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Volume 11
Issue 7
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Children, Volume 11, Issue 7 (July 2024) – 135 articles

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15 pages, 818 KiB  
Article
Nutritional Status in Pediatric Psoriasis: A Case–Control Study in a Tertiary Care Referral Centre
by Adelina-Maria Sendrea, Sinziana Cristea and Carmen Maria Salavastru
Children 2024, 11(7), 885; https://doi.org/10.3390/children11070885 (registering DOI) - 22 Jul 2024
Viewed by 105
Abstract
Background: Psoriasis and obesity are chronic, inflammatory diseases, sharing certain pathophysiological factors. Psoriasis, increasingly viewed as a systemic inflammatory condition, may have various symptoms beyond the skin manifestations. Methods: This research aimed to explore the connection between body mass index (BMI) and pediatric [...] Read more.
Background: Psoriasis and obesity are chronic, inflammatory diseases, sharing certain pathophysiological factors. Psoriasis, increasingly viewed as a systemic inflammatory condition, may have various symptoms beyond the skin manifestations. Methods: This research aimed to explore the connection between body mass index (BMI) and pediatric psoriasis, through a case–control study on 100 psoriasis cases and 100 controls who were matched in terms of age and sex. The percentiles of the BMI by age and sex determined the nutritional status of each patient and control. The severity of psoriasis was evaluated based on the psoriasis area and severity index (PASI), nail involvement based on the nail psoriasis severity index (NAPSI), and quality of life impairment with the dermatology life quality index (DLQI). Results: While no statistically significant relationship was identified between increased BMI and PASI (p = 0.074), the risk of being overweight and obesity was significantly higher in the psoriasis group (OR 6.93, p = 0.003; OR 12.6, p < 0.001, respectively). The BMI increased with the PASI for psoriasis vulgaris but not for psoriasis inverse. No connections were found between disease duration and BMI (p = 0.56) or between BMI and PASI based on sex (p = 0.26). The NAPSI increased significantly with increased BMI (p = 0.000015). Conclusions: This study highlights the association between elevated BMI, psoriasis diagnosis, and severity of psoriatic onychopathy in pediatric patients, advocating for further large-scale studies to confirm these explorations and increasing awareness for better screening and management of such cases for overweight/obese patients. Full article
(This article belongs to the Section Pediatric Dermatology)
16 pages, 1107 KiB  
Review
Pediatric Cardio-Oncology: Screening, Risk Stratification, and Prevention of Cardiotoxicity Associated with Anthracyclines
by Xiaomeng Liu, Shuping Ge and Aijun Zhang
Children 2024, 11(7), 884; https://doi.org/10.3390/children11070884 (registering DOI) - 22 Jul 2024
Viewed by 170
Abstract
Anthracyclines have significantly improved the survival of children with malignant tumors, but the associated cardiotoxicity, an effect now under the purview of pediatric cardio-oncology, due to its cumulative and irreversible effects on the heart, limits their clinical application. A systematic screening and risk [...] Read more.
Anthracyclines have significantly improved the survival of children with malignant tumors, but the associated cardiotoxicity, an effect now under the purview of pediatric cardio-oncology, due to its cumulative and irreversible effects on the heart, limits their clinical application. A systematic screening and risk stratification approach provides the opportunity for early identification and intervention to mitigate, reverse, or prevent myocardial injury, remodeling, and dysfunction associated with anthracyclines. This review summarizes the risk factors, surveillance indexes, and preventive strategies of anthracycline-related cardiotoxicity to improve the safety and efficacy of anthracyclines. Full article
(This article belongs to the Special Issue Research Progress of the Pediatric Cardiology: 3rd Edition)
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<p>Summary of key affected genes with variants identified to be associated with anthracycline-related cardiotoxicity based on the proposed mechanisms of action. ACT, anthracycline-related cardiotoxicity; ABCC, adenosine triphosphate-binding cassette, subfamily C; CBR3, carbonyl reductase 3; CELF4, CUGBP, ELAV-like family member 4; DOX, doxorubicin; GSTM1, glutathione S-transferase M1; HAS3, hyaluronan synthase 3; HFE, hemochromatosis; NOS3, nitric oxide synthase 3; NOS, nitric oxide synthases; RAC2, ras-related C3 botulinum toxin substrate 2; ROS, reactive oxygen species; RARG, retinoic acid receptor gamma; SLC28A3, solute carrier family 28 member 3; SULT2B1, sulfotransferase family cytosolic member 2B1; TNNT2, cardiac troponin T; TOP2β, topoisomerase 2β; TTNtv, titin-truncating variant; UGT1A6, UDP-glucuronosyltransferase family 1A6.</p> Full article ">
21 pages, 956 KiB  
Article
Leisure Time Habits and Levels of Physical Activity in Children and Adolescents
by Juan-José Mijarra-Murillo, Beatriz Polo-Recuero, Adrián Solera-Alfonso, Alberto Arribas-Romano, Miriam Gacía-González, Sofía Laguarta-Val and José Manuel Delfa-de-la-Morena
Children 2024, 11(7), 883; https://doi.org/10.3390/children11070883 (registering DOI) - 21 Jul 2024
Viewed by 276
Abstract
Abstract: Background/Objectives: Childhood and adolescence are important stages of life for acquiring healthy habits. There is a high prevalence of sedentary lifestyles worldwide during these ages, which negatively impacts health. This is attributed, in part, to excessive time spent engaging in sedentary behaviors. [...] Read more.
Abstract: Background/Objectives: Childhood and adolescence are important stages of life for acquiring healthy habits. There is a high prevalence of sedentary lifestyles worldwide during these ages, which negatively impacts health. This is attributed, in part, to excessive time spent engaging in sedentary behaviors. The aim of this study was to assess the time spent on sedentary behaviors and their relationship with physical activity levels in children and adolescents in the Community of Madrid. Methods: A total of 26,729 participants aged 10–17 from various schools and institutes took part in this study. The International Physical Activity Questionnaire Short Form (IPAQ-SF) was used, and they were asked about the time they spent on different leisure time habits (specific sedentary behaviors and organized physical activity). A generalized linear model was used to analyze the association between the time spent in sedentary activities and the time spent in physical activity. Results: The results revealed that children and adolescents engage in low levels of physical activity and most of them spend considerable time in sedentary behaviors such as studying, watching television, or using social media. Completing school homework (Coef: 1.23, 95% CI: −0.51 to 2.97, p = 0.167) or using social media for more than 2 h (Coef: 1.29, 95% CI: −2.98 to 0.40, p = 0.133) compared to not dedicating time to them did not show a significant association with daily physical activity time. Watching television for more than 2 h was associated with a decrease of 2.60 min (95% CI: −4.41 to −0.78, p = 0.005). Thus, no or only irrelevant associations were found between time spent in sedentary activities and physical activity time. Conclusions: Despite the drawbacks of spending time engaging in sedentary behaviors, they seem to be compatible with physical activity levels. Therefore, it is important to continue research on physical activity adherence strategies to promote overall health and well-being. Full article
(This article belongs to the Special Issue Physical Education and Exercise Promotion and Intervention in Children and Adolescents for Health and Wellbeing)
14 pages, 671 KiB  
Article
Examining Caregiver- and Family-Level Psychosocial Influences on Child Oral Health Behavioral Outcomes in Racially and Economically Minoritized Urban Families
by Sally M. Weinstein, Helen H. Lee, John J. Dziak, Michael L. Berbaum, Tong Zhang, David Avenetti, Anna Sandoval and Molly A. Martin
Children 2024, 11(7), 882; https://doi.org/10.3390/children11070882 (registering DOI) - 21 Jul 2024
Viewed by 233
Abstract
Objectives: Understanding the pathways linking caregiver- and family-level psychosocial factors and child oral health behaviors is critical for addressing oral health disparities. The current study examined the associations between caregiver psychosocial functioning and family chaos and child toothbrushing behaviors in children at high [...] Read more.
Objectives: Understanding the pathways linking caregiver- and family-level psychosocial factors and child oral health behaviors is critical for addressing oral health disparities. The current study examined the associations between caregiver psychosocial functioning and family chaos and child toothbrushing behaviors in children at high risk for poor oral health outcomes. Methods: Data were drawn from the baseline wave of the CO-OP Chicago Cohort Study (U01DE030067), a longitudinal study on child/caregiver dyads exploring oral health behaviors and caries development in young children (N = 296 dyads; child mean age = 5.36, SD = 1.03; caregiver mean age = 33.8 years, SD = 6.70; caregiver race = 43% Black; caregiver ethnicity = 55% Latinx). The oral health behavioral outcomes included child toothbrushing frequency, child plaque levels, and caregiver assistance with child toothbrushing. The data included demographics; caregiver depression, anxiety, post-traumatic stress disorder (PTSD) symptoms, social functioning, social support, and resilience; and family-level household chaos. Results: Multiple regression models indicated that greater household chaos was significantly related to lower caregiver assistance with child toothbrushing (p = 0.0075). Additionally, caregiver anxiety and PTSD symptoms as well as number of children in the home significantly predicted higher levels of household chaos (p < 0.01). Notably, 18% of caregivers reported clinically significant PTSD. The relationships between caregiver-level psychosocial factors and child oral health behaviors were not significant. Conclusions: The results suggest household chaos may play an important role in child oral health behaviors and highlight the importance of investigating family-level factors for understanding and addressing child oral health risk. Full article
(This article belongs to the Special Issue Addressing Social Determinants That Influence Children’s Oral Health)
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<p>Conceptual model of the significant caregiver- and family-level influences on child oral health behaviors (caregiver assistance with child toothbrushing).</p> Full article ">
13 pages, 1654 KiB  
Article
The TRUST Study—TRansition US Together: Evaluating the Impact of a Parent- and Adolescent-Centered Transition Toolkit on Transition Readiness in Patients with Juvenile Idiopathic Arthritis and Childhood-Onset Systemic Lupus Erythematosus
by Simran Heera, Karen Beattie, Zubin Punthakee, Briano DiRezze, Julie Herrington, Tania Cellucci, Liane Heale, Mark Matsos, Jan Willem Gorter and Michelle Batthish
Children 2024, 11(7), 881; https://doi.org/10.3390/children11070881 (registering DOI) - 20 Jul 2024
Viewed by 283
Abstract
Objective: Adolescents with chronic rheumatic disease must increasingly take on more responsibility for disease management from parents as they transition from pediatric to adult care. Yet, there are limited resources to inform and support parents about transition. Here, we evaluate the impact of [...] Read more.
Objective: Adolescents with chronic rheumatic disease must increasingly take on more responsibility for disease management from parents as they transition from pediatric to adult care. Yet, there are limited resources to inform and support parents about transition. Here, we evaluate the impact of a Transition Toolkit, geared towards parents and adolescents, on transition readiness, and explore the potential impact of parent–adolescent communication. Methods: A prospective cohort study of youths aged 14–18 years old and their parents was performed. Participant demographics, disease characteristics, transition readiness scores (Transition-Q, max 100), and parent–adolescent communication scores (PACS, max 100) were collected at enrollment (when the Transition Toolkit was shared with adolescents and their parents. Generalized estimating equation (GEE) analyses determined the influence of the Toolkit on transition readiness and explored the role of parent–adolescent communication quality. Subgroup analyses were conducted by sex. Results: A total of 21 patients were included; 19 completed one post-intervention Transition-Q and 16 completed two. Transition-Q scores increased over time and the rate of increase doubled after the Toolkit was shared (β = 7.8, p < 0.05, and β = 15.5, p < 0.05, respectively). Conclusion: Transition readiness improved at each follow-up, the greatest increase was seen after the Toolkit was shared. Parent–adolescent communication quality did not appear to impact changes in transition readiness. Full article
(This article belongs to the Section Pediatric Allergy and Immunology)
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<p>Flow of study timeline.</p> Full article ">Figure 2
<p>Changes in Transition-Q scores over time for each participant (each line represents individual patient participants).</p> Full article ">Figure 3
<p>Transition-Q scores at each time point by sex. Outliers are shown as single dots.</p> Full article ">Figure 4
<p>Parent and adolescent PACS scores by sex. Outliers are shown as single dots.</p> Full article ">
16 pages, 259 KiB  
Article
Physical Activity Participation among Children and Youth with Mental Health Symptoms: Clinician Perspectives
by Madeline Crichton, Julie Vu and Barbara Fenesi
Children 2024, 11(7), 880; https://doi.org/10.3390/children11070880 (registering DOI) - 20 Jul 2024
Viewed by 211
Abstract
Background/Objectives: Physical activity supports mental health and well-being in children and youth. However, there are significant barriers to physical activity participation among individuals impacted by mental health disorders. This study investigates these barriers through the perspective of mental health clinicians who support children [...] Read more.
Background/Objectives: Physical activity supports mental health and well-being in children and youth. However, there are significant barriers to physical activity participation among individuals impacted by mental health disorders. This study investigates these barriers through the perspective of mental health clinicians who support children and youth. Methods: Fourteen mental health clinicians, including registered professional psychologists, psychotherapists, and social workers, were interviewed in a semi-structured format. Qualitative content analysis was performed to identify key themes, including both barriers and facilitators to physical activity. Results: Content analysis revealed that clinicians perceive both internal and external barriers and facilitators to their clients’ participation in physical activity. Barriers included intrapersonal factors, such as the presence of depression, anxiety, or eating disorder symptoms; lack of motivation; and negative self-talk, as well as factors related to the influence of caregivers, financial limitations, screen time use, environmental and cultural factors, and lack of time. Facilitators included enjoyment of physical activity, knowledge about the benefits of physical activity, and caregiver participation. Conclusions: Mental health clinicians demonstrated clear knowledge about the barriers to and facilitators of their clients’ participation in physical activity. These findings provide valuable insights that can be used to support children and youth experiencing mental health difficulty to access the beneficial effects of physical activity. Full article
(This article belongs to the Section Pediatric Mental Health)
11 pages, 1011 KiB  
Article
Construct Validity of the Athlete Introductory Movement Screen in Grassroots Footballers Aged 11–13 Years
by Michael J Duncan, Matteo Crotti, Ricardo Martins, Lucas Guimaraes-Ferreira, Jason Tallis and William Pattison
Children 2024, 11(7), 879; https://doi.org/10.3390/children11070879 (registering DOI) - 19 Jul 2024
Viewed by 222
Abstract
Background: This study examined the construct validity of the Athlete Introductory Movement Screen (AIMS) in children. Methods: Following ethics approval, parental consent, and child assent, 87 children (50 boys, 37 girls) aged 11–13 years (Mean ± SD = 12.4 ± 0.6 years) performed [...] Read more.
Background: This study examined the construct validity of the Athlete Introductory Movement Screen (AIMS) in children. Methods: Following ethics approval, parental consent, and child assent, 87 children (50 boys, 37 girls) aged 11–13 years (Mean ± SD = 12.4 ± 0.6 years) performed the AIMS and Test of Gross Motor Development (TGMD-3) in a counterbalanced order. AIMS tertiles were subsequently created, classifying children with ‘high’, ‘medium’, or ‘low’ movement skills. Results: A 2 (Gender) X 3 (AIMS tertile) ways analysis of covariance (ANCOVA), controlling for age and age at peak height velocity, with TGMD-3 scores as the dependant variable, indicated that TGMD-3 scores were significantly higher for girls categorised as having a medium movement skill compared to girls categorised as low, and those categorised having high movement skill compared to medium and low movement skill groups (all, p = 0.001). There was no difference in TGMD-3 scores for boys classed as having low and medium movement skills. Boys categorised as high for movement skills had significantly greater TGMD-3 scores than their peers categorised as having both low and medium movement skills (p = 0.001). Conclusions: As the AIMS differentiates the theoretically related construct of motor competence, this study demonstrates that the AIMS has construct validity as a measure of movement skill in children aged 11–13 years. Full article
(This article belongs to the Special Issue Movement Behaviors and Health-Related Physical Fitness in Pediatric Population)
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<p>Score distribution from the 4-movement tasks within the AIMS. Each task is scored in four subcriteria and given 1, 2, or 3 points based on competency, with a possible total score range from 4 to 12.</p> Full article ">Figure 2
<p>Mean ± SD of Total FMS scores split by sex and AIMS tertile groups.</p> Full article ">Figure 3
<p>Mean ± SD of Locomotor FMS scores split by sex and AIMS tertile groups.</p> Full article ">Figure 4
<p>Mean ± SD of Object Control FMS scores split by sex and AIMS tertile groups.</p> Full article ">
20 pages, 10264 KiB  
Review
Importance of Cardiovascular Magnetic Resonance Applied to Congenital Heart Diseases in Pediatric Age: A Narrative Review
by Sara Moscatelli, Alice Pozza, Isabella Leo, Jessica Ielapi, Alessandra Scatteia, Sofia Piana, Annachiara Cavaliere, Elena Reffo and Giovanni Di Salvo
Children 2024, 11(7), 878; https://doi.org/10.3390/children11070878 - 19 Jul 2024
Viewed by 242
Abstract
Congenital heart diseases (CHDs) represent a heterogeneous group of congenital defects, with high prevalence worldwide. Non-invasive imaging is essential to guide medical and surgical planning, to follow the patient over time in the evolution of the disease, and to reveal potential complications of [...] Read more.
Congenital heart diseases (CHDs) represent a heterogeneous group of congenital defects, with high prevalence worldwide. Non-invasive imaging is essential to guide medical and surgical planning, to follow the patient over time in the evolution of the disease, and to reveal potential complications of the chosen treatment. The application of cardiac magnetic resonance imaging (CMRI) in this population allows for obtaining detailed information on the defects without the necessity of ionizing radiations. This review emphasizes the central role of CMR in the overall assessment of CHDs, considering also the limitations and challenges of this imaging technique. CMR, with the application of two-dimensional (2D) and tri-dimensional (3D) steady-state free precession (SSFP), permits the obtaining of very detailed and accurate images about the cardiac anatomy, global function, and volumes’ chambers, giving essential information in the intervention planning and optimal awareness of the postoperative anatomy. Nevertheless, CMR supplies tissue characterization, identifying the presence of fat, fibrosis, or oedema in the myocardial tissue. Using a contrast agent for angiography sequences or 2D/four-dimensional (4D) flows offers information about the vascular, valvular blood flow, and, in general, the cardiovascular system hemodynamics. Furthermore, 3D SSFP CMR acquisitions allow the identification of coronary artery abnormalities as an alternative to invasive angiography and cardiovascular computed tomography (CCT). However, CMR requires expertise in CHDs, and it can be contraindicated in patients with non-conditional devices. Furthermore, its relatively longer acquisition time and the necessity of breath-holding may limit its use, particularly in children under eight years old, sometimes requiring anesthesia. The purpose of this review is to elucidate the application of CMR during the pediatric age. Full article
(This article belongs to the Special Issue Cardiovascular Magnetic Resonance in Pediatrics)
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<p>(<b>A</b>) 4-chamber cine SSFP image showing sinus venosus ASD (red arrow); (<b>B</b>) Angiographic reconstruction showing the right upper pulmonary artery draining into the superior vena cava (blue and yellow cross); (<b>C</b>) Basal short axis cine SSFP image; (<b>D</b>) sagittal RV three-chamber view showing perimembranous VSD (yellow arrow); (<b>E</b>) 4-chamber cine SSFP image showing aneurysmal formation of the basal septum involving adjacent septal leaflet of the tricuspid valve (white circle); (<b>F</b>) Sagittal cine SSFP image; and (<b>G</b>) MRA showing PDA: (arrow-heads). SSFP: steady-state free precession, ASD: atrial septal defect, RV: right ventricle, VSD: ventricular septal defect, PDA: patent ductus arteriosus.</p> Full article ">Figure 2
<p>Cine bSSFP image of D-TGA post-atrial switch operation using the Senning technique. The image shows the pulmonary veins (*) being redirected through the baffle into the right atrium and then to the subaortic positioned sRV.</p> Full article ">Figure 3
<p>Cine bSSFP image of D-TGA following an atrial switch operation using the Senning technique. This image illustrates the pathway of the systemic veins, with the superior vena cava (*) and the inferior vena cava (§) shown.</p> Full article ">Figure 4
<p>Reconstruction following angiographic sequences in TGA post-arterial switch operation. The image highlights a suprapulmonary stenosis (white arrows) at the level of the surgical suture of the switch with post-stenotic dilation.</p> Full article ">Figure 5
<p>D-TGA with pulmonary stenosis/atresia post-placement of the right ventricle to pulmonary artery (RV-PA) conduit. (<b>A</b>) shows a sagittal section, and (<b>B</b>) displays a transverse section, both highlighting the pulmonary conduit (marked with *).</p> Full article ">Figure 6
<p>Cine bSSFP image from a 15-year-old male with TOF, post complete correction and Melody valve implantation. The image shows significant migration of the Melody valve into the infundibulum (++).</p> Full article ">Figure 7
<p>Coronal Cine bSSFP image from a 12-year-old male TCPC with dextrocardia. The image illustrates two superior vena cava (*) and the external conduit (§).</p> Full article ">Figure 8
<p>Imaging from a 17-year-old male TCPC. (<b>A</b>) shows a coronal angiography image, while (<b>B</b>) presents a sagittal angiography image displaying a veno-venous fistula (marked with §) between the suprahepatic veins and the pulmonary veins.</p> Full article ">
12 pages, 2011 KiB  
Article
Diving into the Digital Landscape: Assessing the Quality of Online Information on Neonatal Jaundice for Parents
by Michael Karl Baumgartner, Anna-Lena Behr, Anne Christina Garbe, Christoph Quatember, Heiko Reutter, Joachim Woelfle, Fabian Benedikt Fahlbusch and Gregor Hanslik
Children 2024, 11(7), 877; https://doi.org/10.3390/children11070877 - 19 Jul 2024
Viewed by 272
Abstract
Background: Hyperbilirubinemia is a common condition in newborns. While mild cases of jaundice are common and typically resolve spontaneously, severe hyperbilirubinemia can lead to serious neurologic complications if left untreated. With the constant adaptation of guidelines, clinical management has significantly improved, and treatment [...] Read more.
Background: Hyperbilirubinemia is a common condition in newborns. While mild cases of jaundice are common and typically resolve spontaneously, severe hyperbilirubinemia can lead to serious neurologic complications if left untreated. With the constant adaptation of guidelines, clinical management has significantly improved, and treatment has become routine for pediatricians. However, for parents of affected children, managing the condition is not routine. In today’s digital age, parents often seek additional information by accessing a wide range of medical resources on the internet. While this can be empowering, it also presents challenges, as the quality and accuracy of online medical information can vary widely. Therefore, we analyzed the current quality of information on jaundice found on the internet by parents. Methods: A simulated internet search (using the Google search engine) was conducted from a layperson’s perspective using German (“Neugeborenes Gelbsucht”, “Baby Gelbsucht”) and English (“jaundice newborn”, “jaundice baby”) search terms. Subsequently, the quality of the search results was assessed by two independent neonatologists based on the DISCERN Plus Score, HONcode certification, and the JAMA criteria. Results: Websites targeting non-medical laypersons exhibited significant variability in quality. Notably, the content of English websites was superior to that of websites in the German language. The majority of English sites were predominantly institutional, whereas most German sites were commercially oriented. Conclusions: Although information on jaundice is readily accessible online for non-medical individuals, there were notable differences in quality based on language and significant variability in the quality of information warranting attention from healthcare professionals. Furthermore, German websites providing information on jaundice were often hosted by commercial organizations. We propose that pediatric societies engage in developing and maintaining organization-based medical information to improve online resources for parents. Full article
(This article belongs to the Section Pediatric Neonatology)
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<p>Sunburst diagrams displaying staggered JAMA benchmarks (<b>A</b>) and DISCERN Plus Score results (<b>B</b>). The assessment tool analyzes the clarity, balance, and content of the information found on websites and allows for grading from 1 (poor) to 5 (excellent). The first eight questions address reliability; the next seven questions focus on treatment information. DISCERN Plus minimum score = 16; maximum score = 75. Question 16 rates the overall quality, and it was not included in the total DISCERN Plus Score. JAMA benchmark criteria: minimum score = 0; maximum score = 4.</p> Full article ">Figure 2
<p>Heatmap analysis of the mean DISCERN Plus Score in German and English websites on jaundice. Legend: the heatmap shows the average DISCERN Plus Scores for German (<b>left</b>) and English (<b>right</b>) websites on jaundice. <span class="html-italic">Y</span>-axis: the numbers (1 to 25 for German and 1 to 24 for English) represent the top search results on Google. <span class="html-italic">X</span>-axis: the letters (A–P) correspond to different DISCERN questions: A–H: questions about the reliability of the information. I–O: questions about the quality of treatment information provided. P: the overall rating of the website. The colors indicate the scores for each item: brighter colors represent higher DISCERN scores, while dark colors represent lower DISCERN Plus Scores, with blue representing the lowest score (1) and yellow representing the highest score (5).</p> Full article ">Figure 3
<p>German (<b>A</b>) and English (<b>B</b>) websites on jaundice sorted by host. Legend: Med News = medical news site (sponsored), IG/NGO = interest groups/non-governmental organizations, EDU = educational organizations, GOV = governmental organizations, and MedCenter/Univ = medical center/university. Bar color: gray—German websites (<b>A</b>); white—English websites (<b>B</b>). ns = <span class="html-italic">p</span> &gt; 0.05, * indicates statistical significance.</p> Full article ">Figure 4
<p>Spearman correlation analysis of DISCERN Plus Score, JAMA benchmark and Google rank. DISCERN Plus Score correlates positively with the JAMA benchmark. Results from both assessment tools did not correlate with the respective Google ranks.</p> Full article ">
17 pages, 2516 KiB  
Case Report
HEP® (Homeostasis-Enrichment-Plasticity) Approach Changes Sensory–Motor Development Trajectory and Improves Parental Goals: A Single Subject Study of an Infant with Hemiparetic Cerebral Palsy and Twin Anemia Polycythemia Sequence (TAPS)
by Aymen Balikci, Teresa A. May-Benson, Gamze Cagla Sirma and Gul Ilbay
Children 2024, 11(7), 876; https://doi.org/10.3390/children11070876 - 19 Jul 2024
Viewed by 230
Abstract
Background: Early intervention (EI) for infants identified as being at high risk for cerebral palsy (CP), or who have been diagnosed with it, is critical for promotion of postnatal brain organization. The aim of this study was to explore the effectiveness of the [...] Read more.
Background: Early intervention (EI) for infants identified as being at high risk for cerebral palsy (CP), or who have been diagnosed with it, is critical for promotion of postnatal brain organization. The aim of this study was to explore the effectiveness of the Homeostasis-Enrichment-Plasticity (HEP) Approach, which is a contemporary EI model that applies the key principles of enriched environment paradigms and neuronal plasticity from experimental animal studies to ecological theories of human development on the motor development, sensory functions, and parental goals of an infant with twin anemia polycythemia sequence (TAPS) and CP. Methods: An AB phase with follow-up single case study design which consisted of multiple baseline assessments with the Peabody Developmental Motor Scales-2 (PDMS-2) and the Test of Sensory Functions in Infants (TSFI) was used. Non-overlapping confidence intervals analysis was used for pre–post PDMS-2 scores. The measurement of progress toward goals and objectives was conducted using the Goal Attainment Scale (GAS). The HEP Approach intervention consisted of 12 one-hour sessions implemented over a period of 3 months, where a physical therapist provided weekly clinic-based parental coaching. Results: Results found a stable baseline during Phase A and improvement in response to the HEP Approach intervention during Phase B in both the PDMS-2 and TSFI according to 2SD Band analysis. The confidence intervals for the PDMS-2 scores also indicated a significant improvement after HEP intervention. The scores for both the PDMS-2 and the TSFI were consistent or showed improvement throughout the Follow-Up phase. A GAS t-score of 77.14 indicated that the infant exceeded intervention goal expectations. Conclusions: Although our findings suggest that the HEP Approach intervention has promise in enhancing sensory functions, motor skill outcomes, and parental goals in an infant with TAPS and CP, further research is required to validate and apply these results more broadly. Full article
(This article belongs to the Section Pediatric Neurology & Neurodevelopmental Disorders)
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<p>HEP Approach intervention. (<b>A</b>) Z is enclosed within a transparent plastic container, engaging with particular desired objects and exploring a range of possible actions with her body. The box provides a secure setting for her to explore objects and try different means of movement possibilities. Additionally, this support provided opportunities for Z to explore transitional movements from a seated posture to an upright posture. Proximity to the infant’s favored objects or toys acted as a stimulus to move the baby. (<b>B</b>) Arrangement of the space within the car tires to “just right” dimensions enabled Z to explore movement possibilities and objects while in a standing position without too much or too little support. In addition, her sister often accompanied her in this space, which provided support for Z’s drive and enthusiastic investigation of the objects within her reach. (<b>C</b>) Once Z acquired the skill of crawling, several objects were positioned on the room’s floor, prompting her to explore various ways of maneuvering around, over, or under them. The pieces underwent regular repositioning which provided a constant need for adaptive motor behaviors. (<b>D</b>) Enticing balls were placed on the wall to motivate Z to stand, and an inner tube was used as support to facilitate her exploration of the transition from seated to standing. (<b>E</b>) By positioning a compact table close to the sofa, Z was able to conveniently explore environmental opportunities for transitional postural movements while standing. Play activities were strategically arranged with her preferred toys to provide an incentive for her to transition between the table and the couch. (<b>F</b>) Z explored fine motor opportunities for manipulation while engaging in bean play. Her sister’s participation in these activities reinforced her motivation to engage in play and exploration within a social setting.</p> Full article ">Figure 2
<p>PDMS-2 Gross Motor Quotient (GMQ) scores across phases and Follow-Up as plotted about the +/− 2 SDB (between dashed lines). The green vertical line represents the start of the HEP intervention. The red vertical line represents the end of the HEP intervention.</p> Full article ">Figure 3
<p>PDMS-2 Fine Motor Quotient (FMQ) scores across the AB phases and Follow-Up assessment. FMQ scores of PDMS-2 across the AB phases as plotted about the +/− 2 SDB (between dashed lines). A = The green vertical line represented the start of the HEP intervention. The red vertical line represented the end of the HEP intervention.</p> Full article ">Figure 4
<p>PDMS-2 Total Motor Quotient (TMQ) scores across the AB phases and Follow-Up assessment. TMQ scores of PDMS-2 across the AB phases as plotted about the +/− 2 SDB (between dashed lines). A = The green vertical line represented the start of the HEP intervention. The red vertical line represented the end of the HEP intervention.</p> Full article ">Figure 5
<p>TSFI total scores across Phases A, B, and Follow-Up. TSFI total scores are plotted about the +/− 2 SDB (between dashed lines). The green vertical line represented the start of the HEP intervention. The red vertical line represented the end of the HEP intervention.</p> Full article ">
21 pages, 323 KiB  
Article
Atypical Sensory Processing in Neurodevelopmental Disorders: Clinical Phenotypes in Preschool-Aged Children
by Federica Gigliotti, Federica Giovannone, Arianna Belli and Carla Sogos
Children 2024, 11(7), 875; https://doi.org/10.3390/children11070875 - 19 Jul 2024
Viewed by 219
Abstract
Background: Sensory processing issues are frequent in neurodevelopmental disorders (NDDs), with very variable prevalence rates ranging from 20% to 95%. This study aimed to investigate sensory processing in preschool-aged children with NDDs, to clarify the epidemiology, and to identify associated or correlated clinical [...] Read more.
Background: Sensory processing issues are frequent in neurodevelopmental disorders (NDDs), with very variable prevalence rates ranging from 20% to 95%. This study aimed to investigate sensory processing in preschool-aged children with NDDs, to clarify the epidemiology, and to identify associated or correlated clinical and psychometric variables. Methods: A total of 141 NDD children (age range 2–5 years old) were included and enrolled in two subgroups: 72 with ASD and 69 with other NDDs. A standardized neuropsychological evaluation was assessed (Griffiths III/WPPSI-III/Leiter-R, ADOS-2) and the parents completed the CBCL ½–5, the SPM-P, and the ADI-R. Results: Atypical sensory processing was reported in 39.7% of the total sample, more frequently in ASD (44.4%) than in other NDDs (34.8%). No statistically significant differences were found regarding gender and developmental level. A positive correlation was found between sensory processing abnormalities and behavioral problems (p < 0.01). Conclusions: Compared to other NDDs, ASDs more frequently have atypical sensory processing and appear to present a specific vulnerability in the processing of proprioceptive and vestibular inputs. Our results suggest that sensory processing difficulties should be considered regardless of developmental level and in children with behavioral problems. Full article
12 pages, 368 KiB  
Article
Assessment and Treatment of Pain in Hospitalized Children at a Tertiary Children’s Hospital: A Cross-Sectional Mixed Methods Survey
by Nadia Roessler De Angulo, Andrea C. Postier, Lisa Purser, Lena Ngo, Karen Sun and Stefan Friedrichsdorf
Children 2024, 11(7), 874; https://doi.org/10.3390/children11070874 - 19 Jul 2024
Viewed by 225
Abstract
(1) Background: Acute pain in hospitalized children remains under-recognized and under-treated. Our objective is to benchmark pain assessment, documentation, treatment, and patient experience in children admitted to a US children’s hospital. (2) Methods: A cross-sectional, mixed-method survey of pain for children hospitalized ≥24 [...] Read more.
(1) Background: Acute pain in hospitalized children remains under-recognized and under-treated. Our objective is to benchmark pain assessment, documentation, treatment, and patient experience in children admitted to a US children’s hospital. (2) Methods: A cross-sectional, mixed-method survey of pain for children hospitalized ≥24 h. Charts were reviewed for modalities of pain assessment and treatment for all inpatients. If pain was documented, patients/caregivers were surveyed regarding their experience with pain and its management. (3) Results: Chart review: All 107 patients had ≥1 pain score documented. A total of 47 patients had a pain score ≥0, 35 (74.5%) of whom had ≥1 moderate-severe score. Seventy (65.4%) patients received ≥1 intervention for pain, including medications from ≥1 class (e.g., opioids) (n = 55, 51.4%) and/or integrative/non-pharmacologic intervention(s) (n = 39, 36.4%). There were assessment and documentation gaps. Patient survey: A total of 39 (83.0%) interviews were attempted; 25 (53.2%) were completed. The worst pain was mostly caused by acute illness (n = 13, 52%) and painful procedures (n = 10, 40%). Suggestions for improvement included increasing the use of integrative modalities and optimizing patient–clinician communication. (4) Conclusions: All patients admitted ≥24 h had ≥1 pain score documented; however, gaps in documentation were common. Multimodal treatment and integrative modalities were underutilized. Procedures were a frequent cause of under-treated pain, prompting an institution-wide quality improvement project. Full article
(This article belongs to the Section Pediatric Anesthesiology, Pain Medicine and Palliative Care)
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<p>Number of assessments per patient documented in the past 24 h.</p> Full article ">
13 pages, 4299 KiB  
Article
Use of N-Acetylcysteine in Preterm Neonates with Enteral Feeding Intolerance and Intestinal Obstruction: A Case Series and Review of the Literature
by Domenico Umberto De Rose, Francesca Landolfo, Flaminia Pugnaloni, Paola Giliberti, Alessandra Santisi, Claudia Columbo, Ludovica Martini, Maria Paola Ronchetti, Paolo Maria Schingo, Guglielmo Salvatori, Fabio Fusaro, Pietro Bagolan, Andrea Dotta, Irma Capolupo and Andrea Conforti
Children 2024, 11(7), 873; https://doi.org/10.3390/children11070873 - 18 Jul 2024
Viewed by 241
Abstract
(1) Background: The use of N-acetylcysteine (NAC) to relieve meconium obstruction of prematurity in the first days of life has been reported, with NAC reducing the viscosity of luminal contents by cleaving the disulfide bonds of mucoproteins. However, its use in this population [...] Read more.
(1) Background: The use of N-acetylcysteine (NAC) to relieve meconium obstruction of prematurity in the first days of life has been reported, with NAC reducing the viscosity of luminal contents by cleaving the disulfide bonds of mucoproteins. However, its use in this population should be further explored since it has been associated with hypernatremia and transient increase in transaminases and bilirubin. (2) Methods: In this retrospective study, we included neonates admitted because of enteral feeding intolerance and intestinal obstruction from 2019 to 2021 who received NAC as a rescue therapy before explorative laparotomy. (3) Results: We summarized the clinical presentation of six preterm neonates with enteral feeding intolerance and intestinal obstruction who received NAC as a rescue therapy. Four infants (66.7%) gradually improved without the need for explorative laparotomy, whereas two infants (33.3%) underwent the creation of an ileostomy. No cases of hypernatremia or hepatic derangement associated with NAC therapy were observed. (4) Conclusions: We described the use of NAC treatment by nasogastric tube and/or rectal enemas in preterm infants with enteral feeding intolerance and intestinal obstruction after a multidisciplinary assessment, but the limited sample size did not allow us to obtain definitive conclusions and further research is needed in this field, given the limited evidence about NAC treatment in preterm infants. Full article
(This article belongs to the Special Issue Providing Care for Preterm Infants)
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<p>Abdominal X-ray of patient P1 on the 10th day of life (<b>A</b>); contrast enema performed on the 26th day of life (<b>B</b>); abdominal X-ray before the NAC treatment (<b>C</b>) and after the NAC treatment (<b>D</b>).</p> Full article ">Figure 2
<p>Abdominal X-ray of patient P2 on the 36th day of life (<b>A</b>); persistent abdominal distension on the 86th day of life (<b>B</b>); and abdominal X-ray after the NAC treatment (<b>C</b>).</p> Full article ">Figure 3
<p>Abdominal X-ray of patient P3 on the 3rd day of life (<b>A</b>); abdominal X-ray before the NAC treatment (<b>B</b>) and after the NAC treatment (<b>C</b>).</p> Full article ">Figure 4
<p>Abdominal X-ray of patient P4 on the 8th day of life (<b>A</b>); contrast enema before the NAC treatment (<b>B</b>) and after the NAC treatment (<b>C</b>).</p> Full article ">Figure 5
<p>Abdominal X-ray of patient P5 on the 6th day of life (<b>A</b>); barium enema before the NAC treatment (<b>B</b>).</p> Full article ">Figure 6
<p>Abdominal X-ray of patient P6 at 34 weeks of postmenstrual age at our NICU admission (<b>A</b>) and after NAC rectal enemas (<b>B</b>); barium enema documenting dolichosigma and intestinal malrotation (<b>C</b>); and abdominal X-ray at discharge (<b>D</b>).</p> Full article ">
17 pages, 2166 KiB  
Article
Association among Household Wealth, Maternal Employment, and Undernutrition in Children under Three Years of Age in Pakistan
by Muhammad Shahid, Yuantao Xie, Shamshad Bashir, Nazia Noureen, Jiayi Song, Najma Iqbal Malik and Kun Tang
Children 2024, 11(7), 872; https://doi.org/10.3390/children11070872 - 18 Jul 2024
Viewed by 251
Abstract
Background: There is an abundance of studies explaining the separate impact of female employment and household wealth status in reducing malnutrition. However, our study has unraveled the combined impact of maternal employment and household wealth on undernutrition among children under three in Pakistan. [...] Read more.
Background: There is an abundance of studies explaining the separate impact of female employment and household wealth status in reducing malnutrition. However, our study has unraveled the combined impact of maternal employment and household wealth on undernutrition among children under three in Pakistan. Methods: Using a sample of 1093 children under three years of age from the Pakistan Demographic and Health Survey 2017–2018, a binary logistic model was employed to gauge factors influencing the children’s undernutrition. Results: Our results indicated that children up to a certain age (three years old) with residence in certain regions (Pakistan) and recent episodes of diarrhea had an increased risk of undernutrition. Conversely, secondary and higher maternal education, access to improved water sources, and sanitation facilities lowered the chances of undernutrition in children under three in Pakistan. The interaction between maternal employment and household wealth showed that maternal employment significantly lowered the risk of stunting, being underweight, and wasting among the average, rich, and richest households; however, it did not contribute to child nutrition among the poorer and poor households. Notably, regardless of whether the mother was employed, the wealth status of being rich and richest reduced the risk of stunting, being underweight, and wasting. Conclusions: In overcoming undernutrition, maternal employment significantly contributed to middle-income households. However, in the richer and richest households, the wealth status played a more crucial role compared to the maternal employment. This indicates that while employment plays a supportive role in household resources, the wealth status is overall more influential in reducing undernutrition. Full article
(This article belongs to the Special Issue Food Intake and Nutrition Assessment in Children: Focus on Healthy Growth)
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<p>Flow Chart of Study Sample. Source: Authors.</p> Full article ">Figure 2
<p>Undernutrition among children under three years age group. Source: Authors.</p> Full article ">Figure 3
<p>Undernutrition prevalence among children under three years age group across women employment by household wealth Index. Source: Authors.</p> Full article ">Figure 4
<p>Projected probabilities of undernutrition prevalence by women employment status and household wealth status. Source: Authors.</p> Full article ">Figure 5
<p>ROC curves for undernutrition. Source: Authors.</p> Full article ">
45 pages, 674 KiB  
Review
Antibiotics, Analgesic Sedatives, and Antiseizure Medications Frequently Used in Critically Ill Neonates: A Narrative Review
by Angeliki Kontou, Eleni Agakidou, Ilias Chatziioannidis, William Chotas, Evanthia Thomaidou and Kosmas Sarafidis
Children 2024, 11(7), 871; https://doi.org/10.3390/children11070871 - 18 Jul 2024
Viewed by 372
Abstract
Antibiotic, analgesic sedative, and antiseizure medications are among the most commonly used medications in preterm/sick neonates, who are at high risk of nosocomial infections, central nervous system complications, and are exposed to numerous painful/stressful procedures. These severe and potentially life-threatening complications may have [...] Read more.
Antibiotic, analgesic sedative, and antiseizure medications are among the most commonly used medications in preterm/sick neonates, who are at high risk of nosocomial infections, central nervous system complications, and are exposed to numerous painful/stressful procedures. These severe and potentially life-threatening complications may have serious short- and long-term consequences and should be prevented and/or promptly treated. The reported variability in the medications used in neonates indicates the lack of adequate neonatal studies regarding their effectiveness and safety. Important obstacles contributing to inadequate studies in preterm/sick infants include difficulties in obtaining parental consent, physicians’ unwillingness to recruit preterm infants, the off-label use of many medications in neonates, and other scientific and ethical concerns. This review is an update on the use of antimicrobials (antifungals), analgesics (sedatives), and antiseizure medications in neonates, focusing on current evidence or knowledge gaps regarding their pharmacokinetics, indications, safety, dosage, and evidence-based guidelines for their optimal use in neonates. We also address the effects of early antibiotic use on the intestinal microbiome and its association with long-term immune-related diseases, obesity, and neurodevelopment (ND). Recommendations for empirical treatment and the emergence of pathogen resistance to antimicrobials and antifungals are also presented. Finally, future perspectives on the prevention, modification, or reversal of antibiotic resistance are discussed. Full article
(This article belongs to the Special Issue Intensive Care for Critically Ill Neonates: Clinical Diagnosis and Treatment)
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9 pages, 526 KiB  
Article
Parental Attitudes and Practices regarding Atopic Dermatitis: A Cross-Sectional Study among a Thai Population
by Phurithat Nummak, Leelawadee Techasatian, Rattapon Uppala, Phanthila Sitthikarnkha, Suchaorn Saengnipanthkul and Prapassara Sirikarn
Children 2024, 11(7), 870; https://doi.org/10.3390/children11070870 - 18 Jul 2024
Viewed by 203
Abstract
Background: Atopic dermatitis (AD) is a chronic inflammatory skin disorder common in children. Successful pediatric AD therapy requires parental assistance. Thus, evaluating parental knowledge, attitudes, and behaviors regarding childhood AD may lead to more educational recommendations to help children control AD in the [...] Read more.
Background: Atopic dermatitis (AD) is a chronic inflammatory skin disorder common in children. Successful pediatric AD therapy requires parental assistance. Thus, evaluating parental knowledge, attitudes, and behaviors regarding childhood AD may lead to more educational recommendations to help children control AD in the future. This study examined parents’ knowledge, attitudes, and conduct concerning AD in families with and without children with AD. Method: The Pediatric Department, Faculty of Medicine, Khon Kaen University, Thailand, conducted a cross-sectional study from June to December 2023. Parents of children who visited the dermatology clinic with or without AD were asked to complete a Google form questionnaire. Results: A total of 372 parents answered a questionnaire about AD pathophysiology, knowledge, attitudes, and practices. The participants were 293 (78.8%) female participants and 79 (21.2%) male participants. The average age was 29.79 (SD 4.91). Most parents (319, 85.8%) did not work in the medical field, and more than half (228 instances, 61.29%) had children diagnosed with AD. Conclusions: Parents of children with AD understood AD causes and triggers better than parents of children without AD. But, “exposure to furry toys” that may contain dust and allergies and “infection” that may cause AD flare-ups were the most common triggers, regardless of the group. Appropriate information should be supplied because both the parents of children with AD and those of children without AD reported immediate food avoidance without confirmatory testing, which might lead to malnutrition. Clinicians and families handling patients with AD require further education. Full article
(This article belongs to the Section Pediatric Dermatology)
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<p>The decision-making aspects involved in moisturizer selection among the study population.</p> Full article ">Figure 2
<p>The sources that participating parents sought guidance from.</p> Full article ">
13 pages, 682 KiB  
Systematic Review
Nutritional Deficiencies and Associated Oral Health in Adolescents: A Comprehensive Scoping Review
by Man Hung, Amy Blazejewski, Samantha Lee, Johanna Lu, Andres Soto, Connor Schwartz and Amir Mohajeri
Children 2024, 11(7), 869; https://doi.org/10.3390/children11070869 - 18 Jul 2024
Viewed by 303
Abstract
Introduction: The shift to processed foods in American diets has increased vitamin and mineral deficiencies among adolescents, impacting growth and health, often manifesting as oral lesions. This review study aimed to explore the link between nutritional deficiencies and adolescent oral health to improve [...] Read more.
Introduction: The shift to processed foods in American diets has increased vitamin and mineral deficiencies among adolescents, impacting growth and health, often manifesting as oral lesions. This review study aimed to explore the link between nutritional deficiencies and adolescent oral health to improve guidance and prevent long-term issues. Methods: A systematic review of literature from 2013 to 2023 was conducted on adolescents aged 10–19 years, using PRISMA guidelines. Searches in PubMed, Web of Science, Dentistry & Oral Sciences Source—Ebscohost, and Scopus included peer-reviewed articles, excluding reviews and non-empirical studies. Data were screened and extracted with independent reviews for accuracy. Results: Malnutrition strongly correlates with poor oral health. Undernourished children have a 60% increase in dental caries, exacerbated by high sugar intake. Early malnutrition delays dental eruption, temporarily protecting against caries, while stunting and infections cause enamel defects. Chronic conditions like cerebral palsy and celiac disease worsen oral health, with risks persisting into adulthood. Conclusions: Nutritional deficiencies and oral health are interconnected, requiring integrated healthcare. Early interventions and holistic strategies can improve outcomes and reduce long-term burdens. Comprehensive health education and routine dental evaluations are essential for prevention and treatment, enhancing health across all demographics. Full article
(This article belongs to the Special Issue Nutritional Status and Eating Patterns in Children and Adolescents: Prevalence, Screening and Prevention of Metabolic Disorders)
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<p>Flow diagram of article selection.</p> Full article ">
8 pages, 241 KiB  
Article
Neck Circumference and Its Relation with Body Fat Percentage in Children 5–10 Years Old
by Enrique Romero-Velarde, Karen G. Córdova-García, Laura C. Robles-Robles, Ingrid J. Ventura-Gómez and Clío Chávez-Palencia
Children 2024, 11(7), 868; https://doi.org/10.3390/children11070868 - 17 Jul 2024
Viewed by 252
Abstract
Background: Neck circumference (NC) has been proposed as an indicator of upper trunk adiposity and a potential indicator of metabolic risk. The objective was to evaluate NC and its correlation with body fat percentage (BF%) and other indicators of adiposity in children with [...] Read more.
Background: Neck circumference (NC) has been proposed as an indicator of upper trunk adiposity and a potential indicator of metabolic risk. The objective was to evaluate NC and its correlation with body fat percentage (BF%) and other indicators of adiposity in children with normal weight, overweight, and obesity. Methods: In a cross-sectional study, 112 children 5 to 10 years of age were included in the outpatient clinic from a public hospital. Measures of weight and height to calculate BMI (kg/m2), NC, mid-upper arm circumference, waist circumference, and tricipital skinfold thickness. Body composition measurements were performed using an electrical bioimpedance device (BIA). The relationship between anthropometric variables and BF% obtained by BIA was determined using Spearman correlation tests. Multivariate models were constructed with BF% as the dependent variable and anthropometric parameters as independent. Results: In the entire group, there was a direct correlation between NC and BF% (r = 0.50, p < 0.001), but lost statistical significance in the case of normal weight. The relationship maintained its significance in subjects from the overweight and obesity groups. In multivariate models, BMI exhibited the highest correlation with BF%, followed by waist circumference and mid-upper arm circumference; for NC, the R2 value was 0.30 (p < 0.001). Conclusions: Neck circumference is useful in the screening of population groups with the advantage of not requiring any specialized instruments for its measurement other than a tape measure. BMI and waist circumference were the best indicators of general and central adiposity, respectively. Full article
(This article belongs to the Special Issue Nutrition to Improve Child and Adolescent Health)
17 pages, 1060 KiB  
Article
Effect of School-Based Educational Intervention on Childhood Obesity in Croatian Urban and Rural Settings
by Sara Cobal, Darija Vranešić Bender, Jasenka Gajdoš Kljusurić, Ivana Rumora Samarin and Željko Krznarić
Children 2024, 11(7), 867; https://doi.org/10.3390/children11070867 - 17 Jul 2024
Viewed by 234
Abstract
Background: Childhood obesity is a global public health concern. Development of effective public health interventions represents the only viable option for decreasing the prevalence of childhood obesity. The objective of this study was to assess the effectiveness of a school-based “PETICA—Play for Health” [...] Read more.
Background: Childhood obesity is a global public health concern. Development of effective public health interventions represents the only viable option for decreasing the prevalence of childhood obesity. The objective of this study was to assess the effectiveness of a school-based “PETICA—Play for Health” obesity prevention program in urban and rural areas in Croatia. Methods: This before-and-after study included 28 elementary schools in Croatia focused on pupils (n = 753, 2nd grade) and their guardians (n = 753) during the school year 2022/2023. “PETICA” multicomponent lessons and workshops (10) were implemented in the school curriculum and home settings (parents) as part of the intervention. Knowledge and lifestyle habit changes were evaluated via the questionnaire on knowledge and habits regarding nutrition and physical activity pre-/post-education. The Wilcoxon test for paired samples, Student’s t-test (dependent and independent samples), multiple Mann Whitney U tests (p < 0.05), Spearman’s correlation, and heatmaps were used. Results: The analysis showed a significant increase in acquired knowledge among pupils (both settings) and habits in the rural setting (increase in sports activities participation, breakfast, and vegetables consumption (p < 0.001, p = 0.003, p = 0.004)), decrease of sweets and salty snacks intake (p = 0.027, p = 0.011), and also, the link between parents’ and children’s physical activity levels (p = 0.028 vs. p = 0.022), emphasizing the importance of parents as healthy lifestyle role-models. Conclusion: The study shows that “PETICA” is an efficient school-based educational model that contributes to positive changes in children’s knowledge and lifestyle habits that are a prerequisite for childhood obesity prevention. Full article
(This article belongs to the Section Pediatric Endocrinology & Diabetes)
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<p>Flow chart of data collection to test similarities/differences (before and after the education) between the areas (urban and rural) for the observed group (pupils or parents), as well as between the groups in the same area.</p> Full article ">Figure 2
<p>Heatmaps relating parents’ personal physical activity habits and children’s sport activity based on the parents’ level of education (<b>A</b>) and the employment status (<b>B</b>) before and after the educational intervention.</p> Full article ">Figure 2 Cont.
<p>Heatmaps relating parents’ personal physical activity habits and children’s sport activity based on the parents’ level of education (<b>A</b>) and the employment status (<b>B</b>) before and after the educational intervention.</p> Full article ">
14 pages, 881 KiB  
Article
The Mediating Role of Cardiorespiratory Fitness in the Association between a Negative Lifestyle and Poor Mental Health in Chilean Schoolchildren
by Pedro Delgado-Floody, Felipe Caamaño-Navarrete, Guillermo Barahona-Fuentes, Carlos Arriagada-Hernández, Pablo Valdés-Badilla, Indya Del-Cuerpo, Mauricio Cresp-Barría and Manuel Gómez-López
Children 2024, 11(7), 866; https://doi.org/10.3390/children11070866 - 17 Jul 2024
Viewed by 260
Abstract
Background: A negative lifestyle has a reported relationship with psychological problems and deteriorated well-being. However, there is little information regarding the mediating role of cardiorespiratory fitness (CRF) in this relationship. Objectives: The objectives of the present study are twofold: first, to investigate the [...] Read more.
Background: A negative lifestyle has a reported relationship with psychological problems and deteriorated well-being. However, there is little information regarding the mediating role of cardiorespiratory fitness (CRF) in this relationship. Objectives: The objectives of the present study are twofold: first, to investigate the association between negative lifestyle, physical self-concept (PSC), and depression, and second, to assess the potential mediating role of CRF in this complex relationship. Methods: This cross-sectional study included 612 schoolchildren aged between 9 and 14 years from the Araucanía region (southern Chile). CRF was measured using the Leger test, and lifestyle, depression, and PSC were measured using validated questionnaires. Results: A negative lifestyle reported an inverse association with PSC (p < 0.001) and a positive association with depression levels (p < 0.001). The mediation analysis showed that CRF was positively related to PSC (p < 0.001) and inversely related to depression (p = 0.001); besides, the indirect effect CRF acted as a partial mediator in the association between a negative lifestyle and PSC (indirect effect = −1.15; SE = 0.01; 95% CI, −1.87, −0.55) and depression levels (indirect effect = 0.22; SE = 0.08; 95% CI, 0.08, 0.38). Conclusion: In conclusion, CRF in schoolchildren played a potential mediating role in the association between a negative lifestyle and depression and PSC. Full article
(This article belongs to the Special Issue The Health Effects of Daily Physical Activity Behaviours in Children: Physical and Psychological Outcomes)
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<p>Mediations model testing whether the association between negative lifestyle and negative physical self-concept was mediated by cardiorespiratory fitness.</p> Full article ">Figure 2
<p>Mediations model testing whether the association between negative lifestyle and depression was mediated by cardiorespiratory fitness.</p> Full article ">
12 pages, 1910 KiB  
Article
Is It Feasible to Perform Infant CPR during Transfer on a Stretcher until Cannulation for Extracorporeal CPR? A Randomization Simulation Study
by Myriam Santos-Folgar, Felipe Fernández-Méndez, Martín Otero-Agra, Roberto Barcala-Furelos and Antonio Rodríguez-Núñez
Children 2024, 11(7), 865; https://doi.org/10.3390/children11070865 - 17 Jul 2024
Viewed by 350
Abstract
Introduction: Extracorporeal membrane oxygenation (ECMO) improves infant survival outcomes after cardiac arrest. If not feasible at the place of arrest, victims must be transported to a suitable room to perform ECMO while effective, sustained resuscitation maneuvers are performed. The objective of this simulation [...] Read more.
Introduction: Extracorporeal membrane oxygenation (ECMO) improves infant survival outcomes after cardiac arrest. If not feasible at the place of arrest, victims must be transported to a suitable room to perform ECMO while effective, sustained resuscitation maneuvers are performed. The objective of this simulation study was to compare the quality of resuscitation maneuvers on an infant manikin during simulated transfer on a stretcher (stretcher test) within a hospital versus standard stationary resuscitation maneuvers (control test). Methods: A total of 26 nursing students participated in a randomized crossover study. In pairs, the rescuers performed two 2 min tests, consisting of five rescue breaths followed by cycles of 15 compressions and two breaths. The analysis focused on CPR variables (chest compression and ventilation), CPR quality, the rate of perceived exertion and the distance covered. Results: No differences were observed in the chest compression quality variable (82 ± 10% versus 84 ± 11%, p = 0.15). However, significantly worse values were observed in the test for ventilation quality on the stretcher (18 ± 14%) compared to the control test (28 ± 21%), with a value of p = 0.030. Therefore, the overall CPR quality was worse in the stretcher test (50 ± 9%) than in the control test (56 ± 13%) (p = 0.025). Conclusions: Infant CPR performed by nursing students while walking alongside a moving stretcher is possible. However, in this model, the global CPR quality is less due to the low ventilation quality. Full article
(This article belongs to the Section Pediatric Emergency Medicine & Intensive Care Medicine)
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<p>Study design flow chart.</p> Full article ">Figure 2
<p>(<b>A</b>) A visual diagram of the stretcher test process. (<b>B</b>) A diagram of the placement of the materials, participants and assistants of the stretcher test.</p> Full article ">Figure 3
<p>Results of the quality variables. * Statistically significant.</p> Full article ">Figure 4
<p>The results of the variables of perception of fatigue and distance covered. Images of each of the tests. * Statistically significant.</p> Full article ">
30 pages, 618 KiB  
Review
Exploring Mental Health Services for Youth Experiencing Homelessness in East Asian Pacific Regions: A Systematic Scoping Review
by Kimberley Cortez Ermita and Diana Margot Rosenthal
Children 2024, 11(7), 864; https://doi.org/10.3390/children11070864 - 17 Jul 2024
Viewed by 474
Abstract
Background: Youth experiencing homelessness (YEH) in East Asian Pacific (EAP) regions represent one of the most at-risk populations due to cultural and geographical factors. Effective mental health interventions, primarily researched in Western contexts, may not fully apply to YEH in EAP. Their lack [...] Read more.
Background: Youth experiencing homelessness (YEH) in East Asian Pacific (EAP) regions represent one of the most at-risk populations due to cultural and geographical factors. Effective mental health interventions, primarily researched in Western contexts, may not fully apply to YEH in EAP. Their lack of stable shelter, disrupted social networks, and limited access to mental health services elevate their susceptibility to adverse mental health, making urgent interventions essential to address their needs. Objective: The objective of this study is to explore and systematically search the types of mental health services and interventions available for YEH in EAP and their impact on overall quality of life and wellbeing. Methods: Electronic databases (e.g., Medline, PsycINFO, PubMed, Scopus) were systematically searched (publication dates between 1 January 1990 and 13 May 2023), as well as additional online resources specific to homelessness. Articles were screened, and a critical appraisal assessed the quality of the included studies. Results: Eight studies with different interventions were identified in Indonesia (n = 2), Malaysia (n = 1), South Korea (n = 3), and the Philippines (n = 1). These were thematically clustered into six categories: art, cognitive behavioural therapy, life skills education, resilience enhancement, family strengthening, and government interventions/services. Conclusions: This review highlights effective mental health interventions’ positive impact on YEH mental health outcomes and quality of life in EAP, stressing the urgent need to implement socio-culturally sensitive services. Future research should address knowledge gaps through comprehensive studies covering diverse EAP regions and populations, prioritising socio-culturally specific psychological measures. Full article
(This article belongs to the Section Global Pediatric Health)
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<p>PRISMA 2020 flow diagram [<a href="#B61-children-11-00864" class="html-bibr">61</a>] for new systematic reviews, which included searches of databases, registers, and other sources.</p> Full article ">
15 pages, 762 KiB  
Article
Postural Control and Neuromuscular Activation in 11–13-Year-Old Athletic Boy Swimmers
by Rym Baccouch, Ghada Jouira, Cristina Ioana Alexe, Dragoș Ioan Tohănean and Dan Iulian Alexe
Children 2024, 11(7), 863; https://doi.org/10.3390/children11070863 - 16 Jul 2024
Viewed by 366
Abstract
Objective: This study compared postural control and neuromuscular activation in athletic swimmers (A-S) and non-athletic swimmers (N-A-S) in older children. Methods: Ten A-S and ten N-A-S underwent assessments of center of pressure (CoP) parameters under static and dynamic surfaces in two directions (dynamic [...] Read more.
Objective: This study compared postural control and neuromuscular activation in athletic swimmers (A-S) and non-athletic swimmers (N-A-S) in older children. Methods: Ten A-S and ten N-A-S underwent assessments of center of pressure (CoP) parameters under static and dynamic surfaces in two directions (dynamic mediolateral (DML) and dynamic anteroposterior (DAP)) in eyes-open (EO) and eyes-closed (EC) conditions, and electromyography (EMG) parameters under DAP and DML directions in EO and EC conditions. Results: Results showed that A-S demonstrated significantly superior postural control (p < 0.05), with smaller CoP area and lower CoP mean velocity compared with N-A-S, particularly in static with EC, DAP with EO and EC, and DML with EO conditions. A-S exhibited significantly larger neuromuscular activation amplitudes (p < 0.05), especially in the AP direction. Conclusions: These findings suggested that athletic swimming training may enhance postural control and neuromuscular activation in 11–13-year-old children, emphasizing the potential benefits of incorporating swimming exercises in these children. Full article
(This article belongs to the Special Issue Motor Development in Children)
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<p>CoP<sub>area</sub> values in A-S and N-A-S under different surfaces and directional conditions in EO and EC conditions. A-S: athletic swimmers, N-A-S: non athletic swimmers, CoP: center of pressure, S: static, DAP: dynamic anteroposterior, DML: dynamic mediolateral, EO: eyes open, EC: eyes closed. * Significant differences between A-S and N-A-S at <span class="html-italic">p</span> &lt; 0.05; *** Significant differences between A-S and N-A-S at <span class="html-italic">p</span> &lt; 0.001.</p> Full article ">Figure 2
<p>CoP<sub>Vm</sub> values in A-S and N-A-S under different surfaces and directional conditions in EO and EC conditions. A-S: athletic swimmers, N-A-S: non athletic swimmers, CoP: center of pressure, CoP<sub>Vm</sub>: center of pressure mean velocity, S: static, DAP: dynamic anteroposterior, DML: dynamic mediolateral, EO: eyes open, EC: eyes closed. *** Significant differences between A-S and N-A-S at <span class="html-italic">p</span> &lt; 0.001.</p> Full article ">Figure 3
<p>RMS values in A-S and N-A-S under directional conditions in EO and EC conditions. A-S: athletic swimmers, N-A-S: non athletic swimmers, RMS: root mean square, S: static, DAP: dynamic anteroposterior, DML: dynamic mediolateral, EO: eyes open, EC: eyes closed. *** Significant differences between A-S and N-A-S at <span class="html-italic">p</span> &lt; 0.001.</p> Full article ">
20 pages, 517 KiB  
Systematic Review
Impact of Gluten-Free and Casein-Free Diet on Behavioural Outcomes and Quality of Life of Autistic Children and Adolescents: A Scoping Review
by Kristina Zafirovski, Mirjana Trpevska Aleksoska, Joe Thomas and Fahad Hanna
Children 2024, 11(7), 862; https://doi.org/10.3390/children11070862 - 16 Jul 2024
Viewed by 395
Abstract
Background: Gluten- and casein-containing foods could aggravate the symptoms of children and adolescents with autism spectrum disorder (ASD), and subsequently impact their quality of life. However, there is a mixed opinion among researchers concerning the impact of alternative diet on reducing ASD symptoms. [...] Read more.
Background: Gluten- and casein-containing foods could aggravate the symptoms of children and adolescents with autism spectrum disorder (ASD), and subsequently impact their quality of life. However, there is a mixed opinion among researchers concerning the impact of alternative diet on reducing ASD symptoms. Objective: This scoping review aimed at examining the impact of the “gluten-free, casein-free” (GFCF) diet on health outcomes and the quality of life among autistic children and adolescents. Methods: A scoping review of the literature was performed following the Joanna Briggs Institute (JBI) guidelines. Four databases, including EbscoHost, Medline, CINAHL, and ProQuest, were used to obtain subject-specific studies relevant to the research question and published between July 2013 and March 2024. A comprehensive search using keywords such as “autism spectrum disorder”, “gluten-free diet”, and “casein-free diet” was conducted to obtain articles related to the research focus area. Only full-text, peer-reviewed, written in English articles were selected. Data extraction and data analysis were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-extension to Scoping Review (PRISMA-ScR) protocol. Results: From the initial 586 studies, a total of 27 articles were included in the final analysis of the review. The thematic analysis included “GFCF diet and improvement of the core autistic symptoms”, “the gut–brain link”, “dietary interventions and autism”, “possible side effects due to the GCFC diet”, and “inconclusive studies and mixed opinions”. A majority of the studies showed a positive effect of the GFCF diet on a variety of autistic symptoms, including positive changes in cognitive skills, behaviour, and gastrointestinal symptoms, while some showed conflicting evidence. Conclusions: The currently available evidence on the impact of the “GFCF” diet on the quality of life of autistic children and adolescents may warrant potentially effective interventions for alleviating symptoms of autism spectrum disorders. However, this scoping review highlights the need for more research to provide more reliable evidence on the health outcomes and quality of life of ASD sufferers to guide practice. Full article
(This article belongs to the Section Pediatric Neurology & Neurodevelopmental Disorders)
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<p>PRISMA flow chart of the selection process.</p> Full article ">
16 pages, 1877 KiB  
Review
Heterogenic Genetic Background of Distal Arthrogryposis—Review of the Literature and Case Report
by Anett Illés, Henriett Pikó, Virág Bartek, Olívia Szepesi, Gábor Rudas, Zsófia Benkő, Ágnes Harmath, János Pál Kósa and Artúr Beke
Children 2024, 11(7), 861; https://doi.org/10.3390/children11070861 - 16 Jul 2024
Viewed by 252
Abstract
Distal arthrogryposis (DA) is a skeletal muscle disorder that is characterized by the presence of joint contractures in various parts of the body, particularly in the distal extremities. In this study, after a systematic review of the literature, we present a case report [...] Read more.
Distal arthrogryposis (DA) is a skeletal muscle disorder that is characterized by the presence of joint contractures in various parts of the body, particularly in the distal extremities. In this study, after a systematic review of the literature, we present a case report of a non-consanguineous family. In our case, the first-trimester ultrasound was negative, and the presence of the affected mother was not enough for the parents to consent to us performing invasive amniotic fluid sampling. The second-trimester ultrasound showed clear abnormalities suggestive of arthrogryposis. Whole-exome sequencing was performed and an autosomal dominantly inherited disease-associated gene was identified. In our case, a pathogenic variant in the TNNT3 gene c.188G>A, p.Arg63His variant was identified. The mother, who had bilateral clubfoot and hand involvement in childhood, carried the same variant. The TNNT3 gene is associated with distal arthrogryposis type 2B2, which is characterized by congenital contractures of the distal limb joints and facial dysmorphism. In the ultrasound, prominent clubfoot was identified, and the mother, who also carried the same mutation, had undergone surgeries to correct the clubfoot, but facial dysmorphism was not detected. Our study highlights the importance of proper genetic counseling, especially in an affected parent(s), and close follow-up during pregnancy. Full article
(This article belongs to the Section Pediatric Orthopedics & Sports Medicine)
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<p>Systematic literature processing.</p> Full article ">Figure 2
<p>The most common abnormalities observed in distal arthrogryposis.</p> Full article ">Figure 3
<p>Segregation analysis. Sanger sequencing data of the mutation c.188G&gt;A, p.Arg63His in the TNNT3 gene in a heterozygous state (fetus and mother) and in a normal wild state (father). Green: adenine, red: thymine, blue: cytosine, black: guanine. Yellow highlight: examined position in the sequence.</p> Full article ">Figure 4
<p>Clenched hand. Transabdominal ultrasound.</p> Full article ">Figure 5
<p>Clubfoot on the left side. Transabdominal ultrasound.</p> Full article ">
10 pages, 234 KiB  
Review
Transition to Adulthood in Pediatric Palliative Care: A Narrative Review
by Franca Benini, Laura Brogelli, Anna Mercante and Luca Giacomelli
Children 2024, 11(7), 860; https://doi.org/10.3390/children11070860 - 16 Jul 2024
Viewed by 303
Abstract
Pediatric palliative care (PPC) is defined as “the active care of the child’s body, quality of life, mind and spirit, also giving support to the family”. PPC should be established once a diagnosis of life-limiting or life-threatening disease is reached and should continue [...] Read more.
Pediatric palliative care (PPC) is defined as “the active care of the child’s body, quality of life, mind and spirit, also giving support to the family”. PPC should be established once a diagnosis of life-limiting or life-threatening disease is reached and should continue as long as necessary. Therefore, pediatric palliative care (PPC) can continue for years, also given the improved care approaches for children with life-limiting or life-threatening diseases. Over time, the child may grow to become a young adult, and when this happens, the transition to adult healthcare services must be undertaken. This article discusses possible interventions, fostering an efficient transition from pediatric to adult palliative care. A narrative review presents issues, experiences, and existing programs. A “Perspectives” section presents opinions and proposals by the authors. The transition process is not limited to a change from pediatric to adult services. Rather, it includes the entire process of the development of the child and requires interdisciplinary management with proper planning and collaboration among professionals of pediatric and adult teams. Full article
(This article belongs to the Collection Pediatric Palliative Care Update)
14 pages, 2129 KiB  
Review
A Review of Contemporary and Future Pharmacotherapy for Chronic Heart Failure in Children
by Bibhuti B. Das
Children 2024, 11(7), 859; https://doi.org/10.3390/children11070859 - 16 Jul 2024
Viewed by 285
Abstract
This review delves into the most recent therapeutic approaches for pediatric chronic heart failure (HF) as proposed by the International Society for Heart and Lung Transplantation (ISHLT), which are not yet publicly available. The guideline proposes an exhaustive overview of the evolving pharmacological [...] Read more.
This review delves into the most recent therapeutic approaches for pediatric chronic heart failure (HF) as proposed by the International Society for Heart and Lung Transplantation (ISHLT), which are not yet publicly available. The guideline proposes an exhaustive overview of the evolving pharmacological strategies that are transforming the management of HF in the pediatric population. The ISHLT guidelines recognize the scarcity of randomized clinical trials in children, leading to a predominance of consensus-based recommendations, designated as Level C evidence. This review article aims to shed light on the significant paradigm shifts in the proposed 2024 ISHLT guidelines for pediatric HF and their clinical ramifications for pediatric cardiology practitioners. Noteworthy advancements in the updated proposed guidelines include the endorsement of angiotensin receptor-neprilysin inhibitors (ARNIs), sodium-glucose cotransporter 2 inhibitors (SGLT2is), and soluble guanylate cyclase (sGC) stimulators for treating chronic HF with reduced ejection fraction (HFrEF) in children. These cutting-edge treatments show potential for enhancing outcomes in pediatric HFrEF. Nonetheless, the challenge persists in validating the efficacy of therapies proven in adult HFrEF for the pediatric cohort. Furthermore, the proposed ISHLT guidelines address the pharmacological management of chronic HF with preserved ejection fraction (HFpEF) in children, marking a significant step forward in pediatric HF care. This review also discusses the future HF drugs in the pipeline, their mechanism of actions, potential uses, and side effects. Full article
(This article belongs to the Section Pediatric Cardiology)
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<p>Pathophysiology of chronic HFrEF. ↓ Decrease, ↑ Increase. Reproduced from: Das, B.B. Children. 2018, 5(7), 88; [<a href="#B5-children-11-00859" class="html-bibr">5</a>] Creative Commons user license: <a href="https://creativecommons.org/licenses/by/4.0//" target="_blank">https://creativecommons.org/licenses/by/4.0//</a>.</p> Full article ">Figure 2
<p>Mechanism of action of SGLT2i and ARNI to improve Chronic HFrEF.</p> Full article ">Figure 3
<p>Mechanism of action of sGC stimulator (vericiguat) in HFrEF. [eNOS = endothelial nitric oxide synthetase, sGC = soluble guanylate cyclase].</p> Full article ">Figure 4
<p>Mechanism of action of new investigational drugs for HF in the pipeline. sGC, soluble guanylate cyclase; cGMP, cyclic guanylate monophosphate; SGLT-2, sodium glucose co-transporter-2; ROS, reactive oxygen species; LGR, leucine-rich repeat-containing G-protein coupled receptor; NO, nitric oxide; NFκB, nuclear factor kappa B transcription factor; cGMP, cyclic guanylate monophosphate; SERCA, sarcoplasmic/endoplasmic reticulum Ca<sup>2+</sup>-ATPase; ATP, adenosine triphosphate; VEGF, vascular endothelial growth factor; ET, endothelin receptors; TGF, transforming growth factor; PKG, protein kinase G.</p> Full article ">Figure 5
<p>Newer drugs for HFpEF in the pipeline with their mechanism of action. TNF-α = tumor necrosis factor-α; IL-6 = interleukin-6; IL-1β = interleukin-1β; sST2 = soluble ST2 (receptor for IL-1 and 33); cGMP = cyclic guanosine monophosphate; PKG = protein kinase G; SNS = sympathetic nervous system.</p> Full article ">
11 pages, 720 KiB  
Article
Paediatric Post-Traumatic Stress Risk for Young People and Parents following Acute Admission for Paediatric Multisystem Inflammatory Syndrome: Retrospective Analysis of Psychological Screening and Support
by Anita Freeman, Emily Golding, Jennifer Gardner and Zoe Berger
Children 2024, 11(7), 858; https://doi.org/10.3390/children11070858 - 15 Jul 2024
Viewed by 386
Abstract
Background: Paediatric Multisystem Inflammatory Syndrome (PIMS-TS) is a novel condition that was identified for the first time during the COVID-19 pandemic. Limited research exists that describes the psychological needs of children and young people (CYP) following an acute hospital admission for PIMS-TS. Methods: [...] Read more.
Background: Paediatric Multisystem Inflammatory Syndrome (PIMS-TS) is a novel condition that was identified for the first time during the COVID-19 pandemic. Limited research exists that describes the psychological needs of children and young people (CYP) following an acute hospital admission for PIMS-TS. Methods: A retrospective cohort study was conducted to explore both psychological need and access to psychology services for CYP and their families who were admitted to a paediatric tertiary hospital in London, UK, for PIMS-TS between April 2020 and May 2021. Results: We included 121 CYP and a parent/caregiver for each. In total, 23.3% of the CYP were at risk of developing a traumatic stress response and 11.6% were at risk of experiencing emotional disturbance. Of the parents screened, 40.5% also scored above clinical cut-off for a trauma response. There was a significant relationship observed between CYP and parents identified as having a trauma risk. Conclusions: The importance of proactive screening for both trauma and emotional distress in CYP and their parents/caregivers following acute hospital admission is highlighted. In addition, there is a need to think about a CYP as part of a system of care and to ensure that clinicians pay attention to parental wellbeing and mental health when understanding the psychological impact on a child. Full article
(This article belongs to the Special Issue Medical Trauma in Children)
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<p>Typical patient pathways for PIMS-TS paediatric patients.</p> Full article ">Figure 2
<p>Ethnicity of CYP as self-identified and recorded in patient records.</p> Full article ">Figure 3
<p>Percentage of PIMS-TS patient population referred to psychology by Global Majority ethnic background and White/European categories.</p> Full article ">
12 pages, 1315 KiB  
Article
Poor Eating Habits and Low Physical Activity Contribute to Weight Excess and Increase Cardiometabolic Risk in Adolescents Practicing Soccer as a Recreational Sport
by Ikram Bezrati, Raouf Hammami, Halil İbrahim Ceylan, Karuppasamy Govindasamy, Mohamed K. Ben Fradj, Moncef Feki, Abderraouf Ben Mansour and Koulla Parpa
Children 2024, 11(7), 857; https://doi.org/10.3390/children11070857 - 15 Jul 2024
Viewed by 496
Abstract
Background: Monitoring anthropometry, dietary intake, and physical activity (PA) is essential to prevent/counteract childhood obesity. This study examined dietary intake, PA, and anthropometric characteristics in young boys practicing soccer as a recreational sport. Methods: A cross-sectional study included 226 boys aged 8 to [...] Read more.
Background: Monitoring anthropometry, dietary intake, and physical activity (PA) is essential to prevent/counteract childhood obesity. This study examined dietary intake, PA, and anthropometric characteristics in young boys practicing soccer as a recreational sport. Methods: A cross-sectional study included 226 boys aged 8 to 13 years participating in soccer as a recreational activity in football academies located in Tunis, Tunisia. Anthropometric measures allowed the calculation of body mass index, fat mass, and peak height velocity as markers of biological maturity. A three-day food record and a food frequency questionnaire estimated nutrient intake and eating habits. The International Physical Activity Questionnaire (IPAQ) was used to estimate the PA level of the participants. Results: It was found that a high percentage of the children had excess weight (54%) and excess fat mass (47%). The total energy, carbohydrate, and saturated fat intake of the children exceeded the recommended levels by approximately 10%, 15%, and 30%, respectively. However, the intake of unsaturated fat was below the estimated requirements, particularly in obese children. In addition to the unbalanced macronutrient intake, the children also showed an insufficient intake of many essential micronutrients. Around 60% to 70% of the children in all three groups had a low intake of magnesium, n-3 polyunsaturated fatty acids (PUFA), and vitamins B9, B12, and D. Moreover, 20% to 35% of the children in the three groups had an insufficient intake of vitamins A and C. Insufficient vitamin E intake was found in 63% of obese children and 35% of non-obese children. It was observed that the PA level was lower in the overweight/obese group compared to the normal-weight group (p < 0.005). More than three-quarters of overweight/obese children had low PA levels, about 20% were moderately active, and only 1 to 2% were highly active. Conversely, normal-weight children showed moderate to high PA levels. Conclusions: Poor eating behavior, an unbalanced diet, and a low PA level are prevalent in Tunisian boys practicing recreational sports. Such a combination is responsible for a disparity between energy intake and expenditure, contributing to weight excess and increased cardiometabolic risk. The study findings provide meaningful information for practitioners and authorities on applying a balanced diet and adequate PA to prevent and fight against obesity and improve cardiometabolic health in youth. Full article
(This article belongs to the Special Issue Preschool Children Health Promotion: Physical Activity and Nutrition Intervention)
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Full article ">Figure 1
<p>Percentage of difference in energy/macronutrients dietary intakes and estimated needs among children according to body composition. Notes: MUFA, monounsaturated fatty acids; NWG, normal-weight group; OBG, obese group; OWG, overweight group; PUFA, polyunsaturated fatty acids; SFA, saturated fatty acids.</p> Full article ">Figure 2
<p>Selected micronutrient deficiency rates in children according to body composition. Notes: NWG, normal-weight group; OBG, obese group; OWG, overweight group; PUFA, polyunsaturated fatty acids.</p> Full article ">Figure 3
<p>Frequency of consumption of food categories per week in overweight/obese children.</p> Full article ">Figure 4
<p>Distribution of PA score in children according to body composition. Notes: HPA, high PA; LPA, low PA; MPA, moderate PA; NWG, normal-weight group; OBG, obese group; OWG, overweight group. ***: <span class="html-italic">p</span> &lt; 0.001, NS: <span class="html-italic">p</span> &gt; 0.05.</p> Full article ">
17 pages, 703 KiB  
Article
Examination of the Life Habits of Preschool Children Based on Their Screen Use Patterns
by Tuğba Yazıcı Çakıroğlu and Özkan Sapsağlam
Children 2024, 11(7), 856; https://doi.org/10.3390/children11070856 - 14 Jul 2024
Viewed by 289
Abstract
Children who open their eyes to a digital world begin interacting with screens in the early years of life. The interaction between screens and children starts from the very first moments of life and intensifies over time. The aim of this study is [...] Read more.
Children who open their eyes to a digital world begin interacting with screens in the early years of life. The interaction between screens and children starts from the very first moments of life and intensifies over time. The aim of this study is to examine the effects of screen use patterns on the life habits of preschool children. In this context, the relationships between problematic media use, eating habits, and self-care skills among preschool children are analyzed from various perspectives. Structured according to a mixed-methods research approach, this study employs both qualitative and quantitative research designs. The study group consists of 582 children continuing their education in preschool institutions across seven different regions and nine different provinces in Turkey, along with 20 of their parents. Random and non-random sampling methods were used to form the study group. Quantitative data were collected using the Problematic Media Use Measure, Children’s Eating Behavior Inventory, and Preschool Children (36–72 months) Self-Care Skills Scale—Teacher Form, while qualitative data were gathered through a semi-structured parent interview form. The study results indicate that problematic media use and eating behaviors significantly vary according to the screen time of children, with an increase in problematic media use linked to a rise in negative eating behaviors. Parents are found to perceive the use of media devices during mealtime as a necessity, thus employing them, and believe that their children’s social behaviors are shaped according to screen content. Full article
(This article belongs to the Special Issue Screen Time, Adverse Childhood Experiences and Childhood Mental Health on Child and Adolescent Development: Current Research and Future Directions)
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<p>The research process, method, and important results.</p> Full article ">
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