Children

13 pages, 521 KiB

Open AccessEditor’s ChoiceArticle

Physical Activity and Sedentary Behavior in High School Students: A Quasi Experimental Study via Smartphone during the COVID-19 Pandemic

by Regina Márcia Ferreira Silva, Lauryane Fonseca Terra, Michele da Silva Valadão Fernandes, Priscilla Rayanne E. Silva Noll, Alexandre Aparecido de Almeida and Matias Noll

Children 2023, 10(3), 479; https://doi.org/10.3390/children10030479 - 1 Mar 2023

Cited by 9 | Viewed by 4348

Abstract

The objective of this study was to evaluate whether exposure to information about physical activity and its barriers can increase the level of physical activity and reduce the time exposed to sedentary behaviors in high school students involved in integrated professional and technological [...] Read more.

The objective of this study was to evaluate whether exposure to information about physical activity and its barriers can increase the level of physical activity and reduce the time exposed to sedentary behaviors in high school students involved in integrated professional and technological education during the coronavirus disease 2019 pandemic. This quasi experimental study was conducted with integrated education high school students, divided into two groups: Intervention Group (IG; n = 59) and Control Group (CG; n = 54). Physical activity and sedentary behavior were identified and measured using the International Physical Activity Questionnaire pre-and post-intervention for both groups. IG students received educational material thrice a week for four weeks. The focus of the material was the importance of physical activity and need to reduce the time exposed to sedentary behavior. The results revealed that IG students showed an average daily reduction of 47.14 min in time exposed to sedentary behaviors, while the CG students showed an increase of 31.37 min. Despite this, the intervention was not effective in improving physical activity levels in the IG and the mean reduction in the time exposed to sedentary behavior was not significant (p = 0.556). The intervention was ineffective in increasing the practice of physical activity and reducing the time exposed to sedentary behavior. Full article

(This article belongs to the Special Issue Promoting Physical Activity in the School Setting)

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32 pages, 1309 KiB

Open AccessEditor’s ChoiceSystematic Review

Components of Perinatal Palliative Care: An Integrative Review

by Laure Dombrecht, Kenneth Chambaere, Kim Beernaert, Ellen Roets, Mona De Vilder De Keyser, Gaëlle De Smet, Kristien Roelens and Filip Cools

Children 2023, 10(3), 482; https://doi.org/10.3390/children10030482 - 1 Mar 2023

Cited by 16 | Viewed by 5179

Abstract

When a severe diagnosis is made before or after birth, perinatal palliative care (PPC) can be provided to support the infant, parents and involved healthcare providers. An integrative and systematic overview of effectiveness and working components of existing PPC programs was needed. An [...] Read more.

When a severe diagnosis is made before or after birth, perinatal palliative care (PPC) can be provided to support the infant, parents and involved healthcare providers. An integrative and systematic overview of effectiveness and working components of existing PPC programs was needed. An integrative search was conducted in MEDLINE, Embase, CENTRAL, CINAHL, PsycInfo and Web of Science. Study designs examining the effect of PPC compared to regular care, and (empirical) articles describing the components of care included in existing PPC initiatives were included. Three independent authors reviewed titles, abstracts and full texts against eligibility criteria. PRISMA guidelines were followed; 21.893 records were identified; 69 publications met inclusion criteria. Twelve publications (17.4%) discussed the effect of a PPC program. Other publications concerned the description of PPC programs, most often by means of a program description (22/69; 31.9%), guidelines (14/769; 20.3%) or case study (10/69; 14.5%). Outcome measures envisioned four main target categories: care coordination, parents and family members, care for the fetus/neonate and healthcare providers. No trials exist to date. Analysis of working components revealed components related to changes directed to the policy of the hospital wards and components involving actual care being provided within the PPC program, directed to the fetus or infant, the family, involved healthcare providers or external actors. PPC is a growing research field where evidence consists mainly of descriptive studies and guidelines. The extensive list of possible PPC components can serve as a checklist for developing future initiatives worldwide. PPC includes several important actors: the fetus/infant and their family and included healthcare providers on both maternity and neonatal wards. This leads to a large variety of possible care components. However, while some studies show proof of concept, an evidence base to determine which components are actually effective is lacking. Full article

(This article belongs to the Special Issue Palliative Care for the Youngest: Hot Topics in Perinatal and Neonatal Palliative Care across the Globe)

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12 pages, 1207 KiB

Open AccessEditor’s ChoiceArticle

Effect of 11 Weeks of Physical Exercise on Physical Fitness and Executive Functions in Children

by Mingyang Zhang, Hanna Garnier, Guoping Qian and Shunchang Li

Children 2023, 10(3), 485; https://doi.org/10.3390/children10030485 - 1 Mar 2023

Cited by 11 | Viewed by 3736

Abstract

Object: The aim of our study was to evaluate and compare the effects of physical exercise interventions on physical fitness and executive functions in children. Methods: Six-year-old children participated in the study and were randomly divided into physical exercise group (PE group, n [...] Read more.

Object: The aim of our study was to evaluate and compare the effects of physical exercise interventions on physical fitness and executive functions in children. Methods: Six-year-old children participated in the study and were randomly divided into physical exercise group (PE group, n = 43) and control group (C group, n = 46). The children in the PE group participated in a physical exercise program for 45 min daily, four days a week for 11 weeks. The children in the C group continued with their usual routines. Then, all the children were tested before and after the experiment for body composition (height, weight, BMI), physical fitness (20-m shuttle run test, standing long jump test, grip strength test, 4 × 10 m shuttle run test and sit and reach tests), and executive functions test (animal go/no-go task, working memory span task, simple reaction test and flexible item selection task) before and after the 11-week period. Results: The 11 weeks of physical exercise did not significantly affect the body composition of the children (p > 0.05). The physical fitness and executive functions test results showed that 11 weeks of physical exercise interventions improves physical fitness (cardiopulmonary fitness, muscle strength, speed sensitivity and flexibility quality) and executive functions parameters (inhibitory control, working memory, the reaction time, and cognitive flexibility) in children (p < 0.05, p < 0.01). Conclusion: 11 weeks of physical exercise can improve the physical fitness and executive functions of six-year-old children. Full article

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

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11 pages, 283 KiB

Open AccessEditor’s ChoiceArticle

Influence of Tooth Brushing and Previous Dental Visits on Dental Caries Status among Saudi Arabian Children

by Sreekanth Kumar Mallineni, Abdullah Alassaf, Basim Almulhim and Sara Alghamdi

Children 2023, 10(3), 471; https://doi.org/10.3390/children10030471 - 27 Feb 2023

Cited by 12 | Viewed by 3786

Abstract

Objective: To evaluate the dental caries status and its association with tooth brushing frequency and previous dental visits among Arabian children. Methods: Arabian school children attend a specialty pediatric dental clinic at Majmaah University, Saudi Arabia. Only children of Saudi origin with primary [...] Read more.

Objective: To evaluate the dental caries status and its association with tooth brushing frequency and previous dental visits among Arabian children. Methods: Arabian school children attend a specialty pediatric dental clinic at Majmaah University, Saudi Arabia. Only children of Saudi origin with primary dentition were included in the study, and only one examiner was involved in the assessment and data collection. The parents of children completed a questionnaire to investigate possible explanatory variables for caries status, including tooth brushing frequency and previous dental visits. Dental caries were diagnosed according to the criteria recommended by the World Health Organization (2013). The comparison performed was based on sex, age, tooth brushing frequency, and previous dental visits. The descriptive statistics were carried out using SPSS (version 21.0) with a p-value of <0.05 significance. Results: The study involved 268 Saudi children with a mean age of 4.6 ± 1.1 years. The caries prevalence was 78.8%, and the mean dmft was 5.82 ± 4.48, while the overall mean scores for decayed, missing, and filled were 3.903 ± 3.69, 1.18 ± 1.69, and 0.73 ± 1.35, respectively. The mean dmft scores for the <3 years, 3.1–6 years, and >6 years old children were found to be 1.74, 6.58, and 4.58, respectively. Among the children, the females reported higher dmf scores (7.51 ± 4.18) compared to males (4.97 ± 4.39) with a statistically significant difference (p < 0.001). Fifty percent of the children had tooth brushing habits of once daily, followed by never (22.4%), twice daily (15.7%), and rarely (11.2%) brushed their teeth. Statistically significant correlations were found between the children’s dental caries status, age, and dental visits, while sex and tooth brushing did not find a correlation. Conclusion: The prevalence of dental caries among Arabian preschool children was higher. Mandibular second molars were commonly affected by dental caries, while mandibular central incisors were less frequently affected. The child’s age and frequency of dental checkups were positively related to the prevalence of dental caries. Full article

(This article belongs to the Special Issue New Frontiers in Early Childhood Oral Health Care)

22 pages, 1707 KiB

Open AccessEditor’s ChoiceReview

Neuropsychological Outcomes of Children Treated for Brain Tumors

by Alessia Pancaldi, Marisa Pugliese, Camilla Migliozzi, Johanna Blom, Monica Cellini and Lorenzo Iughetti

Children 2023, 10(3), 472; https://doi.org/10.3390/children10030472 - 27 Feb 2023

Cited by 25 | Viewed by 8373

Abstract

Central nervous system (CNS) neoplasms are the most common solid tumors diagnosed in children. CNS tumors represent the leading cause of cancer death and cancer-related morbidity for children less than 20 years of age, although there has been a moderate increase in survival [...] Read more.

Central nervous system (CNS) neoplasms are the most common solid tumors diagnosed in children. CNS tumors represent the leading cause of cancer death and cancer-related morbidity for children less than 20 years of age, although there has been a moderate increase in survival rates over the past several decades. The average survival at 5 years now nearly reaches 75%, and for some, non-malignant histology approximates 97% at 20 years from diagnosis. Neurological, cognitive, and neuropsychological deficits are the most disabling long-term effects of brain tumors in children. Childhood is a time of extreme brain sensitivity and the time of life in which most brain development occurs. Thus, the long-term toxicities that children treated for CNS tumors experience can affect multiple developmental domains and day-to-day functioning, ultimately leading to a poor quality of survival (QoS). We reviewed literature focusing on the risk factors for cognitive and neuropsychological impairment in pediatric patients treated for brain tumors with the aim of better understanding who is at major risk and what the best strategies for monitoring these patients are. Full article

(This article belongs to the Section Pediatric Hematology & Oncology)

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10 pages, 1067 KiB

Open AccessEditor’s ChoiceArticle

Working with Children with Autism Undergoing Health-Care Assessments in a Day Hospital Setting: A Perspective from the Health-Care Professionals

by Chiara Davico, Daniele Marcotulli, Elisa Succi, Carlotta Canavese, Ancuta F. Bodea, Mariacristina Pellegrino, Enrica Cuffari, Valentina F. Cudia, Barbara Svevi, Federico Amianto, Federica Ricci and Benedetto Vitiello

Children 2023, 10(3), 476; https://doi.org/10.3390/children10030476 - 27 Feb 2023

Cited by 10 | Viewed by 5311

Abstract

Background: Hospitals can be especially stressful for children with autism spectrum disorder (ASD) due to the communication and social skills deficits, lower capacity to adapt to disruption, and sensory hypersensitivity that are typical of these patients. Purpose: This study investigated how health-care professionals [...] Read more.

Background: Hospitals can be especially stressful for children with autism spectrum disorder (ASD) due to the communication and social skills deficits, lower capacity to adapt to disruption, and sensory hypersensitivity that are typical of these patients. Purpose: This study investigated how health-care professionals (HPs) experienced the clinical care and management of children with ASD undergoing medical testing in a day hospital setting, and assessed the rate of successful completion of laboratory tests and instrumental examinations. Methods: A cross-sectional questionnaire was administered to 45 HPs, inquiring about their experience in obtaining blood and urine tests, ECG, audiometry, and EEG from children with ASD. The clinical sample included 153 consecutively referred children with ASD (74.5% males, mean age 5.6 years) undergoing a medical diagnostic work-up as part of their diagnostic evaluation. The success rate of completing the various assessments was examined. Results: HPs identified aggressive behavior and communication deficits as the major challenges when providing care to children with ASD. The parents were seen as an important resource for managing the children. The completion rate of the laboratory tests and instrumental examinations was high (between 88.5% and 98.4% according to the specific type of examination). The lowest non-completion rate was found for the EEG (12.5%). Conclusions: Despite considerable challenges being reported by HPs in managing children with ASD, the scheduled assessments could be completed in the large majority of cases. Targeted approaches to preventing aggressive behaviors and obviating the communication barriers in children with ASD undergoing hospital exams are warranted. Full article

(This article belongs to the Special Issue Autism and Children)

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10 pages, 1163 KiB

Open AccessEditor’s ChoiceArticle

Effect of Different Etching Times on Pit-and-Fissure Sealant Micro-Shear Bond Strength to the Enamel of Primary Teeth

by Johnny Kharouba, Anna Annael Gonoratsky, Tamar Brosh, Mahmoud Masri, Rabea Iraqi and Sigalit Blumer

Children 2023, 10(3), 461; https://doi.org/10.3390/children10030461 - 26 Feb 2023

Cited by 7 | Viewed by 3660

Abstract

Successful clinical use of pit-and-fissure sealants relies on the sufficient etching of the enamel, field isolation and sealant retention. The etching time changes the physical and mechanical surface properties of the etched tooth tissues; therefore, it impacts both etching depth and the bond [...] Read more.

Successful clinical use of pit-and-fissure sealants relies on the sufficient etching of the enamel, field isolation and sealant retention. The etching time changes the physical and mechanical surface properties of the etched tooth tissues; therefore, it impacts both etching depth and the bond strength of sealants to the enamel. We examined if reducing the recommended 15 s etching time of primary teeth enamel affects the micro-shear bond strength (µSBS) of pit-and-fissure sealants. The cusps of forty non-carious, extracted human primary molars were separately etched for 8, 15 or 30 s. Then, a pit-and-fissure sealant was placed and light-cured. The µSBS values were evaluated and compared among the three groups. The mean µSBS values ± standard deviations were 34.68 ± 16.93, 34.19 ± 17.35 and 36.56 ± 16.57 MPa in the cusps etched for 8, 15 and 30 s, respectively. No statistically significant differences in µSBS were observed among the three test groups. In this study, we showed for the first time that the recommended etching time of primary teeth enamel may be reduced from 15 to 8 s without compromising the µSBS of the sealant. Further evaluations in a clinical setting are warranted. Full article

(This article belongs to the Special Issue Pediatric Dental Health: Prevalence, Diagnosis and Treatment)

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9 pages, 291 KiB

Open AccessEditor’s ChoiceArticle

Complementary Feeding Methods: Associations with Feeding and Emotional Responsiveness

by Carla Fernandes, Fátima Martins, Ana F. Santos, Marília Fernandes and Manuela Veríssimo

Children 2023, 10(3), 464; https://doi.org/10.3390/children10030464 - 26 Feb 2023

Cited by 10 | Viewed by 3272

Abstract

Learning to eat complementary foods is a crucial milestone for infants, having implications across development. The most used method for introducing complementary foods is Traditional Spoon-Feeding (TSF). However, the alternative method Baby-Led Weaning (BLW) is increasingly becoming used as it has been associated [...] Read more.

Learning to eat complementary foods is a crucial milestone for infants, having implications across development. The most used method for introducing complementary foods is Traditional Spoon-Feeding (TSF). However, the alternative method Baby-Led Weaning (BLW) is increasingly becoming used as it has been associated with positive outcomes. Research analyzing associations between complementary feeding methods and responsive parenting is practically non-existent. Therefore, the objective of this study was to analyze differences in emotional and feeding responsiveness between caregivers who previously implemented traditional vs. non-traditional feeding approaches. Caregivers (mostly mothers) of 179 children between 3 and 5 years were asked about the complementary feeding method that they had followed previously (70.4% reported using the TSF, 16.8% said they used the BLW and 12.8% used both methods simultaneously). In addition, they reported on their feeding practices using the Comprehensive Feeding Practices Questionnaire and on their responses to children’s distress using the Coping with Children’s Negative Emotions Scale. The results showed that parents who reported using a non-traditional (BLW or both) complementary feeding method reported less pressure to eat and minimization of reactions to children’s negative emotions, compared to parents who used a traditional method (although these reported using more problem-focused reactions). The findings suggest that complementary feeding methods and responsive parenting may be linked, leaving the question of which one sets the stage for the other. Full article

(This article belongs to the Special Issue Childhood and Adolescent Obesity and Weight Management: 3rd Edition)

13 pages, 1008 KiB

Open AccessEditor’s ChoiceArticle

Dental Treatment Characteristics of Autistic Children and Differences in Dental Procedures under General Anesthesia Relative to Healthy Counterparts

by Bayan Alghafis, Abdulaziz Alharbi, Sanaa Al-Haj Ali, Faisal Alsineedi and Ohoud Alsudairi

Children 2023, 10(3), 466; https://doi.org/10.3390/children10030466 - 26 Feb 2023

Cited by 6 | Viewed by 3510

Abstract

Here, we assess the dental treatment characteristics among children with autism spectrum disorder (ASD) and compare the dental procedures delivered under general anesthesia (GA) with those of healthy-matched counterparts. In this retrospective cohort study, we collected data from medical records of ASD children [...] Read more.

Here, we assess the dental treatment characteristics among children with autism spectrum disorder (ASD) and compare the dental procedures delivered under general anesthesia (GA) with those of healthy-matched counterparts. In this retrospective cohort study, we collected data from medical records of ASD children (n = 82) which included demographic profile, medical status (including the severity of the ASD and associated comorbidities), and dental history (including dental visits, behavior, care approach, and dental procedures provided). For those children who received dental GA (DGA) (n = 64), we compared all procedures delivered and the number of repeat sessions with healthy children (n = 64). Our results reveal that most ASD children (78%) received DGA, mainly with one repeat session (63.4%). The dental procedures provided to the children differed significantly according to the severity of the ASD and the behavior of the children. Furthermore, increasing severity led to significantly worse behavior of the children, increased need for DGA and repeat sessions. Comparison of the dental procedures under GA with healthy children revealed a significantly lower mean of almost all dental procedures in ASD children, except fissure-sealed teeth (p < 0.05). Considering these findings, DGA is unavoidable for ASD children with moderate-to-severe conditions or negative behavior in the dental office, even when their dental needs are lower than healthy children. The severity of ASD was the most important factor affecting the behavior of the children and the care approach they received. Along with children’s behavior, they most influenced the dental procedures delivered and the need for repeat DGA. Full article

(This article belongs to the Special Issue Oral Health Behaviours and Their Predictors in Children)

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11 pages, 314 KiB

Open AccessEditor’s ChoiceReview

Dexmedetomidine: An Alternative to Pain Treatment in Neonatology

by Laura Mantecón-Fernández, Sonia Lareu-Vidal, Clara González-López, Gonzalo Solís-Sánchez and Marta Suárez-Rodríguez

Children 2023, 10(3), 454; https://doi.org/10.3390/children10030454 - 25 Feb 2023

Cited by 11 | Viewed by 4758

Abstract

Infants might be exposed to pain during their admissions in the neonatal intensive care unit [NICU], both from their underlying conditions and several invasive procedures required during their stay. Considering the particularities of this population, recognition and adequate management of pain continues to [...] Read more.

Infants might be exposed to pain during their admissions in the neonatal intensive care unit [NICU], both from their underlying conditions and several invasive procedures required during their stay. Considering the particularities of this population, recognition and adequate management of pain continues to be a challenge for neonatologists and investigators. Diverse therapies are available for treatment, including non-pharmacological pain management measures and pharmacological agents (sucrose, opioids, midazolam, acetaminophen, topical agents…) and research continues. In recent years one of the most promising drugs for analgesia has been dexmedetomidine, an alpha-2 adrenergic receptor agonist. It has shown a promising efficacy and safety profile as it produces anxiolysis, sedation and analgesia without respiratory depression. Moreover, studies have shown a neuroprotective role in animal models which could be beneficial to neonatal population, especially in preterm newborns. Side effects of this therapy are mainly cardiovascular, but in most studies published, those were not severe and did not require specific therapeutic measures for their resolution. The main objective of this article is to summarize the existing literature on neonatal pain management strategies available and review the efficacy of dexmedetomidine as a new therapy with increasing use in the NICU. Full article

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

18 pages, 317 KiB

Open AccessEditor’s ChoiceReview

Food Advertisement and Dietary Choices in Adolescents: An Overview of Recent Studies

by Anastasia Tsochantaridou, Theodoros N. Sergentanis, Maria G. Grammatikopoulou, Kyriakoula Merakou, Tonia Vassilakou and Eleni Kornarou

Children 2023, 10(3), 442; https://doi.org/10.3390/children10030442 - 24 Feb 2023

Cited by 23 | Viewed by 15157

Abstract

Adolescents are exposed to food marketing through many routes, including television, movies, videos, print media, online games, and social media. The interplay between exposure to unhealthy food advertisements and food choices by adolescents is a field of special interest given the ongoing evolution [...] Read more.

Adolescents are exposed to food marketing through many routes, including television, movies, videos, print media, online games, and social media. The interplay between exposure to unhealthy food advertisements and food choices by adolescents is a field of special interest given the ongoing evolution of social media trends and marketing strategies. The purpose of this review was to synthesize the scientific findings in the last five years (2017–2022) regarding the possible influence of nutrition-related advertisements through television, social media, or video games on the choice and consumption of unhealthy foods and drinks in adolescents. Nineteen studies were included in this review. Adolescents exposed to unhealthy food and beverage advertising showed high desire and intention to consume the advertised foods, as evidenced by the majority of included studies. The effects of advertisements are reinforced by peer pressure and influencers and interact with socioeconomic, biological, and environmental factors. Food marketing represents part of the obesogenic environment of the present time. Full article

(This article belongs to the Special Issue Body Image, Weight Pressure and Disordered Eating Behaviors among Children and Adolescents)

16 pages, 1971 KiB

Open AccessEditor’s ChoiceArticle

Relationship between Product and Process Characteristics of Handwriting Skills of Children in the Second Grade of Elementary School

by Helena Coradinho, Filipe Melo, Gabriela Almeida, Guida Veiga, José Marmeleira, Hans-Leo Teulings and Ana Rita Matias

Children 2023, 10(3), 445; https://doi.org/10.3390/children10030445 - 24 Feb 2023

Cited by 6 | Viewed by 3050

Abstract

The purpose of this study was to analyze the relationship between the quality and speed of handwriting and the process characteristics of the handwriting of children in the second grade of elementary school considered as a function of age and gender. A sample [...] Read more.

The purpose of this study was to analyze the relationship between the quality and speed of handwriting and the process characteristics of the handwriting of children in the second grade of elementary school considered as a function of age and gender. A sample of 57 children (mean age 7.25 years, SD 0.43) participated in the study. The Concise Assessment Method for Children’s Handwriting (BHK) was used to assess the quality and speed of handwriting. The characteristics of the process of handwriting were assessed using MovAlyzeR^® software. The handwriting of boys showed a significantly greater number of strokes and slanted more to the right than the handwriting of girls. Handwriting quality and speed significantly correlated with several process characteristics: the number of strokes, reaction time, duration, relative pen-down duration, average pen pressure, vertical size, horizontal size, road length, and average absolute velocity. This research contributes to the construction of normative values in the process characteristics of the handwriting of elementary school children and provides a promising step towards the early identification of difficulties that can lead to dysgraphia, thus preventing later difficulties in handwriting. Full article

(This article belongs to the Special Issue Child Psychomotricity: Development, Assessment, and Intervention)

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11 pages, 583 KiB

Open AccessEditor’s ChoiceReview

The Role of a First Aid Training Program for Young Children: A Systematic Review

by Eleana Tse, Katerina Plakitsi, Spyridon Voulgaris and George A. Alexiou

Children 2023, 10(3), 431; https://doi.org/10.3390/children10030431 - 23 Feb 2023

Cited by 9 | Viewed by 9603

Abstract

Background: Many first aid programs have been conducted in schools, and researchers have identified that interventions improved students’ knowledge, skills, and attitude. This study examines the content, practices, and assessment of first aid interventions at primary schools and evaluates their effectiveness. Methods: A [...] Read more.

Background: Many first aid programs have been conducted in schools, and researchers have identified that interventions improved students’ knowledge, skills, and attitude. This study examines the content, practices, and assessment of first aid interventions at primary schools and evaluates their effectiveness. Methods: A systematic review was undertaken. We searched MEDLINE and Cochrane library databases from January 1990 to December 2021 using the search terms: ‘’first aid’’ AND ‘’primary school children’’. School-based first aid training targeting 6 to 10 years old studies in English were eligible for inclusion. Results: We included 11 studies that were approached by experimental (n = 6) and by observational studies (n = 5). Researchers conducted interventions in Europe (n = 9) and America (n = 2). An essential part of the teaching was hands-on practice. Most studies included in their program cardiopulmonary resuscitation (n = 8) and basic life support (n = 7). The main findings showed that trained children have significantly better knowledge of and skills in first aid than those before or without training. Children under 11 years old were not strong enough to achieve the proper depth of chest compressions. Depth of chest compressions correlates with children’s age, weight, height (n = 2), and body mass index (n = 3). Conclusions The effectiveness of resuscitative or non-resuscitative first-aid training for primary school children improved students’ knowledge and skills. Subsequent research could investigate children’s reactions in actual first aid conditions. Full article

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

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25 pages, 492 KiB

Open AccessEditor’s ChoiceReview

Food Allergies and Quality of Life among School-Aged Children and Adolescents: A Systematic Review

by Artemis-Eirini Drakouli, Ioanna Kontele, Dimitrios Poulimeneas, Stella Saripanagiotou, Maria G. Grammatikopoulou, Theodoros N. Sergentanis and Tonia Vassilakou

Children 2023, 10(3), 433; https://doi.org/10.3390/children10030433 - 23 Feb 2023

Cited by 13 | Viewed by 4900

Abstract

Recently, besides the focus on the medical diagnosis and therapeutic interventions for food allergy (FA), the psychosocial aspects of this frequent condition have also been investigated. The current systematic review aimed to explore and synthesize the scientific evidence published from January 2015 to [...] Read more.

Recently, besides the focus on the medical diagnosis and therapeutic interventions for food allergy (FA), the psychosocial aspects of this frequent condition have also been investigated. The current systematic review aimed to explore and synthesize the scientific evidence published from January 2015 to April 2022 on Health-Related Quality of Life (HRQoL) among children and adolescents with FAs. Twenty-eight research studies were included in the review, which was conducted on three databases (PubMed, Scopus and Cochrane Library). In most studies, the scores indicate an average level of HRQoL for children and adolescents with FAs, with girls and older children being more negatively affected than boys and younger ones, respectively. Few studies compared HRQoL between children with FA and healthy children, with 3 of them showing worse HRQoL for children with FAs. Immunotherapy has been found to improve the QoL of children with FAs. Anaphylaxis history, number of FAs, additional allergies, number and severity of symptoms were identified as the main factors with a negative impact on QoL. More comparative studies on the HRQoL of children and adolescents with FAs and healthy populations or children with other chronic diseases are required in order to improve QoL of children with FAs. Full article

(This article belongs to the Special Issue Nutrition in Pediatric Patients and Vulnerable Populations: Updates and Advances)

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15 pages, 316 KiB

Open AccessEditor’s ChoiceArticle

Exploring the Opportunity to Use Virtual Reality for the Education of Children with Disabilities

by Ioana Bianca Chițu, Alina Simona Tecău, Cristinel Petrișor Constantin, Bianca Tescașiu, Tamara-Oana Brătucu, Gabriel Brătucu and Ioana-Mădălina Purcaru

Children 2023, 10(3), 436; https://doi.org/10.3390/children10030436 - 23 Feb 2023

Cited by 15 | Viewed by 7557

Abstract

Inclusive education represents one of the most challenging aspects of modern education. In recent years, a major challenge in achieving inclusivity in education has been to find modern tools that might adapt the teaching process to the needs of children with disabilities. This [...] Read more.

Inclusive education represents one of the most challenging aspects of modern education. In recent years, a major challenge in achieving inclusivity in education has been to find modern tools that might adapt the teaching process to the needs of children with disabilities. This article investigates the possibility to use virtual reality (VR) technology to improve the learning process of children with disabilities. In this regard, a qualitative study based on the Focus Group method was conducted among 31 specialists who work with children with disabilities, with the aim of identifying potential opportunities and limits of using VR technology in the education of this category of children. The research results reveal that for most of the interviewees the VR application was a new experience; they appreciated that this technology could improve the educational process for children with disabilities and it could become a useful tool to support the education of such children. These results could have a positive impact on the activities carried out by policymakers, academia, and the economic environment in their efforts to implement policies aimed at improving the inclusive education system. To this end, some VR applications could be developed in a collaborative system involving IT companies and universities in the designing and implementation of these applications. Full article

15 pages, 417 KiB

Open AccessEditor’s ChoiceArticle

The Mother-Baby Bond: Role of Past and Current Relationships

by Emanuela Bianciardi, Francesca Ongaretto, Alberto De Stefano, Alberto Siracusano and Cinzia Niolu

Children 2023, 10(3), 421; https://doi.org/10.3390/children10030421 - 22 Feb 2023

Cited by 11 | Viewed by 6102

Abstract

During the perinatal period, up to 25% of women experience difficulties in relating to their child. The mother-child bond promotes the transition to motherhood, protects the woman from depression, and protects the child from the intergenerational transmission of the disease. This study prospectively [...] Read more.

During the perinatal period, up to 25% of women experience difficulties in relating to their child. The mother-child bond promotes the transition to motherhood, protects the woman from depression, and protects the child from the intergenerational transmission of the disease. This study prospectively investigated if the relationship with the co-parent, the attachment style, and the bond that women had with their parents influenced the mother-fetus and then mother-child bond. We also explored the role of depression and anxiety. One hundred nineteen pregnant women were enrolled. We administered clinical interviews and psychometric tools. A telephone interview was conducted at 1, 3, and 6 months of follow-up. Maternal insecure attachment style (r = −0.253, p = 0.006) and women’s dyadic adjustment in the couple’s relationships (r = 0.182, p = 0.049) were correlated with lower maternal–fetal attachment. Insecure attachment styles and depression correlate with bottle-feeding rather than breastfeeding. The bond women had with their mothers, not their fathers, was associated with breastfeeding. Depression (OR = 0.243, p = 0.008) and anxiety (OR = 0.185, p = 0.004; OR = 0.304, p < 0.0001) were related to mother-infant bonding. Close relationships, past and present, affect the bond with the fetus and the child differently. Psychotherapy can provide reassuring and restorative intersubjective experiences. Full article

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

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15 pages, 1232 KiB

Open AccessEditor’s ChoiceReview

Strategies to Aid Successful Transition of Adolescents with Congenital Heart Disease: A Systematic Review

by Pier Paolo Bassareo, Massimo Chessa, Giovanni Di Salvo, Kevin Patrick Walsh and Colin Joseph Mcmahon

Children 2023, 10(3), 423; https://doi.org/10.3390/children10030423 - 22 Feb 2023

Cited by 10 | Viewed by 3399

Abstract

The majority of patients born with congenital heart disease (CHD) need lifelong surveillance with serial clinical attendance and examinations. However, loss of follow-up (namely no documented follow-up for 3 years or more) is a recognised common problem since it is often related to [...] Read more.

The majority of patients born with congenital heart disease (CHD) need lifelong surveillance with serial clinical attendance and examinations. However, loss of follow-up (namely no documented follow-up for 3 years or more) is a recognised common problem since it is often related to remarkable worsening in the health of CHD patients with increased morbidity and mortality. Transitioning from paediatric to adult care has proven to be the most vulnerable point in the care of these subjects. As such, a systematic review was carried out to ask the following questions: What is the percentage of loss of follow-up worldwide? Are there regional fluctuations in the percentage? Is there a link between loss of follow-up and the complexity of CHD? What strategies should be employed to lower the risk of discontinuity in care? The most recent worldwide averaged loss of follow-up is 26.1%, with significant fluctuations across continents and countries. This percentage is even higher (31.9%) when one includes all untraceable patients, presuming that they are not having any cardiac follow-up. The highest discontinuity of care was reported in the USA and in patients with simple CHD. Planning the rules of transition seems to be one of the most reliable tools to minimise the number of CHD patients who are lost in transition. Recalling patients, with general practitioners who are crucial in readdressing half of the lost to follow-up CHD patients to adult CHD specialists, and a good relationship between paediatric cardiologists and the adult CHD team are two other valuable strategies in aiding successful transition. Full article

(This article belongs to the Special Issue Research Progress of the Pediatric Cardiology: 2nd Edition)

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14 pages, 1006 KiB

Open AccessEditor’s ChoiceArticle

Effects of Telerehabilitation-Based Structured Home Program on Activity, Participation and Goal Achievement in Preschool Children with Cerebral Palsy: A Triple-Blinded Randomized Controlled Trial

by Sinem Asena Sel, Mintaze Kerem Günel, Sabri Erdem and Merve Tunçdemir

Children 2023, 10(3), 424; https://doi.org/10.3390/children10030424 - 22 Feb 2023

Cited by 11 | Viewed by 3718

Abstract

A home program is implemented as an evidence-based mode of delivering services for physiotherapy and rehabilitation. Telerehabilitation is a method applied in physiotherapy modalities for children. This study aims to determine the effectiveness of usual care plus a Telerehabilitation-Based Structured Home Program on [...] Read more.

A home program is implemented as an evidence-based mode of delivering services for physiotherapy and rehabilitation. Telerehabilitation is a method applied in physiotherapy modalities for children. This study aims to determine the effectiveness of usual care plus a Telerehabilitation-Based Structured Home Program on preschool children with cerebral palsy (CP) compared to usual care. Forty-three children aged 3–6 years (mean age 4.66 ± 1.08 years) with CP were randomly assigned to the Telerehabilitation-Based Structured Home Program and usual care groups. Their motor function was assessed with the Gross Motor Function Measure (GMFM); performance and satisfaction were evaluated with the Canadian Occupational Performance Measure (COPM); goal achievement was assessed with the Goal Attainment Scale (GAS); and activity and participation were evaluated with Pediatric Evaluation of Disability Inventory (PEDI). Participants were evaluated at baseline, immediately post-intervention (12 weeks) and at follow-up (24 weeks). There was a statistically significant difference between pre- and post-test GMFM, COPM, GAS and PEDI scores in the intervention and control groups (p < 0.001). The Telerehabilitation-Based Structured Home Program showed statistically significant changes in activity, participation and goal achievement after 12 weeks of intervention (p < 0.001). However, significant results were not obtained in the usual care group. The Telerehabilitation-Based Structured Home Program may be an effective method for preschool children with CP. (Registration number: NCT04807790; no = KA-20124/26.01.2021). Full article

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

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12 pages, 457 KiB

Open AccessEditor’s ChoiceArticle

Improvement of Self-Esteem in Children with Specific Learning Disorders after Donkey-Assisted Therapy

by Francesco Corallo, Lilla Bonanno, Davide Cardile, Francesca Luvarà, Silvia Giliberto, Marcella Di Cara, Simona Leonardi, Angelo Quartarone, Giuseppe Rao and Alessandra Pidalà

Children 2023, 10(3), 425; https://doi.org/10.3390/children10030425 - 22 Feb 2023

Cited by 8 | Viewed by 3623

Abstract

Dyslexia is a learning disorder related to receptive language characterized by difficulties with decoding, fluent word recognition, automatic naming skills and/or reading comprehension skills. It usually leads to severe functional impairment and the permanent need for support and interventions. Since animal-assisted interventions (AAIs) [...] Read more.

Dyslexia is a learning disorder related to receptive language characterized by difficulties with decoding, fluent word recognition, automatic naming skills and/or reading comprehension skills. It usually leads to severe functional impairment and the permanent need for support and interventions. Since animal-assisted interventions (AAIs) have been found to improve physical, emotional, cognitive and/or social functioning in humans, the aim of this study is to demonstrate the effectiveness of onotherapy on children with SLD by improving self-esteem and school performance. Sixteen patients with a diagnosis of dyslexia were randomly assigned to two treatment groups: the first was a conventional neuropsychological group therapy without onotherapy, and the second was a neuropsychological group therapy incorporating AAIs with therapy donkeys. The neuropsychological assessment included the WISC-IV, DDE and the TMA test, which were administered before and after the treatment in both groups. The results of the experimental group show significant improvement in word reading test correctness (p = 0.03) and speed (p = 0.03), non-word reading test speed (p = 0.01), reading text test correctness (p = 0.05) and speed (p = 0.03), word writing test correctness (p = 0.01), non-word writing test correctness (p = 0.02), writing sentences with homophonic words correctness (p = 0.01), interpersonal TMA (p = 0.04) and the total TMA (p = 0.04), which were significative. On the other hand, in the control group, significant differences were found in word reading test speed (p = 0.01), non-word reading test speed (p = 0.04), reading text test speed (p = 0.02), writing word test correctness (p = 0.01), writing non-word test correctness (p = 0.01) and writing sentences with homophonic words (p = 0.01). However, in this group, we observed no significant difference in the esteem of children. Training associated with the donkeys determined improved scholastic performances as far as reading is concerned and a change in self-esteem. Therefore, we can state that AAIs for dyslexia could be a viable and effective option to enhance the rehabilitation process, increase self-esteem and improve cognitive functions and language skills recovery. Full article

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

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14 pages, 289 KiB

Open AccessEditor’s ChoiceArticle

Gaming Preferences and Personality among School Students

by Balan Rathakrishnan, Soon Singh Bikar Singh and Azizi Yahaya

Children 2023, 10(3), 428; https://doi.org/10.3390/children10030428 - 22 Feb 2023

Cited by 10 | Viewed by 6982

Abstract

Gaming has vastly developed into numerous genres; nonetheless, most studies in the literature emphasize the violent genre only. Therefore, this study was conducted to investigate the relationship between personality and gaming preferences among school students. This study also aims to investigate the difference [...] Read more.

Gaming has vastly developed into numerous genres; nonetheless, most studies in the literature emphasize the violent genre only. Therefore, this study was conducted to investigate the relationship between personality and gaming preferences among school students. This study also aims to investigate the difference in the time spent on gaming based on gender. The third objective involves examining the differences in frequency in playing a video game based on age. The sample group comprised 420 school students aged between 12 and 17 years old, including hardcore and casual gamers. The online survey was conducted using Google Forms, and the participants were requested to answer the demographic questionnaire, Big Five Inventory, and Gaming Preferences Questionnaire. The obtained data were analyzed using SPSS 26.0 software for general descriptive statistics. The results show that there was a significant relationship between gaming preferences role-playing game (RPG), combat, online, and music genres) and personality (extraversion, agreeableness, conscientious, neuroticism, and openness). The results also indicate a difference between gender and the number of hours spent on gaming, but no such difference existed between age and the frequency of playing games. From the psychological perspective, gaming preference is related to their personality and influences the behavior of children and overall health in daily life. Full article

(This article belongs to the Section Pediatric Mental Health)

12 pages, 1075 KiB

Open AccessEditor’s ChoiceArticle

Associations between Force-Time Related Single-Leg Counter Movement Jump Variables, Agility, and Linear Sprint in Competitive Youth Male Basketball Players

by Ömer Pamuk, Yücel Makaracı, Levent Ceylan, Hamza Küçük, Tuba Kızılet, Tülay Ceylan and Erdi Kaya

Children 2023, 10(3), 427; https://doi.org/10.3390/children10030427 - 22 Feb 2023

Cited by 17 | Viewed by 5437

Abstract

Background: Previous research has reported a strong relationship between vertical jumping, sprinting, and agility, as a reflection of lower-limb power. Unilateral analysis of this relationship has not yet been explored. This study primarily investigated the associations between single-leg countermovement jump (CMJ), sprint, and [...] Read more.

Background: Previous research has reported a strong relationship between vertical jumping, sprinting, and agility, as a reflection of lower-limb power. Unilateral analysis of this relationship has not yet been explored. This study primarily investigated the associations between single-leg countermovement jump (CMJ), sprint, and agility performances in youth basketball players. Methods: Thirty-five male basketball players from the youth category (age 15.06 ± 2.62 years, n = 32 right-limb dominant; n = 3 left-limb dominant) performed single-leg CMJ, 20 m sprint, and T-drill agility tests over two sessions. Force–time-related performance variables were measured using a single-leg CMJ test on a Kistler force plate. Results: Significant moderate to large negative correlations were observed between single-leg CMJ variables, 20 m sprint, and T-drill agility, except for mean force for both dominant and non-dominant leg measures (r = −0.384 to −0.705). Mean power and mean force were correlated with the physical characteristics of the athletes for both legs (r = −0.389 to −0.843). Flight time and jump height were identified as the best predictor variables for both sprint and agility time in the stepwise model (R² = 0.608 to 0.660). No statistical inter-limb differences were found during the single-leg CMJ test (p > 0.05). Conclusions: The study findings suggest that youth basketball players with greater single-leg jump output most likely have better sprint and agility performances. Thus, trainers and athletic performance coaches may include unilateral limb exercises in their training programs to enhance lower-limb explosive performance and reduce limb asymmetries. Full article

(This article belongs to the Special Issue Childhood Physical Activity and Health)

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12 pages, 5467 KiB

Open AccessEditor’s ChoiceArticle

Effectiveness of an Oral Health Education Program Using a Smart Toothbrush with Quantitative Light-Induced Fluorescence Technology in Children

by Jihyun Lee, Taeyang Lee, Hoi-In Jung, Wonse Park and Je Seon Song

Children 2023, 10(3), 429; https://doi.org/10.3390/children10030429 - 22 Feb 2023

Cited by 10 | Viewed by 6796

Abstract

This randomized controlled trial aimed to educate patients and manage oral hygiene remotely via a smart toothbrush (ST) by using mobile applications and to improve oral hygiene and habits by evaluating the plaque state via images from a Q-ray cam, which is a [...] Read more.

This randomized controlled trial aimed to educate patients and manage oral hygiene remotely via a smart toothbrush (ST) by using mobile applications and to improve oral hygiene and habits by evaluating the plaque state via images from a Q-ray cam, which is a quantitative light-induced fluorescence (QLF) digital imaging device. In total, 68 children (aged 6–12 years) were randomly divided into three groups. Group I was assigned an electro-toothbrush (ET), group II was assigned a smart toothbrush (ST), and group III used a manual toothbrush (MT). Each group used an assigned toothbrush and was checked after 1 and 3 months. Oral hygiene status was evaluated using the patient hygiene performance (PHP) index and fluorescent plaque index (FPI), which are presented in the QLF program. In addition, questionnaires on oral health behaviors and attitudes were also evaluated. There was a 0.24 decrease in the PHP index and a 1.40 decrease in the simple hygiene score three months later compared with the baseline in the ST group, with no significant difference between the three methods (p = 0.518, p = 0.626). Many group II participants said that ST helped with oral hygiene, and they were willing to use it continuously. In addition, all participants’ brushing times and attitudes toward oral hygiene improved after oral hygiene education using a Q-ray cam. Therefore, the use of STs provided good dental health education and a plaque-decreasing effect to children aged 6–12 years old. Furthermore, the QLF device can be used as a useful tool for maintaining good oral hygiene in children. Full article

(This article belongs to the Section Pediatric Dentistry & Oral Medicine)

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17 pages, 867 KiB

Open AccessEditor’s ChoiceReview

Evaluation of Individuals with Non-Syndromic Global Developmental Delay and Intellectual Disability

by Rowim AlMutiri, Maisa Malta, Michael I. Shevell and Myriam Srour

Children 2023, 10(3), 414; https://doi.org/10.3390/children10030414 - 21 Feb 2023

Cited by 9 | Viewed by 5972

Abstract

Global Developmental Delay (GDD) and Intellectual Disability (ID) are two of the most common presentations encountered by physicians taking care of children. GDD/ID is classified into non-syndromic GDD/ID, where GDD/ID is the sole evident clinical feature, or syndromic GDD/ID, where there are additional [...] Read more.

Global Developmental Delay (GDD) and Intellectual Disability (ID) are two of the most common presentations encountered by physicians taking care of children. GDD/ID is classified into non-syndromic GDD/ID, where GDD/ID is the sole evident clinical feature, or syndromic GDD/ID, where there are additional clinical features or co-morbidities present. Careful evaluation of children with GDD and ID, starting with detailed history followed by a thorough examination, remain the cornerstone for etiologic diagnosis. However, when initial history and examination fail to identify a probable underlying etiology, further genetic testing is warranted. In recent years, genetic testing has been shown to be the single most important diagnostic modality for clinicians evaluating children with non-syndromic GDD/ID. In this review, we discuss different genetic testing currently available, review common underlying copy-number variants and molecular pathways, explore the recent evidence and recommendations for genetic evaluation and discuss an approach to the diagnosis and management of children with non-syndromic GDD and ID. Full article

(This article belongs to the Special Issue Genetic Diagnosis in Children with Developmental Delay)

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14 pages, 462 KiB

Open AccessEditor’s ChoiceArticle

Efficacy of a Task-Oriented Intervention for Children with a Dual Diagnosis of Specific Learning Disabilities and Developmental Coordination Disorder: A Pilot Study

by Eugène A. A. Rameckers, Roche Crafford, Gillian Ferguson and Bouwien C. M. Smits Engelsman

Children 2023, 10(3), 415; https://doi.org/10.3390/children10030415 - 21 Feb 2023

Cited by 7 | Viewed by 5438

Abstract

Background: Task-oriented approaches are recommended for children with developmental coordination disorder (DCD) to address deficits in motor performance and reduce activity limitations. Although this approach is used in several settings, the efficacy of these approaches in children with in dual-diagnosis of specific learning [...] Read more.

Background: Task-oriented approaches are recommended for children with developmental coordination disorder (DCD) to address deficits in motor performance and reduce activity limitations. Although this approach is used in several settings, the efficacy of these approaches in children with in dual-diagnosis of specific learning disabilities (SLD) and DCD is less widely known. This study aims to determine the effect of a group-based intervention based on neuromotor task training (NTT) principles on the motor performance of children aged 6–10 years with SLD/DCD. Methods: A pre-post-test controlled study design was conducted in children with a primary diagnosis of specific learning disabilities (SLD). DCD status was confirmed based on clinical assessment. Children scoring ≤16th percentile on the Motor Assessment Battery for Children 2nd Edition (MABC-2), who also presented with a functional motor problem, according to the MABC checklist were considered as having DCD. Children were allocated to the NTT intervention group based on teachers’ perceived notion of need and received two 45–60 min training sessions per week for nine weeks. Children allocated to the usual care (UC) group, received their planned occupational therapy and physical education. The MABC-2 was used to assess changes in motor performance. Outcome and Results: Our numbers confirm that it is crucial to identify the presence of motor coordination difficulties in children who have been diagnosed with SLD. A task-oriented training program based on NTT principles, presented in small groups, has a positive effect on the motor performance in learners with neurodevelopmental disorders and this effect was larger than in the usual care group. Conclusion and Implications: Although using a small group format in children with multiple neurodevelopmental disorders may be challenging for the therapists, it may be a way of delivering services to children in schools for special education. What this paper adds: Children with DCD plus LSD show improvement in their motor skills by performing group-based NTT in the school environment. Group-based NTT shows a significant improvement in the TSS score of the MABC-2 compared to usual care. Children with DCD plus SLD show equal effect sizes after NTT intervention as DCD without SLD. Full article

(This article belongs to the Special Issue Advances in Rehabilitation of Children with Disabilities)

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11 pages, 421 KiB

Open AccessEditor’s ChoiceArticle

Neuroactive Amino Acid Profile in Autism Spectrum Disorder: Results from a Clinical Sample

by Martina Randazzo, Adriana Prato, MariaAnna Messina, Concetta Meli, Antonino Casabona, Renata Rizzo and Rita Barone

Children 2023, 10(2), 412; https://doi.org/10.3390/children10020412 - 20 Feb 2023

Cited by 16 | Viewed by 4660

Abstract

Biological bases of autism spectrum disorder (ASD) include both genetic and epigenetic causes. Patients with ASD show anomalies in the profile of certain plasma amino acids, including neuroactive amino acids. Monitoring plasma amino acids may be relevant for patient care and interventions. We [...] Read more.

Biological bases of autism spectrum disorder (ASD) include both genetic and epigenetic causes. Patients with ASD show anomalies in the profile of certain plasma amino acids, including neuroactive amino acids. Monitoring plasma amino acids may be relevant for patient care and interventions. We evaluated the plasma amino acid profile in samples extracted from dry blood spots by electrospray ionization-tandem mass spectrometry. Fourteen amino acids and eleven amino acid ratios were examined in patients with ASD and intellectual disability (ID), and neurotypical control subjects (TD). The amino acid profile in the ASD group showed reduced levels of ornithine (p = 0.008), phenylalanine (p = 0.042) and tyrosine (p = 0.013). The statistically significant amino acid ratios were Leu+Val/Phe+Tyr (p = 0.002), Tyr/Leu (p = 0.007) and Val/Phe (p = 0.028), such differences remaining significant only in the comparison between ASD and TD. Finally, a positive correlation emerged between the score of the restricted and repetitive behavior on ADOS-2 and the citrulline levels in the ASD group (p = 0.0047). To conclude, patients with ASD may show a distinguishable metabolic profile useful for studying their metabolic pathways in order to develop screening tests and targeted therapies. Full article

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

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12 pages, 825 KiB

Open AccessEditor’s ChoiceArticle

The Effect of the Treatment of Severe Early Childhood Caries on Growth-Development and Quality of Life

by Ecenur Eyisoy Bagis, Sera Simsek Derelioglu, Fatih Sengül and Sinan Yılmaz

Children 2023, 10(2), 411; https://doi.org/10.3390/children10020411 - 20 Feb 2023

Cited by 9 | Viewed by 3902

Abstract

Purpose: Untreated early childhood caries (ECC) adversely affect children’s quality of life. Our aim was to evaluate the effects of ECC on growth, development, and quality of life. Design and Methods: A total of 95 children were divided into three groups: general anesthesia [...] Read more.

Purpose: Untreated early childhood caries (ECC) adversely affect children’s quality of life. Our aim was to evaluate the effects of ECC on growth, development, and quality of life. Design and Methods: A total of 95 children were divided into three groups: general anesthesia (GA) (n = 31), dental clinic (DC) (n = 31), and control (n = 33). ECOHIS was applied to the parents in the GA and DC groups during a pre-treatment period and also applied in the post-treatment in the first and sixth months. Height, weight, and BMI measurements of the children in the study groups were taken and recorded at the pre-treatment stage and in the post-treatment in the first and sixth months. However, for the control group, these measurements were made just at the baseline and in the sixth month. Results: Upon the treatment of ECC, the total ECOHIS score significantly decreased (p < 0.001) in both groups in the following first month, whereas the scores of the children in the GA group reached a similar level to the DC group at the end of the sixth month. Following treatment, the weight and height of the children with ECC who initially had significantly lower BMI percentiles than the control group (p = 0.008) were observed to increase and, thus, they reached a similar BMI percentile value to the control group in the sixth month. Conclusions: The results of our study revealed that development and growth deficiencies in the children with ECC could be reversed rapidly by dental treatments and, thus, their quality of life would increase. The importance of treating ECC was revealed since treating ECC had positive effects both on the children’s growth and development and on the quality of life of the children and their parents. Full article

(This article belongs to the Section Global Pediatric Health)

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10 pages, 1137 KiB

Open AccessEditor’s ChoiceArticle

Postnatal Outcomes of Fetuses with Prenatal Diagnosis of 6–9.9 mm Pyelectasis

by Sivan Farladansky-Gershnabel, Hadar Gluska, Segev Meyer, Maya Sharon-Weiner, Hanoch Schreiber, Shmuel Arnon and Ofer Markovitch

Children 2023, 10(2), 407; https://doi.org/10.3390/children10020407 - 19 Feb 2023

Cited by 6 | Viewed by 8192

Abstract

Pyelectasis, also known as renal pelvic dilatation or hydronephrosis, is frequently found on fetal ultrasound. This study correlated prenatally-detected, moderate pyelectasis with postnatal outcomes. This retrospective, observational study was conducted at a tertiary medical center in Israel. The study group consisted of 54 [...] Read more.

Pyelectasis, also known as renal pelvic dilatation or hydronephrosis, is frequently found on fetal ultrasound. This study correlated prenatally-detected, moderate pyelectasis with postnatal outcomes. This retrospective, observational study was conducted at a tertiary medical center in Israel. The study group consisted of 54 fetuses with prenatal diagnosis of pyelectasis on ultrasound scan during the second trimester, defined as anteroposterior renal pelvic diameter (APRPD) 6–9.9 mm. Long-term postnatal outcomes and renal-related sequelae were obtained using medical records and telephone-based questionnaires. The control group included 98 cases with APRPD < 6 mm. Results indicate that fetal pyelectasis 6–9.9 mm was more frequent among males (68.5%) than females (51%, p = 0.034). We did not find significant correlations between 6–9.9 mm pyelectasis and other anomalies or chromosomal/genetic disorders. Pyelectasis resolved during the pregnancy in 15/54 (27.8%) cases. There was no change in 17/54 (31.5%) and 22/54 (40.7%) progressed to hydronephrosis Among the study group, 25/54 (46.3%) were diagnosed with neonatal hydronephrosis. There were more cases of renal reflux or renal obstruction in the study group compared to the control group 8/54 (14.8%) vs. 1/98 (1.0%), respectively; p = 0.002. In conclusion, most cases of 6–9.9 mm pyelectasis remained stable or resolved spontaneously during pregnancy. There was a higher rate of postnatal renal reflux and renal obstruction in this group; however, most did not require surgical intervention. Full article

(This article belongs to the Special Issue Advances in Healthcare for Neonates Volume II)

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14 pages, 1078 KiB

Open AccessEditor’s ChoiceArticle

Peer Support and Exercise Adherence in Adolescents: The Chain-Mediated Effects of Self-Efficacy and Self-Regulation

by Yuxin Zou, Shijie Liu, Shuangshuang Guo, Qiuhao Zhao and Yujun Cai

Children 2023, 10(2), 401; https://doi.org/10.3390/children10020401 - 18 Feb 2023

Cited by 28 | Viewed by 7583

Abstract

In the context of exercise psychology, the mediating relationship between peer support, self-efficacy and self-regulation, and adolescents’ exercise adherence was to be explored. Methods: A questionnaire was distributed among 2200 teenagers from twelve middle schools in Shanghai. The “process” program in SPSS and [...] Read more.

In the context of exercise psychology, the mediating relationship between peer support, self-efficacy and self-regulation, and adolescents’ exercise adherence was to be explored. Methods: A questionnaire was distributed among 2200 teenagers from twelve middle schools in Shanghai. The “process” program in SPSS and the bootstrap method were applied to construct and analyze the direct and indirect effects of peer support on adolescents’ exercise adherence. Results: Peer support directly affected adolescents’ exercise adherence (β = 0.135, p < 0.001, effect size of 59%) and self-efficacy (β = 0.493, p < 0.001, effect size accounted for 42%), and self-regulation (β = −0.184, p < 0.001, effect size of 11%) influenced exercise adherence indirectly. In addition, self-efficacy and self-regulation could impose a chain-mediated effect on peer support and exercise adherence (effect size of 6%). Conclusion: Peer support could promote adolescents’ exercise adherence. Self-efficacy and self-regulation are mediating factors of peer support on exercise adherence in teenagers, self-regulation as well as self-efficacy-imposed chain-mediating effects on peer support and adolescents’ exercise adherence. Full article

(This article belongs to the Special Issue Physical Education, Physical Activity, and Health Education in Children and Adolescents)

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17 pages, 395 KiB

Open AccessEditor’s ChoiceReview

Current Worldwide Trends in Pediatric Helicobacter pylori Antimicrobial Resistance

by Reka Borka Balas, Lorena Elena Meliț and Cristina Oana Mărginean

Children 2023, 10(2), 403; https://doi.org/10.3390/children10020403 - 18 Feb 2023

Cited by 14 | Viewed by 3220

Abstract

Helicobacter pylori (H. pylori) has acquired several resistance mechanisms in order to escape the currently used eradication regimens such as mutations that impair the replication, recombination, and transcription of DNA; the antibiotics capability to interact with protein synthesis and ribosomal activity; [...] Read more.

Helicobacter pylori (H. pylori) has acquired several resistance mechanisms in order to escape the currently used eradication regimens such as mutations that impair the replication, recombination, and transcription of DNA; the antibiotics capability to interact with protein synthesis and ribosomal activity; the adequate redox state of bacterial cells; or the penicillin-binding proteins. The aim of this review was to identify the differences in pediatric H. pylori antimicrobial-resistance trends between continents and countries of the same continent. In Asian pediatric patients, the greatest antimicrobial resistance was found to metronidazole (>50%), probably due to its wide use for parasitic infections. Aside from the increased resistance to metronidazole, the reports from different Asian countries indicated also high resistance rates to clarithromycin, suggesting that ciprofloxacin-based eradication therapy and bismuth-based quadruple therapy might be optimal choices for the eradication of H. pylori in Asian pediatric population. The scarce evidence for America revealed that H. pylori strains display an increased resistance to clarithromycin (up to 79.6%), but not all studies agreed on this statement. Pediatric patients from Africa also presented the greatest resistance rate to metronidazole (91%), but the results in terms of amoxicillin remain contradictory. Nevertheless, the lowest resistance rates in most of the African studies were found for quinolones. Among European children, the most frequent antimicrobial resistance was also noticed for metronidazole and clarithromycin (up to 59% and 45%) but with a predominance for clarithromycin as compared to other continents. The differences in antibiotic use among continents and countries worldwide is clearly responsible for the discrepancies regarding H. pylori antimicrobial-resistance patterns, emphasizing the crucial role of global judicious antibiotic use in order to control the increasing resistance rates worldwide. Full article

(This article belongs to the Special Issue Childhood Helicobacter pylori Infection: Treatment and Prevention)

11 pages, 1321 KiB

Open AccessEditor’s ChoiceArticle

The Effectiveness of the Schroth Best Practice Program and Chêneau-Type Brace Treatment in Adolescent Idiopathic Scoliosis: Long-Term Follow-Up Evaluation Results

by Tuğba Kuru Çolak, Burçin Akçay, Adnan Apti and İlker Çolak

Children 2023, 10(2), 386; https://doi.org/10.3390/children10020386 - 16 Feb 2023

Cited by 10 | Viewed by 7237

Abstract

Background: Although the number of studies showing the efficacy of conservative treatment in adolescent idiopathic scoliosis has increased, studies with long-term follow-up are very limited. The aim of this study was to present the long-term effects of a conservative management method including exercise [...] Read more.

Background: Although the number of studies showing the efficacy of conservative treatment in adolescent idiopathic scoliosis has increased, studies with long-term follow-up are very limited. The aim of this study was to present the long-term effects of a conservative management method including exercise and brace in adolescent idiopathic scoliosis patients. Methods: This retrospective cohort study included patients with idiopathic scoliosis who presented at our department and were followed up for at least 2 years after completing the treatment. The main outcome measurements were the Cobb angle and angle of trunk rotation (ATR). Results: The cohort participants were 90.4% female, with a mean age of 11 years and the maximum Cobb angle was mean 32.1°. The mean post-treatment follow-up period was 27.8 months (range 24–71 months). The improvements after treatment in mean maximum Cobb angle (p < 0.001) and ATR (p = 0.001) were statistically significant. At the end of treatment, the maximum Cobb angle was improved in 88.1% of the patients and worsened in 11.9% compared to baseline. In the long-term follow-up evaluations, 83.3% of the curvatures remained stable. Conclusions: The results of this study showed that moderate idiopathic scoliosis in growing adolescents can be successfully halted with appropriate conservative treatment and that long-term improvement is largely maintained. Full article

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

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14 pages, 292 KiB

Open AccessEditor’s ChoiceReview

High-Risk Neuroblastoma: A Surgical Perspective

by Jillian C. Jacobson, Rachael A. Clark and Dai H. Chung

Children 2023, 10(2), 388; https://doi.org/10.3390/children10020388 - 16 Feb 2023

Cited by 13 | Viewed by 3800

Abstract

High-risk neuroblastoma requires multimodal treatment including systemic chemotherapy, surgical resection, radiation therapy, stem cell transplant, and immunotherapy. Surgeons play a vital role in obtaining local control of neuroblastoma and must therefore be knowledgeable about this complex pathology. This article provides a review of [...] Read more.

High-risk neuroblastoma requires multimodal treatment including systemic chemotherapy, surgical resection, radiation therapy, stem cell transplant, and immunotherapy. Surgeons play a vital role in obtaining local control of neuroblastoma and must therefore be knowledgeable about this complex pathology. This article provides a review of the optimal timing and extent of resection, the impact of various image-defined risk factors on surgical planning, and surgical approaches and techniques to enhance the resection of tumors in different anatomic locations. Full article

(This article belongs to the Section Pediatric Cardiology)

10 pages, 248 KiB

Open AccessFeature PaperEditor’s ChoiceArticle

Perioperative Risk Factors for Bleeding in Adolescents Undergoing Pedicle Screw Instrumentation for Scoliosis

by Venla Soini, Johanna Syvänen, Ilkka Helenius, Linda Helenius and Arimatias Raitio

Children 2023, 10(2), 381; https://doi.org/10.3390/children10020381 - 15 Feb 2023

Cited by 5 | Viewed by 2219

Abstract

Progressive scoliosis eventually leads to extensive spinal fusion surgery, which carries a risk for significant bleeding. Neuromuscular scoliosis (NMS) patients have an additional inherent risk of major perioperative bleeding. The purpose of our research was to investigate the risk factors for measured (intraoperative, [...] Read more.

Progressive scoliosis eventually leads to extensive spinal fusion surgery, which carries a risk for significant bleeding. Neuromuscular scoliosis (NMS) patients have an additional inherent risk of major perioperative bleeding. The purpose of our research was to investigate the risk factors for measured (intraoperative, drain output) and hidden blood loss related to pedicle screw instrumentation in adolescents, divided into adolescent idiopathic scoliosis (AIS) and NMS patient groups. A retrospective cohort study with prospectively collected data of consecutive AIS and NMS patients undergoing segmental pedicle screw instrumentation at a tertiary level hospital between 2009 and 2021 was conducted. In total, 199 AIS (mean age 15.8 years, 143 females) and 81 NMS patients (mean age 15.2 years, 37 females) were included in the analysis. In both groups, levels fused, increased operative time, and smaller or larger size of erythrocytes were associated with perioperative blood loss (p < 0.05 for all correlations). In AIS, male sex (p < 0.001) and the number of osteotomies correlated with more drain output. In NMS, levels fused correlated with drain output, p = 0.00180. In AIS, patients’ lower preoperative MCV levels (p = 0.0391) and longer operation times, p = 0.0038, resulted into more hidden blood loss, but we did not find any significant risk factors for hidden blood loss in NMS patients. Full article

(This article belongs to the Special Issue Research in Paediatric Orthopaedic Surgery)

10 pages, 230 KiB

Open AccessEditor’s ChoiceArticle

Nicotine and Nicotine-Free Vaping Behavior among a Sample of Canadian High School Students: A Cross-Sectional Study

by Evan R. Wiley and Jamie A. Seabrook

Children 2023, 10(2), 368; https://doi.org/10.3390/children10020368 - 13 Feb 2023

Cited by 9 | Viewed by 7264

Abstract

Youth vaping is a public health concern in Canada. Researchers have explored factors associated with vape use, but rarely differentiated between types of use. This study estimates the prevalence and correlations among past-month nicotine vaping, nicotine-free vaping, and dual-use vaping (nicotine and nicotine-free) [...] Read more.

Youth vaping is a public health concern in Canada. Researchers have explored factors associated with vape use, but rarely differentiated between types of use. This study estimates the prevalence and correlations among past-month nicotine vaping, nicotine-free vaping, and dual-use vaping (nicotine and nicotine-free) in grades 9–12 high school students. Data came from the 2019 Canadian Student Tobacco, Alcohol and Drugs Survey (CSTADS). The total sample consisted of 38,229 students. We used multinomial regression to assess for the correlations among different categories of vape use. Approximately 12% of the students reported past-month vape use exclusively with nicotine, 2.8% reported exclusively nicotine-free vape use, and 14% reported both nicotine vaping and nicotine-free vaping. Substance use (smoking, alcohol, cannabis) and being male were associated with membership in every category of vape use. Age was associated with vape use, but in different directions. Grade 10 and 11 students were more likely than grade 9 students to vape exclusively with nicotine (aOR 1.36; 95% CI: 1.05, 1.77 and aOR 1.46; 95% CI: 1.09, 1.97), while grade 9 students were more likely than grade 11 and 12 students to vape with both nicotine and nicotine-free vapes (aOR 0.82; 95% CI: 0.67, 0.99 and aOR 0.49; 95% CI: 0.37, 0.64). The prevalence of nicotine and nicotine-free vaping is high, with many students reporting the use of both. Full article

19 pages, 1211 KiB

Open AccessEditor’s ChoiceArticle

Assessment of the Relationship between Body Weight Status and Physical Literacy in 8 to 12 Year Old Pakistani School Children: The PAK-IPPL Cross-Sectional Study

by Yinghai Liu, Syed Ghufran Hadier, Long Liu, Syed Muhammad Zeeshan Haider Hamdani, Syed Danish Hamdani, Shaista Shireen Danish, Syeda Urooj Fatima and Yanlan Guo

Children 2023, 10(2), 363; https://doi.org/10.3390/children10020363 - 11 Feb 2023

Cited by 10 | Viewed by 2714

Abstract

(1) Background: Physical literacy (PL) is a multidimensional concept, since it fosters lifetime engagement in physical activities and reduces obesity; however, empirical evidence is lacking to support this association. This study first aimed to establish PL levels stratified by normal weight children and [...] Read more.

(1) Background: Physical literacy (PL) is a multidimensional concept, since it fosters lifetime engagement in physical activities and reduces obesity; however, empirical evidence is lacking to support this association. This study first aimed to establish PL levels stratified by normal weight children and children with overweight and obesity. Furthermore, this study determined a correlation between PL domains and BMI by weight status among South Punjab school children. (2) Methods: This cross-sectional study involved 1360 (Boys: 675 and Girls: 685) children aged 8 to 12, and was conducted using CAPL-2. T-tests and chi-square were used to determine the difference between categorical variables, with MANOVA used to compare weight statuses. Spearman correlation was employed to determine the correlation between variables; p < 0.05 was considered significant. (3) Results: Normal weight children had significantly higher PL and domain scores, except for the knowledge domain. Most children with normal weights were at the achieving and excelling levels, while children with overweight and obesity were at the beginning and progressing levels. The correlation among PL domains in normal and overweight and obese children ranged from weak to strong (r = 0.001 to 0.737), and the knowledge domain was inversely correlated with the motivation domain (r = −0.023). PL and domain scores were inversely correlated to BMI, except for the knowledge domain. (4) Conclusions: Children with normal weight tend to have higher PL and domain scores, while those with overweight or obesity tend to have lower scores. There was a positive relationship between normal weight and higher PL and domain scores, and an inverse relationship was observed between BMI and higher PL scores. Full article

(This article belongs to the Section Global Pediatric Health)

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18 pages, 339 KiB

Open AccessFeature PaperEditor’s ChoiceReview

A Literature Review on the Role of Hope in Promoting Positive Youth Development across Non-WEIRD Contexts

by Rachael M. Bowers and Edmond P. Bowers

Children 2023, 10(2), 346; https://doi.org/10.3390/children10020346 - 10 Feb 2023

Cited by 8 | Viewed by 5401

Abstract

Theoretical and empirical evidence has identified hope as a key adolescent strength that is linked to positive youth developmental outcomes. Although hope must be understood from a cultural lens, most of the evidence regarding adolescent hope is derived from samples of white youth [...] Read more.

Theoretical and empirical evidence has identified hope as a key adolescent strength that is linked to positive youth developmental outcomes. Although hope must be understood from a cultural lens, most of the evidence regarding adolescent hope is derived from samples of white youth from Western, educated, industrialized, rich, and democratic (WEIRD) nations. Therefore, in order to have a more comprehensive and global understanding of the antecedents, outcomes, and processes of hope, we apply a positive youth development perspective in order to review the literature (N = 52 studies) on hope from diverse cultural and international contexts. In organizing the findings by global region, our review provides evidence of the shared function of hope in promoting positive youth developmental outcomes and the usefulness of the Child Hope Scale across contexts. Family and parental relationships were identified as key assets in promoting hope; however, there exists cultural and contextual variation in what aspects of these relationships promote hope. We conclude this review by considering the priorities for research, practice, and policy, based on these findings. Full article

(This article belongs to the Section Global Pediatric Health)

11 pages, 2128 KiB

Open AccessEditor’s ChoiceArticle

Masked Randomized Trial of Epinephrine versus Vasopressin in an Ovine Model of Perinatal Cardiac Arrest

by Munmun Rawat, Sylvia Gugino, Carmon Koenigsknecht, Justin Helman, Lori Nielsen, Deepika Sankaran, Jayasree Nair, Praveen Chandrasekharan and Satyan Lakshminrusimha

Children 2023, 10(2), 349; https://doi.org/10.3390/children10020349 - 10 Feb 2023

Cited by 8 | Viewed by 3198

Abstract

Background: Current neonatal resuscitation guidelines recommend the use of epinephrine for bradycardia/arrest not responding to ventilation and chest compressions. Vasopressin is a systemic vasoconstrictor and is more effective than epinephrine in postnatal piglets with cardiac arrest. There are no studies comparing vasopressin with [...] Read more.

Background: Current neonatal resuscitation guidelines recommend the use of epinephrine for bradycardia/arrest not responding to ventilation and chest compressions. Vasopressin is a systemic vasoconstrictor and is more effective than epinephrine in postnatal piglets with cardiac arrest. There are no studies comparing vasopressin with epinephrine in newly born animal models with cardiac arrest induced by umbilical cord occlusion. Objective: To compare the effect of epinephrine and vasopressin on the incidence and time to return of spontaneous circulation (ROSC), hemodynamics, plasma drug levels, and vasoreactivity in perinatal cardiac arrest. Design/Methods: Twenty-seven term fetal lambs in cardiac arrest induced by cord occlusion were instrumented and resuscitated following randomization to epinephrine or vasopressin through a low umbilical venous catheter. Results: Eight lambs achieved ROSC prior to medication. Epinephrine achieved ROSC in 7/10 lambs by 8 ± 2 min. Vasopressin achieved ROSC in 3/9 lambs by 13 ± 6 min. Plasma vasopressin levels in nonresponders were much lower than responders after the first dose. Vasopressin caused in vivo increased pulmonary blood flow and in vitro coronary vasoconstriction. Conclusions: Vasopressin resulted in lower incidence and longer time to ROSC compared to epinephrine in a perinatal model of cardiac arrest supporting the current recommendations for exclusive use of epinephrine in neonatal resuscitation. Full article

(This article belongs to the Section Pediatric Neonatology)

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15 pages, 570 KiB

Open AccessEditor’s ChoiceArticle

Acceptability and Tolerability of Extended Reality Relaxation Training with and without Wearable Neurofeedback in Pediatric Migraine

by Mark Connelly, Madeline Boorigie and Klanci McCabe

Children 2023, 10(2), 329; https://doi.org/10.3390/children10020329 - 9 Feb 2023

Cited by 10 | Viewed by 2640

Abstract

Objective. To determine the acceptability of using extended reality (XR) relaxation training as a preventive treatment for pediatric migraine. Methods. Youths aged 10–17 years old with migraine were recruited from a specialty headache clinic and completed baseline measures evaluating their vestibular symptoms and [...] Read more.

Objective. To determine the acceptability of using extended reality (XR) relaxation training as a preventive treatment for pediatric migraine. Methods. Youths aged 10–17 years old with migraine were recruited from a specialty headache clinic and completed baseline measures evaluating their vestibular symptoms and attitudes about technology. The patients were then instructed in three XR-based relaxation training conditions (fully immersive virtual reality with and without neurofeedback, and augmented reality with neurofeedback), in counterbalanced order, and completed acceptability and side effect questionnaires after each. The patients also took XR equipment home for one week to use for relaxation practice and again completed the measures about their experience. The acceptability and side effect data were compared against predetermined acceptable thresholds and were evaluated for their association with the participant characteristics. Results. The aggregate acceptability questionnaire scores exceeded our minimum threshold of 3.5/5, with the two fully immersive virtual reality conditions preferred over augmented reality for relaxation training (z = −3.02, p = 0.003, and z = −2.31, p = 0.02). The endorsed side effects were rated by all but one participant as mild, with vertigo being the most common. The acceptability ratings were not reliably associated with age, sex, typical hours per day of technology use, or technology attitudes, but were inversely related to the side effect scores. Conclusions. The preliminary data on acceptability and tolerability of immersive XR technology for relaxation training among youths with migraine supports further intervention development work. Full article

(This article belongs to the Special Issue Innovative Approaches to Treating and Preventing Pediatric Chronic Pain)

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13 pages, 3002 KiB

Open AccessEditor’s ChoiceArticle

Effectiveness of Extracorporeal Shockwave Therapy on Controlling Spasticity in Cerebral Palsy Patients: A Meta-Analysis of Timing of Outcome Measurement

by Min Cheol Chang, You Jin Choo, Sang Gyu Kwak, Kiyeun Nam, Sae Yoon Kim, Hee Jin Lee and Soyoung Kwak

Children 2023, 10(2), 332; https://doi.org/10.3390/children10020332 - 9 Feb 2023

Cited by 9 | Viewed by 3229

Abstract

Extracorporeal shockwave therapy (ESWT) has been suggested as an alternative treatment for reducing spasticity in patients with cerebral palsy (CP). However, the duration of its effect was rarely known. A meta-analysis was performed to investigate the effectiveness of ESWT at controlling spasticity in [...] Read more.

Extracorporeal shockwave therapy (ESWT) has been suggested as an alternative treatment for reducing spasticity in patients with cerebral palsy (CP). However, the duration of its effect was rarely known. A meta-analysis was performed to investigate the effectiveness of ESWT at controlling spasticity in patients with CP according to the follow-up period. We included studies in which ESWT was used to manage spasticity in patients with CP, and the effect was compared with that in a control group. Finally, three studies were included. In the meta-analysis, spasticity, measured using the modified Ashworth scale (MAS), was significantly reduced after ESWT compared with that in the control group; however, it was sustained for only 1 month. After ESWT, significant increases in passive ankle range of motion (ROM) and plantar surface area in the standing position were observed compared with those in the control group and sustained for up to 3 months. Although spasticity measured using MAS was significantly reduced for only 1 month, improvement in spasticity-associated symptoms, such as ankle ROM and plantar surface area contacting the ground, persisted for over 3 months. ESWT appears to be a useful and effective therapeutic option for managing spasticity in patients with CP. Full article

(This article belongs to the Special Issue Advances in Pediatric Neuromuscular Disorders)

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11 pages, 663 KiB

Open AccessEditor’s ChoiceArticle

Oxytocin Levels Increase and Anxiety Decreases in Mothers Who Sing and Talk to Their Premature Infants during a Painful Procedure

by Manuela Filippa, Maria Grazia Monaci, Carmen Spagnuolo, Massimiliano Di Benedetto, Paolo Serravalle and Didier Grandjean

Children 2023, 10(2), 334; https://doi.org/10.3390/children10020334 - 9 Feb 2023

Cited by 12 | Viewed by 2980

Abstract

(1) Background: Preterm infants spend their first weeks of life in the hospital partially separated from their parents and subjected to frequent potentially painful clinical procedures. Previous research has found that early vocal contact reduces infant pain perception while simultaneously increasing oxytocin (OXT) [...] Read more.

(1) Background: Preterm infants spend their first weeks of life in the hospital partially separated from their parents and subjected to frequent potentially painful clinical procedures. Previous research has found that early vocal contact reduces infant pain perception while simultaneously increasing oxytocin (OXT) levels. The current study aims to assess the effect of maternal singing and speaking on mothers. (2) Methods: During a painful procedure over two days, twenty preterm infants were randomly exposed to their mother’s live voice (speaking or singing). Maternal OXT levels were measured twice: before and after singing, as well as before and after speaking. The anxiety and resilience responses of mothers were studied before and after the two-day interventions, regardless of the speaking/singing condition. OXT levels in mothers increased in response to both singing and speech. Concurrently, anxiety levels decreased, but no significant effects on maternal resilience were found. (3) Conclusions: OXT could be identified as a key mechanism for anxiety regulation in parents, even in sensitive care situations, such as when their infant is in pain. Active involvement of parents in the care of their preterm infants can have a positive effect on their anxiety as well as potential benefits to their sensitivity and care abilities through OXT. Full article

(This article belongs to the Section Pediatric Neonatology)

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9 pages, 2917 KiB

Open AccessEditor’s ChoiceReview

The Ophthalmic Manifestations of Down Syndrome

by Emily Sun and Courtney L. Kraus

Children 2023, 10(2), 341; https://doi.org/10.3390/children10020341 - 9 Feb 2023

Cited by 10 | Viewed by 5568

Abstract

Down Syndrome is one of the most common chromosomal conditions in the world, affecting an estimated 1:400–1:500 births. It is a multisystem genetic disorder but has a wide range of ophthalmic findings. These include strabismus, amblyopia, accommodation defects, refractive error, eyelid abnormalities, nasolacrimal [...] Read more.

Down Syndrome is one of the most common chromosomal conditions in the world, affecting an estimated 1:400–1:500 births. It is a multisystem genetic disorder but has a wide range of ophthalmic findings. These include strabismus, amblyopia, accommodation defects, refractive error, eyelid abnormalities, nasolacrimal duct obstruction, nystagmus, keratoconus, cataracts, retinal abnormalities, optic nerve abnormalities, and glaucoma. These ophthalmic conditions are more prevalent in children with Down Syndrome than the general pediatric population, and without exception, early identification with thoughtful screening in this patient population can drastically improve prognosis and/or quality of life. Full article

(This article belongs to the Special Issue Advances in Pediatric Ophthalmology)

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11 pages, 415 KiB

Open AccessEditor’s ChoiceArticle

Influence of Rule Manipulation on Technical–Tactical Actions in Young Basketball Players: A Scoping Review

by Ricardo André Birrento Aguiar, José Maria Giménez Egido, José Manuel Palao Andrés and Enrique Ortega-Toro

Children 2023, 10(2), 323; https://doi.org/10.3390/children10020323 - 8 Feb 2023

Cited by 5 | Viewed by 3190

Abstract

The purpose of this scoping review was to analyse the effect of rules modification on technical and tactical action in young basketball. The publications search period ranged from January 2007 to December 2021. The search covered the following electronic databases: SCOPUS, SportDiscus, and [...] Read more.

The purpose of this scoping review was to analyse the effect of rules modification on technical and tactical action in young basketball. The publications search period ranged from January 2007 to December 2021. The search covered the following electronic databases: SCOPUS, SportDiscus, and the Web of Science core collection. Following this search process, 18 articles were included in the review. The following variables were analysed: characteristics of the sample, the constraints manipulated, the duration of the intervention, and the effect on technical–tactical actions. The studies reviewed modified the following constraints: (a) number of players (66.7%), (b) court dimensions (27.8%), (c) ball/player interactions (11.1%), and (d) ball/player interactions, basket height, game time and number of baskets (5.6%, respectively). The findings show that rule manipulation can increase players’ participation and promote the variability of players’ actions. The current evidence about rule modification in youth basketball presents areas in which more studies are needed to have a complete perspective of their impact in practice and competition through the different stages of players’ development. Taking into account individual needs and developmental stages, further studies should consider different age groups (e.g., from U-10 to zU-14) and female players. Expanding scientific knowledge in this area would help coaches make short- and long-term plans in accordance with players’ developmental stages. Full article

(This article belongs to the Special Issue Sports Science in Children)

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18 pages, 1226 KiB

Open AccessEditor’s ChoiceReview

Cyberbullying as a Learned Behavior: Theoretical and Applied Implications

by Christopher P. Barlett

Children 2023, 10(2), 325; https://doi.org/10.3390/children10020325 - 8 Feb 2023

Cited by 13 | Viewed by 17586

Abstract

Cyberbullying perpetration has emerged as a world-wide societal issue. Interventions need to be continuously updated to help reduce cyberbullying perpetration. We believe that data derived from theory can best accomplish this objective. Here, we argue for the importance of learning theory to understand [...] Read more.

Cyberbullying perpetration has emerged as a world-wide societal issue. Interventions need to be continuously updated to help reduce cyberbullying perpetration. We believe that data derived from theory can best accomplish this objective. Here, we argue for the importance of learning theory to understand cyberbullying perpetration. The purpose of this manuscript is to firstly describe the various learning theories that are applicable to describe cyberbullying perpetration, such as social learning, operant conditioning, the general learning model, and others. Second, we delve into the Barlett Gentile Cyberbullying Model, which integrates learning postulates and distinguishes cyber from traditional bullying. Finally, we offer a learning perspective on interventions and future research. Full article

(This article belongs to the Section Pediatric Mental Health)

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24 pages, 1141 KiB

Open AccessEditor’s ChoiceArticle

Developmental Pathway Choices of Young People Presenting to a Gender Service with Gender Distress: A Prospective Follow-Up Study

by Joseph Elkadi, Catherine Chudleigh, Ann M. Maguire, Geoffrey R. Ambler, Stephen Scher and Kasia Kozlowska

Children 2023, 10(2), 314; https://doi.org/10.3390/children10020314 - 7 Feb 2023

Cited by 14 | Viewed by 13989

Abstract

This prospective case-cohort study examines the developmental pathway choices of 79 young people (13.25–23.75 years old; 33 biological males and 46 biological females) referred to a tertiary care hospital’s Department of Psychological Medicine (December 2013–November 2018, at ages 8.42–15.92 years) for diagnostic assessment [...] Read more.

This prospective case-cohort study examines the developmental pathway choices of 79 young people (13.25–23.75 years old; 33 biological males and 46 biological females) referred to a tertiary care hospital’s Department of Psychological Medicine (December 2013–November 2018, at ages 8.42–15.92 years) for diagnostic assessment for gender dysphoria (GD) and for potential gender-affirming medical interventions. All of the young people had attended a screening medical assessment (including puberty staging) by paediatricians. The Psychological Medicine assessment (individual and family) yielded a formal DSM-5 diagnosis of GD in 66 of the young people. Of the 13 not meeting DSM-5 criteria, two obtained a GD diagnosis at a later time. This yielded 68 young people (68/79; 86.1%) with formal diagnoses of GD who were potentially eligible for gender-affirming medical interventions and 11 young people (11/79; 13.9%) who were not. Follow-up took place between November 2022 and January 2023. Within the GD subgroup (n = 68) (with two lost to follow-up), six had desisted (desistance rate of 9.1%; 6/66), and 60 had persisted on a GD (transgender) pathway (persistence rate of 90.9%; 60/66). Within the cohort as a whole (with two lost to follow-up), the overall persistence rate was 77.9% (60/77), and overall desistance rate for gender-related distress was 22.1% (17/77). Ongoing mental health concerns were reported by 44/50 (88.0%), and educational/occupational outcomes varied widely. The study highlights the importance of careful screening, comprehensive biopsychosocial (including family) assessment, and holistic therapeutic support. Even in highly screened samples of children and adolescents seeking a GD diagnosis and gender-affirming medical care, outcome pathways follow a diverse range of possibilities. Full article

(This article belongs to the Section Pediatric Mental Health)

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12 pages, 1561 KiB

Open AccessEditor’s ChoiceArticle

Therapeutic Approaches to Dysautonomia in Childhood, with a Special Focus on Long COVID

by Reiner Buchhorn

Children 2023, 10(2), 316; https://doi.org/10.3390/children10020316 - 7 Feb 2023

Cited by 13 | Viewed by 3938

Abstract

Background: Dysautonomia seems to be important for the pathophysiology of psychosomatic diseases and, more recently, for long COVID. This concept may explain the clinical symptoms and could help open new therapeutic approaches. Methods: We compared our data from an analysis of heart rate [...] Read more.

Background: Dysautonomia seems to be important for the pathophysiology of psychosomatic diseases and, more recently, for long COVID. This concept may explain the clinical symptoms and could help open new therapeutic approaches. Methods: We compared our data from an analysis of heart rate variability (HRV) in an active standing test in 28 adolescents who had developed an inappropriate sinus tachycardia (IST, n = 13) or postural orthostatic tachycardia syndrome (POTS, n = 15) after contracting COVID-19 disease and/or vaccination with 64 adolescents from our database who developed dysautonomia due to psychosomatic diseases prior to the COVID-19 pandemic. We prove the effects of our treatment: omega-3 fatty acid supplementation (O3-FA, n = 18) in addition to propranolol (low dose, up to 20-20-0 mg, n = 32) or ivabradine 5-5-0 mg (n = 17) on heart rate regulation and heart rate variability (HRV). Results: The HRV data were not different between the adolescents with SARS-CoV-2-related disorders and the adolescents with dysautonomia prior to the pandemic. The heart rate increases in children with POTS while standing were significantly lower after low-dose propranolol (27.2 ± 17.4 bpm***), ivabradine (23.6 ± 8.12 bpm*), and O-3-FA (25.6 ± 8.4 bpm*). The heart rate in children with IST while lying/standing was significantly lower after propranolol (81.6 ± 10.1 bpm**/101.8 ± 18.8***), ivabradine (84.2 ± 8.4 bpm***/105.4 ± 14.6**), and O-3-FA (88.6 ± 7.9 bpm*/112.1/14.9*). Conclusions: The HRV data of adolescents with dysautonomia after COVID-19 disease/vaccination are not significantly different from a historical control of adolescents with dysautonomia due to psychosomatic diseases prior to the pandemic. Low-dose propranolol > ivabradine > omega-3 fatty acids significantly decrease elevated heart rates in patients with IST and the heart rate increases in patients with POTS and may be beneficial in these children with dysautonomia. Full article

(This article belongs to the Section Pediatric Infectious Diseases)

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10 pages, 898 KiB

Open AccessEditor’s ChoiceArticle

Effects of a High Intensity Interval Training (HIIT) Program on Anthropomorphic and Cardiometabolic Variables in School Children with Overweight and Obesity

by José Miguel Espinoza Silva, Pedro Ángel Latorre Román, José Carlos Cabrera Linares, Juan A. Párraga Montilla and Cristian Martínez Salazar

Children 2023, 10(2), 317; https://doi.org/10.3390/children10020317 - 7 Feb 2023

Cited by 11 | Viewed by 3099

Abstract

The aim of this study was to assess the effects of a high intensity interval training (HIIT) program on anthropomorphic and cardiometabolic variables in schoolchildren with overweight and obesity. A total of 443 schoolchildren (age: 6.37 ± 0.65 years) took part in this [...] Read more.

The aim of this study was to assess the effects of a high intensity interval training (HIIT) program on anthropomorphic and cardiometabolic variables in schoolchildren with overweight and obesity. A total of 443 schoolchildren (age: 6.37 ± 0.65 years) took part in this study. The experimental group (EG; n = 295; age = 6.40 ± 0.64 years) was compound with children with overweight and obesity, whereas children with normoweight were included in the control group (CG; n = 148; 6.31 ± 0.67 years). The EG performed a training program based on HIIT two times per week for 28 weeks (56 sessions), whilst the CG performed their habitual physical education classes based on the national curriculum. Body mass index (BMI), waist circumference, body fat, ∑ 4 skinfold fat, waist to height ratio, waist circumference, and cardiometabolic risk were measured. The dependent variables were analysed by two-way analysis of covariance (ANCOVA 2 × 2). To analyse the percentage differences between groups, the chi-square test was used. P-value was set at p < 0.05. Significant differences were found in the EG in BMI, waist circumference, body fat, ∑ 4 skinfold fat, and waist to height ratio. In conclusion, an HIIT training program can be an effective tool for improving anthropomorphic variables and reducing cardiometabolic risk in schoolchildren with overweight and obesity. Full article

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

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27 pages, 5517 KiB

Open AccessEditor’s ChoiceReview

Patient-Specific 3D-Printed Models in Pediatric Congenital Heart Disease

by Zhonghua Sun

Children 2023, 10(2), 319; https://doi.org/10.3390/children10020319 - 7 Feb 2023

Cited by 20 | Viewed by 5608

Abstract

Three-dimensional (3D) printing technology has become increasingly used in the medical field, with reports demonstrating its superior advantages in both educational and clinical value when compared with standard image visualizations or current diagnostic approaches. Patient-specific or personalized 3D printed models serve as a [...] Read more.

Three-dimensional (3D) printing technology has become increasingly used in the medical field, with reports demonstrating its superior advantages in both educational and clinical value when compared with standard image visualizations or current diagnostic approaches. Patient-specific or personalized 3D printed models serve as a valuable tool in cardiovascular disease because of the difficulty associated with comprehending cardiovascular anatomy and pathology on 2D flat screens. Additionally, the added value of using 3D-printed models is especially apparent in congenital heart disease (CHD), due to its wide spectrum of anomalies and its complexity. This review provides an overview of 3D-printed models in pediatric CHD, with a focus on educational value for medical students or graduates, clinical applications such as pre-operative planning and simulation of congenital heart surgical procedures, and communication between physicians and patients/parents of patients and between colleagues in the diagnosis and treatment of CHD. Limitations and perspectives on future research directions for the application of 3D printing technology into pediatric cardiology practice are highlighted. Full article

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

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13 pages, 3218 KiB

Open AccessEditor’s ChoiceArticle

Is Surface Topography Useful in the Diagnosis of Scoliosis? Validation of the Biometrical Holistic of Human Body (BHOHB)

by Angelo G. Aulisa, Diletta Bandinelli, Martina Marsiolo, Francesco Falciglia, Marco Giordano and Renato M. Toniolo

Children 2023, 10(2), 320; https://doi.org/10.3390/children10020320 - 7 Feb 2023

Cited by 7 | Viewed by 2399

Abstract

Background: The concern around repeated exposure to X-rays has been motivating doctors involved in scoliosis to seek alternative solutions. Surface topography (ST) analysis is a modern system that has been shown to have good results. The purpose of the study is to validate [...] Read more.

Background: The concern around repeated exposure to X-rays has been motivating doctors involved in scoliosis to seek alternative solutions. Surface topography (ST) analysis is a modern system that has been shown to have good results. The purpose of the study is to validate the new BHOHB hardware for the investigation of scoliosis in adolescents by comparing it to X-ray examinations and to assess the reliability of intraoperator and interoperator tests. Methods: Ninety-five patients were enrolled in our study. All the patients were analyzed via the BHOHB method 2 times by 2 independent physicians (t0) and for a second time 2 or 3 months later (t1). The Pearson correlation coefficient was used to evaluate the relationship between the measurements obtained by BHOHB and the gold standard. The intraclass correlation coefficient (ICC) was used to assess intra- and interoperator reliability. Statistical analysis was performed with the GraphPad Prism 8 software. Results: The correlations between the first and second operators in the measurements and between the BHOHB method and X-ray showed a very good to excellent r for both. A very good correlation was also confirmed for prominence measured by operators and by the BHOHB machine. Intra- and interoperator reliability was found to be very positive for both the first and the second physicians. Conclusions: We can state that ST can be useful for diagnosing and treating scoliosis. The recommendation is to use it primarily to evaluate the evolution of the curve, as in this mode, you can reduce the patient’s exposure to X-rays. The results indicate that BHOHB measures are comparable to radiographs and not influenced by the operator. Full article

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

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14 pages, 639 KiB

Open AccessEditor’s ChoiceArticle

Maternal and Paternal Authoritarian Parenting and Adolescents’ Impostor Feelings: The Mediating Role of Parental Psychological Control and the Moderating Role of Child’s Gender

by Yosi Yaffe

Children 2023, 10(2), 308; https://doi.org/10.3390/children10020308 - 6 Feb 2023

Cited by 9 | Viewed by 5887

Abstract

Introduction: Recent systematic reviews about the impostor phenomenon unveil a severe shortage of research data on adolescents. The present study aimed at reducing this gap in the literature by investigating the association between maternal and paternal authoritarian parenting and impostor feelings among adolescents, [...] Read more.

Introduction: Recent systematic reviews about the impostor phenomenon unveil a severe shortage of research data on adolescents. The present study aimed at reducing this gap in the literature by investigating the association between maternal and paternal authoritarian parenting and impostor feelings among adolescents, while testing the mediating role played by parental psychological control and the moderating role of the child’s gender in this context. Methods: Three hundred and eight adolescents took part in an online survey, in which they reported anonymously on their impostor feelings and their parents’ parenting styles via several valid psychological questionnaires. The sample consisted of 143 boys and 165 girls, whose age ranged from 12 to 17 (M = 14.67, SD = 1.64). Results: Of the sample’s participants, over 35% reported frequent to intense impostor feelings, with girls scoring significantly higher than boys on this scale. In general, the maternal and paternal parenting variables explained 15.2% and 13.3% (respectively) of the variance in the adolescents’ impostor scores. Parental psychological control fully mediated (for fathers) and partially mediated (for mothers) the association between parental authoritarian parenting and the adolescents’ impostor feelings. The child’s gender moderated solely the maternal direct effect of authoritarian parenting on impostor feelings (this association was significant for boys alone), but not the mediating effect via psychological control. Conclusions: The current study introduces a specific explanation for the possible mechanism describing the early emergence of impostor feelings in adolescents based on parenting styles and behaviors. Full article

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

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15 pages, 303 KiB

Open AccessEditor’s ChoiceArticle

Telehealth Use in Pediatric Care during the COVID-19 Pandemic: A Qualitative Study on the Perspectives of Caregivers

by Gergana Damianova Kodjebacheva, Charlotte Tang, Faith Groesbeck, Loretta Walker, Jillian Woodworth and Jennifer Schindler-Ruwisch

Children 2023, 10(2), 311; https://doi.org/10.3390/children10020311 - 6 Feb 2023

Cited by 16 | Viewed by 3706

Abstract

This qualitative study surveyed caregivers regarding their perspectives on the benefits of, challenges with, and suggestions for improving telehealth during the COVID-19 pandemic. Caregivers who had the responsibility for caring for at least one child aged under 18 years of age in Genesee [...] Read more.

This qualitative study surveyed caregivers regarding their perspectives on the benefits of, challenges with, and suggestions for improving telehealth during the COVID-19 pandemic. Caregivers who had the responsibility for caring for at least one child aged under 18 years of age in Genesee County, MI, participated. The caregivers were biological parents, stepparents, foster parents, adoptive parents, and guardians. A total of 105 caregivers completed a survey with open-ended questions via Qualtrics. Two independent coders developed themes based on the responses using grounded theory. Participants were primarily biological parents and non-Hispanic White and African Americans. According to the participants, the benefits of telehealth included prevention of exposure to the COVID-19 virus, quality communication with physicians, savings in travel time, and cost-effective methods to receive care. The challenges included a lack of in-person interaction, fear of compromised confidentiality, and the potential for misdiagnosis. Suggestions for improvement by caregivers included increasing access to telehealth for poorer families, offering a media educational campaign to promote telehealth use, and creating a universal platform to share patient information. Future studies may test the effectiveness of interventions such as those suggested by caregivers in this study to improve telehealth. Full article

(This article belongs to the Section Pediatric Nursing)

15 pages, 888 KiB

Open AccessEditor’s ChoiceReview

Gastrointestinal Involvement in Children with Systemic Lupus Erythematosus

by Angela Mauro, Teresa Giani, Clelia Di Mari, Martina Sandini, Antonella Talenti, Valentina Ansuini, Luigi Biondi, Giovanni Di Nardo and Luca Bernardo

Children 2023, 10(2), 309; https://doi.org/10.3390/children10020309 - 6 Feb 2023

Cited by 9 | Viewed by 4210

Abstract

Systemic lupus erythematosus (SLE) is a systemic autoimmune disorder. When it presents before the age of 18 years (childhood-onset systemic lupus erythematosus, cSLE), the disease course tends to be more severe with a higher rate of organ involvement and requires an early diagnosis. [...] Read more.

Systemic lupus erythematosus (SLE) is a systemic autoimmune disorder. When it presents before the age of 18 years (childhood-onset systemic lupus erythematosus, cSLE), the disease course tends to be more severe with a higher rate of organ involvement and requires an early diagnosis. Gastrointestinal involvement in cSLE is rare and scarcely reported in the literature. Any organ of the gastrointestinal system may be affected, either as a direct consequence of the disease, as a subsequent complication, or as an adverse drug event. Abdominal pain is the most common GI symptom, it can be diffuse or well localized, and can underline different conditions such as hepatitis, pancreatitis, appendicitis, peritonitis, or enteritis. cSLE may have an alteration of the intestinal barrier with features of protein-losing enteropathy or, in genetically predisposed patients, may develop associated autoimmune disorders such as Coeliac Disease or Autoimmune Hepatitis. The aim of this manuscript is to provide a narrative review of gastrointestinal manifestations in cSLE focused on hepatic, pancreatic, and intestinal involvement. A comprehensive literature search based on the PubMed database was performed. Full article

(This article belongs to the Special Issue Rheumatic Diseases in Children)

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