Children

13 pages, 445 KB

Open AccessEditor’s ChoiceReview

Role of Valganciclovir in Children with Congenital CMV Infection: A Review of the Literature

by Davide Pata, Danilo Buonsenso, Arianna Turriziani-Colonna, Gilda Salerno, Lucia Scarlato, Lara Colussi, Rolando Ulloa-Gutierrez and Piero Valentini

Children 2023, 10(7), 1246; https://doi.org/10.3390/children10071246 - 19 Jul 2023

Cited by 11 | Viewed by 5026

Abstract

Background: Cytomegalovirus (CMV) is the most common agent of congenital infection in humans. It is a main cause of neurodevelopmental delay and sensorineural hearing loss in infancy. Since the 2000s, a number of studies have used Valganciclovir as a therapy for children with [...] Read more.

Background: Cytomegalovirus (CMV) is the most common agent of congenital infection in humans. It is a main cause of neurodevelopmental delay and sensorineural hearing loss in infancy. Since the 2000s, a number of studies have used Valganciclovir as a therapy for children with congenital CMV infection. Methods: In order to evaluate the efficacy of Valganciclovir in preventing clinical sequelae and its possible side effects, we performed a review of the published literature. This search was completed via PubMed for manuscripts published from January 2007 to December 2021, combining the MeSH words “Valganciclovir”, “Congenital”, and “Cytomegalovirus”. Results: A total of 27 articles were included (12 retrospective studies, 4 prospective studies, 1 randomized controlled trial, and 10 case reports). The clinical features were similar to those already described in the literature. The therapeutic protocols used were very different between the various studies included and neonatal antiviral treatments were only moderately effective. The therapy proved to be well-tolerated. Conclusions: The quality of the included studies and the sample size were limited due to the rarity of the disease. The use of different therapeutic protocols in terms of starting dates, doses, and durations made it impossible to compare and correctly evaluate the efficacy of the treatments. Randomized controlled trials are needed to establish the correct effective dose with the fewest side effects and the most efficient duration of therapy. Full article

(This article belongs to the Section Pediatric Infectious Diseases)

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16 pages, 813 KB

Open AccessEditor’s ChoiceReview

Lifestyle and Pharmacological Interventions and Treatment Indications for the Management of Obesity in Children and Adolescents

by Despina Herouvi, George Paltoglou, Alexandra Soldatou, Christina Kalpia, Spyridon Karanasios and Kyriaki Karavanaki

Children 2023, 10(7), 1230; https://doi.org/10.3390/children10071230 - 17 Jul 2023

Cited by 12 | Viewed by 6731

Abstract

Obesity is a multifactorial chronic impairment that further decreases quality of life and life expectancy. Worldwide, childhood obesity has become a pandemic health issue causing several comorbidities that frequently present already in childhood, including cardiovascular (hypertension, dyslipidemia), metabolic (Type 2 diabetes mellitus, fatty [...] Read more.

Obesity is a multifactorial chronic impairment that further decreases quality of life and life expectancy. Worldwide, childhood obesity has become a pandemic health issue causing several comorbidities that frequently present already in childhood, including cardiovascular (hypertension, dyslipidemia), metabolic (Type 2 diabetes mellitus, fatty liver disease, metabolic syndrome), respiratory, gastrointestinal and musculoskeletal disorders. In addition, obese children frequently experience stress and psychosocial symptoms, including mood disorders, anxiety, prejudice and low self-esteem. Given that cardiovascular risk factors and pediatric obesity have the tendency to pertain into adulthood, obesity management, including weight control and physical activity, should start before the late teens and certainly before the first signs of atherosclerosis can be detected. This review aims to concisely present options for childhood obesity management, including lifestyle modification strategies and pharmacological treatment, as well as the respective treatment indications for the general practitioner. Full article

(This article belongs to the Special Issue Current Advances and Perspectives in Clinical Paediatric Endocrinology, Diabetes and Metabolism Research)

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17 pages, 780 KB

Open AccessEditor’s ChoiceReview

Impact of Chemicals on the Age of Menarche: A Literature Review

by Xristos Anastasiadis, Alkis Matsas, Theodoros Panoskaltsis, Panagiotis Bakas, Dimitrios T. Papadimitriou and Panagiotis Christopoulos

Children 2023, 10(7), 1234; https://doi.org/10.3390/children10071234 - 17 Jul 2023

Cited by 7 | Viewed by 5161

Abstract

A growing body of evidence suggests that chemicals interfere with the age of onset of menarche. We conducted a review in order to demonstrate the relationship between several categories of chemicals and menarche. We searched for English language papers using the Medline/PubMed database [...] Read more.

A growing body of evidence suggests that chemicals interfere with the age of onset of menarche. We conducted a review in order to demonstrate the relationship between several categories of chemicals and menarche. We searched for English language papers using the Medline/PubMed database until April 2023. The chemical factors found to affect menarche were prenatal and antenatal smoke, phthalates, phenols, organochlorines, perfluoroalkyls and polyfluoroalkyls, metals, air pollutants and polybrominated diphenyl ethers. Low or high exposure to each chemical compound could affect the age of menarche, leading to early or delayed menarche. Furthermore, the results show that intrauterine exposure may have a different impact from antenatal exposure. There is evidence that endocrine-disrupting chemicals affect the age of menarche, but more research needs to be conducted. Full article

(This article belongs to the Special Issue New Trends in Adolescent Health and Development)

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10 pages, 2601 KB

Open AccessEditor’s ChoiceArticle

Comparative Analysis of Skeletal Changes, Occlusal Changes, and Palatal Morphology in Children with Mild Class III Malocclusion Treated with Elastodontic Appliances and Bimaxillary Plates

by Vincenzo Ronsivalle, Vincenzo Quinzi, Salvatore La Rosa, Rosalia Leonardi and Antonino Lo Giudice

Children 2023, 10(7), 1219; https://doi.org/10.3390/children10071219 - 14 Jul 2023

Cited by 8 | Viewed by 2910

Abstract

Background: The aim of the present study was to compare the changes observed in children after the early treatment of mild class III malocclusion using bimaxillary removable plates supported by class III elastics and elastodontic devices. Methods: Twenty children (mean age 7.6 ± [...] Read more.

Background: The aim of the present study was to compare the changes observed in children after the early treatment of mild class III malocclusion using bimaxillary removable plates supported by class III elastics and elastodontic devices. Methods: Twenty children (mean age 7.6 ± 1.1 years) with signs of class III malocclusion were treated using by-maxillary plates (PG group) with class III elastics (10 subjects = mean age 7.9 ± 1.3 years) or using class III elastodontic devices (EG group) (10 subjects = mean age 7.4 ± 0.8 years). Digital models and lateral cephalograms were obtained before treatment (T0) and at the end of treatment (T1). The digital models were analyzed to assess occlusal changes and maxillary morphology using the surface-to-surface matching technique. Changes in cephalometric parameters were also analyzed. The data outcomes were statistically analyzed using the paired Student’s t test for inter-timing assessments and the independent Student’s t test for inter-group assessments. Results: Both groups showed correction of class III malocclusions, with a significant increase in the ANB angle and the overjet (p < 0.05). Subjects in the PG group exhibited a greater reduction in the inter-incisal angle compared to the EG group (p < 0.05). The children in the EG group had a significantly lower percentage of palatal morphology matching between T0 and T1 compared to the PG group (p < 0.05), suggesting greater morphological changes in the palate. Conclusions: Elastodontic appliances (EAs) and bi-maxillary plates successfully correct class III malocclusions in children. However, elastodontic devices significantly improved the morphology of the palate, both in the transverse and anteroposterior directions. Full article

(This article belongs to the Special Issue New Clinical Evidences in Pediatric Orthodontics and Pediatric Dentistry)

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22 pages, 307 KB

Open AccessEditor’s ChoiceReview

Diagnosis and Management of Neonatal Hypoglycemia: A Comprehensive Review of Guidelines

by Sonia Giouleka, Maria Gkiouleka, Ioannis Tsakiridis, Anastasia Daniilidou, Apostolos Mamopoulos, Apostolos Athanasiadis and Themistoklis Dagklis

Children 2023, 10(7), 1220; https://doi.org/10.3390/children10071220 - 14 Jul 2023

Cited by 16 | Viewed by 18169

Abstract

Hypoglycemia represents one of the most frequent metabolic disturbances of the neonate, associated with increased morbidity and mortality, especially if left untreated or diagnosed after the establishment of brain damage. The aim of this study was to review and compare the recommendations from [...] Read more.

Hypoglycemia represents one of the most frequent metabolic disturbances of the neonate, associated with increased morbidity and mortality, especially if left untreated or diagnosed after the establishment of brain damage. The aim of this study was to review and compare the recommendations from the most recently published influential guidelines on the diagnosis, screening, prevention and management of this common neonatal complication. Therefore, a descriptive review of the guidelines from the American Academy of Pediatrics (AAP), the British Association of Perinatal Medicine (BAPM), the European Foundation for the Care of the Newborn Infants (EFCNI), the Queensland Clinical Guidelines-Australia (AUS), the Canadian Pediatric Society (CPS) and the Pediatric Endocrine Society (PES) on neonatal hypoglycemia was carried out. There is a consensus among the reviewed guidelines on the risk factors, the clinical signs and symptoms of NH, and the main preventive strategies. Additionally, the importance of early recognition of at-risk infants, timely identification of NH and prompt initiation of treatment in optimizing the outcomes of hypoglycemic neonates are universally highlighted. All medical societies, except PES, recommend screening for NH in asymptomatic high-risk and symptomatic newborn infants, but they do not provide consistent screening approaches. Moreover, the reviewed guidelines point out that the diagnosis of NH should be confirmed by laboratory methods of BGL measurement, although treatment should not be delayed until the results become available. The definition of NH lacks uniformity and it is generally agreed that a single BG value cannot accurately define this clinical entity. Therefore, all medical societies support the use of operational thresholds for the management of NH, although discrepancies exist regarding the recommended cut-off values, the optimal treatment and surveillance strategies of both symptomatic and asymptomatic hypoglycemic neonates as well as the treatment targets. Over the past several decades, ΝH has remained an issue of keen debate as it is a preventable cause of brain injury and neurodevelopmental impairment; however, there is no clear definition or consistent treatment policies. Thus, the establishment of specific diagnostic criteria and uniform protocols for the management of this common biochemical disorder is of paramount importance as it will hopefully allow for the early identification of infants at risk, the establishment of efficient preventive measures, the optimal treatment in the first hours of a neonate’s life and, subsequently, the improvement of neonatal outcomes. Full article

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

13 pages, 925 KB

Open AccessEditor’s ChoiceArticle

Symptom Profiles of Children and Young People 12 Months after SARS-CoV-2 Testing: A National Matched Cohort Study (The CLoCk Study)

by Snehal M. Pinto Pereira, Manjula D. Nugawela, Kelsey McOwat, Emma Dalrymple, Laila Xu, Shamez N. Ladhani, Ruth Simmons, Trudie Chalder, Olivia Swann, Tamsin Ford, Isobel Heyman, Terry Segal, Malcolm G. Semple, Natalia K. Rojas, CLoCk Consortium, Roz Shafran and Terence Stephenson

Children 2023, 10(7), 1227; https://doi.org/10.3390/children10071227 - 14 Jul 2023

Cited by 14 | Viewed by 2886

Abstract

Background: Although 99% of children and young people have been exposed to SARS-CoV-2, the long-term prevalence of post-COVID-19 symptoms in young people is unclear. The aim of this study is to describe symptom profiles 12 months after SARS-CoV-2 testing. Method: A matched cohort [...] Read more.

Background: Although 99% of children and young people have been exposed to SARS-CoV-2, the long-term prevalence of post-COVID-19 symptoms in young people is unclear. The aim of this study is to describe symptom profiles 12 months after SARS-CoV-2 testing. Method: A matched cohort study of a national sample of 20,202 children and young people who took a SARS-CoV-2 PCR test between September 2020 and March 2021. Results: 12 months post-index-test, there was a difference in the number of symptoms reported by initial negatives who never tested positive (NN) compared to the other three groups who had at least one positive test (p < 0.001). Similarly, 10.2% of the NN group described five-plus symptoms at 12 months compared to 15.9–24.0% in the other three groups who had at least one positive test. The most common symptoms were tiredness, sleeping difficulties, shortness of breath, and headaches for all four groups. For all these symptoms, the initial test positives with subsequent reports of re-infection had higher prevalences than other positive groups (p < 0.001). Symptom profiles, mental health, well-being, fatigue, and quality of life did not vary by vaccination status. Conclusions: Following the pandemic, many young people, particularly those that have had multiple SARS-CoV-2 positive tests, experience a range of symptoms that warrant consideration and potential investigation and intervention. Full article

(This article belongs to the Section Pediatric Infectious Diseases)

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11 pages, 2022 KB

Open AccessEditor’s ChoiceReview

Pain Evaluation and Treatment in Children: A Practical Approach

by Lorenzo Sansone, Cristina Gentile, Eleonora Agata Grasso, Armando Di Ludovico, Saverio La Bella, Francesco Chiarelli and Luciana Breda

Children 2023, 10(7), 1212; https://doi.org/10.3390/children10071212 - 13 Jul 2023

Cited by 29 | Viewed by 9753

Abstract

Pain is the most common complaint reported by children who access the emergency departments, but despite its frequency and the availability of many international guidelines, it often remains underreported and undertreated. Recently, the American Academy of Pediatrics and the American Pain Society have [...] Read more.

Pain is the most common complaint reported by children who access the emergency departments, but despite its frequency and the availability of many international guidelines, it often remains underreported and undertreated. Recently, the American Academy of Pediatrics and the American Pain Society have reiterated the importance of a multidisciplinary approach in order to eliminate pain in children. In all pediatric settings, an adequate assessment is the initial stage in a proper clinical approach to pain, especially in the emergency departments; therefore, an increasing number of age-related tools have been validated. A wide range of analgesic agents are currently available for pain management, and they should be tailored according to the patient’s age, the drug’s pharmacokinetics and the intensity of pain. In order to facilitate the choice of the appropriate drug, a treatment algorithm based on a ladder approach can be used. Moreover, non-pharmacological techniques should be considered to alleviate anxiety and distress in pediatric age. This review aims to offer a simple but intuitive description of the best strategies for pain relief in children, starting with the prompt recognition and quantification of pain through adequate assessment scales, and following with the identification of the most appropriate therapeutic choice among the ones available for pediatric age. Full article

(This article belongs to the Special Issue Pain and Therapeutic Interventions in Children)

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26 pages, 1040 KB

Open AccessEditor’s ChoiceReview

Narrative Review of the Complex Interaction between Pain and Trauma in Children: A Focus on Biological Memory, Preclinical Data, and Epigenetic Processes

by Veronica Rivi, Giovanna Rigillo, Ylenia Toscano, Cristina Benatti and Johanna Maria Catharina Blom

Children 2023, 10(7), 1217; https://doi.org/10.3390/children10071217 - 13 Jul 2023

Cited by 10 | Viewed by 7593

Abstract

The incidence and collective impact of early adverse experiences, trauma, and pain continue to increase. This underscores the urgent need for translational efforts between clinical and preclinical research to better understand the underlying mechanisms and develop effective therapeutic approaches. As our understanding of [...] Read more.

The incidence and collective impact of early adverse experiences, trauma, and pain continue to increase. This underscores the urgent need for translational efforts between clinical and preclinical research to better understand the underlying mechanisms and develop effective therapeutic approaches. As our understanding of these issues improves from studies in children and adolescents, we can create more precise preclinical models and ultimately translate our findings back to clinical practice. A multidisciplinary approach is essential for addressing the complex and wide-ranging effects of these experiences on individuals and society. This narrative review aims to (1) define pain and trauma experiences in childhood and adolescents, (2) discuss the relationship between pain and trauma, (3) consider the role of biological memory, (4) decipher the relationship between pain and trauma using preclinical data, and (5) examine the role of the environment by introducing the importance of epigenetic processes. The ultimate scope is to better understand the wide-ranging effects of trauma, abuse, and chronic pain on children and adolescents, how they occur, and how to prevent or mitigate their effects and develop effective treatment strategies that address both the underlying causes and the associated physiological and psychological effects. Full article

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

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13 pages, 776 KB

Open AccessEditor’s ChoiceReview

An Insight into Indonesia’s Challenges in Implementing Newborn Screening Programs and Their Future Implications

by Gilbert Sterling Octavius, Vamela Adman Daleni and Yulita Delfia Sari Sagala

Children 2023, 10(7), 1216; https://doi.org/10.3390/children10071216 - 13 Jul 2023

Cited by 9 | Viewed by 2893

Abstract

Due to high entry barriers, countries might find it daunting to implement the NBS program, especially those just trying to start it. This review aims to discuss Indonesia’s barriers that hinder newborn screening (NBS) implementation while discussing the future implications. Literature in Pubmed [...] Read more.

Due to high entry barriers, countries might find it daunting to implement the NBS program, especially those just trying to start it. This review aims to discuss Indonesia’s barriers that hinder newborn screening (NBS) implementation while discussing the future implications. Literature in Pubmed and Google Scholar was scoured with keywords such as “Newborn Screening”, “Neonatal Screening”, “Indonesia”, “Asia Pacific”, “Barriers”, and “Challenges”. We also searched for relevant references in those published articles. Grey literature, such as state regulations, informative webinars on the topics by experts regarding current situations, and press releases by the Indonesian Minister of Health (MoH), was also searched. Newborn screening is no longer considered just a laboratory test but an array of well-harmonized systems that must be orchestrated well. Some of the barriers Indonesia faces in implementing NBS are a lack of prevalence data, ethical issues, infrastructure, cost-benefit analysis, logistical issues, government support, patient issues, a lack of commitments, and a lack of healthcare workers, specialization, and training. Government support with professional advocates and support groups, proper infrastructure, and a single-payer system for NBS programs are necessary to accelerate NBS programs in Indonesia. Full article

(This article belongs to the Special Issue Current Challenges and Advances in Newborn Screening)

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11 pages, 560 KB

Open AccessEditor’s ChoiceArticle

The Association between Internalizing Symptoms and Witnessing School Bullying and Defending Behavior: An Analysis of Gender Differences among Elementary and Middle School Students

by Diana M. Doumas, Aida Midgett and Matt Peck

Children 2023, 10(7), 1199; https://doi.org/10.3390/children10071199 - 11 Jul 2023

Cited by 7 | Viewed by 2623

Abstract

Bullying is a significant public health concern that begins as early as elementary school and peaks in middle school. Although researchers have demonstrated the relationship between internalizing symptoms and being a target of bullying, there is limited research examining the association between internalizing [...] Read more.

Bullying is a significant public health concern that begins as early as elementary school and peaks in middle school. Although researchers have demonstrated the relationship between internalizing symptoms and being a target of bullying, there is limited research examining the association between internalizing symptoms and witnessing school bullying and defending targets or gender differences in these relationships. In this cross-sectional study, we examined gender as a moderator of the relationships between internalizing symptoms (e.g., depressive symptoms and social anxiety) and witnessing school bullying and defending behavior in a sample of elementary and middle school students (N = 126; 51.6% female; 3rd–8th grade). Results demonstrated that witnessing school bullying was a significant predictor of depressive symptoms. For social anxiety, the gender x witnessing school bullying interaction was significant for social avoidance and distress (SAD), such that among female students, SAD was positively related to witnessing school bullying. In contrast, the gender x defending behavior interaction was significant for fear of negative evaluation (FNE), such that among male students, FNE was positively related to defending behavior. Findings suggest bullying prevention should incorporate bystander training programs that include a focus on gender differences in social anxiety associated with being a bullying bystander. Full article

(This article belongs to the Special Issue School Bullying during Childhood and Adolescence)

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13 pages, 2606 KB

Open AccessEditor’s ChoiceArticle

Brief Autism Mealtime Behavior Inventory (BAMBI): Italian Translation and Validation

by Antonella Lamboglia, Roberta Romano, Donatella Valente, Anna Berardi, Gioia Cavalli, Federica Giovannone, Carla Sogos, Marco Tofani and Giovanni Galeoto

Children 2023, 10(7), 1201; https://doi.org/10.3390/children10071201 - 11 Jul 2023

Cited by 12 | Viewed by 6673

Abstract

Food selectivity is among the most common problems for children with Autism Spectrum Disorder (ASD). The present study aims to validate the Brief Autism Mealtime Behavior Inventory (BAMBI) in an Italian population of children with ASD. BAMBI was translated and cross-culturally adapted following [...] Read more.

Food selectivity is among the most common problems for children with Autism Spectrum Disorder (ASD). The present study aims to validate the Brief Autism Mealtime Behavior Inventory (BAMBI) in an Italian population of children with ASD. BAMBI was translated and cross-culturally adapted following international guidelines, then we investigated internal consistency as measured by Cronbach’s alpha and test–retest reliability, as measured by the Intraclass Correlation Coefficient (ICC) in a sample of both children with ASD and with typical development (TD). A total of 131 children were recruited in a clinical and community sample. Internal consistency revealed significant data for both TD and ASD children, with a Cronbach’s Alpha of 0.86 and 0.71, respectively. Test–retest reliability showed excellent values for each item of the BAMBI (range 0.83–1.00). Furthermore, we investigated differences in gender and body max index; however, no significant differences were found among groups. In conclusion, the Italian version of the BAMBI showed good internal consistency and test–retest reliability and it can be used for clinical and research purposes. Full article

(This article belongs to the Special Issue Updates on Perinatal Depression and Child Developmental Disorders)

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12 pages, 797 KB

Open AccessEditor’s ChoiceArticle

Influence of Family Social Support and Diabetes Self-Efficacy on the Emotional Wellbeing of Children and Adolescents with Type 1 Diabetes: A Longitudinal Study

by Joaquín Villaécija, Bárbara Luque, Rosario Castillo-Mayén, Naima Z. Farhane-Medina and Carmen Tabernero

Children 2023, 10(7), 1196; https://doi.org/10.3390/children10071196 - 10 Jul 2023

Cited by 13 | Viewed by 3917

Abstract

Type 1 diabetes (T1D) is a chronic disease that is usually diagnosed in childhood, underscoring the importance of early disease control for overall wellbeing. Our aim was to design an explanatory model of subjective emotional wellbeing in children and adolescents with T1D. A [...] Read more.

Type 1 diabetes (T1D) is a chronic disease that is usually diagnosed in childhood, underscoring the importance of early disease control for overall wellbeing. Our aim was to design an explanatory model of subjective emotional wellbeing in children and adolescents with T1D. A longitudinal study was conducted at the Reina Sofia University Hospital in Cordoba (Spain). A total of 151 patients (mean age = 14.50, SD = 2.67; 41.1% girls) participated at T1, while 97 participated at T2 (mean age = 14.93, SD = 2.56; 39.2% girls). Participants completed a self-report questionnaire. Descriptive, reliability, correlation, path, and mediation analyses were performed. The explanatory model showed excellent fit indices [χ² (10) = 8.62, p = 0.57, RMSEA = 0.00, 95% [0.00, 0.10], CFI = 1.00, GFI = 0.98, AGFI = 0.93, and TLI = 1.01]. The results showed significant and positive relationships between family social support and subjective emotional wellbeing and improved self-care skills. Self-efficacy presented a mediating role between family social support and subjective emotional wellbeing. Given that self-efficacy is a self-regulatory mechanism and a determinant of health, it is argued that future psychoeducational interventions could aim to improve self-efficacy to manage chronic diseases, to achieve greater emotional wellbeing in children and adolescents with T1D. Full article

(This article belongs to the Special Issue 10th Anniversary of Children: Urgent Issues in the Health of Children – 2023–2033)

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15 pages, 3318 KB

Open AccessEditor’s ChoiceArticle

Behavioral and Sleep Disorders in Children and Adolescents following COVID-19 Disease: A Case-Control Study

by Michele Miraglia del Giudice, Angela Klain, Giulio Dinardo, Elisabetta D’Addio, Chiara Lucia Bencivenga, Cristina Fontanella, Fabio Decimo, Giuseppina Rosaria Umano, Margherita Siciliano, Marco Carotenuto and Cristiana Indolfi

Children 2023, 10(7), 1189; https://doi.org/10.3390/children10071189 - 10 Jul 2023

Cited by 7 | Viewed by 2824

Abstract

Introduction: Recent studies show that neuropsychiatric disorders are the most frequent sequelae of COVID-19 in children. Purpose: Our work aimed to evaluate the impact of SARS-CoV-2 infection on behavior and sleep in children and adolescents. Materials and Methods: We enrolled 107 patients aged [...] Read more.

Introduction: Recent studies show that neuropsychiatric disorders are the most frequent sequelae of COVID-19 in children. Purpose: Our work aimed to evaluate the impact of SARS-CoV-2 infection on behavior and sleep in children and adolescents. Materials and Methods: We enrolled 107 patients aged 1.5–18 years who contracted COVID-19 between one year and one month prior to data collection, referred to the University of Campania Luigi Vanvitelli in Italy. We asked their parents to complete two standardized questionnaires for the assessment of behavior (Child Behavior CheckList (CBCL)) and sleep (Sleep Disturbance Scale for Children (SLDS)). We analysed and compared the results with a control group (pre-COVID-19 pandemic). Results: In the COVID-19 group, the major results were found for sleep breathing disorders, sleep–wake transition disorders and disorders of initiating and maintaining sleep for the SDSC questionnaire, and internalizing scale, total scale and anxiety/depression for the CBCL questionnaire. The comparison of the CBCL results of the cases with the controls revealed statistically significant differences for the following items: internalizing scale, externalizing scale, somatic complaints, total score, thought problems [(p < 0.01)], anxious/depressed problems and withdrawn [(p < 0.001)]. Conclusions: COVID-19 has impacted children’s and adolescents’ mental health. Adolescents were the most affected patient group for internalizing problems, including anxiety and depression. Full article

(This article belongs to the Special Issue The Effect of COVID-19 on Youth Mental Health)

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12 pages, 310 KB

Open AccessEditor’s ChoiceArticle

Adolescent Life Satisfaction: Association with Psychological, School-Related, Religious and Socially Supportive Factors

by Bettina F. Piko

Children 2023, 10(7), 1176; https://doi.org/10.3390/children10071176 - 7 Jul 2023

Cited by 16 | Viewed by 4986

Abstract

Adolescent life satisfaction is crucial to later adult health and well-being; therefore, searching for its correlates should receive priority in research. The aim of this study was to explore the role of psychological (depression, future orientation), school-related (school achievement, satisfaction with school), religious [...] Read more.

Adolescent life satisfaction is crucial to later adult health and well-being; therefore, searching for its correlates should receive priority in research. The aim of this study was to explore the role of psychological (depression, future orientation), school-related (school achievement, satisfaction with school), religious (going to church, importance of religion), socially supportive (family and friend support), other familial, and sociodemographic (age, sex, self-assessed socioeconomic status) factors in adolescent life satisfaction. This cross-sectional survey (entitled Szeged Youth Study 2022) involved a sample of middle and high school students (N = 2239, aged 11–18 years, 51.8% females) from public schools in Szeged, Hungary. Besides descriptive statistics, correlation and multiple regression analysis were applied to the data analyses. Boys scored higher on the life satisfaction scale (Satisfaction with Life Scale, SWLS), while the level of depression (Children’s Depression Inventory, CDI) was higher among girls. In the final regression model, family support was the strongest predictor of life satisfaction (β = 0.44, p < 0.001), followed by depression (as a negative contributor), socioeconomic (SES) self-assessment, future orientation, satisfaction with school, going to church, and friend support. School prevention programs should be focused not only on preventing mental health difficulties but also promoting adolescent well-being. Full article

(This article belongs to the Section Pediatric Mental Health)

13 pages, 316 KB

Open AccessEditor’s ChoiceArticle

Long- and Short-Term High-Intensity Interval Training on Lipid Profile and Cardiovascular Disorders in Obese Male Adolescents

by Ghazi Racil, Mohamed-Souhaiel Chelly, Jeremy Coquart, Johnny Padulo, Dragos Florin Teodor and Luca Russo

Children 2023, 10(7), 1180; https://doi.org/10.3390/children10071180 - 7 Jul 2023

Cited by 9 | Viewed by 3073

Abstract

This study investigated the effects of short-term and long-term periods (8 and 16 weeks) of high-intensity interval training (HIIT) on cardiovascular components, blood lipids, and 6-min walking test performance in obese young boys (age = 16.2 ± 0.7) with >34% body fat. The [...] Read more.

This study investigated the effects of short-term and long-term periods (8 and 16 weeks) of high-intensity interval training (HIIT) on cardiovascular components, blood lipids, and 6-min walking test performance in obese young boys (age = 16.2 ± 0.7) with >34% body fat. The participants were split into two groups: severe obesity (SOG; n = 17) and moderate obesity (MOG; n = 16). All participants performed on a cycle ergometer for 16 weeks (3 times per week) of HIIT at 100% peak power output at the ventilatory threshold and recovered at 50% of peak power. Except for BMI, both groups improved all body composition measures after 16 weeks, with a higher percentage of change (Δ) in SOG. The 6-min walking test increased in both groups (p < 0.001). Furthermore, cardiovascular variables, blood lactate concentration at rest and after 5-min post-exercise, blood lipids, and insulin concentrations improved significantly in both groups. After 16 weeks, MOG significantly improved in HR_peak, blood glucose concentration, and rating of perceived exertion (RPE), but the percentage of change (Δ) was higher in SOG for all the other variables. SOG showed a higher (Δ) waist-to-hip ratio, maximum heart rate, resting heart rate, systolic blood pressure, blood lactate at 5-min post-exercise, and triglyceride concentrations after 8 and 16 weeks of training. In conclusion, a long-term HIIT program appears to be an appropriate training approach for obese boys with extra body fat. However, considering the RPE values, short-duration training sessions should be planned. Full article

(This article belongs to the Section Pediatric Cardiology)

13 pages, 1063 KB

Open AccessEditor’s ChoiceArticle

Obesity in Childhood and Adolescence: The Role of Motivation for Physical Activity, Self-Esteem, Implicit and Explicit Attitudes toward Obesity and Physical Activity

by Silvia Scotto di Luzio, Guillaume Martinent, Maria Popa-Roch, Mathilde Ballereau, Soufyane Chahdi, Lucie Escudero and Emma Guillet-Descas

Children 2023, 10(7), 1177; https://doi.org/10.3390/children10071177 - 7 Jul 2023

Cited by 10 | Viewed by 3596

Abstract

The purpose of the present study was to compare attitudes toward body weight and physical activity in both regular-weight and overweight/obese children and adolescents, and assessing relations between attitudes and self-esteem, motivation for physical activity, life satisfaction and level of physical activity. A [...] Read more.

The purpose of the present study was to compare attitudes toward body weight and physical activity in both regular-weight and overweight/obese children and adolescents, and assessing relations between attitudes and self-esteem, motivation for physical activity, life satisfaction and level of physical activity. A total of 126 children (Mage = 12.2, SD = 3.4), divided into two subsamples (i.e., overweight/obese, N = 44, and regular-weight), voluntarily participated in the study. A series of univariate analyses of variance was conducted to examine the differences in the study variables across the subsamples. Correlational analyses were conducted to examine the relationships among the variables. The results indicated that obese/overweight participants expressed a more positive implicit attitude toward the thin category than regular-weight participants. Furthermore, among overweight/obese participants, implicit attitude toward physical activity was significantly negatively correlated with explicit attitude toward physical activity and general self-esteem. Significant differences between obese/overweight and regular-weight participants indicated that the status in terms of weight played a key role in attitudes toward the explored constructs. Full article

(This article belongs to the Special Issue Current Issues and Future Perspectives in Youth Sports)

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19 pages, 1081 KB

Open AccessEditor’s ChoiceReview

Pediatric Advance Care Planning: A Scoping Review

by Nadine Lusney, Camara van Breemen, Edlyn Lim, Colleen Pawliuk and Zahra Hussein

Children 2023, 10(7), 1179; https://doi.org/10.3390/children10071179 - 7 Jul 2023

Cited by 12 | Viewed by 3334

Abstract

To assess current practice and provide a basis for a provincial template, clinicians at a Canadian pediatric hospice reviewed the literature surrounding pediatric advance care planning (pACP) documentation, process, and implementation for children/youth. The scoping review protocol was developed in accordance with the [...] Read more.

To assess current practice and provide a basis for a provincial template, clinicians at a Canadian pediatric hospice reviewed the literature surrounding pediatric advance care planning (pACP) documentation, process, and implementation for children/youth. The scoping review protocol was developed in accordance with the Joanna Briggs Institute methodology for scoping reviews, and was prospectively registered on the Open Science Framework. MEDLINE, Embase, CINAHL, the Web of Science Core Collection, and Google Scholar, as well as sources of unpublished studies and grey literature, were reviewed. Sixty-four articles met the criteria. Fifteen pACP documentation forms/tools were also identified. Overall, the included articles highlighted that pACP should be a structured, collaborative and iterative process between the family and a trusted or relevant healthcare provider, encompassing medical and non-medical issues. Few articles provided insights into specific elements recommended for advance directive forms. Identified strategies for implementation included a structured, step-by-step pACP interventional tool along with ongoing training, mentorship, and defined organizational structures for the clinician. No single specific ACP tool was acknowledged as the gold standard. Use of a pACP tool, along with ongoing provider education and communication skill development, standardized/accessible documentation, and system-wide quality improvement support, were noted as integral components of pACP. Full article

(This article belongs to the Section Pediatric Nursing)

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14 pages, 298 KB

Open AccessEditor’s ChoiceArticle

Self-Compassion and Anxiety in Adolescents with and without Anxiety Disorder

by Edibe Tali, Eva S. Potharst, Esther I. de Bruin and Elisabeth M. W. J. Utens

Children 2023, 10(7), 1181; https://doi.org/10.3390/children10071181 - 7 Jul 2023

Cited by 9 | Viewed by 3475

Abstract

Previous studies have linked self-compassion to mental health, specifically anxiety, in non-clinical adolescents, suggesting that self-compassion can be a protective factor against anxiety. This study compared the overall level of self-compassion and (un)compassionate self-responding in adolescents with and without an anxiety disorder and [...] Read more.

Previous studies have linked self-compassion to mental health, specifically anxiety, in non-clinical adolescents, suggesting that self-compassion can be a protective factor against anxiety. This study compared the overall level of self-compassion and (un)compassionate self-responding in adolescents with and without an anxiety disorder and assessed the association between self-compassion and anxiety. This cross-sectional study included adolescents (12–19 years) with an anxiety disorder (N = 23) and a reference group (N = 28). Participants completed the Self-Compassion Scale (SCS) and State Trait Anxiety Inventory (STAI). Results showed that overall self-compassion and uncompassionate self-responding were significantly lower and higher in the clinical than the reference group, respectively, while compassionate self-responding did not differ between groups. In the clinical group, only uncompassionate self-responding was significantly associated with higher anxiety. In the reference group, uncompassionate self-responding showed a significant positive association with anxiety, and compassionate self-responding showed a significant negative association with anxiety. Although the results suggest that low uncompassionate self-responding may buffer against anxiety, the role of compassionate and uncompassionate self-responding remains unclear. An alternative explanation is that the uncompassionate self-responding items measure the presence of psychopathology in adolescents with an anxiety disorder. More research on the construct validity of the SCS uncompassionate self-responding scale is needed. Full article

(This article belongs to the Special Issue Depression, Anxiety and Stress in Children and Adolescents)

15 pages, 680 KB

Open AccessEditor’s ChoiceReview

Effectiveness of Conservative Treatments in Positional Plagiocephaly in Infants: A Systematic Review

by Maria Blanco-Diaz, Maria Marcos-Alvarez, Isabel Escobio-Prieto, Marta De la Fuente-Costa, Borja Perez-Dominguez, Elena Pinero-Pinto and Alvaro Manuel Rodriguez-Rodriguez

Children 2023, 10(7), 1184; https://doi.org/10.3390/children10071184 - 7 Jul 2023

Cited by 10 | Viewed by 7760

Abstract

Objective: The objective of this study is to analyze conservative treatments implemented to manage positional plagiocephaly in infants. Methods: This is a systematic review conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, performed in the Medline (PubMed), Scopus, [...] Read more.

Objective: The objective of this study is to analyze conservative treatments implemented to manage positional plagiocephaly in infants. Methods: This is a systematic review conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, performed in the Medline (PubMed), Scopus, Web of Science, and Cochrane databases. Articles were selected according to the eligibility criteria, regarding the effectiveness of conservative treatments in positional plagiocephaly in infants, published in the last 10 years with a score ≥3 in the PEDro Scale. Results: A total of 318 articles were identified and 9 of them were finally selected. Conclusions: Physical therapy treatment is considered as the first line of intervention in plagiocephaly with non-synostotic asymmetries and manual therapy is the method that obtains the best results within this intervention. In cases of moderate or severe plagiocephaly, helmet therapy can be an effective second-line intervention; however, the best way to prevent this condition is through counseling of parents or caregivers, and early treatment is essential for optimal therapeutic outcomes. The review was registered in PROSPERO (CDR42022306466). Full article

(This article belongs to the Special Issue New Trends in Physical Therapy for Children)

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20 pages, 606 KB

Open AccessEditor’s ChoiceReview

Mental Health and Psychosocial Problems among Children and Adolescents in Jordan: A Scoping Review

by Rana AlHamawi, Yousef Khader, Sara Abu Khudair, Eizaburo Tanaka and Mohannad Al Nsour

Children 2023, 10(7), 1165; https://doi.org/10.3390/children10071165 - 4 Jul 2023

Cited by 13 | Viewed by 4335

Abstract

Introduction: In Jordan, mental health morbidity among children and adolescents is on the rise. Several studies in Jordan have assessed mental health issues and their associated factors among adolescents; however, there remains a lack of a collation of data regarding such issues. [...] Read more.

Introduction: In Jordan, mental health morbidity among children and adolescents is on the rise. Several studies in Jordan have assessed mental health issues and their associated factors among adolescents; however, there remains a lack of a collation of data regarding such issues. Objectives: To review the prevalence rates of mental health problems among children and adolescents in Jordan to understand the evidence base concerning psychiatric morbidity. Methods: The PubMed database, Cochrane Library, Virtual Health Library (VHL) Lilac, and APA PsycArticles were searched for literature published between January 2010 and May 2023. Studies were included if they were conducted on children and adolescents (≤19 years), were observational studies that reported prevalence data regarding psychosocial problems, and were studies conducted in Jordan. Results: The search yielded 211 records, of which 33 studies were assessed for eligibility and 28 met the inclusion criteria. The sample age ranged from 6–19 years. The prevalence rates ranged from 7.1% to 73.8% for depression, 16.3% to 46.8% for anxiety, 13.0–40.6% for ADHD, 11.7–55.2% for overall emotional and behavioral difficulties, 16.2–65.1% for PTSD, and 12–40.4% for eating disorders. Conclusions: The findings highlight the magnitude of mental health problems among children and adolescents and the heterogeneity of the results. Further studies are needed to investigate the prevalence of eating disorders among refugees, as well as sleeping disorders and substance use disorders among all adolescents. Full article

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

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17 pages, 2899 KB

Open AccessEditor’s ChoiceArticle

Do Girls Have an Advantage Compared to Boys When Their Motor Skills Are Tested Using the Movement Assessment Battery for Children, 2nd Edition?

by Bouwien Smits-Engelsman, Dané Coetzee, Ludvík Valtr and Evi Verbecque

Children 2023, 10(7), 1159; https://doi.org/10.3390/children10071159 - 1 Jul 2023

Cited by 8 | Viewed by 2499

Abstract

This study aims to investigate sex-related differences in raw item scores on the Movement Assessment Battery for Children, 2nd Edition (MABC-2) in a large data set collected in different regions across the world, seeking to unravel whether there is an interaction effect between [...] Read more.

This study aims to investigate sex-related differences in raw item scores on the Movement Assessment Battery for Children, 2nd Edition (MABC-2) in a large data set collected in different regions across the world, seeking to unravel whether there is an interaction effect between sex and the origin of the sample (European versus African). In this retrospective study, a secondary analysis was performed on anonymized data of 7654 children with a mean age of 8.6 (range 3 to 16; SD: 3.4), 50.0% of whom were boys. Since country-specific norms were not available for all samples, the raw scores per age band (AB) were used for analysis. Our results clearly show that in all age bands sex-related differences are present. In AB1 and AB2, girls score better on most manual dexterity and balance items, but not aiming and catching items, whereas in AB3 the differences seem to diminish. Especially in the European sample, girls outperform boys in manual dexterity and balance items, whereas in the African sample these differences are less marked. In conclusion, separate norms for boys and girls are needed in addition to separate norms for geographical regions. Full article

(This article belongs to the Section Global Pediatric Health)

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15 pages, 332 KB

Open AccessEditor’s ChoiceArticle

Association of Atherogenic Index of Plasma with Cardiometabolic Risk Factors and Markers in Lean 14-to-20-Year-Old Individuals: A Cross-Sectional Study

by Katarína Šebeková, Radana Gurecká, Melinda Csongová, Ivana Koborová and Peter Celec

Children 2023, 10(7), 1144; https://doi.org/10.3390/children10071144 - 30 Jun 2023

Cited by 7 | Viewed by 2536

Abstract

Cardiometabolic risk factors at a young age pose a significant risk for developing atherosclerotic cardiovascular disease in adulthood. Atherogenic dyslipidemia is highly associated with obesity and metabolic syndrome already in young age. It remains unclear whether cardiometabolic risk factors associate with the atherogenic [...] Read more.

Cardiometabolic risk factors at a young age pose a significant risk for developing atherosclerotic cardiovascular disease in adulthood. Atherogenic dyslipidemia is highly associated with obesity and metabolic syndrome already in young age. It remains unclear whether cardiometabolic risk factors associate with the atherogenic index of plasma (AIP = log (TAG/HDL-C) in lean subjects with low atherogenic risk. As both the AIP and markers of cardiometabolic risk are continuous variables, we expected their association to be linear before the manifestation of obesity and atherogenic dyslipidemia. We analyzed the prevalence of increased atherogenic risk (AIP ≥ 0.11) in 2012 lean 14-to-20-year-old subjects (55% females) and the trends of cardiometabolic risk factors across the quartiles (Q) of AIP in a subgroup of 1947 (56% females) subjects with low atherogenic risk (AIP < 0.11). The prevalence of AIP ≥ 0.11 reached 3.6% in females and 8.5% in males. HDL-C, non-HDL-C, triglycerides, and the continuous metabolic syndrome score showed a stepwise worsening across the AIP quartiles in both sexes. Measures of obesity and insulin resistance were worse in Q4 vs. Q1 groups, and leukocyte counts were higher in Q4 and Q3 vs. Q1. Females in Q4 presented with a higher C-reactive protein and lower adiponectin, estradiol, and testosterone levels. The multivariate regression model selected non-HDL-C, QUICKI, and erythrocyte counts as significant predictors of AIP in males; and non-HDL-C and C-reactive protein in females. A question arises whether the lean individuals on the upper edge of low atherogenic risk are prone to earlier manifestation of metabolic syndrome and shift to the higher AIP risk group. Full article

(This article belongs to the Special Issue 10th Anniversary of Children: Challenges and Opportunities towards the Future)

12 pages, 599 KB

Open AccessEditor’s ChoiceArticle

The Association between 24 h Movement Guidelines and Internalising and Externalising Behaviour Problems among Chinese Preschool Children

by Na Zhu, Hongzhi Guo, Dongmei Ma, Qiang Wang, Jiameng Ma and Hyunshik Kim

Children 2023, 10(7), 1146; https://doi.org/10.3390/children10071146 - 30 Jun 2023

Cited by 7 | Viewed by 2256

Abstract

This study examined the relationship between adherence to 24 h movement guidelines (24 h MGs) and internalising and externalising behavioural problems in Chinese children aged 3–6 years, with a specific focus on the differences between weekdays and weekends. The guidelines include recommendations for [...] Read more.

This study examined the relationship between adherence to 24 h movement guidelines (24 h MGs) and internalising and externalising behavioural problems in Chinese children aged 3–6 years, with a specific focus on the differences between weekdays and weekends. The guidelines include recommendations for physical activity (PA), screen time (ST), and sleep duration (SD). The results indicated a stronger association between adherence to these guidelines and behavioural problems on weekends compared to weekdays. Specifically, the odds of experiencing internalising problems were 1.33 higher (95% CI: 1.05–1.69) when not satisfying all three behaviours compared to not satisfying one or two. Moreover, on weekends, when ST was not fulfilled, there was a higher likelihood of externalising behaviour problems compared to when it was fulfilled (OR, 1.18, 95% CI, 1.01–1.38), and when all three behaviours were not met, the likelihood was even higher (OR, 1.50, 95% CI, 1.04–2.18). Children who met all three guidelines had fewer internalising and externalising behavioural problems, suggesting a potential beneficial effect on mental health. The study revealed that a higher adherence to these recommendations corresponded to a lower risk of mental health problems. Additionally, higher screen time was linked to an increase in externalising behavioural issues. These findings underscore the importance of adherence to 24 h MGs for optimal mental health in children. Future interventions should consider these behavioural factors and incorporate strategies to promote adherence to these guidelines, particularly on weekends. Full article

(This article belongs to the Section Pediatric Mental Health)

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20 pages, 673 KB

Open AccessEditor’s ChoiceArticle

Exploring Parenting Styles Patterns and Children’s Socio-Emotional Skills

by Aikaterini Vasiou, Wassilis Kassis, Anastasia Krasanaki, Dilan Aksoy, Céline Anne Favre and Spyridon Tantaros

Children 2023, 10(7), 1126; https://doi.org/10.3390/children10071126 - 29 Jun 2023

Cited by 19 | Viewed by 22019

Abstract

In this study, we adopted parenting styles as a multidimensional and latent construct that includes different aspects of parenting, rather than solely focusing on a single parenting style. In a Web-based survey with 1203 Greek parents, we identified parenting styles and their SDQ [...] Read more.

In this study, we adopted parenting styles as a multidimensional and latent construct that includes different aspects of parenting, rather than solely focusing on a single parenting style. In a Web-based survey with 1203 Greek parents, we identified parenting styles and their SDQ reports on their children. According to our results by Latent Profile Analysis, we must use a more complex approach concerning parenting styles. We identified a “Highly Authoritative style” profile with high levels of authoritative, low levels of authoritarian and middle levels of permissive parenting styles. We additionally identified a profile called “Relaxed Authoritative style”, with still high but lower levels of authoritative style, low but slightly heightened levels of authoritarian style, and middle levels of permissive style. A further profile, named “Permissive Focused Authoritative style”, had a mix of high levels of authoritative, moderate levels of permissive, and elevated levels of authoritarian parenting styles. Finally, in a profile named “Inconsistent Parenting style”, we identified parents with a blend of still high, but the lowest of all four levels of authoritative and highest levels of permissive and authoritarian parenting styles. When combining the four identified parenting patterns with the SDQ results, we identified the “highly authoritative parenting style” profile to be the least connected to internalizing or externalizing problems of the respective children. Full article

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

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13 pages, 848 KB

Open AccessEditor’s ChoiceReview

Development and Disorders of the Airway in Bronchopulmonary Dysplasia

by Douglas Bush, Courtney Juliano, Selina Bowler and Caterina Tiozzo

Children 2023, 10(7), 1127; https://doi.org/10.3390/children10071127 - 29 Jun 2023

Cited by 8 | Viewed by 2711

Abstract

Bronchopulmonary dysplasia (BPD), a disorder characterized by arrested lung development, is a frequent cause of morbidity and mortality in premature infants. Parenchymal lung changes in BPD are relatively well-characterized and highly studied; however, there has been less emphasis placed on the role that [...] Read more.

Bronchopulmonary dysplasia (BPD), a disorder characterized by arrested lung development, is a frequent cause of morbidity and mortality in premature infants. Parenchymal lung changes in BPD are relatively well-characterized and highly studied; however, there has been less emphasis placed on the role that airways disease plays in the pathophysiology of BPD. In preterm infants born between 22 and 32 weeks gestation, the conducting airways are fully formed but still immature and therefore susceptible to injury and further disruption of development. The arrest of maturation results in more compliant airways that are more susceptible to deformation and damage. Consequently, neonates with BPD are prone to developing airway pathology, particularly for patients who require intubation and positive-pressure ventilation. Airway pathology, which can be divided into large and small airways disease, results in increased respiratory morbidity in neonates with chronic lung disease of prematurity. Full article

(This article belongs to the Special Issue Acute and Chronic Lung Disease of the Newborn: Open Challenges and Novel Insights)

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10 pages, 449 KB

Open AccessEditor’s ChoiceArticle

The Association of Prenatal Antibiotic Use with Attention Deficit and Autism Spectrum Disorders: A Nationwide Cohort Study

by Yu-Chun Lin, Ching-Heng Lin and Ming-Chih Lin

Children 2023, 10(7), 1128; https://doi.org/10.3390/children10071128 - 29 Jun 2023

Cited by 8 | Viewed by 3188

Abstract

(1) Background: Attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are common cognitive and behavioral disorders. Antibiotics are widely used in pregnant women and their newborns. The objective of this study was to examine the potential association between prenatal exposure to [...] Read more.

(1) Background: Attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are common cognitive and behavioral disorders. Antibiotics are widely used in pregnant women and their newborns. The objective of this study was to examine the potential association between prenatal exposure to antibiotics and the risk of ADHD and ASD in childhood from a nationwide perspective. (2) Methods: The Taiwan National Health Insurance Research Database (NHIRD) was used as the primary data source. This nationwide cohort study included only first-time pregnancies. A total of 906,942 infants were enrolled. All infants were followed up for at least 6 years. The Cox regression model was applied for covariate control. (3) Results: Prenatal exposure to antibiotics was found to significantly increase the cumulative incidence of ADHD while having only a borderline effect on the cumulative incidence of ASD. Exposure to antibiotics during any of the three different gestational age ranges significantly increased the cumulative risk. However, only exposure after 34 weeks of gestation had a significant impact on the occurrence of ASD. The study also revealed a dose-dependent effect on the occurrence of ADHD but no effect on the occurrence of ASD. (4) Conclusions: This study suggests that prenatal exposure to antibiotics may increase the risk of developing ADHD and ASD later in life. Full article

(This article belongs to the Special Issue Maternal–Fetal Health: Helping Children Grow)

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12 pages, 274 KB

Open AccessEditor’s ChoiceArticle

Parental Burnout in the Context of Special Needs, Adoption, and Single Parenthood

by Isabelle Roskam and Moïra Mikolajczak

Children 2023, 10(7), 1131; https://doi.org/10.3390/children10071131 - 29 Jun 2023

Cited by 9 | Viewed by 4086

Abstract

Although early work on parental burnout in the 1980s did not link parental burnout to specific parenting situations, the idea that parents affected by specific vulnerability factors were particularly at risk of burnout quickly emerged. Based on the etiological model of parental burnout [...] Read more.

Although early work on parental burnout in the 1980s did not link parental burnout to specific parenting situations, the idea that parents affected by specific vulnerability factors were particularly at risk of burnout quickly emerged. Based on the etiological model of parental burnout (i.e., the balance between risks and resources), the objective of this study was to investigate if there were specific vulnerability factors that significantly increase the risk of parental burnout. 2563 parents participated in the study. We compared parents with a child with special needs (n = 25), parents who had adopted a child (n = 130), and single parents (n = 109), to strictly matched control groups of parents. Parents with a child with special needs displayed higher burnout and lower balance between risk and resources than the control group; parents with an adopted child had similar levels of both parental burnout and balance; and single parents had higher parental burnout but similar balance. Parents who combined specific several vulnerability factors were at greater risk of burnout. Single parenthood and adoption do not in themselves trigger a process leading de facto to other risk factors, but having a child with special needs does. Full article

24 pages, 13183 KB

Open AccessEditor’s ChoiceReview

Ovarian Masses in Children and Adolescents: A Review of the Literature with Emphasis on the Diagnostic Approach

by Effrosyni Birbas, Theofilos Kanavos, Fani Gkrozou, Chara Skentou, Angelos Daniilidis and Anastasia Vatopoulou

Children 2023, 10(7), 1114; https://doi.org/10.3390/children10071114 - 27 Jun 2023

Cited by 31 | Viewed by 10485

Abstract

Most abdominal masses in the pediatric population derive from the ovaries. Ovarian masses can occur in all ages, although their incidence, clinical presentation and histological distribution vary among different age groups. Children and adolescents may develop non-neoplastic ovarian lesions, such as functional cysts, [...] Read more.

Most abdominal masses in the pediatric population derive from the ovaries. Ovarian masses can occur in all ages, although their incidence, clinical presentation and histological distribution vary among different age groups. Children and adolescents may develop non-neoplastic ovarian lesions, such as functional cysts, endometrioma, torsion, abscess and lymphangioma as well as neoplasms, which are divided into germ cell, epithelial, sex-cord stromal and miscellaneous tumors. Germ cell tumors account for the majority of ovarian neoplasms in the pediatric population, while adults most frequently present with epithelial tumors. Mature teratoma is the most common ovarian neoplasm in children and adolescents, whereas dysgerminoma constitutes the most frequent ovarian malignancy. Clinical manifestations generally include abdominal pain, palpable mass, nausea/vomiting and endocrine alterations, such as menstrual abnormalities, precocious puberty and virilization. During the investigation of pediatric ovarian masses, the most important objective is to evaluate the likelihood of malignancy since the management of benign and malignant lesions is fundamentally different. The presence of solid components, large size and heterogenous appearance on transabdominal ultrasonography, magnetic resonance imaging and computed tomography indicate an increased risk of malignancy. Useful tumor markers that raise concern for ovarian cancer in children and adolescents include alpha-fetoprotein, lactate dehydrogenase, beta subunit of human chorionic gonadotropin, cancer antigen 125 and inhibin. However, their serum levels can neither confirm nor exclude malignancy. Management of pediatric ovarian masses needs to be curative and, when feasible, function-preserving and minimally invasive. Children and adolescents with an ovarian mass should be treated in specialized centers to avoid unnecessary oophorectomies and ensure the best possible outcome. Full article

(This article belongs to the Section Global Pediatric Health)

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13 pages, 1098 KB

Open AccessEditor’s ChoiceArticle

Adolescent Perception of Mental Health: It’s Not Only about Oneself, It’s about Others Too

by Justė Lukoševičiūtė-Barauskienė, Monika Žemaitaitytė, Vaida Šūmakarienė and Kastytis Šmigelskas

Children 2023, 10(7), 1109; https://doi.org/10.3390/children10071109 - 25 Jun 2023

Cited by 15 | Viewed by 4978

Abstract

Adolescents are at an increased risk of mental health problems due to the natural processes of development and maturation. Given that their mental health is mainly assessed by adults and not by the adolescents themselves, the purpose of this study is to reveal [...] Read more.

Adolescents are at an increased risk of mental health problems due to the natural processes of development and maturation. Given that their mental health is mainly assessed by adults and not by the adolescents themselves, the purpose of this study is to reveal adolescents’ perceptions of mental health. Semi-structured, in-depth interviews were conducted, and an inductive qualitative approach with thematic analysis was used. The qualitative study consisted of 19 adolescents aged 11–17 years. Five themes were identified: (1) What does mental health mean to you? (subthemes: realm of emotions, customary behavior, and relationships with others); (2) needs (subthemes: communication and support, self-expression and freedom of decision-making, and a safe and personal environment); (3) risk factors (subthemes: un-healthy relationships and social media dangers); (4) red flags (subthemes: self-exclusion from social life and self-destructive behavior); and (5) role of mental health professionals (subthemes: attentiveness to and proper pace for adolescent and acceptance of adolescent’s life in its entirety). This study revealed that adolescents view their mental health not only from their own emotional and behavioral perspectives but also through the prism of relationships with other people. Full article

(This article belongs to the Section Global Pediatric Health)

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13 pages, 802 KB

Open AccessEditor’s ChoiceReview

Genus-Level Analysis of Gut Microbiota in Children with Autism Spectrum Disorder: A Mini Review

by Mariya Levkova, Trifon Chervenkov and Rouzha Pancheva

Children 2023, 10(7), 1103; https://doi.org/10.3390/children10071103 - 23 Jun 2023

Cited by 8 | Viewed by 3896

Abstract

Autism is a global health problem, probably due to a combination of genetic and environmental factors. There is emerging data that the gut microbiome of autistic children differs from the one of typically developing children and it is important to know which bacterial [...] Read more.

Autism is a global health problem, probably due to a combination of genetic and environmental factors. There is emerging data that the gut microbiome of autistic children differs from the one of typically developing children and it is important to know which bacterial genera may be related to autism. We searched different databases using specific keywords and inclusion criteria and identified the top ten bacterial genera from the selected articles that were significantly different between the studied patients and control subjects studied. A total of 34 studies that met the inclusion criteria were identified. The genera Bacteroides, Bifidobacterium, Clostridium, Coprococcus, Faecalibacterium, Lachnospira, Prevotella, Ruminococcus, Streptococcus, and Blautia exhibited the most substantial data indicating that their fluctuations in the gastrointestinal tract could be linked to the etiology of autism. It is probable that autism symptoms are influenced by both increased levels of harmful bacteria and decreased levels of beneficial bacteria. Interestingly, these genera demonstrated varying patterns of increased or decreased levels across different articles. To validate and eliminate the sources of this fluctuation, further research is needed. Consequently, future investigations on the causes of autism should prioritize the examination of the bacterial genera discussed in this publication. Full article

(This article belongs to the Special Issue Advances in Autism Research: Diagnosis, Treatment and Best Practices)

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14 pages, 1308 KB

Open AccessEditor’s ChoiceArticle

Increase of Prevalence of Obesity and Metabolic Syndrome in Children and Adolescents in Korea during the COVID-19 Pandemic: A Cross-Sectional Study Using the KNHANES

by Jung Eun Choi, Hye Ah Lee, Sung Won Park, Jung Won Lee, Ji Hyen Lee, Hyesook Park and Hae Soon Kim

Children 2023, 10(7), 1105; https://doi.org/10.3390/children10071105 - 23 Jun 2023

Cited by 15 | Viewed by 3567

Abstract

(1) Background: The aim of this study was to evaluate the prevalence of obesity and metabolic syndrome since the COVID-19 pandemic outbreak utilizing representative data on youth aged 2–18 years from the Korean National Health and Nutrition Examination Surveys (KNHANES) conducted in 2019–2020. [...] Read more.

(1) Background: The aim of this study was to evaluate the prevalence of obesity and metabolic syndrome since the COVID-19 pandemic outbreak utilizing representative data on youth aged 2–18 years from the Korean National Health and Nutrition Examination Surveys (KNHANES) conducted in 2019–2020. (2) Methods: The survey consists of three parts: health interviews, health examinations, and nutrition surveys. From the 2019 and 2020 surveys, 1371 (2–9 years = 702 and 10–18 years = 669) and 1124 (2–9 years = 543 and 10–18 years = 581) individuals were included in the analysis. (3) Results: The mean body mass index (BMI) increased significantly among youth aged 2–9 years from 16.53 kg/m² in 2019 to 17.1 kg/m² in 2020 (p < 0.01). In youth aged 10–18 years, the BMI was found to increase slightly from 21.25 kg/m² in 2019 to 21.41 kg/m² in 2020 (p = 0.64). The increasing prevalence of extreme obesity was significant in girls, especially those aged 2–9 years (p < 0.01). However, extreme obesity had increased in 10–18-year-old boys (p = 0.08). The overall prevalence of metabolic syndrome in adolescents increased from 3.79% to 7.79% during the COVID-19 pandemic (p = 0.01). (4) Conclusions: We observed that the prevalence of obesity and metabolic syndrome among children and adolescents has increased after the COVID-19 outbreak. This is believed to be associated with an increase in the rate of early comorbidities in adulthood. The prevention of the progression of pediatric obesity has recently become an urgent public health concern in Korea. Full article

(This article belongs to the Section Global Pediatric Health)

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20 pages, 681 KB

Open AccessEditor’s ChoiceReview

Teaching and Rehabilitation of Handwriting for Children in the Digital Age: Issues and Challenges

by Nathalie Bonneton-Botté, Ludovic Miramand, Rodolphe Bailly and Christelle Pons

Children 2023, 10(7), 1096; https://doi.org/10.3390/children10071096 - 22 Jun 2023

Cited by 13 | Viewed by 11338

Abstract

Handwriting is a determining factor for academic success and autonomy for all children. Making knowledge accessible to all is a challenge in the context of inclusive education. Given the neurodevelopmental diversity within a classroom of children, ensuring that the handwriting of all pupils [...] Read more.

Handwriting is a determining factor for academic success and autonomy for all children. Making knowledge accessible to all is a challenge in the context of inclusive education. Given the neurodevelopmental diversity within a classroom of children, ensuring that the handwriting of all pupils progresses is very demanding for education professionals. The development of tools that can take into account the variability of the profiles and learning abilities of children with handwriting difficulties offers a new potential for the development of specific and adapted remediation strategies. This narrative review aims to present and discuss the challenges of handwriting learning and the opportunities offered by new technologies involving AI for school and health professionals to successfully improve the handwriting skills of all children. Full article

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

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24 pages, 24832 KB

Open AccessEditor’s ChoiceReview

Emergency MRI in Spine Trauma of Children and Adolescents—A Pictorial Review

by Aapo Sirén, Mikko Nyman, Johanna Syvänen, Kimmo Mattila and Jussi Hirvonen

Children 2023, 10(7), 1094; https://doi.org/10.3390/children10071094 - 21 Jun 2023

Cited by 9 | Viewed by 4914

Abstract

Severe spinal trauma is uncommon in the pediatric population, but due to the potentially devastating consequences of missed injury, it poses a diagnostic challenge in emergency departments. Diagnostic imaging is often needed to exclude or confirm the injury and to assess its extent. [...] Read more.

Severe spinal trauma is uncommon in the pediatric population, but due to the potentially devastating consequences of missed injury, it poses a diagnostic challenge in emergency departments. Diagnostic imaging is often needed to exclude or confirm the injury and to assess its extent. Magnetic resonance imaging (MRI) offers an excellent view of both bony and soft tissue structures and their traumatic findings without exposing children to ionizing radiation. Our pictorial review aims to demonstrate the typical traumatic findings, physiological phenomena, and potential pitfalls of emergency MRI in the trauma of the growing spine. Full article

(This article belongs to the Special Issue Advanced Research in Pediatric Radiology and Nuclear Medicine (Volume II))

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11 pages, 677 KB

Open AccessEditor’s ChoiceArticle

2021/22 and 2022/23 Post-Pandemic Bronchiolitis Seasons in Two Major Italian Cities: A Prospective Study

by Anna Camporesi, Rosa Morello, Ugo Maria Pierucci, Francesco Proli, Ilaria Lazzareschi, Giulia Bersani, Piero Valentini, Damian Roland and Danilo Buonsenso

Children 2023, 10(6), 1081; https://doi.org/10.3390/children10061081 - 20 Jun 2023

Cited by 7 | Viewed by 1811

Abstract

Objectives: Bronchiolitis remains a major cause of morbidity and mortality in children under 24 months. During the first year of the pandemic, non-pharmacological interventions resulted in a significant reduction of bronchiolitis cases. Early in 2021, a rebound of bronchiolitis was reported with a [...] Read more.

Objectives: Bronchiolitis remains a major cause of morbidity and mortality in children under 24 months. During the first year of the pandemic, non-pharmacological interventions resulted in a significant reduction of bronchiolitis cases. Early in 2021, a rebound of bronchiolitis was reported with a description of out-of-season outbreaks. In this study, we prospectively evaluated the impact of bronchiolitis in two Italian University centers located in different geographical areas, aiming to compare two post-pandemic bronchiolitis seasons (2021/22 and 2022/23) in terms of severity, outcomes, microbiology and temporal distribution. Methods: This was a bicentric prospective observational cohort study. All consecutive children under 24 months of age assessed in the participating institutions during the specified seasons and receiving a clinical diagnosis of bronchiolitis were included. Results: A total of 900 patients were enrolled. Patients in the second season were globally younger and had comorbidities less often. Temporal distribution changed between the two seasons. Of the patients, 56% were tested for RSV; 60% of these was positive. Patients with RSV were globally younger (3.5 months vs. 4.9, p < 0.001), more often had a need for any kind of respiratory and fluid support and more often needed ward or PICU admission. At the end of the ED visit, 430 patients were discharged home, 372 (41.3%) were admitted to an inpatient ward and 46 (5.1%) to a pediatric intensive care unit. Conclusions: The 2022/23 post-COVID bronchiolitis was mostly similar to that of 2021/22, and was in line with pre-pandemic expectations. Full article

(This article belongs to the Section Pediatric Infectious Diseases)

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17 pages, 3464 KB

Open AccessEditor’s ChoiceReview

State of the Art Bowel Management for Pediatric Colorectal Problems: Functional Constipation

by Elizaveta Bokova, Wendy Jo Svetanoff, John M. Rosen, Marc A. Levitt and Rebecca M. Rentea

Children 2023, 10(6), 1078; https://doi.org/10.3390/children10061078 - 19 Jun 2023

Cited by 13 | Viewed by 7669

Abstract

Background: Functional constipation (FC) affects up to 32% of the pediatric population, and some of these patients are referred to pediatric surgery units to manage their constipation and/or fecal incontinence. The aim of the current paper is to report the recent updates on [...] Read more.

Background: Functional constipation (FC) affects up to 32% of the pediatric population, and some of these patients are referred to pediatric surgery units to manage their constipation and/or fecal incontinence. The aim of the current paper is to report the recent updates on the evaluation and management of children with FC as a part of a manuscript series on bowel management in patients with anorectal malformations, Hirschsprung disease, spinal anomalies, and FC. Methods: A literature search was performed using Medline/PubMed, Google Scholar, Cochrane, and EMBASE databases and focusing on the manuscripts published within the last 5–10 years. Results: The first step of management of children with FC is to exclude Hirschsprung disease with a contrast study, examination under anesthesia, anorectal manometry (AMAN). If AMAN shows absent rectoanal inhibitory reflex, a rectal biopsy is performed. Internal sphincter achalasia or high resting pressures indicate botulinum toxin injection. Medical management options include laxatives, rectal enemas, transanal irrigations, and antegrade flushes. Those who fail conservative treatment require further assessment of colonic motility and can be candidates for colonic resection. The type of resection (subtotal colonic resection vs. Deloyer’s procedure) can be guided with a balloon expulsion test. Conclusion: Most of the patients with FC referred for surgical evaluation can be managed conservatively. Further studies are required to determine an optimal strategy of surgical resection in children unresponsive to medical treatment. Full article

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

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15 pages, 305 KB

Open AccessEditor’s ChoiceArticle

Experiences of Healthcare Providers Who Provide Emergency Care to Migrant Children Who Arriving in Spain by Small Boats (Patera): A Qualitative Study

by María del Mar Jiménez-Lasserrotte, Rosalía Artés-Navarro, José Granero-Molina, Isabel María Fernández-Medina, María Dolores Ruiz-Fernández and María Isabel Ventura-Miranda

Children 2023, 10(6), 1079; https://doi.org/10.3390/children10061079 - 19 Jun 2023

Cited by 8 | Viewed by 1916

Abstract

Background: The phenomenon of migration from regions with more limited resources is a reality of the globalized world. It is estimated that at the end of 2019, almost 80 million migrants were displaced around the world, with 46% of them being children. Almost [...] Read more.

Background: The phenomenon of migration from regions with more limited resources is a reality of the globalized world. It is estimated that at the end of 2019, almost 80 million migrants were displaced around the world, with 46% of them being children. Almost 20% of the irregular immigrants who arrived in Spain were child irregular migrants, who travelled alone or accompanied by family members after leaving their countries of origin seeking, to find a better future. Child irregular migrants have specific healthcare needs. The objectives of our present study were to describe and understand the experiences of healthcare providers in relation to the healthcare needs and the process of emergency care for child irregular migrants who come to Spain in small vessels. Methods: In this descriptive qualitative study, two focus groups were convened, and in-depth interviews with 21 participants were conducted, followed by inductive data analysis using ATLAS.ti 9.3 software. Results: Three main themes emerged from the analysis: (1) more vulnerable groups for whom the priority is emergency care; (2) the health and social care of child migrants; and (3) challenges and advances in the care of child migrants. Conclusions: For healthcare providers, protecting children, placing value on the family unit, and ensuring that children feel safe at all times are very important. Learning about the experiences of healthcare providers can contribute towards improving the health and social care of children in emergency care. Full article

(This article belongs to the Special Issue Advances in Social Sustainability: Health, Inclusion and Rights in Childhood and Adolescence)

20 pages, 560 KB

Open AccessEditor’s ChoiceArticle

Supporting Preschoolers’ Mental Health and Academic Learning through the PROMEHS Program: A Training Study

by Elisabetta Conte, Valeria Cavioni, Veronica Ornaghi, Alessia Agliati, Sabina Gandellini, Margarida Frade Santos, Anabela Caetano Santos, Celeste Simões and Ilaria Grazzani

Children 2023, 10(6), 1070; https://doi.org/10.3390/children10061070 - 16 Jun 2023

Cited by 12 | Viewed by 3948

Abstract

There is compelling evidence that early school intervention programs enhance children’s development of life skills, with a positive knock-on effect on their behaviors and academic outcomes. To date, most universal interventions have displayed gains in children’s social-emotional competencies with a limited reduction in [...] Read more.

There is compelling evidence that early school intervention programs enhance children’s development of life skills, with a positive knock-on effect on their behaviors and academic outcomes. To date, most universal interventions have displayed gains in children’s social-emotional competencies with a limited reduction in problem behaviors. This may depend on programs’ curricula focused to a greater extent on preschoolers’ social-emotional competencies rather than problem behaviors. Promoting Mental Health at Schools (PROMEHS) is a European, school-based, universal mental health program explicitly focused on both promoting students’ mental health and preventing negative conduct by adopting a whole-school approach. In this study, we set out to evaluate the effectiveness of the program for Italian and Portuguese preschoolers. We recruited 784 children (age range = 4–5 years), assigning them to either an experimental group (six months’ participation in the PROMEHS program under the guidance of their teachers, who had received ad hoc training) or a waiting list group (no intervention). We found that PROMEHS improved preschoolers’ social-emotional learning (SEL) competencies, prosocial behavior, and academic outcomes. The more practical activities were carried out at school, the more children’s SEL competencies increased, and the more their internalizing and externalizing behaviors decreased. Furthermore, marginalized and disadvantaged children were those who benefited most from the program, displaying both greater improvements in SEL and more marked decreases in internalizing problems compared to the rest of the sample. Full article

(This article belongs to the Special Issue Research on Socio-Emotional Development from Childhood to Adulthood)

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13 pages, 281 KB

Open AccessEditor’s ChoiceArticle

Exploring the Psychosocial Factors between Adaptive and Maladaptive Use of Gaming among Korean Adolescents

by Bee Kim and Nami Kim

Children 2023, 10(6), 1059; https://doi.org/10.3390/children10061059 - 14 Jun 2023

Cited by 7 | Viewed by 2362

Abstract

(1) Background: Various studies have been conducted on the effects of video (online, mobile, and console) games on users’ lives and psychological health. However, the effectiveness of a game can vary depending on user characteristics. This study explored the level of game use [...] Read more.

(1) Background: Various studies have been conducted on the effects of video (online, mobile, and console) games on users’ lives and psychological health. However, the effectiveness of a game can vary depending on user characteristics. This study explored the level of game use and its associated psychosocial factors among adolescents. (2) Methods: Survey data were compiled from 582 middle and high school students. Frequency analysis, the chi-square test, and analysis of variance were performed using SPSS Windows software, version 23.0. (3) Results: First, it was confirmed that there were no differences in the levels of self-esteem, morality, or life satisfaction between the adaptive game use and normal groups, but these were higher than those of the maladaptive game use group. However, at the level of self-control, the adaptive group scored lower than the normal group but higher than the maladaptive group. Second, the adaptive and normal groups exhibited comparatively lower levels of aggression, anxiety, depression, loneliness, academic stress, and social stress in school. Third, they also exhibit relatively high levels of social intelligence, social capital, and friendship support. (4) Conclusions: The adaptive and general game-use groups showed similar levels of psychosocial factors, whereas the maladaptive game-use group exhibited lower levels of positive psychological and social factors. Based on these results, developing an intervention program that reduces maladaptation and increases adaptive gaming use is necessary. Future follow-up studies are needed to confirm how positive and negative psychosocial factors affect adaptive and maladaptive game use as protective and risk factors, respectively. Full article

(This article belongs to the Section Pediatric Mental Health)

9 pages, 254 KB

Open AccessEditor’s ChoiceArticle

Body Image Perception and Satisfaction of Junior High School Students: Analysis of Possible Determinants

by Huizi Song, Yepeng Cai, Qian Cai, Wen Luo, Xiuping Jiao, Tianhua Jiang, Yun Sun and Yuexia Liao

Children 2023, 10(6), 1060; https://doi.org/10.3390/children10061060 - 14 Jun 2023

Cited by 13 | Viewed by 4634

Abstract

Body image (BI) is a multidimensional construct that refers to one’s perceptions of and attitudes toward one’s own physical characteristics. Adolescence is a critical developmental stage in which concerns about BI increase. Therefore, the present cross-sectional study aimed to evaluate body image and [...] Read more.

Body image (BI) is a multidimensional construct that refers to one’s perceptions of and attitudes toward one’s own physical characteristics. Adolescence is a critical developmental stage in which concerns about BI increase. Therefore, the present cross-sectional study aimed to evaluate body image and aesthetic body shape standards in a sample of middle school students living in China. The researchers gathered demographic information, as well as height and weight data, for their study. They used a body silhouette to assess body image perception and body shape aesthetics and calculated two indexes: BIP, which measures the accuracy of self-perception and the estimation of bodily dimensions, and BIS, which indicates the difference between an individual’s perceived and ideal body images. A total of 1585 students in three grades at two middle schools were included in the study (759 = female, mean age = 13.67 ± 0.90; 839 = male, mean age = 13.70 ± 0.90). The results showed that the BIP bias rate of middle school students was 55.7%, and the BI dissatisfaction rate was 81.0%. Females tended to overestimate their body shape and desire to be thinner compared to males. Students with a higher BMI grading were more prone to underestimating their body shape and aspiring to be thinner. Furthermore, 8.6% of students chose underweight as the ideal body type for boys, while 22.6% chose underweight as the ideal body type for girls. In conclusion, there are significant gender differences in the aesthetic standards of body shape, and adolescents believe that for women, a thin body shape is beautiful. Full article

(This article belongs to the Section Pediatric Mental Health)

11 pages, 283 KB

Open AccessEditor’s ChoiceReview

The Effect of Breastfeeding on Food Allergies in Newborns and Infants

by Zoi Koukou, Eleftheria Papadopoulou, Eleftherios Panteris, Styliani Papadopoulou, Anna Skordou, Maria Karamaliki and Elisavet Diamanti

Children 2023, 10(6), 1046; https://doi.org/10.3390/children10061046 - 12 Jun 2023

Cited by 15 | Viewed by 8462

Abstract

Breastfeeding is the preferred method of infant feeding and its establishment is one of the primary goals for the infant. Allergic diseases are common in childhood, with increased morbidity. Food allergies are also associated with a strong negative impact on health-related quality of [...] Read more.

Breastfeeding is the preferred method of infant feeding and its establishment is one of the primary goals for the infant. Allergic diseases are common in childhood, with increased morbidity. Food allergies are also associated with a strong negative impact on health-related quality of life and is a major public health problem. In addition, maternal exclusion of common allergens during pregnancy and/or lactation suggests that supplementation with regular cow’s milk formula during the first week of life should be avoided. Breast milk contains many active immune factors, such as cytokines, inflammatory mediators, signaling molecules and soluble receptors, which may also reduce the risk of allergic disease. The prophylactic effects of breastfeeding have been the subject of many studies, some with weak evidence. In this narrative review, we aim to provide an up-to-date account of the effects of prophylactic breastfeeding on food allergy and other common allergies in infants and children up to 5 years of age. Colostrum in particular has been shown to be prophylactic against food allergy. The American Academy of Pediatrics cautions that the relationship between duration of breastfeeding and incidence of food allergy in early childhood is unclear. The protective role of breastfeeding has a positive effect on allergy prevention, which is opposed by the early introduction of solid foods, but larger studies are needed to confirm the evidence. There is evidence that breastfeeding is effective in providing partial protection to infants. Full article

(This article belongs to the Special Issue Infant Feeding: Advances and Future Challenges)

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17 pages, 4112 KB

Open AccessEditor’s ChoiceArticle

An Observational Study on Play and Physical Activity Associated with a Recreational Facility-Led Park-Based “Loose Parts” Play Intervention during the COVID-19 Pandemic

by Calli Naish, Gavin R. McCormack, Anita Blackstaffe, Levi Frehlich and Patricia K. Doyle-Baker

Children 2023, 10(6), 1049; https://doi.org/10.3390/children10061049 - 12 Jun 2023

Cited by 7 | Viewed by 2748

Abstract

Play is a human right, yet opportunities for unstructured play are declining. The COVID-19 pandemic further reduced children’s play opportunities. We conducted an observational study of a novel community-based intervention (play hubs) that facilitated unstructured play by offering loose parts in parks (Calgary, [...] Read more.

Play is a human right, yet opportunities for unstructured play are declining. The COVID-19 pandemic further reduced children’s play opportunities. We conducted an observational study of a novel community-based intervention (play hubs) that facilitated unstructured play by offering loose parts in parks (Calgary, Canada) during the pandemic. Our descriptive study included systematic observation using the System for Observing Children’s Activity and Relationships During Play (SOCARP) and Tool for Observing Play Outdoors (TOPO) to capture physical activity, play, and social and environment interactions among children participating in the play hubs for 10-weeks in 2021 (n = 160) and 2022 (n = 147). Play hub attendance was low. Most children observed were aged 5 to 12 years (2021: 93% and 2022 98%), with boys and girls represented (2021: 58% male/42% female and 2022: 52% male/48% female). Standing, sitting, and moderate activity were common activities. Physical, exploratory, and expressive play were common, while digital, bio, and rule-based play were less common. Children typically played alone or in small groups and engaged with loose parts or played in the open spaces. The play hubs encouraged unstructured play and promoted positive social interactions among children, despite the challenges of implementing a community-based intervention under pandemic public health restrictions. Full article

(This article belongs to the Special Issue Physical Activities of Children and Adolescents during COVID-19 Pandemic)

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15 pages, 1086 KB

Open AccessEditor’s ChoiceReview

A Scientometric Review of Infant Cry and Caregiver Responsiveness: Literature Trends and Research Gaps over 60 Years of Developmental Study

by Alessandro Carollo, Pietro Montefalcone, Marc H. Bornstein and Gianluca Esposito

Children 2023, 10(6), 1042; https://doi.org/10.3390/children10061042 - 10 Jun 2023

Cited by 9 | Viewed by 6253

Abstract

Infant cry is an adaptive signal of distress that elicits timely and mostly appropriate caring behaviors. Caregivers are typically able to decode the meaning of the cry and respond appropriately, but maladaptive caregiver responses are common and, in the worst cases, can lead [...] Read more.

Infant cry is an adaptive signal of distress that elicits timely and mostly appropriate caring behaviors. Caregivers are typically able to decode the meaning of the cry and respond appropriately, but maladaptive caregiver responses are common and, in the worst cases, can lead to harmful events. To tackle the importance of studying cry patterns and caregivers’ responses, this review aims to identify key documents and thematic trends in the literature as well as existing research gaps. To do so, we conducted a scientometric review of 723 documents downloaded from Scopus and performed a document co-citation analysis. The most impactful publication was authored by Barr in 1990, which describes typical developmental patterns of infant cry. Six major research thematic clusters emerged from the analysis of the literature. Clusters were renamed “Neonatal Pain Analyzer” (average year of publication = 2002), “Abusive Head Trauma” (average year of publication = 2007), “Oxytocin” (average year of publication = 2009), “Antecedents of Maternal Sensitivity” (average year of publication = 2010), “Neurobiology of Parental Responses” (average year of publication = 2011), and “Hormonal Changes & Cry Responsiveness” (average year of publication = 2016). Research clusters are discussed on the basis of a qualitative inspection of the manuscripts. Current trends in research focus on the neurobiology of caregiver responses and the identification of factors promoting maternal sensitivity. Recent studies have also developed evidence-based strategies for calming crying babies and preventing caregivers’ maladaptive responses. From the clusters, two topics conspicuously call for future research: fathers’ responsiveness to infant cry and the impact of caregiver relationship quality on cry responsiveness. Full article

(This article belongs to the Section Pediatric Nursing)

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19 pages, 1065 KB

Open AccessEditor’s ChoiceReview

Multiple Sclerosis—Related Dietary and Nutritional Issues: An Updated Scoping Review with a Focus on Pediatrics

by Claudia Mandato, Angelo Colucci, Roberta Lanzillo, Annamaria Staiano, Elena Scarpato, Luigi Schiavo, Francesca Felicia Operto, Maria Rosaria Serra, Cristina Di Monaco, Julia Sara Napoli, Grazia Massa and Pietro Vajro

Children 2023, 10(6), 1022; https://doi.org/10.3390/children10061022 - 7 Jun 2023

Cited by 9 | Viewed by 4846

Abstract

Purpose. Lifestyle/dietetic habits play an important role in the development and progression of multiple sclerosis (MS) disease. Here, we examine the basic pathomechanisms underlying intestinal and brain barrier modifications in MS and consider diets and dietary supplementations proposed over time to complement pharmacological [...] Read more.

Purpose. Lifestyle/dietetic habits play an important role in the development and progression of multiple sclerosis (MS) disease. Here, we examine the basic pathomechanisms underlying intestinal and brain barrier modifications in MS and consider diets and dietary supplementations proposed over time to complement pharmacological therapies for improving disease outcome both in adults and in children. Methods. Scoping literature search about evidence-based findings in MS-related gut-brain axis (GBA) pathophysiology and nutritional issues at all ages. Findings. Data show that (1) no universal best diet exists, (2) healthy/balanced diets are, however, necessary to safeguard the adequate intake of all essential nutrients, (3) diets with high intakes of fruits, vegetables, whole grains, and lean proteins that limit processed foods, sugar, and saturated fat appear beneficial for their antioxidant and anti-inflammatory properties and their ability to shape a gut microbiota that respects the gut and brain barriers, (4) obesity may trigger MS onset and/or its less favorable course, especially in pediatric-onset MS. Vitamin D and polyunsaturated fatty acids are the most studied supplements for reducing MS-associated inflammation. Conclusions. Pending results from other and/or newer approaches targeting the GBA (e.g., pre- and probiotics, engineered probiotics, fecal-microbiota transplantation), accurate counseling in choosing adequate diet and maintaining physical activity remains recommended for MS prevention and management both in adults and children. Full article

(This article belongs to the Special Issue 10th Anniversary of Children: Challenges and Opportunities towards the Future)

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26 pages, 809 KB

Open AccessEditor’s ChoiceReview

A Scoping Review of Trauma-Informed Pediatric Interventions in Response to Natural and Biologic Disasters

by Kimberly Burkhart, Neel Agarwal, Sehyun Kim, Mandy Neudecker and Carolyn E. Ievers-Landis

Children 2023, 10(6), 1017; https://doi.org/10.3390/children10061017 - 5 Jun 2023

Cited by 6 | Viewed by 6893

Abstract

A scoping review was performed of trauma-informed psychological interventions to treat anxiety, depression, and posttraumatic stress symptoms in youth in response to natural/biologic disasters. The specific aims were to identify psychosocial interventions used in response to natural/biologic disasters, report the interventions’ effectiveness, describe [...] Read more.

A scoping review was performed of trauma-informed psychological interventions to treat anxiety, depression, and posttraumatic stress symptoms in youth in response to natural/biologic disasters. The specific aims were to identify psychosocial interventions used in response to natural/biologic disasters, report the interventions’ effectiveness, describe limitations, and provide treatment recommendations and future directions. Of the 45 studies extracted, 28 were on natural disasters and 17 on biologic disasters with the majority related to the COVID-19 pandemic. The most commonly implemented interventions were Cognitive Behavioral Therapy (CBT), Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), and eye movement desensitization and reprocessing (EMDR). The UCLA Posttraumatic Stress Disorder Reaction Index (UCLA PTSD-RI) and the Strengths and Difficulties Questionnaire (SDQ) were the most frequently used measures. Methodological rigor was varied, with 60% randomized, controlled trials. Overall, there was a significant decrease in posttraumatic stress symptoms, distress, anxiety, and depression regardless of whether the participant received CBT, TF-CBT, or EMDR. Generally, there was not a significant decrease in anxiety and depression with yoga, cognitive fear-reduction, emotion-based drawing, and community health education. Recommendations for future directions include larger-scale studies with group and on-line interventions that include younger children with moderation analyses by gender and race/ethnicity. Full article

(This article belongs to the Section Global Pediatric Health)

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15 pages, 346 KB

Open AccessEditor’s ChoiceReview

Neonatal Care Unit Interventions on Preterm Development

by Alexia Séassau, Pascale Munos, Catherine Gire, Barthélémy Tosello and Isabelle Carchon

Children 2023, 10(6), 999; https://doi.org/10.3390/children10060999 - 2 Jun 2023

Cited by 23 | Viewed by 7828

Abstract

Prematurity is becoming a real public health issue as more and more children are being born prematurely, alongside a higher prevalence of neurodevelopmental disorders. Early intervention programs in Neonatal Intensive Care Units (NICUs) correspond to these uni- or multi-sensorial solicitations aiming to prevent [...] Read more.

Prematurity is becoming a real public health issue as more and more children are being born prematurely, alongside a higher prevalence of neurodevelopmental disorders. Early intervention programs in Neonatal Intensive Care Units (NICUs) correspond to these uni- or multi-sensorial solicitations aiming to prevent and detect complications in order to support the development of preterm infants. This article aims to distinguish sensory intervention programs according to the gradient of the type of solicitations, uni- or multi-modal, and according to the function of the person who performs these interventions. Uni-sensorial interventions are essentially based on proprioceptive, gustatory, or odorant solicitations. They allow, in particular, a reduction of apneas that support the vegetative states of the preterm infant. On the other hand, the benefits of multi-sensory interventions seem to have a longer-term impact. Most of them allow the support of the transition from passive to active feeding, an increase in weight, and the improvement of sleep-wake cycles. These solicitations are often practiced by caregivers, but the intervention of parents appears optimal since they are the main co-regulators of their preterm child’s needs. Thus, it is necessary to co-construct and train the parents in this neonatal care. Full article

(This article belongs to the Section Pediatric Neonatology)

10 pages, 479 KB

Open AccessEditor’s ChoiceArticle

Early Development of Spinal Deformities in Children Severely Affected with Spinal Muscular Atrophy after Gene Therapy with Onasemnogene Abeparvovec—Preliminary Results

by Venla Soini, Gudrun Schreiber, Bernd Wilken and Anna Kathrin Hell

Children 2023, 10(6), 998; https://doi.org/10.3390/children10060998 - 2 Jun 2023

Cited by 15 | Viewed by 3000

Abstract

Spinal muscular atrophy (SMA) is a rare genetic disorder, with the most common form being 5q SMA. Survival of children with severe SMA is poor, yet major advances have been made in recent years in pharmaceutical treatment, such as gene-therapy, which has improved [...] Read more.

Spinal muscular atrophy (SMA) is a rare genetic disorder, with the most common form being 5q SMA. Survival of children with severe SMA is poor, yet major advances have been made in recent years in pharmaceutical treatment, such as gene-therapy, which has improved patient survival. Therefore, clinical problems, such as the development of spinal deformities in these genetically treated SMA children represent an unknown challenge in clinical work. In a retrospective case series, the development of spinal deformities was analyzed in 16 SMA children (9 male, 7 female) treated with onasemnogene abeparvovec in two institutions during the years 2020 to 2022. Ten out of sixteen patients had a significant kyphosis, and nine out of sixteen patients had significant scoliosis, with the mean curvature angles of 24 ± 27° for scoliosis, and 69 ± 15° for kyphosis. Based on these preliminary data, it can be assumed that early-onset kyphosis presents a clinical challenge in gene-therapy-treated SMA children. Larger datasets with longer follow-up times need to be collected in order to verify these preliminary observations. Full article

(This article belongs to the Section Pediatric Neurology & Neurodevelopmental Disorders)

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11 pages, 266 KB

Open AccessEditor’s ChoiceArticle

Prevalence and Associated Factors of Dental Caries in Syrian Immigrant Children Aged 6–12 Years

by Zeynep Meva Altaş and Mehmet Akif Sezerol

Children 2023, 10(6), 1000; https://doi.org/10.3390/children10061000 - 2 Jun 2023

Cited by 12 | Viewed by 2428

Abstract

Immigrant children are among the groups that are sensitive to problems related to dental health. The aim of this study was to examine the dental caries of Syrian immigrant children. The study is a descriptive and retrospective study. Its population consists of Syrian [...] Read more.

Immigrant children are among the groups that are sensitive to problems related to dental health. The aim of this study was to examine the dental caries of Syrian immigrant children. The study is a descriptive and retrospective study. Its population consists of Syrian immigrant children aged 6–12 years who were screened for dental health in the year 2022 in Istanbul. DMF-T (permanent teeth) and dmf-t (milk teeth) indices were used, which are the (t-T) criteria obtained by dividing the sum of caries (d-D), caries extracted (m-M) and caries-filled (f-F) teeth by the number of people examined. Higher dmft and DMFT scores indicate worse dental health. Dental screening was performed on 549 Syrian immigrant children. In total, 27.2% (n = 149) were brushing their teeth once a day and 97.3% of the children (n = 534) had at least one decayed tooth. The dmft score for the 6–7 year age (6.45 ± 3.33) group was significantly higher than the 8–9 year (4.98 ± 2.78) and 10–12 year (3.22 ± 2.02) age groups (p < 0.001). In our study, the dental caries were seen at a very-high frequency among immigrant children and the habit of tooth brushing remains at a low level. Lower age was the relevant factor for dental caries in our study. Full article

(This article belongs to the Special Issue 10th Anniversary of Children: Pediatric Dentistry Progress)

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14 pages, 761 KB

Open AccessEditor’s ChoiceReview

Relationship between Executive Functions and Creativity in Children and Adolescents: A Systematic Review

by Tania Pasarín-Lavín, Amanda Abín, Trinidad García and Celestino Rodríguez

Children 2023, 10(6), 1002; https://doi.org/10.3390/children10061002 - 2 Jun 2023

Cited by 8 | Viewed by 5106

Abstract

(1) Background: Executive functions and creativity could play an important role in children’s education. To date, research on the relationship between these constructs has focused on adults. The objective of this systematic review was to analyze the relationship between executive functions (EFs) and [...] Read more.

(1) Background: Executive functions and creativity could play an important role in children’s education. To date, research on the relationship between these constructs has focused on adults. The objective of this systematic review was to analyze the relationship between executive functions (EFs) and creativity in children to provide teachers with tools to improve students’ abilities. (2) Methods: A total of 12 studies were identified using WOS, SCOPUS and PsycINFO, which matched the following criteria: (i) empirical studies with measures of executive functions and creativity; (ii) a sample of children or adolescents (3 to 18 years old); and (iii) in the previous decade (2012–2021). (3) Results: The results indicated a clear relationship between flexibility and creativity. Flexibility is positively correlated and inhibition is negatively correlated with creativity. There is no clear evidence that the remaining EFs, such as working memory, correlate with creativity. There was insufficient evidence on the relationship between intelligence, executive functions and creativity in a sample of children for the results to be generalized. (4) Conclusion: Future studies should consider the variability of standardized tests that measure these two constructs in order to be able to compare measurements and obtain generalizable results. Full article

(This article belongs to the Section Pediatric Neurology & Neurodevelopmental Disorders)

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18 pages, 332 KB

Open AccessEditor’s ChoiceArticle

Differential Diagnosis of ICD-11 Personality Disorder and Autism Spectrum Disorder in Adolescents

by Bo Bach and Martin Vestergaard

Children 2023, 10(6), 992; https://doi.org/10.3390/children10060992 - 1 Jun 2023

Cited by 16 | Viewed by 11635

Abstract

The International Classification of Diseases 11th Revision (ICD-11) introduces fundamentally new diagnostic descriptions for personality disorder and autism spectrum disorder. Instead of the traditional categorical taxonomies, both personality disorder and autism spectrum disorder are described as being on a continuum. Accumulating research has [...] Read more.

The International Classification of Diseases 11th Revision (ICD-11) introduces fundamentally new diagnostic descriptions for personality disorder and autism spectrum disorder. Instead of the traditional categorical taxonomies, both personality disorder and autism spectrum disorder are described as being on a continuum. Accumulating research has pointed out that, in some cases, adolescents with autism spectrum disorder are at risk of being confused with having a personality disorder, which particularly applies to female adolescents. Case reports describe how adult autistic women struggled with social and identity roles as children and adolescents, using compensatory strategies such as social imitation and other types of camouflaging. Furthermore, some adolescents with autism display emotion dysregulation and self-injury. The ICD-11 recognizes that features of autism spectrum disorder may resemble features of personality disorder, but the two diagnoses have not yet been formally compared to one another. The present article therefore sought to outline and discuss the overlap and boundaries between the ICD-11 definitions of personality disorder and autism spectrum disorder and propose guiding principles that may assist practitioners in differential diagnosis with female adolescents. We specifically highlight how aspects of the self and interpersonal functioning along with emotional, cognitive, and behavioral manifestations may overlap across the two diagnoses. Restricted, repetitive, and inflexible patterns of behavior, interests, and activities are core features of autism spectrum disorder, which may be masked or less pronounced in female adolescents. Collecting a developmental history of the early presence or absence of autistic features is vital for a conclusive diagnosis, including features that are typically camouflaged in females. A number of future directions for research and clinical practice are proposed. Full article

(This article belongs to the Special Issue ICD-11 Personality Disorder in Adolescents: Potentials and Pitfalls)

13 pages, 359 KB

Open AccessEditor’s ChoiceArticle

Prenatal Predictors of Neurobehavioral Outcome in Children with Fetal Growth Restriction at 6 Years of Age: A Retrospective Cohort Study

by Mª José Benítez Marín, Marta Blasco Alonso and Ernesto González Mesa

Children 2023, 10(6), 997; https://doi.org/10.3390/children10060997 - 1 Jun 2023

Cited by 6 | Viewed by 2453

Abstract

(1) Background: Fetal growth restriction (FGR) increases the risk of adverse neurodevelopmental outcomes, especially in preterm newborns. This study aims to describe the behavioral results of FGR at 6 years of age and to demonstrate the relationship of certain predictive factors with this [...] Read more.

(1) Background: Fetal growth restriction (FGR) increases the risk of adverse neurodevelopmental outcomes, especially in preterm newborns. This study aims to describe the behavioral results of FGR at 6 years of age and to demonstrate the relationship of certain predictive factors with this development. (2) Methods: This retrospective cohort study included 70 children born in 2015 at the University Hospital Carlos Haya, Málaga, Spain who had been exposed to FGR during pregnancy; neonatal and infant data were recorded retrospectively. Children were assessed prospectively at 6 years of age by means of a strengths and difficulties questionnaire (SDQ) to study behavioral outcomes. (3) Results: We demonstrated that there are higher behavioral disability rates in children exposed to FGR during pregnancy and, in particular, high rates of hyperactivity or conduct problems. We also proved a negative relationship between the birth weight percentile and the total behavioral scale score, along with a positive correlation between hyperactivity and the emotional and behavioral scales. Learning difficulties were more frequent in early-onset FGR than in late-onset FGR. (4) Conclusions: Our study of behavioral development has demonstrated higher behavioral disability rates in children with FGR at 6 years of age; specifically, high rates of hyperactivity or conduct problems. At the same time, we have proved a negative relationship between the birth weight percentile and the total behavioral scale score. Full article

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

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