Search Results (180)

Background/Objectives: Health literacy plays a fundamental role in adolescents’ health-related decisions and behaviors. The aim of our study was to assess the level of health literacy among 16–17-year-old students in Southern Hungary and to examine the associations between sociodemographic characteristics and health behaviors. Methods: This cross-sectional quantitative study was conducted in the autumn of 2024 in Baranya and Somogy counties. A total of 133 students completed a self-administered questionnaire including sociodemographic variables and health behaviors. Health literacy was measured using the validated HELMA-H instrument. Statistical analysis included chi-square tests, t-tests, and ANOVA (p < 0.05). Results: Overall, 62.7% of the students demonstrated adequate, while 37.3% demonstrated inadequate levels of health literacy. No significant association was found between overall health literacy and sociodemographic variables; however, partial associations were observed on specific subscales. Boys reported better access to health information (p = 0.037), while children of mothers with higher educational attainment scored better in comprehension (p = 0.042) and appraisal (p = 0.036). In the case of the numeracy subscale, children of mothers with the lowest educational level showed significantly better results (p = 0.006). Students with higher health literacy levels were less likely to smoke or consume caffeine; however, a reverse trend was observed regarding alcohol consumption. Physical activity showed a positive association with healthier behaviors (p < 0.05). Discussion: The use of digital technologies, interactive learning strategies, and the involvement of family members—especially mothers—may support the development of health-conscious decision-making in adolescents. Consequently, health education programs should focus not only on knowledge transfer but also on fostering critical thinking and decision-making skills. Full article

Background: Dental anxiety often poses a significant barrier to effective dental care in pediatric patients. This study evaluated the efficacy and safety of oral midazolam at two different doses for sedation and amnesia in preschool children undergoing dental procedures under 30 min, including primary teeth extraction, root canal treatment, dental filling, and stainless-steel crown. Methods: This prospective, double-blind, randomized controlled trial included 80 children aged 3–6 years with dental anxiety (Types 1 and 2 of the Frankl Behavior Rating Scale) at the National Hospital of Odonto-Stomatology, Hanoi. following the CONSORT guidelines. Participants were randomly assigned to receive oral midazolam at 0.3 mg/kg or 0.6 mg/kg. Sedation efficacy, onset time, procedure duration, cooperation level (Houpt Behavior Rating Scale), recovery time, and amnesia at 12 h, 24 h, and 1 week, as well as adverse events, were recorded and analyzed. Results: Both midazolam doses were effective for sedation (0.3 mg/kg: 95% vs. 0.6 mg/kg: 100%, p = 0.49). The higher dose (0.6 mg/kg) provided significantly longer effective procedural time (27.3 ± 4.1 min vs. 20.3 ± 4.0 min, p < 0.001) and better patient cooperation (95% vs. 78.9%, p = 0.045), but slightly prolonged recovery time (34.6 ± 4.6 min vs. 31.8 ± 4.4 min, p = 0.008). Both doses produced similar amnesic effects, with approximately 90% anterograde amnesia at 12 h post-procedure. Adverse events were minimal and mild. Conclusions: Both 0.3 mg/kg and 0.6 mg/kg doses of oral midazolam are safe and effective for sedation and amnesia in preschool children undergoing dental procedures. While the 0.6 mg/kg dose provides better procedural cooperation and prolonged sedation, it also requires a slightly longer recovery time. Full article

Background and Objectives: The COVID-19 pandemic affected children’s lifestyle, due to strict lockdown restrictions. This study evaluated Romanian children’s lifestyle prior to and during the pandemic and their associated factors. Materials and Methods: A longitudinal study was performed in 7 urban schools from Romania. Data were gathered at baseline (T1), from October to November 2019, and follow-up (T2), from December 2020 to February 2021. Results: A total of 880 children were enrolled at baseline, 484 at T2, and 350 in both evaluations. Initially, 66.3% did not perform at least one hour of physical activity per day, two thirds did not sleep at least 9 h per night during the week, and more than one third used the internet more than 2 h daily. Investigating changes before and during COVID-19 among students participating at both evaluations, a statistically significant drop in physical activity and sleep time during the week was recorded, while weekend sleep and internet use increased. Several gender- and age-related differences were noted. Physical activity and sleep patterns as well as internet use behavior at T1 predicted the same behavior at T2. Reduced sleep during the week and internet overuse were positively associated at both waves as well as longitudinally. Conclusions: These findings highlight calls for combined strategies that include parents, schools, and community, aiming to enhance a healthier lifestyle among children. Full article

Introduction: People with disabilities are characterized by suboptimal health and lower self-rating health. Their need for health care is greater, they often have a higher prevalence of health problems and they have more difficulty accessing health care. The aim of this study was to assess the health behaviors and health indicators of 12–18-year-old young people with intellectual disabilities and autism spectrum disorder, and to explore their school-related perceptions in the Northern Great Plain region of Hungary. Materials and Methods: A cross-sectional questionnaire survey was conducted with the participation of 185 young people. A custom questionnaire was used, based on the Health Behavior in School-aged Children (HBSC) survey, assessing eating habits, oral care, physical activity, mental well-being, and self-reported health status. The sample was categorized into three groups: the ID1 (Intellectual Disability level 1) group, encompassing young individuals with mild intellectual disability; the ID2 group, encompassing young people with moderate intellectual disability; and the ID+ASD group, encompassing young individuals affected by both intellectual disability and autism spectrum disorder. Results: Consumption of various food types was below optimal levels. Low intake of fruits and vegetables was common, with only 21.6% of the respondents consuming fruit daily and 23.8% consuming vegetables daily. ID1 group reported significantly higher rates of nervousness several times a week (17.8% vs. 5.6% and 6.9%, p < 0.001), sleep difficulties (28.8% vs. 7.4% and 15.5%, p = 0.032), and dizziness (9.6% vs. 1.9% and 3.4%, p = 0.022) compared to the other two groups. A third school-related factor, related to negative emotions, showed a near-significant difference (p = 0.064), suggesting that students with both autism spectrum disorder and intellectual disability perceive lower levels of acceptance from teachers. On school-free days, computer usage was significantly highest in the ID+ASD group; 50% of them used a computer for at least 4 h per day. Conclusions: To improve mental well-being among affected children, psychological support and the implementation of mental health programs are recommended. In addition to teaching stress management techniques and coping mechanisms, integrating relaxation techniques into comprehensive developmental programs—both individually and in groups—is advised. For teachers, it is recommended to acquire disability-specific communication strategies. Full article

Pediatric central nervous system (CNS) tumors, including gliomas, medulloblastomas, and diffuse midline gliomas (previously diffuse intrinsic pontine gliomas), remain a major clinical challenge due to their complex biology, limited treatment effectiveness, and generally poor prognosis. Standard treatments are often aggressive and associated with substantial toxicity, particularly in advanced stages. This review highlights recent developments in radiopharmaceuticals for molecular imaging and targeted radiotherapy. A comprehensive literature analysis was conducted, focusing on radiotracers with clinical relevance in pediatric neuro-oncology, including metabolic, peptide receptor-based, and antibody-based agents. Radiopharmaceuticals such as ¹⁸F-FLT, ⁶⁴CuCl₂, and 1-L-18F-FETrp have improved the ability to monitor tumor biology, proliferation, and treatment response, aiding in diagnosis at an early stage, assessment of tumor behavior, and detection of recurrence or progression. Additionally, peptide receptor-based radiotracers, such as ⁶⁸Ga-DOTATATE and ¹⁷⁷Lu-DOTATATE, are already used for both diagnostic purposes and targeted radiotherapy, particularly in neuroblastomas and gliomas. Antibody-based radiotracers like ¹³¹I-omburtamab, targeting B7-H3, are emerging as promising tools for addressing difficult-to-treat tumors such as diffuse midline glioma. Collectively, these advances provide new hope for children afflicted by these devastating malignancies, offering promising solutions for more specific and precise diagnosis and, additionally, for more effective, personalized, and less toxic tumor therapies. Full article

Background/objectives: Early childhood is marked by rapid physical and cognitive development, underscoring the critical influence of parental choices in shaping habits, pastimes, and traditions. The World Health Organization highlights habits of physical activity, sleep, and screen use as modulators of healthy development and well-being in young children. As a first, this birth cohort study investigates the relationship between movement behaviors in toddlerhood and subsequent sport participation during middle childhood. Methods: Participants are 930 boys and 926 girls from the Quebec Longitudinal Study of Child Development. Using a population-based analytical approach, we examined the relationship between parent-reported active leisure, sleep, and sedentary screen time at age 2 years and trajectory of sport participation between ages 6 and 10 years using sex-stratified linear regressions that account for a range of pre-existing individual and family confounding factors. Results: Many child and family characteristics predicted early childhood movement behaviors, distinctly for boys and girls. Moreover, parental regulation of screen time during early childhood significantly influenced their decisions to enroll and encourage sport participation in sons during school age. Specifically, boys who spent more than 1 h/day on screens had 10% fewer chances of consistently participating in sport throughout middle childhood, even after accounting for adherence to other lifestyle habits. Conclusions: Our findings suggest that parental values regarding early childhood screen exposure are an effective potential target for intervention fostering healthy and active development. Future research should focus on parent and child motivations for sport involvement in the long-term. Full article

Background/Objectives: Increasing screen time in childhood has been suggested to impact physical health, eating behaviors, and well-being. This study investigated how screen time affects mindfulness, mindful eating, and diet quality in Turkish adolescents aged 9–12 years. Methods: One hundred thirty-seven participants completed surveys on anthropometry, screen time, the Godin Leisure-Time Exercise Questionnaire, the Mediterranean Diet Quality Index, the Mindful Eating Questionnaire for Children, and the Child and Adolescent Mindfulness Measure. Results: The average screen time was 4.43 ± 2.37 h/day. Significant negative correlations emerged between screen time and mindfulness (r = −0.471, p < 0.001), as well as between screen time and diet quality (r = −0.244, p < 0.05). A regression analysis revealed significant associations only for mindfulness (B = −0.158, p < 0.001) and age (B = 0.636, p = 0.002). Conclusions: Higher mindfulness and younger age correlated with lower screen time, suggesting mindfulness interventions in schools may reduce screen use. Full article

Background: While the mHealth and school-based scale-up intervention for salt reduction (EduSaltS) effectively reduced salt intake and blood pressure among adults living with participating schoolchildren, the sustainability of these effects remains uncertain. This study aimed to evaluate whether these effects persisted one year post intervention. Methods: A one-year follow-up of a cluster randomized controlled trial was conducted, involving 524 children and their 524 adult family members from 20 primary schools. At 24 months, 509 children (97.1%) and 486 adults (92.7%) completed the assessment. Mixed linear models were used to analyze the difference in changes in salt intake between the intervention and control groups at 24 months, compared to baseline and 12 months, as measured by consecutive 24 h urinary sodium excretions. Secondary outcomes included the differences in changes in blood pressure and salt-related knowledge, attitudes, and practices (KAP) scores. Results: The adjusted mean difference in changes in salt intake between groups was −0.34 g/24 h (95% CI: −0.94 to 0.26, p = 0.265) for children and −0.72 g/24 h (95% CI: −1.48 to 0.05, p = 0.065) for adults at 24 months versus baseline. The corresponding differences from 12 to 24 months were −0.09 g/24 h (95% CI: −0.69 to 0.51, p = 0.775) for children and 0.29 g/24 h (95% CI: −0.50 to 1.08, p = 0.468) for adults. The adjusted difference in changes in adult blood pressure showed a slight, nonsignificant rebound at 24 months. The intervention group maintained significantly higher KAP scores than the control group at both 12 and 24 months. Conclusions: The effects of EduSaltS on reducing salt intake and blood pressure in adults diminished slightly one year after the intervention ended. However, sustained improvements in salt-related KAP were observed in both children and adults. Ongoing support is vital to sustain long-term salt-reduction behaviors. Full article

Background/Objectives: Identifying the factors influencing compliance is essential to improve the effectiveness of interventions. However, no study has examined factors that influence the longitudinal patterns of obesity intervention compliance. We aim to identify the longitudinal trajectories of parental and child compliance using group-based trajectory modeling (GBTM) and assess the influencing factors. Methods: The Diet, ExerCIse, and CarDiovascular hEalth Children (DECIDE-Children) was a 9-month app-assisted obesity prevention intervention targeted 8–10-year-old children. Altogether, 684 child–parent pairs from the intervention group were included. Parents were required to use the mobile app to learn health knowledge, monitor children’s diet and exercise behaviors, manage children’s weight, and received the assessment results. Parental compliance was assessed as the monthly usage times and duration of the mobile app. For child compliance, we used data recorded by parents in the “behavior monitoring” module. We employed group-based trajectory modeling (GBTM) to identify distinct trajectories of parental and child compliance and examined their associations with childhood obesity outcomes. Univariate and multivariate logistic regressions were performed to identify the influencing factors associated with the identified compliance groups. Results: Distinct trajectory groups of parental and child compliance were identified. The compliance trajectories of parents and children are related to the extent of changes in the child’s obesity-related outcomes (waist circumference, waist-to-hip ratio, and body fat percentage. p < 0.05). A majority of parents were classified into the “relatively low compliance” group. Parents in this group was associated with having a daughter (OR: 1.95, 95% CI: 1.17, 3.31) and the father having a higher education level (OR: 1.65, 95% CI: 1.05, 2.60). For children, 20.2% were assigned to the “decreasing compliance” group. Children in this group were more likely to have a younger mother (OR: 1.05, 95% CI: 1.01, 1.10) and parents with poorer compliance (OR: 2.36, 95% CI: 1.16, 5.47). Conclusions: Both student and parental compliance were shown to influence the effectiveness of childhood obesity interventions, highlighting the need to prioritize the assessment and promotion of compliance in such interventions. Child sex, paternal educational level, and maternal age were identified as significant factors associated with compliance, while the level of family involvement was found to play a pivotal role in fostering healthy behaviors in children. These findings suggest that future intervention strategies should place greater emphasis on engaging families and providing targeted supervision and support for populations at risk of lower compliance in order to enhance intervention outcomes. Full article

Research on how an active lifestyle impacts the social functions of neurodiverse children, particularly within the context of twenty-four-hour (24 h) movement behaviors (i.e., physical activity, sedentary behaviors, sleep), has been emerging but has yet to receive a systematic synthesis. In this scoping review, we aimed (1) to synthesize current knowledge in the field of 24 h movement behaviors and social functions in neurodiverse children; and (2) to offer insights into implications for future research and practices. Specifically, we conducted a systematic search via four databases, namely the Web of Science, PubMed, Scopus, and EBSCOhost, through 31st December 2024, and followed scoping review guidelines for results synthesis. The initial search returned 2342 articles, of which 50 studies fulfilled the inclusion criteria following a robust selection and screening process. These retained studies were published between 2004 and 2024, primarily focused on children with neurodiversity of autism spectrum disorder, or ASD (70%), and attention deficit/hyperactivity disorder, or ADHD (23%), and using quantitative methods (84%). Only 6% of studies considered the combined effects of different 24 h movement behaviors, with most examining physical activity alone. Longer group exercise interventions were found to be more effective in improving social functions in neurodiverse children. Overall, the findings support the position that 24 h behaviors have a positive influence on the social functioning of neurodiverse children. However, current research tends to focus primarily on ASD, uses quantitative methods, and often overlooks the combined effects of physical activity, sleep, and sedentary behavior. Future studies should address these limitations and examine 24 h movement behaviors in children with a broader range of neurodiverse characteristics. Research and practices should also consider qualitative approaches as a complement to quantitative measures for monitoring and evaluation. Full article

Background/Objectives: Dietary patterns rich in plant-based foods during pregnancy have been associated with neurodevelopmental outcomes in offspring. However, not all components of these diets are healthy, and the impact of their quality on behavioral outcomes remains unexplored. Therefore, this study aimed to examine the association between healthy and unhealthy plant-based diets and offspring behavioral problems at the age of four. Methods: This research involved 201 mother–child pairs from the ECLIPSES study. Maternal diet during pregnancy was assessed using a validated food frequency questionnaire, from which the healthy plant-based diet index (hPDI) was calculated, emphasizing the consumption of fruits, vegetables, legumes and nuts, along with the unhealthy plant-based diet index (uPDI), highlighting the intake of sugary drinks and refined grains. Children’s behavior was evaluated using the Child Behavior Checklist 1.5-5. Multivariable logistic regression analyses were conducted to estimated odds ratios (ORs) and their 95% confidence intervals (CIs). Results: Greater adherence to the uPDI during pregnancy was associated with higher odds for externalizing problems, including attention-deficit/hyperactivity problems (OR = 1.08; 95%CI from 1.01 to 1.16) and oppositional defiant behavior (OR = 1.09; 95%CI from 1.00 to 1.19) in offspring, particularly girls. Higher adherence to the hPDI was not associated with children’s behavior. Conclusions: The consumption of unhealthy components of a plant-based dietary pattern during gestation has been associated with adverse behavioral outcomes in children at age four. These findings underscore the importance of discerning between the healthy and unhealthy components of plant-based diets when assessing their impact on child development. Full article

Pain management in children remains a challenge. Postoperative pain assessment, which currently relies on behavioral and subjective scales, could be enhanced by the identification of single nucleotide polymorphisms effect on pain thresholds and opioid metabolism. This study explores the impact of nine SNPs—rs1799971, rs4680, rs4633, rs6269, rs4818 (with catechol-o-methyltransferase haplotypes), rs7832704, rs1801253, and rs1045642—on postoperative pain intensity, opioid requirements, coanalgesic use, C-reactive protein levels, and post-anesthesia care unit length of stay. This study involved 42 pediatric patients undergoing scoliosis correction surgery with postoperative sufentanil infusion. The genotyping was performed using real-time PCR with peripheral blood samples. Patients with the rs1801253 ADRB1 GG genotype showed significantly lower 24 h NRS pain ratings (p = 0.032) and lower sufentanil infusion rates at the level of statistical tendency (p = 0.093). Patients with the rs1205 CRP CT genotype had a shorter PACU length of stay (p = 0.012). In contrast, those with the rs1045642 ABCB1 GG genotype had a longer PACU stay by 0.72 h (p = 0.046). No significant associations were found for OPRM1 rs1799971, COMT, or ENPP2 SNPs. ADRB1 rs1801253may be a novel SNP indicating higher postoperative pain risk, while rs1205 CRP and rs1045642 ABCB1 could predict increased care requirements in PACUs. The ADRB1 rs1801253 SNP may also predict opioid demand. These results suggest SNPs should be considered in acute pain assessment. Full article

Background: This study aims to explore the association between sleep patterns in children and their exposure to phthalates to assess potential health implications. Methods: Participants (n = 60) completed the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Consumer behavior scores (CBS) were calculated. The Tanner scale was used to monitor the stages of puberty. First-morning urine samples were analyzed by high-performance liquid chromatography–tandem mass spectrometry. Results: The average sleep duration was 8 h and 44 min, with boys sleeping significantly longer (p = 0.01). Notably, 51.7% of participants reported sleeping less than 9 h. The nonlinear effects of phthalate metabolite in association with PSQI were observed for hydroxy-mono-isononyl phthalate (OH-MiNP, p = 0.003) and MnOP (p < 0.001), indicating that the relationship does not follow a simple linear pattern. Simple linear regression revealed a significant positive association between the Mono-n-octyl phthalate (MnOP) and PSQI scores (p = 0.016). After adjustment for place of residence, BMI, CBS, sex, and age, the significance of associations between phthalate metabolites and sleep quality diminished, necessitating cautious interpretation. No statistically significant associations between pubertal changes and the value of PSQI as well as phthalates were observed. Conclusion: Our results provide preliminary evidence of potential nonlinear associations that require validation in a larger cohort. The findings highlight the importance of monitoring phthalate exposure in children, as it may influence sleep patterns and overall health. Full article

Background/Objectives: Sleep is a fundamental physiological function that plays a crucial role in maintaining health and well-being. The aim of this study was to assess dietary and lifestyle factors associated with adequate sleep duration in children and adolescents living in five Mediterranean countries. Methods: Parents of children and adolescents taking part in an initial survey for the DELICIOUS project were examined to assess their children’s dietary and eating habits (i.e., meal routines), as well as other lifestyle behaviors (i.e., physical activity levels, screen time, etc.) potentially associated with adequate sleep duration (defined as 8–10 h according to the National Sleep Foundation). The youth healthy eating index (Y-HEI) was used to assess the diet quality of children and adolescents. Multivariate logistic regression analyses were performed to calculate the odds ratios (ORs) and 95% confidence intervals (CIs), indicating the level of association between variables. Results: A total of 2011 individuals participated in the survey. The adolescents and children of younger parents reported being more likely to have inadequate sleep duration. Among eating behaviors, having breakfast (OR = 2.23, 95% CI: 1.62, 3.08) and eating at school (OR = 1.33, 95% CI: 1.01, 1.74) were associated with adequate sleep duration. In contrast, children eating alone, screen time, and eating outside of the home were less likely to have adequate sleep duration, although these findings were only significant in the unadjusted model. After adjusting for covariates, a better diet quality (OR = 1.63, 95% CI: 1.24, 2.16), including higher intake of fruits, meat, fish, and whole grains, was associated with adequate sleep duration. Conclusions: Adequate sleep duration seems to be highly influenced by factors related to individual lifestyles, family and school eating behaviors, as well as diet quality. Full article

Background: The worldwide increase in the prevalence of childhood obesity necessitates effective prevention and treatment strategies. Clinical practice guidelines (CPGs) offer guidance, but significant heterogeneity or lack of practical application exists in their recommendations. The purpose of the present study is to provide an expert, comprehensive, and comparative analysis of gaps in current CPGs for the prevention and treatment of obesity in children and adolescents. Results: A total of 14 CPGs were identified, focusing on childhood obesity prevention (n = 11), treatment (n = 9), or both (n = 6). Prevention CPGs generally recommend body mass index (BMI) assessment, but specific measurement frequency is often absent. While some provide age-specific dietary recommendations, graphical tools are lacking. Recommendations for increased physical activity and reduced screen time are common, but age-stratified guidance is deficient. Furthermore, recommendations regarding mental health and sleep are notably absent. Treatment CPGs utilize BMI for obesity diagnosis, but inconsistencies in cut-off points persist. Comorbidity assessment is generally recommended, yet age-specific guidance remains lacking. Dietary recommendations are present in most CPGs, but many lack detailed specifications (e.g., meal frequency, portion sizes, macronutrient distribution, age-appropriate examples). Most CPGs advocate for 60 min of daily physical activity and limit screen time to 2 h per day. Recommendations concerning sleep are consistently absent. While parental involvement is acknowledged, specific guidance for active participation in prevention and treatment is deficient. Pharmacological treatment options are frequently outdated, and surgical intervention is reserved for exceptional cases of severe obesity. Conclusions: Standardizing BMI cut-off points and defining age groups across CPGs would improve consistency and comparability in the diagnosis, prevention, and treatment of childhood obesity. Tailoring recommendations for diet, physical activity, sedentary behavior, and sleep to specific age groups would ensure developmentally appropriate interventions. A stronger emphasis on early prevention strategies is needed to address the root causes of obesity. Clear guidance for parents and families would facilitate their active engagement in prevention and treatment. Up-to-date information regarding pharmacological and surgical treatments is imperative. Full article