Children

Article

10 pages, 2582 KiB

Open AccessEditor’s ChoiceArticle

Comparison of MTA versus Biodentine in Apexification Procedure for Nonvital Immature First Permanent Molars: A Randomized Clinical Trial

by Yasser Alsayed Tolibah, Chaza Kouchaji, Thuraya Lazkani, Ibrahim Ali Ahmad and Ziad D. Baghdadi

Children 2022, 9(3), 410; https://doi.org/10.3390/children9030410 - 14 Mar 2022

Cited by 12 | Viewed by 6425

Abstract

This study aimed to evaluate the radiological and clinical outcomes of Biodentine apical plugs compared to mineral trioxide aggregate (MTA) in treating immature molars with apical lesions in children. Materials and Methods: Thirty immature roots of 24 permanent lower first molars with apical [...] Read more.

This study aimed to evaluate the radiological and clinical outcomes of Biodentine apical plugs compared to mineral trioxide aggregate (MTA) in treating immature molars with apical lesions in children. Materials and Methods: Thirty immature roots of 24 permanent lower first molars with apical lesions were randomly divided into two groups: group 1 (15 roots) treated with MTA apical plugs and group 2 (15 roots) treated with Biodentine apical plugs. Treatment radiological outcomes were assessed using the periapical index (PAI) scale after 6 and 12 months of treatment. The presence or absence of apical calcified barrier (ACB) was assessed after 12 months of treatment. The visual analog scale (VAS) was used to compare the postoperative pain between the two groups after 1, 3, 7, and 14 days of treatment. PAI scores between the two groups were compared using the Mann–Whitney U test, the presence or absence of the ACB was compared using the chi-square test, and the VAS scores were compared using the t-test. The statistical significance threshold was set at 0.05. Results: There were no statistically significant differences in the PAI between the two groups at 6 and 12 months postoperatively. After 12 months, four cases in the Biodentine group showed ACB formation, whereas ACB was not found in any case treated with MTA. The VAS scores were statistically lower in the MTA group on the first day after treatment. Nevertheless, these scores were not statistically significantly different after 3, 7, and 14 days of treatment between the two groups. Conclusions: Biodentine can be used as an apical plug to treat immature permanent molars with apical lesions in a single visit in children. Biodentine showed favorable outcomes in apical lesions healing, which was comparable to MTA but with a decreased treatment time associated with its use. Full article

(This article belongs to the Collection Advance in Pediatric Dentistry)

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11 pages, 1032 KiB

Open AccessEditor’s ChoiceArticle

Behavioural Differences in Sensorimotor Profiles: A Comparison of Preschool-Aged Children with Sensory Processing Disorder and Autism Spectrum Disorders

by Giulia Purpura, Francesco Cerroni, Marco Carotenuto, Renata Nacinovich and Luca Tagliabue

Children 2022, 9(3), 408; https://doi.org/10.3390/children9030408 - 14 Mar 2022

Cited by 14 | Viewed by 5270

Abstract

Sensory Processing Disorders (SPDs) define dysfunctions in modulating, organising, and using information from several sensory channels for regulating motor, behavioural, emotional and attention responses. Although SPD can be identified also as an isolated condition in young children, its presence in Autism Spectrum Disorder [...] Read more.

Sensory Processing Disorders (SPDs) define dysfunctions in modulating, organising, and using information from several sensory channels for regulating motor, behavioural, emotional and attention responses. Although SPD can be identified also as an isolated condition in young children, its presence in Autism Spectrum Disorder (ASD) population is really frequent. The study purpose is to explore the SPD clinical expression and the putative correlation with several behavioural aspects both in children with ASD and in those with isolated SPD. Therefore, 43 preschool-aged children (25 ASD vs. 18 SPD) were recruited, and their parents completed three questionnaires (Developmental Profile-3, Sensory Processing Measure–Preschool, Repetitive Behaviour Scale-Revised) to evaluate behavioural alterations and developmental levels. The main result is that both ASD and SPD groups had significantly sensory-related behavioural symptoms, although ASD children seem to be more impaired in all areas. Several significant correlations were found between sensory processing difficulties and repetitive behaviours, but in the SPD group a specific relationship between Body Awareness and Ritualistic/Sameness Behaviour was found. Conversely, in the ASD group, more diffuse interlinks between sensory processing difficulties and motor behaviours were significant. In conclusion, the present study confirms the key role of sensory–motor skills in early diagnosis and intervention among children at risk for neurodevelopmental disorders. Full article

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

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24 pages, 712 KiB

Open AccessEditor’s ChoiceArticle

The Eating Healthy and Daily Life Activities (EHDLA) Study

by José Francisco López-Gil

Children 2022, 9(3), 370; https://doi.org/10.3390/children9030370 - 7 Mar 2022

Cited by 28 | Viewed by 8113

Abstract

Background: Childhood obesity is one of the greatest public health concerns facing advanced societies, Spain being one of the countries with the highest incidence. In this sense, the Region of Murcia has been pointed out as the Spanish autonomous community with the highest [...] Read more.

Background: Childhood obesity is one of the greatest public health concerns facing advanced societies, Spain being one of the countries with the highest incidence. In this sense, the Region of Murcia has been pointed out as the Spanish autonomous community with the highest prevalence of excess weight among young people. More specifically, the Valle de Ricote has shown an even greater proportion of excess weight among young people. Several sociodemographic, environmental, lifestyle, health-related, cognitive, and psychological factors are related to excess weight. Based on the lack of information, this research project will try to provide relevant information to design intervention programs, as well as to implement effective public policies to try and reverse this alarming situation. Therefore, this research project aims (1) to obtain cross-sectional and longitudinal data on the excess weight and their potential sociodemographic, environmental, lifestyle, health-related, cognitive, and psychological factors associated among adolescents from the Valle de Ricote (Region of Murcia, Spain) (aged 12–17 years), and (2) to examine the association between excess weight and their potential sociodemographic, environmental, lifestyle, health-related, cognitive, and psychological factors associated among this population. Methods: A cross-sectional study and follow-up study will be performed. This research project will involve adolescents using a simple random sampling technique. A total of three secondary schools from the Valle de Ricote (Region of Murcia, Spain) will be included in this project. The minimum sample size will be 1138, establishing a 95% confidence interval, a 40% prevalence of excess weight, a 3% margin of error, and a non-response rate of 10%. Primary outcome measures will be: (1) anthropometric measurements, (2) sociodemographic factors, (3) environmental factors, (4) lifestyle factors, (5) health-related factors, (6) cognitive factors, and (7) psychological factors. Conclusion: This research project will aim to determine the prevalence of excess weight and interrelate their potential sociodemographic, environmental, lifestyle, health-related, cognitive, and psychological factors associated. The obtained results will help to manage and propose possible multidisciplinary interventions and strategies in order to prevent and reduce the excess weight in adolescents from the Valle de Ricote. Furthermore, orientations will be given to transfer the obtained results to the public sector to evaluate or change the adopted policies. Full article

(This article belongs to the Special Issue Childhood and Adolescent Obesity and Weight Management: 2nd Edition)

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8 pages, 1063 KiB

Open AccessEditor’s ChoiceArticle

Gastroesophageal Reflux in Children with Asthma

by Vasile Valeriu Lupu, Ingrith Miron, Elena Tarca, Laura Mihaela Trandafir, Dana-Teodora Anton-Paduraru, Stefana Maria Moisa, Magdalena Starcea, Andrei Cernomaz, Lucian Miron and Ancuta Lupu

Children 2022, 9(3), 336; https://doi.org/10.3390/children9030336 - 2 Mar 2022

Cited by 13 | Viewed by 2816

Abstract

Background: Nowadays it is considered that a specific causal relationship exists between asthma and gastroesophageal reflux (GER), because of the aspiration of gastric refluate which leads to and maintain spasticity even real crisis of paroxystic expiratory dyspnea. This study explores this relationship and [...] Read more.

Background: Nowadays it is considered that a specific causal relationship exists between asthma and gastroesophageal reflux (GER), because of the aspiration of gastric refluate which leads to and maintain spasticity even real crisis of paroxystic expiratory dyspnea. This study explores this relationship and evaluates the results after treatment. Methods: 56 children diagnosed with asthma, hospitalized in a regional center of pediatric gastroenterology in Northeast Romania, underwent 24-hour continuous esophageal pH monitoring in order to establish the presence of GER. The Boix-Ochoa score was used to interpret the results. Proton pump inhibitors were administered to those with GER and the patients were reevaluated after 2 months. Results: 39 patients (69.64%) had GER, with a Boix-Ochoa score above normal (N < 11.99), and 17 patients (30.36%) had normal score. After administering proton pump inhibitors for 2 months, 7 patients still had high Boix-Ochoa score (17.95%). The result of this analysis shows that the presence of asthma increases the chance of GER by 2.86 times. Conclusions: In children with asthma we have to look for GER in order to treat, because it can help the treatment of asthma or even solve some cases resistant to standard treatment. Full article

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10 pages, 648 KiB

Open AccessEditor’s ChoiceArticle

Anterior Chamber Angle in Adults Born Extremely, Very, and Moderately Preterm with and without Retinopathy of Prematurity—Results of the Gutenberg Prematurity Eye Study

by Achim Fieß, Sandra Gißler, Eva Mildenberger, Michael S. Urschitz, Agnes Fauer, Heike M. Elflein, Fred Zepp, Bernhard Stoffelns, Norbert Pfeiffer and Alexander K. Schuster

Children 2022, 9(2), 281; https://doi.org/10.3390/children9020281 - 18 Feb 2022

Cited by 17 | Viewed by 2233

Abstract

Purpose: To determine whether prematurity and associated factors affect the anterior chamber angle (ACA) width in adulthood. Methods: The Gutenberg Prematurity Eye Study (GPES) is a retrospective cohort study with a prospective ophthalmologic examination of adults (age 18–52 years) in Germany. All participants [...] Read more.

Purpose: To determine whether prematurity and associated factors affect the anterior chamber angle (ACA) width in adulthood. Methods: The Gutenberg Prematurity Eye Study (GPES) is a retrospective cohort study with a prospective ophthalmologic examination of adults (age 18–52 years) in Germany. All participants were examined with Scheimpflug imaging (Pentacam HR, Oculus Optikgeräte GmbH, Wetzlar, Germany) using linear regression analysis to assess the associations of ACA in the different sectors with gestational age (GA), birth weight, birth weight percentile, retinopathy of prematurity (ROP), ROP treatment, placental insufficiency, preeclampsia, and breastfeeding. Results: In total, 516 eyes of 319 preterm and full-term individuals (aged 28.9 ± 8.8 years, 188 females) were examined. ROP treatment was associated with smaller ACA width in the nasal (B = −9.6 [95%CI: −14.7; −4.5] degree; p < 0.001) and temporal positions (B = −11.5 [95%CI: −17.7; −5.3] degree; p = 0.001), whereas non-treated individuals with ROP had an unaltered ACA width, as did individuals with low gestational age without ROP. Conclusion: Advanced stages of ROP following treatment with laser- and cryocoagulation lead to a smaller ACA width until adulthood, and hence may increase the risk of angle closure in later life. Full article

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

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18 pages, 1349 KiB

Open AccessFeature PaperEditor’s ChoiceArticle

Finding the True Number of Females with Autistic Spectrum Disorder by Estimating the Biases in Initial Recognition and Clinical Diagnosis

by Robert McCrossin

Children 2022, 9(2), 272; https://doi.org/10.3390/children9020272 - 17 Feb 2022

Cited by 21 | Viewed by 30179

Abstract

The proportion of females whose ASD diagnosis is missed is unknown. The ratio of males to females with ASD is generally quoted as 4:1, though it is believed that there are biases preventing females from being diagnosed and that the true ratio is [...] Read more.

The proportion of females whose ASD diagnosis is missed is unknown. The ratio of males to females with ASD is generally quoted as 4:1, though it is believed that there are biases preventing females from being diagnosed and that the true ratio is lower. These biases have not been clearly identified or quantified. Starting with a clinical dataset of 1711 children <18 years old, four different methods were employed in an inductive study to identify and quantify the biases and calculate the proportion of females missed. A mathematical model was constructed to compare the findings with current published data. The true male-to-female ratio appears to be 3:4. Eighty percent of females remain undiagnosed at age 18, which has serious consequences for the mental health of young women. Full article

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

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11 pages, 942 KiB

Open AccessEditor’s ChoiceArticle

The Mental Health of Black Youth Affected by Community Violence: Family and School Context as Pathways to Resilience

by Donte T. Boyd, Kristian V. Jones, Camille R. Quinn, Adrian Gale, Ed-Dee G. Williams and Husain Lateef

Children 2022, 9(2), 259; https://doi.org/10.3390/children9020259 - 15 Feb 2022

Cited by 11 | Viewed by 4825

Abstract

Black youth who experience community violence occupy multiple environments with varying levels of influence on how they display resiliency to prevent adverse mental health outcomes. Considering the recent rise of mental health concerns (i.e., increase in suicidal outcomes) among Black youth, along with [...] Read more.

Black youth who experience community violence occupy multiple environments with varying levels of influence on how they display resiliency to prevent adverse mental health outcomes. Considering the recent rise of mental health concerns (i.e., increase in suicidal outcomes) among Black youth, along with the abundance of research illustrating the detrimental impact of community violence, more research is needed to examine how different environmental factors (e.g., family and school) shape how youth protect their mental health while displaying resiliency navigating community violence. The purpose of this study was to examine how family and school contexts predict Black youths’ ability to display resiliency to navigate community violence and prevent adverse mental health outcomes. This study utilized a path analysis to examine the associations between parent relationships, parent bonding, school climate, resilience to adverse community experiences, community violence, and mental health among 548 Black adolescents in Chicago. Findings highlight that parent relationships, parent bonding, and school climate influence the association between resilience to community violence and mental health outcomes among Black youth. Implications for mental health practice and policy among Black youth are discussed. Full article

(This article belongs to the Special Issue Family Risk and Protective Factors and Child Development)

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15 pages, 643 KiB

Open AccessEditor’s ChoiceArticle

Weight Pressures and Eating Disorder Symptoms among Adolescent Female Gymnasts of Different Performance Levels in Greece

by Ioanna Kontele, Tonia Vassilakou and Olyvia Donti

Children 2022, 9(2), 254; https://doi.org/10.3390/children9020254 - 14 Feb 2022

Cited by 12 | Viewed by 5570

Abstract

This study examined the weight pressures within the gymnastics environment and explored associations between these pressures and eating disorder (ED) symptoms in adolescent female gymnasts. One hundred and forty-seven competitive gymnasts and 122 recreational-level gymnasts (11–17 years old) completed the Eating Attitudes Test [...] Read more.

This study examined the weight pressures within the gymnastics environment and explored associations between these pressures and eating disorder (ED) symptoms in adolescent female gymnasts. One hundred and forty-seven competitive gymnasts and 122 recreational-level gymnasts (11–17 years old) completed the Eating Attitudes Test (EAT-26), the Weight-Pressures in Sport-Females (WPS-F), the Social Desirability Scale (SDS) and provided information on their training. It was found that 16.3% of competitive gymnasts and 7.4% of non-competitive gymnasts scored ≥20 in EAT-26, indicating disordered eating behavior. Competitive gymnasts scored higher than non-competitive in the total score of EAT-26 (p = 0.027), as well as in the total score of WPS-F, the sport and coaches weight pressures sub-scale and the appearance and performance weight pressures sub-scale (p < 0.001). Multiple regression analyses indicated that sport and coaches weight pressures, appearance and performance weight pressures and body mass index accounted for 30.3% of the variance of EAT-26 in competitive gymnasts, while the appearance and performance weight pressures sub-scale accounted for 16.3% of the variance of EAT-26 in non-competitive gymnasts. Sport and coaches weight pressures are associated with ED in competitive gymnasts, while body appearance and performance demands correlate with ED in female gymnasts irrespective of competitive level. Full article

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

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12 pages, 272 KiB

Open AccessEditor’s ChoiceArticle

The Associations of Child’s Clinical Conditions and Behavioral Problems with Parenting Stress among Families of Preschool-Aged Children: 2018–2019 National Survey of Child Health

by Soyang Kwon, Meghan E. O’Neill and Carolyn C. Foster

Children 2022, 9(2), 241; https://doi.org/10.3390/children9020241 - 11 Feb 2022

Cited by 9 | Viewed by 2000

Abstract

To understand parental stress resulting from parenting young children, the current literature has primarily focused on families of children with clinical conditions, but has placed far less attention on the general population. The aim of this study was to examine parenting stress related [...] Read more.

To understand parental stress resulting from parenting young children, the current literature has primarily focused on families of children with clinical conditions, but has placed far less attention on the general population. The aim of this study was to examine parenting stress related to children’s clinical conditions and behavioral problems in a nationally representative sample of US children aged 3 to 5 years. The study sample included 8454 children aged 3 to 5 years and their parents who participated in the 2018–2019 US National Survey of Child Health (NSCH). Using online/paper NSCH questionnaires, parents reported their children’s special health care needs (SHCN), clinically diagnosed mental, emotional, developmental, and behavioral (MEDB) problems (e.g., anxiety problem, developmental delay), and externalizing behaviors. Parents also reported the frequency of feeling aggravated from parenting the participating child as an indicator of elevated parenting stress. In the sample, the prevalence of elevated parenting stress was 5.1% overall (95% CI = 4.2, 6.0); however, it was significantly higher among parents of children with SHCN (20.8%; 95% CI = 16.7, 24.9), with MEDB problems (24.8%; 95% CI = 19.9, 29.8), and with externalizing behavior problems (14.7%; 95% CI = 11.8, 17.6). A multivariable logistic regression model showed that elevated parenting stress was associated with the child’s SHCN (adjusted odds ratio [AOR] = 2.3; 1.3, 3.9), MEDB problems (AOR = 4.8; 95% CI = 2.5, 9.1), and externalizing behavior problems (AOR = 5.4; 95% CI = 3.1, 9.4). Even in children without SHCN or MEDB problems, externalizing behavior problems were associated with elevated parenting stress (AOR = 6.4; 95% CI = 3.3, 12.7). The findings call for greater attention to subclinical or yet to be diagnosed externalizing behavior problems among the general preschool-aged child population and their underestimated impact on parenting stress. Full article

(This article belongs to the Section Pediatric Mental Health)

10 pages, 316 KiB

Open AccessEditor’s ChoiceArticle

Family Environment and Portuguese Adolescents: Impact on Quality of Life and Well-Being

by Fábio Botelho Guedes, Ana Cerqueira, Susana Gaspar, Tania Gaspar, Carmen Moreno and Margarida Gaspar de Matos

Children 2022, 9(2), 200; https://doi.org/10.3390/children9020200 - 3 Feb 2022

Cited by 11 | Viewed by 2930

Abstract

Background: A healthy and supportive family environment leads to more positive results regarding adolescents’ development. The main objective of this study was to explore and analyze the relationship between adolescents’ quality of life (QoL) and their family environment/relationship. Method: The sample was collected [...] Read more.

Background: A healthy and supportive family environment leads to more positive results regarding adolescents’ development. The main objective of this study was to explore and analyze the relationship between adolescents’ quality of life (QoL) and their family environment/relationship. Method: The sample was collected as part of the Health Behavior in School-aged Children 2018 study, which included 8215 adolescents, 52.7% female, with a mean age of 14.36 years (SD = 2.28). Results: Girls are more involved in family activities (such as family meals), report being treated with fairness by their parents and feel less parental pressure to get good grades. Boys have a higher perception regarding their family affluence, better family relationships and support and better QoL. Having an above-average QoL is significantly related to high family affluence, better communication with both parents, greater involvement in family activities, greater perception of help from parents regarding decision-making, greater perception of being treated with fairness by parents and less pressure from parents to get good grades, as well as a better family relationship/support. Conclusion: It is important to determine the impact that parental divorce/separation or a weak parent–child relationship can have on adolescents. It is also necessary to consider the family relationship and structure when devising strategies and public policies related to the promotion of adolescents’ health and well-being. Full article

9 pages, 786 KiB

Open AccessEditor’s ChoiceArticle

Changes in Suicide Rate and Characteristics According to Age of Suicide Attempters before and after COVID-19

by Min-Jung Kim, So-Hyun Paek, Jae-Hyun Kwon, Soo-Hyun Park, Hyun-Jung Chung and Young-Hoon Byun

Children 2022, 9(2), 151; https://doi.org/10.3390/children9020151 - 25 Jan 2022

Cited by 22 | Viewed by 6083

Abstract

This study aims to identify age-related suicide-related factors and changes in suicide rate before and after the onset of the COVID-19 pandemic. Methods: From 2018 to 2020, the patients who presented to the ED of a university hospital with a suicide attempt were [...] Read more.

This study aims to identify age-related suicide-related factors and changes in suicide rate before and after the onset of the COVID-19 pandemic. Methods: From 2018 to 2020, the patients who presented to the ED of a university hospital with a suicide attempt were classified into adolescents (≤18 years), adults (19–65 years), and elderly (>65 years), and the visits were grouped into before and after COVID-19. Results: There were 853 visits before and 388 visits after COVID-19, and the results showed that the number of adolescent and adult suicide patients increased immediately after the pandemic, but the overall trend did not show a significant difference from before the pandemic. In the adolescents, the ratio of male patients increased, interpersonal and school-related motivations decreased, the poisoning and cutting methods of suicide were more common, and hospitalization admissions increased. Among the elderly, the ratio of female patients increased, the number of single patients and patients without previous psychiatric problems increased, the motives for physical illness and death of people around increased, the falling and hanging methods of suicide were more common, and hospitalization admissions and deaths increased. Conclusion: The impact of COVID-19 on suicide rates and suicide-related factors varies by age group. This finding requires different approaches and methods to suicide prevention based on age. Full article

(This article belongs to the Section Pediatric Mental Health)

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17 pages, 1463 KiB

Open AccessEditor’s ChoiceArticle

Alterations of the Gut Microbiome Associated to Methane Metabolism in Mexican Children with Obesity

by Sofía Magdalena Murga-Garrido, Yaneth Citlalli Orbe-Orihuela, Cinthya Estefhany Díaz-Benítez, Ana Cristina Castañeda-Márquez, Fernanda Cornejo-Granados, Adrian Ochoa-Leyva, Alejandro Sanchez-Flores, Miguel Cruz, Ana Isabel Burguete-García and Alfredo Lagunas-Martínez

Children 2022, 9(2), 148; https://doi.org/10.3390/children9020148 - 24 Jan 2022

Cited by 9 | Viewed by 5069

Abstract

Gut microbiota is associated with the development of metabolic disorders. To study its association with childhood obesity, we performed a cross-sectional study with 46 children (6–12 years old). We collected fecal samples, food-frequency questionnaires (FFQs), and anthropometric measurements. Shotgun metagenomics were used to [...] Read more.

Gut microbiota is associated with the development of metabolic disorders. To study its association with childhood obesity, we performed a cross-sectional study with 46 children (6–12 years old). We collected fecal samples, food-frequency questionnaires (FFQs), and anthropometric measurements. Shotgun metagenomics were used to obtain the microbial taxonomic diversity and metabolic potential. We identified two dietary profiles characterized by complex carbohydrates and proteins (pattern 1) and saturated fat and simple carbohydrates (pattern 2). We classified each participant into normal weight (NW) or overweight and obese (OWOB) using their body mass index (BMI) z-score. The ratio of Firmicutes/Bacteroidetes and alpha diversity were not different between the BMI groups. Genera contributing to beta diversity between NW and OWOB groups included Bacteroides rodentium, B. intestinalis, B. eggerthii, Methanobrevibacter smithii, Eubacterium sp., and Roseburia sp. B. rodentium was associated with lower BMI and dietary pattern 1 intake. Eubacterium sp. and Roseburia sp. were associated with BMI increments and high consumption of dietary pattern 2. Methane and energy metabolism were found enriched in under-represented KEGG pathways of NW group compared to OWOB. Complex dietary and microbiome interaction leads to metabolic differences during childhood, which should be elucidated to prevent metabolic diseases in adolescence and adulthood. Full article

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13 pages, 413 KiB

Open AccessEditor’s ChoiceArticle

The Needs of Parents of Children Suffering from Cancer—Continuation of Research

by Anna Lewandowska

Children 2022, 9(2), 144; https://doi.org/10.3390/children9020144 - 23 Jan 2022

Cited by 21 | Viewed by 4599

Abstract

Background: Parents experience many healthcare needs when caring for their sick children. Research shows that parents of oncological children have a high level of unmet needs, including psychosocial, emotional, physical, informational, financial, educational, and spiritual needs. To date, little quantitative research has been [...] Read more.

Background: Parents experience many healthcare needs when caring for their sick children. Research shows that parents of oncological children have a high level of unmet needs, including psychosocial, emotional, physical, informational, financial, educational, and spiritual needs. To date, little quantitative research has been carried out on the specific needs of parents of children with cancer, which creates uncertainty about what areas should be addressed in care. This study investigated the prevalence of unmet needs among parents of children with cancer. Methods: A population survey was conducted between 2015 and 2020. Caregivers of children diagnosed with cancer were invited to participate in the study to assess their problems and needs. Results: The analysis found that 97% of the participants experienced some level of need for one or more items, and 73% of the respondents reported a moderate or high need for one or more items. In the field of medical information, 70% of respondents had moderate or high needs, 55% of parents reported a moderate or high level of need for help in the psychological or emotional field, and 30% in the financial domain. The prevalence of moderate or high need in the remaining domains ranged from 10% to 15%. Conclusions: Parents of children with cancer experience a high level of needs, especially psychological, emotional, and information. These data suggest that the existing healthcare system does not meet the needs of parents of sick children. The results show the need to investigate the mechanisms by which healthcare providers can use the healthcare system to identify and meet needs. Full article

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

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11 pages, 553 KiB

Open AccessEditor’s ChoiceArticle

Is Vesicostomy Still a Contemporary Method of Managing Posterior Urethral Valves?

by Aybike Hofmann, Maximilian Haider, Alexander Cox, Franziska Vauth and Wolfgang H. Rösch

Children 2022, 9(2), 138; https://doi.org/10.3390/children9020138 - 21 Jan 2022

Cited by 7 | Viewed by 3200

Abstract

In boys with posterior urethral valves (PUVs) the main treatment aim is to preserve long-term bladder and renal function. To determine the effectiveness of secondary vesicostomy in boys with PUVs, the medical records of 21 patients with PUV (2010–2019), divided into two groups [...] Read more.

In boys with posterior urethral valves (PUVs) the main treatment aim is to preserve long-term bladder and renal function. To determine the effectiveness of secondary vesicostomy in boys with PUVs, the medical records of 21 patients with PUV (2010–2019), divided into two groups (group I: valve ablation; group II: secondary vesicostomy), were reviewed regarding the course of serum creatinine, renal ultrasound, voiding cystourethrogram, urodynamics, postoperative complications, need of further surgery, and long-term solution. The median age of all patients at first follow-up was 11 (9–13) months and at last follow-up 64.5 (39.5–102.5) months. Despite a significant difference of the SWDR score (shape, wall, reflux, and diverticula) (p = 0.014), both groups showed no significant differences preoperatively. Postoperatively, serum creatinine (p = 0.024), grade of vesicoureteral reflux (p = 0.003), side of upper tract dilatation (p = 0.006), side of megaureter (p = 0.004), and SWDR score (p = 0.002) were significantly decreased in group II. Postoperative urodynamic measurements showed comparable results in both groups. Stoma complications were found in three (20%) patients (group II). Eight (53.3%) patients already received a closure of the vesicostomy. Seven out of eight (87.5%) patients were able to micturate spontaneously. Vesicostomy remains a reliable treatment option for boys with PUV to improve bladder function and avoid further damage to the urinary tract. Full article

(This article belongs to the Special Issue Urology in Pediatrics)

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10 pages, 1158 KiB

Open AccessEditor’s ChoiceArticle

Maternal Singing but Not Speech Enhances Vagal Activity in Preterm Infants during Hospitalization: Preliminary Results

by Manuela Filippa, Mimma Nardelli, Elisa Della Casa, Alberto Berardi, Odoardo Picciolini, Sara Meloni, Clara Lunardi, Alessandra Cecchi, Alessandra Sansavini, Luigi Corvaglia, Enzo Pasquale Scilingo, Fabrizio Ferrari and EVC Group

Children 2022, 9(2), 140; https://doi.org/10.3390/children9020140 - 21 Jan 2022

Cited by 12 | Viewed by 3538

Abstract

Background: Early parental interventions in the Neonatal Intensive Care Units (NICUs) have beneficial effects on preterm infants’ short and long-term outcomes. The aim of this study was to investigate the effects of Early Vocal Contact (EVC)—singing and speaking—on preterm infants’ vagal activity and [...] Read more.

Background: Early parental interventions in the Neonatal Intensive Care Units (NICUs) have beneficial effects on preterm infants’ short and long-term outcomes. The aim of this study was to investigate the effects of Early Vocal Contact (EVC)—singing and speaking—on preterm infants’ vagal activity and autonomic nervous system (ANS) maturation. Methods: In this multi-center randomized clinical trial, twenty-four stable preterm infants, born at 25–32 weeks gestational age, were randomized to either the EVC group or control group, where mothers did not interact with the babies but observed their behavior. Heart Rate Variability (HRV) was acquired before intervention (pre-condition), during vocal contact, and after it (post condition). Results: No significant effect of the vocal contact, singing and speaking, was found in HRV when the intervention group was compared to the control group. However, a significant difference between the singing and the pre and post conditions, respectively, preceding and following the singing intervention, was found in the Low and High Frequency power nu, and in the low/high frequency features (p = 0.037). By contrast, no significant effect of the speaking was found. Conclusions: Maternal singing, but not speaking, enhances preterm infants’ vagal activity in the short-term, thus improving the ANS stability. Future analyses will investigate the effect of enhanced vagal activity on short and long-term developmental outcomes of preterm infants in the NICU. Full article

(This article belongs to the Section Pediatric Neonatology)

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19 pages, 333 KiB

Open AccessEditor’s ChoiceArticle

Prevalence of Overweight and Obesity and Associated Diet-Related Behaviours and Habits in a Representative Sample of Adolescents in Greece

by Rafaela Makri, Michail Katsoulis, Anastasios Fotiou, Eleftheria Kanavou, Myrto Stavrou, Clive Richardson, Afroditi Kanellopoulou, Philippos Orfanos, Vassiliki Benetou and Anna Kokkevi

Children 2022, 9(1), 119; https://doi.org/10.3390/children9010119 - 17 Jan 2022

Cited by 12 | Viewed by 5305

Abstract

Excessive body weight during adolescence represents a significant public health problem worldwide. Identifying factors associated with its development is crucial. We estimated the prevalence of overweight and obesity in a representative sample of 11, 13 and, 15-year-olds living in Greece and explored the [...] Read more.

Excessive body weight during adolescence represents a significant public health problem worldwide. Identifying factors associated with its development is crucial. We estimated the prevalence of overweight and obesity in a representative sample of 11, 13 and, 15-year-olds living in Greece and explored the association with diet-related behaviours and habits. Self-reported data on weight, height, diet-related behaviours and habits were used from 3816 students (1898 boys, 1918 girls) participants in the Greek arm of the international Health Behaviour in School-Aged Children (HBSC) study during 2018. Overweight and obesity were defined using the 2007 WHO growth charts classification. Prevalence of overweight was 19.4% in the total sample, 24.1% for boys and 14.7% for girls, and prevalence of obesity was 5.3% in the total sample, 7.3% for boys and 3.4% for girls, respectively. In the total sample, overweight (including obesity) was positively associated with male gender, low family affluence, skipping breakfast, and being on a diet, and inversely associated with age and being physically active. Eating rarely with the family was positively associated with overweight only among boys and eating snacks/meals in front of screens only among girls. No association was noted for eating in fast-food restaurants, consuming vegetables, fruits, sweets, and sugar-sweetened beverages. Full article

(This article belongs to the Special Issue Childhood and Adolescent Obesity and Weight Management: 2nd Edition)

14 pages, 1492 KiB

Open AccessEditor’s ChoiceArticle

Positive Associations between Body Mass Index and Hematological Parameters, Including RBCs, WBCs, and Platelet Counts, in Korean Children and Adolescents

by Hwal Rim Jeong, Hae Sang Lee, Young Suk Shim and Jin Soon Hwang

Children 2022, 9(1), 109; https://doi.org/10.3390/children9010109 - 14 Jan 2022

Cited by 14 | Viewed by 3510

Abstract

We conducted this study to investigate the associations between hematological parameters and obesity in children and adolescents. The levels of hematological parameters (including white blood cells [WBCs], red blood cells [RBCs], hemoglobin [Hb], hematocrit [Hct], and platelets) of 7997 participants (4259 boys and [...] Read more.

We conducted this study to investigate the associations between hematological parameters and obesity in children and adolescents. The levels of hematological parameters (including white blood cells [WBCs], red blood cells [RBCs], hemoglobin [Hb], hematocrit [Hct], and platelets) of 7997 participants (4259 boys and 3738 girls) aged 10–18 years were recorded. The parameters were compared among participants with normal weight, overweight, and obesity. Significantly higher mean levels of WBCs (7.16 vs. 6.16 × 103/mm³, p < 0.001), RBCs (4.90 vs. 4.82 × 106/mm³, p < 0.001), Hb (14.07 vs. 13.99 g/dL, p < 0.05), Hct (42.31 vs. 41.91%, p < 0.001), and platelets (311.87 vs. 282.66 × 103/mm³, p < 0.001) were found in the obese than normal weight group, respectively, after adjusting for body mass index (BMI) and sex. BMI SDS had significant positive associations with the levels of WBCs (β = 0.275, p < 0.001), RBCs (β = 0.028, p < 0.001), Hb (β = 0.034, p < 0.001), Hct (β = 0.152, p < 0.001), and platelets (β = 8.372, p < 0.001) after adjusting for age, sex, and socioeconomic factors in a multiple linear regression analysis. A higher BMI was associated with elevated WBC, RBC, Hb, Hct, and platelet counts in children and adolescents. Because higher levels of hematological parameters are potential risk factors for obesity-related diseases, hematological parameters should be evaluated in obese children and adolescents. Full article

(This article belongs to the Special Issue Body Composition in Children)

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10 pages, 234 KiB

Open AccessEditor’s ChoiceArticle

The Incidence and Causes of Unplanned Reoperations as a Quality Indicator in Pediatric Surgery

by Miro Jukić, Ivona Biuk and Zenon Pogorelić

Children 2022, 9(1), 106; https://doi.org/10.3390/children9010106 - 13 Jan 2022

Cited by 14 | Viewed by 2692

Abstract

Background: Unplanned return to the operating room (uROR) within the 30-day postoperative period can be used as a quality indicator in pediatric surgery. The aim of this study was to investigate and evaluate uROR as a quality indicator. Methods: The case records of [...] Read more.

Background: Unplanned return to the operating room (uROR) within the 30-day postoperative period can be used as a quality indicator in pediatric surgery. The aim of this study was to investigate and evaluate uROR as a quality indicator. Methods: The case records of pediatric patients who underwent reoperation within the 30-day period after primary surgery, from 1 January 2018 to 31 December 2020 were retrospectively reviewed. The primary outcome of the study was the rate of uROR as a quality indicator in pediatric surgery. Secondary outcomes were indications for primary and secondary surgery, types and management of complications, factors that led to uROR, length of hospital stay, duration of surgery and anesthesia, and starting time of surgery. Results: A total of 3982 surgical procedures, under general anesthesia, were performed during the three-year study period (2018, n = 1432; 2019, n = 1435; 2020, n = 1115). Elective and emergency surgeries were performed in 3032 (76.1%) and 950 (23.9%) patients, respectively. During the study period 19 (0.5%) pediatric patients, with the median age of 11 years (IQR 3, 16), underwent uROR within the 30-day postoperative period. The uROR incidence was 6 (0.4%), 6 (0.4%), and 7 (0.6%) for years 2018, 2019, and 2020, respectively (p = 0.697). The incidence of uROR was significantly higher in males (n = 14; 73.7%) than in females (n = 5; 26.3%) (p = 0.002). The share of unplanned reoperations in studied period was 4.5 times higher in primarily emergency surgeries compared to primarily elective surgeries (p < 0.001). The difference in incidence was 0.9% (95% CI, 0.4–1.4). Out of children that underwent uROR within the 30-day period after elective procedures, 50% had American Society of Anesthesiologists (ASA) score three or higher (p = 0.016). The most common procedure which led to uROR was appendectomy (n = 5, 26.3%) while the errors in surgical technique were the most common cause for uROR (n = 11, 57.9%). Conclusion: Unplanned reoperations within the 30-day period after the initial surgical procedure can be a good quality indicator in pediatric surgery. Risk factors associated with uROR are emergency surgery, male gender, and ASA score ≥3 in elective pediatric surgery. Full article

(This article belongs to the Section Pediatric Surgery)

11 pages, 1812 KiB

Open AccessEditor’s ChoiceArticle

Burden of Traumatic Brain Injuries in Children and Adolescents in Europe: Hospital Discharges, Deaths and Years of Life Lost

by Marek Majdan, Juliana Melichova, Dominika Plancikova, Patrik Sivco, Andrew I. R. Maas, Valery L. Feigin, Suzanne Polinder and Juanita A. Haagsma

Children 2022, 9(1), 105; https://doi.org/10.3390/children9010105 - 13 Jan 2022

Cited by 9 | Viewed by 2516

Abstract

Children and adolescents are at high risk of traumatic brain injuries (TBI). To identify those most at risk across Europe, a comprehensive epidemiological study on the burden of TBI is needed. Our aim was to estimate the burden of TBI in the pediatric [...] Read more.

Children and adolescents are at high risk of traumatic brain injuries (TBI). To identify those most at risk across Europe, a comprehensive epidemiological study on the burden of TBI is needed. Our aim was to estimate the burden of TBI in the pediatric and adolescent population of Europe by calculating rates of hospital-based incidence, death and years of life lost (YLL) due to TBI in 33 countries of Europe in 2014 (most recent available data). We conducted a cross-sectional observational, population-based study. All cases with TBI in the age range 0 to 19, registered in the causes of death databases or hospital discharge databases of 33 European countries were included. Crude and age-standardized rates of hospital discharges, deaths and YLLs due to TBI; and pooled estimates for all countries combined were calculated. TBI caused 2303 deaths (71% in boys), 154,282 YLLs (68% in boys) and 441,368 hospital discharges (61% in boys) in the population of 0–19 year-olds. We estimated pooled age-standardized rates of death (2.8, 95% CI: 2.4–3.3), YLLs (184.4, 95% CI: 151.6–217.2) and hospital discharges (344.6, 95% CI: 250.3–438.9) for the analyzed countries in 2014. The population of 15–19 year-olds had the highest rates of deaths and YLLs, and the population of 0–4 year-olds had the highest rate of hospital discharges. Detailed estimates of hospital discharge, death and YLL rates based on high-quality, standardized data may be used to develop health policies, aid decision-making and plan prevention. Full article

(This article belongs to the Section Global Pediatric Health)

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8 pages, 277 KiB

Open AccessEditor’s ChoiceArticle

The Impact of Weekday-to-Weekend Sleep Differences on Health Outcomes among Adolescent Students

by Jinseok Kim, Jin-Won Noh, Ahraemi Kim and Young Dae Kwon

Children 2022, 9(1), 52; https://doi.org/10.3390/children9010052 - 3 Jan 2022

Cited by 12 | Viewed by 3407

Abstract

The sleep difference between weekdays and weekends can lead to negative physical and mental health outcomes in adolescents. Thus, this study has attempted to analyze the impact of sleep time differences on various health outcomes, using nationally representative panel data. Data from the [...] Read more.

The sleep difference between weekdays and weekends can lead to negative physical and mental health outcomes in adolescents. Thus, this study has attempted to analyze the impact of sleep time differences on various health outcomes, using nationally representative panel data. Data from the junior high school student panel of the Korean Children and Youth Panel Survey were analyzed. The sleep difference was defined as the difference between the average sleep duration on weekdays and that on weekends in minutes. A series of mixed effect linear regression models for continuous variables or mixed effect logit regression for binary variables was utilized. Korean adolescent students reported from 96.8 min to 133.2 min of sleep duration difference between weekdays and weekends. After controlling for gender, parent work status, and type of housing, the weekday-to-weekend sleep differences were associated with various health-related outcomes including concentration difficulty, aggression, somatic symptoms, and withdrawal. Additionally, adolescent student life satisfaction was associated with sleep difference. The sleep differences among adolescent students were more associated with mental health-related outcomes and emotional symptoms than with physical health-related outcomes. The appropriate intervention to reduce the sleep difference gap is an important key to improve health in the adolescence period. Full article

(This article belongs to the Section Global Pediatric Health)

11 pages, 419 KiB

Open AccessEditor’s ChoiceArticle

Improving Motor Skills in Early Childhood through Goal-Oriented Play Activity

by Panggung Sutapa, Kukuh Wahyudin Pratama, Maziah Mat Rosly, Syed Kamaruzaman Syed Ali and Manil Karakauki

Children 2021, 8(11), 994; https://doi.org/10.3390/children8110994 - 2 Nov 2021

Cited by 47 | Viewed by 19385

Abstract

Goal-oriented play activity encourages children to exercise and triggers the movement of body muscles. Active muscles are stronger, more agile, faster, and more powerful. Purpose: The purpose of this study is to determine that goal-oriented play activity in early childhood improves motor skills. [...] Read more.

Goal-oriented play activity encourages children to exercise and triggers the movement of body muscles. Active muscles are stronger, more agile, faster, and more powerful. Purpose: The purpose of this study is to determine that goal-oriented play activity in early childhood improves motor skills. Methods: Forty children aged 4.5–6 years old were recruited and took part in a set of training activities divided into Posts 1–5. To pass each post, a child had to run, walk on a balance beam, move sticks, throw and catch the ball, and arrange blocks. Training was given three times every week for 12 weeks. Data collected consisted of running 25 m, walking on the balance beam, throwing the ball as far as possible, locomotor movement, arranging cans, and bouncing the ball. Paired t and Wilcoxon signed-rank tests were used for analysis. Results: The results showed that there were significant differences in the motor skills evaluated pre- and post-training with p < 0.05. Conclusion: All six training activities conducted for 12 weeks provided significant improvements in the motor skills areas in children aged 4.5–6 years old. Full article

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13 pages, 1435 KiB

Open AccessEditor’s ChoiceArticle

Adverse Childhood Experiences Predict Common Neurodevelopmental and Behavioral Health Conditions among U.S. Children

by Kasra Zarei, Guifeng Xu, Bridget Zimmerman, Michele Giannotti and Lane Strathearn

Children 2021, 8(9), 761; https://doi.org/10.3390/children8090761 - 31 Aug 2021

Cited by 24 | Viewed by 6328

Abstract

Objective: Adverse childhood experiences (ACEs) can have a significant but variable effect on childhood neurodevelopment. The purpose of this study was to quantify and compare the associations between “household challenge” ACEs and common childhood neurodevelopmental and behavioral health conditions, using nationally representative U.S. [...] Read more.

Objective: Adverse childhood experiences (ACEs) can have a significant but variable effect on childhood neurodevelopment. The purpose of this study was to quantify and compare the associations between “household challenge” ACEs and common childhood neurodevelopmental and behavioral health conditions, using nationally representative U.S. data. Method: This study used data from the 2016–2019 National Survey of Children’s Health, a nationwide, population-based, cross-sectional survey. Seven household challenge ACEs (not including child maltreatment) were reported by parents/guardians: parental death, incarceration, divorce/separation, family violence, mental illness, substance abuse, and poverty. Logistic regression with sample weights was used to estimate the odds ratio (OR) for 15 parent-reported neurodevelopmental and behavioral health conditions, by the number of reported ACEs. A dose-response relationship was examined by applying tests of orthogonal polynomial contrasts to fitted logistic regression models. Results: Down syndrome, Tourette syndrome and cerebral palsy were not associated with household challenge ACEs, whereas behavior/conduct problems, depression, and substance abuse were strongly associated, with adjusted ORs ranging from 6.36 (95% confidence interval (CI) 5.53, 7.32) to 9.19 (95% CI 7.79, 10.84). Other neurodevelopmental conditions not traditionally associated with childhood adversity showed moderate yet robust associations with ACEs, including autism (adjusted OR 2.15, 95% CI 1.64, 2.81), learning disability (adjusted OR 3.26, 95% CI 2.80, 3.80), and attention deficit hyperactivity disorder (adjusted OR 3.95, 95% CI 3.44, 4.53). The ORs increased with the number of ACEs, showing significant positive linear trends. Conclusion: We found significant dose-dependent or cumulative associations between ACEs and multiple neurodevelopmental and behavioral conditions. Full article

(This article belongs to the Special Issue Adverse Childhood Experiences: Prevention, Intervention, and Access to Care)

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8 pages, 665 KiB

Open AccessEditor’s ChoiceArticle

Cardiac Manifestations in Children with SARS-COV-2 Infection: 1-Year Pediatric Multicenter Experience

by Nicoletta Cantarutti, Virginia Battista, Rachele Adorisio, Marianna Cicenia, Claudia Campanello, Elisa Listo, Andrea Campana, Gianluca Trocchio and Fabrizio Drago

Children 2021, 8(8), 717; https://doi.org/10.3390/children8080717 - 23 Aug 2021

Cited by 28 | Viewed by 5350

Abstract

Since the spread of COVID-19, pediatric patients were initially considered less affected by SARS-COV-2, but current literature reported subsets of children with multisystem inflammatory syndrome (MIS-C). This study aims to describe the cardiac manifestation of SARS-COV-2 infection in a large cohort of children [...] Read more.

Since the spread of COVID-19, pediatric patients were initially considered less affected by SARS-COV-2, but current literature reported subsets of children with multisystem inflammatory syndrome (MIS-C). This study aims to describe the cardiac manifestation of SARS-COV-2 infection in a large cohort of children admitted to two Italian pediatric referral centers. Between March 2020 and March 2021, we performed a cardiac evaluation in 294 children (mean age 9 ± 5.9 years, male 60%) with active or previous SARS-COV-2 infection. Twenty-six showed ECG abnormalities: 63 repolarization anomalies, 13 Long QTc, five premature ventricular beats, two non-sustained ventricular tachycardia, and one atrial fibrillation. In total, 146 patients underwent cardiac biomarkers: NT-proBNP was elevated in 57, troponin in 34. An echocardiogram was performed in 98, showing 54 cardiac anomalies: 27 left-ventricular dysfunction, 42 pericarditis, 16 coronaritis. MIS-C was documented in 46 patients (mean age 9 ± 4.8 years, male 61%) with cardiac manifestations in 97.8%: 27 ventricular dysfunctions, 32 pericarditis, 15 coronaritis, 3 arrhythmias. All patients recovered, and during follow-up, no cardiac anomalies were recorded. Our experience showed that cardiac involvement is not rare in children with SARS-COV-2, and occurred in almost all patients with MIS-C. However, patients’ recovery is satisfactory and no additional events were reported during FU. Full article

(This article belongs to the Special Issue Cardiac Manifestation in Multisystem Inflammatory Syndrome in Children during Global SARS-CoV-2 Pandemic)

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14 pages, 1054 KiB

Open AccessEditor’s ChoiceArticle

Dietary Sugar Intake and Its Association with Obesity in Children and Adolescents

by Emmanuella Magriplis, George Michas, Evgenia Petridi, George P. Chrousos, Eleftheria Roma, Vassiliki Benetou, Nikos Cholopoulos, Renata Micha, Demosthenes Panagiotakos and Antonis Zampelas

Children 2021, 8(8), 676; https://doi.org/10.3390/children8080676 - 3 Aug 2021

Cited by 49 | Viewed by 12593

Abstract

Sugar intake has been associated with increased prevalence of childhood overweight/obesity; however, results remain controversial. The aim of this study was to examine the probability of overweight/obesity with higher sugar intakes, accounting for other dietary intakes. Data from 1165 children and adolescents aged [...] Read more.

Sugar intake has been associated with increased prevalence of childhood overweight/obesity; however, results remain controversial. The aim of this study was to examine the probability of overweight/obesity with higher sugar intakes, accounting for other dietary intakes. Data from 1165 children and adolescents aged ≥2–18 years (66.8% males) enrolled in the Hellenic National Nutrition and Health Survey (HNNHS) were used; specifically, 781 children aged 2–11 years and 384 adolescents 12–18 years. Total and added sugar intake were assessed using two 24 h recalls (24 hR). Foods were categorized into specific food groups to evaluate the main foods contributing to intakes. A significant proportion of children (18.7%) and adolescents (24.5%) exceeded the recommended cut-off of 10% of total energy intake from added sugars. Sweets (29.8%) and processed/refined grains and cereals (19.1%) were the main sources of added sugars in both age groups, while in adolescents, the third main contributor was sugar-sweetened beverages (20.6%). Being overweight or obese was 2.57 (p = 0.002) and 1.77 (p = 0.047) times more likely for intakes ≥10% of total energy from added sugars compared to less <10%, when accounting for food groups and macronutrient intakes, respectively. The predicted probability of becoming obese was also significant with higher total and added-sugar consumption. We conclude that high consumption of added sugars increased the probability for overweight/obesity among youth, irrespectively of other dietary or macronutrient intakes. Full article

(This article belongs to the Special Issue Body Composition in Children)

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14 pages, 1530 KiB

Open AccessEditor’s ChoiceArticle

Influence of a Child’s Cancer on the Functioning of Their Family

by Anna Lewandowska

Children 2021, 8(7), 592; https://doi.org/10.3390/children8070592 - 13 Jul 2021

Cited by 32 | Viewed by 4987

Abstract

Background—A child’s cancer affects their entire family and is a source of chronic stress for a sick child, as well as for their parents and siblings. It deprives them of the feeling of security; introduces uncertainty, fear and anxiety; and destabilises their life. [...] Read more.

Background—A child’s cancer affects their entire family and is a source of chronic stress for a sick child, as well as for their parents and siblings. It deprives them of the feeling of security; introduces uncertainty, fear and anxiety; and destabilises their life. It mobilises the family since they have to reconcile the treatment and frequent appointments at the hospital with the hardships of everyday life. The emotional burden they have to deal with is enormous. Recognition of the needs of such a family allows for the implementation of support, psychosocial care and psychoeducation, as well as the provision of reliable information. Patients and Methods—A population survey was conducted between 2015 and 2020. Caregivers of children diagnosed with cancer were invited to participate in the study to assess their problems and needs. Results—All respondents in their legal status were parents of children with cancer. The study included 800 people, where women accounted for 85% and men accounted for 15%. The mean age of the mother was 38.09, SD = 7.25, and the mean age of the father was 41.11, SD = 7.03. The occurrence of problems negatively correlated with both the age of the parents (p < 0.0001) and the level of education (p < 0.0001). Parents who admitted having financial problems more often reported problems of a different kind; moreover, financial problems were more often reported by parents of children who were ill for a longer time (p = 0.01). Conclusions—Parents of children suffering from cancer reported numerous psychological, social and somatic problems. The identification of problems through screening should translate into specific interventions, thus creating support for the families of children with cancer. Promoting coping with difficult emotions and the ability to solve problems when a child is ill has a positive effect on the functioning of the family. Full article

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

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11 pages, 1451 KiB

Open AccessEditor’s ChoiceArticle

Introducing Less-Invasive Surfactant Administration into a Level IV NICU: A Quality Improvement Initiative

by Steven M. Conlon, Allison Osborne, Julie Bodie, Jaime Marasch, Rita M. Ryan and Tara Glenn

Children 2021, 8(7), 580; https://doi.org/10.3390/children8070580 - 7 Jul 2021

Cited by 13 | Viewed by 6709

Abstract

Less-invasive surfactant administration (LISA), a newer technique of delivering surfactant via a thin catheter, avoids mechanical ventilation. LISA has been widely adopted in Europe but less so in the US. Our goal was to increase the percentage of surfactant delivered via LISA from [...] Read more.

Less-invasive surfactant administration (LISA), a newer technique of delivering surfactant via a thin catheter, avoids mechanical ventilation. LISA has been widely adopted in Europe but less so in the US. Our goal was to increase the percentage of surfactant delivered via LISA from 0% to 51% by 12/2020. Project planning and literature review started 12/2019, and included a standardized equipment kit and simulation training sessions. We began Plan–Do–Study–Act (PDSA) cycles in 6/2020. Initial exclusions for LISA were gestational age (GA) <28 weeks (w) or ≥36 w, intubation in the delivery room, or PCO2 >70 if known; GA exclusion is now <25 w. From 6 to 12/2020, 97 patients received surfactant, 35 (36%) via LISA. When non-LISA-eligible patients were excluded, 35/42 (83%) received LISA successfully. There were only 2/37 patients for whom LISA was not able to be performed. Three LISA infants required mechanical ventilation in the first week of life. Sedation remained an initial challenge but improved when sucrose was used routinely. LISA was safely and successfully introduced in our NICU. Full article

(This article belongs to the Section Pediatric Neonatology)

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15 pages, 2853 KiB

Open AccessEditor’s ChoiceArticle

Neonatal Multisystem Inflammatory Syndrome (MIS-N) Associated with Prenatal Maternal SARS-CoV-2: A Case Series

by Ravindra Pawar, Vijay Gavade, Nivedita Patil, Vijay Mali, Amol Girwalkar, Vyankatesh Tarkasband, Sanjog Loya, Amit Chavan, Narendra Nanivadekar, Rahul Shinde, Uday Patil and Satyan Lakshminrusimha

Children 2021, 8(7), 572; https://doi.org/10.3390/children8070572 - 2 Jul 2021

Cited by 79 | Viewed by 20689

Abstract

Multisystem inflammatory syndrome in children (MIS-C) is a post-infectious immune-mediated condition, seen 3–5 weeks after COVID-19. Maternal SARS-CoV-2 may potentially cause a similar hyperinflammatory syndrome in neonates due to transplacental transfer of antibodies. We reviewed the perinatal history, clinical features, and outcomes of [...] Read more.

Multisystem inflammatory syndrome in children (MIS-C) is a post-infectious immune-mediated condition, seen 3–5 weeks after COVID-19. Maternal SARS-CoV-2 may potentially cause a similar hyperinflammatory syndrome in neonates due to transplacental transfer of antibodies. We reviewed the perinatal history, clinical features, and outcomes of 20 neonates with features consistent with MIS-C related to maternal SARS-CoV-2 in Kolhapur, India, from 1 September 2020 to 30 April 2021. Anti-SARS-CoV-2 IgG and IgM antibodies were tested in all neonates. Fifteen singletons and five twins born to eighteen mothers with a history of COVID-19 disease or exposure during pregnancy presented with features consistent with MIS-C during the first 5 days after birth. Nineteen were positive for anti-SARS-CoV-2 IgG and all were negative for IgM antibodies. All mothers were asymptomatic and therefore not tested by RTPCR-SARS-CoV-2 at delivery. Eighteen neonates (90%) had cardiac involvement with prolonged QTc, 2:1 AV block, cardiogenic shock, or coronary dilatation. Other findings included respiratory failure (40%), fever (10%), feeding intolerance (30%), melena (10%), and renal failure (5%). All infants had elevated inflammatory biomarkers and received steroids and IVIG. Two infants died. We speculate that maternal SARS-CoV-2 and transplacental antibodies cause multisystem inflammatory syndrome in neonates (MIS-N). Immunomodulation may be beneficial in some cases, but further studies are needed. Full article

(This article belongs to the Special Issue Stabilization and Resuscitation of Newborns)

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11 pages, 5527 KiB

Open AccessEditor’s ChoiceArticle

Pyelonephritis in Pediatric Uropathic Patients: Differences from Community-Acquired Ones and Therapeutic Protocol Considerations. A 10-Year Single-Center Retrospective Study

by Giovanni Parente, Tommaso Gargano, Stefania Pavia, Chiara Cordola, Marzia Vastano, Francesco Baccelli, Giulia Gallotta, Laura Bruni, Adelaide Corvaglia and Mario Lima

Children 2021, 8(6), 436; https://doi.org/10.3390/children8060436 - 23 May 2021

Cited by 19 | Viewed by 2746

Abstract

Pyelonephritis (PN) represents an important cause of morbidity in the pediatric population, especially in uropathic patients. The aim of the study is to demonstrate differences between PNs of uropathic patients and PNs acquired in community in terms of uropathogens involved and antibiotic sensitivity; [...] Read more.

Pyelonephritis (PN) represents an important cause of morbidity in the pediatric population, especially in uropathic patients. The aim of the study is to demonstrate differences between PNs of uropathic patients and PNs acquired in community in terms of uropathogens involved and antibiotic sensitivity; moreover, to identify a proper empiric therapeutic strategy. A retrospective study was conducted on antibiograms on urine cultures from PNs in vesicoureteral reflux (VUR) patients admitted to pediatric surgery department and from PNs in not VUR patients admitted to Pediatric Emergency Unit between 2010 and 2020. We recorded 58 PNs in 33 patients affected by VUR and 112 PNs in the not VUR group. The mean age of not VUR patients at the PN episode was 1.3 ± 2.6 years (range: 20 days of life–3 years), and almost all the urine cultures, 111 (99.1%), isolated Gram-negative bacteria and rarely, 1 (0.9%), Gram-positive bacteria. The Gram-negative uropathogens isolated were Escherichia coli (97%), Proteus mirabilis (2%), and Klebsiella spp. (1%). The only Gram-positive bacteria isolated was an Enterococcus faecalis. As regards the antibiograms, 96% of not VUR PNs responded to beta-lactams, 99% to aminoglycosides, and 80% to sulfonamides. For the VUR group, mean age was 3.0 years ± 3.0 years (range: 9 days of life–11 years) and mean number of episodes per patient was 2.0 ± 1.0 (range: 1–5); 83% of PNs were by Gram-negatives bacteria vs. 17% by Gram-positive: the most important Gram-negative bacteria were Pseudomonas aeruginosa (44%), Escherichia coli (27%), and Klebsiella spp. (12%), while Enterococcus spp. determined 90% of Gram-positive UTIs. Regimen ampicillin/ceftazidime (success rate: 72.0%) was compared to ampicillin/amikacin (success rate of 83.0%): no statistically significant difference was found (p = 0.09). The pathogens of PNs in uropathic patients are different from those of community-acquired PNs, and clinicians should be aware of their peculiar antibiotic susceptibility. An empiric therapy based on the association ampicillin + ceftazidime is therefore suggested. Full article

(This article belongs to the Special Issue Urology in Pediatrics)

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10 pages, 429 KiB

Open AccessEditor’s ChoiceArticle

Validity of Appendicitis Inflammatory Response Score in Distinguishing Perforated from Non-Perforated Appendicitis in Children

by Zenon Pogorelić, Jakov Mihanović, Stipe Ninčević, Bruna Lukšić, Sara Elezović Baloević and Ozren Polašek

Children 2021, 8(4), 309; https://doi.org/10.3390/children8040309 - 19 Apr 2021

Cited by 32 | Viewed by 5555

Abstract

Background: This prospective observational study aimed to evaluate the validity of appendicitis inflammatory response (AIR) score in differentiating advanced (perforated) from simple (non-perforated) appendicitis in pediatric patients. Methods: A single-center prospective cross-sectional study was conducted between 1 January 2019 until 1 May 2020 [...] Read more.

Background: This prospective observational study aimed to evaluate the validity of appendicitis inflammatory response (AIR) score in differentiating advanced (perforated) from simple (non-perforated) appendicitis in pediatric patients. Methods: A single-center prospective cross-sectional study was conducted between 1 January 2019 until 1 May 2020 including 184 pediatric patients who underwent appendectomy. Based on the intraoperative finding of advanced (n = 38) or simple (n = 146) appendicitis the patients were divided into two groups. Recipient-operator curve (ROC), with calculation of sensitivity and specificity of best cutoff and the area under the curve (AUC), were used to measure the diagnostic value and the potential for risk stratification of the AIR score, among the patients with simple or advanced acute appendicitis. Results: The median value of the AIR score in the perforated and non-perforated groups was 10 (interquartile range, IQR 9, 11), and was 7 (IQR 6, 9), respectively (p < 0.001). Based on the calculated value of AIR score, the patients were classified with a high precision into low, indeterminate and high risk groups for acute appendicitis (p < 0.001). A cutoff value of ≥9 was demonstrated to serve as a reliable indicator of perforated appendicitis with a sensitivity and a specificity of 89.5% and 71.9%, respectively (AUC = 0.80; 95% CI: 0.719–0.871; p < 0.001). Conclusions: Acute appendicitis can be detected with a high level of sensitivity and specificity using the AIR score. Also, the AIR score may differentiate perforated from non-perforated appendicitis in pediatric patients with a high level of accuracy. Full article

(This article belongs to the Special Issue Abdominal Surgery in Pediatrics)

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13 pages, 264 KiB

Open AccessEditor’s ChoiceArticle

Motor Development among Spanish Preschool Children

by Cristina Honrubia-Montesinos, Pedro Gil-Madrona and Luisa Losada-Puente

Children 2021, 8(1), 41; https://doi.org/10.3390/children8010041 - 12 Jan 2021

Cited by 24 | Viewed by 5010

Abstract

The purpose of this study was to analyze motor development of Spanish preschoolers, taking into account sex and age, being an only child, prematurity, and the practice of extracurricular activities. The sample was composed of 300 preschoolers (132 girls, 168 boys) ages 3 [...] Read more.

The purpose of this study was to analyze motor development of Spanish preschoolers, taking into account sex and age, being an only child, prematurity, and the practice of extracurricular activities. The sample was composed of 300 preschoolers (132 girls, 168 boys) ages 3 to 6 years. Preschoolers were tested on 12 fundamental motor skills (locomotor and object control) through the Test of Gross Motor Development—Second Edition (TGMD-2). Nonparametric analysis indicated that there are differences between girls and boys in locomotor and object control skills in the age range of 3–4 years. However, boys and girls scored similarly at the age of 5 years in locomotor development. There were not differences between only children and those who are not only children. Similarly, prematurity was not associated with locomotor and object control development. Nevertheless, those preschoolers who practice extracurricular physical activities scored significantly higher in comparison with those children do not. Further research is needed to shed light on the differences between boys and girls in object control. It may be explained by the types of extracurricular activities. Full article

(This article belongs to the Special Issue Physical Activity and Motor Competence in Preschool Children)

16 pages, 621 KiB

Open AccessEditor’s ChoiceArticle

“Girls Aren’t Meant to Exercise”: Perceived Influences on Physical Activity among Adolescent Girls—The HERizon Project

by Emma S. Cowley, Paula M. Watson, Lawrence Foweather, Sarahjane Belton, Andrew Thompson, Dick Thijssen and Anton J. M. Wagenmakers

Children 2021, 8(1), 31; https://doi.org/10.3390/children8010031 - 7 Jan 2021

Cited by 45 | Viewed by 13418

Abstract

Background. Adolescent girls are less active than boys, with approximately 10% of girls in Ireland and the United Kingdom meeting the minimum recommended daily physical activity (PA) guidelines. This study investigated factors perceived to influence PA among adolescent girls from low socioeconomic areas [...] Read more.

Background. Adolescent girls are less active than boys, with approximately 10% of girls in Ireland and the United Kingdom meeting the minimum recommended daily physical activity (PA) guidelines. This study investigated factors perceived to influence PA among adolescent girls from low socioeconomic areas in order to inform the design of a future intervention (The HERizon Project). Methods. A total of 48 adolescent girls (13–18 years) from low socioeconomic areas of the United Kingdom and Ireland participated in focus groups (n = 8), to explore perspectives of physical activity and the influence of gender within this. Focus groups were thematically analyzed and interpreted within a socioecological framework. Results. Most girls enjoyed PA and were aware of its benefits. They identified both barriers and facilitators to PA at intrapersonal (fear of judgement and changing priorities WITH age), interpersonal (changing social pressures and support from others) and organizational (delivery of PE) levels. Gender inequality was a multilevel factor, crossing all socioecological levels. Conclusion. Although many adolescent girls enjoy PA, their experiences appear to be limited by a fear of judgement and an overarching sense of gender inequality. Future interventions, such as the HERizon Project, should address influences at intrapersonal, interpersonal and organizational levels to promote positive PA experiences for adolescent girls. Full article

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

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Review

17 pages, 838 KiB

Open AccessEditor’s ChoiceReview

Maternal Infection and Preterm Birth: From Molecular Basis to Clinical Implications

by George Daskalakis, Alexandros Psarris, Antonios Koutras, Zacharias Fasoulakis, Ioannis Prokopakis, Antonia Varthaliti, Christina Karasmani, Thomas Ntounis, Ekaterini Domali, Marianna Theodora, Panos Antsaklis, Kalliopi I. Pappa and Angeliki Papapanagiotou

Children 2023, 10(5), 907; https://doi.org/10.3390/children10050907 - 22 May 2023

Cited by 18 | Viewed by 6606

Abstract

As the leading cause of neonatal morbidity and mortality, preterm birth is recognized as a major public health concern around the world. The purpose of this review is to analyze the connection between infections and premature birth. Spontaneous preterm birth is commonly associated [...] Read more.

As the leading cause of neonatal morbidity and mortality, preterm birth is recognized as a major public health concern around the world. The purpose of this review is to analyze the connection between infections and premature birth. Spontaneous preterm birth is commonly associated with intrauterine infection/inflammation. The overproduction of prostaglandins caused by the inflammation associated with an infection could lead to uterine contractions, contributing to preterm delivery. Many pathogens, particularly Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, Gardnerella vaginalis, Ureaplasma urealyticum, Mycoplasma hominis, Actinomyces, Candida spp., and Streptococcus spp. have been related with premature delivery, chorioamnionitis, and sepsis of the neonate. Further research regarding the prevention of preterm delivery is required in order to develop effective preventive methods with the aim of reducing neonatal morbidity. Full article

(This article belongs to the Section Global Pediatric Health)

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25 pages, 1895 KiB

Open AccessEditor’s ChoiceReview

Ultra-Processed Food, Reward System and Childhood Obesity

by Valeria Calcaterra, Hellas Cena, Virginia Rossi, Sara Santero, Alice Bianchi and Gianvincenzo Zuccotti

Children 2023, 10(5), 804; https://doi.org/10.3390/children10050804 - 29 Apr 2023

Cited by 14 | Viewed by 7542

Abstract

Obesity and overweight are a major public health problem globally. Diet quality is critical for proper child development, and an unhealthy diet is a preventable risk factor for noncommunicable diseases (NCDs), such as obesity. Consumption of sugar-sweetened beverages and ultra-processed foods (UPFs) in [...] Read more.

Obesity and overweight are a major public health problem globally. Diet quality is critical for proper child development, and an unhealthy diet is a preventable risk factor for noncommunicable diseases (NCDs), such as obesity. Consumption of sugar-sweetened beverages and ultra-processed foods (UPFs) in childhood may increase the BMI/BMI z-score, body fat percentage, or likelihood of overweight. A strict feeding regulation system allows for sufficient food to be consumed to meet ongoing metabolic demands while avoiding overconsumption. This narrative review explores the issues of obesity and the regulation of food intake related to reward systems and UPF consumption. Nutrient composition alone cannot explain the influence of UPFs on the risk of obesity. Furthermore, the non-nutritional properties of UPFs may explain the mechanisms underlying the relationship with obesity and NCDs. UPFs are designed to be highly palatable, appealing, and energy dense with a unique combination of the main taste enhancer ingredients to generate a strong rewarding stimulus and influence the circuits related to feeding facilitation. How individual UPF ingredients influence eating behavior and reward processes remains not fully elucidated. To increase the knowledge on the relationship between UPFs and pediatric obesity, it may be useful to limit the rapid growth in the prevalence of obesity and subsequent related complications, and to develop new strategies for appropriate food and nutrition policies. Full article

(This article belongs to the Special Issue Food Intake and Nutrition Assessment in Children: Focus on Healthy Growth)

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13 pages, 700 KiB

Open AccessEditor’s ChoiceReview

PANDAS/PANS in the COVID-19 Age: Autoimmunity and Epstein–Barr Virus Reactivation as Trigger Agents?

by Stefano Pallanti and Michele Di Ponzio

Children 2023, 10(4), 648; https://doi.org/10.3390/children10040648 - 30 Mar 2023

Cited by 7 | Viewed by 5713

Abstract

COVID-19 impacted the entire world’s population, frequently resulting in long-lasting neuropsychiatric complications. Furthermore, social distancing, lockdowns and fear for one’s personal health worsen individual psychological wellbeing, especially in children and adolescents. Herein, we discuss the results of studies that specifically reported data about [...] Read more.

COVID-19 impacted the entire world’s population, frequently resulting in long-lasting neuropsychiatric complications. Furthermore, social distancing, lockdowns and fear for one’s personal health worsen individual psychological wellbeing, especially in children and adolescents. Herein, we discuss the results of studies that specifically reported data about the impact of the COVID-19 pandemic or infection on children with Pediatric Acute-Onset Neuropsychiatric Disorders (PANS). Furthermore, we present the cases of five adolescents with PANS whose symptomatology increased following SARS-CoV-2 infection. What emerged from this study was that COVID-19 resulted in the exacerbation of obsessions, tics, anxiety and mood symptoms and decreased wellbeing. Moreover, new symptoms, as well as new PANS cases, are reported to have arisen after COVID-19 infection. Here, we hypothesize that the pathogenic mechanisms of silent viruses, such as the Epstein–Barr virus, are related to neuroinflammation, immune responses and reactivation, with additional roles played by social-isolation-related inflammatory processes. The discussion of PANS, which represents a model of immune-mediated neuropsychiatric manifestations, is particularly relevant, with the aim of uncovering the mechanisms that lead to neuropsychiatric Post-Acute COVID-19 Syndrome (PACS). Prospects for future studies and treatment implications are discussed. Full article

(This article belongs to the Special Issue Focus on Children 2021: Challenges and Opportunities towards the Future)

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14 pages, 1202 KiB

Open AccessEditor’s ChoiceReview

Pediatric Bowel Management Options and Organizational Aspects

by Elizaveta Bokova, Wendy Jo Svetanoff, Marc Aaron Levitt and Rebecca Maria Rentea

Children 2023, 10(4), 633; https://doi.org/10.3390/children10040633 - 28 Mar 2023

Cited by 9 | Viewed by 2700

Abstract

A bowel management program (BMP) to treat fecal incontinence and severe constipation is utilized for patients with anorectal malformations, Hirschsprung disease, spinal anomalies, and functional constipation, decreasing the rate of emergency department visits, and hospital admissions. This review is part of a manuscript [...] Read more.

A bowel management program (BMP) to treat fecal incontinence and severe constipation is utilized for patients with anorectal malformations, Hirschsprung disease, spinal anomalies, and functional constipation, decreasing the rate of emergency department visits, and hospital admissions. This review is part of a manuscript series and focuses on updates in the use of antegrade flushes for bowel management, as well as organizational aspects, collaborative approach, telemedicine, the importance of family education, and one-year outcomes of the bowel management program. Implementation of a multidisciplinary program involving physicians, nurses, advanced practice providers, coordinators, psychologists, and social workers leads to rapid center growth and enhances surgical referrals. Education of the families is crucial for postoperative outcomes, prevention, and early detection of complications, especially Hirschsprung-associated enterocolitis. Telemedicine can be proposed to patients with a defined anatomy and is associated with high parent satisfaction and decreased patient stress in comparison to in-person visits. The BMP has proved to be effective in all groups of colorectal patients at a 1- and 2-year follow-up with social continence achieved in 70–72% and 78% of patients, respectively, and an improvement in the patients’ quality of life. A transitional care to adult program is essential to maintain the same quality of care, and continuity of care and to achieve desired long-term outcomes as the patient reaches adult age. Full article

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

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23 pages, 438 KiB

Open AccessEditor’s ChoiceReview

Efficacy and Safety of Elexacaftor-Tezacaftor-Ivacaftor in the Treatment of Cystic Fibrosis: A Systematic Review

by Nikoletta Kapouni, Maria Moustaki, Konstantinos Douros and Ioanna Loukou

Children 2023, 10(3), 554; https://doi.org/10.3390/children10030554 - 15 Mar 2023

Cited by 21 | Viewed by 4914

Abstract

Elexacaftor/Tezacaftor/Ivacaftor (ELX/TEZ/IVA) is a new CFTR (Cystic Fibrosis Transmembrane Conductance Regulator) modulator treatment, used over the last few years, which has shown an improvement in different clinical outcomes in patients with cystic fibrosis (CF). The objective of this study was a systematic research [...] Read more.

Elexacaftor/Tezacaftor/Ivacaftor (ELX/TEZ/IVA) is a new CFTR (Cystic Fibrosis Transmembrane Conductance Regulator) modulator treatment, used over the last few years, which has shown an improvement in different clinical outcomes in patients with cystic fibrosis (CF). The objective of this study was a systematic research of the literature on the efficacy and safety of this CFTR modulator on patients with CF. A search of Pubmed was conducted for randomized clinical trials and observational studies published from 2012 to September 2022. The included full manuscripts comprised nine clinical trials and 16 observational studies, whose participants were aged ≥12 years or were children 6–11 years old with at least one Phe508del mutation and/or advanced lung disease (ALD). These studies reported that ELX/TEZ/IVA has a significant positive effect on the lung function of patients with CF, by ameliorating parameters such as FEV₁, LCI, pulmonary exacerbations or sweat chloride concentration, increasing BMI and improving quality of their life. Its role in cystic fibrosis-related diabetes (CFRD) is not yet clear. It was found that this new CFTR modulator has an overall favorable safety profile, with mild to moderate adverse events. Further studies are needed for a deeper understanding of the impact of CFTR modulators on other CF manifestations, or the possibility of treating with ELX/TEZ/IVA CF patients with rare CFTR mutations. Full article

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

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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 15 | Viewed by 3803

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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15 pages, 670 KiB

Open AccessFeature PaperEditor’s ChoiceReview

Psychiatric Disorders and Obesity in Childhood and Adolescence—A Systematic Review of Cross-Sectional Studies

by Ioulia Kokka, Iraklis Mourikis and Flora Bacopoulou

Children 2023, 10(2), 285; https://doi.org/10.3390/children10020285 - 1 Feb 2023

Cited by 18 | Viewed by 4106

Abstract

Obesity and psychiatric disorders have high prevalence and are both considered major health problems. Within the last decades, the rates of obesity have risen over 6%, while the prevalence of psychiatric disorders is over 12% for children and adolescents. The aim of this [...] Read more.

Obesity and psychiatric disorders have high prevalence and are both considered major health problems. Within the last decades, the rates of obesity have risen over 6%, while the prevalence of psychiatric disorders is over 12% for children and adolescents. The aim of this study was to systematically review the evidence regarding the relation of obesity and psychiatric disorders in childhood and adolescence. This review, based on the PRISMA guidelines, included cross-sectional studies published within the last decade, pertaining to the relation between psychiatric disorders and obesity in children and adolescents up to the age of 19 years. Studies on eating disorders were excluded. A total of 14 studies of 23,442 children and adolescents that investigated the relation of obesity with anxiety, mood disorders, and psychosis were included in this systematic review. Nine of the included studies reported a significant relationship between the psychiatric disorder under investigation and obesity. Understanding the nexus between obesity and psychiatric disorders in children and adolescents is of great importance, given the alarming increase in both conditions in youth. Such findings could facilitate the development and implementation of targeted interventions. Full article

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

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0 pages, 3963 KiB

Open AccessEditor’s ChoiceReview

Nutrition Profile for Countries of the Eastern Mediterranean Region with Different Income Levels: An Analytical Review

by Hanna Leppäniemi, Eman T. Ibrahim, Marwa M. S. Abbass, Elaine Borghi, Monica C. Flores-Urrutia, Elisa Dominguez Muriel, Giovanna Gatica-Domínguez, Richard Kumapley, Asmus Hammerich and Ayoub Al-Jawaldeh

Children 2023, 10(2), 236; https://doi.org/10.3390/children10020236 - 28 Jan 2023

Cited by 7 | Viewed by 5914

Abstract

The World Health Organization’s (WHO) Eastern Mediterranean Region (EMR) is suffering from a double burden of malnutrition in which undernutrition coexists with rising rates of overweight and obesity. Although the countries of the EMR vary greatly in terms of income level, living conditions [...] Read more.

The World Health Organization’s (WHO) Eastern Mediterranean Region (EMR) is suffering from a double burden of malnutrition in which undernutrition coexists with rising rates of overweight and obesity. Although the countries of the EMR vary greatly in terms of income level, living conditions and health challenges, the nutrition status is often discussed only by using either regional or country-specific estimates. This analytical review studies the nutrition situation of the EMR during the past 20 years by dividing the region into four groups based on their income level—the low-income group (Afghanistan, Somalia, Sudan, Syria, and Yemen), the lower-middle-income group (Djibouti, Egypt, Iran, Morocco, Pakistan, Palestine, and Tunisia), the upper-middle-income group (Iraq, Jordan, Lebanon, and Libya) and the high-income group (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and United Arab Emirates)—and by comparing and describing the estimates of the most important nutrition indicators, including stunting, wasting, overweight, obesity, anaemia, and early initiation and exclusive breastfeeding. The findings reveal that the trends of stunting and wasting were decreasing in all EMR income groups, while the percentages of overweight and obesity predominantly increased in all age groups across the income groups, with the only exception in the low-income group where a decreasing trend among children under five years existed. The income level was directly associated with the prevalence rates of overweight and obesity among other age groups except children under five, while an inverse association was observed regarding stunting and anaemia. Upper-middle-income country group showed the highest prevalence rate of overweight among children under five. Most countries of the EMR revealed below-desired rates of early initiation and exclusive breastfeeding. Changes in dietary patterns, nutrition transition, global and local crises, and nutrition policies are among the major explanatory factors for the findings. The scarcity of updated data remains a challenge in the region. Countries need support in filling the data gaps and implementing recommended policies and programmes to address the double burden of malnutrition. Full article

(This article belongs to the Special Issue Food Intake and Nutrition Assessment in Children: Focus on Healthy Growth)

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18 pages, 3180 KiB

Open AccessEditor’s ChoiceReview

Orthodontic Retainers—A Critical Review

by Ioannis Lyros, Ioannis A. Tsolakis, Michael P. Maroulakos, Eleni Fora, Theodoros Lykogeorgos, Maria Dalampira and Apostolos I. Tsolakis

Children 2023, 10(2), 230; https://doi.org/10.3390/children10020230 - 28 Jan 2023

Cited by 13 | Viewed by 11864

Abstract

The achievement of aesthetic, functional occlusion should not mark the end of the orthodontic intervention. To prevent relapse, retention needs advance planning, and may vary in duration. This review aims to present and comment on the available means of retention. The ever-popular, passive [...] Read more.

The achievement of aesthetic, functional occlusion should not mark the end of the orthodontic intervention. To prevent relapse, retention needs advance planning, and may vary in duration. This review aims to present and comment on the available means of retention. The ever-popular, passive Hawley-like removable appliances are credible in maintaining the desired occlusion. Modifications are the removable appliance Wrap Around, having the labial archwire extending to the premolars; the translucent retainer, Astics, a unique aesthetic Hawley-type device; and the reinforced removable retainer, which features a metallic grid reinforcing the acrylic base. Vacuum-formed retainers are easy to fabricate and are readily prescribed. By contrast, fixed retainers are made of orthodontic wire and composite resin bonded on the lingual or palatal surfaces of the anterior teeth. Patient-related variables need evaluation to select the appropriate retainer, while patients ought to realize the importance of retention and comply with offered guidance. Overall, the orthodontist is responsible for keeping the patient informed on the properties and the duration of retention, even before starting active orthodontic treatment. Full article

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

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18 pages, 3712 KiB

Open AccessEditor’s ChoiceReview

The Use of Stress Cardiovascular Imaging in Pediatric Population

by Sara Moscatelli, Francesco Bianco, Andrea Cimini, Mario Panebianco, Isabella Leo, Chiara Bucciarelli-Ducci and Marco Alfonso Perrone

Children 2023, 10(2), 218; https://doi.org/10.3390/children10020218 - 26 Jan 2023

Cited by 12 | Viewed by 2941

Abstract

Although not frequent in the pediatric population, ischemia could occur in children due to several congenital and acquired disease. Stress imaging is key for the non-invasive evaluation of myocardial abnormalities and perfusion defect in this clinical setting. Moreover, beyond ischemia assessment, it can [...] Read more.

Although not frequent in the pediatric population, ischemia could occur in children due to several congenital and acquired disease. Stress imaging is key for the non-invasive evaluation of myocardial abnormalities and perfusion defect in this clinical setting. Moreover, beyond ischemia assessment, it can provide complementary diagnostic and prognostic information in valvular heart disease and cardiomyopathies. When performed using cardiovascular magnetic resonance, it could detect, in addition, myocardial fibrosis and infarction, increasing the diagnostic yield. Several imaging modalities are currently available for the evaluation of stress myocardial perfusion. Advances in technologies have also increased the feasibility, safety and availability of these modalities in the pediatric age group. However, despite the established role of stress imaging and its increasing use in daily clinical practice, there are currently no specific guidelines, and little data are available in the literature on this topic. The aim of this review is to summarize the most recent evidence on pediatric stress imaging and its clinical application with a focus on the advantages and limitations of each imaging modality currently available. Full article

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

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20 pages, 377 KiB

Open AccessEditor’s ChoiceReview

Push and Pull Factors: Contextualising Biological Maturation and Relative Age in Talent Development Systems

by Liam Sweeney, Jamie Taylor and Áine MacNamara

Children 2023, 10(1), 130; https://doi.org/10.3390/children10010130 - 9 Jan 2023

Cited by 14 | Viewed by 3692

Abstract

In this conceptual paper, we contextualise ongoing attempts to manage challenge dynamics in talent systems in sport. Firstly, we review the broad literature base related to biological maturation, relative age, and the proposed interventions to mitigate effects. We suggest that the relative age [...] Read more.

In this conceptual paper, we contextualise ongoing attempts to manage challenge dynamics in talent systems in sport. Firstly, we review the broad literature base related to biological maturation, relative age, and the proposed interventions to mitigate effects. We suggest that the relative age effect may be a population level effect, indicative of deeper phenomena, rather than having a direct effect on challenge levels. In contrast, we suggest that biological maturation has a direct effect on challenge at the individual level. Therefore, our main critique of many existing approaches to the management of challenge is a lack of individual nuance and flexibility. We suggest the necessity for talent systems to adopt a more holistic approach, conceptualising biological maturation and relative age within a broader field of “push and pull factors” that impact challenge dynamics in talent development in sport. Finally, we provide practical guidance for talent systems in their approach to relative age and biological maturation, recognising that there is no “gold standard”. Instead, there is a need to recognize the highly individual and contextual nature of these concepts, focusing on strategic coherence through talent systems for the management of selection and development processes. Full article

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

19 pages, 1007 KiB

Open AccessEditor’s ChoiceReview

by Federica Di Spirito, Alessandra Amato, Maria Pia Di Palo, Giuseppe A. Ferraro, Adone Baroni, Rosario Serpico and Maria Contaldo

Children 2022, 9(12), 1942; https://doi.org/10.3390/children9121942 - 10 Dec 2022

Cited by 14 | Viewed by 2995

Abstract

In addition to the direct impact of the SARS-CoV-2 infection, the COVID-19 pandemic reports multiple effects on people’s health and psycho-physical well-being. In the dental field, oral hygiene sessions, regular dental check-ups, and aerosol-generating procedures were commonly postponed, thus resulting in repercussions on [...] Read more.

In addition to the direct impact of the SARS-CoV-2 infection, the COVID-19 pandemic reports multiple effects on people’s health and psycho-physical well-being. In the dental field, oral hygiene sessions, regular dental check-ups, and aerosol-generating procedures were commonly postponed, thus resulting in repercussions on oral health also favored by the changing eating and oral hygiene habits during the multiple lockdowns. Furthermore, dental settings and practices were generally perceived as at high risk for SARS-CoV-2 transmission, thus unsafe, and by general and pediatric dentists themselves. Last, the consequences of stress related to deprivation of social life and playful activities should not be underestimated in children, exposing them to the deleterious effects of bad oral habits, with repercussions on the balanced growth and development of the stomatognathic system. The present work intends to analyze the medium-term and long-term impact of COVID-19 on pediatric oral and dental care provision, reviewing pediatric dentistry practice and oral and dental needs of pedodontics patients during the first peak and the various waves of the COVID-19 pandemic, and lessons learned. Full article

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

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20 pages, 6433 KiB

Open AccessFeature PaperEditor’s ChoiceReview

Role of Cardiovascular Imaging in the Follow-Up of Patients with Fontan Circulation

by Sara Moscatelli, Nunzia Borrelli, Jolanda Sabatino, Isabella Leo, Martina Avesani, Claudia Montanaro and Giovanni Di Salvo

Children 2022, 9(12), 1875; https://doi.org/10.3390/children9121875 - 30 Nov 2022

Cited by 13 | Viewed by 3836

Abstract

Since its first description in 1971, the Fontan procedure and its modifications have led to a substantial improvement in the survival rates of patients with a variety of types of complex Congenital Heart Disease (CHD) characterised by the presence of a single, dominant [...] Read more.

Since its first description in 1971, the Fontan procedure and its modifications have led to a substantial improvement in the survival rates of patients with a variety of types of complex Congenital Heart Disease (CHD) characterised by the presence of a single, dominant ventricle. However, despite the significant improvement of the prognosis over the years, Fontan patients are still exposed to several cardiovascular and systemic complications. It is, therefore, important to fully understand the pitfalls hidden behind a Fontan anatomy and the potential predictors of ventricular failure. Cardiovascular imaging plays a key role in this context, allowing for the early identification of complications with important prognostic implications. Echocardiography remains the first-line imaging modality for serial evaluation of Fontan patients. However, there is a growing role of cardiovascular magnetic resonance and cardiac computed tomography from pre-operative assessment to longitudinal follow-up. The aim of this paper will be to provide a comprehensive overview of the role, strengths, and weaknesses of each imaging modality in the assessment of congenital cardiac conditions palliated with the Fontan procedure. Full article

(This article belongs to the Special Issue Research Progress of the Pediatric Cardiology)

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15 pages, 1315 KiB

Open AccessEditor’s ChoiceReview

Cardiovascular Morbidities in Adults Born Preterm: Getting to the Heart of the Matter!

by Vasantha H. S. Kumar

Children 2022, 9(12), 1843; https://doi.org/10.3390/children9121843 - 28 Nov 2022

Cited by 11 | Viewed by 3012

Abstract

Advances in perinatal and neonatal care have led to improved survival of preterm infants into adulthood. However, the shift in focus to long-term health in adults born preterm requires a clear understanding of the impact of prematurity on developing organ systems and the [...] Read more.

Advances in perinatal and neonatal care have led to improved survival of preterm infants into adulthood. However, the shift in focus to long-term health in adults born preterm requires a clear understanding of the impact of prematurity on developing organ systems and the development of adult-oriented disease. A less well-recognized area of risk for surviving preterm infants is their cardiometabolic health. Epidemiologic evidence has linked preterm birth to the development of systemic hypertension, type 2 diabetes, metabolic syndrome, heart failure, and ischemic heart disease. Of more significant concern is that the risk of cardiometabolic disorders is higher in adults born preterm compared to full-term infants. The interconnected nature of the cardio-pulmonary system means worsening morbidity and mortality in adults born preterm. Addressing the problems of adults born preterm holistically would help promote cardiovascular health, wellness, and quality of life over their lifetime. Recognizing that adults born preterm are a unique subset of the population is a challenge in the current healthcare environment. Addressing issues relevant to adults born preterm in the clinically and research domain, using technology to characterize cardiopulmonary physiology and exercise tolerance, developing screening tools for early diagnosis and treatment, and robust follow-up of these infants with access to longitudinal data would improve both the quality and longevity of life in adults born preterm. Full article

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

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11 pages, 909 KiB

Open AccessEditor’s ChoiceReview

Metabolomics: A New Tool in Our Understanding of Congenital Heart Disease

by Pier Paolo Bassareo and Colin J. McMahon

Children 2022, 9(12), 1803; https://doi.org/10.3390/children9121803 - 24 Nov 2022

Cited by 10 | Viewed by 2177

Abstract

Although the genetic origins underpinning congenital heart disease (CHD) have been extensively studied, genes, by themselves, do not entirely predict phenotypes, which result from the complex interplay between genes and the environment. Consequently, genes merely suggest the potential occurrence of a specific phenotype, [...] Read more.

Although the genetic origins underpinning congenital heart disease (CHD) have been extensively studied, genes, by themselves, do not entirely predict phenotypes, which result from the complex interplay between genes and the environment. Consequently, genes merely suggest the potential occurrence of a specific phenotype, but they cannot predict what will happen in reality. This task can be revealed by metabolomics, the most promising of the “omics sciences”. Though metabolomics applied to CHD is still in its infant phase, it has already been applied to CHD prenatal diagnosis, as well as to predict outcomes after cardiac surgery. Particular metabolomic fingerprints have been identified for some of the specific CHD subtypes. The hallmarks of CHD-related pulmonary arterial hypertension have also been discovered. This review, which is presented in a narrative format, due to the heterogeneity of the selected papers, aims to provide the readers with a synopsis of the literature on metabolomics in the CHD setting. Full article

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21 pages, 1368 KiB

Open AccessEditor’s ChoiceReview

Evaluation and Treatment of Pain in Fetuses, Neonates and Children

by Santiago Mencía, Clara Alonso, Carmen Pallás-Alonso, Jesús López-Herce and Maternal and Child Health and Development Network II (SAMID II)

Children 2022, 9(11), 1688; https://doi.org/10.3390/children9111688 - 3 Nov 2022

Cited by 11 | Viewed by 4754

Abstract

The perception of pain is individual and differs between children and adults. The structures required to feel pain are developed at 24 weeks of gestation. However, pain assessment is complicated, especially in neonates, infants and preschool-age children. Clinical scales adapted to age are [...] Read more.

The perception of pain is individual and differs between children and adults. The structures required to feel pain are developed at 24 weeks of gestation. However, pain assessment is complicated, especially in neonates, infants and preschool-age children. Clinical scales adapted to age are the most used methods for assessing and monitoring the degree of pain in children. They evaluate several behavioral and/or physiological parameters related to pain. Some monitors detect the physiological changes that occur in association with painful stimuli, but they do not yet have a clear clinical use. Multimodal analgesia is recommended for pain treatment with non-pharmacological and pharmacological interventions. It is necessary to establish pharmacotherapeutic protocols for analgesia adjusted to the acute or chronic, type and intensity of pain, as well as age. The most used analgesics in children are paracetamol, ibuprofen, dipyrone, opioids (morphine and fentanyl) and local anesthetics. Patient-controlled analgesia is an adequate alternative for adolescent and older children in specific situations, such as after surgery. In patients with severe or persistent pain, it is very important to consult with specific pain services. Full article

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

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13 pages, 541 KiB

Open AccessEditor’s ChoiceReview

Bracing Interventions Can Help Adolescents with Idiopathic Scoliosis with Surgical Indication: A Systematic Review

by Fabio Zaina, Claudio Cordani, Sabrina Donzelli, Stefano Giuseppe Lazzarini, Chiara Arienti, Matteo Johann Del Furia and Stefano Negrini

Children 2022, 9(11), 1672; https://doi.org/10.3390/children9111672 - 31 Oct 2022

Cited by 7 | Viewed by 2700

Abstract

There is a common agreement that bracing is appropriate for curves between 20 and 40° for the Cobb angle during growth, but for larger curves, the experts’ opinions are not consistent. We designed this systematic review to report the updated evidence about the [...] Read more.

There is a common agreement that bracing is appropriate for curves between 20 and 40° for the Cobb angle during growth, but for larger curves, the experts’ opinions are not consistent. We designed this systematic review to report the updated evidence about the effectiveness of bracing in scoliosis patients with curves ≥40° and a residual growth period. We included randomized controlled trials, non-randomized controlled trials, prospective and retrospective observational studies, and case series addressing the effect of bracing in patients with idiopathic scoliosis during growth with curves ≥40° for the Cobb angle, published from 2000 onwards. Outcome: The percentage of patients with surgery, curves above 45° or 50°, and a Cobb angle change are all included in the study. Nine papers (563 patients, average worst curve of 44.8°) are included: four are retrospective case series, two are retrospective and two are prospective cohort studies, and one is a prospective controlled study. The overall quality was good, with respect to the type of design. A total of 32% of the patients improved, 26% were stable, and 42% worsened. The rate of improvement ranged from 11% to 78%; the rate of worsening ranged from 4% to 64%. There are some studies suggesting the use of bracing even in the case of severe curves when patients are motivated by trying to avoid surgery. More and better-quality research with coherent outcome criteria is needed. Full article

(This article belongs to the Special Issue Evidence on Conservative Treatment and Assessment of Idiopathic Scoliosis and Other Spinal Deformities)

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22 pages, 2560 KiB

Open AccessEditor’s ChoiceReview

Association between Harmful and Addictive Perceptions of E-Cigarettes and E-Cigarette Use among Adolescents and Youth—A Systematic Review and Meta-Analysis

by Ameera Syafiqah Aly, Rokiah Mamikutty and Jamaludin Marhazlinda

Children 2022, 9(11), 1678; https://doi.org/10.3390/children9111678 - 31 Oct 2022

Cited by 9 | Viewed by 5040

Abstract

Background: Recognising the association between the perceived risks of e-cigarettes and e-cigarette usage among youth is critical for planning effective prevention and intervention initiatives; thus, a systematic review and meta-analysis were performed. Methods: Fourteen databases were searched for eligible studies from the Inception [...] Read more.

Background: Recognising the association between the perceived risks of e-cigarettes and e-cigarette usage among youth is critical for planning effective prevention and intervention initiatives; thus, a systematic review and meta-analysis were performed. Methods: Fourteen databases were searched for eligible studies from the Inception of database until March 2022 to examine the effect estimates of the association between perceptions of harmfulness and addictiveness and overall e-cigarette usage among adolescents and youth. Results: The meta-analysis showed that in comparison to non-users, young people who were ever e-cigarette users were two times more likely to disagree that e-cigarettes are harmful (OR: 2.20, 95% CI: 1.41–3.43) and perceived e-cigarettes as less harmful than tobacco cigarettes (OR: 2.01, 95% CI 1.47–2.75). Youths who were ever e-cigarette users were also 2.3 and 1.8 times more likely to perceive e-cigarettes as less addictive (OR: 2.28, 95% CI: 1.81–2.88) or perceive e-cigarettes as more addictive (OR: 1.82, 95% CI: 1.22–2.73) than tobacco cigarettes, as compared with non-users. The subgroup analysis reported that adolescents were more likely to believe that e-cigarettes are less harmful than tobacco cigarettes, while youth users perceived otherwise. Conclusion: the risk perceptions of e-cigarettes are associated with e-cigarette use among adolescents and youth and could be the focus of health promotion to prevent and curb the uptake of e-cigarettes among young people. Full article

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15 pages, 612 KiB

Open AccessEditor’s ChoiceReview

Parental Stress Assessment with the Parenting Stress Index (PSI): A Systematic Review of Its Psychometric Properties

by Mercedes Ríos, Sara Zekri, Yurena Alonso-Esteban and Esperanza Navarro-Pardo

Children 2022, 9(11), 1649; https://doi.org/10.3390/children9111649 - 28 Oct 2022

Cited by 14 | Viewed by 6627

Abstract

Parental stress is a construct related to people’s perception of difficulties and feelings of not being able to cope with the demands of parenting. This construct is often experienced as a negative or aversive response to parental obligations, and the available evidence also [...] Read more.

Parental stress is a construct related to people’s perception of difficulties and feelings of not being able to cope with the demands of parenting. This construct is often experienced as a negative or aversive response to parental obligations, and the available evidence also suggests that excessive parenting stress reduces the use of positive parenting behaviors and are related to dysfunctional parenting. Different instruments exist to assess parental stress. This article is part of a project to translate and adapt the Parenting Stress Index (PSI), fourth edition, in its two forms (full and short). The aim of this research is to identify the psychometric indicators obtained by this instrument and to review the evidence they can provide. Method: Following the PRISMA guide (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), the studies related to the PSI were identified in different databases (ERIC, PsycArticles, PubMed, Scopus and Web of Science). Results: The screening process resulted in 16 articles; four have analyzed the psychometric properties of the PSI-4 and the rest have studied the PSI-3. Although version 4 was published in 2012, the studies are scarce. However, they follow the line noted in the previous short version, a high internal consistency and a factor structure of three factors. Conclusions: The difficulties of working with a measurement instrument with 101 items means that the full version of the PSI has been little studied, except in translation and linguistic adaptation studies. Full article

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