Editor’s Choice Articles

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

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18 pages, 2610 KB  
Article
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 26 | Viewed by 5163
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 KB  
Review
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 14 | Viewed by 5027
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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11 pages, 775 KB  
Review
Sleep Disordered Breathing in Children with Autism Spectrum Disorder: An In-Depth Review of Correlations and Complexities
by Marco Zaffanello, Giorgio Piacentini, Luana Nosetti and Leonardo Zoccante
Children 2023, 10(10), 1609; https://doi.org/10.3390/children10101609 - 27 Sep 2023
Cited by 8 | Viewed by 3308
Abstract
Sleep-disordered breathing is a significant problem affecting the pediatric population. These conditions can affect sleep quality and children’s overall health and well-being. Difficulties in social interaction, communication, and repetitive behavioral patterns characterize autism spectrum disorder. Sleep disturbances are common in children with ASD. [...] Read more.
Sleep-disordered breathing is a significant problem affecting the pediatric population. These conditions can affect sleep quality and children’s overall health and well-being. Difficulties in social interaction, communication, and repetitive behavioral patterns characterize autism spectrum disorder. Sleep disturbances are common in children with ASD. This literature review aims to gather and analyze available studies on the relationship between SDB and children with autism spectrum disorder. We comprehensively searched the literature using major search engines (PubMed, Scopus, and Web of Science). After removing duplicates, we extracted a total of 96 records. We selected 19 studies for inclusion after a thorough title and abstract screening process. Seven articles were ultimately incorporated into this analysis. The research findings presented herein emphasize the substantial influence of sleep-disordered breathing on pediatric individuals diagnosed with autism spectrum disorder (ASD). These findings reveal a high incidence of SDB in children with ASD, emphasizing the importance of early diagnosis and specialized treatment. Obesity in this population further complicates matters, requiring focused weight management strategies. Surgical interventions, such as adenotonsillectomy, have shown promise in improving behavioral issues in children with ASD affected by OSA, regardless of their obesity status. However, more comprehensive studies are necessary to investigate the benefits of A&T treatment, specifically in children with ASD and OSA. The complex relationship between ASD, SDB, and other factors, such as joint hypermobility and muscle hypotonia, suggests a need for multidisciplinary treatment approaches. Physiotherapy can play a critical role in addressing these intricate health issues. Early sleep assessments and tailored weight management strategies are essential for timely diagnosis and intervention in children with ASD. Policy initiatives should support these efforts to enhance the overall well-being of this population. Further research is crucial to understand the complex causes of sleep disturbances in children with ASD and to develop effective interventions considering the multifaceted nature of these conditions. Full article
(This article belongs to the Special Issue Sleep Health in Infants, Children and Adolescents)
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15 pages, 298 KB  
Review
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 35 | Viewed by 11161
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
13 pages, 278 KB  
Article
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 7 | Viewed by 2563
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
11 pages, 1326 KB  
Article
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 10 | Viewed by 2491
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 KB  
Review
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 23 | Viewed by 6843
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 KB  
Article
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 3803
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 KB  
Article
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 18 | Viewed by 8878
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
19 pages, 261 KB  
Article
Cognitive Testing of Items Measuring Movement Behaviours in Young Children Aged Zero to Five Years: Development of the Movement Behaviour Questionnaires for -Baby (MBQ-B) and -Child (MBQ-C)
by Rebecca Byrne, Caroline O. Terranova, Li Kheng Chai, Denise S. K. Brookes and Stewart G. Trost
Children 2023, 10(9), 1554; https://doi.org/10.3390/children10091554 - 14 Sep 2023
Cited by 7 | Viewed by 1873
Abstract
This paper describes the cognitive interview phase of the development of two brief surveys, the Movement Behaviour Questionnaire-Baby (MBQ-B) and Movement Behaviour Questionnaire-Child (MBQ-C), which measure the duration of physical activity, screen time, and sleep of children aged 0–5 years. The aims were [...] Read more.
This paper describes the cognitive interview phase of the development of two brief surveys, the Movement Behaviour Questionnaire-Baby (MBQ-B) and Movement Behaviour Questionnaire-Child (MBQ-C), which measure the duration of physical activity, screen time, and sleep of children aged 0–5 years. The aims were (1) review the format, content, and clarity of questionnaire items and response options, (2) understand how parents retrieve, encode, and formulate responses when asked about their child’s movement behaviours, and (3) identify potential sources of response error and make appropriate modifications. Interviews with parents of children aged 0–5 years were conducted using concurrent think-aloud techniques and probing questions. Parents reviewed the MBQ-B and/or MBQ-C depending on the developmental stage of their child(ren). Twenty-nine interviews were conducted with 20 parents, over four iterative rounds. Participants recalled usual family routines and rules when estimating the duration/frequency of behaviours. To estimate active play, parents referred to the child’s daily routine considering wake and bedtimes, naps, and mealtimes. Participants were influenced by the examples provided, being unable to interpret these as exemplars only. Decomposing general items into specific questions with examples was well received. Use of numeracy skills when estimating duration was evident. Interviews informed revisions to item wording, examples, and recall prompts, which will be taken forward into the MBQ-B and MBQ-C validation studies. Utilising cognitive interviewing can enhance confidence that questionnaire items are correctly interpreted and understood by participants. Full article
(This article belongs to the Section Global Pediatric Health)
13 pages, 305 KB  
Article
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 14 | Viewed by 7044
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)
16 pages, 627 KB  
Article
Stress and Anxiety among High School Adolescents: Correlations between Physiological and Psychological Indicators in a Longitudinal Follow-Up Study
by Gábor Pál Stromájer, Melinda Csima, Réka Iváncsik, Bernadett Varga, Krisztina Takács and Tímea Stromájer-Rácz
Children 2023, 10(9), 1548; https://doi.org/10.3390/children10091548 - 14 Sep 2023
Cited by 9 | Viewed by 9132
Abstract
Mental and psychological disorders are serious health problems worldwide. Anxiety among high school students can affect school performance, relationships, and family life. Objective: Our aim is to understand the anxiety levels and associated factors among high school students and compare the results of [...] Read more.
Mental and psychological disorders are serious health problems worldwide. Anxiety among high school students can affect school performance, relationships, and family life. Objective: Our aim is to understand the anxiety levels and associated factors among high school students and compare the results of psychological tests measuring anxiety with the cortisol levels obtained from biological sampling. Method: In our longitudinal follow-up study, we involved 125 individuals in May 2019. Validated measurement tools were used during questionnaire data collection, including the State–Trait Anxiety Inventory, Clear Communication Scale, Multiple Social Perceived Support Scale, and related HBSC questions. As objective data, we collected hair samples for cortisol level measurement. Results: At the end of the school year, the anxiety levels measured by psychological tests were significantly higher (p = 0.001) compared to the anxiety levels at the beginning of the next school year. Anxiety levels were higher among girls and were influenced by the type of school and parental expectations. Both state anxiety and trait anxiety showed a strong correlation with psychosomatic symptoms (p < 0.001) and anxiety arising from school expectations (p < 0.05). The changes in cortisol levels did not follow the changes in psychological tests. Cortisol level increased (p = 0.01) in the second sample. Full article
(This article belongs to the Special Issue Depression, Anxiety and Stress in Children and Adolescents)
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19 pages, 2065 KB  
Article
Enhancing Handwriting Performance of Children with Developmental Coordination Disorder (DCD) Using Computerized Visual Feedback
by Rachel Bartov, Michael Wagner, Nir Shvalb and Michal Hochhauser
Children 2023, 10(9), 1534; https://doi.org/10.3390/children10091534 - 11 Sep 2023
Cited by 8 | Viewed by 3629
Abstract
Recent studies have analyzed the writing metrics of children with developmental coordination disorder (DCD) using computerized systems. To date, the use of computerized visual feedback to improve handwriting has not been investigated. This study aimed to examine the effects of computerized visual feedback [...] Read more.
Recent studies have analyzed the writing metrics of children with developmental coordination disorder (DCD) using computerized systems. To date, the use of computerized visual feedback to improve handwriting has not been investigated. This study aimed to examine the effects of computerized visual feedback on handwriting performance in time, spatial orientation, and pressure indices for children with DCD. Twenty-seven children aged 7 to 12 years with DCD assessed by the Movement Assessment Battery for Children and the Developmental Coordination Disorder Questionnaire received one weekly intervention session for 8 weeks, during which they twice copied an excerpt onto a tablet. Once, they received visual feedback where the writing color corresponded to the degree of pressure on the writing surface, and once they received no visual feedback. The two conditions were counterbalanced throughout the sessions. Pre-intervention sessions were compared with post-intervention sessions and with new texts for time, spatial orientation, and pressure measures. The findings revealed significantly decreased total and mean letter writing, in-air, and writing time and increased capacity in the visual feedback condition. In the spatial variables, a significant decrease in letter height variance was found. Pressure increased significantly throughout the intervention with visual feedback, whereas it decreased post-test in the writing task in both conditions and was maintained in the new text. Visual feedback intervention can increase the kinesthetic–haptic feedback required to regulate pressure during writing, promoting more efficient feedforward processes and improving output quality and capacity. The training effectiveness was transferable, and the intervention accessibility could increase student autonomy. Full article
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12 pages, 749 KB  
Article
Similarities and Differences between Multisystem Inflammatory Syndrome in Children (MIS-C) and Kawasaki Disease Shock Syndrome
by Jin Lee, Beom Joon Kim, Kyoung-Soon Cho, Jung Woo Rhim, Soo-Young Lee and Dae Chul Jeong
Children 2023, 10(9), 1527; https://doi.org/10.3390/children10091527 - 8 Sep 2023
Cited by 8 | Viewed by 2600
Abstract
This study aimed to investigate the characteristics of COVID-19-associated multisystem inflammatory syndrome in children (MIS-C) and Kawasaki disease shock syndrome (KDSS) and to compare the similarities and differences between the two diseases. The incidence of KDSS and MIS-C was also estimated. Medical records [...] Read more.
This study aimed to investigate the characteristics of COVID-19-associated multisystem inflammatory syndrome in children (MIS-C) and Kawasaki disease shock syndrome (KDSS) and to compare the similarities and differences between the two diseases. The incidence of KDSS and MIS-C was also estimated. Medical records of patients diagnosed with MIS-C or KDSS at four hospitals from January 2013 to December 2022 were retrospectively reviewed. Thirty-one patients were enrolled in the study in either an MIS-C group (n = 22) or a KDSS group (n = 9). The incidence of KDSS in KD was 0.8% (9/1095) and the incidence of MIS-C versus KD was 10.2% (22/216). Compared with the MIS-C group, the KDSS group had longer hospital stays and more severe systemic inflammation (e.g., anemia, elevated C-reactive protein, hypoalbuminemia, and pyuria) and organ dysfunction (e.g., number of involved organs, shock, vasoactive infusion, and intensive care unit admission). All patients in the MIS-C group, but none in the KDSS group, including two patients during the COVID-19 pandemic, had laboratory evidence of SARS-CoV-2 infection. MIS-C and KDSS shared demographic, clinical, and laboratory characteristics; organ dysfunction; treatment; and outcomes. Overall severity was more severe in patients with KDSS than in those with MIS-C. The most important difference between MIS-C and KDSS was whether SARS-CoV-2 was identified as an infectious trigger. Full article
(This article belongs to the Section Pediatric Infectious Diseases)
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12 pages, 553 KB  
Article
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 10 | Viewed by 2677
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 KB  
Article
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 16 | Viewed by 3931
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
17 pages, 1063 KB  
Article
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 3131
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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13 pages, 261 KB  
Article
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 3456
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)
19 pages, 497 KB  
Article
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 3397
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 KB  
Article
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 15 | Viewed by 2665
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 KB  
Article
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 8 | Viewed by 2466
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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20 pages, 357 KB  
Review
State of the Evidence for Use of Psychotropic Medications in School-Age Youth
by Jeffrey D. Shahidullah, Holly Roberts, John Parkhurst, Rachel Ballard, Jennifer A. Mautone and John S. Carlson
Children 2023, 10(9), 1454; https://doi.org/10.3390/children10091454 - 26 Aug 2023
Cited by 7 | Viewed by 5646
Abstract
Psychotropic medications are commonly prescribed to school-aged youth for the management of mental health concerns. This paper describes the current state of evidence for psychotropic medications in school-aged youth. More specifically, the following sections summarize relevant medication research trials and practice parameters pertaining [...] Read more.
Psychotropic medications are commonly prescribed to school-aged youth for the management of mental health concerns. This paper describes the current state of evidence for psychotropic medications in school-aged youth. More specifically, the following sections summarize relevant medication research trials and practice parameters pertaining to psychotropic medication prescribing as well as the specific medications indicated for a range of commonly presenting disorders and symptom clusters in school-aged youth. For each of these disorders and symptom clusters, key findings pertaining to the current state of science and practice are highlighted for the purpose of offering patients, clinicians, researchers, and policymakers with nuanced considerations for the role of psychopharmacology within the context of a larger “whole-child” approach to care that relies on the collaboration of providers and services across systems of care to promote optimal child and family health and wellness. The paper concludes with a discussion about supporting the use of medication treatments in schools, including considerations for ensuring effective family-school-health system collaboration to best meet youth mental health needs. Full article
(This article belongs to the Section Pediatric Mental Health)
30 pages, 2223 KB  
Review
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 15 | Viewed by 8174
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 KB  
Article
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 8 | Viewed by 2210
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
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21 pages, 1258 KB  
Review
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 11 | Viewed by 3952
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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19 pages, 866 KB  
Review
The Current Role of the sFlt-1/PlGF Ratio and the Uterine–Umbilical–Cerebral Doppler Ultrasound in Predicting and Monitoring Hypertensive Disorders of Pregnancy: An Update with a Review of the Literature
by Cristian Nicolae Chirilă, Claudiu Mărginean, Paula Maria Chirilă and Mirela Liana Gliga
Children 2023, 10(9), 1430; https://doi.org/10.3390/children10091430 - 22 Aug 2023
Cited by 7 | Viewed by 3739
Abstract
Regarding the hypertensive disorders of pregnancy, pre-eclampsia (PE) remains one of the leading causes of severe and life-threatening maternal and fetal complications. Screening of early-onset PE (<34 weeks of pregnancy), as well as late-onset PE (≥34 weeks), shows poor performance if based solely [...] Read more.
Regarding the hypertensive disorders of pregnancy, pre-eclampsia (PE) remains one of the leading causes of severe and life-threatening maternal and fetal complications. Screening of early-onset PE (<34 weeks of pregnancy), as well as late-onset PE (≥34 weeks), shows poor performance if based solely on clinical features. In recent years, biochemical markers from maternal blood—the pro-angiogenic protein placental growth factor (PlGF) and the antiangiogenic protein soluble FMS-like tyrosine kinase 1 (sFlt-1)—and Doppler velocimetry indices—primarily the mean uterine pulsatility index (PI), but also the uterine resistivity index (RI), the uterine systolic/diastolic ratio (S/D), uterine and umbilical peak systolic velocity (PSV), end-diastolic velocity (EDV), and uterine notching—have all shown improved screening performance. In this review, we summarize the current status of knowledge regarding the role of biochemical markers and Doppler velocimetry indices in early prediction of the onset and severity of PE and other placenta-related disorders, as well as their role in monitoring established PE and facilitating improved obstetrical surveillance of patients categorized as high-risk in order to prevent adverse outcomes. A sFlt-1/PlGF ratio ≤ 33 ruled out early-onset PE with 95% sensitivity and 94% specificity, whereas a sFlt-1/PlGF ≥88 predicted early-onset PE with 88.0% sensitivity and 99.5% specificity. Concerning the condition’s late-onset form, sFlt-1/PlGF ≤ 33 displayed 89.6% sensitivity and 73.1% specificity in ruling out the condition, whereas sFlt-1/PlGF ≥ 110 predicted the condition with 58.2% sensitivity and 95.5% specificity. The cut-off values of the sFlt-1/PlGF ratio for the screening of PE were established in the PROGNOSIS study: a sFlt-1/PlGF ratio equal to or lower than 38 ruled out the onset of PE within one week, regardless of the pregnancy’s gestational age. The negative predictive value in this study was 99.3%. In addition, sFlt-1/PlGF > 38 showed 66.2% sensitivity and 83.1% specificity in predicting the occurrence of PE within 4 weeks. Furthermore, 2018 ISUOG Practice Guidelines stated that a second-trimester mean uterine artery PI ≥ 1.44 increases the risk of later PE development. The implementation of a standard screening procedure based on the sFlt-1/PlGF ratio and uterine Doppler velocimetry may improve early detection of pre-eclampsia and other placenta-related disorders. Full article
(This article belongs to the Special Issue Recent Advances in Obstetrics and Perinatal Medicine)
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13 pages, 971 KB  
Review
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 9 | Viewed by 5308
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 KB  
Review
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 14 | Viewed by 5985
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 KB  
Review
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 5732
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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14 pages, 685 KB  
Article
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 14 | Viewed by 3234
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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11 pages, 417 KB  
Article
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 8 | Viewed by 5508
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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16 pages, 1321 KB  
Article
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 15 | Viewed by 12236
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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16 pages, 302 KB  
Article
Adolescents and Trust in Online Social Interactions: A Qualitative Exploratory Study
by Elisa Colì, Marinella Paciello, Ernestina Lamponi, Rubina Calella and Rino Falcone
Children 2023, 10(8), 1408; https://doi.org/10.3390/children10081408 - 18 Aug 2023
Cited by 8 | Viewed by 4826
Abstract
Social media have become increasingly embedded in adolescents’ daily lives. Although these contexts have been widely studied, how trust in online relationships is built among adolescents is still an unexplored issue. By adopting the theoretical socio-cognitive model of trust, this study aims to [...] Read more.
Social media have become increasingly embedded in adolescents’ daily lives. Although these contexts have been widely studied, how trust in online relationships is built among adolescents is still an unexplored issue. By adopting the theoretical socio-cognitive model of trust, this study aims to explore the components of online trust as far as today’s teenagers are concerned. The study involved 10 adolescents aged between 12 and 18 (M = 15.5). The data were collected using individual semi-structured, audio-recorded, and faithfully transcribed interviews. A deductive-inductive content analysis carried out with the NVivo10 software was performed on the textual material. Results show that adolescents seem to be aware of online trust value in “selecting” peers to be trusted. To protect themselves from the risks they are exposed to, they choose to interact with peers/friends who are already known in real life or are similar to them in terms of interests, ways of thinking, passions, and age. Additionally, others’ competencies and willingness play an important role in adolescents’ evaluations and decisions to rely on others online. The results of this study could be useful for developing awareness-raising interventions on the risks that adolescents are exposed to in order to promote “safe” relationships of trust and emphasize the possible positive use of technologies (e.g., by building online trust relationships using peer “safe” models). Full article
13 pages, 292 KB  
Review
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 11 | Viewed by 5651
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)
22 pages, 1806 KB  
Article
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 3253
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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12 pages, 308 KB  
Review
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 13 | Viewed by 5240
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 KB  
Article
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 13 | Viewed by 7951
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
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19 pages, 3055 KB  
Review
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 17 | Viewed by 4484
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 KB  
Article
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 11 | Viewed by 4942
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 KB  
Review
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 14 | Viewed by 6211
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 KB  
Review
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 33 | Viewed by 21109
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 KB  
Article
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 6014
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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11 pages, 478 KB  
Review
Treatment of High-Risk Neuroblastoma
by Julie Krystal and Jennifer H. Foster
Children 2023, 10(8), 1302; https://doi.org/10.3390/children10081302 - 28 Jul 2023
Cited by 24 | Viewed by 4239
Abstract
High-risk neuroblastoma is a highly aggressive solid tumor that most commonly presents in early childhood. Advances in treatment through decades of clinical trials and research have led to improved outcomes. This review provides an overview of the current state of treatment for high-risk [...] Read more.
High-risk neuroblastoma is a highly aggressive solid tumor that most commonly presents in early childhood. Advances in treatment through decades of clinical trials and research have led to improved outcomes. This review provides an overview of the current state of treatment for high-risk neuroblastoma. Full article
(This article belongs to the Section Pediatric Neurology & Neurodevelopmental Disorders)
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17 pages, 356 KB  
Article
Child Nutrition Outcomes and Maternal Nutrition-Related Knowledge in Rural Localities of Mbombela, South Africa
by Lucy Nomsa Masilela and Perpetua Modjadji
Children 2023, 10(8), 1294; https://doi.org/10.3390/children10081294 - 27 Jul 2023
Cited by 9 | Viewed by 4331
Abstract
Poor nutrition outcomes among children have become one of the major public health concerns in South Africa, attributed to poor feeding practices and maternal nutrition-related knowledge with conflicting data. In view of this, a cross-sectional study was conducted to determine the association of [...] Read more.
Poor nutrition outcomes among children have become one of the major public health concerns in South Africa, attributed to poor feeding practices and maternal nutrition-related knowledge with conflicting data. In view of this, a cross-sectional study was conducted to determine the association of nutrition outcomes of children aged under two years with feeding practices and maternal nutrition-related knowledge in Mbombela, South Africa. Mothers’ nutrition-related knowledge was estimated using an adapted structured questionnaire on colostrum, continued breastfeeding, diarrhea prevention and treatment using oral rehydration solution, immunization, and family planning, and scored as excellent (80–100), good (60–79), average (40–59), and fair (0–39). This was along with questions on socio-demographic factors and obstetric history, as well as anthropometric measurements. Child nutrition outcomes were estimated by WHO classification using z-scores for stunting (length-for-age (LAZ)), underweight (weight-for-age (WAZ)), and thinness (body mass index-for-age (BAZ)). Using STATA 17, 400 pairs of children (8 ± 6 months) and their mothers (29 ± 6 years) participated in the study and were living in a poor socio-economic status environment. Half of children were stunted (50%) and over half (54%) were obese, while mothers were underweight (39%) and overweight (34%). In addition to one third of mothers reporting obstetric complications, two thirds, initiated breastfeeding within one hour of delivery, 30% exclusively breastfed, 48% introduced early complementary feeding, and 70% practiced mixed feeding. Twenty-eight percent (28%) of mothers had fair nutrition-related knowledge, while 66% had average knowledge, 6% good knowledge, and none of the mothers had excellent knowledge. A chi-square test showed that mothers’ nutrition-related knowledge was significantly associated with child stunting. The final hierarchical logistic regression showed significant associations of stunting with mothers’ nutrition-related knowledge (average: AOR = 1.92, 95%CI: 1.12–3.29), child’s age (6–11 months: AOR = 2.63, 95%CI: 1.53–4.53 and 12–23 months: AOR = 3.19, 95%CI: 1.41–7.25), and education (completing Grade 12: AOR = 0.36, 95%CI: 0.15–0.86). Contextual and intensified interventions on continued education for mothers to gain accurate information on nutrition-related knowledge and feeding practices could ultimately enhance child nutrition outcomes in poorer settings. Efforts should therefore be made to ensure that nutrition knowledge is appropriately provided based on the phases of child growth from 0 to 2 years, even beyond infancy into school age. Full article
13 pages, 456 KB  
Article
Correlation of Different MRI Scoring Systems with Long-Term Cognitive Outcome in Cooled Asphyxiated Newborns
by Ok-Hap Kang, Peter Jahn, Joachim G. Eichhorn, Till Dresbach, Andreas Müller and Hemmen Sabir
Children 2023, 10(8), 1295; https://doi.org/10.3390/children10081295 - 27 Jul 2023
Cited by 9 | Viewed by 4056
Abstract
(1) Background: Cerebral MRI plays a significant role in assessing the extent of brain injury in neonates with neonatal encephalopathy after perinatal asphyxia. Over the last decades, several MRI scoring systems were developed to enhance the predictive accuracy of MRI. The aim of [...] Read more.
(1) Background: Cerebral MRI plays a significant role in assessing the extent of brain injury in neonates with neonatal encephalopathy after perinatal asphyxia. Over the last decades, several MRI scoring systems were developed to enhance the predictive accuracy of MRI. The aim of this study was to validate the correlation of four established MRI scoring systems with cognitive long-term outcomes in cooled asphyxiated newborns. (2) Methods: Forty neonates with neonatal encephalopathy treated with therapeutic hypothermia were included in this retrospective study. The MRI scans from the second week of life were scored using four existing MRI scoring systems (Barkovich, NICHD, Rutherford, and Weeke). The patients’ outcome was assessed with the Bayley Scales of Infant Development (BSID-III) at the age of 2 years. To evaluate the correlation between the MRI scoring system with the cognitive scores of BSID-III, the correlation coefficient was calculated for each scoring system. (3) Results: All four MRI scoring systems showed a significant correlation with the cognitive scores of BSID-III. The strongest correlation was found between the Weeke Score (r2 = 0.43), followed by the Rutherford score (r2 = 0.39), the NICHD score (r2 = 0.22), and the Barkovich score (r2 = 0.17). (4) Conclusion: Our study confirms previously published results in an independent cohort and indicates that the Weeke and Rutherford scores have the strongest correlation with the cognitive score of BSID-III in cooled asphyxiated newborns. Full article
(This article belongs to the Special Issue Advances in Neonatal Hypoxic–Ischemic Brain Injury)
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16 pages, 1113 KB  
Review
Ultrasound Elastography in Children
by Mirjam Močnik and Nataša Marčun Varda
Children 2023, 10(8), 1296; https://doi.org/10.3390/children10081296 - 27 Jul 2023
Cited by 10 | Viewed by 3497
Abstract
Ultrasound elastography is a novel ultrasound technique, being extensively researched in children in the last decade. It measures tissue elasticity with the observation of tissue response after an external stimulus. From research to clinical practice, ultrasound elastography has evolved significantly in liver fibrosis [...] Read more.
Ultrasound elastography is a novel ultrasound technique, being extensively researched in children in the last decade. It measures tissue elasticity with the observation of tissue response after an external stimulus. From research to clinical practice, ultrasound elastography has evolved significantly in liver fibrosis evaluation in children; however, several other applications of the technique are available in both clinical practice and research environments. Practically, in children any organ can be assessed, including the brain in early ages, along with muscle and connective tissue elasticity evaluation, spleen, kidney, skin, lymphatic tissue, etc. The elastography method, age, body mass index and technical points should be considered when performing ultrasound elastography. This review highlights its vast potential as a diagnostic tool in the pediatric population, where ultrasound is a dominant imaging tool; however, the indications and exam protocol for its clinical use in several fields in pediatrics have yet to be elucidated. Full article
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28 pages, 4556 KB  
Article
The Role of Working Memory in Early Literacy and Numeracy Skills in Kindergarten and First Grade
by Marina Shvartsman and Shelley Shaul
Children 2023, 10(8), 1285; https://doi.org/10.3390/children10081285 - 26 Jul 2023
Cited by 8 | Viewed by 3733
Abstract
The working memory system supports learning processes such as acquiring new information and the development of new skills. Working memory has been found to be related to both early literacy and early numeracy in kindergarten and to linguistic and mathematical academic skills at [...] Read more.
The working memory system supports learning processes such as acquiring new information and the development of new skills. Working memory has been found to be related to both early literacy and early numeracy in kindergarten and to linguistic and mathematical academic skills at older ages, but the contribution of each of the memory components at these ages is not yet clear. The purpose of this study is to examine the unique connections among the various systems of WM, early literacy, and early numeracy using various assessment tests of simple WM and complex WM, as well as a variety of tasks in math and language skills administered to the same 250 children in kindergarten and 150 children in first grade. Consistent with the predictions, significant relations among all components of memory and mathematics and language knowledge at both ages were found, although these connections were differential for the different types of tasks and memory systems. The connection of complex WM was stronger in its contribution and more significant in first grade in both mathematics and language domains. Complex WM resources were more important in early literacy at kindergarten age, while simple WM seems to be important in early numeracy. The theoretical and educational implications of these results are discussed accordingly. Full article
(This article belongs to the Section Pediatric Neurology & Neurodevelopmental Disorders)
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12 pages, 592 KB  
Article
Psychological Well-Being and Mental Health in Youth: Technical Adequacy of the Comprehensive Inventory of Thriving
by Gökmen Arslan
Children 2023, 10(7), 1269; https://doi.org/10.3390/children10071269 - 23 Jul 2023
Cited by 13 | Viewed by 9664
Abstract
Well-being is a crucial construct in young people’s lives that directly affects their overall quality of life, academic performance, and social relationships. Although there is an emphasis on the significance of positive psychological states in mental health, few have focused on positive states, [...] Read more.
Well-being is a crucial construct in young people’s lives that directly affects their overall quality of life, academic performance, and social relationships. Although there is an emphasis on the significance of positive psychological states in mental health, few have focused on positive states, and psychological well-being is often conceptualized using negative indicators of mental health. The present study aims to fill the gap in the literature by testing the reliability and validity of the Turkish version of the Comprehensive Inventory of Thriving for Youth (CIT-Y) and exploring the relationship between psychological well-being and mental health problems among Turkish young people. The study involved 459 youths from a state elementary school in a city in Türkiye, with 48.8% (224 females and 235 males) of them being female and aged between 11 and 15 years (M = 12.85, SD = 0.73). Findings from the study suggest that the CIT-Y is a reliable and valid measure for assessing psychological well-being in Turkish young people. Additionally, the results show that young people with internalizing and externalizing problems report fewer positive psychological states compared to those without such problems. This emphasizes the significance of well-being domains, including loneliness and respect, in comprehending mental health issues among young people. These findings can aid mental health providers in designing interventions to enhance the psychosocial adjustment of students by providing resources to cultivate mental health and well-being. Full article
(This article belongs to the Section Pediatric Mental Health)
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17 pages, 1829 KB  
Review
Comparison of Different Types of Palatal Expanders: Scoping Review
by Angelo Michele Inchingolo, Assunta Patano, Matteo De Santis, Gaetano Del Vecchio, Laura Ferrante, Roberta Morolla, Carmela Pezzolla, Roberta Sardano, Leonardo Dongiovanni, Francesco Inchingolo, Ioana Roxana Bordea, Andrea Palermo, Alessio Danilo Inchingolo and Gianna Dipalma
Children 2023, 10(7), 1258; https://doi.org/10.3390/children10071258 - 21 Jul 2023
Cited by 22 | Viewed by 6459
Abstract
Maxillary bone contraction is caused by genetics or ambiental factors and is often accompanied by dental crowding, with the possibility of canine inclusion, crossbite, class II and III malocclusion, temporomandibular joint disorder, and obstructive sleep apnea (OSAS). Transverse maxillary deficits, in which the [...] Read more.
Maxillary bone contraction is caused by genetics or ambiental factors and is often accompanied by dental crowding, with the possibility of canine inclusion, crossbite, class II and III malocclusion, temporomandibular joint disorder, and obstructive sleep apnea (OSAS). Transverse maxillary deficits, in which the maxillary growth is unusually modest, are frequently treated with maxillary expansion. The purpose of this study is to compare the dental and skeletal effects of different types of expanders, particularly the Leaf Expander, rapid and slow dental-anchored or skeletal-anchored maxillary expanders. Methods: We chose studies that compared effects determined by palatal expansion using a rapid palatal expander, expander on palatal screws, and leaf expander. Results: Reports assessed for eligibility are 26 and the reports excluded were 11. A final number of 15 studies were included in the review for qualitative analysis. Conclusions: Clinically and radiographically, the outcomes are similar to those obtained with RME and SME appliances; Therefore, it might be a useful treatment choice as an alternative to RME/SME equipment in cases of poor patient compliance or specific situations. Finally, all of the devices studied produce meaningful skeletal growth of the palate. The use of skeletally anchored devices does, without a doubt, promote larger and more successful growth in adolescent patients. Full article
(This article belongs to the Section Pediatric Dentistry & Oral Medicine)
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12 pages, 288 KB  
Article
The Efficacy of the Global Intensive Feeding Therapy on Feeding and Swallowing Abilities in Children with Autism Spectrum Disorder: A Pilot Study
by Antonella Cerchiari, Carolina Giordani, Silvia Franceschetti, Serena Mazzafoglia, Flavia Carosi, Francesca Pizza, Gessica Della Bella, Massimiliano Raponi and Marco Tofani
Children 2023, 10(7), 1241; https://doi.org/10.3390/children10071241 - 19 Jul 2023
Cited by 9 | Viewed by 3826
Abstract
The present investigation aims to explore the efficacy of Global Intensive Feeding Therapy (GIFT) on feeding and swallowing abilities in children with autism spectrum disorder (ASD). GIFT was developed as an intensive rehabilitation approach, divided into 30 sessions for 2 weeks, three times [...] Read more.
The present investigation aims to explore the efficacy of Global Intensive Feeding Therapy (GIFT) on feeding and swallowing abilities in children with autism spectrum disorder (ASD). GIFT was developed as an intensive rehabilitation approach, divided into 30 sessions for 2 weeks, three times a day. GIFT focused on (a) encouraging desensitization; (b) widening the food repertoire (in terms of both variety and quantity); (c) reducing inappropriate mealtime behaviors; and (d) encouraging the development of appropriate chewing and swallowing abilities. GIFT was preliminarily implemented among 11 children with a diagnosis of ASD. To measure the efficacy of GIFT, the Karaduman Chewing Performance Scale (KCPS), the Brief Autism Mealtime Behavior Inventory (BAMBI), and food repertoire were investigated using Wilcoxon signed-rank test in three different times: baseline (T1), after treatment (T2), and one month after treatment (T3). Using Bonferroni correction, statistically significant differences were found between T1 and T2 for behavioral issues, as measured with BAMBI (p = 0.007), as well as for chewing abilities as measured with KCPS (p = 0.005) and for food acceptance (p = 0.005). These improvements were maintained after a month of follow-up, thanks to the collaboration of families and/or primary caregivers. In conclusion, GIFT seems to be an effective approach to improving behavioral issues, food acceptance, and chewing abilities in children with ASD. Full article
(This article belongs to the Section Pediatric Mental Health)
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