–18 years was designed to assess the efficacy and safety of biologic drugs at 16 weeks of treatment (T1). The effectiveness was measured using validated questionnaires (ACQ-5 for asthma, UAS7 for CSU, and EASI score for AD). Secondary outcome measures included reductions in inhaled corticosteroid (ICS) dosages, asthma-related hospitalizations/exacerbations, and quality of life (QoL) indicators (iNRS, sNRS, DLQI/cDLQI) for CSU and AD. Safety was expressed according to the descriptions of adverse events provided by EMA and FDA. Results: The study cohort consisted of eighteen children (mean age 12.9 ± 3.4 years). The omalizumab treatment significantly reduced ACQ-5 and UAS7 scores (p = 0.002 and p < 0.001, respectively). In patients with asthma, decreased ICS dosage and hospitalization/exacerbation rates were observed. QoL parameters significantly improved in CSU and AD patients. No severe adverse events were reported for either treatment. Conclusions: Our findings validate omalizumab and dupilumab as effective and safe therapeutic options for managing moderate-to-severe allergic diseases in children and adolescents. Full article
(This article belongs to the Section Pediatric Allergy and Immunology)
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12 pages, 1189 KiB  
Article
COVID-19 Pediatric Follow-Up: Respiratory Long COVID-Associated Comorbidities and Lung Ultrasound Alterations in a Cohort of Italian Children
by Cristiana Indolfi, Angela Klain, Giulio Dinardo, Elisabetta D’Addio, Serena Ferrara, Fabio Decimo, Giorgio Ciprandi, Maria Angela Tosca and Michele Miraglia del Giudice
Children 2024, 11(2), 166; https://doi.org/10.3390/children11020166 - 27 Jan 2024
Cited by 8 | Viewed by 2023
Abstract
In children, the factors that influence COVID-19 disease and its medium- and long-term effects are little known. Our investigation sought to evaluate the presence of comorbidity factors associated with respiratory long COVID manifestations in children and to study ultrasound abnormalities following SARS-CoV-2 infection. [...] Read more.
In children, the factors that influence COVID-19 disease and its medium- and long-term effects are little known. Our investigation sought to evaluate the presence of comorbidity factors associated with respiratory long COVID manifestations in children and to study ultrasound abnormalities following SARS-CoV-2 infection. Children, who arrived at the ‘Respiratory Diseases of Pediatric Interest Unit’ at the Department of Woman, Child, and General and Specialized Surgery of the University of Campania ‘Luigi Vanvitelli’, were selected during the timeframe from September 2021 to October 2022. The children were diagnosed with a SARS-CoV-2 infection that occurred at least one month before the visit. All patients followed a COVID-19 follow-up protocol, developed by the Italian Society of Pediatric Respiratory Diseases (SIMRI), which included: collection of data regarding SARS-CoV-2 illness and history of known respiratory and allergic diseases; physical examination; BMI assessment; baseline spirometry and after bronchodilation test; six-minute walking test; and lung ultrasound (LUS). In a cohort of 104 participants with respiratory long COVID symptoms (64.7% male, average age 8.92 years), 46.1% had fever with other symptoms, and 1% required hospitalization. BMI analysis showed 58.4% of the cohort was overweight. The LUS was positive in 27.0% of cases. A significant BMI association was observed with COVID-19 symptoms and LUS score (p-value < 0.05). No associations were found with asthma or atopy. Full article
(This article belongs to the Section Pediatric Allergy and Immunology)
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14 pages, 2525 KiB  
Article
A Survey of the Union of European Neonatal and Perinatal Societies on Neonatal Respiratory Care in Neonatal Intensive Care Units
by Corrado Moretti, Camilla Gizzi, Luigi Gagliardi, Flavia Petrillo, Maria Luisa Ventura, Daniele Trevisanuto, Gianluca Lista, Raffaele L. Dellacà, Artur Beke, Giuseppe Buonocore, Antonia Charitou, Manuela Cucerea, Boris Filipović-Grčić, Nelly Georgieva Jeckova, Esin Koç, Joana Saldanha, Manuel Sanchez-Luna, Dalia Stoniene, Heili Varendi, Giulia Vertecchi and Fabio Moscaadd Show full author list remove Hide full author list
Children 2024, 11(2), 158; https://doi.org/10.3390/children11020158 - 26 Jan 2024
Cited by 7 | Viewed by 3108
Abstract
(1) Background: Our survey aimed to gather information on respiratory care in Neonatal Intensive Care Units (NICUs) in the European and Mediterranean region. (2) Methods: Cross-sectional electronic survey. An 89-item questionnaire focusing on the current modes, devices, and strategies employed in neonatal units [...] Read more.
(1) Background: Our survey aimed to gather information on respiratory care in Neonatal Intensive Care Units (NICUs) in the European and Mediterranean region. (2) Methods: Cross-sectional electronic survey. An 89-item questionnaire focusing on the current modes, devices, and strategies employed in neonatal units in the domain of respiratory care was sent to directors/heads of 528 NICUs. The adherence to the “European consensus guidelines on the management of respiratory distress syndrome” was assessed for comparison. (3) Results: The response rate was 75% (397/528 units). In most Delivery Rooms (DRs), full resuscitation is given from 22 to 23 weeks gestational age. A T-piece device with facial masks or short binasal prongs are commonly used for respiratory stabilization. Initial FiO2 is set as per guidelines. Most units use heated humidified gases to prevent heat loss. SpO2 and ECG monitoring are largely performed. Surfactant in the DR is preferentially given through Intubation-Surfactant-Extubation (INSURE) or Less-Invasive-Surfactant-Administration (LISA) techniques. DR caffeine is widespread. In the NICUs, most of the non-invasive modes used are nasal CPAP and nasal intermittent positive-pressure ventilation. Volume-targeted, synchronized intermittent positive-pressure ventilation is the preferred invasive mode to treat acute respiratory distress. Pulmonary recruitment maneuvers are common approaches. During NICU stay, surfactant administration is primarily guided by FiO2 and SpO2/FiO2 ratio, and it is mostly performed through LISA or INSURE. Steroids are used to facilitate extubation and prevent bronchopulmonary dysplasia. (4) Conclusions: Overall, clinical practices are in line with the 2022 European Guidelines, but there are some divergences. These data will allow stakeholders to make comparisons and to identify opportunities for improvement. Full article
(This article belongs to the Special Issue Neonatal Airway Management)
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17 pages, 885 KiB  
Review
Non-Cariogenic Effect of Milk and Dairy Products on Oral Health in Children and Adolescents: A Scoping Review
by Flavia Vitiello, Denis Bourgeois, Giulia Orilisi, Giovanna Orsini and Florence Carrouel
Children 2024, 11(2), 149; https://doi.org/10.3390/children11020149 - 24 Jan 2024
Cited by 6 | Viewed by 3275
Abstract
Diet plays an important role in the etiopathology of dental caries. Milk and dairy products (DPs), especially in children and adolescents, are important sources of protein, calcium and phosphorus and could have an effect on dental and oral health. The aim of this [...] Read more.
Diet plays an important role in the etiopathology of dental caries. Milk and dairy products (DPs), especially in children and adolescents, are important sources of protein, calcium and phosphorus and could have an effect on dental and oral health. The aim of this scoping review was to analyze the scientific literature on the non-cariogenic effect of milk and DPs, with a focus on their potential to prevent dental caries in children and adolescents. PubMed, EMBASE, and Web of Science were searched for publications relevant to our topic from January 2013 to 30 September 2023. Thirty-eight studies were included in the qualitative analysis. The included studies highlight the properties of milk and DPs that contribute to enamel remineralization, exhibit antibacterial action, inhibit the growth of cariogenic bacteria, and promote a balanced oral microbiome. With regard to the addition of probiotics (PBs) and fluoride (F) to DPs, the mixed results of the studies analyzed did not allow a clear statement to be made about their non-cariogenic effects. However, several studies show that the addition of PBs can reduce cariogenic bacteria, create a protective barrier against pathogens and support the host’s natural defense mechanisms. Further long-term and high-quality studies are needed to understand the impact of milk and its constituents on oral health in order to promote effective caries prevention strategies in children and adolescents. Full article
(This article belongs to the Special Issue Advance Research in Pediatric Dental Disease: 2nd Edition)
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14 pages, 496 KiB  
Review
Ensuring Optimal Outcomes for Preterm Infants after NICU Discharge: A Life Course Health Development Approach to High-Risk Infant Follow-Up
by Jonathan S. Litt, Neal Halfon, Michael E. Msall, Shirley Ann Russ and Susan R. Hintz
Children 2024, 11(2), 146; https://doi.org/10.3390/children11020146 - 24 Jan 2024
Cited by 9 | Viewed by 4425
Abstract
Children born prematurely (<37 weeks’ gestation) have an increased risk for chronic health problems and developmental challenges compared to their term-born peers. The threats to health and development posed by prematurity, the unintended effects of life-sustaining neonatal intensive care, the associated neonatal morbidities, [...] Read more.
Children born prematurely (<37 weeks’ gestation) have an increased risk for chronic health problems and developmental challenges compared to their term-born peers. The threats to health and development posed by prematurity, the unintended effects of life-sustaining neonatal intensive care, the associated neonatal morbidities, and the profound stressors to families affect well-being during infancy, childhood, adolescence, and beyond. Specialized clinical programs provide medical and developmental follow-up care for preterm infants after hospital discharge. High-risk infant follow-up, like most post-discharge health services, has many shortcomings, including unclear goals, inadequate support for infants, parents, and families, fragmented service provisions, poor coordination among providers, and an artificially foreshortened time horizon. There are well-documented inequities in care access and delivery. We propose applying a life course health development framework to clinical follow-up for children born prematurely that is contextually appropriate, developmentally responsive, and equitably deployed. The concepts of health development, unfolding, complexity, timing, plasticity, thriving, and harmony can be mapped to key components of follow-up care delivery to address pressing health challenges. This new approach envisions a more effective version of clinical follow-up to support the best possible functional outcomes and the opportunity for every premature infant to thrive within their family and community environments over their life course. Full article
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17 pages, 299 KiB  
Review
Harnessing the Power of Artificial Intelligence in Cleft Lip and Palate: An In-Depth Analysis from Diagnosis to Treatment, a Comprehensive Review
by Khalid A. Almoammar
Children 2024, 11(2), 140; https://doi.org/10.3390/children11020140 - 23 Jan 2024
Cited by 7 | Viewed by 3646
Abstract
Cleft lip and palate (CLP) is the most common craniofacial malformation, with a range of physical, psychological, and aesthetic consequences. In this comprehensive review, our main objective is to thoroughly examine the relationship between CLP anomalies and the use of artificial intelligence (AI) [...] Read more.
Cleft lip and palate (CLP) is the most common craniofacial malformation, with a range of physical, psychological, and aesthetic consequences. In this comprehensive review, our main objective is to thoroughly examine the relationship between CLP anomalies and the use of artificial intelligence (AI) in children. Additionally, we aim to explore how the integration of AI technology can bring about significant advancements in the fields of diagnosis, treatment methods, and predictive outcomes. By analyzing the existing evidence, we will highlight state-of-the-art algorithms and predictive AI models that play a crucial role in achieving precise diagnosis, susceptibility assessment, and treatment planning for children with CLP anomalies. Our focus will specifically be on the efficacy of alveolar bone graft and orthodontic interventions. The findings of this review showed that deep learning (DL) models revolutionize the diagnostic process, predict susceptibility to CLP, and enhance alveolar bone grafts and orthodontic treatment. DL models surpass human capabilities in terms of precision, and AI algorithms applied to large datasets can uncover the intricate genetic and environmental factors contributing to CLP. Additionally, Machine learning aids in preoperative planning for alveolar bone grafts and provides personalized treatment plans in orthodontic treatment. In conclusion, these advancements inspire optimism for a future where AI seamlessly integrates with CLP management, augmenting its analytical capabilities. Full article
(This article belongs to the Section Pediatric Dentistry & Oral Medicine)
16 pages, 2664 KiB  
Article
High-Fat, High-Calorie Breast Milk in Women with Overweight or Obesity and Its Association with Maternal Serum Insulin Concentration and Triglycerides Levels
by Michael G. Ross, Manasa P. Kavasery, MacKenzie K. Cervantes, Guang Han, Bernardo Horta, Kelly P. Coca, Suleyma O. Costa and Mina Desai
Children 2024, 11(2), 141; https://doi.org/10.3390/children11020141 - 23 Jan 2024
Cited by 5 | Viewed by 3117
Abstract
The childhood obesity epidemic continues to be a challenge. Maternal obesity and excessive infant weight gain are strong predictors of childhood obesity, which itself is a major risk factor for adult obesity. The primary source of nutrition during early life is breast milk, [...] Read more.
The childhood obesity epidemic continues to be a challenge. Maternal obesity and excessive infant weight gain are strong predictors of childhood obesity, which itself is a major risk factor for adult obesity. The primary source of nutrition during early life is breast milk, and its composition is impacted by maternal habitus and diet. We thus studied the relationship between maternal BMI, serum lipids and insulin, and breast milk fat and calorie content from foremilk to hindmilk. Women who were exclusively breastfeeding at 7–8 weeks postpartum were BMI classified as Normal (18.5–24.9, n = 9) and women with Overweight/Obese (OW/OB ≥ 25, n = 13). Maternal blood and continuous breast milk samples obtained from foremilk to hindmilk were analyzed, and infant milk intake was assessed. Women with OW/OB had significantly higher milk fat and calorie content in the first foremilk and last hindmilk sample as compared to Normal BMI women. Amongst all women, maternal serum triglycerides, insulin, and HOMA were significantly correlated with foremilk triglyceride concentration, suggesting that maternal serum triglyceride and insulin action contribute to human milk fat content. As the milk fat content of OW/OB women has caloric implications for infant growth and childhood obesity, these results suggest the potential for modulating milk fat content by a reduction in maternal serum lipids or insulin. Full article
(This article belongs to the Special Issue Promoting Breastfeeding and Human Milk in Infants)
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18 pages, 358 KiB  
Article
Family Functioning, Maternal Depression, and Adolescent Cognitive Flexibility and Its Associations with Adolescent Depression: A Cross-Sectional Study
by Justyna Urbańska-Grosz, Emilia J. Sitek, Anna Pakalska, Bożena Pietraszczyk-Kędziora, Kalina Skwarska and Maciej Walkiewicz
Children 2024, 11(1), 131; https://doi.org/10.3390/children11010131 - 22 Jan 2024
Cited by 8 | Viewed by 4955
Abstract
Background: This study explores family functioning and its associations with adolescent major depressive disorder (MDD), comparing its dynamics with healthy counterparts. Family functioning (cohesion, flexibility, communication, and satisfaction), maternal depressive symptoms, postpartum depression history, parental divorce, parental alcohol abuse, and the adolescents’ cognitive [...] Read more.
Background: This study explores family functioning and its associations with adolescent major depressive disorder (MDD), comparing its dynamics with healthy counterparts. Family functioning (cohesion, flexibility, communication, and satisfaction), maternal depressive symptoms, postpartum depression history, parental divorce, parental alcohol abuse, and the adolescents’ cognitive flexibility, are examined. The research incorporates the perspectives of both adolescents and mothers. Methods: The sample includes 63 mother-teenager dyads in the clinical group and 43 in the control group. Instruments encompass the Family Adaptability and Cohesion Evaluation Scales (FACES IV), Children’s Depression Inventory (CDI-2), Beck Depression Inventory (BDI-II), The Brixton Spatial Anticipation Test, and structured interviews. Results: Families of adolescents with MDD exhibit lower flexibility, cohesion, communication, and overall satisfaction. Depressed adolescents display reduced cognitive flexibility. Discrepancies were observed between adolescents’ and mothers’ perspectives as associated with adolescents’ MDD. Teenagers emphasized the severity of maternal depressive symptoms, while mothers highlighted the importance of family cohesion and flexibility. Conclusions: This study emphasizes a holistic strategy in addressing adolescent depression, including family-based assessment and therapy. Screening for maternal depressive symptoms is identified as valuable. Cognitive flexibility also needs to be addressed during therapy for depression in adolescence. Full article
(This article belongs to the Special Issue Child and Adolescent Psychiatry and Mental Health Progress)
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15 pages, 590 KiB  
Article
Experiences and Challenges of Health Professionals in Implementing Family-Centred Planning: A Qualitative Study
by Lorena Cuenca-Sánchez, David Sánchez-Teruel and Maria Auxiliadora Robles-Bello
Children 2024, 11(1), 132; https://doi.org/10.3390/children11010132 - 22 Jan 2024
Cited by 5 | Viewed by 2482
Abstract
Early childhood intervention is crucial for the development of minors with disabilities or at risk. Family-centred planning (FCP), which involves families in care, stands out in this context. Despite its importance, little is known about professionals’ experiences of its implementation. FCP aims to [...] Read more.
Early childhood intervention is crucial for the development of minors with disabilities or at risk. Family-centred planning (FCP), which involves families in care, stands out in this context. Despite its importance, little is known about professionals’ experiences of its implementation. FCP aims to tailor services to the needs of the family and the child within the Spanish health system. This study highlights the importance of assessing professionals’ perceptions of FCP. Professionals rooted in traditional approaches may resist change. To assess the implementation of FCPs, the study explores the perspectives of 25 healthcare professionals using qualitative methods to assess their experiences. The qualitative descriptive phenomenological design, following Giorgi’s modified Husserlian approach, seeks to understand the essence of the phenomenon from the participants’ perspective. Two main themes emerged: (1) a social and work organization that perpetuates rehabilitation or early stimulation practices and (2) a socio-family and work organization that promotes FCP adherence, along with subthemes and units of meaning. The evaluation reveals common challenges, such as the need for solid training and institutional support. Evaluating the experience of professionals is essential to overcome barriers and ensure the successful implementation of FCPs. Administrators have an important role to play in providing social, health, and educational alternatives. Full article
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17 pages, 6549 KiB  
Review
Imaging of Acute Complications of Community-Acquired Pneumonia in the Paediatric Population—From Chest Radiography to MRI
by Efthymia Alexopoulou, Spyridon Prountzos, Maria Raissaki, Argyro Mazioti, Pablo Caro-Dominguez, Franz Wolfgang Hirsch, Jovan Lovrenski and Pierluigi Ciet
Children 2024, 11(1), 122; https://doi.org/10.3390/children11010122 - 18 Jan 2024
Cited by 6 | Viewed by 5832
Abstract
The most common acute infection and leading cause of death in children worldwide is pneumonia. Clinical and laboratory tests essentially diagnose community-acquired pneumonia (CAP). CAP can be caused by bacteria, viruses, or atypical microorganisms. Imaging is usually reserved for children who do not [...] Read more.
The most common acute infection and leading cause of death in children worldwide is pneumonia. Clinical and laboratory tests essentially diagnose community-acquired pneumonia (CAP). CAP can be caused by bacteria, viruses, or atypical microorganisms. Imaging is usually reserved for children who do not respond to treatment, need hospitalisation, or have hospital-acquired pneumonia. This review discusses the imaging findings for acute CAP complications and the diagnostic role of each imaging modality. Pleural effusion, empyema, necrotizing pneumonia, abscess, pneumatocele, pleural fistulas, and paediatric acute respiratory distress syndrome (PARDS) are acute CAP complications. When evaluating complicated CAP patients, chest radiography, lung ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) can be used, with each having their own pros and cons. Imaging is usually not needed for CAP diagnosis, but it is essential for complicated cases and follow-ups. Lung ultrasound can supplement chest radiography (CR), which starts the diagnostic algorithm. Contrast-enhanced computed tomography (CECT) is used for complex cases. Advances in MRI protocols make it a viable alternative for diagnosing CAP and its complications. Full article
(This article belongs to the Special Issue Pediatric Respiratory Diseases: Diagnosis, Treatment, and Prevention)
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15 pages, 1998 KiB  
Review
Fostering Motivation: Exploring the Impact of ICTs on the Learning of Students with Autism
by José María Fernández-Batanero, Marta Montenegro-Rueda, José Fernández-Cerero and Eloy López-Meneses
Children 2024, 11(1), 119; https://doi.org/10.3390/children11010119 - 18 Jan 2024
Cited by 4 | Viewed by 3900
Abstract
Currently, the use of digital tools has led to significant changes in the educational system, favouring equity and the inclusion of students with educational needs. In this context, students with autism spectrum disorder (ASD) benefit from using these electronic devices to improve their [...] Read more.
Currently, the use of digital tools has led to significant changes in the educational system, favouring equity and the inclusion of students with educational needs. In this context, students with autism spectrum disorder (ASD) benefit from using these electronic devices to improve their learning experience. This study focuses on conducting a bibliometric analysis of the impact of information and communication technologies on the learning of students with ASD, with the aim of addressing two research questions. Through the analysis of three databases (Scopus, Dialnet, and Web of Science), a total of 24 articles related to the subject were collected. The results show that the use of different technological devices has numerous benefits for these students. Among the most prominent are the use of augmented reality and educational robotics, mainly providing improvements in academic performance, motivation and improved retention of knowledge acquired in the classroom. In conclusion, the clear need to train teachers in digital competencies and to intensify efforts in this line of research in order to improve the education of students, as well as to enrich the knowledge available to the scientific community, is highlighted. Full article
(This article belongs to the Special Issue Research on the Academic Motivation of Children and Adolescents)
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21 pages, 1538 KiB  
Article
Trait Anxiety, Emotion Regulation, and Metacognitive Beliefs: An Observational Study Incorporating Separate Network and Correlation Analyses to Examine Associations with Executive Functions and Academic Achievement
by François-Xavier Cécillon, Martial Mermillod, Christophe Leys, Jean-Philippe Lachaux, Sarah Le Vigouroux and Rebecca Shankland
Children 2024, 11(1), 123; https://doi.org/10.3390/children11010123 - 18 Jan 2024
Cited by 4 | Viewed by 3799
Abstract
Trait anxiety, emotion regulation strategies, and metacognitive beliefs influence executive functions (EFs) and academic achievement. This study examines their interplay and impact on academic success. In total, 275 adolescents (10–17 years) and parents completed an online questionnaire assessing trait anxiety, emotion regulation strategies, [...] Read more.
Trait anxiety, emotion regulation strategies, and metacognitive beliefs influence executive functions (EFs) and academic achievement. This study examines their interplay and impact on academic success. In total, 275 adolescents (10–17 years) and parents completed an online questionnaire assessing trait anxiety, emotion regulation strategies, metacognition, parent-reported behaviors related to executive functioning, and overall school average. Preliminary analyses confirmed consistency with the existing literature for each variable and their interaction. Furthermore, we conducted a network analysis among the main variables. This analysis supports the need to pay more attention to reflective variables—maladaptive emotion regulation strategies and metacognitive beliefs about worry—when studying trait anxiety. These variables were linked to problematic executive functioning in adolescents, and the latter was negatively linked to academic achievement. This study offers innovative insights by investigating relationships less explored in the scientific literature. It reveals high and significant correlations between metacognitive beliefs, maladaptive emotion regulation strategies, and trait anxiety (r > 0.500, p < 0.001) but also between these variables and both executive functioning and academic achievement. These findings offer new perspectives for research and underscore the importance of holistically examining the psychological factors related to academic success. Full article
(This article belongs to the Section Pediatric Mental Health)
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14 pages, 255 KiB  
Article
The Role of Systemic Family Psychotherapy in Glycemic Control for Children with Type 1 Diabetes
by Andreea Salcudean and Maria Melania Lica
Children 2024, 11(1), 104; https://doi.org/10.3390/children11010104 - 15 Jan 2024
Cited by 8 | Viewed by 1899
Abstract
(1) Background: Family factors play an important role in the management of diabetes, establishing a relationship between conflicts and non-adherence to therapy. High values of HbA1c are involved in specific complications of the disease (retinopathy, nephropathy, neuropathy, ketoacidosis). This study aimed to determine [...] Read more.
(1) Background: Family factors play an important role in the management of diabetes, establishing a relationship between conflicts and non-adherence to therapy. High values of HbA1c are involved in specific complications of the disease (retinopathy, nephropathy, neuropathy, ketoacidosis). This study aimed to determine the role of systemic family psychotherapeutic interventions in increasing the quality of parent–child/adolescent relationships and in optimizing the child’s glycemic control. (2) Methods: In this prospective observational study, 64 parents of children and adolescents with type 1 diabetes were evaluated regarding their relationship with their children, using the Child–Parent Relationship Scale-Short Form (CPRS-short form). The children were divided into three groups: one participated for 6 months in systemic family psychotherapy with children and their parents (FT), the second group participated in individual psychotherapy (IT), and the control group (CG) received no intervention. HbA1c values were recorded before and after the interventions. (3) Results: HbA1c means decreased significantly after the family psychotherapy program. The scores on closeness in the family therapy group increased significantly, and the scores on conflict decreased significantly after the intervention, compared with IT and CG. (4) Conclusions: Systemic family psychotherapy produces better results in disease management and in strengthening parent–child relationships. Full article
(This article belongs to the Special Issue Advances in Gastrointestinal Diseases in Children and Adolescents)
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10 pages, 523 KiB  
Article
Physical Activity, Body Composition, Physical Fitness, and Body Dissatisfaction in Physical Education of Extremadura Adolescents: An Exploratory Study
by María Isabel Moreno-Díaz, Miguel Vaquero-Solís, Miguel Ángel Tapia-Serrano and Pedro Antonio Sánchez-Miguel
Children 2024, 11(1), 83; https://doi.org/10.3390/children11010083 - 10 Jan 2024
Cited by 8 | Viewed by 3124
Abstract
In recent years, physical activity levels among youths have declined significantly. This has led to a decline in adherence to physical activity recommendations. In this sense, physical education offers an ideal environment that contributes positively to improving adherence to physical activity recommendations, as [...] Read more.
In recent years, physical activity levels among youths have declined significantly. This has led to a decline in adherence to physical activity recommendations. In this sense, physical education offers an ideal environment that contributes positively to improving adherence to physical activity recommendations, as it teaches students movement-related skills and knowledge. The objective of the present research was to investigate the relationship between physical activity levels, body composition, fitness in Physical Education, and body dissatisfaction levels, and to analyse sex differences in relation to the study variables. The sample was formed of 1166 participants from the 1st and 2nd secondary compulsory education, of which 642 were boys (age 13.16 ± 0.91), and 524 girls (age 13.08 ± 0.85). The measure of physical activity was the Physical Activity Questionnaire for Adolescents (PAQ-A). Body composition was assessed using weight and height to calculate their body mass index. Cardiorespiratory capacity was assessed using the Course-Navette test in Physical Education lessons. The results showed the relationship between physical activity and body mass index, cardiorespiratory capacity, and body satisfaction. It was also confirmed that higher levels of physical activity were associated with a lower body mass index, improvements in cardiorespiratory fitness, and lower levels of body dissatisfaction to a greater extent in boys than in girls. The study concludes that improvements in the study variables were associated with increased physical activity. In addition, it seems necessary to promote healthy lifestyles in physical education lessons, especially during adolescence, as they could serve as a gateway for the improvement of health-related fitness in future generations. Increasing the amount of physical activity among young people is vital. Therefore, it would be essential to develop intervention programs in physical education classes, especially during adolescence, aimed at promoting and increasing physical activity and its benefits. Full article
(This article belongs to the Special Issue Motor Competence and Physical Activity in School Children)
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11 pages, 227 KiB  
Article
Real-World Use of Dalbavancin for Treatment of Soft Tissue and Bone Infection in Children: Safe, Effective and Hospital-Time Sparing
by Désirée Caselli, Marcello Mariani, Claudia Colomba, Chiara Ferrecchi, Claudio Cafagno, Daniela Trotta, Ines Carloni, Daniela Dibello, Elio Castagnola and Maurizio Aricò
Children 2024, 11(1), 78; https://doi.org/10.3390/children11010078 - 9 Jan 2024
Cited by 11 | Viewed by 2366
Abstract
Acute bacterial skin and skin structure infections (ABSSSI) and osteoarticular infections compound the burden of morbidity, mortality and prolonged hospitalizations among gram-positive infections. Dalbavancin, a second-generation, intravenous lipoglycopeptide, due to its prolonged half-life, can be a valuable alternative in their treatment when administered [...] Read more.
Acute bacterial skin and skin structure infections (ABSSSI) and osteoarticular infections compound the burden of morbidity, mortality and prolonged hospitalizations among gram-positive infections. Dalbavancin, a second-generation, intravenous lipoglycopeptide, due to its prolonged half-life, can be a valuable alternative in their treatment when administered as inpatient treatment at the price of an extended hospital stay. Between October 2019 and September 2023, 31 children and adolescents were treated with dalbavancin because of bone and joint infections (n = 12 patients, 39%), ABSSSI (n = 13 patients, 42%), mainly for the limbs, facial cellulitis or complicated ABSSSI (n = 6 patients, 19%), at five Italian pediatric centers. Microbiological study provided gram-positive bacterial isolate in 16 cases, in 11 cases from a positive blood culture; 9 of them were MRSA. Twenty-five patients were initially treated with a different antibiotic therapy: beta-lactam-based in 18 patients (58%), glycopeptide-based in 15 patients (48%) and daptomycin in 6 (19%). The median time that elapsed between admission and start of dalbavancin was 18 days. A total of 61 doses of dalbavancin were administered to the 31 patients: 16 received a single dose while the remaining 15 patients received between two (n = 9) and nine doses. The frequency of administration was weekly in five cases or fortnightly in nine patients. Median length of stay in hospital was 16 days. Median time to discharge after the first dose of dalbavancin was 1 day. Treatment was very well-tolerated: of the 61 administered doses, only four doses, administered to four patients, were associated with an adverse event: drug extravasation during intravenous administration occurred in two patients, with no sequelae; however, in two patients the first administration was stopped soon after infusion start: in one (ID #11), due to headache and vomiting; in another (ID #12) due to a systemic reaction. In both patients, drug infusion was not repeated. None of the remaining 29 patients reported treatment failure (resistant or recurrent disease) or an adverse effect during a median follow-up time of two months. The use of dalbavancin was safe, feasible and also effective in shortening the hospital stay in children and adolescents. Full article
(This article belongs to the Section Pediatric Orthopedics & Sports Medicine)
11 pages, 229 KiB  
Article
The Associations between the Number of School Sports Teams That a Student Regularly Participates in and Factors Such as Perceived Stress, Loneliness, and Sleep Satisfaction among Korean Adolescents Who Have Attempted Suicide
by Jeonga Kwon and Jusun Jang
Children 2024, 11(1), 77; https://doi.org/10.3390/children11010077 - 9 Jan 2024
Cited by 5 | Viewed by 1968
Abstract
Adolescents who have attempted suicide are more likely to experience a recurrence of suicidal behavior, thus necessitating systematic follow-ups and management. We aimed to investigate the association between the number of school sports teams that a student regularly participates in and psychological factors [...] Read more.
Adolescents who have attempted suicide are more likely to experience a recurrence of suicidal behavior, thus necessitating systematic follow-ups and management. We aimed to investigate the association between the number of school sports teams that a student regularly participates in and psychological factors such as perceived stress, loneliness, and sleep satisfaction among 1393 Korean adolescents who have attempted suicide by using data from the 2022 Korea Youth Risk Behavior Survey. Frequency analyses were performed to evaluate participant characteristics. Chi-square analyses were used to examine the differences in participant characteristics according to the number of teams. Multivariate logistic regression analysis was used to examine the associations between the number of teams and perceived stress, loneliness, and sleep satisfaction. Our results indicated that participating in a greater number of sports teams at school was more strongly associated with reduced perceived stress, reduced loneliness, and increased sleep satisfaction. Specifically, the odds ratio (OR) for feeling very much stressed was 0.613 (range: 0.387–0.969; p = 0.036) among the participants who belonged to one team. Among those who belonged to two teams, the OR for feeling very much stressed was 0.482 (range: 0.281–0.286; p = 0.008). Among those who belonged to two teams, the OR for feeling a lot of stress was 0.514 (range: 0.304–0.870; p = 0.013), and that for not feeling much stress was 2.663 (range: 1.103–6.426; p = 0.029). The OR for not feeling much stress was 4.697 for those who belonged to three teams (range: 1.531–14.408; p = 0.007) and 6.671 for those who belonged to four or more teams (range: 1.858–23.953; p = 0.004). The OR for feeling no stress at all was 11.629 (range: 2.229–60.661; p = 0.004) for those who belonged to three teams and 93.531 (range: 19.260–454.207; p < 0.001) for those who belonged to four or more teams. In terms of loneliness, the OR for rarely feeling lonely was 2.651 (range: 1.148–6.123; p = 0.022) among those who belonged to one team. The OR for feeling lonely all the time was 0.370 (range: 0.155–0.884; p = 0.025) among those who belonged to two teams. In terms of sleep satisfaction, the OR for having very sufficient sleep was 4.371 (range: 1.627–11.742; p = 0.003) for those who belonged to four or more teams. These results suggest that school sports are an advantageous tool for suicide prevention, given their low costs, absence of side effects, and ease of participation. Full article
(This article belongs to the Special Issue Childhood Physical Activity and Health)
13 pages, 554 KiB  
Article
Inflammatory and Hematologic Liver and Platelet (HALP) Scores in Hypothermia-Treated Hypoxic–Ischemic Encephalopathy (HIE)
by Handan Hakyemez Toptan, Kübra Gökçe Tezel, Oğuzhan Tezel, Ömer Ataç, Gonca Vardar, Sinem Gülcan Kersin and Eren Özek
Children 2024, 11(1), 72; https://doi.org/10.3390/children11010072 - 8 Jan 2024
Cited by 5 | Viewed by 1718
Abstract
Objective: This study examined systemic inflammatory indices and “Hemoglobin, Albumin, Lymphocyte, Platelet (HALP) scores” in neonates with hypoxic–ischemic encephalopathy (HIE). Methods: A total of 43 neonates with moderate-to-severe HIE at 36 weeks’ gestation were assessed. Systemic inflammatory markers were measured before HT commenced [...] Read more.
Objective: This study examined systemic inflammatory indices and “Hemoglobin, Albumin, Lymphocyte, Platelet (HALP) scores” in neonates with hypoxic–ischemic encephalopathy (HIE). Methods: A total of 43 neonates with moderate-to-severe HIE at 36 weeks’ gestation were assessed. Systemic inflammatory markers were measured before HT commenced within 0–6 h after birth and between 60 and 72 h during and after therapy or before adjusting for hypothermia. Results: Platelet counts, hemoglobin levels, and platelet indices in the HIE group were significantly lower at both time points (p = 0.001). Both the neutrophil-to-lymphocyte ratio (NLR) and monocyte-to-lymphocyte ratio (MLR) decreased in the HIE group after hypothermia therapy (p = 0.001). Seizures, PVL, and kidney injuries were associated with higher HALP scores. The AUCs of NLR, PLR, MLR, SII, SIRI, and platelet, neutrophil, monocyte, and lymphocyte Index (PIV) showed significant sensitivity and specified HIE, with area under the curve (AUC) values of 0.654, 0.751, 0.766, 0.700, 0.722, and 0.749, respectively. Conclusions: A significant difference in systemic inflammatory markers was found between the HIE and control groups after hypothermia treatment, with significant reductions in the MLR and NLR. These markers, particularly MLR, were significant predictors of adverse clinical outcomes including seizures, PVL, and kidney damage. Full article
(This article belongs to the Section Pediatric Neurology & Neurodevelopmental Disorders)
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19 pages, 1106 KiB  
Review
Wilson’s Disease with Acute Hepatic Onset: How to Diagnose and Treat It
by Valeria Delle Cave, Fabiola Di Dato and Raffaele Iorio
Children 2024, 11(1), 68; https://doi.org/10.3390/children11010068 - 6 Jan 2024
Cited by 6 | Viewed by 3872
Abstract
Wilson’s disease (WD) with acute onset poses a diagnostic challenge because it is clinically indistinguishable from other acute liver diseases. In addition, serum ceruloplasmin and urinary copper excretion, the first-line diagnostic tools for WD, can show false positive results in the case of [...] Read more.
Wilson’s disease (WD) with acute onset poses a diagnostic challenge because it is clinically indistinguishable from other acute liver diseases. In addition, serum ceruloplasmin and urinary copper excretion, the first-line diagnostic tools for WD, can show false positive results in the case of acute liver failure, and the diagnostic role of genetic analysis is limited by the time required to perform it. In the case of fulminant onset, there is a clear indication of liver transplantation. “New Wilson Index” is frequently used to discriminate between patients who need liver transplantation versus those who can be successfully managed by medical treatment, but its reliability remains controversial. Timely referral of patients with acute liver failure due to WD may be a key factor in improving patient survival. Although liver transplant very often represents the only chance for such patients, maximum effort should be made to promote survival with a native liver. The management of these aspects of WD is still a matter of debate and will be the subject of this review. Full article
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15 pages, 318 KiB  
Review
Updates in the Management of Congenital Melanocytic Nevi
by Mia A. Mologousis, Serena Yun-Chen Tsai, Kristin A. Tissera, Yakir S. Levin and Elena B. Hawryluk
Children 2024, 11(1), 62; https://doi.org/10.3390/children11010062 - 2 Jan 2024
Cited by 9 | Viewed by 6842
Abstract
Congenital melanocytic nevi (CMN) carry an increased risk of melanoma and may be disfiguring, and consensus regarding treatment recommendations is lacking. While clinical monitoring is the standard of care, many caregivers are interested in its removal to prevent psychosocial burden or to decrease [...] Read more.
Congenital melanocytic nevi (CMN) carry an increased risk of melanoma and may be disfiguring, and consensus regarding treatment recommendations is lacking. While clinical monitoring is the standard of care, many caregivers are interested in its removal to prevent psychosocial burden or to decrease risk. Although melanoma can occur regardless of CMN removal, there are a variety of treatments that may offer improved cosmesis or local symptom control, including surgical excision, laser therapy, and other superficially destructive techniques. Regardless of the selected management, these patients are monitored for ongoing melanoma risk. An extensive discussion with families regarding the risks and benefits of observation versus active intervention is essential. To facilitate these discussions, we herein summarize current CMN management strategies and considerations. Full article
(This article belongs to the Section Pediatric Dermatology)
11 pages, 866 KiB  
Article
Incidence and Management of Appendiceal Neuroendocrine Tumors in Pediatric Population: A Bicentric Experience with 6285 Appendectomies
by Zenon Pogorelić, Vladimir Ercegović, Marko Bašković, Miro Jukić, Ivana Karaman and Ivana Mrklić
Children 2023, 10(12), 1899; https://doi.org/10.3390/children10121899 - 8 Dec 2023
Cited by 9 | Viewed by 2923
Abstract
Background: Neuroendocrine tumors (NETs) are rare tumors that arise from neuroendocrine cells and are the most common tumors of the appendix. NETs of the appendix usually cause no symptoms and often go unnoticed until they cause acute appendicitis or are discovered during an [...] Read more.
Background: Neuroendocrine tumors (NETs) are rare tumors that arise from neuroendocrine cells and are the most common tumors of the appendix. NETs of the appendix usually cause no symptoms and often go unnoticed until they cause acute appendicitis or are discovered during an accidental appendectomy. As the trend towards the conservative treatment of acute appendicitis increases in the pediatric population, the question arises as to whether the majority of NETs go undetected and are only discovered at an advanced stage. The purpose of the proposed study is to review the incidence and outcomes of treatment for NETs of the appendix in children and include the data presented in the data pool for further review. Methods: From 1 January 2009 to 1 November 2023, a total of 6285 appendectomies were performed in two large pediatric centers in Croatia. After a retrospective review of the case records and histopathologic findings, a total of 31 children (0.49%) were diagnosed with NET of the appendix and included in the further analysis. The primary outcome of this study was the incidence and treatment outcome of pediatric patients diagnosed with NET of the appendix. Secondary outcomes included the patients’ demographic, clinical, and laboratory data and the histopathologic characteristics of tumor species. Results: The overall incidence of NETs of the appendix was stable over the study years, with minor fluctuations. The median age of patients was 14 (interquartile range—IQR: 12, 16) years, with a female predominance (64.5%). The majority of patients (96.8%) presented with acute abdominal pain and underwent appendectomy because acute appendicitis was suspected. Acute appendicitis was confirmed by histopathology in 18 (58%) cases. NETs of the appendix were not detected preoperatively in any of the patients. Among patients with confirmed acute appendicitis, most (n = 14; 77.8%) were found to have non-perforated acute appendicitis. In most children, the tumor was located at the tip of the appendix (n = 18; 58.1%), and the majority of tumors had a diameter of less than 1 cm (n = 21, 67.7%). The mitotic count (n = 25, 80.6%) and Ki-67 proliferation index (n = 23, 74.2%) were low in most patients, so most tumors were classified as NET G1 (n = 25, 80.6%), while NET G2 and NET G3 were found in four (12.9%) and two (6.5%) patients, respectively. All children were treated with appendectomy only. The median follow-up time was 54 (IQR: 24, 95) months. Conclusions: The incidence of appendiceal NET among pediatric patients is very low. NET occurs most frequently in adolescents, with a female predominance. Most tumors are less than 1 cm in diameter, located at the tip, and associated with non-perforated appendicitis. Appendectomy is the treatment of choice, and major surgery was not necessary in our cohort. Full article
(This article belongs to the Special Issue Advances in Gastrointestinal Surgery in Children)
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14 pages, 593 KiB  
Article
Bullying Victimization and Adolescent Depression, Anxiety and Stress: The Mediation of Cognitive Emotion Regulation
by Mariacarolina Vacca, Silvia Cerolini, Anna Zegretti, Andrea Zagaria and Caterina Lombardo
Children 2023, 10(12), 1897; https://doi.org/10.3390/children10121897 - 7 Dec 2023
Cited by 10 | Viewed by 5820
Abstract
Background: Existing research has revealed a robust association between bullying victimization and psychological distress, but less is known about the underlying mechanism of this link. cognitive emotion regulation (CER) strategies could be a potential mediator. The current study examined the role of functional [...] Read more.
Background: Existing research has revealed a robust association between bullying victimization and psychological distress, but less is known about the underlying mechanism of this link. cognitive emotion regulation (CER) strategies could be a potential mediator. The current study examined the role of functional and dysfunctional CER strategies as potential mediators of the association between bullying victimization and depression, anxiety, and stress symptoms among 638 high school students (53.9% boys; Mean age = 15.65, SD = 1.32). Method: Participants completed a series of questionnaires assessing bullying victimization (Olweus Bully/Victim Questionnaire), CER strategies (CERQ-18), and symptoms of depression, anxiety, and stress (DASS-21). The indirect relationships between bullying victimization and psychopathological symptoms via functional and dysfunctional CER strategies were tested through structural equation modeling. Results: Dysfunctional CER strategies mediated the impact of bullying victimization on depression, anxiety, and stress. In contrast, bullying victimization did not significantly influence functional CER strategies. Conclusions: The findings provide additional support for the detrimental role of bullying victimization on mental distress, also suggesting that this effect is not only direct, but indirect is well. These results are particularly relevant in light of the absence of mediation by protective factors such as the use of positive emotion regulation strategies. Full article
(This article belongs to the Special Issue School Bullying during Childhood and Adolescence)
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16 pages, 7451 KiB  
Review
Elastodontic Appliances for the Interception of Malocclusion in Children: A Systematic Narrative Hybrid Review
by Vincenzo Ronsivalle, Ludovica Nucci, Nicolò Bua, Giuseppe Palazzo and Salvatore La Rosa
Children 2023, 10(11), 1821; https://doi.org/10.3390/children10111821 - 17 Nov 2023
Cited by 10 | Viewed by 2871
Abstract
Background. Interceptive orthodontic treatment aims to eliminate factors that prevent the harmonious development of the maxillary and mandibular arches during childhood, and elastodontic appliances (EAs) represent a group of devices with an increasingly important role. This systematic narrative hybrid review (HR) aims to [...] Read more.
Background. Interceptive orthodontic treatment aims to eliminate factors that prevent the harmonious development of the maxillary and mandibular arches during childhood, and elastodontic appliances (EAs) represent a group of devices with an increasingly important role. This systematic narrative hybrid review (HR) aims to provide an overview of the clinical indications for the use of EAs according to the available evidence and to identify potential research areas for unexplored applications. Materials and methods. To assess the available literature on the subject, selective database searches were performed between July 2023 and September 2023. With the assistance of a health sciences librarian, a search strategy that utilized terms related to elastodontic therapy was developed. Embase, Scopus, PubMed, and Web of Science were the databases used. Results. The current literature addressing the usability of EAs is scarce and mostly limited to case reports and case series. After 2168 citations were found through the searches, 13 studies were ultimately included. In this regard, information about the clinical use and effectiveness of EAs are reported in a narrative form, defining specific domains of the application that are clinically oriented, including sagittal and transversal discrepancies, atypical swallowing, teeth malposition, two-phase orthodontics and a lack of teeth retention. Conclusions. Within the intrinsic quality limitation of the available literature, it seems that EAs may represent a promising treatment alternative for managing mild-to-moderate malocclusion in children as an adjuvant therapy to the interruption of spoiled habits. Full article
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18 pages, 738 KiB  
Article
Effects of Smartphone Activities on Postural Balance in Adolescents with Intellectual Disabilities
by Ghada Jouira, Cristina Ioana Alexe, Julien Narcis Herlo, Cristina Elena Moraru, Mihaela Bogdan, Dan Iulian Alexe, Gabriel Mareș and Sonia Sahli
Children 2023, 10(11), 1810; https://doi.org/10.3390/children10111810 - 14 Nov 2023
Cited by 8 | Viewed by 2207
Abstract
Considering the rising prevalence of smartphone usage among adolescents with intellectual disabilities and their frequent motor challenges, understanding its impact on their physical well-being is important. This study aims to investigate the impact of smartphone activities on postural balance in adolescents with intellectual [...] Read more.
Considering the rising prevalence of smartphone usage among adolescents with intellectual disabilities and their frequent motor challenges, understanding its impact on their physical well-being is important. This study aims to investigate the impact of smartphone activities on postural balance in adolescents with intellectual disabilities. Two groups of adolescents participated in the study: an intellectual disability group (IDG) (n = 16) and atypical development group (TDG) (n = 12). Static postural balance, using a stabilometric platform on firm and foam surfaces, and dynamic balance, using the Timed Up-and-Go Test (TUGT), were performed under various conditions, such as playing a game, watching videos, video calls, and listening to music. The center of pressure (CoP) values significantly increased (p < 0.05) during all smartphone activities (except listening to music) compared to the control condition in both groups, with the IDG demonstrated a more pronounced increase (p < 0.05) during playing video games and video calls on the firm surface. TUGT scores significantly increased (p < 0.05) during smartphone activities, with greater changes observed in the IDG (p < 0.05), and significantly decreased (p < 0.01) during listening to music in both groups. Our study suggests that adolescents with intellectual disabilities need special tools and guidance to ensure their safety and well-being when using smartphones. Full article
(This article belongs to the Section Global Pediatric Health)
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13 pages, 5174 KiB  
Review
Managing Dental Phobia in Children with the Use of Virtual Reality: A Systematic Review of the Current Literature
by Alessio Rosa, Alberto Maria Pujia, Raffaella Docimo and Claudio Arcuri
Children 2023, 10(11), 1763; https://doi.org/10.3390/children10111763 - 30 Oct 2023
Cited by 11 | Viewed by 4162
Abstract
Background: It is common today to encounter anxiety in patients facing dental treatment. Virtual reality (VR) is presented as a high-performing and innovative procedure because it can distract patients undergoing dental procedures or prepare them for such treatments. In addition, this meta-analysis has [...] Read more.
Background: It is common today to encounter anxiety in patients facing dental treatment. Virtual reality (VR) is presented as a high-performing and innovative procedure because it can distract patients undergoing dental procedures or prepare them for such treatments. In addition, this meta-analysis has gathered evidence on VR and its ability to reduce dental anxiety in pediatric patients undergoing different treatments. Methods: The major Scopus, PubMed, EMBASE and Web of Science databases were searched for scientific articles published up to 2023. Studies in which VR was used for children and adults as a measure against anxiety during dental treatments were included. VR was defined as a three-dimensional place where patients experience a sense of immersion as they find themselves in attractive and interactive environments that detach them from reality. Anxiety and pain were examined and measured during dental treatments in which VR was used by comparing them with standard care situations. Results: Twenty-five studies were identified, of which eleven met the inclusion criteria. The effect of VR was studied mainly in the pediatric population as a distractive method. Only two studies (not significant) on an adult population were considered. Conclusions: this review shows that VR is an excellent distraction method that is effective in reducing anxiety before dental treatment; however, due to the few studies in this area, further research on VR as a tool to prepare patients for dental treatment is needed. Full article
(This article belongs to the Section Pediatric Dentistry & Oral Medicine)
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13 pages, 266 KiB  
Article
Impacts of Integrating Family-Centered Care and Developmental Care Principles on Neonatal Neurodevelopmental Outcomes among High-Risk Neonates
by Nourah Alsadaan, Osama Mohamed Elsayed Ramadan, Mohammed Alqahtani, Mostafa Shaban, Nadia Bassuoni Elsharkawy, Enas Mahrous Abdelaziz and Sayed Ibrahim Ali
Children 2023, 10(11), 1751; https://doi.org/10.3390/children10111751 - 28 Oct 2023
Cited by 14 | Viewed by 4772
Abstract
Background: Integrating family-centered care (FCC) and developmental care (DC) principles in neonatal care settings may improve neurodevelopmental outcomes for high-risk neonates. However, the combined impact of FCC and DC has been underexplored. This study aimed to investigate the effects of integrated FCC and [...] Read more.
Background: Integrating family-centered care (FCC) and developmental care (DC) principles in neonatal care settings may improve neurodevelopmental outcomes for high-risk neonates. However, the combined impact of FCC and DC has been underexplored. This study aimed to investigate the effects of integrated FCC and DC on neurodevelopment and length of hospital stay in high-risk neonates. Methods: A quasi-experimental pre–post study was conducted among 200 high-risk neonates (<32 weeks gestation or <1500 g) admitted to neonatal intensive care units (NICU) in Saudi Arabia. The intervention group (n = 100) received integrated FCC and DC for 6 months. The control group (n = 100) received standard care. Neurodevelopment was assessed using the Bayley Scales of Infant Development-III. Length of stay and readmissions were extracted from medical records. Results: The intervention group showed significant improvements in cognitive, motor, and language scores compared to controls (p < 0.05). The intervention group had a 4.3-day reduction in the mean length of stay versus a 1.4-day reduction in controls (p = 0.02). Integrated care independently predicted higher cognitive scores (p = 0.001) and shorter stays (p = 0.006) in regression models. Conclusion: Integrating FCC and DC in neonatal care enhances neurodevelopmental outcomes and reduces hospitalization for high-risk neonates compared to standard care. Implementing relationship-based, developmentally supportive models is critical for optimizing outcomes in this vulnerable population. Full article
(This article belongs to the Special Issue 10th Anniversary of Children: Feature Papers in Neonatology)
17 pages, 751 KiB  
Article
Family Communication as a Mediator between Family Resilience and Family Functioning under the Quarantine and COVID-19 Pandemic in Arabic Countries
by Aiche Sabah, Musheer A. Aljaberi, Jamel Hajji, Chuan-Yin Fang, Yu-Chen Lai and Chung-Ying Lin
Children 2023, 10(11), 1742; https://doi.org/10.3390/children10111742 - 27 Oct 2023
Cited by 23 | Viewed by 4741
Abstract
The coronavirus pandemic has become an unprecedented world crisis in which we have struggled against the most potent threat of the twenty-first century. This pandemic has had a profound impact on individuals and families. Therefore, the study aimed to examine family communication as [...] Read more.
The coronavirus pandemic has become an unprecedented world crisis in which we have struggled against the most potent threat of the twenty-first century. This pandemic has had a profound impact on individuals and families. Therefore, the study aimed to examine family communication as a mediator of the relationship between family resilience and family functioning under the quarantine and coronavirus pandemic in Algeria and Iraq. This study was conducted among individuals in Iraq and Algeria (N = 361). The respondents completed the Family Communication Scale (FCS), Walsh Family Resilience Questionnaire (WFRQ), and Family Functioning Scale (FFS). Structural equation modeling (SEM) with the bootstrapping method was used to conduct the mediated effects of family communication. Using the bootstrapping method in SEM, family resilience and communication significantly affected family functioning (coefficient = 0.808). Moreover, the direct effect and indirect effect (via family functioning) of family resilience on family functioning were both significant, with coefficients of 0.682 and 0.126. In addition, numerous groups from Iraq and Algeria have been analyzed as a sample and have shown no differences in the relationships between family resilience, family communication, and family functioning. In conclusion, the results showed that family communication mediated the relationship between family resilience and family functioning. Moreover, the type of this mediation seemed to be partial because of the significant direct relationship between family resilience and family functioning. According to the findings, healthcare providers should consider improving family resilience and communication to achieve good family functioning. Full article
(This article belongs to the Special Issue Child and Adolescent Psychiatry and Mental Health Progress)
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