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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12 pages, 1189 KB  
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 2435
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 KB  
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 8 | Viewed by 3650
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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14 pages, 496 KB  
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 12 | Viewed by 5661
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, 885 KB  
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 10 | Viewed by 4422
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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17 pages, 299 KB  
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 9 | Viewed by 4308
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 KB  
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 9 | Viewed by 3638
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 KB  
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 12 | Viewed by 6694
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 KB  
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 2915
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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15 pages, 666 KB  
Review
Plant Sterols and Stanols for Pediatric Patients with Increased Cardiovascular Risk
by Cristina Pederiva, Giacomo Biasucci, Giuseppe Banderali and Maria Elena Capra
Children 2024, 11(1), 129; https://doi.org/10.3390/children11010129 - 20 Jan 2024
Cited by 7 | Viewed by 4461
Abstract
The atherosclerotic process begins in childhood and progresses throughout adult age. Hypercholesterolemia, especially familial hypercholesterolemia (FH) and metabolic dysfunctions linked to weight excess and obesity, are the main atherosclerosis risk factors in pediatric patients and can be detected and treated starting from childhood. [...] Read more.
The atherosclerotic process begins in childhood and progresses throughout adult age. Hypercholesterolemia, especially familial hypercholesterolemia (FH) and metabolic dysfunctions linked to weight excess and obesity, are the main atherosclerosis risk factors in pediatric patients and can be detected and treated starting from childhood. Nutritional intervention and a healthy-heart lifestyle are cornerstones and first-line treatments, with which, if necessary, drug therapy should be associated. For several years, functional foods enriched with plant sterols and stanols have been studied in the treatment of hypercholesterolemia, mainly as nutritional complements that can reduce LDL cholesterol; however, there is a lack of randomized controlled trials defining their long-term efficacy and safety, especially in pediatric age. This review aims to evaluate what the main published studies on sterols and stanols in pediatric subjects with dyslipidemia have taught us, providing an updated picture of the possible use of these dietary supplements in children and adolescents with dyslipidemia and increased cardiovascular risk. Nowadays, we can state that plant sterols and stanols should be considered as a valuable therapy in pediatric patients with hypercholesterolemia, bearing in mind that nutritional and lifestyle counseling and, when necessary, pharmacologic therapy, are the cornerstones of the treatment in developmental age. Full article
(This article belongs to the Section Global Pediatric Health)
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17 pages, 6549 KB  
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 8 | Viewed by 8849
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 KB  
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 5 | Viewed by 4730
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 KB  
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 8 | Viewed by 4654
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, 279 KB  
Article
Insights from a Qualitative Exploration of Adolescents’ Opinions on Sex Education
by María Victoria Díaz-Rodríguez, Vicent Bataller i Perelló, José Granero-Molina, Isabel María Fernández-Medina, María Isabel Ventura-Miranda and María del Mar Jiménez-Lasserrotte
Children 2024, 11(1), 110; https://doi.org/10.3390/children11010110 - 16 Jan 2024
Cited by 7 | Viewed by 3865
Abstract
Background: Adolescence is a crucial time in the development of young people’s identity, and sexuality is a key issue. Comprehensive sex education provides the knowledge and skills to help adolescents protect their sexual and reproductive health and rights. Policies on sex education in [...] Read more.
Background: Adolescence is a crucial time in the development of young people’s identity, and sexuality is a key issue. Comprehensive sex education provides the knowledge and skills to help adolescents protect their sexual and reproductive health and rights. Policies on sex education in secondary schools are highly influential in the development of quality programmes that support comprehensive sex education. The aim of this study was to explore, describe and understand adolescents’ experiences of sex education. Methods: A qualitative study based on Gadamer’s phenomenology was used. Two focus groups and four in-depth interviews were conducted with 12 private school students, followed by inductive data analysis using ATLAS.ti software 9.0. Results: Two main themes were identified in the analysis: (1) sex education is a challenge for secondary schools and (2) student expectations of sex education. Conclusion: It is essential for adolescents to have access to comprehensive sex education that is adapted to the different stages of their development, is provided by specialised teachers, and involves their families in the process. Full article
13 pages, 609 KB  
Article
Outcomes of a Parent-Delivered Baby-mCIMT Model for Infants at High Risk of Unilateral Cerebral Palsy Using Remote Coaching in Telerehabilitation
by Katarina Svensson, Heléne Sundelin and Ann-Christin Eliasson
Children 2024, 11(1), 101; https://doi.org/10.3390/children11010101 - 15 Jan 2024
Cited by 6 | Viewed by 2412
Abstract
There is growing evidence of the positive effects of constraint-induced movement therapy (CIMT) for infants at high risk of unilateral cerebral palsy (UCP) when provided by parents with in-person coaching/supervision from occupational therapists during home visits. The aim of this study is to [...] Read more.
There is growing evidence of the positive effects of constraint-induced movement therapy (CIMT) for infants at high risk of unilateral cerebral palsy (UCP) when provided by parents with in-person coaching/supervision from occupational therapists during home visits. The aim of this study is to investigate whether Baby-mCIMT (modifiedCIMT) can be as effective if parents are coached/supervised remotely. In this case-control study, we recruited 20 infants and re-used 18 controls, 4–8-month-old infants in both groups at high risk of UCP. The same protocol regarding inclusion criteria, data collection, and training volume was used in both groups. The training was conducted for two 6-week periods, separated by a 6-week break, consisting of daily 30 min sessions conducted by parents, supported by therapist coaching once a week. The primary outcome was measured using the Hand Assessment for Infants (HAI). There was no difference in the change of HAI units (p = 0.803) or that of the affected-hand raw score (p = 0.942) between the two groups. The remote coaching method was well received by parents. In conclusion, this demonstrates that remote coaching/supervision is as effective as the in-person approach, requiring less time and effort for both families and healthcare providers. Full article
(This article belongs to the Special Issue Research in Rehabilitation for Children with Motor Disability)
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14 pages, 255 KB  
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 21 | Viewed by 2282
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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11 pages, 256 KB  
Review
The Future for the Children of Tomorrow: Avoiding Salt in the First 1000 Days
by Giorgia Mazzuca, Silvia Artusa, Angelo Pietrobelli, Giuseppe Di Cara, Giorgio Piacentini and Luca Pecoraro
Children 2024, 11(1), 98; https://doi.org/10.3390/children11010098 - 14 Jan 2024
Cited by 6 | Viewed by 3537
Abstract
It is widely known that optimal nutrition in the first 1000 days of life positively impacts the child’s development throughout adulthood. In this setting, salt should not be added to complementary feeding. In developed countries, salt intake is generally higher than recommended for [...] Read more.
It is widely known that optimal nutrition in the first 1000 days of life positively impacts the child’s development throughout adulthood. In this setting, salt should not be added to complementary feeding. In developed countries, salt intake is generally higher than recommended for children. Excessive salt intake is the major determinant of hypertension and is associated with several cardiovascular outcomes. Therefore, pediatricians have a key role in raising awareness among parents to avoid salt consumption in the first 1000 days of life to ensure better health for their children. Starting from a review of the literature published in PubMed/MedLine regarding the short- and long-term consequences of salt consumption during the first 1000 days of life, our comprehensive review aims to analyze the beneficial effects of avoiding salt at such a vulnerable stage of life as the first 1000 days. Obesity, hypertension, increased salt sensitivity, high sweet drink consumption, increased mortality, and morbidity persisting in adult age represent the principal consequences of a higher salt intake during the first 1000 days of life. Full article
(This article belongs to the Special Issue Infant and Early Childhood Nutrition)
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11 pages, 426 KB  
Article
The Family Talk Intervention in Pediatric Oncology: Potential Effects Reported by Parents
by Maria Ayoub, Camilla Udo, Kristofer Årestedt, Ulrika Kreicbergs and Malin Lövgren
Children 2024, 11(1), 95; https://doi.org/10.3390/children11010095 - 12 Jan 2024
Cited by 6 | Viewed by 2704
Abstract
Background: Childhood cancer impacts the family system and has psychosocial consequences for all family members. For the parents, the ill child, and the siblings to be able to adjust to this challenging situation, the whole family needs access to psychosocial support. However, only [...] Read more.
Background: Childhood cancer impacts the family system and has psychosocial consequences for all family members. For the parents, the ill child, and the siblings to be able to adjust to this challenging situation, the whole family needs access to psychosocial support. However, only a few such family interventions in pediatric oncology have been evaluated. The aim of this study was to explore the potential effects of a family-centered intervention, the Family Talk Intervention (FTI), in pediatric oncology from the parents’ perspectives. Methods: A concurrent mixed methods design was used for this study. Data were derived from a pilot study of 26 families recruited from one pediatric oncology center in Sweden. This study focused on questionnaire and interview data from 52 parents. Results: After participation in FTI, the parents felt more satisfied with the conversations within the family about the illness. FTI also contributed to strengthened family togetherness, including more open communication and improved family relations, as described by the parents. Parents further expressed that they felt more empowered in their parenting role following FTI. Conclusions: The findings regarding FTI’s ability to improve family communication and family relations, thus strengthening family togetherness in families with childhood cancer, are promising. This provides motivation for a large-scale study of FTIs in pediatric oncology. Full article
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11 pages, 502 KB  
Article
How Do Children “Think outside the Box”? Fluid Intelligence and Divergent Thinking: A Moderated Mediation Study of Field Dependent-Independent Cognitive Style and Gender
by Marco Giancola, Massimiliano Palmiero, Maria Chiara Pino, Marta Sannino and Simonetta D’Amico
Children 2024, 11(1), 89; https://doi.org/10.3390/children11010089 - 11 Jan 2024
Cited by 6 | Viewed by 2835
Abstract
The interplay between fluid intelligence (Gf) and divergent thinking (DT) has widely characterized current research in the psychology of creativity. Nevertheless, the evidence on the main factors involved in this association during childhood remains a matter of debate. Present research has addressed the [...] Read more.
The interplay between fluid intelligence (Gf) and divergent thinking (DT) has widely characterized current research in the psychology of creativity. Nevertheless, the evidence on the main factors involved in this association during childhood remains a matter of debate. Present research has addressed the interplay between Gf and DT, exploring the mediating role of a field dependent-independent cognitive style (FDI) and the moderating effect of gender in 101 children (Mage = 8.02; SDage = 1.43). Participants carried out Raven’s Colored Progressive Matrices, the Children Embedded Figure Test, and the Alternative Uses Task. The results revealed the mediating effect of FDI in the association between Gf and DT, providing evidence that this cognitive style represents a function of controlled mental processes underpinned by Gf, which are useful to thinking divergently. In addition, the findings reported that the interplay between FDI and DT was moderated by gender, suggesting that the impact of FDI on DT was stronger among boys. Through a multidimensional approach, these current research findings provide further insight into the primary children’s factors involved in the ability to find alternative solutions and think divergently. Full article
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10 pages, 523 KB  
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 10 | Viewed by 3617
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 KB  
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 14 | Viewed by 2743
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 KB  
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 2269
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 KB  
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 6 | Viewed by 2009
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 KB  
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 6056
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 KB  
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 11 | Viewed by 10436
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)
13 pages, 595 KB  
Article
Guided Growth Technique for Epiphysiodesis and Hemiepiphysiodesis: Safety and Performance Evaluation
by Giovanni Luigi Di Gennaro, Giovanni Trisolino, Stefano Stallone, Marco Ramella, Gino Rocca and Giovanni Gallone
Children 2024, 11(1), 49; https://doi.org/10.3390/children11010049 - 29 Dec 2023
Cited by 8 | Viewed by 3919
Abstract
Background: Guided-growth modulation is a first-line treatment widely adopted to correct lower-limb angular deformities and limb-length discrepancies (LLD) in the paediatric population. Methods: We conducted a retrospective study to evaluate the safety and performance of a new construct (8-Plate Plus or Guided-Growth Plate [...] Read more.
Background: Guided-growth modulation is a first-line treatment widely adopted to correct lower-limb angular deformities and limb-length discrepancies (LLD) in the paediatric population. Methods: We conducted a retrospective study to evaluate the safety and performance of a new construct (8-Plate Plus or Guided-Growth Plate System Plus, Orthofix S.r.l) used to correct angular deformities and LLD in non-skeletally mature children. The primary endpoint was safety (from plate implantation to removal). The secondary endpoint was performance; patients treated for LLD achieved complete correction if a pre- and post-surgery difference of <0 was observed; angular deformities performance was measured in terms of IMD, ICD, mMPTA, and mLDFA. Results: We performed 69 procedures in 41 patients. A total of 10 patients had an LLD, and 31 had an angular deformity. We observed nine minor complications in the hemiepiphysiodesis group. One patient experienced rebound. All 10 LLD patient treatments were successful. A total of 30/31 patients with an angular deformity had a successful treatment; the remaining patient had a partial correction. Conclusions: Guided-growth by temporary epiphysiodesis or hemiepiphysiodesis was safe and effective for angular deformities and limb-length discrepancies. Further prospective and/or randomized controlled trial studies assessing more significant cohorts of patients and a comparison group could add evidence to our findings. Full article
(This article belongs to the Section Pediatric Orthopedics & Sports Medicine)
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20 pages, 835 KB  
Review
Update on Fever of Unknown Origin in Children: Focus on Etiologies and Clinical Approach
by Sandra Trapani, Adele Fiordelisi, Mariangela Stinco and Massimo Resti
Children 2024, 11(1), 20; https://doi.org/10.3390/children11010020 - 24 Dec 2023
Cited by 11 | Viewed by 11533
Abstract
Fever of unknown origin (FUO) can be caused by four etiological categories of diseases. The most common cause of FUO in children is represented by infections, followed by inflammatory conditions and neoplastic causes; a decreasing quote remains still without diagnosis. Despite the fact [...] Read more.
Fever of unknown origin (FUO) can be caused by four etiological categories of diseases. The most common cause of FUO in children is represented by infections, followed by inflammatory conditions and neoplastic causes; a decreasing quote remains still without diagnosis. Despite the fact that several diagnostic and therapeutic approaches have been proposed since the first definition of FUO, none of them has been fully validated in pediatric populations. A focused review of the patient’s history and a thorough physical examination may offer helpful hints in suggesting a likely diagnosis. The diagnostic algorithm should proceed sequentially, and invasive testing should be performed only in select cases, possibly targeted by a diagnostic suspect. Pioneering serum biomarkers have been developed and validated; however, they are still far from becoming part of routine clinical practice. Novel noninvasive imaging techniques have shown promising diagnostic accuracy; however, their positioning in the diagnostic algorithm of pediatric FUO is still not clear. This narrative review aims to provide a synopsis of the existent literature on FUO in children, with its major causes and possible diagnostic workup, to help the clinician tackle the complex spectrum of pediatric FUO in everyday clinical practice. Full article
(This article belongs to the Section Pediatric Allergy and Immunology)
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16 pages, 457 KB  
Review
Language Skills in Children with Attention Deficit Hyperactivity Disorder and Developmental Language Disorder: A Systematic Review
by Inmaculada Méndez-Freije, Débora Areces and Celestino Rodríguez
Children 2024, 11(1), 14; https://doi.org/10.3390/children11010014 - 21 Dec 2023
Cited by 7 | Viewed by 10862
Abstract
(1) Background: Attention Deficit Hyperactivity Disorder (ADHD) and Developmental Language Disorder (DLD) are neurodevelopmental disorders that affect various areas of children’s development, such as language. It exists an emerging idea that ADHD is characterised by the presence of language difficulties, which can be [...] Read more.
(1) Background: Attention Deficit Hyperactivity Disorder (ADHD) and Developmental Language Disorder (DLD) are neurodevelopmental disorders that affect various areas of children’s development, such as language. It exists an emerging idea that ADHD is characterised by the presence of language difficulties, which can be explained by the high comorbidity between ADHD and DLD. The aim of this review is to analyse the empirical evidence of language competence in children aged 6–17 years old, diagnosed with ADHD and/or DLD. (2) Method: Fifteen studies with experimental designs were identified from Scopus, PsycINFO, and WoS databases, reporting on language skills in children diagnosed with ADHD and/or DLD. Studies relating executive functioning to language skills in this target population were also included. (3) Results: The literature is heterogeneous and different components of language are also examined. Even though the results are contradictory, they convincingly demonstrate there are overlapping symptoms between ADHD and DLD, such as language skills and executive functions. (4) Conclusions: The differences in the samples limit the generalisability of the results. Therefore, this review highlights the importance of considering language skills when designing individualised interventions for the population with ADHD and DLD, both in comorbidity and in isolation. Full article
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11 pages, 866 KB  
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 12 | Viewed by 3395
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 KB  
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 15 | Viewed by 7435
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 KB  
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 13 | Viewed by 3620
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 KB  
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 10 | Viewed by 2519
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 KB  
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 20 | Viewed by 5225
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 KB  
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 20 | Viewed by 6200
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 KB  
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 27 | Viewed by 11741
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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30 pages, 913 KB  
Article
Uncertainty and the NICU Experience: A Qualitative Evaluation of Family and Provider Perspectives
by Katharine Griffin Gorsky, Saloni Butala, Madison House, Chelsea Moon, Sam Calvetti, Tenzin Khando, Michele Kipke and Ashwini Lakshmanan
Children 2023, 10(11), 1745; https://doi.org/10.3390/children10111745 - 27 Oct 2023
Cited by 8 | Viewed by 3550
Abstract
There is limited information regarding caregiver and provider perspectives on uncertainty across the continuum of the neonatal intensive care unit (NICU) experience. Open-ended semi-structured interviews were conducted with providers and English- and Spanish-speaking caregivers of infants with a history of admission to a [...] Read more.
There is limited information regarding caregiver and provider perspectives on uncertainty across the continuum of the neonatal intensive care unit (NICU) experience. Open-ended semi-structured interviews were conducted with providers and English- and Spanish-speaking caregivers of infants with a history of admission to a quaternary safety-net NICU. Major themes were generated using inductive–deductive thematic analysis. Seventy-six individuals participated in the study: 47 caregivers and 29 providers. The median gestational age of the infants was 29 weeks and 85% were classified as having chronic complex disease per the Pediatric Medical Complexity Algorithm. Most providers were neonatologists (37%) and nurses (27%) and more than half had over ten years of experience. A conceptual model of caregiver uncertainty was developed and key domains included drivers of uncertainty and its impact, and factors influencing coping and adaptation. Our analysis found a positive association between caregiver information gathering, clinical continuity, support systems, maternal mental health supports, and witnessing a child’s progress and the development of adjustment to chronic uncertainty. These results suggest key areas for intervention that can promote parental adaptation to the uncertainty inherent in the NICU experience. Full article
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19 pages, 1927 KB  
Review
Multimodality Imaging Assessment of Tetralogy of Fallot: From Diagnosis to Long-Term Follow-Up
by Sara Moscatelli, Valeria Pergola, Raffaella Motta, Federico Fortuni, Nunzia Borrelli, Jolanda Sabatino, Isabella Leo, Martina Avesani, Claudia Montanaro, Elena Surkova, Massimo Mapelli, Marco Alfonso Perrone and Giovanni di Salvo
Children 2023, 10(11), 1747; https://doi.org/10.3390/children10111747 - 27 Oct 2023
Cited by 11 | Viewed by 4657
Abstract
Tetralogy of Fallot (TOF) is the most common complex congenital heart disease with long-term survivors, demanding serial monitoring of the possible complications that can be encountered from the diagnosis to long-term follow-up. Cardiovascular imaging is key in the diagnosis and serial assessment of [...] Read more.
Tetralogy of Fallot (TOF) is the most common complex congenital heart disease with long-term survivors, demanding serial monitoring of the possible complications that can be encountered from the diagnosis to long-term follow-up. Cardiovascular imaging is key in the diagnosis and serial assessment of TOF patients, guiding patients’ management and providing prognostic information. Thorough knowledge of the pathophysiology and expected sequalae in TOF, as well as the advantages and limitations of different non-invasive imaging modalities that can be used for diagnosis and follow-up, is the key to ensuring optimal management of patients with TOF. The aim of this manuscript is to provide a comprehensive overview of the role of each modality and common protocols used in clinical practice in the assessment of TOF patients. Full article
(This article belongs to the Special Issue Research Progress of the Pediatric Cardiology: 2nd Edition)
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10 pages, 800 KB  
Article
The 2023 Turkey Earthquake: Management of 627 Pediatric Musculoskeletal Injuries in the First Month
by Mesut Uluöz and Mehmet Yiğit Gökmen
Children 2023, 10(11), 1733; https://doi.org/10.3390/children10111733 - 26 Oct 2023
Cited by 10 | Viewed by 2186
Abstract
(1) Background: On 6February 2023, two consecutive earthquakes hit Kahramanmaraş and surrounding ten cities, killing over 50,000 people. We aimed to reveal the treatment process of pediatric patients admitted to Adana City Hospital (ACH) in the first month after the earthquake. (2) Methods: [...] Read more.
(1) Background: On 6February 2023, two consecutive earthquakes hit Kahramanmaraş and surrounding ten cities, killing over 50,000 people. We aimed to reveal the treatment process of pediatric patients admitted to Adana City Hospital (ACH) in the first month after the earthquake. (2) Methods: Demographic data of the patients, time of presentation to the emergency department, injury locations, treatment procedures, and patient file information were recorded retrospectively and evaluated statistically. (3) Results: There were 1246 patients under the age of 18. A total of 560 patients were hospitalized in the orthopedic clinic; 42% were admitted in the first 24 h and 58% in the first three days. Of these children, 69 (12%) were referred, 52 (10%) were transferred to other departments within the hospital, and 421 (75.2%) were discharged in stable condition. The number of patients with large bone fractures was 77 (34 open fractures). Fasciotomy surgery was performed on 131 patients, 78 of whom had bilateral procedures. Of the 31 patients who underwent amputation, 17 (55%) were performed within the first 24 h and 28 (90%) within the first week. (4) Conclusions: Almost all injured children are admitted to the hospital during the first few days after an earthquake. The management of earthquake injuries in pediatric patients requires specialized care and immediate attention during the treatment process. Full article
(This article belongs to the Special Issue Orthopedics and Trauma in Children: 2nd Edition)
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13 pages, 572 KB  
Article
Long-Term Effects of Maternal Depression during Postpartum and Early Parenthood Period on Child Socioemotional Development
by Anna Suarez, Liubov Shraibman and Vera Yakupova
Children 2023, 10(10), 1718; https://doi.org/10.3390/children10101718 - 23 Oct 2023
Cited by 15 | Viewed by 6146
Abstract
Most research on the impact of maternal depressive symptoms on child development is conducted during the first year postpartum. Findings on long-term effects of maternal depression are still contradictory and underexplored. The present study investigates the long-term impact of maternal depression during the [...] Read more.
Most research on the impact of maternal depressive symptoms on child development is conducted during the first year postpartum. Findings on long-term effects of maternal depression are still contradictory and underexplored. The present study investigates the long-term impact of maternal depression during the postpartum and early parenthood periods on child behavioral problems at the mean age of 2.25 years. The Edinburgh postnatal depression scale and Beck depression Inventory were used to assess postpartum and early parenthood depression, respectively. The Child Behavior Checklist was used to examine child’s behavioral problems. The regression analysis showed statistically significant associations between child behavioral problems and maternal depression during early parenthood and no significant associations with postpartum depression. Four maternal depressive symptoms’ trajectories were identified: consistently low, consistently high, decreased, and increased. The children of mothers with consistently high depressive symptoms at both research stages had the most significant total, internalizing, and externalizing problems. Children of mothers whose depressive symptoms decreased over time had the lowest scores in all three domains of behavioral problems. It is extremely important to implement programs for screening and early intervention for maternal mental health problems that could greatly influence the well-being of women and their children’s development. Full article
(This article belongs to the Special Issue Updates on Perinatal Depression and Child Developmental Disorders)
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21 pages, 357 KB  
Review
“Light” on Phototherapy—Complications and Strategies for Shortening Its Duration, A Review of the Literature
by Irit Shoris, Ayala Gover, Arina Toropine, Adir Iofe, Rasha Zoabi-Safadi, Svetlana Tsuprun and Arieh Riskin
Children 2023, 10(10), 1699; https://doi.org/10.3390/children10101699 - 17 Oct 2023
Cited by 14 | Viewed by 7127
Abstract
Neonatal hyperbilirubinemia is an extremely common metabolic complication of the neonatal period which may be associated with bilirubin encephalopathy and even death. Adverse neurological consequences are preventable if a timely diagnosis and treatment are provided. Phototherapy is usually the preferred option to decrease [...] Read more.
Neonatal hyperbilirubinemia is an extremely common metabolic complication of the neonatal period which may be associated with bilirubin encephalopathy and even death. Adverse neurological consequences are preventable if a timely diagnosis and treatment are provided. Phototherapy is usually the preferred option to decrease hyperbilirubinemia. Although considered to be safe, evidence in recent years has shown that this treatment may not be free of side effects and short- and long-term unfavorable outcomes. These are usually mild or rare, but should be decreased or avoided if possible. Many useful complementary measures and treatments have been described that could shorten the duration of exposure to phototherapy. However, there is no current unequivocal recommendation to use any of the methods presented in this review. Our review aims to depict the wide range of possible complementary treatments to phototherapy, and to provide the scientific and clinical evidence available regarding their usefulness. It is essential that, while utilizing the full potential of phototherapy to treat hyperbilirubinemia, caregivers are aware of its side effects and possible inherent dangers, and seek ways to minimize the exposure to phototherapy to what is really needed for the newborn. Further studies are needed to clarify the preferred complementary treatments that could reduce the duration of exposure to phototherapy without impairing its effectiveness. Full article
(This article belongs to the Special Issue Advances in Healthcare for Neonates Volume II)
14 pages, 320 KB  
Article
Body Image and Psychological Impact of Dental Appearance in Adolescents with Malocclusion: A Preliminary Exploratory Study
by Federica Sicari, Emanuele Maria Merlo, Giulia Gentile, Riccardo Nucera, Marco Portelli, Salvatore Settineri, Liam Alexander MacKenzie Myles and Angela Militi
Children 2023, 10(10), 1691; https://doi.org/10.3390/children10101691 - 16 Oct 2023
Cited by 13 | Viewed by 5000
Abstract
Background: Body image and psychosocial functioning represent central challenges during adolescence and early adulthood. Malocclusion, defined as an irregularity in the alignment of the teeth, is known to negatively influence psychological outcomes. The current study aimed to elucidate the role of malocclusion, together [...] Read more.
Background: Body image and psychosocial functioning represent central challenges during adolescence and early adulthood. Malocclusion, defined as an irregularity in the alignment of the teeth, is known to negatively influence psychological outcomes. The current study aimed to elucidate the role of malocclusion, together with age, gender, and dental class, in body image and psychological functioning. Methods: A total of 126 participants aged from 12 to 19 years old (mean: 15.87, SD: 2.35, female participants: 52.4%, male participants: 47.6%) were recruited. Participants were visited at the University Hospital of Messina, Italy, and completed a sociodemographic questionnaire, the Body Image Concern Inventory (I-BICI), and the Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ). Results: Significant correlations were found between age, dental class, the BICI, and the PIDAQ. In particular, age showed a positive and significant correlation with PIDAQ—total score. The correlations between occlusal status and the BICI variables were all significant and positive. All correlations between occlusal status and the PIDAQ variables were all significant and positive, except for dental self-confidence. The correlations between the variables of the PIDAQ and BICI instruments were all significant and positive, except for dental self-confidence, where the directions were significant and negative. Moreover, age, gender, and occlusal status predicted BICI and PIDAQ scores. Age was a positive predictor for PIDAQ self-confidence, gender for BICI and PIDAQ total scores, along with dysmorphic symptoms, social impact, psychological impact, and aesthetic concerns. Several significant gender differences were highlighted by the analyses, with higher scores in the female group on all the BICI variables, except symptom interference, and all the PIDAQ variables, except dental self-confidence. Conclusions: Malocclusion appeared to play a central role in the psychological, representational, and psychosocial life of the participants. This research suggests that malocclusion and dental issues influence the psychological, representational, and psychosocial life of adolescents. Further research is required to examine the psychological impact of dental problems. Full article
(This article belongs to the Special Issue Advances in Oral Health and Dental Care of Children: Update)
15 pages, 650 KB  
Review
Effectiveness of School-Based Interventions in Europe for Promoting Healthy Lifestyle Behaviors in Children
by Archontoula Drouka, Dora Brikou, Céline Causeret, Nur Al Ali Al Malla, Stéphane Sibalo, Concha Ávila, Gabriela Alcat, Anastasia E. Kapetanakou, Patricia Gurviez, Nawel Fellah-Dehiri, Marine Masson, Meropi D. Kontogianni and Mary Yannakoulia
Children 2023, 10(10), 1676; https://doi.org/10.3390/children10101676 - 11 Oct 2023
Cited by 15 | Viewed by 3755
Abstract
The objective of this narrative review was to summarize existing literature on the effectiveness of school-based interventions, implemented in Europe, under the aim of promoting healthy lifestyle behaviors in children (6–10 years old). A search of PubMed, Scopus, EFSA and Google Scholar databases [...] Read more.
The objective of this narrative review was to summarize existing literature on the effectiveness of school-based interventions, implemented in Europe, under the aim of promoting healthy lifestyle behaviors in children (6–10 years old). A search of PubMed, Scopus, EFSA and Google Scholar databases was performed for studies published from January 2016 to June 2022. Specific search terms and exclusion criteria were used. Based on the results, diet and physical activity interventions had favorable effects on a series of health outcomes, including anthropometric parameters, biomarkers, eating behavior and self-efficacy. Diet-only interventions had a positive impact specifically on eating habits, mostly on water consumption. Most successful interventions lasted for 1 school year, and they were characterized by parental involvement and teachers’ training. Full article
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13 pages, 473 KB  
Article
Characteristics of the Inflammatory Bowel Disease in Children: A Croatian Single-Centre Retrospective Study
by Ivan Pivac, Antonia Jelicic Kadic, Ranka Despot, Vanda Zitko, Darija Tudor, Edita Runjic and Josko Markic
Children 2023, 10(10), 1677; https://doi.org/10.3390/children10101677 - 11 Oct 2023
Cited by 9 | Viewed by 2166
Abstract
Inflammatory bowel diseases (IBDs), encompassing ulcerative colitis (UC) and Crohn’s disease (CD), are chronic gastrointestinal disorders often diagnosed in youth, presenting unique features compared to adult-onset cases. We aimed to profile pediatric IBD patients in Croatia through a retrospective analysis of children up [...] Read more.
Inflammatory bowel diseases (IBDs), encompassing ulcerative colitis (UC) and Crohn’s disease (CD), are chronic gastrointestinal disorders often diagnosed in youth, presenting unique features compared to adult-onset cases. We aimed to profile pediatric IBD patients in Croatia through a retrospective analysis of children up to 18 years old diagnosed with IBD at the University Hospital of Split from 1 January 2012, to 31 December 2021, utilizing data collected during hospitalization for diagnosis. Over a decade, 107 children were diagnosed, with 43.9% having UC, 55.1% CD, and 0.9% IBD-unclassified. Median age at diagnosis was 14.1 years, with UC patients being older (14.8 vs. 13.7 years, p = 0.044). Males constituted 60.7% of patients. Median symptom duration was 2.0 months, with CD patients experiencing a longer diagnostic delay (3.0 vs. 2.0 months, p = 0.003). The median incidence rate was 9.89 (95% CI 5.93–13.84) per 100,000 children/year, varying across age groups. Median (IQR) BMI z-score was −0.34 (−0.97–0.45). Common symptoms included diarrhea (60.7%) and abdominal pain (50.5%), with rectal bleeding more prevalent in UC (72.3% vs. 32.2%, p < 0.001). While our study offers valuable insights into pediatric IBD in Croatia, further prospective research is needed to clarify disease progression and development. Full article
(This article belongs to the Section Pediatric Gastroenterology and Nutrition)
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17 pages, 812 KB  
Article
Promoting Equity in Access to Quality Early Childhood Education in China
by Nirmala Rao, Yi Yang, Yufen Su and Caroline Cohrssen
Children 2023, 10(10), 1674; https://doi.org/10.3390/children10101674 - 10 Oct 2023
Cited by 11 | Viewed by 4779
Abstract
This paper reviews the Chinese government’s efforts and progress towards ensuring equitable access to quality early childhood education (ECE). It begins with an overview of the Chinese context and analysing the reasons for a policy focus on ECE in recent decades. Thereafter, from [...] Read more.
This paper reviews the Chinese government’s efforts and progress towards ensuring equitable access to quality early childhood education (ECE). It begins with an overview of the Chinese context and analysing the reasons for a policy focus on ECE in recent decades. Thereafter, from a historical perspective, it critically reviews policies pertaining to enhancing access to and the quality of ECE in China since 2010. Nationally representative data are used to document policy implementation. Our analyses of national policies and representative data suggest that the state considers ECE a public good. This is evident from policy changes, efforts to bridge urban–rural disparities, fiscal allocations to the most economically disadvantaged groups, and strategies to enhance the quality of ECE.A significant focus on policy implementation with improved regulation and monitoring of services provided by both state and non-state actors was found. However, it is evident that gaps persist between urban and rural areas regarding infrastructure and resourcing, gross enrolment rates, and teacher–child ratios. That stated, the momentum that has driven policy change and the dramatic gains demonstrates the priority accorded to ECE. Full article
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10 pages, 259 KB  
Article
Hikikomori (Severe Social Withdrawal) in Italian Adolescents: Clinical Features and Follow-Up
by Greta Tolomei, Gabriele Masi, Annarita Milone, Pamela Fantozzi, Valentina Viglione, Antonio Narzisi and Stefano Berloffa
Children 2023, 10(10), 1669; https://doi.org/10.3390/children10101669 - 9 Oct 2023
Cited by 7 | Viewed by 3138
Abstract
Severe social withdrawal, including staying alone in one’s bedroom, non-attendance at school or work, and minimal or absent social contacts, sometimes only through electronic devices, can be found in several psychiatric disorders, or in a ‘primary’ form, firstly defined in Japan as ‘Hikikomori’. [...] Read more.
Severe social withdrawal, including staying alone in one’s bedroom, non-attendance at school or work, and minimal or absent social contacts, sometimes only through electronic devices, can be found in several psychiatric disorders, or in a ‘primary’ form, firstly defined in Japan as ‘Hikikomori’. The distinction between primary and secondary forms is questionable, as it prevalently depends on the quality of psychiatric assessment. To date, few studies specifically explored Hikikomori in an adolescent population outside Japan. The aim of the present study is to describe clinical features of a consecutive group of 80 referred youth (13 to 18 years, 57 males) with social isolation, of which 40 were followed up on for 4–6 months, to characterize clinical features and outcome. All the participants presented psychiatric comorbid disorders, prevalently anxiety disorders, mood disorders, and autism spectrum disorder. Suicidality (ideation and behavior) was reported in 32.5% of the participants, and 20% of the participants attempted suicide. More than half of the participants exceeded the cut-off of the Internet Addiction Test, and 42.4% met the criteria for the Internet Gaming Disorder. At the follow-up appointment, an improvement of social withdrawal was reported in 75% of the sample; 67.5% of the participants significantly improved according to the CGI-improvement scale; and 55% of the participants had an improvement of functioning according to the C-GAS. Our findings suggest that Hikikomori is a transnosographic entity, with high rates of suicidality and Internet addiction, and that can it improve when it is timely diagnosed and treated. Full article
(This article belongs to the Special Issue New Trends in Adolescent Health and Development)
17 pages, 532 KB  
Article
Child Rights during the COVID-19 Pandemic: Learning from Child Health-and-Rights Professionals across the World
by Eva Jörgensen, Laura Wood, Margaret A. Lynch, Nicholas Spencer and Geir Gunnlaugsson
Children 2023, 10(10), 1670; https://doi.org/10.3390/children10101670 - 9 Oct 2023
Cited by 7 | Viewed by 2904
Abstract
The COVID-19 pandemic underscores the importance of a child rights-based approach to policymaking and crisis management. Anchored in the United Nations Convention on the Rights of the Child, the 3P framework—provision, protection, and participation—forms the foundation for health professionals advocating for children’s rights. [...] Read more.
The COVID-19 pandemic underscores the importance of a child rights-based approach to policymaking and crisis management. Anchored in the United Nations Convention on the Rights of the Child, the 3P framework—provision, protection, and participation—forms the foundation for health professionals advocating for children’s rights. Expanding it with two additional domains—preparation and power—into a 5P framework has the potential to enhance child rights-based policies in times of crisis and future pandemics. The study aimed to (1) gather perspectives from child health-and-rights specialists on how children’s rights were highlighted during the early phase of the pandemic in their respective settings; and (2) evaluate the usefulness of the 5P framework in assessing children’s visibility and rights. A qualitative survey was distributed among child health-and-rights professionals; a total of 68 responses were analysed in Atlas.ti 9 from a multi-disciplinary group of policymakers and front-line professionals in eight world regions. As framed by the 5Ps, children’s rights were generally not safeguarded in the initial pandemic response and negatively impacted children’s health and wellbeing. Further, children lacked meaningful opportunities to raise their concerns to policymakers. The 5P framework holds the potential to shape an ethical child rights-based decision-making framework for future crises, both nationally and globally. Full article
(This article belongs to the Section Global Pediatric Health)
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17 pages, 860 KB  
Review
Screen Time and Its Health Consequences in Children and Adolescents
by Nikos Priftis and Demosthenes Panagiotakos
Children 2023, 10(10), 1665; https://doi.org/10.3390/children10101665 - 8 Oct 2023
Cited by 35 | Viewed by 30262
Abstract
Nowadays, children and adolescents are exposed to digital media (DM) from an early age. Therefore, specific guidelines have been published by the World Health Organization, whose aim is to limit daily screen time (ST) viewing. However, during the COVID-19 pandemic, a rise in [...] Read more.
Nowadays, children and adolescents are exposed to digital media (DM) from an early age. Therefore, specific guidelines have been published by the World Health Organization, whose aim is to limit daily screen time (ST) viewing. However, during the COVID-19 pandemic, a rise in DM use, and consequently ST viewing, was observed. More and more aspects of modern life are thought to be affected by excessive ST viewing. Accordingly, the aim of this review is to document the health effects of excessive ST viewing on children and adolescents. A narrative review was performed in searchable databases. In total, 43 original articles were considered. Excessive ST viewing was correlated with increased risk for obesity and other cardiometabolic risk factors, mental health, unhealthy dietary habits and eating disorders, and problems in development and child–parent relationships. Sleep, physical activity, eyesight, headaches, and the musculoskeletal system were negatively affected as well. However, the effect of ST was weighted by the type of media used and the way types of media were used. Other confounding factors were reported. There is evidence to suggest a negative correlation between excessive ST and youth health exists. Nevertheless, more research is needed if this correlation is to be established. Full article
(This article belongs to the Special Issue Childhood and Adolescence in the Digital Age)
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13 pages, 663 KB  
Article
Anthropometric Characteristics and Weight Status of Early Adolescents (Aged 12–14) in Montenegro; Urban–Rural and Regional Differences
by Borko Katanic, Dusko Bjelica, Mima Stankovic, Zoran Milosevic, Jovan Vukovic and Amel Mekic
Children 2023, 10(10), 1664; https://doi.org/10.3390/children10101664 - 8 Oct 2023
Cited by 11 | Viewed by 3744
Abstract
The aim of this study was to determine urban–rural and regional differences in anthropometric characteristics among adolescents aged 12–14, as well as to present the prevalence of weight status. A total of 534 adolescents aged 12–14 from primary schools across Montenegro participated in [...] Read more.
The aim of this study was to determine urban–rural and regional differences in anthropometric characteristics among adolescents aged 12–14, as well as to present the prevalence of weight status. A total of 534 adolescents aged 12–14 from primary schools across Montenegro participated in this cross-sectional study (283 boys, aged 13.52 ± 0.42, body height 169.43 ± 8.89, body weight 60.54 ± 13.47; 251 girls, aged 13.51 ± 0.40, body height 165.54 ± 6.67, body weight 55.28 ± 9.27). The sample was divided by geographic region in Montenegro into northern, central, and coastal regions, and according to settlement type into urban and rural inhabitants. Anthropometric characteristics were assessed using a battery of seven variables: arm span (AS); body height (BH); body weight (BW); waist circumference (WC); hip circumference (HC); body mass index (BMI); and waist-to-hip ratio (WHR). BMI was categorized based on the World Health Organization’s (WHO) cut-offs. The results indicate that girls from urban areas exhibited significantly greater body height and lower BMI values compared to their rural counterparts. Similarly, boys from urban areas also demonstrated lower BMI values compared to their rural peers. However, no statistically significant differences were observed in other anthropometric characteristics between these two groups of adolescents. Based on analysis of variance (ANOVA) and post-hoc analysis, it was found that girls from central areas had significantly greater body height compared to those from northern and coastal areas. Likewise, boys from northern areas showed higher body mass and BMI values compared to those from central areas. Additionally, both boys and girls from central areas had higher values compared to those from coastal areas. Nevertheless, no significant differences were detected in other anthropometric characteristics among adolescents from these regions. This study identified significant differences in anthropometric parameters among participants based on urban–rural status and within regional divisions. However, further research encompassing a larger sub-sample and a broader array of anthropometric variables is needed to draw a more comprehensive conclusion. Full article
(This article belongs to the Section Pediatric Endocrinology & Diabetes)
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14 pages, 550 KB  
Review
Artificial Intelligence and Child Abuse and Neglect: A Systematic Review
by Francesco Lupariello, Luca Sussetto, Sara Di Trani and Giancarlo Di Vella
Children 2023, 10(10), 1659; https://doi.org/10.3390/children10101659 - 6 Oct 2023
Cited by 9 | Viewed by 5382
Abstract
All societies should carefully address the child abuse and neglect phenomenon due to its acute and chronic sequelae. Even if artificial intelligence (AI) implementation in this field could be helpful, the state of the art of this implementation is not known. No studies [...] Read more.
All societies should carefully address the child abuse and neglect phenomenon due to its acute and chronic sequelae. Even if artificial intelligence (AI) implementation in this field could be helpful, the state of the art of this implementation is not known. No studies have comprehensively reviewed the types of AI models that have been developed/validated. Furthermore, no indications about the risk of bias in these studies are available. For these reasons, the authors conducted a systematic review of the PubMed database to answer the following questions: “what is the state of the art about the development and/or validation of AI predictive models useful to contrast child abuse and neglect phenomenon?”; “which is the risk of bias of the included articles?”. The inclusion criteria were: articles written in English and dated from January 1985 to 31 March 2023; publications that used a medical and/or protective service dataset to develop and/or validate AI prediction models. The reviewers screened 413 articles. Among them, seven papers were included. Their analysis showed that: the types of input data were heterogeneous; artificial neural networks, convolutional neural networks, and natural language processing were used; the datasets had a median size of 2600 cases; the risk of bias was high for all studies. The results of the review pointed out that the implementation of AI in the child abuse and neglect field lagged compared to other medical fields. Furthermore, the evaluation of the risk of bias suggested that future studies should provide an appropriate choice of sample size, validation, and management of overfitting, optimism, and missing data. Full article
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17 pages, 3923 KB  
Article
Detection of ASD Children through Deep-Learning Application of fMRI
by Min Feng and Juncai Xu
Children 2023, 10(10), 1654; https://doi.org/10.3390/children10101654 - 5 Oct 2023
Cited by 23 | Viewed by 6290
Abstract
Autism spectrum disorder (ASD) necessitates prompt diagnostic scrutiny to enable immediate, targeted interventions. This study unveils an advanced convolutional-neural-network (CNN) algorithm that was meticulously engineered to examine resting-state functional magnetic resonance imaging (fMRI) for early ASD detection in pediatric cohorts. The CNN architecture [...] Read more.
Autism spectrum disorder (ASD) necessitates prompt diagnostic scrutiny to enable immediate, targeted interventions. This study unveils an advanced convolutional-neural-network (CNN) algorithm that was meticulously engineered to examine resting-state functional magnetic resonance imaging (fMRI) for early ASD detection in pediatric cohorts. The CNN architecture amalgamates convolutional, pooling, batch-normalization, dropout, and fully connected layers, optimized for high-dimensional data interpretation. Rigorous preprocessing yielded 22,176 two-dimensional echo planar samples from 126 subjects (56 ASD, 70 controls) who were sourced from the Autism Brain Imaging Data Exchange (ABIDE I) repository. The model, trained on 17,740 samples across 50 epochs, demonstrated unparalleled diagnostic metrics—accuracy of 99.39%, recall of 98.80%, precision of 99.85%, and an F1 score of 99.32%—and thereby eclipsed extant computational methodologies. Feature map analyses substantiated the model’s hierarchical feature extraction capabilities. This research elucidates a deep learning framework for computer-assisted ASD screening via fMRI, with transformative implications for early diagnosis and intervention. Full article
(This article belongs to the Special Issue Updates on Child Neuropsychiatry)
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13 pages, 962 KB  
Review
A Narrative Review of the Association between Prematurity and Attention-Deficit/Hyperactivity Disorder and Accompanying Inequities across the Life-Course
by Yarden S. Fraiman, Genevieve Guyol, Dolores Acevedo-Garcia, Andrew F. Beck, Heather Burris, Tumaini R. Coker and Henning Tiemeier
Children 2023, 10(10), 1637; https://doi.org/10.3390/children10101637 - 30 Sep 2023
Cited by 8 | Viewed by 3909
Abstract
Preterm birth is associated with an increased risk of neurodevelopmental and neurobehavioral impairments including attention-deficit/hyperactivity disorder (ADHD), the most common neurobehavioral disorder of childhood. In this narrative review, we examine the known associations between prematurity and ADHD and highlight the impact of both [...] Read more.
Preterm birth is associated with an increased risk of neurodevelopmental and neurobehavioral impairments including attention-deficit/hyperactivity disorder (ADHD), the most common neurobehavioral disorder of childhood. In this narrative review, we examine the known associations between prematurity and ADHD and highlight the impact of both prematurity and ADHD on multiple domains across the pediatric life-course. We develop a framework for understanding the health services journey of individuals with ADHD to access appropriate services and treatments for ADHD, the “ADHD Care Cascade”. We then discuss the many racial and ethnic inequities that affect the risk of preterm birth as well as the steps along the “ADHD Care Cascade”. By using a life-course approach, we highlight the ways in which inequities are layered over time to magnify the neurodevelopmental impact of preterm birth on the most vulnerable children across the life-course. Full article
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