Search Results (4,098)

Objective: To evaluate the clinical, radiological, and bronchoscopic features of pediatric patients admitted to the pediatric intensive care unit (PICU) with suspected foreign body aspiration (FBA), and to compare the diagnostic performance of chest radiography (CXR) and computed tomography (CT). Methods: We retrospectively analyzed 71 children admitted to the PICU of Kayseri City Training and Research Hospital for suspected tracheobronchial FBA between January 2020 and December 2024. Demographic data, clinical presentations, imaging findings, bronchoscopic results, and outcomes were recorded. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CXR and CT were calculated using bronchoscopy as the reference standard. Results: The mean age was 2.61 ± 3.59 years, and 66.1% were male. Organic materials were the most commonly aspirated objects, especially in children aged 0–3 years. The right main bronchus was the most frequently affected site. CXR had a sensitivity of 94.9% (95% CI: 83.1–98.6) and a specificity of 71.0% (95% CI: 53.4–83.9), while CT had a sensitivity of 63.2% (95% CI: 41.0–80.9) and a specificity of 100% (95% CI: 87.5–100.0). Bronchoscopy revealed no foreign body in 45.1% of cases. Most patients (94.4%) fully recovered; complications included two deaths, one lobectomy, and one case of hypoxic sequelae. Conclusion: FBA remains a critical pediatric emergency, particularly in young children. CXR is a highly sensitive and accessible screening tool, while CT offers high specificity but lower sensitivity. Prompt diagnosis and bronchoscopy by experienced teams ensure favorable outcomes. Full article

Background: Thallium is a metal that is ubiquitous in our natural environment. Despite its potential for high toxicity, thallium is understudied and not regulated in food. The California Department of Public Health was alerted to a household cluster of elevated urine thallium levels noted among a mother (peak 5.6 µg/g creatinine; adult reference: ≤0.4 µg/g creatinine) and her three young children (peak 10.5 µg/g creatinine; child reference: ≤0.8 µg/g creatinine). Objectives: This case report identifies questions raised after a public health investigation linked a household’s thallium exposure to a commercially available food product. We provide an overview of the public health investigation. We then explore concerns, such as gaps in toxicological data and limited surveillance of thallium in the food supply, which make management of individual and population exposure risks challenging. Methods: We highlight findings from a cross-agency investigation, including a household exposure survey, sampling of possible environmental and dietary exposures (ICP-MS analysis measured thallium in kale chips at 1.98 mg/kg and 2.15 mg/kg), and monitoring of symptoms and urine thallium levels after the source was removed. We use regulatory and research findings to describe the challenges and opportunities in characterizing the scale of thallium in our food supply and effects of dietary exposures on health. Discussion: Thallium can bioaccumulate in our food system, particularly in brassica vegetables like kale. Thallium concentration in foods can also be affected by manufacturing processes, such as dehydration. We have limited surveillance data nationally regarding this metal in our food supply. Dietary reviews internationally show increased thallium intake in toddlers. Limited information is available about low-dose or chronic exposures, particularly among children, although emerging evidence shows that there might be risks associated at lower levels than previously thought. Improved toxicological studies are needed to guide reference doses and food safety standards. Promising action towards enhanced monitoring of thallium is being pursued by food safety agencies internationally, and research is underway to deepen our understanding of thallium toxicity. Full article

Background/Objectives: Pacifier use in infants has both beneficial and harmful implications, and dipping pacifiers in sweeteners is used by some parents to soothe infants. This study aimed to assess pacifier usage among mothers in Jeddah, Saudi Arabia, and to examine its association with child demographics, maternal socioeconomic status (SES), and maternal knowledge of the risks associated with dipping pacifiers in sweeteners. Methods: A cross-sectional study was conducted among mothers of healthy children aged 2 to 4 years during community-awareness events in Jeddah. Participants completed a validated Arabic questionnaire covering pacifier use patterns, feeding practices, SES background, and knowledge regarding the adverse effects of pacifier sweetening. Results: A total of 1438 mothers participated. The mean age of children was 34.3 ± 10.7 months, with 441 children (30.7%) reported as pacifier users. Among them, 202 (45.8%) used pacifiers both during the day and at night. Most children (35.6%) discontinued use between 4 and 6 months of age. Only 6.1% of mothers reported adding sweeteners to pacifiers. Pacifier usage was significantly higher among first-born children (37.6%, p < 0.001), those who received both bottle- and breastfeeding (65.5%, p < 0.001), and children enrolled in nursery (62.1%, p = 0.007). Most mothers (75.6%) were aware of the link between sweetened pacifiers and dental caries, and 69.4% of those who had this knowledge avoided giving their child a pacifier (p = 0.077). Conclusions: Birth order, feeding practices, and nursery attendance are key predictors of pacifier use. Enhancing parental awareness and education may support early interventions to promote healthier oral and feeding habits in young children. Full article

This study explores the perceptions of future educators, specifically Early Childhood Education students at the Universities of Cádiz and Gdansk, regarding the interconnections between critical thinking and sustainability. The work aims to provide valuable insights into general teacher training, examining how these students’ experiences are contextualized within their respective educational systems and cultural contexts. To achieve this, eleven group interviews (three in Cádiz, eight in Gdansk) were conducted using a structured and expert-validated script. The transcribed data were qualitatively analyzed using QDA MINER v.6 software. Key findings reveal divergent perceptions of critical thinking among pre-service teachers: while Spanish students leaned towards a subjective understanding, Polish students emphasized an objective, data-driven approach. This distinction has significant implications for the conceptualization and teaching of critical thinking in educator training. Despite these differences, both groups of participants highlighted the necessity of implementing active methodologies in higher education (such as cooperative learning, problem-solving, and debates) to foster critical thinking, both for their own development and for preparing for their future practice with young children. This study also identified an excessive emphasis on theoretical aspects of sustainability in these future teachers’ training and a limited understanding of their practical application in the classroom. Furthermore, explicit connections between critical thinking and sustainability were scarce in student responses, highlighting a gap in current educator training in these areas. Collectively, the results suggest significant weaknesses in current teacher training efforts regarding the development of critical thinking and its effective integration with sustainability competencies. Full article

This systematic literature review investigates how the concept of time is taught and learned in early mathematics education. While young children are commonly expected to learn how to tell time, this review explores what additional aspects should be emphasised to foster a deeper and more sustainable understanding of time. Using the EBSCO database, 36 relevant articles published up to December 2024 were identified. To cover different aspects related to the teaching and learning of time, peer-reviewed scientific articles as well as practice-based reports were included in the search. A majority of the articles focused on clock reading as an aspect of time. The aspects duration, sequencing, and measurement of time also frequently appeared whereas expressions of time, or cross-disciplinary aspects were seldom mentioned. Drawing on the findings, this review proposes a comprehensive framework outlining key aspects that should be included in early mathematics education to support the teaching and learning of time. Full article

In this pilot study, the crossing behavior of elementary school students commuting on bicycles was investigated with the objective of enhancing safety around pedestrian crossings within school zones. With a noticeable increase in crashes involving young cyclists near schools, this research assessed the effectiveness of visual nudges in the form of red strips displaying “CYCLISTS DISMOUNT” instructions. Initial observations indicated a lack of compliance with dismounting regulations. After the initial observations, a specific elementary school was selected for the implementation of the nudging intervention and additional pre- (N = 91) and post-intervention (N = 71) observations. The pre-intervention observations again revealed poor adherence to the regulations requiring cyclists to dismount at specific points. Following our targeted intervention, the post-intervention observations marked an improvement in compliance. Indeed, the visual nudge effectively communicated the necessity of dismounting at a critical location, leading to a higher rate of adherence among cyclists (52.74% pre-intervention, 97.18% post-intervention). Although it also indirectly affected the behavior of the accompanying adult, who more often held hands with their children while crossing, this effect was weaker than the direct effect on dismounting behavior (20.88% pre-intervention, 39.44% post-intervention). The findings of the current pilot study underscore the possible impact of nudging on behavior and advocate for a combined approach utilizing physical nudges to bolster safety within school zones. Follow-up research, including, for instance, multiple sites, long-term effects, or children traveling alone, is called for. Full article

Background/Objectives: There is a growing need for autism spectrum disorder (ASD) assessment tools that are diagnostically aligned, clinically usable, and accessible across diverse service contexts. The Diagnostic Autism Spectrum Interview—Version 2 (DASI-2) is a freely available, semi-structured clinical interview mapped directly to DSM-5 and ICD-11 criteria. This pilot study aimed to adapt DASI-2 into Hungarian and explore the (1) acceptability of DASI-2 administration, (2) agreement with prior clinical ASD diagnoses, and (3) relationship between DASI-2 observational ratings and ADOS-2 classifications. Methods: Following a multistep translation procedure, DASI-2 was administered to seven children previously assessed for ASD in a multidisciplinary Hungarian clinical setting. The assessment included a parent interview, direct assessment with the child or young person, and completion of the DASI observational record (OR1–OR4). DASI diagnostic outcomes were compared with prior clinical decisions, and OR scores were analyzed in relation to ADOS-2 classifications. Results: All participants completed the DASI-2 interview in full. Agreement with prior clinical diagnosis was found in six of seven cases (κ = 0.70, indicating substantial agreement). When exploring the one non-aligned case, the divergence in diagnostic outcome was due to broader contextual information considered by the initial clinical team which influenced clinical opinion. The five participants diagnosed with ASD showed substantially higher DASI observational scores (mean = 15.26) than the two who were not diagnosed (mean = 1.57), mirroring ADOS-2 severity classifications. Conclusions: These findings support the acceptability and preliminary validity of DASI-2. Its inclusive structured observational record may provide a practical complement to resource-intensive tools such as the ADOS-2; however, further validation in larger and more diverse samples is needed. Full article

Phubbing, a relatively new phenomenon in the field of digital risks, refers to the act of ignoring someone in favor of focusing on a smartphone during face-to-face interactions. Parental phubbing, a specific form of this behavior, is a prevalent negative parenting practice that can affect parent–child relationships and child development. However, the impact of parental phubbing on the emotional and behavioral development of preschool children remains unclear. This study aims to explore the relationship between parental phubbing and preschoolers’ behavioral problems, as well as test whether parents’ mindful attention awareness (MAA) acts as a mediator between them. Method: A questionnaire was administered to 138 Italian parents (mean age = 38.5, SD = 6.2) of 138 kindergarten preschoolers (mean age = 3.9, SD = 1.03). Questionnaires included the Generic Scale of Phubbing (GSP), the Mindful Attention Awareness Scale (MAAS), and the Strengths and Difficulties Questionnaire (SDQ). Results: Analyses revealed a significant negative correlation between the MAAS and SDQ total scores, a positive correlation between the GSP total score and the SDQ total score, and a negative correlation between the GSP total score and the MAAS total score. The mediation analysis did not show a direct effect of GSP on SDQ, suggesting that parental phubbing did not directly predict children’s behavioral difficulties. Nevertheless, the indirect effect measured by bootstrapping was significant, indicating that parental MAA fully mediated the relationship between parental phubbing and preschoolers’ problematic behaviors. Conclusions: Although further research is needed, parental mindfulness may influence phubbing behaviors in parents providing valuable insights for early interventions aimed at reducing problem behaviors in young children. Full article

Introduction: Cystic fibrosis (CF) is a genetic condition affecting several organs and systems, including the pancreas, colon, respiratory system, and reproductive system. The detection of a growing number of CFTR variants and genotypes has contributed to an increase in the CF population which, in turn, has had an impact on the overall statistics regarding the prognosis and outcome of the condition. Given the increase in life expectancy, it is critical to better predict outcomes and prognosticate in CF. Thus, each person’s choice to aggressively treat specific disease components can be more appropriate and tailored, further increasing survival. The objective of our narrative review is to summarize the most recent information concerning the value and significance of clinical parameters in predicting outcomes, such as gender, diabetes, liver and pancreatic status, lung function, radiography, bacteriology, and blood and sputum biomarkers of inflammation and disease, and how variations in these parameters affect prognosis from the prenatal stage to maturity. Materials and methods: A methodological search of the available data was performed with regard to prognostic factors in the evolution of CF in children and young adults. We evaluated articles from the PubMed academic search engine using the following search terms: prognostic factors AND children AND cystic fibrosis OR mucoviscidosis. Results: We found that it is crucial to customize CF patients’ care based on their unique clinical and biological parameters, genetics, and related comorbidities. Conclusions: The predictive significance of more dynamic clinical condition markers provides more realistic future objectives to center treatment and targets for each patient. Over the past ten years, improvements in care, diagnostics, and treatment have impacted the prognosis for CF. Although genotyping offers a way to categorize CF to direct research and treatment, it is crucial to understand that a variety of other factors, such as epigenetics, genetic modifiers, environmental factors, and socioeconomic status, can affect CF outcomes. The long-term management of this complicated multisystem condition has been made easier for patients, their families, and physicians by earlier and more accurate identification techniques, evidence-based research, and centralized expert multidisciplinary care. Full article

Shaken Baby Syndrome (SBS) is one of the primary causes of fatal head trauma in infants and young children, occurring in about 33 per 100,000 infants annually in the U.S., with mortality rates being between 15% and 38%. Survivors frequently endure long-term disabilities, such as cognitive deficits, visual impairments, and motor dysfunction. Diagnosing SBS remains difficult due to the lack of visible injuries and delayed symptom onset. Existing detection methods—such as neuroimaging, biomechanical modeling, and infant monitoring systems—cannot perform real-time detection and face ethical, technical, and accuracy limitations. This study proposes an inertial measurement unit (IMU)-based detection system enhanced with machine learning to identify aggressive shaking patterns. Findings indicate that wearable-based motion analysis is a promising method for recognizing high-risk shaking, offering a non-invasive, real-time solution that could minimize infant harm and support timely intervention. Full article

Background: Mothers’ health significantly affects their well-being and that of their families. The early years of motherhood can be tough and impact mental health. This study examined the associations between mothers’ self-compassion, social support, and self-care behaviors and their physical and mental well-being. Methods: In August 2023, an online cross-sectional survey was conducted among 514 Israeli mothers with children under three. Mothers’ physical and mental health was assessed using SF12. Self-compassion was measured by the Self-Compassion Scale (SCS). Social support was evaluated through the Multidimensional Scale of Perceived Social Support (MSPSS), and self-care was assessed via the Pittsburgh Enjoyable Activities Test (PEAT). Results: Respondents’ average age was 31.5 years. Their self-reported physical health was relatively high, with a mean of 78.36 (SD = 21) on a 0–100 scale (n = 442). Mental health scores were lower, with a mean of 65.88 (SD = 20.28, n = 401). Perceived physical health was higher among Jewish mothers, younger mothers, and those with higher income levels. Additionally, greater social support and self-compassion correlated with better perceived physical health (Adj R² = 0.11, p < 0.001). For mental health, higher scores were observed among Jewish mothers, younger mothers, and full-time employed mothers. Furthermore, higher social support, self-compassion, and self-care practices were associated with improved perceptions of mental health (Adj R² = 0.39, p < 0.001). Conclusions: Promoting the well-being of mothers is crucial for their health, their children’s well-being, and the family unit. Health professionals working with mothers of young children should emphasize and help promote social support, self-compassion, and self-care activities. Full article

Introduction: Biodegradable Temporizing Matrix (BTM) is a new synthetic dermal substitute suitable for wound closure and tissue regeneration. The data in paediatric population remain limited. The study purpose is to review the indications for BTM application in paediatric patients, evaluate the short-term and long-term results, including complications and functional outcomes, as well as to share some unique observations regarding the use of BTM in paediatric population. Patients and Methods: Patients undergoing reconstructive surgery and BTM application during the last three years were included. Data collected included patient demographics, primary diagnosis, previous surgical management, post-operative complications and final outcomes. BTM was used in 32 patients. The indications varied including epidermolysis bullosa (n = 6), burns (n = 4), trauma (n = 7), infection (n = 4), ischemia or necrosis (n = 11). Results: The results were satisfying with acceptable aesthetic and functional outcomes. Complications included haematoma underneath the BTM leading to BTM removal and re-application (n = 1), BTM infection (n = 1) and split-thickness skin graft failure on top of BTM requiring re-grafting (n = 2). Conclusions: BTM can be a good alternative to large skin grafts, locoregional flaps or even free flaps. The big advantages over other dermal substitutes or skin grafts are that BTM is less prone to infection and offers excellent scarring by preserving the normal skin architecture. Specifically in children, BTM might not require grafting, resulting in spontaneous healing with good scarring. In critically ill patients, BTM reduces the operation time and there is no donor site morbidity. BTM should be considered in the reconstructive ladder when discussing defect coverage options in children and young people. Full article

Participation in organized sport is widely encouraged for youth development, yet positive outcomes are not guaranteed. Parents play a pivotal role in shaping young athletes’ experiences, requiring emotional support, interpersonal skills, and self-regulation. This study examines the meanings parents attribute to their children’s sports participation and how young athletes construct their experiences under parental and coaching influences. An interpretive phenomenological methodology involved semi-structured interviews with coaches, focus groups with parents, and open-ended questionnaires to young athletes. Seventeen players (M = 11.2 years, SD = 0.59), nineteen parents (M = 47.6 years, SD = 3.61), and two coaches from the same football club volunteered to participate in the study. Participants were selected through purposive sampling to ensure a homogeneous experience. The findings reveal that parental involvement balances support and pressure, while trust-building between parents and coaches significantly impacts the athletes’ experiences. The evolving role of technology and the importance of social dynamics within teams also emerged as critical factors. Intrinsic motivation, fostering emotional bonding through the sport, and adopting a developmental rather than purely competitive framework were emphasized factors identified as supporting positive youth sport experiences. These findings offer insights into how interconnected relationships among parents, coaches, and athletes influence children’s sports engagement and development. Full article

Respiratory syncytial virus (RSV) is a major cause of acute lower respiratory infections (ALRIs) in young children, especially bronchiolitis, with significant global health and economic impact. Increasing evidence links early-life RSV infection to long-term respiratory complications, notably recurrent wheezing and asthma. This narrative review examines these associations, emphasizing predictive factors and emerging biomarkers for risk stratification. Early RSV infection can trigger persistent airway inflammation and immune dysregulation, increasing the likelihood of chronic respiratory outcomes. Risk factors include severity of the initial infection, age at exposure, genetic susceptibility, prematurity, air pollution, and tobacco smoke. Biomarkers such as cytokines and chemokines are showing promise in identifying children at higher risk, potentially guiding early interventions. RSV-related bronchiolitis may also induce airway remodeling and promote Th2/Th17-skewed immune responses, mechanisms closely linked to asthma development. Advances in molecular profiling are shedding light on these pathways, suggesting novel targets for early therapeutic strategies. Furthermore, passive immunization and maternal vaccination offer promising approaches to reducing both acute and long-term RSV-related morbidity. A deeper understanding of RSV’s prolonged impact is essential to develop targeted prevention, enhance risk prediction, and improve long-term respiratory health in children. Future studies should aim to validate biomarkers and refine immunoprophylactic strategies. Full article

Background and Objectives: Anemia and stunting are major public health concerns for young Indonesian children. Limited information is available from studies on multi-micronutrient supplements in Indonesia. The objective of this study was to investigate the effect of 12-month multi-micronutrient powder (MNP) supplementation on serum hemoglobin levels, anemia, and growth. Methods: A randomized double-blinded placebo-controlled study was performed, including 232 eligible children aged 8–10 months old. Children with severe anemia or stunting/those classed as underweight were not included as subjects. The study was performed in a low-socioeconomic-status community in Jakarta. With an active-to-placebo ratio of 60:40, 139 subjects received MNP sachets twice/day, and 93 subjects received placebo sachets, mixed with complementary food. The outcome parameters were hemoglobin level, anemia, and growth indicators. Per-protocol analysis was performed for 179 (intervention: 110; control: 69) subjects. Results: There were no differences at baseline between the groups, except for the weight-for-length z-scores (WLZ). Upon intervention, the serum hemoglobin level and anemia proportion did not change significantly within the group, and no significant differences were found between the groups (p > 0.05). However, subgroup analysis of non-anemic children at baseline showed a significant increase in hemoglobin levels in the youngest age group (8.0–8.9 months old) receiving MNP compared to placebo (0.13 vs. −0.79, p = 0.031). Iron deficiency anemia proportion showed a similar upward trend upon intervention in both groups. No significant differences in growth were found between both groups. Conclusions: This study failed to find a significant effect of 12-month MNP supplementation on serum hemoglobin level, anemia, and growth. Full article