Children

13 pages, 266 KiB

Open AccessEditor’s ChoiceArticle

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 17 | Viewed by 5162

Abstract

Background: Integrating family-centered care (FCC) and developmental care (DC) principles in neonatal care settings may improve neurodevelopmental outcomes for high-risk neonates. However, the combined impact of FCC and DC has been underexplored. This study aimed to investigate the effects of integrated FCC and [...] Read more.

Background: Integrating family-centered care (FCC) and developmental care (DC) principles in neonatal care settings may improve neurodevelopmental outcomes for high-risk neonates. However, the combined impact of FCC and DC has been underexplored. This study aimed to investigate the effects of integrated FCC and DC on neurodevelopment and length of hospital stay in high-risk neonates. Methods: A quasi-experimental pre–post study was conducted among 200 high-risk neonates (<32 weeks gestation or <1500 g) admitted to neonatal intensive care units (NICU) in Saudi Arabia. The intervention group (n = 100) received integrated FCC and DC for 6 months. The control group (n = 100) received standard care. Neurodevelopment was assessed using the Bayley Scales of Infant Development-III. Length of stay and readmissions were extracted from medical records. Results: The intervention group showed significant improvements in cognitive, motor, and language scores compared to controls (p < 0.05). The intervention group had a 4.3-day reduction in the mean length of stay versus a 1.4-day reduction in controls (p = 0.02). Integrated care independently predicted higher cognitive scores (p = 0.001) and shorter stays (p = 0.006) in regression models. Conclusion: Integrating FCC and DC in neonatal care enhances neurodevelopmental outcomes and reduces hospitalization for high-risk neonates compared to standard care. Implementing relationship-based, developmentally supportive models is critical for optimizing outcomes in this vulnerable population. Full article

(This article belongs to the Special Issue 10th Anniversary of Children: Feature Papers in Neonatology)

17 pages, 751 KiB

Open AccessEditor’s ChoiceArticle

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 25 | Viewed by 5114

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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19 pages, 1927 KiB

Open AccessEditor’s ChoiceReview

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 9 | Viewed by 4158

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 KiB

Open AccessEditor’s ChoiceArticle

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 8 | Viewed by 1983

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 KiB

Open AccessEditor’s ChoiceArticle

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 9 | Viewed by 5614

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 KiB

Open AccessEditor’s ChoiceReview

“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 13 | Viewed by 5756

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 KiB

Open AccessEditor’s ChoiceArticle

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 4390

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 KiB

Open AccessEditor’s ChoiceReview

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 13 | Viewed by 3485

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

(This article belongs to the Special Issue Dietary Habits, Social Determinants of Health and Obesity Risk in Children and Adolescents)

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13 pages, 473 KiB

Open AccessEditor’s ChoiceArticle

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 8 | Viewed by 2027

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 KiB

Open AccessEditor’s ChoiceArticle

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 10 | Viewed by 4156

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

(This article belongs to the Special Issue Early Childhood Care and Education in Low- and Middle- Income Countries)

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10 pages, 259 KiB

Open AccessEditor’s ChoiceArticle

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 6 | Viewed by 2814

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 KiB

Open AccessEditor’s ChoiceArticle

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 6 | Viewed by 2728

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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13 pages, 663 KiB

Open AccessEditor’s ChoiceArticle

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 9 | Viewed by 3104

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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17 pages, 860 KiB

Open AccessEditor’s ChoiceReview

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 30 | Viewed by 26779

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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14 pages, 550 KiB

Open AccessEditor’s ChoiceReview

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 8 | Viewed by 4934

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 KiB

Open AccessEditor’s ChoiceArticle

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 21 | Viewed by 4697

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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18 pages, 2610 KiB

Open AccessEditor’s ChoiceArticle

Machine Learning Algorithms for Predicting Stunting among Under-Five Children in Papua New Guinea

by Hao Shen, Hang Zhao and Yi Jiang

Children 2023, 10(10), 1638; https://doi.org/10.3390/children10101638 - 30 Sep 2023

Cited by 22 | Viewed by 4411

Abstract

Preventing stunting is particularly important for healthy development across the life course. In Papua New Guinea (PNG), the prevalence of stunting in children under five years old has consistently not improved. Therefore, the primary objective of this study was to employ multiple machine [...] Read more.

Preventing stunting is particularly important for healthy development across the life course. In Papua New Guinea (PNG), the prevalence of stunting in children under five years old has consistently not improved. Therefore, the primary objective of this study was to employ multiple machine learning algorithms to identify the most effective model and key predictors for stunting prediction in children in PNG. The study used data from the 2016–2018 Papua New Guinea Demographic Health Survey, including from 3380 children with complete height-for-age data. The least absolute shrinkage and selection operator (LASSO) and random-forest-recursive feature elimination were used for feature selection. Logistic regression, a conditional decision tree, a support vector machine with a radial basis function kernel, and an extreme gradient boosting machine (XGBoost) were employed to construct the prediction model. The performance of the final model was evaluated using accuracy, precision, recall, F1 score, and area under the curve (AUC). The results of the study showed that LASSO-XGBoost has the best performance for predicting stunting in PNG (AUC: 0.765; 95% CI: 0.714–0.819) with accuracy, precision, recall, and F1 scores of 0.728, 0.715, 0.628, and 0.669, respectively. Combined with the SHAP value method, the optimal prediction model identified living in the Highlands Region, the age of the child, being in the richest family, and having a larger or smaller birth size as the top five important characteristics for predicting stunting. Based on the model, the findings support the necessity of preventing stunting early in life. Emphasizing the nutritional status of vulnerable maternal and child populations in PNG is recommended to promote maternal and child health and overall well-being. Full article

(This article belongs to the Special Issue Nutrition to Improve Child and Adolescent Health)

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17 pages, 1843 KiB

Open AccessEditor’s ChoiceReview

A Practical Update on Pediatric Eosinophilic Esophagitis

by Martina Votto, Maria De Filippo, Silvia Caimmi, Cristiana Indolfi, Alessandro Raffaele, Maria Angela Tosca, Gian Luigi Marseglia and Amelia Licari

Children 2023, 10(10), 1620; https://doi.org/10.3390/children10101620 - 28 Sep 2023

Cited by 12 | Viewed by 4494

Abstract

Eosinophilic esophagitis (EoE) is an emerging atopic disease of unknown etiology limited to the esophagus. The pathogenesis is still understood and is likely characterized by type 2 inflammation. Food allergens are the primary triggers of EoE that stimulate inflammatory cells through an impaired [...] Read more.

Eosinophilic esophagitis (EoE) is an emerging atopic disease of unknown etiology limited to the esophagus. The pathogenesis is still understood and is likely characterized by type 2 inflammation. Food allergens are the primary triggers of EoE that stimulate inflammatory cells through an impaired esophageal barrier. In children and adolescents, clinical presentation varies with age and mainly includes food refusal, recurrent vomiting, failure to thrive, abdominal/epigastric pain, dysphagia, and food impaction. Upper-gastrointestinal endoscopy is the gold standard for diagnosing and monitoring EoE. EoE therapy aims to achieve clinical, endoscopic, and histological (“deep”) remission; prevent esophageal fibrosis; and improve quality of life. In pediatrics, the cornerstones of therapy are proton pump inhibitors, topical steroids (swallowed fluticasone and viscous budesonide), and food elimination diets. In recent years, much progress has been made in understanding EoE pathogenesis, characterizing the clinical and molecular heterogeneity, and identifying new therapeutic approaches. Notably, clinical, molecular, endoscopic, and histological features reflect and influence the evolution of inflammation over time and the response to currently available treatments. Therefore, different EoE phenotypes and endotypes have recently been recognized. Dupilumab recently was approved by FDA and EMA as the first biological therapy for adolescents (≥12 years) and adults with active EoE, but other biologics are still under consideration. Due to its chronic course, EoE management requires long-term therapy, a multidisciplinary approach, and regular follow-ups. Full article

(This article belongs to the Section Pediatric Allergy and Immunology)

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15 pages, 298 KiB

Open AccessEditor’s ChoiceReview

Prematurity and Low Birth Weight and Their Impact on Childhood Growth Patterns and the Risk of Long-Term Cardiovascular Sequelae

by Iwona Jańczewska, Jolanta Wierzba, Alicja Jańczewska, Małgorzata Szczurek-Gierczak and Iwona Domżalska-Popadiuk

Children 2023, 10(10), 1599; https://doi.org/10.3390/children10101599 - 25 Sep 2023

Cited by 26 | Viewed by 6117

Abstract

Preterm birth (before 37 completed weeks of gestation) is a global health problem, remaining the main reason for neonatal mortality and morbidity. Improvements in perinatal and neonatal care in recent decades have been associated with a higher survival rate of extremely preterm infants, [...] Read more.

Preterm birth (before 37 completed weeks of gestation) is a global health problem, remaining the main reason for neonatal mortality and morbidity. Improvements in perinatal and neonatal care in recent decades have been associated with a higher survival rate of extremely preterm infants, leading to a higher risk of long-term sequelae in this population throughout life. Numerous surveillance programs for formerly premature infants continue to focus on neurodevelopmental disorders, while long-term assessment of the impact of preterm birth and low birth weight on child growth and the associated risk of cardiovascular disease in young adults is equally necessary. This review will discuss the influence of prematurity and low birth weight on childhood growth and cardiovascular risk in children, adolescents and young adults. The risk of cardiovascular and metabolic disorders is increased in adult preterm survivors. In early childhood, preterm infants may show elevated blood pressure, weakened vascular growth, augmented peripheral vascular resistance and cardiomyocyte remodeling. Increased weight gain during the early postnatal period may influence later body composition, promote obesity and impair cardiovascular results. These adverse metabolic alterations contribute to an increased risk of cardiovascular incidents, adult hypertension and diabetes. Preterm-born children and those with fetal growth restriction (FGR) who demonstrate rapid changes in their weight percentile should remain under surveillance with blood pressure monitoring. A better understanding of lifelong health outcomes of preterm-born individuals is crucial for developing strategies to prevent cardiovascular sequelae and may be the basis for future research to provide effective interventions. Full article

(This article belongs to the Special Issue Prematurity, Preterm-Born Adults, and Long-Term Effects on Children and Adults (Volume II))

13 pages, 278 KiB

Open AccessEditor’s ChoiceArticle

Mechanisms of Stigmatization in Family-Based Prevention and Treatment of Childhood Overweight and Obesity

by Didde Hoeeg, Katherine L. Frohlich, Ulla Christensen and Dan Grabowski

Children 2023, 10(10), 1590; https://doi.org/10.3390/children10101590 - 23 Sep 2023

Cited by 6 | Viewed by 2424

Abstract

It is well established that overweight and obesity are often accompanied by stigmatization. However, the influence of stigmatization on interventions for overweight and obesity remains unknown. Stigma may be particularly harmful to children. This study aimed to examine how stigmatization affects efforts to [...] Read more.

It is well established that overweight and obesity are often accompanied by stigmatization. However, the influence of stigmatization on interventions for overweight and obesity remains unknown. Stigma may be particularly harmful to children. This study aimed to examine how stigmatization affects efforts to reduce childhood overweight and obesity through family interventions. This research was conducted in a socially disadvantaged area in Denmark. Twenty-seven families and forty professionals participated in in-depth interviews or workshops. The data were analyzed using CMO configurations from a realist evaluation and the theory of stigmatization developed by Link and Phelan. Thus, an abductive approach was employed in the analysis, with its foundation rooted in the empirical data. The study found that the mechanisms of stigmatization could 1. restrain professionals and parents from approaching the problem—thereby challenging family recruitment; 2. prevent parents from working with their children to avoid eating unhealthy food for fear of labeling the child as overweight or obese; and 3. cause children with obesity to experience a separation from other slimmer family members, leading at times to status loss, discrimination, and self-stigmatization. The study showed how the mechanisms of stigmatization may obstruct prevention and treatment of childhood obesity through family interventions. It is suggested that the concept of stigma should be incorporated into the program theories of interventions meant to reduce childhood overweight and obesity. Full article

(This article belongs to the Special Issue Dietary Habits, Social Determinants of Health and Obesity Risk in Children and Adolescents)

11 pages, 1326 KiB

Open AccessEditor’s ChoiceArticle

Anaphylaxis after Shrimp Intake in a European Pediatric Population: Role of Molecular Diagnostics and Implications for Novel Foods

by Michele Miraglia del Giudice, Giulio Dinardo, Angela Klain, Elisabetta D’Addio, Chiara Lucia Bencivenga, Fabio Decimo and Cristiana Indolfi

Children 2023, 10(10), 1583; https://doi.org/10.3390/children10101583 - 22 Sep 2023

Cited by 9 | Viewed by 2239

Abstract

(1) Background: Tropomyosin is a major cause of shellfish allergy and anaphylaxis triggered by food. It acts as a pan-allergen, inducing cross-reactivity in insects, dust mites, crustaceans, and mollusks. Our study investigates anaphylaxis in children with asthma or atopic diseases after consuming tropomyosin-containing [...] Read more.

(1) Background: Tropomyosin is a major cause of shellfish allergy and anaphylaxis triggered by food. It acts as a pan-allergen, inducing cross-reactivity in insects, dust mites, crustaceans, and mollusks. Our study investigates anaphylaxis in children with asthma or atopic diseases after consuming tropomyosin-containing food. (2) Methods: We analyzed the molecular sensitization profiles of pediatric patients at the University of Campania ‘Luigi Vanvitelli’ from 2017 to 2021, with conditions such as allergic rhinitis, asthma, atopic dermatitis, urticaria, and food allergies. (3) Results: Out of a total of 253 patients aged 1 to 18 years (167 males, 86 females), 21 patients (8.3%) experienced anaphylaxis after shrimp ingestion. All 21 (100%) were sensitized to various tropomyosins: Pen m 1 (100%), Der p 10 (90.5%), Ani s 3 (81%), and Bla g 7 (76.2%). Clinical symptoms included allergic asthma (76.2%), atopic dermatitis (61.9%), urticaria (38.1%), and allergic rhinitis (38.1%). (4) Conclusions: Crustaceans and mollusks are major allergens in Italy and Europe, requiring mandatory declaration on food labels. Italian pediatric patients demonstrated significant anaphylaxis after consuming shrimp, often accompanied by multiple atopic disorders such as asthma, rhinitis, and atopic dermatitis. Considering the cross-reactivity of tropomyosin among various invertebrates and the emergence of ‘novel foods’ containing insect flours in Europe, there is ongoing debate about introducing precautionary labeling for these products. Full article

(This article belongs to the Section Pediatric Allergy and Immunology)

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9 pages, 239 KiB

Open AccessEditor’s ChoiceReview

A Clinical Approach of Allergic Rhinitis in Children

by Ioannis Goniotakis, Evanthia Perikleous, Sotirios Fouzas, Paschalis Steiropoulos and Emmanouil Paraskakis

Children 2023, 10(9), 1571; https://doi.org/10.3390/children10091571 - 19 Sep 2023

Cited by 21 | Viewed by 5566

Abstract

Allergic rhinitis is an important disease with a global footprint and a growing prevalence, affecting children and adults. Although it is commonly under-diagnosed and under-treated, it causes important social and economic effects (diminished quality of life, poor academic performance, escalated medical visits, heightened [...] Read more.

Allergic rhinitis is an important disease with a global footprint and a growing prevalence, affecting children and adults. Although it is commonly under-diagnosed and under-treated, it causes important social and economic effects (diminished quality of life, poor academic performance, escalated medical visits, heightened medication usage, and effects in other chronic conditions, e.g., asthma). It is characterized by distinctive, easily identifiable symptoms (sneezing, nasal discharge, nasal congestion, nasal–eye–palatal itching) and indirect accompanying indicators (fatigue and decreased school performance). The classification of allergic rhinitis hinges upon its nature and chronic distribution (seasonal or perennial) and its intensity, which spans from mild to moderate and severe. The diagnostic process primarily relies upon recognizing key clinical indicators, evaluating historical records, and considering risk factors. It is supported by abnormal laboratory findings, like in vitro allergen-specific IgE tests (enzyme immunoassay—EIA, chemiluminense immunoassay—CLIA) or in vivo skin prick tests for specific allergens. In the differential diagnosis, other chronic diseases manifesting with chronic rhinitis should be excluded (e.g., rhinosinusitis, chronic non-allergic rhinitis, rhinitis triggered by medications). The treatment of allergic rhinitis in children is mainly chronic and is focused on allergen exposure prevention, drug therapy, and immunotherapy in severe cases. Locally administered intranasal corticosteroids are the cornerstone of therapy. They are safe, effective, and have a favorable safety profile even during long-term use. Choosing a suitable intranasal corticosteroid drug with low systemic bioavailability makes long-term treatment even safer. Combinations of intranasal corticosteroids and H1 antihistamines are available in several countries and are widely used in more severe cases and the presence of year-round symptoms. Adding newer-generation oral H1-antihistamines broadens the available therapeutic inventory without significant effects compared to using previous-generation, once widely available, H1-antihistamines. Treatment of allergic rhinitis is complex and multi-dimensional, requiring an effective approach by a specialized group of specialized pediatricians, and is severely affected by the concurrent presence or development of other diseases in the spectrum of allergic diseases (conjunctivitis, asthma). Full article

(This article belongs to the Section Pediatric Allergy and Immunology)

13 pages, 2219 KiB

Open AccessEditor’s ChoiceArticle

Parents’ Knowledge of and Attitude toward Acute Otitis Media and Its Treatment in Children: A Survey at Primary Healthcare Centers in the Aseer Region

by Hayfa Abdulkhaleq AlHefdhi, Maraam Mohammed Al Qout, Alhanouf Yahya Alqahtani, Meshal Mohammed Alqahtani, Roaa Mohammed Asiri, Omair Mohammed Alshahrani, Hanan Delem Almoghamer, Naglaa Youssef and Ramy Mohamed Ghazy

Children 2023, 10(9), 1573; https://doi.org/10.3390/children10091573 - 19 Sep 2023

Cited by 5 | Viewed by 3268

Abstract

Background: Acute otitis media (AOM) in children aged 5 years old and younger poses a critical health concern, affecting both the general health of children and the emotional well-being of parents. The objective of this study was to evaluate parental understanding, attitudes, and [...] Read more.

Background: Acute otitis media (AOM) in children aged 5 years old and younger poses a critical health concern, affecting both the general health of children and the emotional well-being of parents. The objective of this study was to evaluate parental understanding, attitudes, and experiences related to AOM and its management, including the use of antibiotics without physician prescription. Method: A cross-sectional study was carried out during the months of May and June of 2023. To collect data for this study, a validated questionnaire was converted into a Google form and given to parents of children aged 5 years and younger who sought healthcare for their children in primary healthcare centers in Abha city, Aseer region, Saudi Arabia. Results: A total of 406 parents participated in this study, 64.8% of them were women and 45.3% of them were in the age range of 25 to 34 years. The majority (90.1%) resided in urban areas and a significant proportion (72.2%) had a university education. Among the respondents, 22.7% agreed that bacteria are the cause of AOM, while 21.7% agreed that it is caused by viruses. A total of 51.0% acknowledged the need for antibiotics in the management of AOM. In terms of treatment, 84.5% and 83.5% believed that analgesics and antibiotics, respectively, were the most effective for otalgia. A substantial portion, 43.1%, 34.7%, and 37.7%, respectively, believed that antibiotics could reduce pain, relieve fever, and prevent recurrence. Almost three-quarters sought medical advice primarily from paediatricians and 37.7% obtained information about AOM from the Internet. Furthermore, almost a third (28.8%) chose not to wait for the physician’s appointment and immediately administered antibiotics without the physician’s prescription due to concerns about disease progression. Approximately two fifths (38.4%) requested physicians to prescribe antibiotics, a pattern that was in agreement with the actual rate of antibiotic prescriptions (38.4%). Conclusions: A notable deficiency in knowledge and unsafe practices about AOM and its management is evident among parents in the Aseer region. This underscores the pressing need for an educational program aimed at improving parental health literacy regarding otitis media causes and treatments, as well as its preventive measures. Full article

(This article belongs to the Section Pediatric Otolaryngology)

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17 pages, 345 KiB

Open AccessEditor’s ChoiceArticle

Neurodevelopmental, Mental Health, and Parenting Issues in Preterm Infants

by Richard J. Shaw, Soudabeh Givrad, Celeste Poe, Elizabeth C. Loi, Margaret K. Hoge and Melissa Scala

Children 2023, 10(9), 1565; https://doi.org/10.3390/children10091565 - 18 Sep 2023

Cited by 14 | Viewed by 7772

Abstract

The World Health Organization in its recommendations for the care of preterm infants has drawn attention to the need to address issues related to family involvement and support, including education, counseling, discharge preparation, and peer support. A failure to address these issues may [...] Read more.

The World Health Organization in its recommendations for the care of preterm infants has drawn attention to the need to address issues related to family involvement and support, including education, counseling, discharge preparation, and peer support. A failure to address these issues may translate into poor outcomes that extend across the lifespan. In this paper, we review the often far-reaching impact of preterm birth on the health and wellbeing of the parents and highlight the ways in which psychological stress may have a negative long-term impact on the parent-child interaction, attachment, and the styles of parenting. This paper addresses the following topics: (1) neurodevelopmental outcomes in preterm infants, including cognitive, sensory, and motor difficulties, (2) long-term mental health issues in premature infants that include elevated rates of anxiety and depressive disorders, autism, and somatization, which may affect social relationships and quality of life, (3) adverse mental health outcomes for parents that include elevated rates of depression, anxiety, and symptoms of post-traumatic stress, as well as increased rates of substance abuse, and relationship strain, (4) negative impacts on the parent-infant relationship, potentially mediated by maternal sensitivity, parent child-interactions, and attachment, and (5) impact on the parenting behaviors, including patterns of overprotective parenting, and development of Vulnerable Child Syndrome. Greater awareness of these issues has led to the development of programs in neonatal mental health and developmental care with some data suggesting benefits in terms of shorter lengths of stay and decreased health care costs. Full article

(This article belongs to the Special Issue The Implications of Preterm Birth for Health and Wellbeing over the Life Course)

13 pages, 305 KiB

Open AccessEditor’s ChoiceArticle

Food Selectivity in Children with Autism Spectrum Disorder: A Statistical Analysis in Southern Italy

by Angela Alibrandi, Agata Zirilli, Federica Loschiavo, Maria Cristina Gangemi, Alessandro Sindoni, Graziella Tribulato, Roberto Lo Giudice and Fausto Famà

Children 2023, 10(9), 1553; https://doi.org/10.3390/children10091553 - 14 Sep 2023

Cited by 13 | Viewed by 6181

Abstract

This paper focuses on autism spectrum disorder (ASD) and food selectivity, both of which are prevalent in the pediatric population. In this context, the authors paid attention to food selectivity and its possible correlation with the atypicality of sensory processes, outlining the useful [...] Read more.

This paper focuses on autism spectrum disorder (ASD) and food selectivity, both of which are prevalent in the pediatric population. In this context, the authors paid attention to food selectivity and its possible correlation with the atypicality of sensory processes, outlining the useful rehabilitation treatments to draw on. This research included the parents or caregivers of pediatric patients diagnosed with autism spectrum disorder and placed within a therapeutic clinic. The sample is composed of 111 children, males and females, aged between 2 and 10 years, and includes 60 children diagnosed with autism and 51 children with normotypical development, similar in characteristics but without the disorder. The standardized questionnaire, “Brief Autism Mealtime Behavior Inventory”, was developed to examine behavior during meals, especially in children with ASD. The “Brief Sensory Profile”, and the “Child Oral and Motor Proficiency Scale”, were also administered. The results obtained from the analysis lead to evidence of eating and food selectivity difficulty. Additionally, our study demonstrates that food selectivity can be caused by extreme sensory modulation and sensory problems related to the smell, texture, color, and temperature of food. In fact, the results obtained emphasize the correlation between food selectivity and the sensory domains of taste and smell. Furthermore, this research highlights a correlation between motor skills and eating skills, particularly regarding food selectivity, which is closely associated with atypical and disruptive behaviors during meals. Full article

(This article belongs to the Section Global Pediatric Health)

12 pages, 553 KiB

Open AccessEditor’s ChoiceArticle

Motor Coordination in Primary School Students: The Role of Age, Sex, and Physical Activity Participation in Turkey

by Tulay Canli, Umut Canli, Cuneyt Taskin and Monira I. Aldhahi

Children 2023, 10(9), 1524; https://doi.org/10.3390/children10091524 - 8 Sep 2023

Cited by 8 | Viewed by 2422

Abstract

Motor coordination (MC) is an essential skill underpinning precise and controlled movements, contributing significantly to daily functioning and overall performance. The developmental trajectory of MC in children is intricately shaped by a spectrum of factors encompassing age, gender, and physical activity engagement. Delving [...] Read more.

Motor coordination (MC) is an essential skill underpinning precise and controlled movements, contributing significantly to daily functioning and overall performance. The developmental trajectory of MC in children is intricately shaped by a spectrum of factors encompassing age, gender, and physical activity engagement. Delving into the complex interrelation of these variables holds the potential to unravel nuanced developmental trends and offer targeted avenues for interventions aimed at augmenting motor proficiency in the pediatric population. This study aimed to assess the differences in MC of primary school students based on sex, age, and physical activity participation (PAP). A total of 848 students from public primary schools, aged between 6–9 years, including 412 boys and 436 girls. The MC was measured using Körperkoordinationstest für Kinder (KTK3+) test battery, which included Jumping sideways (JS), Balancing backward (BB), Moving sideways (MS), and Eye–Hand Coordination (EHC). One-way multivariate analysis of variance (MANOVA) was used to determine the binary and triple interactions of sex, age, and PAP variables on the MC parameters of the participants. The study revealed that boys aged 6–9 had higher scores than girls on eye–hand coordination (EHC) (p < 0.02). No significant gender-related differences in balancing backward (BB), jumping sideways (JS), and moving sideways (MS) were found. When the subtests of KTK3+ were compared by age, a significant difference was observed between the groups in all subtests (p < 0.05). With respect to PAP, students with PAP had a significant advantage in all subtests of the KTK3+ (p < 0.05). The double co-effects or triple co-effects of age, sex, and PAP parameters do not influence the KTK parameters. This study presents evidence supporting sex differences in the motor skills of children within this age range and highlights the potential impact of age and physical activity on motor development. Full article

(This article belongs to the Special Issue Movement Behaviors and Motor Skills in Early Years Children)

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11 pages, 253 KiB

Open AccessEditor’s ChoiceArticle

Social Stigma in Children with Long COVID

by Danilo Buonsenso, Anna Camporesi, Rosa Morello, Cristina De Rose, Matteo Fracasso, Daniela Pia Rosaria Chieffo and Piero Valentini

Children 2023, 10(9), 1518; https://doi.org/10.3390/children10091518 - 7 Sep 2023

Cited by 13 | Viewed by 3746

Abstract

There is growing evidence that adults with Long COVID suffer from different sets of stigmata related to their condition. In children with Long COVID, this aspect has never been investigated. This study aims to investigate if children with Long COVID also experience stigma. [...] Read more.

There is growing evidence that adults with Long COVID suffer from different sets of stigmata related to their condition. In children with Long COVID, this aspect has never been investigated. This study aims to investigate if children with Long COVID also experience stigma. Methods: Children with a previous SARS-CoV-2 infection evaluated at 3 month follow-ups in a pediatric post COVID unit were asked to fill in an online Long COVID Stigma Scale survey before they were assessed by a pediatrician. Doctors were unaware of children’s responses when they performed a diagnosis of Long COVID or full recovery from previous infection, according to the World Health Organization definition of pediatric Long COVID. Responses to the Stigma scale were then compared in the two cohorts of children. Results: 224 patients responded to the questionnaire; 40 patients were diagnosed with Long COVID. Children with Long COVID significantly more frequently felt embarrassed about having Long COVID (p 0.035), felt embarrassed about having physical limitations (p < 0.001), felt they were valued less due to Long COVID (p 0.003), felt they were different from other peers due to Long COVID (p 0.033), felt significantly more frequently that people behaved differently towards them because they might be lying since the diagnosis of Long COVID (p 0.006), that they were less respected by others due to Long COVID (p 0.017), that other people thought that Long COVID is not a real disease (p 0.007), that other people thought that developing Long COVID is a sign of weakness (p 0.008), and that other people might judge them negatively due to their diagnosis of Long COVID (p < 0.001). Conclusions: Children with Long COVID, similar to adults, are suffering from stigmata due to their condition,. These data may have implication and should be used by the public, policy makers, and healthcare professionals regarding pediatric Long COVID. Full article

(This article belongs to the Special Issue Long COVID or Post-COVID-19 Syndrome in Children: What Do We Know So Far?)

13 pages, 261 KiB

Open AccessEditor’s ChoiceArticle

Perspectives of Healthcare Providers to Inform the Design of an AI-Enhanced Social Robot in the Pediatric Emergency Department

by Summer Hudson, Fareha Nishat, Jennifer Stinson, Sasha Litwin, Frauke Zeller, Brittany Wiles, Mary Ellen Foster and Samina Ali

Children 2023, 10(9), 1511; https://doi.org/10.3390/children10091511 - 6 Sep 2023

Cited by 9 | Viewed by 3310

Abstract

Children commonly experience pain and distress in healthcare settings related to medical procedures such as blood tests and intravenous insertions (IVIs). Inadequately addressed pain and distress can result in both short- and long-term negative consequences. The use of socially assistive robotics (SARs) to [...] Read more.

Children commonly experience pain and distress in healthcare settings related to medical procedures such as blood tests and intravenous insertions (IVIs). Inadequately addressed pain and distress can result in both short- and long-term negative consequences. The use of socially assistive robotics (SARs) to reduce procedure-related distress and pain in children’s healthcare settings has shown promise; however, the current options lack autonomous adaptability. This study presents a descriptive qualitative needs assessment of healthcare providers (HCPs) in two Canadian pediatric emergency departments (ED) to inform the design an artificial intelligence (AI)-enhanced social robot to be used as a distraction tool in the ED to facilitate IVIs. Semi-structured virtual individual and focus group interviews were conducted with eleven HCPs. Four main themes were identified: (1) common challenges during IVIs (i.e., child distress and resource limitations), (2) available tools for pain and distress management during IVIs (i.e., pharmacological and non-pharmacological), (3) response to SAR appearance and functionality (i.e., personalized emotional support, adaptive distraction based on child’s preferences, and positive reinforcement), and (4) anticipated benefits and challenges of SAR in the ED (i.e., ensuring developmentally appropriate interactions and space limitations). HCPs perceive AI-enhanced social robots as a promising tool for distraction during IVIs in the ED. Full article

(This article belongs to the Section Pediatric Emergency Medicine & Intensive Care Medicine)

17 pages, 1063 KiB

Open AccessEditor’s ChoiceArticle

Exploratory Investigation of Handwriting Disorders in School-Aged Children from First to Fifth Grade

by Clémence Lopez and Laurence Vaivre-Douret

Children 2023, 10(9), 1512; https://doi.org/10.3390/children10091512 - 6 Sep 2023

Cited by 5 | Viewed by 2770

Abstract

Handwriting disorders (HDs) are prevalent in school-aged children, with significant interference with academic performances. The current study offers a transdisciplinary approach with the use of normed and standardized clinical assessments of neuropsychomotor, neuropsychological and oculomotor functions. The aim is to provide objective data [...] Read more.

Handwriting disorders (HDs) are prevalent in school-aged children, with significant interference with academic performances. The current study offers a transdisciplinary approach with the use of normed and standardized clinical assessments of neuropsychomotor, neuropsychological and oculomotor functions. The aim is to provide objective data for a better understanding of the nature and the etiology of HDs. Data from these clinical assessments were analyzed for 27 school-aged children with HD (first to fifth grade). The results underline a high heterogeneity of the children presenting HDs, with many co-occurrences often unknown. However, it was possible to highlight three levels of HDs based on BHK scores: mild HD not detected by the BHK test (26% of children), moderate HD (33%) and dysgraphia (41% of children). The mild nature of the HDs not detected by the BHK test appears to occur at a relatively low frequency of the associated disorders identified during clinical evaluations. On the contrary, dysgraphia appears to be associated with a high frequency of co-occurring disorders identified in the clinical assessment, with a predominance of oculomotor disorders (55% of children), leading to visual-perceptual difficulties and a high level of handwriting deterioration. Finally, children with moderate HD have fewer co-occurrences than children with dysgraphia, but have more difficulties than children with mild HD. This highlights the importance of differentiating between different degrees of HDs that do not respond to the same semiologies. Our findings support the interest in performing a transdisciplinary and standardized clinical examination with developmental standards (neuropsychomotor, neuropsychological and oculomotor) in children with HD. Indeed, HDs can therefore be associated with a multitude of disorders of different natures ranging from poor coordination of the graphomotor gesture to a more general and more complex impairment affecting perceptual-motor, cognitive and/or psycho-affective functions. Full article

(This article belongs to the Special Issue Motor Learning of Handwriting and Developmental Dysgraphia)

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19 pages, 497 KiB

Open AccessEditor’s ChoiceArticle

Surviving the Immediate Aftermath of a Disaster: A Preliminary Investigation of Adolescents’ Acute Stress Reactions and Mental Health Needs after the 2023 Turkey Earthquakes

by Gökçe Yağmur Efendi, Rahime Duygu Temeltürk, Işık Batuhan Çakmak and Mustafa Dinçer

Children 2023, 10(9), 1485; https://doi.org/10.3390/children10091485 - 31 Aug 2023

Cited by 11 | Viewed by 3166

Abstract

On 6 February, southeastern Turkey and parts of Syria were struck by two powerful earthquakes, one measuring a magnitude of 7.8 and the other, nine hours later, at a magnitude of 7.5. These earthquakes have been recorded as some of the deadliest natural [...] Read more.

On 6 February, southeastern Turkey and parts of Syria were struck by two powerful earthquakes, one measuring a magnitude of 7.8 and the other, nine hours later, at a magnitude of 7.5. These earthquakes have been recorded as some of the deadliest natural disasters worldwide since the 2010 Haiti earthquake, impacting around 14 million people in Turkey. For trauma survivors, the stressors associated with an event can lead to the development of acute stress disorder (ASD) or other psychiatric disorders. Trauma experiences during adolescence can impact development and affect adolescents differently than adults. Although ASD in adults has been addressed in several studies, there is much less information available about how younger populations respond to acute stress. The aim of our study was to assess the occurrence of ASD among individuals seeking help at the Şanlıurfa Mehmet Akif İnan Research and Training Hospital Child and Adolescent Outpatient Clinic following the 2023 Turkey Earthquakes and the factors associated with acute stress reactions. A child and adolescent psychiatry specialist conducted psychiatric interviews with the adolescents, and the individuals were also asked to complete ‘The National Stressful Events Survey Acute Stress Disorder Short Scale’ (NSESSS) to evaluate acute stress symptoms. ASD diagnoses were established according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria. Results showed that 81.6% of the participants (n = 49) were diagnosed with ASD, and drug treatment was initiated in 61.7% of the cases (n = 37). It was determined that ASD rates did not differ according to gender, and patients without physical injury had higher acute stress symptom scores (p > 0.05). According to the logistic regression models, paternal educational levels and adolescents’ own requests for psychiatric assistance were predictors of acute stress disorder (OR 10.1, β = 2.31, p = 0.006 and OR 16.9, 95 β = 2.83, p = 0.001, respectively). Our findings revealed striking results in demonstrating the need for careful evaluation of adolescents without physical injury in terms of acute stress disorder and the need to pay close attention to the psychiatric complaints of adolescents willing to seek mental health assistance. Moreover, our study suggests that the proportion of adolescents experiencing acute stress symptoms after earthquakes might be higher than previously reported. Estimation of the incidence rate and symptoms of psychiatric distress in the short-term period following a disaster is important for establishing disaster epidemiology and implementing efficient relief efforts in the early stages. The outcomes of this study have the potential to yield novel insights into the realms of disaster mental health and emergency response policies, as well as their pragmatic implementations. Full article

(This article belongs to the Special Issue Behavioral and Mental Health Problems in Children)

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12 pages, 1426 KiB

Open AccessEditor’s ChoiceArticle

The Association of Serum Uric Acid Levels and Various Uric Acid-Related Ratios with Insulin Resistance and Obesity: A Preliminary Study in Adolescents

by Okan Dikker, Ayşe Aktaş, Mustafa Şahin, Murat Doğan and Hüseyin Dağ

Children 2023, 10(9), 1493; https://doi.org/10.3390/children10091493 - 31 Aug 2023

Cited by 14 | Viewed by 2417

Abstract

Background: Studies have shown that serum uric acid levels and uric acid-related ratios, such as uric acid-to-albumin ratio (UAR), uric acid-to-creatinine ratio (UCR), uric acid-to-high-density lipoprotein cholesterol (HDL cholesterol) ratio (UHR), and uric acid-to-lymphocyte ratio (ULR), are associated with various diseases and their [...] Read more.

Background: Studies have shown that serum uric acid levels and uric acid-related ratios, such as uric acid-to-albumin ratio (UAR), uric acid-to-creatinine ratio (UCR), uric acid-to-high-density lipoprotein cholesterol (HDL cholesterol) ratio (UHR), and uric acid-to-lymphocyte ratio (ULR), are associated with various diseases and their complications, and that these ratios can be used as biomarkers. In the current study, we aimed to investigate uric acid levels in obese adolescents and the relationship of uric acid-related ratios with insulin resistance and obesity for the first time in the literature. Methods: A total of 100 adolescents (60 obese and 40 healthy) aged 10–17 years were retrospectively included. Participants were assigned to two groups: the obese group and the healthy control group. Obesity was defined as a body mass index (BMI) >the 95th percentile for age and gender. Demographic and laboratory data (serum glucose, urea, creatinine, uric acid, albumin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), C-reactive protein (CRP), total cholesterol, triglyceride, HDL cholesterol, thyroid-stimulating hormone (TSH), free T4 (fT4), insulin levels, and complete blood count) were obtained from the laboratory information management system. A homeostatic model of assessment for insulin resistance (HOMA-IR), low-density lipoprotein cholesterol (LDL cholesterol), and uric acid-related ratios were calculated. Results: Uric acid, UAR, UCR, and UHR levels of obese adolescents were significantly higher than the healthy group (p < 0.05). We found that HOMA-IR was positively correlated with uric acid, UAR, and UHR. No correlation was found between BMI and uric acid or uric acid-related ratios. We did not find any difference between the two groups in terms of ULR levels, and we did not find any correlation between BMI and HOMA-IR. Conclusion: High levels of serum uric acid, UAR, UCR, and UHR were associated with obesity. Furthermore, we found that uric acid, UAR, and UHR were positively correlated with insulin resistance. Full article

(This article belongs to the Section Global Pediatric Health)

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18 pages, 1009 KiB

Open AccessEditor’s ChoiceArticle

Perceived Quality of Life and Life Satisfaction: Does the Role of Gender, Age, Skills, and Psychological Factors Remain Relevant after the COVID-19 Pandemic?

by Cátia Branquinho, Bárbara Moraes, Catarina Noronha, Tomás Ferreira, Nuno Neto Rodrigues and Margarida Gaspar de Matos

Children 2023, 10(9), 1460; https://doi.org/10.3390/children10091460 - 27 Aug 2023

Cited by 7 | Viewed by 2299

Abstract

Background: After two years of psychological, physical, social, economic, environmental, and societal challenges, this paper examines the psychological health and well-being of Portuguese students based on their socioemotional skills (SSES), positive youth development (PYD), depression, anxiety, and stress (DASS), as well as the [...] Read more.

Background: After two years of psychological, physical, social, economic, environmental, and societal challenges, this paper examines the psychological health and well-being of Portuguese students based on their socioemotional skills (SSES), positive youth development (PYD), depression, anxiety, and stress (DASS), as well as the relationship between these variables and their influence on perceived quality of life and life satisfaction. Methods: This study examined 3235 students from lower to upper secondary, half of whom were female (M = 14.46 ± 1.883 years old). Using SPSS software, descriptive statistics were determined for all variables; mean differences between age and gender were found using ANOVA and the post hoc Scheffe test. Linear regressions with the Enter method were used to study how to predict perceived quality of life and satisfaction with life. Results: Males had scores indicating more SSES|optimism, emotional control, resilience, confidence, sociability, creativity, energy, a sense of belonging to school, and PYD. Girls had better skills for cooperating and relating to teachers but more test anxiety and DASS. Younger adolescents had better psychological health, greater skills, and a better perception of quality of life and life satisfaction when compared to older adolescents. Age, gender, SSES, PYD, and the DASS variables can explain 69% of the variance in life satisfaction, while these variables can explain 60.5% of the variance in perceived quality of life. Conclusions: These results point to the relevance of SSES for psychological health and well-being, suggesting that interventions should focus on promoting these variables, paying special attention to female gender and age-related challenges. Full article

(This article belongs to the Section Pediatric Mental Health)

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30 pages, 2223 KiB

Open AccessEditor’s ChoiceReview

Pediatric Spinal Cord Injury: A Review

by Natalia S. C. Cunha, Anahita Malvea, Sarah Sadat, George M. Ibrahim and Michael G. Fehlings

Children 2023, 10(9), 1456; https://doi.org/10.3390/children10091456 - 26 Aug 2023

Cited by 13 | Viewed by 7094

Abstract

A spinal cord injury (SCI) can be a devastating condition in children, with profound implications for their overall health and quality of life. In this review, we aim to provide a concise overview of the key aspects associated with SCIs in the pediatric [...] Read more.

A spinal cord injury (SCI) can be a devastating condition in children, with profound implications for their overall health and quality of life. In this review, we aim to provide a concise overview of the key aspects associated with SCIs in the pediatric population. Firstly, we discuss the etiology and epidemiology of SCIs in children, highlighting the diverse range of causes. We explore the unique anatomical and physiological characteristics of the developing spinal cord that contribute to the specific challenges faced by pediatric patients. Next, we delve into the clinical presentation and diagnostic methods, emphasizing the importance of prompt and accurate diagnosis to facilitate appropriate interventions. Furthermore, we approach the multidisciplinary management of pediatric SCIs, encompassing acute medical care, surgical interventions, and ongoing supportive therapies. Finally, we explore emerging research as well as innovative therapies in the field, and we emphasize the need for continued advancements in understanding and treating SCIs in children to improve their functional independence and overall quality of life. Full article

(This article belongs to the Special Issue Prevention and Treatment of Spinal Cord Dysfunction in Children)

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16 pages, 777 KiB

Open AccessEditor’s ChoiceArticle

Attendance-Based Adherence and Outcomes of Obesity Management Program in Arab Adolescents

by Nasser M. Al-Daghri, Osama E. Amer, Malak N. K. Khattak, Syed D. Hussain, Ghadah Alkhaldi, Hanan A. Alfawaz, Mohamed A. Elsaid and Shaun Sabico

Children 2023, 10(9), 1449; https://doi.org/10.3390/children10091449 - 25 Aug 2023

Cited by 7 | Viewed by 1951

Abstract

Pediatric obesity has become a global pandemic in the last century, contributing to short and long-term medical conditions that heighten the risk of morbidity and mortality in children. The 12-month school-based obesity management educational program aims to assess the effect of adherence to [...] Read more.

Pediatric obesity has become a global pandemic in the last century, contributing to short and long-term medical conditions that heighten the risk of morbidity and mortality in children. The 12-month school-based obesity management educational program aims to assess the effect of adherence to the lifestyle educational program and target outcomes, obesity, and hypertension. A total of 363 (nonadherent, N = 179; adherent, N = 184) Saudi school adolescents aged 12–18 were recruited from 60 schools in Riyadh City, Saudi Arabia. Anthropometrics, lipid profile, and blood glucose were measured at baseline and post-intervention. The level of adherence was based on the number of attended educational sessions, and participants were grouped accordingly into two groups: adherent group (attended ≥ 3 sessions) and nonadherent group (attended 1–2 sessions) out of a total of five sessions. Results demonstrated that significantly more participants in the adherent group achieved the primary program goal of reducing obesity indices [body weight, body mass index (BMI), and BMI z-score] than the nonadherent group. Additionally, among adherent obese participants, BMI z-score significantly decreased after the 12-month intervention (post-intervention: 1.5 ± 0.7 vs. baseline: 1.7 ± 0.6, p < 0.05), while the trend in BMI z-score modestly increased in the nonadherent obese participants post-intervention (post-intervention: 1.8 ± 0.7 vs. baseline: 1.7 ± 0.6, p > 0.05). Moreover, there was a substantial reduction in hypertension prevalence only in the adherent group (p = 0.003) and among adherent obese participants in particular (p = 0.03). Furthermore, adherence to session attendance was higher in girls than boys, which led to better outcomes among girls than boys. For the secondary outcomes, lipid profile indices increased in both groups, while no changes were observed in the glycemic profile. In conclusion, greater adherence to educational sessions achieved modest but favorable weight changes and improved blood pressure among obese adolescents. Future intervention studies should take into consideration the need to improve attendance to enhance adherence to the program among adolescents at risk. Full article

(This article belongs to the Special Issue Dietary Habits, Social Determinants of Health and Obesity Risk in Children and Adolescents)

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21 pages, 1258 KiB

Open AccessEditor’s ChoiceReview

Traffic Accidents in Children and Adolescents: A Complex Orthopedic and Medico-Legal Approach

by Ștefan Popa, Carmen Iulia Ciongradi, Ioan Sârbu, Ovidiu Bîcă, Irene Paula Popa and Diana Bulgaru-Iliescu

Children 2023, 10(9), 1446; https://doi.org/10.3390/children10091446 - 24 Aug 2023

Cited by 9 | Viewed by 3567

Abstract

Traffic accidents involving children and adolescents present complex challenges from both the medico-legal and orthopedic standpoints. Despite the implementation of road traffic safety laws, pediatric road traffic injuries continue to be a significant contributor to mortality rates, physical harm, and hospitalization on a [...] Read more.

Traffic accidents involving children and adolescents present complex challenges from both the medico-legal and orthopedic standpoints. Despite the implementation of road traffic safety laws, pediatric road traffic injuries continue to be a significant contributor to mortality rates, physical harm, and hospitalization on a global scale. For children and young people, automobile accidents are considered to be the primary culprit of mortality in developed nations. Even in highly developed nations, trauma is a significant factor in infant mortality. Each age category, from childhood to young adulthood, has its fracture patterns, as their skeletons are considerably different from those of adults. The consequences of traffic accidents extend beyond the immediate physical trauma. The medico-legal aspects surrounding these incidents add another layer of complexity, as legal repercussions may affect the responsible adult or parent, particularly in cases involving child fatalities. To effectively address traffic accidents in children and adolescents, a comprehensive approach is necessary. This approach should involve not only medical professionals but also legal experts and policymakers. Collaboration between orthopedic specialists, medico-legal professionals, law enforcement agencies, and relevant government bodies can facilitate the development and implementation of strategies aimed at prevention, education, the enforcement of traffic laws, and improved infrastructure. By addressing both the medical and legal aspects, it is possible to enhance road safety for children and adolescents, reducing the incidence of injuries and their associated long-term consequences. In this review, we aimed to summarize traffic accidents in children and adolescents from a complex orthopedic and medico-legal approach. Full article

(This article belongs to the Special Issue New Trends in Pediatric Orthopedic Trauma)

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13 pages, 971 KiB

Open AccessEditor’s ChoiceReview

Klippel–Trenaunay Syndrome, Segmental/Focal Overgrowth Malformations: A Review

by Piero Pavone, Lidia Marino, Giovanni Cacciaguerra, Alessandra Di Nora, Enrico Parano, Giuseppe Musumeci, Martino Ruggieri, Agata Polizzi and Raffaele Falsaperla

Children 2023, 10(8), 1421; https://doi.org/10.3390/children10081421 - 21 Aug 2023

Cited by 8 | Viewed by 4562

Abstract

Klippel–Trenaunay syndrome is an uncommon, infrequent, congenital disorder characterized by a triad of capillary malformation, varicosities, and tissue and bone hypertrophy. The presence of two of these three signs is enough to obtain the diagnosis. Capillary malformations are usually present at birth, whereas [...] Read more.

Klippel–Trenaunay syndrome is an uncommon, infrequent, congenital disorder characterized by a triad of capillary malformation, varicosities, and tissue and bone hypertrophy. The presence of two of these three signs is enough to obtain the diagnosis. Capillary malformations are usually present at birth, whereas venous varicosities and limb hypertrophy become more evident later. The syndrome has usually a benign course, but serious complications involving various organs, such as gastrointestinal and genitourinary organs, as well as the central nervous system, may be observed. Recently, Klippel–Trenaunay syndrome has been included in the group of PIK3CA-related overgrowth spectrum (PROS) disorders. In terms of this disorder, new results in etiopathogenesis and in modalities of treatment have been advanced. We report here a review of the recent genetic findings, the main clinical characteristics and related severe complications, differential diagnoses with a similar disorder, and the management of patients with this complex and uncommon syndrome. Full article

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

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13 pages, 1578 KiB

Open AccessEditor’s ChoiceReview

Exploring the Intricate Links between Adenotonsillar Hypertrophy, Mouth Breathing, and Craniofacial Development in Children with Sleep-Disordered Breathing: Unraveling the Vicious Cycle

by Luana Nosetti, Marco Zaffanello, Francesca De Bernardi di Valserra, Daniela Simoncini, Giulio Beretta, Pietro Guacci, Giorgio Piacentini and Massimo Agosti

Children 2023, 10(8), 1426; https://doi.org/10.3390/children10081426 - 21 Aug 2023

Cited by 13 | Viewed by 4876

Abstract

Adenotonsillar hypertrophy has been well-acknowledged as the primary instigator of sleep-disordered breathing in the pediatric population. This condition spans a spectrum, from typical age-related growth that the immune system influences to persistent pathological hypertrophy. Reduction in air spaces, metabolic changes, neurobehavioral alterations, and [...] Read more.

Adenotonsillar hypertrophy has been well-acknowledged as the primary instigator of sleep-disordered breathing in the pediatric population. This condition spans a spectrum, from typical age-related growth that the immune system influences to persistent pathological hypertrophy. Reduction in air spaces, metabolic changes, neurobehavioral alterations, and chronic inflammation characterizes the latter form. As the go-to treatment, adenotonsillectomy has proven effective. However, it is not a guarantee for all patients, leaving us without reliable predictors of treatment success. Evidence suggests a connection between adenotonsillar hypertrophy and specific oral breathing patterns resulting from craniofacial development. This finding implies an intricate interdependence between the two, hinting at a self-sustaining vicious cycle that persists without proper intervention. The theories regarding the relationship between craniofacial conformation and sleep-disordered breathing have given rise to intriguing perspectives. In particular, the “gracilization theory” and the “gravitational hypothesis” have provided fascinating insights into the complex interaction between craniofacial conformation and SDB. Further investigation is crucial to unraveling the underlying pathophysiological mechanisms behind this relationship. It is also vital to explore the risk factors linked to adenotonsillectomy failure, study the long-term effects of adenotonsillar hypertrophy on craniofacial growth, and devise innovative diagnostic techniques to detect upper airway compromise early. Moreover, to assess their efficacy, we must delve into novel therapeutic approaches for cases that do not respond to traditional treatment, including positional therapy and orofacial myofunctional therapy. Though complex and unpredictable, these challenges promise to enhance our understanding and treatment of adenotonsillar hypertrophy and its related complications in children. By taking on this task, we can pave the way for more effective and targeted interventions, ultimately improving affected individuals’ well-being and quality of life. Full article

(This article belongs to the Section Pediatric Pulmonary and Sleep Medicine)

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18 pages, 2626 KiB

Open AccessEditor’s ChoiceReview

State of the Art Bowel Management for Pediatric Colorectal Problems: Hirschsprung Disease

by Elizaveta Bokova, Ninad Prasade, Sanjana Janumpally, John M. Rosen, Irene Isabel P. Lim, Marc A. Levitt and Rebecca M. Rentea

Children 2023, 10(8), 1418; https://doi.org/10.3390/children10081418 - 20 Aug 2023

Cited by 12 | Viewed by 5123

Abstract

After an initial pull-though, patients with Hirschsprung disease (HD) can present with obstructive symptoms, Hirschsprung-associated enterocolitis (HAEC), failure to thrive, or fecal soiling. This current review focuses on algorithms for evaluation and treatment in children with HD as a part of a manuscript [...] Read more.

After an initial pull-though, patients with Hirschsprung disease (HD) can present with obstructive symptoms, Hirschsprung-associated enterocolitis (HAEC), failure to thrive, or fecal soiling. This current review focuses on algorithms for evaluation and treatment in children with HD as a part of a manuscript series on updates in bowel management. In constipated patients, anatomic causes of obstruction should be excluded. Once anatomy is confirmed to be normal, laxatives, fiber, osmotic laxatives, or mechanical management can be utilized. Botulinum toxin injections are performed in all patients with HD before age five because of the nonrelaxing sphincters that they learn to overcome with increased age. Children with a patulous anus due to iatrogenic damage of the anal sphincters are offered sphincter reconstruction. Hypermotility is managed with antidiarrheals and small-volume enemas. Family education is crucial for the early detection of HAEC and for performing at-home rectal irrigations. Full article

(This article belongs to the Special Issue Advance in Pediatric Surgery)

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11 pages, 417 KiB

Open AccessEditor’s ChoiceArticle

Comorbidities Affecting Children with Autism Spectrum Disorder: A Retrospective Chart Review

by Jessy Burns, Ryan Phung, Shayna McNeill, Ana Hanlon-Dearman and M. Florencia Ricci

Children 2023, 10(8), 1414; https://doi.org/10.3390/children10081414 - 19 Aug 2023

Cited by 7 | Viewed by 4938

Abstract

Autism spectrum disorder (ASD) is a developmental disorder characterized by deficits in social interaction/communication, restricted interests, and repetitive behaviors. Recent discussions have emerged worldwide regarding the heterogeneity around presentation/etiology and comorbidities. This study aimed to determine the frequency and characteristics of comorbidities among [...] Read more.

Autism spectrum disorder (ASD) is a developmental disorder characterized by deficits in social interaction/communication, restricted interests, and repetitive behaviors. Recent discussions have emerged worldwide regarding the heterogeneity around presentation/etiology and comorbidities. This study aimed to determine the frequency and characteristics of comorbidities among children diagnosed with ASD in Manitoba and to evaluate differences in presentation between those with and without medical comorbidities. We conducted a retrospective chart review of >1900 electronic charts at the only publicly funded referral site for children ≤6 years requiring evaluation for ASD in Manitoba. All children aged 0–6 years diagnosed with ASD at this site between May 2016 and September 2021 were identified. χ² and t-tests were used to compare groups. Of the total of 1858 children identified, 1452 (78.1%) were boys, 251 (13.5%) were prematurely born, and 539 (29.0%) had ≥1 medical comorbidity. Global developmental delay (GDD) was diagnosed in 428 (23.0%). The age of referral and diagnosis did not differ between groups. Comorbidities were more common among premature children (16.0% vs. 12.5%, p: 0.005) and children with comorbid GDD (34.9% vs. 18.2%, p < 0.001). Neurological comorbidities were most common (37.1%). No sex difference in the overall presence of comorbidities was found (boys = 77.1% vs. 78.5%, p: 0.518); however, girls had a higher incidence of neurological comorbidities, e.g., cerebral palsy, seizures, hypotonia (14.8% vs. 9.64%, p: 0.009), as well as genetic comorbidities (4.92% vs. 2.75%, p: 0.04). The high rates of associated neurological conditions, GDD, and prematurity add heterogeneity to this group leading to potential difficulties with prognosis and service allocation. Primary vs. secondary ASD can be a way of separating individuals based on relevant medical comorbidities. Full article

(This article belongs to the Special Issue Child and Adolescent Psychiatry and Mental Health Progress)

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14 pages, 685 KiB

Open AccessEditor’s ChoiceArticle

Caring for Children with Dravet Syndrome: Exploring the Daily Challenges of Family Caregivers

by Jan Domaradzki and Dariusz Walkowiak

Children 2023, 10(8), 1410; https://doi.org/10.3390/children10081410 - 19 Aug 2023

Cited by 13 | Viewed by 2999

Abstract

While Polish studies focus on the symptoms, causes and treatment of people suffering from Dravet syndrome (DS), much less is known about the situation of the family caregivers of DS children. This study was designed to explore the experiences, daily challenges and needs [...] Read more.

While Polish studies focus on the symptoms, causes and treatment of people suffering from Dravet syndrome (DS), much less is known about the situation of the family caregivers of DS children. This study was designed to explore the experiences, daily challenges and needs related to caring for DS children. An anonymous self-administered online questionnaire was developed. The survey was completed by 75 family caregivers affiliated with the Association for People with Severe Refractory Epilepsy DRAVET.PL on Facebook. Most caregivers felt burdened by their children’s reduced mobility (57.3%), mood swings (57.3%), lack of access to rehabilitation and medicine (56%) and healthcare expenses (50.7%). Caregivers also complained of a lack of time to themselves (76%) and work restrictions resulting from caregiving (72%). They consequently reported experiencing fatigue (84%), a deterioration of mental health (60%) and intimacy problems with their spouse/partner (53.4%). An important source of strain was a prolonged diagnostic odyssey and the constant struggle over the healthcare services for DS children. Since DS caregivers’ problems and needs are often overlooked, they may be described as the forgotten people in DS. Healthcare professionals should be educated about the challenges related to caring for DS child, psycho-social status and coping resources of DS caregivers, and should focus on identification, monitoring and supporting caregivers’ physical and mental well-being and needs. Full article

(This article belongs to the Topic Children’s Diseases, Family Management, and Quality of Life)
(This article belongs to the Section Pediatric Nursing)

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16 pages, 1321 KiB

Open AccessEditor’s ChoiceArticle

Online Safety for Children and Youth under the 4Cs Framework—A Focus on Digital Policies in Australia, Canada, and the UK

by Yujin Jang and Bomin Ko

Children 2023, 10(8), 1415; https://doi.org/10.3390/children10081415 - 19 Aug 2023

Cited by 13 | Viewed by 10615

Abstract

This study analyzes the previous literature on the online safety of children and youth under “the 4Cs risk framework” concerning contact, content, conduct, and contract risks. It then conducts a comparative study of Australia, Canada, and the UK, comparing their institutions, governance, and [...] Read more.

This study analyzes the previous literature on the online safety of children and youth under “the 4Cs risk framework” concerning contact, content, conduct, and contract risks. It then conducts a comparative study of Australia, Canada, and the UK, comparing their institutions, governance, and government-led programs. Relevant research in Childhood Education Studies is insufficient both in quantity and quality. To minimize the four major online risks for children and youth in cyberspace, it is necessary to maintain a regulatory approach to the online exposure of children under the age of 13. Moreover, the global society should respond together to these online risks with “multi-level” policymaking under a “multi-stakeholder approach”. At the international level, multilateral discussion within the OECD and under UN subsidiaries should continue to lead international cooperation. At the domestic level, a special agency in charge of online safety for children and youth should be established in each country, encompassing all relevant stakeholders, including educators and digital firms. At the school and family levels, both parents and teachers need to work together in facilitating digital literacy education, providing proper guidelines for the online activities of children and youth, and helping them to become more satisfied and productive users in the digital era. Full article

(This article belongs to the Section Global Pediatric Health)

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22 pages, 1806 KiB

Open AccessEditor’s ChoiceArticle

Co-Creation of a School-Based Motor Competence and Mental Health Intervention: Move Well, Feel Good

by Lauren Clifford, Richard Tyler, Zoe Knowles, Emma Ashworth, Lynne Boddy, Lawrence Foweather and Stuart J. Fairclough

Children 2023, 10(8), 1403; https://doi.org/10.3390/children10081403 - 17 Aug 2023

Cited by 9 | Viewed by 3030

Abstract

Low motor competence (MC) and inhibited psychosocial development are associated with mental health difficulties. Improving children’s MC through school-based physical activity interventions emphasising psychosocial development may therefore be a mechanism for promoting positive mental health. This study describes and provides reflective insights into [...] Read more.

Low motor competence (MC) and inhibited psychosocial development are associated with mental health difficulties. Improving children’s MC through school-based physical activity interventions emphasising psychosocial development may therefore be a mechanism for promoting positive mental health. This study describes and provides reflective insights into the co-creation of ‘Move Well Feel Good’, a primary school physical activity intervention to improve children’s MC and mental health. Class teachers, school leaders, physical activity specialists, and children (aged 8–9 years) participated in a series of co-creation workshops. Stakeholders’ knowledge and experiences were integrated with existing research evidence using creative methods (e.g., post-it note tasks, worksheets, and drawings) to facilitate discussion. The co-creation process culminated in stakeholder consensus voting for one of three proposed intervention ideas. Children cited physical and mental health benefits, enjoyment with friends, and high perceived competence as motives for being physically active. Opportunities to develop MC across the different segments of the school day were identified by adult stakeholders, who perceived children’s lack of resilience, an overloaded curriculum, and poor parental support for physical activity as barriers to intervention implementation. The chosen intervention idea received six out of a possible twelve votes. Co-creation projects are specific to the contexts in which they are implemented. This study reinforces the complex nature of school-based intervention development and highlights the value of engaging with stakeholders in co-creation processes. Full article

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

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13 pages, 292 KiB

Open AccessEditor’s ChoiceReview

Pediatric Palliative Care: Insights into Assessment Tools and Review Instruments

by Simonetta Papa, Anna Mercante, Luca Giacomelli and Franca Benini

Children 2023, 10(8), 1406; https://doi.org/10.3390/children10081406 - 17 Aug 2023

Cited by 10 | Viewed by 5092

Abstract

The proper assessment of needs and outcomes in pediatric palliative care (PPC) is imperative
to ensure the best possible service to patients and families. However, given the multidimensional
nature of PPC, the low number of patients in this setting, the heterogeneity of diseases, [...] Read more.

The proper assessment of needs and outcomes in pediatric palliative care (PPC) is imperative
to ensure the best possible service to patients and families. However, given the multidimensional
nature of PPC, the low number of patients in this setting, the heterogeneity of diseases, the presence
of cognitive impairment in many patients, and the physiological development of children, outcomes
can be complex and difficult to measure. Consequently, in this context, the use of standardized
and validated tools to assess the needs of children and families, to assess symptom severity, and
to estimate the quality of PPC service represent a current need. Even if efforts have been made to
standardize approaches and tools for palliative care in adults, to our knowledge, a similar comprehensive
assessment of PPC has not yet been conducted to date. This narrative review provides an
overview and discusses the evaluation of tools currently applied in PPC, with an educational intent
for healthcare providers. We found that several instruments are available to assess different dimensions
of PPC. We proposed a classification into eligibility tools, patient and family needs assessment
tools, and care assessment tools. At present, two main eligibility tools exist, the PaPaS Scale and the
ACCAPED Scale questionnaire. Most of the tools for patient and family needs assessment have not
been specifically validated in the PPC setting, and many may be more readily applied in research
settings rather than in daily practice. Similar considerations can be made for tools assessing QoL,
while tools assessing PPC service quality seem to be easily applied. Efforts to develop new specific
tools and validate existing ones are undoubtedly advocated. However, in the patient’s best interest,
PPC healthcare providers should start using available tools, regardless of their validation status. Full article

(This article belongs to the Section Pediatric Anesthesiology, Pain Medicine and Palliative Care)

12 pages, 308 KiB

Open AccessEditor’s ChoiceReview

Diagnostic and Management Issues in Patients with Late-Onset Ornithine Transcarbamylase Deficiency

by Majitha Seyed Ibrahim, Jessica I. Gold, Alison Woodall, Berna Seker Yilmaz, Paul Gissen and Karolina M. Stepien

Children 2023, 10(8), 1368; https://doi.org/10.3390/children10081368 - 9 Aug 2023

Cited by 11 | Viewed by 4468

Abstract

Ornithine transcarbamylase deficiency (OTCD) is the most common inherited disorder of the urea cycle and, in general, is transmitted as an X-linked recessive trait. Defects in the OTC gene cause an impairment in ureagenesis, resulting in hyperammonemia, which is a direct cause of [...] Read more.

Ornithine transcarbamylase deficiency (OTCD) is the most common inherited disorder of the urea cycle and, in general, is transmitted as an X-linked recessive trait. Defects in the OTC gene cause an impairment in ureagenesis, resulting in hyperammonemia, which is a direct cause of brain damage and death. Patients with late-onset OTCD can develop symptoms from infancy to later childhood, adolescence or adulthood. Clinical manifestations of adults with OTCD vary in acuity. Clinical symptoms can be aggravated by metabolic stressors or the presence of a catabolic state, or due to increased demands upon the urea. A prompt diagnosis and relevant biochemical and genetic investigations allow the rapid introduction of the right treatment and prevent long-term complications and mortality. This narrative review outlines challenges in diagnosing and managing patients with late-onset OTCD. Full article

(This article belongs to the Section Pediatric Nephrology & Urology)

14 pages, 1508 KiB

Open AccessEditor’s ChoiceArticle

Specific Learning Disorders (SLD) and Behavior Impairment: Comorbidity or Specific Profile?

by Daniela Pia Rosaria Chieffo, Valentina Arcangeli, Federica Moriconi, Angelica Marfoli, Federica Lino, Sofia Vannuccini, Elisa Marconi, Ida Turrini, Claudia Brogna, Chiara Veredice, Alessandro Antonietti, Gabriele Sani and Eugenio Maria Mercuri

Children 2023, 10(8), 1356; https://doi.org/10.3390/children10081356 - 7 Aug 2023

Cited by 12 | Viewed by 7107

Abstract

Introduction: Specific Learning Disorder (SLD) is a neurodevelopmental disorder characterized by difficulties in perceiving and processing verbal and non-verbal information. It is usually accompanied by impaired academic skills leading to school dropout and emotional disturbances, resulting in significant distress and behavioral problems. Methods: [...] Read more.

Introduction: Specific Learning Disorder (SLD) is a neurodevelopmental disorder characterized by difficulties in perceiving and processing verbal and non-verbal information. It is usually accompanied by impaired academic skills leading to school dropout and emotional disturbances, resulting in significant distress and behavioral problems. Methods: A cognitive, academic, and emotional-behavioral assessment was performed at T0 and T1 in children and adolescents with SLD. Participants received psychotherapy and speech therapy treatment from T0 to T1. Results: In SLD, the most compromised cognitive functions were working memory and writing skills. An impact on academic abilities was found. Children and adolescents with SLD experience greater anxiety and depression levels compared to their control peers. Conclusions: SLD may adversely influence psychological well-being. To counteract such a consequence, more specific cognitive and academic skill-oriented strategies should be taken into consideration. Full article

(This article belongs to the Special Issue Dyslexia and Dyscalculia: Profiles, Developmental Trajectories, and Insights from Genetic Syndromes)

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19 pages, 3055 KiB

Open AccessEditor’s ChoiceReview

Diagnosis of Paediatric Obstructive Sleep-Disordered Breathing beyond Polysomnography

by Melissa Borrelli, Adele Corcione, Chiara Cimbalo, Anna Annunziata, Simona Basilicata, Giuseppe Fiorentino and Francesca Santamaria

Children 2023, 10(8), 1331; https://doi.org/10.3390/children10081331 - 1 Aug 2023

Cited by 15 | Viewed by 3843

Abstract

Obstructive sleep-disordered breathing (SDB) has significant impacts on health, and therefore, a timely and accurate diagnosis is crucial for effective management and intervention. This narrative review provides an overview of the current approaches utilised in the diagnosis of SDB in children. Diagnostic methods [...] Read more.

Obstructive sleep-disordered breathing (SDB) has significant impacts on health, and therefore, a timely and accurate diagnosis is crucial for effective management and intervention. This narrative review provides an overview of the current approaches utilised in the diagnosis of SDB in children. Diagnostic methods for SDB in children involve a combination of clinical assessment, medical history evaluation, questionnaires, and objective measurements. Polysomnography (PSG) is the diagnostic gold standard. It records activity of brain and tibial and submental muscles, heart rhythm, eye movements, oximetry, oronasal airflow, abdominal and chest movements, body position. Despite its accuracy, it is a time-consuming and expensive tool. Respiratory polygraphy instead monitors cardiorespiratory function without simultaneously assessing sleep and wakefulness; it is more affordable than PSG, but few paediatric studies compare these techniques and there is optional recommendation in children. Nocturnal oximetry is a simple and accessible exam that has high predictive value only for children at high risk. The daytime nap PSG, despite the advantage of shorter duration and lower costs, is not accurate for predicting SDB. Few paediatric data support the use of home testing during sleep. Finally, laboratory biomarkers and radiological findings are potentially useful hallmarks of SDB, but further investigations are needed to standardise their use in clinical practice. Full article

(This article belongs to the Special Issue Advances in Sleep Respiratory Disorders in Children and Adolescents)

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11 pages, 554 KiB

Open AccessEditor’s ChoiceArticle

Feasibility and Effectiveness of Speech Intervention Implemented with a Virtual Reality System in Children with Developmental Language Disorders: A Pilot Randomized Control Trial

by Irene Cappadona, Augusto Ielo, Margherita La Fauci, Maria Tresoldi, Carmela Settimo, Maria Cristina De Cola, Rosalia Muratore, Carmela De Domenico, Marcella Di Cara, Francesco Corallo, Emanuela Tripodi, Caterina Impallomeni, Angelo Quartarone and Francesca Cucinotta

Children 2023, 10(8), 1336; https://doi.org/10.3390/children10081336 - 1 Aug 2023

Cited by 9 | Viewed by 4307

Abstract

Language disorders are characterized by impairments in verbal expression/understanding, including difficulties with one or more language components. The Virtual Reality Rehabilitation System (VRRS) is a bioelectromedical device equipped with exercise sections aimed at improving cognitive and language deficits. It also increases patient motivation [...] Read more.

Language disorders are characterized by impairments in verbal expression/understanding, including difficulties with one or more language components. The Virtual Reality Rehabilitation System (VRRS) is a bioelectromedical device equipped with exercise sections aimed at improving cognitive and language deficits. It also increases patient motivation and engagement. The aim of our study was to test the feasibility and efficacy of VRRS intervention to improve speech therapy treatment for children with speech disorders. Thirty-two patients were enrolled in this study and randomly assigned to the experimental (EG) or control group (CG). The CG underwent conventional speech therapy, while EG underwent VRRS-implemented speech therapy. Both groups were evaluated before (T0) and after (T1) the intervention using the Language Assessment Test. The results showed improvements in both groups. However, the EG group showed greater improvement in various areas, including comprehension of total words, repetition, naming of body parts, naming of everyday objects, total naming, morphosyntactic accuracy, sentence construction, average length of utterance, and spontaneous word production. This study demonstrated that VRRS can be a valuable tool for implementing effective speech rehabilitation. Further studies are needed, as the use of VRRS is still in its early stages, requiring larger samples sizes and long-term follow-up. Full article

(This article belongs to the Section Pediatric Mental Health)

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14 pages, 285 KiB

Open AccessEditor’s ChoiceReview

Coregulation: A Multilevel Approach via Biology and Behavior

by Marc H. Bornstein and Gianluca Esposito

Children 2023, 10(8), 1323; https://doi.org/10.3390/children10081323 - 31 Jul 2023

Cited by 11 | Viewed by 5184

Abstract

In this article, we explore the concept of coregulation, which encompasses the mutual adaptation between partners in response to one another’s biology and behavior. Coregulation operates at both biological (hormonal and nervous system) and behavioral (affective and cognitive) levels and plays a [...] Read more.

In this article, we explore the concept of coregulation, which encompasses the mutual adaptation between partners in response to one another’s biology and behavior. Coregulation operates at both biological (hormonal and nervous system) and behavioral (affective and cognitive) levels and plays a crucial role in the development of self-regulation. Coregulation extends beyond the actions of individuals in a dyad and involves interactive contributions of both partners. We use as an example parent–child coregulation, which is pervasive and expected, as it emerges from shared genetic relatedness, cohabitation, continuous interaction, and the influence of common factors like culture, which facilitate interpersonal coregulation. We also highlight the emerging field of neural attunement, which investigates the coordination of brain-based neural activities between individuals, particularly in social interactions. Understanding the mechanisms and significance of neural attunement adds a new dimension to our understanding of coregulation and its implications for parent–child relationships and child development. Full article

(This article belongs to the Special Issue Developmental Psychopathology in Children: Risk Factors and Parenting)

15 pages, 4072 KiB

Open AccessEditor’s ChoiceReview

Congenital Syphilis—An Illustrative Review

by Deepika Sankaran, Elizabeth Partridge and Satyan Lakshminrusimha

Children 2023, 10(8), 1310; https://doi.org/10.3390/children10081310 - 29 Jul 2023

Cited by 30 | Viewed by 17623

Abstract

Congenital syphilis is caused by the spirochete, Treponema pallidum, which can be transmitted from an infected mother to her fetus during pregnancy or by contact with a maternal lesion at the time of delivery. The incidence of congenital syphilis is rapidly increasing [...] Read more.

Congenital syphilis is caused by the spirochete, Treponema pallidum, which can be transmitted from an infected mother to her fetus during pregnancy or by contact with a maternal lesion at the time of delivery. The incidence of congenital syphilis is rapidly increasing all over world with 700,000 to 1.5 million cases reported annually between 2016 and 2023. Despite the widespread availability of Penicillin, 2677 cases were reported in 2021 in the US. Clinical manifestations at birth can vary widely ranging from asymptomatic infection to stillbirth or neonatal death. Low birth weight, rash, hepatosplenomegaly, osteolytic bone lesions, pseudoparalysis, central nervous system infection, and long-term disabilities have been reported in newborns with congenital syphilis. Prevention of congenital syphilis is multifaceted and involves routine antenatal screening, timely treatment of perinatal syphilis with penicillin, partner tracing and treatment, and health education programs emphasizing safe sex practices and strategies to curb illicit drug use. Neonatal management includes risk stratification based on maternal syphilis history, evaluation (nontreponemal testing, complete blood counts, cerebrospinal fluid, and long-bone analysis), treatment with penicillin, and followup treponemal testing. Public health measures that enhance early detection during pregnancy and treatment with penicillin, especially in high-risk mothers, are urgently needed to prevent future cases of congenital syphilis. Full article

(This article belongs to the Special Issue Stabilization and Resuscitation of Newborns: 2nd Edition)

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9 pages, 255 KiB

Open AccessEditor’s ChoiceArticle

Evaluation of Neuropsychiatric Effects of Montelukast–Levocetirizine Combination Therapy in Children with Asthma and Allergic Rhinitis

by Uğur Altaş, Zeynep Meva Altaş, Fırat Öz and Mehmet Yaşar Özkars

Children 2023, 10(8), 1301; https://doi.org/10.3390/children10081301 - 28 Jul 2023

Cited by 8 | Viewed by 5458

Abstract

Drug-induced neuropsychiatric effects are important for disease management. We aim to evaluate the neuropsychiatric effects of montelukast–levocetirizine combination therapy in children. This descriptive study was conducted with children aged 2–5 years, diagnosed with asthma and allergic rhinitis, who began to receive montelukast and [...] Read more.

Drug-induced neuropsychiatric effects are important for disease management. We aim to evaluate the neuropsychiatric effects of montelukast–levocetirizine combination therapy in children. This descriptive study was conducted with children aged 2–5 years, diagnosed with asthma and allergic rhinitis, who began to receive montelukast and levocetirizine combination therapy. The respiratory and asthma control test for children (TRACK), Rhino Conjunctivitis Scoring System (RCSS), and common neuropsychiatric effects (irritable behavior, hallucinations, headaches, nightmares, sleep disorders, behavioral and mood disorder, restlessness, depression) were ascertained by the questionnaire applied before and 4 weeks after the treatment. Parents answered on behalf of their children. The most common finding before and after treatment was irritable behavior. While irritable behavior was observed in 82.4% (n = 56) of children before the treatment, this percentage was 63.2% (n = 43) after the treatment (p = 0.004). The percentage of children who developed at least one neuropsychiatric symptom after treatment was 22.1% (n = 15). There was no significant effect of age, gender, RCSS, TRACK, or allergy test positivity on the development of neuropsychiatric symptoms (p > 0.05). According to the results, at least one neuropsychiatric finding developed in approximately one in five children. Identifying risk factors will enable more careful treatment or consideration of alternative treatments for children at higher risk in the clinical follow-up period. Full article

(This article belongs to the Special Issue Effectiveness and Safety of Drugs for Children)

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