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Children, Volume 10, Issue 7 (July 2023) – 186 articles

Cover Story (view full-size image): Pediatric palliative care aims to improve children's quality of life, but this outcome is rarely measured in clinical care. In Belgium, pediatric palliative care is provided through six transmural mobile liaison teams, ensuring continuity of care. This study aims to measure the quality of life of children with life-limiting conditions followed up by liaison teams and the quality of life of their parents. Seventy-three children aged 1–18 were included in this national cross-sectional study. Especially for items focusing on emotional topics, children reported their quality of life as higher than their parents did. The quality-of-life scores were not significantly associated with the child's condition's severity. This study provides, for the first time, an overview of the quality of life of children and parents followed up by specialized pediatric palliative care teams in Belgium. View this paper
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10 pages, 535 KiB  
Article
Computed Tomography Utilization in the Management of Children with Mild Head Trauma
by Ernest Leva, Minh-Tu Do, Rachael Grieco and Anna Petrova
Children 2023, 10(7), 1274; https://doi.org/10.3390/children10071274 - 24 Jul 2023
Viewed by 872
Abstract
This study demonstrates the trend of computed tomography (CT) usage for children with mild traumatic brain injury (mTBI) in the context of the initiation of the Safe CT Imaging Collaborative Initiative to promote the Pediatric Emergency Care Applied Research Network (PECARN) rules at [...] Read more.
This study demonstrates the trend of computed tomography (CT) usage for children with mild traumatic brain injury (mTBI) in the context of the initiation of the Safe CT Imaging Collaborative Initiative to promote the Pediatric Emergency Care Applied Research Network (PECARN) rules at the acute care hospitals in New Jersey. We used administrative databases of 10 children’s and 59 general hospitals to compare CT rates before 2014–2015, during 2016, and after the initiation of the program (2017–2019). The CT usage rates at baseline and the end of surveillance in children’s hospitals (19.2% and 14.2%) were lower than in general hospitals (36.7% and 21.0%), p < 0.0001. The absolute mean difference from baseline to the end of surveillance in children’s hospitals was 5.1% compared to a high of 9.7% in general hospitals, medium-high with 13.2%, and 14.0% in a medium volume of pediatric patients (p < 0.001–0.0001). The time-series model demonstrates a positive trend of CT reduction in pediatric patients with mTBI within four years of the program’s implementation (p < 0.03–0.001). The primary CT reduction was recorded during the year of program implementation. Regression analysis revealed the significant role of a baseline CT usage rate in predicting the level of CT reduction independent of the volume of pediatric patients and type of hospital. Full article
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10 pages, 269 KiB  
Brief Report
Latent Transitions of Learning Interests among Kindergarteners in Hakka Bilingual Teaching Programs
by Chung-Chin Wu
Children 2023, 10(7), 1273; https://doi.org/10.3390/children10071273 - 24 Jul 2023
Viewed by 795
Abstract
The profiles of kindergarteners’ learning interests in Hakka bilingual teaching programs are unclear and the effects of these programs on the transition of such interests over the long term are under investigation. This study analyzed the learning interest profiles of 112 kindergarteners (data [...] Read more.
The profiles of kindergarteners’ learning interests in Hakka bilingual teaching programs are unclear and the effects of these programs on the transition of such interests over the long term are under investigation. This study analyzed the learning interest profiles of 112 kindergarteners (data gathered by kindergarten teachers) enrolled in immersion/non-immersion Hakka bilingual programs in Taiwan. Latent transitions in these profiles were analyzed based on pre- and post-implementation data. The results showed that two different subgroups were identified based on the kindergarteners’ learning interest profiles before and after the implementation of the Hakka bilingual program. The pre-implementation subgroups contained the “moderate situational and low-to-moderate individual interest” and the “high situational and moderate-to-high individual interest” profiles. Post-implementation subgroups consisting of “moderate-to-high situational and moderate individual interest” and “high situational and individual interest” profiles were identified. Moreover, four patterns of transition in the kindergarteners’ learning interest profiles were uncovered: (1) a slight increase in both learning interests, (2) a significant increase in both learning interests, (3) a slight regression in both, and (4) a maintenance of situational interest coupled with a slight increase in individual interest. Lastly, the non-immersion Hakka program showed significant and more positive effects on the “moderate situational and low-to-moderate individual interest” profile subgroup compared to the equivalent group from the Hakka immersion program. These results provide new evidence complementing previous findings reached via different analytical approaches and contribute to the overall conclusion that bilingual programs improve learning outcomes. Full article
15 pages, 2462 KiB  
Article
The Price of Success—The Long-Term Outcomes of Children with Craniopharyngioma—Two Institutions’ Experience
by Aleksandra Napieralska, Marek Mandera, Ryszard Sordyl, Aleksandra Antosz, Barbara Bekman and Sławomir Blamek
Children 2023, 10(7), 1272; https://doi.org/10.3390/children10071272 - 24 Jul 2023
Viewed by 1241
Abstract
An analysis of patients below 21 years old treated due to craniopharyngioma in the years 1979–2022 was performed with the aim of evaluating the long-term outcome and treatment side-effects. The standard statistical tests were used, and 56 patients with a median age of [...] Read more.
An analysis of patients below 21 years old treated due to craniopharyngioma in the years 1979–2022 was performed with the aim of evaluating the long-term outcome and treatment side-effects. The standard statistical tests were used, and 56 patients with a median age of 11 years were evaluated. Surgery was the primary treatment in 55 patients; however, in only 29 it was the only neurosurgical intervention. Eighteen children were treated with radiotherapy (RTH) in primary treatment. The most common neurosurgical side effects observed were visual and endocrine deficits and obesity, which were diagnosed in 27 (49%), 50 (91%), and 25 (52%) patients, respectively. Complications after RTH were diagnosed in 14 cases (32%). During the median follow-up of 8.4 years (range: 0.4–39.8 years), six patients died and the 5- and 10-year overall survival was 97% and 93%, respectively. Five-year progression-free survival for gross total resection, resection with adjuvant RTH, and non-radical resection alone was 83%, 68%, and 23%, respectively (p = 0.0006). Surgery combined with RTH provides comparable results to gross tumor resection in terms of oncologic outcome in craniopharyngioma patients. Adjuvant irradiation applied in primary or salvage treatment improves disease control. The rate of complications is high irrespective of improved surgical and radiotherapeutic management. Full article
(This article belongs to the Special Issue Advances in Endocrine Pediatric Oncology)
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10 pages, 1641 KiB  
Article
Household Wealth Gradient in Low Birthweight in India: A Cross-Sectional Analysis
by Bishwajit Ghose
Children 2023, 10(7), 1271; https://doi.org/10.3390/children10071271 - 24 Jul 2023
Viewed by 935
Abstract
A low birthweight is a common complication that can result from numerous physiological, environmental, and socioeconomic factors, and can put babies at an increased risk for health issues such as breathing difficulties, developmental delays, and even death in severe cases. In this analysis, [...] Read more.
A low birthweight is a common complication that can result from numerous physiological, environmental, and socioeconomic factors, and can put babies at an increased risk for health issues such as breathing difficulties, developmental delays, and even death in severe cases. In this analysis, I aim to assess the differences in the burden of low birthweight based on household wealth status in India using data from the latest National Family Health Survey (NFHS 2019–21). The sample population includes 161,596 mother–child dyads. A low birthweight is defined as a weight that is <2500 g at birth. I used descriptive and multivariate regression analyses in R studio to analyse the data. The findings show that 16.86% of the babies had a low birthweight. At the state level, the percentage of low birthweights ranges from 3.85% in Nagaland to 21.81% in Punjab. The mean birthweights range from 2759.68 g in the poorest, 2808.01 g in the poorer, 2838.17 g in the middle, 2855.06 g in the richer, and 2871.30 g in the richest wealth quintile households. The regression analysis indicates that higher wealth index quintiles have progressively lower risks of low birthweight, with the association being stronger in the rural areas. Compared with the poorest wealth quintile households, the risk ratio of low birthweight was 0.90 times lower for the poorer households and 0.74 times lower for the richest households. These findings indicate that household wealth condition is an important predictor of low birthweight by which low-income households are disproportionately affected. As wealth inequality continues to rise in India, health policymakers must take the necessary measures to support the vulnerable populations in order to improve maternal and infant health outcomes. Full article
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2 pages, 168 KiB  
Editorial
A Psycho-Dynamically Oriented Reflection on Early Sexual Relationships in Pre-Adolescents
by Luca Cerniglia and Silvia Cimino
Children 2023, 10(7), 1270; https://doi.org/10.3390/children10071270 - 23 Jul 2023
Viewed by 741
Abstract
Pre-adolescence is generally considered a period of change during which sexual energy remains latent before gradually beginning to express itself in adolescence and later in life [...] Full article
(This article belongs to the Section Child and Adolescent Psychiatry)
12 pages, 592 KiB  
Article
Psychological Well-Being and Mental Health in Youth: Technical Adequacy of the Comprehensive Inventory of Thriving
by Gökmen Arslan
Children 2023, 10(7), 1269; https://doi.org/10.3390/children10071269 - 23 Jul 2023
Cited by 2 | Viewed by 4202
Abstract
Well-being is a crucial construct in young people’s lives that directly affects their overall quality of life, academic performance, and social relationships. Although there is an emphasis on the significance of positive psychological states in mental health, few have focused on positive states, [...] Read more.
Well-being is a crucial construct in young people’s lives that directly affects their overall quality of life, academic performance, and social relationships. Although there is an emphasis on the significance of positive psychological states in mental health, few have focused on positive states, and psychological well-being is often conceptualized using negative indicators of mental health. The present study aims to fill the gap in the literature by testing the reliability and validity of the Turkish version of the Comprehensive Inventory of Thriving for Youth (CIT-Y) and exploring the relationship between psychological well-being and mental health problems among Turkish young people. The study involved 459 youths from a state elementary school in a city in Türkiye, with 48.8% (224 females and 235 males) of them being female and aged between 11 and 15 years (M = 12.85, SD = 0.73). Findings from the study suggest that the CIT-Y is a reliable and valid measure for assessing psychological well-being in Turkish young people. Additionally, the results show that young people with internalizing and externalizing problems report fewer positive psychological states compared to those without such problems. This emphasizes the significance of well-being domains, including loneliness and respect, in comprehending mental health issues among young people. These findings can aid mental health providers in designing interventions to enhance the psychosocial adjustment of students by providing resources to cultivate mental health and well-being. Full article
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17 pages, 645 KiB  
Article
Nutritional Value of Meals Designed for a School-Based Food Aid Program and Comparison with Similar Commercial Products: An Example of Good Practice from the DIATROFI Program
by Matina Kouvari, Dimitrios V. Diamantis, Konstantinos Katsas, Vasiliki Radaios, Afroditi Veloudaki and Athena Linos
Children 2023, 10(7), 1268; https://doi.org/10.3390/children10071268 - 23 Jul 2023
Viewed by 1294
Abstract
Providing meals of high nutritional value should be the principal objective of large-scale school-based food aid programs. This study aimed at highlighting the nutritional value of meals distributed in the school-based food assistance DIATROFI Program by comparing them to their commercially available counterparts. [...] Read more.
Providing meals of high nutritional value should be the principal objective of large-scale school-based food aid programs. This study aimed at highlighting the nutritional value of meals distributed in the school-based food assistance DIATROFI Program by comparing them to their commercially available counterparts. For the purpose of this study, n = 13 DIATROFI meals and n = 50 commercial products from the 2016–2017 school year, and n = 12 DIATROFI meals and n = 40 commercial products from the 2022–2023 school year were selected. The protein, carbohydrate, total sugar, dietary fiber, total fat, sodium/salt content, and fatty acid methyl ester profile of DIATROFI meals were estimated through recipe simulation and national/international food databases, and verified through laboratory analyses while the relevant information was extracted from the label for commercial products. As verified by laboratory analyses and in comparison with food labels, most DIATROFI meals had lower total fat, saturated fatty acid, and sugar content, and most had higher dietary fiber content during both years. Many recipes’ nutrient profiles also improved over time. DIATROFI meals present significant advantages over available commercial products. Such tailored-made school meals can prove to be advantageous in terms of nutrition profile compared to commercially available, which have yet to be impacted by food reformulation. Full article
(This article belongs to the Special Issue Nutrition to Improve Child and Adolescent Health)
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13 pages, 1394 KiB  
Article
Human Milk Feeding Is Associated with Decreased Incidence of Moderate-Severe Bronchopulmonary Dysplasia in Extremely Preterm Infants
by Sergio Verd, Roser Porta, Gemma Ginovart, Alejandro Avila-Alvarez, Fermín García-Muñoz Rodrigo, Montserrat Izquierdo Renau and Paula Sol Ventura
Children 2023, 10(7), 1267; https://doi.org/10.3390/children10071267 - 23 Jul 2023
Viewed by 1628
Abstract
Background: An increased rate of bronchopulmonary dysplasia (BPD) is reported in extremely preterm infants. A potential role of human milk feeding in protecting against this condition has been suggested. Methods: A retrospective descriptive study was conducted based on data about morbidity in the [...] Read more.
Background: An increased rate of bronchopulmonary dysplasia (BPD) is reported in extremely preterm infants. A potential role of human milk feeding in protecting against this condition has been suggested. Methods: A retrospective descriptive study was conducted based on data about morbidity in the population of infants born between 22+0 and 26+6 weeks of gestation, included in the Spanish network SEN1500 during the period 2004–2019 and discharged alive. The primary outcome was moderate-severe BPD. Associated conditions were studied, including human milk feeding at discharge. The temporal trends of BPD and human milk feeding rates at discharge were also studied. Results: In the study population of 4341 infants, the rate of moderate-severe BPD was 43.7% and it increased to >50% in the last three years. The factors significantly associated with a higher risk of moderate-severe BPD were birth weight, male sex, high-frequency oscillatory ventilation, duration of invasive mechanical ventilation, inhaled nitric oxide, patent ductus arteriosus, and late-onset sepsis. Exclusive human milk feeding and any amount of human milk at discharge were associated with a lower incidence of moderate-severe BPD (OR 0.752, 95% CI 0.629–0.901 and OR 0.714, 95% CI 0.602–0.847, respectively). During the study period, the proportion of infants with moderate-severe BPD fed any amount of human milk at discharge increased more than twofold. And the proportion of infants with moderate-severe BPD who were exclusively fed human milk at discharge increased at the same rate. Conclusions: Our work shows an inverse relationship between human milk feeding at discharge from the neonatal unit and the occurrence of BPD. Full article
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20 pages, 904 KiB  
Article
Knowledge and Attitudes around First Aid and Basic Life Support of Kindergarten and Elementary School Teachers and Parents in Taif City, Saudi Arabia
by Shadi Tamur, Raghad Mousa Alasmari, Matooqa Abdulkareem Alnemari, Manar Abdullah Altowairgi, Atheer Hammad Altowairqi, Nouf Mohammed Alshamrani, Maryam Aljaid, Sultan Al-Malki, Abdullah Khayat, Ahmad Alzahrani and Anwar Shams
Children 2023, 10(7), 1266; https://doi.org/10.3390/children10071266 - 22 Jul 2023
Cited by 1 | Viewed by 3773
Abstract
Background: The foremost cause of children’s (1–19 year) death is inadvertent injuries. While most of these accidental harms occur at home and school, rapid and suitable parental and teacher intervention is required to increase the chances of a child’s survival. Therefore, both parents [...] Read more.
Background: The foremost cause of children’s (1–19 year) death is inadvertent injuries. While most of these accidental harms occur at home and school, rapid and suitable parental and teacher intervention is required to increase the chances of a child’s survival. Therefore, both parents and teachers of the children in kindergarten and elementary school must be knowledgeable in first aid practice and basic life support (BLS) training. Objectives: In the current study, our ambition is to evaluate the orientation level, knowledge, and attitudes around first aid and BLS training of kindergarten and elementary school teachers and parents in the city of Taif, Makkah region. Methods: A cross-sectional study in Taif, Saudi Arabia, targeted kindergarten and elementary school teachers and parents of students enrolled at these levels. There were 648 participants included in this study. The researchers assessed teachers’ and parents’ knowledge and attitudes around first aid and BLS using a validated, self-administered online questionnaire. Results: The study included 648 participants, including 248 (38.3%) teachers and 400 (61.7%) parents. The socio-demographic analysis showed that 412 (63.6%) are females and 233 (36.5%) are between the ages of 36 and 45 years. Approximately 142 (21.9%) participants reported previous training in the cardiopulmonary resuscitation (CPR) program, though more than half of them (53.5%) had outdated certificates (more than 2 years). The mean total knowledge for our study was 4.6 ± 1.4, with 22.4% of the participants being educated about first aid support and expressing a fair level of CPR foundations. Only a small percentage (2.3%) of the participants exposed a good and adequate theoretical level of knowledge around CPR skills and performance, while most of the contributors unveiled a poor level of knowledge (over 75%). There were no statistically significant differences between parents and teachers (p > 0.05). Finally, numerous participants (85%) appreciated training in the CPR program, and the most common motive was a “wish to avoid unnecessary death”. Conclusions: We concluded that a sizable portion of the contributors expressed a lack of proficiency in the fundamental CPR training knowledge and skills, pointing to an alarming public concern. Promisingly, a sizable percentage of participants expressed motivated attitudes toward CPR training. Therefore, additional study and data are required to effectively combat injury, with an emphasis on investigating causes and risk factors, burden and socioeconomic health determinants, community awareness level and desire to contribute, and accessibility for disseminating specific intervention strategies. Full article
(This article belongs to the Section Global and Public Health)
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12 pages, 271 KiB  
Article
Obstructive Sleep Apnea in Developmental Age: 22-Item Pediatric Sleep Questionnaire for an Observational Descriptive Investigation
by Francesca Cremonini, Ludovica Zucchini, Federica Pellitteri, Mario Palone and Luca Lombardo
Children 2023, 10(7), 1265; https://doi.org/10.3390/children10071265 - 22 Jul 2023
Cited by 1 | Viewed by 1310
Abstract
The aim of this paper is to perform an observational descriptive study of the Obstructive Sleep Apnea Syndrome (OSAS) in a population of children by evaluating the prevalence and role of sex and age variables. The 22-item Pediatric Sleep Questionnaire (PSQ) was administered [...] Read more.
The aim of this paper is to perform an observational descriptive study of the Obstructive Sleep Apnea Syndrome (OSAS) in a population of children by evaluating the prevalence and role of sex and age variables. The 22-item Pediatric Sleep Questionnaire (PSQ) was administered to parents of children aged 3 to 12 years. The questionnaire is a very simple tool since it allows for the indication of patients with possible OSAS diagnosis through a cut-off of 0.33. The anonymous diagnostic questionnaire, available in digital format, was administered to the population under study by a link or QR code. Only the questionnaires completed in all their parts were recorded and analyzed. Eight hundred and thirty-two questionnaires were collected. One hundred and fifty-four subjects obtained a PSQ score > 0.33 and the prevalence of OSAS was 18.51%. The Chi-square test showed a statistically significant association between the PSQ score > 0.33 and male sex. The higher prevalence of subjects with a value of PSQ > 0.33 (n = 277) are aged 3–4–5 years, followed by the 6–7–8 range in the group with PSQ score > 0.33, p < 0.05. The prevalence of OSAS was 18.51% in children aged 3 to 12 years. The variables male biological sex and the age group 3–8 year were statistically significant for subjects with OSAS diagnosis. This study underlines the use of the 22-item Pediatric Sleep Questionnaire as a first screening tool to identify children at risk of OSAS. Full article
12 pages, 523 KiB  
Article
Depression Disorders in Mexican Adolescents: A Predictive Model
by Gilda Gómez-Peresmitré and Romana Silvia Platas-Acevedo
Children 2023, 10(7), 1264; https://doi.org/10.3390/children10071264 - 22 Jul 2023
Cited by 1 | Viewed by 1090
Abstract
Depression is a type of mood disorder that can impact individuals of any age. A variety of factors, including biological, psychological, and environmental factors, can contribute to the likelihood of developing depression. If the environment in which a person exists does not support [...] Read more.
Depression is a type of mood disorder that can impact individuals of any age. A variety of factors, including biological, psychological, and environmental factors, can contribute to the likelihood of developing depression. If the environment in which a person exists does not support its occurrence, the disorder may not manifest. The current research follows a retrospective, correlational approach, utilizing a non-probability sample of 557 high school students from public schools in Mexico City. This sample includes 181 males and 376 females, aged between 15 and 18 years, with an average age of 15.66 and a standard deviation of 0.68. The main objective of this research is to identify the variables that serve as risk factors for the development of depressive disorders in Mexican adolescents in high school. The data show that 78% of the adolescents in the total sample were at risk of depression, which is consistent with what has been reported by other researchers. The regression model shows that alcohol and drug consumption is associated with and influences the emergence and presence of depressive symptomatology and major depressive disorder. Adolescents with different sexual orientations than heterosexuals are twice as likely to suffer depression and emotional dysregulation. It was confirmed that the developmental stage and adolescence contributes as a context that favors the evolution of such a symptomatology. Full article
(This article belongs to the Special Issue Depression, Anxiety and Stress in Children and Adolescents)
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13 pages, 986 KiB  
Article
Body Image and Lifestyle Behaviors in High School Adolescents
by Manon Bordeleau, Natalie Alméras, Shirin Panahi and Vicky Drapeau
Children 2023, 10(7), 1263; https://doi.org/10.3390/children10071263 - 22 Jul 2023
Viewed by 1290
Abstract
This secondary data analysis study aimed to examine the associations between 1) body size perception (BSP) and body size dissatisfaction (BSD) and 2) lifestyle behaviors and BSP and BSD in adolescents. The study pooled cross-sectional data from two studies (n = 301) [...] Read more.
This secondary data analysis study aimed to examine the associations between 1) body size perception (BSP) and body size dissatisfaction (BSD) and 2) lifestyle behaviors and BSP and BSD in adolescents. The study pooled cross-sectional data from two studies (n = 301) performed in adolescents. Weight and height were measured, while lifestyle behaviors and perceived actual and desired body size variables were self-reported. Linear regression analysis assessed the contribution of sex and zBMI to BSP and BSD scores. Pearson’s correlation explored associations between BSP and BSD. Cohen’s effect sizes compared satisfied and dissatisfied adolescents within the underestimators subgroup. A positive association between BSP and BSD scores was observed among girls living with normal-weight and overweight/obesity only (r = 0.26; p ≤ 0.001 and r = 0.38; p < 0.05, respectively). Underestimators who were satisfied with their body size showed a moderate effect size for a lower zBMI, a small effect size for lower screen time, and higher sleep duration compared to dissatisfied underestimators. Underestimation was associated with more body size satisfaction in adolescent girls with normal weight and overweight/obesity, suggesting a protective effect of underestimation. These findings support the hypothesis that body size satisfaction and underestimation in adolescents is associated with healthier lifestyle behaviors. Full article
(This article belongs to the Special Issue Physical Activity and Lifestyle Habits in Children and Adolescents)
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13 pages, 7310 KiB  
Case Report
Pediatric Cervicofacial Necrotizing Fasciitis—A Challenge for a Medical Team
by Adina Simona Coșarcă, Dániel Száva, Bálint Bögözi, Alina Iacob, Anca Frățilă and Guzun Sergiu
Children 2023, 10(7), 1262; https://doi.org/10.3390/children10071262 - 22 Jul 2023
Viewed by 1182
Abstract
Cervical necrotizing fasciitis is a very rare complication of a bacterial infection that can have a dental cause. This type of infection typically affects fascial plane, which has a poor blood supply and can affect soft tissue and cervical fascia and can spread [...] Read more.
Cervical necrotizing fasciitis is a very rare complication of a bacterial infection that can have a dental cause. This type of infection typically affects fascial plane, which has a poor blood supply and can affect soft tissue and cervical fascia and can spread quickly causing infection of mediastinum. Initially, in the first stage, the overlying tissues are unaffected, and this can delay diagnosis and surgical intervention. Incidence in children is extremely rare and can be frequently associated with various other general pathologies that decrease the immune system response. We present a case of a young 12-year-old boy diagnosed with this type of infection in the head and neck as a complication of a second inferior molar pericoronitis. The treatment and the management of the case was difficult not only due to the presence of the infection but also because of the prolonged intubation. Full article
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11 pages, 273 KiB  
Article
Assessment of Diet Quality in Children and Adolescents with Overweight or Obesity in Greece
by Odysseas Androutsos, Thomas Tsiampalis, Matina Kouvari, Maria Manou, Maria Dimopoulou, Alexandra Georgiou, Rena I. Kosti and Evangelia Charmandari
Children 2023, 10(7), 1261; https://doi.org/10.3390/children10071261 - 22 Jul 2023
Viewed by 1424
Abstract
The adoption of healthy nutritional habits constitutes one of the most important determinants of healthy growth and development in childhood. Few studies in Greece have examined children’s diet quality using diet indices. The present study aimed to assess the diet quality of a [...] Read more.
The adoption of healthy nutritional habits constitutes one of the most important determinants of healthy growth and development in childhood. Few studies in Greece have examined children’s diet quality using diet indices. The present study aimed to assess the diet quality of a large cohort of children and adolescents with overweight or obesity. Study participants (n = 1335), aged 2–18, were recruited through the Out-patient Clinic for the Prevention and Management of Overweight and Obesity in Childhood and Adolescence, Aghia Sophia Children’s Hospital, Athens, Greece. Anthropometric, socio-demographic, and behavioral data were collected using standard methods and equipment. The Diet Quality Index (DQI), which includes four subcomponents (i.e., dietary diversity, dietary quality, dietary equilibrium, and meal index), was calculated to assess each subject’s diet quality. According to the results of this study, children’s total DQI score was 63.1%. It was observed that 66.7% of the children had at least moderate diet quality (total DQI ≥ 59.34%). Boys had higher values of the total DQI and certain components of the DQI (i.e., dietary equilibrium score and meal index) compared to girls. Three out of ten children with overweight/obesity had poor diet quality (i.e., DQI ≤ 59.33). Younger children (2–5 years old) were found to have the lowest values of dietary equilibrium compared to older children (6–9 and 12–18 years old). Moreover, boys had higher values of the total DQI score and of specific components of this index (i.e., dietary equilibrium and meal index) compared to girls. Children living in urban areas had higher values in the dietary quality score compared to those living in rural areas. Children with overweight had higher values of the dietary quality score and the total DQI score compared to children with obesity. The present study highlighted that children and adolescents with overweight or obesity have poor diet quality. Multilevel and higher intensity interventions should be designed specifically for this group to achieve tangible outcomes. Full article
(This article belongs to the Section Global and Public Health)
12 pages, 3844 KiB  
Brief Report
Early Gut Microbiota Profile in Healthy Neonates: Microbiome Analysis of the First-Pass Meconium Using Next-Generation Sequencing Technology
by Yi-Sheng Chang, Chang-Wei Li, Ling Chen, Xing-An Wang, Maw-Sheng Lee and Yu-Hua Chao
Children 2023, 10(7), 1260; https://doi.org/10.3390/children10071260 - 22 Jul 2023
Cited by 2 | Viewed by 1235
Abstract
Gut microbiome development during early life has significant long-term effects on health later in life. The first-pass meconium is not sterile, and it is important to know the initial founder of the subsequent gut microbiome. However, there is limited data on the microbiota [...] Read more.
Gut microbiome development during early life has significant long-term effects on health later in life. The first-pass meconium is not sterile, and it is important to know the initial founder of the subsequent gut microbiome. However, there is limited data on the microbiota profile of the first-pass meconium in healthy neonates. To determine the early gut microbiota profile, we analyzed 39 samples of the first-pass meconium from healthy neonates using 16S rRNA sequencing. Our results showed a similar profile of the microbiota composition in the first-pass meconium samples. Pseudomonas was the most abundant genus in most samples. The evenness of the microbial communities in the first-pass meconium was extremely poor, and the average Shannon diversity index was 1.31. An analysis of the relationship between perinatal characteristics and the meconium microbiome revealed that primigravidae babies had a significantly higher Shannon diversity index (p = 0.041), and the Bacteroidales order was a biomarker for the first-pass meconium of these neonates. The Shannon diversity index was not affected by the mode of delivery, maternal intrapartum antibiotic treatment, prolonged rupture of membranes, or birth weight. Our study extends previous research with further characterization of the gut microbiome in very early life. Full article
(This article belongs to the Special Issue Nutrition, Gut Microbiota and Pediatric Health)
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12 pages, 316 KiB  
Article
Anthropometric Indicators and Dietary Intake in Toddlers Aged from 12 to 24 Months Who Attended Private Clinics in the Metropolitan Area of Guadalajara
by Citlalli Álvarez-Zaragoza, Edgar M. Vásquez-Garibay, Carmen Alicia Sánchez Ramírez and Alfredo Larrosa Haro
Children 2023, 10(7), 1259; https://doi.org/10.3390/children10071259 - 21 Jul 2023
Viewed by 1047
Abstract
The objective was to evaluate the anthropometric indicators and dietary intake of toddlers attending private clinics in Guadalajara. In a cross-sectional study, 101 toddlers aged 12 to 24 months were included. They were born full term, had an adequate weight for gestational age, [...] Read more.
The objective was to evaluate the anthropometric indicators and dietary intake of toddlers attending private clinics in Guadalajara. In a cross-sectional study, 101 toddlers aged 12 to 24 months were included. They were born full term, had an adequate weight for gestational age, and attended private clinics in Guadalajara. Two 24 h dietary recalls were administered. Anthropometric measurements were taken, and anthropometric indices were estimated. Student’s t test or the Mann–Whitney U test, chi-square test, and odds ratio were used for quantitative or qualitative variables. Males had lower Z scores for the weight/age index than females. During the week, energy intake was excessive in males [OR = 5.5 (95% CI 1.4, 20.8)], and cholesterol intake was insufficient in females [OR = 3.03 (95% CI 1.2, 7.1)]. On weekends, energy [OR = 2.5 (95% CI 1.1, 5.7)] and fiber intake [OR = 3.1 (95% CI 1.2, 7.8)] were insufficient in females. Most of the toddlers who attend the private clinics in the upper-middle socioeconomic stratum of the Guadalajara Metropolitan Area had excessive protein intake, excessive consumption of added sugars was frequent, and there was insufficient intake of vitamin D and calcium. Sex was shown to be a factor influencing nutrient intake in these toddlers aged 12–24 months. Males had a Z-score of weight/age lower than females, suggesting nutritional risk. Full article
(This article belongs to the Section Global and Public Health)
17 pages, 1829 KiB  
Review
Comparison of Different Types of Palatal Expanders: Scoping Review
by Angelo Michele Inchingolo, Assunta Patano, Matteo De Santis, Gaetano Del Vecchio, Laura Ferrante, Roberta Morolla, Carmela Pezzolla, Roberta Sardano, Leonardo Dongiovanni, Francesco Inchingolo, Ioana Roxana Bordea, Andrea Palermo, Alessio Danilo Inchingolo and Gianna Dipalma
Children 2023, 10(7), 1258; https://doi.org/10.3390/children10071258 - 21 Jul 2023
Cited by 6 | Viewed by 1755
Abstract
Maxillary bone contraction is caused by genetics or ambiental factors and is often accompanied by dental crowding, with the possibility of canine inclusion, crossbite, class II and III malocclusion, temporomandibular joint disorder, and obstructive sleep apnea (OSAS). Transverse maxillary deficits, in which the [...] Read more.
Maxillary bone contraction is caused by genetics or ambiental factors and is often accompanied by dental crowding, with the possibility of canine inclusion, crossbite, class II and III malocclusion, temporomandibular joint disorder, and obstructive sleep apnea (OSAS). Transverse maxillary deficits, in which the maxillary growth is unusually modest, are frequently treated with maxillary expansion. The purpose of this study is to compare the dental and skeletal effects of different types of expanders, particularly the Leaf Expander, rapid and slow dental-anchored or skeletal-anchored maxillary expanders. Methods: We chose studies that compared effects determined by palatal expansion using a rapid palatal expander, expander on palatal screws, and leaf expander. Results: Reports assessed for eligibility are 26 and the reports excluded were 11. A final number of 15 studies were included in the review for qualitative analysis. Conclusions: Clinically and radiographically, the outcomes are similar to those obtained with RME and SME appliances; Therefore, it might be a useful treatment choice as an alternative to RME/SME equipment in cases of poor patient compliance or specific situations. Finally, all of the devices studied produce meaningful skeletal growth of the palate. The use of skeletally anchored devices does, without a doubt, promote larger and more successful growth in adolescent patients. Full article
(This article belongs to the Section Pediatric Dentistry)
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9 pages, 240 KiB  
Case Report
Occupational Therapy Intervention in the Child with Leukodystrophy: Case Report
by Rachele Simeon, Anna Berardi, Donatella Valente, Tiziana Volpi, Samuele Vagni and Giovanni Galeoto
Children 2023, 10(7), 1257; https://doi.org/10.3390/children10071257 - 21 Jul 2023
Viewed by 1115
Abstract
Background: There are many different types of Leukodystrophies. Specifically, children with hypomyelination and congenital cataract syndrome (HCC) in addition to motor retardation development, hypotonia and progressive spastic paraplegia, associated with cerebellar ataxia and peripheral neuropathy, have early bilateral cataracts and intellectual disability as [...] Read more.
Background: There are many different types of Leukodystrophies. Specifically, children with hypomyelination and congenital cataract syndrome (HCC) in addition to motor retardation development, hypotonia and progressive spastic paraplegia, associated with cerebellar ataxia and peripheral neuropathy, have early bilateral cataracts and intellectual disability as pathognomonic symptoms. HCC rehabilitation treatment is not well defined, but a significant amount of evidence in the literature has demonstrated the effectiveness of occupational therapy (OT) treatment in children with similar symptomatology. For this reason, the aim of this study was to describe the improvement in the autonomies and social participation of a child with HCC following OT treatment. Methods: A.E. was a 9-year-old child with HCC with severe intellectual disability. OT intervention lasted 3 months biweekly and each session lasted 45 min. Each session was divided into two parts: The first part aimed to increase the child’s active involvement through activities; the second part involved training in Activities of Daily living (ADL). The outcome measures were: ABILHAND-Kids; Pediatric Evaluation of Disability Inventory; Comprehensive OT Evaluation Scale; ADL and Instrumental Activities of Daily Living. Results: A.E.’s outcome measure reported an improvement from an autonomy standpoint and in the child’s general activity participation; there was also an increase in A.E.’s interpersonal skills. Conclusion: OT treatment improved A.E.’s autonomy. Full article
(This article belongs to the Special Issue Neurological Diseases in Children and Adolescent)
12 pages, 276 KiB  
Article
Deficiencies in the Intentions, Attitudes, and Knowledge of Future Healthcare Professionals Regarding Breastfeeding
by Marija Čatipović, Štefica Mikšić, Rajko Fureš, Zrinka Puharić and Dragica Pavlović
Children 2023, 10(7), 1256; https://doi.org/10.3390/children10071256 - 21 Jul 2023
Cited by 1 | Viewed by 961
Abstract
The aim of this study was to determine the level of knowledge, positive intentions, and attitudes regarding breastfeeding among university students. A validated questionnaire collected data from 236 students of the Faculty of Dental Medicine and Health Osijek about breastfeeding intentions, attitudes, and [...] Read more.
The aim of this study was to determine the level of knowledge, positive intentions, and attitudes regarding breastfeeding among university students. A validated questionnaire collected data from 236 students of the Faculty of Dental Medicine and Health Osijek about breastfeeding intentions, attitudes, and knowledge. Descriptive methods were used to present the students’ results in terms of their intentions, attitudes, and knowledge. For each question included in the questionnaire, the maximum possible and maximum achieved numbers of points were calculated, as well as the percentage of points achieved in relation to the maximum possible number. Correlations between the results on individual scales of the questionnaire and the total results of the questionnaire are shown by Spearman’s correlation coefficient. Questionnaire answers that were least in line with professional recommendations were selected and analyzed. We found that the areas that should be given special attention in the education of students are: the intention of breastfeeding for more than a year; the use of breaks for breastfeeding in the workplace; attitudes and knowledge about the quality of breast milk in relation to substitutes; attitudes about breastfeeding in public places and breastfeeding for more than two years; and the feeling of maternity and breastfeeding (compared to bottle feeding). The relationship between the results was considered in terms of intentions, attitudes, and knowledge in relation to the overall results of the questionnaire, and the authors’ thoughts on the reasons behind the poorer results achieved for certain questions were presented. Full article
7 pages, 247 KiB  
Brief Report
P-Wave Axis of Schoolchildren Who Were Once Breastfed
by Juan-Antonio Costa, Carla Rodriguez-Trabal, Ignacio Pareja, Alicia Tur, Marianna Mambié, Mercedes Fernandez-Hidalgo and Sergio Verd
Children 2023, 10(7), 1255; https://doi.org/10.3390/children10071255 - 21 Jul 2023
Cited by 1 | Viewed by 841
Abstract
Background. It has been known for decades that breastfeeding leads to a lower risk of asthma, respiratory infections, or metabolic syndrome at school age. In addition, evidence is now accumulating on the influence of breast milk on the shape, volume, or function of [...] Read more.
Background. It has been known for decades that breastfeeding leads to a lower risk of asthma, respiratory infections, or metabolic syndrome at school age. In addition, evidence is now accumulating on the influence of breast milk on the shape, volume, or function of the heart and lungs. Within this field of research into the effects of breast milk on the structure of the heart and lungs, we have set out to analyze the differential electrocardiographic characteristics of schoolchildren who were once breastfed. Method. This was an observational cross-sectional study, including 138 children aged 6 or 12 consecutively presenting to a well-child clinic between May and December 2022. Inclusion criteria. The ability to perform reproducible ECG records, the feasibility of weighing and measuring patient, and breastfeeding data collected from birth were used as the inclusion criteria. Results. Using the 40° cut-off value for the mean P-wave axis among schoolchildren, 76% of never-breastfed children in our sample have a P-wave axis in a more vertical position than the mean as compared to 58% of ever-breastfed children (OR: 2.25; 95% CI: 3.13–1.36); there was no other significant difference between infant feeding groups in somatometric characteristics or ECG parameters. Conclusion. We found a significant difference of the mean values of the P-wave axis between never- and ever-breastfed children. Although this report should be approached cautiously, these findings add to the renewed interest in discerning developmental interventions to improve cardiovascular health. Full article
(This article belongs to the Special Issue Nutrition in Pediatrics)
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10 pages, 497 KiB  
Article
Penile Length Assessment of Children Treated for Primary Buried Penis: Can Satisfying Penile Growth Always Be Achieved?
by Marco Pensabene, Maria Sergio, Fabio Baldanza, Francesco Grasso, Gregorio Serra, Benedetto Spataro, Roberta Bonfiglio, Maria Patti, Valentina Maggiore, Chiara Cambiaso, Mario Giuffré, Giovanni Corsello, Marcello Cimador and Maria Rita Di Pace
Children 2023, 10(7), 1254; https://doi.org/10.3390/children10071254 - 21 Jul 2023
Viewed by 1626
Abstract
Primary buried (BP) penis is describes as a small penis caused by a penile ligaments anomaly; it is unclear if a primary BP could reach a normal length. We selected 49 patients treated at our institution between 2015 and 2020 in order to [...] Read more.
Primary buried (BP) penis is describes as a small penis caused by a penile ligaments anomaly; it is unclear if a primary BP could reach a normal length. We selected 49 patients treated at our institution between 2015 and 2020 in order to post-operatively evaluate the SPL after one year. SPL was evaluated according to the PH Tanner staging system for pre-pubertal patients according to age-normalized values. A micropenis was detected if the SPL was below 2.5 SD. A normal SPL was found in thirty-two patients, eighteen were in PH Stage 1, four were in PH Stage 2, six were in PH Stage 3, and four were in PH Stage 5. Seventeen patients showed a reduced SPL; in seven of these (four in PH Stage 4 and three in PH Stage 5), their SPL was <2.5 ST. The difference in micropenis prevalence between the pre-pubertal and post-pubertal patients was significant (p = 0.038). A primary BP grows normally during the pre-pubertal period, where patients frequently showed a normal SPL, but it seems to be unable to reach a normal length in the higher PH stages, where the SPL is used to detect a micropenis. We suggest that a primary BP should be considered not as a simple defect of the penile ligaments and surrounding tissues, but as an incomplete manifestation of a micropenis due to a growth slowdown of the organ in late puberty. Full article
(This article belongs to the Section Pediatric Surgery)
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10 pages, 735 KiB  
Article
Effects of Adverse Events and 12-Week Group Step Aerobics on Sleep Quality in Chinese Adolescents
by Yuwei Hu, Xiyan Duan, Zhuoran Zhang, Chunxia Lu and Yang Zhang
Children 2023, 10(7), 1253; https://doi.org/10.3390/children10071253 - 21 Jul 2023
Viewed by 1011
Abstract
Background: In China, sleep disorders have become a public health concern. This study aimed to model the relationship between adverse events and sleep quality, as well as the effect of group step aerobics on sleep quality. Methods: The modeling was built on surveying [...] Read more.
Background: In China, sleep disorders have become a public health concern. This study aimed to model the relationship between adverse events and sleep quality, as well as the effect of group step aerobics on sleep quality. Methods: The modeling was built on surveying 2760 16–19-year-old adolescents. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality, and the Adolescent Self-rating Life Events Checklist (ASLEC) was used to evaluate adverse events. Adolescents with sleep disorders (PSQI ≥ 8) were randomized into the control (n = 26) and exercise (n = 26) groups. The exercise group participated in 12-week step aerobics, and the 300 min weekly volume is compliant with the WHO physical activity guidelines. Results: The double Poisson distribution was chosen to fit the data. ASLEC had a nonlinear relationship with the PSQI. Participants in the exercise group slept better (p < 0.05) from the eighth week until the end of the study. A random adolescent, therefore, has a 92.5% probability of experiencing improved sleep quality after 12 weeks of step aerobics. Conclusions: Intervention should be implemented before adverse events accumulate. An active lifestyle should be a preparedness strategy for increasing the resilience of adolescent mental health in the face of adversity. Full article
(This article belongs to the Special Issue Physical Activity and Lifestyle Habits in Children and Adolescents)
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11 pages, 691 KiB  
Article
Effectiveness of an Intervention to Enhance First Aid Knowledge among Early Childhood Education Students: A Pilot Study
by Patxi León-Guereño, Laura Cid-Aldama, Héctor Galindo-Domínguez and Alaitz Amezua-Urrutia
Children 2023, 10(7), 1252; https://doi.org/10.3390/children10071252 - 21 Jul 2023
Cited by 1 | Viewed by 4478
Abstract
Empowering early childhood education students from the beginning with the necessary knowledge and skills to act swiftly in emergency situations could be crucial in saving lives in certain cases. In order to improve the first aid knowledge and skills of early childhood education [...] Read more.
Empowering early childhood education students from the beginning with the necessary knowledge and skills to act swiftly in emergency situations could be crucial in saving lives in certain cases. In order to improve the first aid knowledge and skills of early childhood education students, a pre/post study was conducted with a two-week intermediate intervention involving 13 early childhood education students. Their knowledge and skills in first aid were assessed using an ad-hoc instrument before and after the intervention. The results demonstrate a statistically significant improvement in all items related to first aid general knowledge, first aid kits, and CPR maneuvers, as well as in the overall scale. These findings provide evidence that early childhood education students can be equipped through low-cost interventions to acquire and apply certain essential first aid skills, such as dialing emergency services, understanding the purpose of first aid kit items, and recognizing vital signs in individuals, that may be crucial in saving lives in the future. Full article
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11 pages, 279 KiB  
Article
Neurological Symptoms That May Represent a Warning in Terms of Diagnosis and Treatment in a Group of Children and Adolescents with Vitamin D Deficiency
by Oguzhan Korkut and Hilal Aydin
Children 2023, 10(7), 1251; https://doi.org/10.3390/children10071251 - 20 Jul 2023
Cited by 1 | Viewed by 1121
Abstract
Aim: This research was intended to evaluate the clinical and laboratory findings of children presenting to our pediatric neurology clinic with symptoms potentially linked to vitamin D deficiency and with low vitamin D levels and the distribution of those findings by sex, age [...] Read more.
Aim: This research was intended to evaluate the clinical and laboratory findings of children presenting to our pediatric neurology clinic with symptoms potentially linked to vitamin D deficiency and with low vitamin D levels and the distribution of those findings by sex, age groups, and vitamin D levels. Methods: This retrospective study involved patients presenting to our clinic with symptoms potentially associated with vitamin D deficiency and low serum concentrations of 25 OH vitamin D (25 OH D) (<75 nmol/L, 30 µg/mL). Patients’ movement disorders and central nervous system-related symptoms at the time of presentation and serum 25 OH D, calcium (Ca), phosphorus (P), and magnesium (Mg) levels were recorded and evaluated in terms of age, sex, and vitamin D levels. Results: Eight hundred twenty-two cases of vitamin D deficiency were included in the study, 50.2% (n = 413) boys and 49.8% (n = 409) girls. Although cases of vitamin D deficiency were present across all the age groups between 1 and 18, they were most common in the 5–14 age range (n = 372, 45.3%). Movement disorders were observed in 14.6% (n = 120) of our cases, and neurological findings associated with the central nervous system were observed in 52.6% (n = 432). The most common accompanying movement in our cases was difficulty remaining in balance (n = 42, 35%), while the most frequent accompanying central nervous system finding was vertigo (n = 99, 22.92%). Other movement disorders encountered included limb shaking (n = 32, 26.7%), abnormal posture (n = 20, 16.67%), easy falling (n = 16, 13.33%), body rigidity (n = 15, 12.5%), and hand clenching (n = 5, 4.17%). Other frequently encountered neurological findings were headache (n = 88, 20.37%), epileptic seizures (n = 83, 19.21%), fainting (n = 58, 13.43%), developmental delay (n = 41, 9.49%), febrile seizures (n = 33, 7.64%), and numbness in the fingers (n = 20, 4.63%). Other neurological findings were sleep disorders (n = 10, 2.31%), nightmares (n = 8, 1.85%), pain in the extremities (n = 7, 1.62%), and sweating and frailty (n = 4, 0.93% for both). Ca, P, and Mg levels were lower in cases with vitamin D levels < 12 µg/mL. The prevalences of both movement disorders and central nervous system findings varied according to age groups, sex, and vitamin D levels. Conclusions: Our study results show that vitamin D deficiency can present with different neurological findings and that these may vary according to age group, sex, and vitamin D levels. Clinicians must take particular care in pediatric cases with neurological findings in terms of the early diagnosis and treatment of vitamin D deficiency. Full article
(This article belongs to the Section Child Neurology)
10 pages, 1869 KiB  
Article
Two Year Neurodevelopmental Outcome after Fetoscopic Laser Therapy for Twin–Twin Transfusion Syndrome: Comparison with Uncomplicated Monochorionic Diamniotic Twins
by Ángel Chimenea, Lutgardo García-Díaz and Guillermo Antiñolo
Children 2023, 10(7), 1250; https://doi.org/10.3390/children10071250 - 20 Jul 2023
Cited by 2 | Viewed by 1079
Abstract
Background: Twin–twin Transfusion Syndrome (TTTS) represents a significant complication in monochorionic twin pregnancies, caused by an unbalanced shunting of blood through intertwin placental vascular anastomoses. Despite advances in fetoscopic laser surgery, TTTS is still associated with a high rate of cerebral injury. However, [...] Read more.
Background: Twin–twin Transfusion Syndrome (TTTS) represents a significant complication in monochorionic twin pregnancies, caused by an unbalanced shunting of blood through intertwin placental vascular anastomoses. Despite advances in fetoscopic laser surgery, TTTS is still associated with a high rate of cerebral injury. However, there are no studies comparing these pregnancies with uncomplicated monochorionic diamniotic (MCDA) twin pregnancies, establishing the baseline risk of neurodevelopmental impairment. The aim of this study is to evaluate the odds of neurodevelopmental impairment in MCDA twins who undergo fetoscopic laser surgery for twin–twin transfusion syndrome, in comparison to a cohort of uncomplicated MCDA twin pregnancies. Study design: This is a retrospective cohort study of children born from MCDA twin pregnancies at a single center between 2008 and 2019. A routine, standardized follow-up assessment was conducted at a minimum of 2 years after delivery. The primary outcome of this was a 2 year neurodevelopmental impairment. Neurological, motor, and cognitive development was assessed by using the revised Brunet–Lézine scale. Results: 176 children met the enrolment criteria. Of these, 42 (24%; TTTS group) underwent fetoscopic laser surgery for TTTS during pregnancy, and 134 (76%; uncomplicated MCDA group) were uncomplicated MCDA pregnancies. The primary outcome was found in four children (9.52%) in the TTTS group and ten children (7.46%) in the uncomplicated MCDA group (p = 0.67, aOR 2.82, 95% CI 0.49–16.23). Major neurologic impairment was found in 2.38% after fetoscopic laser surgery and 1.49% in uncomplicated MCDA twins (p = 0.70, aOR 0.97, 95% CI 0.22–4.24). The data were adjusted by birth order, birth weight, and gestational age at birth. Conclusions: The outcome in MCDA twins who underwent fetoscopic laser surgery for TTTS is comparable to the outcome in uncomplicated MCDA twins. Our findings emphasize the need for long-term neurodevelopmental follow-ups in all children from monochorionic twin gestations. Full article
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13 pages, 671 KiB  
Article
Assessing the Correlation between Blood Trace Element Concentrations, Picky Eating Habits, and Intelligence Quotient in School-Aged Children
by Abdullah A. Saati and Heba M. Adly
Children 2023, 10(7), 1249; https://doi.org/10.3390/children10071249 - 20 Jul 2023
Cited by 2 | Viewed by 1241
Abstract
Introduction: Inadequate levels of iron, zinc, and copper have been linked to growth impairment and cognitive and motor development deficits. The objective of this study is to examine the deficiencies of trace elements and their correlation with selective eating patterns and the intelligence [...] Read more.
Introduction: Inadequate levels of iron, zinc, and copper have been linked to growth impairment and cognitive and motor development deficits. The objective of this study is to examine the deficiencies of trace elements and their correlation with selective eating patterns and the intelligence quotient (IQ) of children. Methods and Patients: The cross-sectional analysis involved 430 children aged between 7 and 10 years. Blood samples were analyzed using Inductively Coupled Plasma Mass Spectrometry (ICP-MS) to measure the trace elements levels. Children’s IQs were assessed using Raven’s Standard Progressive Matrices. Results: Among the sample group, 20.3% exhibited iron deficiency, 42.5% had zinc deficiency, and 14% had insufficient copper levels. Single trace element deficiency was observed in 56.9% of the children, while 66.7% showed coexisting deficiencies of iron and zinc. Children with lower development levels exhibited significantly lower serum zinc levels compared to those with higher development levels (76.78 ± 10.67 vs. 81.14 ± 10.19 μg/dL). The analysis reveals that picky eaters had lower serum iron levels (76.59 ± 10.42 μg/dL) and higher serum copper levels (123.74 ± 13.45 μg/dL). Conclusion: A strong association was observed between zinc deficiency, picky eating habits, and lower developmental stages. The findings underscore the importance of monitoring nutritional status in children, given the significant implications for their cognitive development. Full article
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12 pages, 310 KiB  
Article
Factors Influencing the Likelihood of Alcohol and Tobacco Use in Adolescent Athletes: Type of Sport, Age, and Action Tendencies in Sport
by Alejandro Carriedo, José Antonio Cecchini and Antonio Méndez-Giménez
Children 2023, 10(7), 1248; https://doi.org/10.3390/children10071248 - 20 Jul 2023
Viewed by 1096
Abstract
This article proposes a new approach to understand substance use among adolescent athletes. Thus, this article describes an investigation of the likelihood of alcohol and tobacco use in adolescent athletes considering the type of sport, age, gender, and their action tendencies. A total [...] Read more.
This article proposes a new approach to understand substance use among adolescent athletes. Thus, this article describes an investigation of the likelihood of alcohol and tobacco use in adolescent athletes considering the type of sport, age, gender, and their action tendencies. A total of 552 athletes with an age range of 12–16 years were engaged in medium–high-contact sports (n = 291) and non-contact sports (n = 261). They completed the Children’s Action Tendency Scale, the Sport Children’s Action Tendency Scale, and the Personal and Social Responsibility Questionnaire. The results showed that 16-year-old athletes were the most likely to drink alcohol and to smoke tobacco (p < 0.001). Likewise, it was found that practicing a medium–high-contact sport was a risk factor for alcohol and tobacco use (p < 0.01). The more aggressive athletes were more likely to have smoked tobacco during the last month (p = 0.019) and also to drink more alcohol that the less aggressive ones (p < 0.001). Finally, the athletes who showed more submissiveness were less likely to have drunk alcohol in the last year and the last month (p < 0.001). These findings show the predictive value of new factors associated with alcohol and tobacco use among adolescent athletes. Preventive measures should be targeted, since a new link between the action tendencies in sport and substance use has been found. Full article
19 pages, 860 KiB  
Systematic Review
Direct Parent Engagement to Improve Fundamental Movement Skills in Children: A Systematic Review
by Robert J. Flynn, Andy Pringle and Clare M. P. Roscoe
Children 2023, 10(7), 1247; https://doi.org/10.3390/children10071247 - 19 Jul 2023
Cited by 3 | Viewed by 3002
Abstract
Fundamental movement skills (FMS) are basic movements in children that represent the building blocks for more complex motor skill development and act as a prerequisite for enduring sport and physical activity (PA) engagement and positive health-related behaviours. The FMS proficiency is currently inadequate [...] Read more.
Fundamental movement skills (FMS) are basic movements in children that represent the building blocks for more complex motor skill development and act as a prerequisite for enduring sport and physical activity (PA) engagement and positive health-related behaviours. The FMS proficiency is currently inadequate worldwide, and consequently there are alarming levels of inactivity and childhood obesity. However, parents are role models to their children and possess the power to influence their PA behaviour. This review investigated if parent-focused interventions could improve FMS in 2–7-year-old children and evaluated which setting and method of parent engagement was most impactful. Keyword searches were conducted via Scopus, Web of Science, SPORTDiscus, PubMed, Science Direct, and Google Scholar. Only nine articles met the inclusion criteria. No research originated from the United Kingdom, highlighting the urgent need for further FMS interventions involving parents. The FMS improved in all nine studies, with significant changes in seven of the articles (p < 0.05). Parent–child co-activity, the education and empowerment of parents, and the provision of clear FMS guidance, messaging, and structure can positively influence children’s FMS. Recently, smartphone apps have increased the feasibility and accessibility of FMS practice at home and may be integral to future interventions. Further research with direct parental involvement is clearly warranted. Full article
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13 pages, 445 KiB  
Review
Role of Valganciclovir in Children with Congenital CMV Infection: A Review of the Literature
by Davide Pata, Danilo Buonsenso, Arianna Turriziani-Colonna, Gilda Salerno, Lucia Scarlato, Lara Colussi, Rolando Ulloa-Gutierrez and Piero Valentini
Children 2023, 10(7), 1246; https://doi.org/10.3390/children10071246 - 19 Jul 2023
Cited by 4 | Viewed by 2169
Abstract
Background: Cytomegalovirus (CMV) is the most common agent of congenital infection in humans. It is a main cause of neurodevelopmental delay and sensorineural hearing loss in infancy. Since the 2000s, a number of studies have used Valganciclovir as a therapy for children with [...] Read more.
Background: Cytomegalovirus (CMV) is the most common agent of congenital infection in humans. It is a main cause of neurodevelopmental delay and sensorineural hearing loss in infancy. Since the 2000s, a number of studies have used Valganciclovir as a therapy for children with congenital CMV infection. Methods: In order to evaluate the efficacy of Valganciclovir in preventing clinical sequelae and its possible side effects, we performed a review of the published literature. This search was completed via PubMed for manuscripts published from January 2007 to December 2021, combining the MeSH words “Valganciclovir”, “Congenital”, and “Cytomegalovirus”. Results: A total of 27 articles were included (12 retrospective studies, 4 prospective studies, 1 randomized controlled trial, and 10 case reports). The clinical features were similar to those already described in the literature. The therapeutic protocols used were very different between the various studies included and neonatal antiviral treatments were only moderately effective. The therapy proved to be well-tolerated. Conclusions: The quality of the included studies and the sample size were limited due to the rarity of the disease. The use of different therapeutic protocols in terms of starting dates, doses, and durations made it impossible to compare and correctly evaluate the efficacy of the treatments. Randomized controlled trials are needed to establish the correct effective dose with the fewest side effects and the most efficient duration of therapy. Full article
(This article belongs to the Section Pediatric Infectious Diseases)
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23 pages, 6240 KiB  
Article
Integrated Collection of Patient-Reported Outcomes and Experiences in Children with Kidney and Hematological Diseases: A Pilot Study
by Karolis Ažukaitis, Roma Puronaitė, Goda Elizabeta Vaitkevičienė, Justas Trinkūnas, Augustina Jankauskienė and Danguolė Jankauskienė
Children 2023, 10(7), 1245; https://doi.org/10.3390/children10071245 - 19 Jul 2023
Viewed by 867
Abstract
We aimed to explore the feasibility and potential relevance of integrated electronic collection of patient-reported outcome and experience measures (PROM and PREM) in children with special healthcare needs (CSHCN) by using the example of children with kidney and hematological diseases. We performed a [...] Read more.
We aimed to explore the feasibility and potential relevance of integrated electronic collection of patient-reported outcome and experience measures (PROM and PREM) in children with special healthcare needs (CSHCN) by using the example of children with kidney and hematological diseases. We performed a cross-sectional, single-center study of children <18 years of age. Children (≥10 years) and their parents received Generic PedsQL Core Scale 4.0 and custom PREM surveys to their email addresses via the REDCap platform, and the results were integrated into the hospital’s electronic health records system. A total of 192 patients (98 with kidney diseases and 94 with hematological diseases) were enrolled. The overall response rate was 51%, and the median time for completion of each proxy questionnaire was approximately three minutes. The lowest PROM scores were observed in the emotional and school functioning dimensions. More favorable experiences in the diagnosis establishment process were associated with higher scores in physical, social, school functioning, and total PROM scores. A better evaluation of the hospital’s environment was associated with higher social functioning, while better information provision correlated with higher physical functioning and total PROM scores. Our data indicates that integrated electronic collection of PROMs and PREMs in the population of CSHCN is feasible, but efforts to increase the response rate are needed. The associations between PROMs and PREMs suggest that future studies exploring targeted interventions at the healthcare service level to improve subjective patient outcomes are needed. Full article
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