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Children, Volume 11, Issue 1 (January 2024) – 137 articles

Cover Story (view full-size image): The potential of sonothrombolysis as a noninvasive pediatric therapy for thrombotic disease remains untapped, warranting urgent research to investigate its safety and efficacy in children. This timely review explores the state of the art of this emerging clot-busting technique utilizing ultrasound waves, microbubbles, and thrombolytic agents. While numerous preclinical animal and human studies demonstrate success in treating adults, quantified data on pediatric sonothrombolysis applications is lacking. The authors review known protocols, parameters, and study outcomes, highlighting promising results and knowledge gaps inhibiting clinical implementation in young patients. This paper emphasizes further research on mapping sonothrombolysis’ future pediatric landscape to realize this technology’s clinical promise in a way that is both ethical and safe for children. View this paper
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11 pages, 309 KiB  
Brief Report
The Effects of a Physical Activity Intervention on Adiposity, Physical Fitness and Motor Competence: A School-Based, Non-Randomized Controlled Trial
by Andrés Godoy-Cumillaf, Paola Fuentes-Merino, Frano Giakoni-Ramírez, Daniel Duclos-Bastías, José Bruneau-Chávez and Eugenio Merellano-Navarro
Children 2024, 11(1), 137; https://doi.org/10.3390/children11010137 - 22 Jan 2024
Viewed by 1295
Abstract
Evidence suggests that early physical activity interventions are a means of preventing childhood obesity and are more effective when delivered in a school setting and based on the ecological model. Therefore, the present study aims to determine the effect of a multicomponent intervention [...] Read more.
Evidence suggests that early physical activity interventions are a means of preventing childhood obesity and are more effective when delivered in a school setting and based on the ecological model. Therefore, the present study aims to determine the effect of a multicomponent intervention based on the ecological model on adiposity, physical fitness and motor competence in children aged 4 to 5 years. Methods: This study is a non-randomized controlled trial involving 173 children from Chile. The intervention was based on an ecological model and consisted of a physical activity program with three simultaneous parts, affecting intra- and interpersonal dimensions. The adiposity index, body mass index and waist circumference were measured. For physical fitness, muscle strength in the lower part, speed/agility and cardiorespiratory fitness were measured. Motor competence was assessed using catching, aiming and dynamic and static balance tests. Results: After the intervention, there was no reduction in adiposity indices; in the intervention group, body mass index increased significantly with a high effect size. The intervention group showed significant differences in physical fitness in the components of muscle strength in the lower part (p = 0.000) and speed/agility (p = 0.002). For motor competence, the intervention group showed significant improvements in most components. Conclusions: The multicomponent intervention did not reduce adiposity indices; however, it caused significant improvements in the physical fitness and motor competence components, so it seems prudent to continue implementing it, given the benefits that adequate levels of motor competence and physical fitness bring to children’s health, both in the short and long term. Full article
8 pages, 399 KiB  
Brief Report
Long-Term Hepatitis B Vaccine Immunity in Ethiopian Children That Received a Pentavalent Vaccine Series: A Retrospective Cohort Study
by Tinsae Alemayehu, Million Dechassa Daba and Danilo Buonsenso
Children 2024, 11(1), 136; https://doi.org/10.3390/children11010136 - 22 Jan 2024
Viewed by 1167
Abstract
Background: Chronic hepatitis B affects close to 300 million people globally with 1.5 million new infections per year. It causes the highest numbers of cirrhosis and liver cancer diagnoses each year. In children, perinatal transmission and contact with infected blood or body fluids [...] Read more.
Background: Chronic hepatitis B affects close to 300 million people globally with 1.5 million new infections per year. It causes the highest numbers of cirrhosis and liver cancer diagnoses each year. In children, perinatal transmission and contact with infected blood or body fluids remain the main methods of transmission. There are increasing reports of breakthrough hepatitis B infections in fully vaccinated children born to hepatitis B-negative mothers, especially in low- and middle-income countries. Our study aimed to measure the adequacy of hepatitis B surface antibody levels among children and adolescents who received three rounds of hepatitis B vaccination during infancy and delivered to hepatitis B-negative mothers in Addis Ababa, Ethiopia. Method: This was a retrospective cohort study analyzing results of paired serology tests for hepatitis B surface antibody and antigen tests performed for children aged 1–18 years from July 2022 to June 2023. All recorded data were transferred to SPSS version 29.0. The prevalence of adequate hepatitis B surface antibody levels was determined and sub-group analysis conducted using descriptive statistics, frequencies and tables. The magnitude of association between different variables and vaccine-induced hepatitis B immunity was assessed using logistic regression. Statistically significant differences were taken at p < 0.05. Results: A total of 256 children were included in the study (mean age: 7.53 years). Six children (2.3%) had breakthrough hepatitis B infections. Overall, 37 children (14.4%) were categorized as having optimal hepatitis B surface antibody levels (vaccine-induced antibody titers of >10 IU/mL), while 219 (85.6%) had low titers of <10 IU/mL. Nearly all (97.4%) of the sub-group aged 10 years and above had below-par antibody levels, with adolescents (11–18 years) being ten times more likely to have low seroprotection than those aged less than 5 years. Conclusions: Our study showed markedly low vaccine-induced hepatitis B surface antibody levels among the study population, especially adolescents. The presence of breakthrough infections may suggest a genuine lack of response and not just a mere drop in antibody titers and thus could highlight a significant public health problem in Ethiopia. Further immunologic studies and a thorough analysis of vaccine storage and administration should be conducted to inform prevention programs. Full article
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12 pages, 628 KiB  
Review
Management of Blunt Pancreatic Trauma in Children: A Persistent Controversy—Case Report and Comprehensive Literature Review
by Igor Sukhotnik and Neta Cohen
Children 2024, 11(1), 135; https://doi.org/10.3390/children11010135 - 22 Jan 2024
Viewed by 1003
Abstract
Blunt pancreatic injury (BPI) is relatively uncommon in children, and is associated with relatively high morbidity and mortality, especially if diagnosis is delayed. The aim of this report is to review the literature regarding controversial questions in the early diagnosis and management of [...] Read more.
Blunt pancreatic injury (BPI) is relatively uncommon in children, and is associated with relatively high morbidity and mortality, especially if diagnosis is delayed. The aim of this report is to review the literature regarding controversial questions in the early diagnosis and management of pediatric BPI. A representative case of blunt pancreatic trauma in a six-year-old girl with delayed diagnosis and intraoperative and postoperative complications was described. A systematic search of databases and the grey literature in Scopus and Web of Science using relevant keywords was conducted. A total of 26 relevant articles published in last 5 years were found in PubMed. Although early CT performance is considered part of initial pancreatic trauma workup, the sensitivity of CT for detecting main pancreatic duct injuries in children is relatively low. MRCP and ERCP (if available) are useful for assessing ductal injury and should be performed when the status of the pancreatic duct is unclear on the CT. Most patients with low-grade pancreatic damage may be treated conservatively. Although surgery involving distal pancreatectomy remains the preferred approach for most children with high-grade pancreatic injury, there is growing evidence to suggest that non-operative management (NOM) is safe and effective. Most pancreatic pseudo cysts following NOM had relatively mild complications, and most resolved spontaneously. For those children who do require surgery, a conservative operative approach with the least risk is advocated. In conclusion, the optimal management for pediatric pancreatic trauma is controversial. Further clinical trials are required to generate clinical practice guidelines on pancreatic trauma in a child population. Full article
(This article belongs to the Special Issue Recent Advances in Hepatobiliary and Pancreatic Surgery in Children)
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10 pages, 260 KiB  
Article
Pathogens in Pediatric Septic Arthritis: A Multi-Center Study in Turkiye (PEDSART Study)
by Merve Iseri Nepesov, Omer Kilic, Enes Sali, Edanur Yesil, Asuman Akar, Ayse Kaman, Ozge Metin Akcan, Merve Kilic Cil, Canan Ozlu, Sibel Lacinel Gurlevik, Emel Ulusoy, Benhur Sirvan Cetin, Narin Akici, Deniz Cakir, Fatma Deniz Uslu Aygun, Cafer Ozgur Hancerli, Ayse Tekin Yilmaz, Gulsum Alkan, Hatice Uygun, Ibrahim Hakan Bucak, Burcu Bursal, Taylan Celik, Murat Sutcu, Fatma Nur Oz, Zeynep Gokce Gayretli Aydin, Adem Karbuz, Hacer Akturk, Eda Kepenekli, Melike Emiroglu, Selim Oncel, Cagatay Nuhoglu, Ismail Hakki Korucu, Mustafa Incesu, Ahmet Kaya, Hasan Bombaci, Meltem Dinleyici, Kursat Bora Carman, Murat Duman, Ozden Turel, Dilek Yilmaz, Derya Alabaz, Nursen Belet, Gonul Tanir, Mehmet Turgut, Solmaz Celebi, Necdet Kuyucu, Emin Sami Arisoy, Gul Durmaz, Mucahit Kaya, Ates Kara and Ener Cagri Dinleyiciadd Show full author list remove Hide full author list
Children 2024, 11(1), 134; https://doi.org/10.3390/children11010134 - 22 Jan 2024
Cited by 1 | Viewed by 1091
Abstract
Objectives: Septic arthritis (SA) is a serious bacterial infection that must be treated efficiently and timely. The large number of culture-negative cases makes local epidemiological data important. Accordingly, this study aimed to evaluate the etiology, clinical characteristics, and therapeutic approach of SA in [...] Read more.
Objectives: Septic arthritis (SA) is a serious bacterial infection that must be treated efficiently and timely. The large number of culture-negative cases makes local epidemiological data important. Accordingly, this study aimed to evaluate the etiology, clinical characteristics, and therapeutic approach of SA in children in Turkiye, emphasizing the role of real-time polymerase chain reaction (PCR) techniques in the diagnosis. Methods: In this multi-center, prospective study, children hospitalized due to SA between February 2018 and July 2020 in 23 hospitals in 14 cities in Turkiye were included. Clinical, demographic, laboratory, and radiological findings were assessed, and real-time PCR was performed using synovial fluid samples. Results: Seventy-five children aged between 3 and 204 months diagnosed with acute SA were enrolled. Joint pain was the main complaint at admission, and the most commonly involved joints were the knees in 58 patients (77.4%). The combination of synovial fluid culture and real-time PCR detected causative bacteria in 33 patients (44%). In 14 (18.7%) patients, the etiological agent was demonstrated using only PCR. The most commonly isolated etiologic agent was Staphylococcus aureus, which was detected in 22 (29.3%) patients, while Streptococcus pyogenes was found in 4 (5.3%) patients and Kingella kingae in 3 (4%) patients. Streptococcus pyogenes and Kingella kingae were detected using only PCR. Most patients (81.3%) received combination therapy with multiple agents, and the most commonly used combination was glycopeptides plus third-generation cephalosporin. Conclusions: Staphylococcus aureus is the main pathogen in pediatric SA, and with the use of advanced diagnostic approaches, such as real-time PCR, the chance of diagnosis increases, especially in cases due to Kingella kingae and Streptococcus pyogenes. Full article
(This article belongs to the Section Pediatric Infectious Diseases)
8 pages, 694 KiB  
Brief Report
Hospital Factors Associated with the Survival of Infants Born at Periviable Gestation: The USA National Database
by Ibrahim Qattea, Amani Quatei, Mohsen A. A. Farghaly, Alshimaa Abdalla, Mohamed A. Mohamed and Hany Aly
Children 2024, 11(1), 133; https://doi.org/10.3390/children11010133 - 22 Jan 2024
Viewed by 735
Abstract
Background: Reports on the survival of infants born at periviable gestation (GA of ≤24 weeks and birth weight of <500 gm) vary significantly. We aimed to determine hospital factors associated with their survival and to assess the trend for the timing of postnatal [...] Read more.
Background: Reports on the survival of infants born at periviable gestation (GA of ≤24 weeks and birth weight of <500 gm) vary significantly. We aimed to determine hospital factors associated with their survival and to assess the trend for the timing of postnatal mortality in these periviable infants. Methods: We utilized the de-identified National Inpatient Sample (NIS) dataset of the Healthcare Cost and Utilization Project (HCUP) from the Agency for Healthcare Research and Quality (AHRQ). National data were analyzed for the years 2010–2018. Hospitals were categorized according to delivery volume, USA regions, and teaching status. Results: We identified 33,998,014 infants born during the study period; 76,231 infants were ≤24 weeks. Survival at birth and first 2 days of life was greatest in urban teaching hospitals in infants <24 weeks and those who completed 24 weeks, respectively. The Northeast region has the lowest survival rate. There was a significant delay in the postnatal day of mortality in periviable infants. Conclusions: Hospital factors are associated with increased survival rates. Improved survival in large teaching hospitals supports the need for the regionalization of care in infants born at the limits of viability. There was a significant delay in the postnatal mortality day. Full article
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15 pages, 590 KiB  
Article
Experiences and Challenges of Health Professionals in Implementing Family-Centred Planning: A Qualitative Study
by Lorena Cuenca-Sánchez, David Sánchez-Teruel and Maria Auxiliadora Robles-Bello
Children 2024, 11(1), 132; https://doi.org/10.3390/children11010132 - 22 Jan 2024
Viewed by 1101
Abstract
Early childhood intervention is crucial for the development of minors with disabilities or at risk. Family-centred planning (FCP), which involves families in care, stands out in this context. Despite its importance, little is known about professionals’ experiences of its implementation. FCP aims to [...] Read more.
Early childhood intervention is crucial for the development of minors with disabilities or at risk. Family-centred planning (FCP), which involves families in care, stands out in this context. Despite its importance, little is known about professionals’ experiences of its implementation. FCP aims to tailor services to the needs of the family and the child within the Spanish health system. This study highlights the importance of assessing professionals’ perceptions of FCP. Professionals rooted in traditional approaches may resist change. To assess the implementation of FCPs, the study explores the perspectives of 25 healthcare professionals using qualitative methods to assess their experiences. The qualitative descriptive phenomenological design, following Giorgi’s modified Husserlian approach, seeks to understand the essence of the phenomenon from the participants’ perspective. Two main themes emerged: (1) a social and work organization that perpetuates rehabilitation or early stimulation practices and (2) a socio-family and work organization that promotes FCP adherence, along with subthemes and units of meaning. The evaluation reveals common challenges, such as the need for solid training and institutional support. Evaluating the experience of professionals is essential to overcome barriers and ensure the successful implementation of FCPs. Administrators have an important role to play in providing social, health, and educational alternatives. Full article
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18 pages, 358 KiB  
Article
Family Functioning, Maternal Depression, and Adolescent Cognitive Flexibility and Its Associations with Adolescent Depression: A Cross-Sectional Study
by Justyna Urbańska-Grosz, Emilia J. Sitek, Anna Pakalska, Bożena Pietraszczyk-Kędziora, Kalina Skwarska and Maciej Walkiewicz
Children 2024, 11(1), 131; https://doi.org/10.3390/children11010131 - 22 Jan 2024
Viewed by 1650
Abstract
Background: This study explores family functioning and its associations with adolescent major depressive disorder (MDD), comparing its dynamics with healthy counterparts. Family functioning (cohesion, flexibility, communication, and satisfaction), maternal depressive symptoms, postpartum depression history, parental divorce, parental alcohol abuse, and the adolescents’ cognitive [...] Read more.
Background: This study explores family functioning and its associations with adolescent major depressive disorder (MDD), comparing its dynamics with healthy counterparts. Family functioning (cohesion, flexibility, communication, and satisfaction), maternal depressive symptoms, postpartum depression history, parental divorce, parental alcohol abuse, and the adolescents’ cognitive flexibility, are examined. The research incorporates the perspectives of both adolescents and mothers. Methods: The sample includes 63 mother-teenager dyads in the clinical group and 43 in the control group. Instruments encompass the Family Adaptability and Cohesion Evaluation Scales (FACES IV), Children’s Depression Inventory (CDI-2), Beck Depression Inventory (BDI-II), The Brixton Spatial Anticipation Test, and structured interviews. Results: Families of adolescents with MDD exhibit lower flexibility, cohesion, communication, and overall satisfaction. Depressed adolescents display reduced cognitive flexibility. Discrepancies were observed between adolescents’ and mothers’ perspectives as associated with adolescents’ MDD. Teenagers emphasized the severity of maternal depressive symptoms, while mothers highlighted the importance of family cohesion and flexibility. Conclusions: This study emphasizes a holistic strategy in addressing adolescent depression, including family-based assessment and therapy. Screening for maternal depressive symptoms is identified as valuable. Cognitive flexibility also needs to be addressed during therapy for depression in adolescence. Full article
(This article belongs to the Special Issue Child and Adolescent Psychiatry and Mental Health Progress)
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12 pages, 810 KiB  
Article
An Effective and Playful Way of Practicing Online Motor Proficiency in Preschool Children
by Eleanna Adamopoulou, Konstantina Karatrantou, Ioannis Kaloudis, Charalampos Krommidas and Vassilis Gerodimos
Children 2024, 11(1), 130; https://doi.org/10.3390/children11010130 - 20 Jan 2024
Viewed by 1483
Abstract
The children’s fairytale is a playful educational tool that can be modified in such a way to enhance motor proficiency. This study investigated the effect of an online exercise program with modified fairytales on children’s motor proficiency during the kindergarten curriculum. Forty preschool [...] Read more.
The children’s fairytale is a playful educational tool that can be modified in such a way to enhance motor proficiency. This study investigated the effect of an online exercise program with modified fairytales on children’s motor proficiency during the kindergarten curriculum. Forty preschool children (20 girls and 20 boys; 5.13 ± 0.24 years old) were divided into two equal groups: an intervention (IG) group and a control group (CG). The IG followed a 3-month (3 times/week) online exercise intervention program (supervised by the class’s kindergarten teacher) with modified children’s fairytales, during the COVID-19 pandemic, with an aim to improve their motor proficiency. The CG did not attend any exercise intervention program. The Democritos Movement Screening Tool for Preschool Children (DEMOST-PRE), consisting of ten tests, was used to assess the children’s motor proficiency. Τhe IG, after the end of the intervention program, significantly improved in the DEMOST-PRE total score (p < 0.001; mean change: 40.7%), while the CG did not significantly improve in the total score (p > 0.05). Furthermore, in the IG, a significant negative correlation between the pre-training DEMOST-PRE total score and the percentage change following the intervention (r = −0.64; p = 0.002) was observed. A modified exercise program using children’s fairytales may be incorporated into the kindergarten curriculum as an effective educational tool for the improvement of motor proficiency. Full article
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15 pages, 666 KiB  
Review
Plant Sterols and Stanols for Pediatric Patients with Increased Cardiovascular Risk
by Cristina Pederiva, Giacomo Biasucci, Giuseppe Banderali and Maria Elena Capra
Children 2024, 11(1), 129; https://doi.org/10.3390/children11010129 - 20 Jan 2024
Cited by 1 | Viewed by 1187
Abstract
The atherosclerotic process begins in childhood and progresses throughout adult age. Hypercholesterolemia, especially familial hypercholesterolemia (FH) and metabolic dysfunctions linked to weight excess and obesity, are the main atherosclerosis risk factors in pediatric patients and can be detected and treated starting from childhood. [...] Read more.
The atherosclerotic process begins in childhood and progresses throughout adult age. Hypercholesterolemia, especially familial hypercholesterolemia (FH) and metabolic dysfunctions linked to weight excess and obesity, are the main atherosclerosis risk factors in pediatric patients and can be detected and treated starting from childhood. Nutritional intervention and a healthy-heart lifestyle are cornerstones and first-line treatments, with which, if necessary, drug therapy should be associated. For several years, functional foods enriched with plant sterols and stanols have been studied in the treatment of hypercholesterolemia, mainly as nutritional complements that can reduce LDL cholesterol; however, there is a lack of randomized controlled trials defining their long-term efficacy and safety, especially in pediatric age. This review aims to evaluate what the main published studies on sterols and stanols in pediatric subjects with dyslipidemia have taught us, providing an updated picture of the possible use of these dietary supplements in children and adolescents with dyslipidemia and increased cardiovascular risk. Nowadays, we can state that plant sterols and stanols should be considered as a valuable therapy in pediatric patients with hypercholesterolemia, bearing in mind that nutritional and lifestyle counseling and, when necessary, pharmacologic therapy, are the cornerstones of the treatment in developmental age. Full article
(This article belongs to the Section Global and Public Health)
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16 pages, 2329 KiB  
Article
Determinants of Knowledge, Attitudes, Perceptions and Behaviors Regarding Air Pollution in Schoolchildren in Pristina, Kosovo
by Zana Shabani Isenaj, Hanns Moshammer, Merita Berisha and Lisbeth Weitensfelder
Children 2024, 11(1), 128; https://doi.org/10.3390/children11010128 - 19 Jan 2024
Viewed by 1788
Abstract
Air pollution poses a significant public health challenge, and Kosovo, a low-middle-income country in the Balkan peninsula, suffers from particularly poor air quality, especially around the area of the capital Pristina. The availability of accurate and timely information is crucial in mitigating the [...] Read more.
Air pollution poses a significant public health challenge, and Kosovo, a low-middle-income country in the Balkan peninsula, suffers from particularly poor air quality, especially around the area of the capital Pristina. The availability of accurate and timely information is crucial in mitigating the adverse effects of air pollution. This study aimed at evaluating the knowledge, attitudes, behaviors, and perceptions (KAPB) related to poor air quality in Pristina’s low-middle schools. Furthermore, the study explored the connections between these factors and socio-demographic and health attributes and provided valuable inputs for the development of future strategies and policies in air pollution mitigation. Regression analysis provided insights into how these various factors interacted with KAPB scores. The results revealed limited knowledge about air pollution sources and risks among pupils, with insufficient awareness of reliable information sources. While attitudes were generally positive, they declined with higher grade levels. Parental education significantly influenced knowledge and attitudes, and better health correlated with more positive attitudes. Perceptions of air pollution risks were influenced by grade, gender, and parental education, with better-educated parents associated with improved perceptions. Overall behavior scores increased with higher levels of parental education. Understanding the factors that shape pupils’ responses to air pollution is critical for strategy and policy development. These findings can guide strategies to enhance environmental awareness and promote healthy behavior, helping address the pressing issue of air pollution in the country. Full article
(This article belongs to the Section Global and Public Health)
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25 pages, 541 KiB  
Article
Development of a Play-Based Motor Learning Approach (A.MO.GIOCO) in Children with Bilateral Cerebral Palsy: Theoretical Framework and Intervention Methodology
by Maria Foscan, Antonella Luparia, Francesca Molteni, Elisa Bianchi, Shari Gandelli, Emanuela Pagliano and Ermellina Fedrizzi
Children 2024, 11(1), 127; https://doi.org/10.3390/children11010127 - 19 Jan 2024
Viewed by 1534
Abstract
The early intervention of motor training based on specific tasks and parent empowerment represents the new paradigm for the rehabilitation of children with Cerebral Palsy (CP). However, most published studies address the problem of the effectiveness of rehabilitation intervention without describing the treatment [...] Read more.
The early intervention of motor training based on specific tasks and parent empowerment represents the new paradigm for the rehabilitation of children with Cerebral Palsy (CP). However, most published studies address the problem of the effectiveness of rehabilitation intervention without describing the treatment methodology or briefly mentioning it. The purpose of the study is to illustrate the development of a play-based motor learning approach titled A.MO.GIOCO (Apprendimento MOtorio nel GIOCO) and its systematization. Fifteen children aged between 2 and 6 years with bilateral CP will be enrolled and treated for 6–8 weeks (48 h). Motor Teaching methods applied by senior therapists have been extensively described, starting from rehabilitation goals and proposed therapeutic play activities, tailored to the functional profile of each child. This child-friendly rehabilitative approach (A.MO.GIOCO) refers to the systemic cognitive model of learning and movement control and is implemented in the context of spontaneous play activities and in the therapist–child–family interaction. In this study the theoretical framework of the approach and the process followed by the therapists to transfer it into rehabilitative practice are highlighted. As a result, an operational guide has been created. Further studies will explore the efficacy of the proposed standardized approach. Full article
(This article belongs to the Section Child Neurology)
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18 pages, 607 KiB  
Review
Attrition from Face-to-Face Pediatric Outpatient Chronic Pain Interventions: A Narrative Review and Theoretical Model
by Kristen Tiong, Greta M. Palmer and Tiina Jaaniste
Children 2024, 11(1), 126; https://doi.org/10.3390/children11010126 - 19 Jan 2024
Cited by 1 | Viewed by 1018
Abstract
There is limited understanding of attrition (premature treatment withdrawal and non-completion) from pediatric chronic pain services. This narrative review aimed to summarize attrition prevalence from face-to-face pediatric outpatient chronic pain interventions, identify associated factors and develop a theoretical model to account for attrition [...] Read more.
There is limited understanding of attrition (premature treatment withdrawal and non-completion) from pediatric chronic pain services. This narrative review aimed to summarize attrition prevalence from face-to-face pediatric outpatient chronic pain interventions, identify associated factors and develop a theoretical model to account for attrition in this setting. A comprehensive search of the published literature revealed massive variability (0–100%) in the reported attrition rates from pediatric chronic pain interventions that varied in type and format (individual vs. group, single discipline vs. interdisciplinary, psychological only vs. multiple combined interventions, of different durations). The factors associated with attrition from pediatric chronic pain programs varied between the studies: some have assessed patient sex, psychological and other comorbidities, avoidance strategies, missed schooling, family composition/tensions, caregiver catastrophizing, scheduling, caregiver leave and clinic access. A theoretical model is presented depicting youth, caregiver and service factors that may impact attrition from pediatric chronic pain interventions. Where available, literature is drawn from the pediatric chronic pain context, but also from adult chronic pain and pediatric weight management fields. The implications for research and clinical practice are discussed, including improved reporting, patient screening and targeted supports to promote intervention completion. This review contributes to a better understanding of attrition, which is crucial for optimizing pediatric chronic pain service outcomes. Full article
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12 pages, 288 KiB  
Article
Influence of Body Mass Index, Physical Fitness, and Physical Activity on Energy Expenditure during Recess
by Carlos Ayán-Pérez, Daniel González-Devesa, José Carlos Diz-Gómez and Silvia Varela
Children 2024, 11(1), 125; https://doi.org/10.3390/children11010125 - 18 Jan 2024
Viewed by 1059
Abstract
This study aims to investigate the potential relationship between energy expenditure, physical fitness level, physical activity, and body mass index among children taking part in a 30 min school recess. A total of 259 participants from three schools were included in this study. [...] Read more.
This study aims to investigate the potential relationship between energy expenditure, physical fitness level, physical activity, and body mass index among children taking part in a 30 min school recess. A total of 259 participants from three schools were included in this study. Data on energy expenditure during recess, age, gender, anthropometric measurements, global physical fitness, and physical activity index were recorded. The evaluation sessions occurred twice a week on alternate days over two weeks. A significant gender difference was observed in energy expenditure during recess, favoring boys (p < 0.01). The participants classified as very active exhibited significantly higher scores compared to those categorized as sedentary and moderately active, respectively (p < 0.01), with a poor but significant correlation (rho: 0.208; p < 0.001). There were significant differences between energy expenditure and cardiorespiratory fitness and energy expenditure and global physical fitness (p < 0.01) with fair (rho: 0.289; p < 0.001) and poor (rho: 0.196, p = 0.001) correlation, respectively. In contrast, there were no significant differences by body mass index categories (p = 0.571). These results suggest that gender, physical activity index, and global physical fitness were found to influence energy expenditure during a 30 min recess. However, no significant relationships were found with the body mass index. Full article
(This article belongs to the Special Issue Promoting Physical Activity in the School Setting)
17 pages, 1793 KiB  
Article
Investigating the Association between Serum and Hematological Biomarkers and Neonatal Sepsis in Newborns with Premature Rupture of Membranes: A Retrospective Study
by Maura-Adelina Hincu, Gabriela-Ildiko Zonda, Petronela Vicoveanu, Valeriu Harabor, Anamaria Harabor, Alexandru Carauleanu, Alina-Sînziana Melinte-Popescu, Marian Melinte-Popescu, Elena Mihalceanu, Mariana Stuparu-Cretu, Ingrid-Andrada Vasilache, Dragos Nemescu and Luminita Paduraru
Children 2024, 11(1), 124; https://doi.org/10.3390/children11010124 - 18 Jan 2024
Viewed by 1050
Abstract
(1) Background: Neonatal early-onset sepsis (EOS) is associated with important mortality and morbidity. The aims of this study were to evaluate the association between serum and hematological biomarkers with early onset neonatal sepsis in a cohort of patients with prolonged rupture of membranes [...] Read more.
(1) Background: Neonatal early-onset sepsis (EOS) is associated with important mortality and morbidity. The aims of this study were to evaluate the association between serum and hematological biomarkers with early onset neonatal sepsis in a cohort of patients with prolonged rupture of membranes (PROM) and to calculate their diagnostic accuracy. (2) Methods: A retrospective cohort study was conducted on 1355 newborns with PROM admitted between January 2017 and March 2020, who were divided into two groups: group A, with PROM ≥ 18 h, and group B, with ROM < 18 h. Both groups were further split into subgroups: proven sepsis, presumed sepsis, and no sepsis. Descriptive statistics, analysis of variance (ANOVA) and a Random Effects Generalized Least Squares (GLS) regression were used to evaluate the data. (3) Results: The statistically significant predictors of neonatal sepsis were the high white blood cell count from the first (p = 0.005) and third day (p = 0.028), and high C-reactive protein (CRP) values from the first day (p = 0.004). Procalcitonin (area under the curve—AUC = 0.78) and CRP (AUC = 0.76) measured on the first day had the best predictive performance for early-onset neonatal sepsis. (4) Conclusions: Our results outline the feasibility of using procalcitonin and CRP measured on the first day taken individually in order to increase the detection rate of early-onset neonatal sepsis, in the absence of positive blood culture. Full article
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21 pages, 1538 KiB  
Article
Trait Anxiety, Emotion Regulation, and Metacognitive Beliefs: An Observational Study Incorporating Separate Network and Correlation Analyses to Examine Associations with Executive Functions and Academic Achievement
by François-Xavier Cécillon, Martial Mermillod, Christophe Leys, Jean-Philippe Lachaux, Sarah Le Vigouroux and Rebecca Shankland
Children 2024, 11(1), 123; https://doi.org/10.3390/children11010123 - 18 Jan 2024
Cited by 1 | Viewed by 1314
Abstract
Trait anxiety, emotion regulation strategies, and metacognitive beliefs influence executive functions (EFs) and academic achievement. This study examines their interplay and impact on academic success. In total, 275 adolescents (10–17 years) and parents completed an online questionnaire assessing trait anxiety, emotion regulation strategies, [...] Read more.
Trait anxiety, emotion regulation strategies, and metacognitive beliefs influence executive functions (EFs) and academic achievement. This study examines their interplay and impact on academic success. In total, 275 adolescents (10–17 years) and parents completed an online questionnaire assessing trait anxiety, emotion regulation strategies, metacognition, parent-reported behaviors related to executive functioning, and overall school average. Preliminary analyses confirmed consistency with the existing literature for each variable and their interaction. Furthermore, we conducted a network analysis among the main variables. This analysis supports the need to pay more attention to reflective variables—maladaptive emotion regulation strategies and metacognitive beliefs about worry—when studying trait anxiety. These variables were linked to problematic executive functioning in adolescents, and the latter was negatively linked to academic achievement. This study offers innovative insights by investigating relationships less explored in the scientific literature. It reveals high and significant correlations between metacognitive beliefs, maladaptive emotion regulation strategies, and trait anxiety (r > 0.500, p < 0.001) but also between these variables and both executive functioning and academic achievement. These findings offer new perspectives for research and underscore the importance of holistically examining the psychological factors related to academic success. Full article
(This article belongs to the Section Child and Adolescent Psychiatry)
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17 pages, 6549 KiB  
Review
Imaging of Acute Complications of Community-Acquired Pneumonia in the Paediatric Population—From Chest Radiography to MRI
by Efthymia Alexopoulou, Spyridon Prountzos, Maria Raissaki, Argyro Mazioti, Pablo Caro-Dominguez, Franz Wolfgang Hirsch, Jovan Lovrenski and Pierluigi Ciet
Children 2024, 11(1), 122; https://doi.org/10.3390/children11010122 - 18 Jan 2024
Viewed by 1641
Abstract
The most common acute infection and leading cause of death in children worldwide is pneumonia. Clinical and laboratory tests essentially diagnose community-acquired pneumonia (CAP). CAP can be caused by bacteria, viruses, or atypical microorganisms. Imaging is usually reserved for children who do not [...] Read more.
The most common acute infection and leading cause of death in children worldwide is pneumonia. Clinical and laboratory tests essentially diagnose community-acquired pneumonia (CAP). CAP can be caused by bacteria, viruses, or atypical microorganisms. Imaging is usually reserved for children who do not respond to treatment, need hospitalisation, or have hospital-acquired pneumonia. This review discusses the imaging findings for acute CAP complications and the diagnostic role of each imaging modality. Pleural effusion, empyema, necrotizing pneumonia, abscess, pneumatocele, pleural fistulas, and paediatric acute respiratory distress syndrome (PARDS) are acute CAP complications. When evaluating complicated CAP patients, chest radiography, lung ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) can be used, with each having their own pros and cons. Imaging is usually not needed for CAP diagnosis, but it is essential for complicated cases and follow-ups. Lung ultrasound can supplement chest radiography (CR), which starts the diagnostic algorithm. Contrast-enhanced computed tomography (CECT) is used for complex cases. Advances in MRI protocols make it a viable alternative for diagnosing CAP and its complications. Full article
(This article belongs to the Special Issue Pediatric Respiratory Diseases: Diagnosis, Treatment, and Prevention)
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11 pages, 2575 KiB  
Article
Impact of Nutritional Status on Total Brain Tissue Volumes in Preterm Infants
by Cyndi Valdes, Parvathi Nataraj, Katherine Kisilewicz, Ashley Simenson, Gabriela Leon, Dahyun Kang, Dai Nguyen, Livia Sura, Nikolay Bliznyuk and Michael Weiss
Children 2024, 11(1), 121; https://doi.org/10.3390/children11010121 - 18 Jan 2024
Viewed by 1161
Abstract
Preterm infants bypass the crucial in utero period of brain development and are at increased risk of malnutrition. We aimed to determine if their nutritional status is associated with brain tissue volumes at term equivalent age (TEA), applying recently published malnutrition guidelines for [...] Read more.
Preterm infants bypass the crucial in utero period of brain development and are at increased risk of malnutrition. We aimed to determine if their nutritional status is associated with brain tissue volumes at term equivalent age (TEA), applying recently published malnutrition guidelines for preterm infants. We performed a single center retrospective chart review of 198 infants < 30 weeks’ gestation between 2018 and 2021. We primarily analyzed the relationship between the manually obtained neonatal MR-based brain tissue volumes with the maximum weight and length z-score. Significant positive linear associations between brain tissue volumes at TEA and weight and length z-scores were found (p < 0.05). Recommended nutrient intake for preterm infants is not routinely achieved despite efforts to optimize nutrition. Neonatal MR-based brain tissue volumes of preterm infants could serve as objective, quantitative and reproducible surrogate parameters of early brain development. Nutrition is a modifiable factor affecting neurodevelopment and these results could perhaps be used as reference data for future timely nutritional interventions to promote optimal brain volume. Full article
(This article belongs to the Special Issue Advances in NICU Health Care)
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2 pages, 155 KiB  
Correction
Correction: Nerdrum Aagaard et al. Significance of Neonatal Heart Rate in the Delivery Room—A Review. Children 2023, 10, 1551
by Ellisiv Nerdrum Aagaard, Anne Lee Solevåg and Ola Didrik Saugstad
Children 2024, 11(1), 120; https://doi.org/10.3390/children11010120 - 18 Jan 2024
Viewed by 547
Abstract
In the original publication [...] Full article
(This article belongs to the Special Issue Neonatal Heart Rate at Birth)
15 pages, 1998 KiB  
Review
Fostering Motivation: Exploring the Impact of ICTs on the Learning of Students with Autism
by José María Fernández-Batanero, Marta Montenegro-Rueda, José Fernández-Cerero and Eloy López-Meneses
Children 2024, 11(1), 119; https://doi.org/10.3390/children11010119 - 18 Jan 2024
Cited by 1 | Viewed by 1384
Abstract
Currently, the use of digital tools has led to significant changes in the educational system, favouring equity and the inclusion of students with educational needs. In this context, students with autism spectrum disorder (ASD) benefit from using these electronic devices to improve their [...] Read more.
Currently, the use of digital tools has led to significant changes in the educational system, favouring equity and the inclusion of students with educational needs. In this context, students with autism spectrum disorder (ASD) benefit from using these electronic devices to improve their learning experience. This study focuses on conducting a bibliometric analysis of the impact of information and communication technologies on the learning of students with ASD, with the aim of addressing two research questions. Through the analysis of three databases (Scopus, Dialnet, and Web of Science), a total of 24 articles related to the subject were collected. The results show that the use of different technological devices has numerous benefits for these students. Among the most prominent are the use of augmented reality and educational robotics, mainly providing improvements in academic performance, motivation and improved retention of knowledge acquired in the classroom. In conclusion, the clear need to train teachers in digital competencies and to intensify efforts in this line of research in order to improve the education of students, as well as to enrich the knowledge available to the scientific community, is highlighted. Full article
(This article belongs to the Special Issue Research on the Academic Motivation of Children and Adolescents)
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11 pages, 1142 KiB  
Article
Association of Functional Gastrointestinal Disorders with Adolescent Idiopathic Scoliosis
by Soo-Bin Lee, Hyun-Wook Chae, Ji-Won Kwon, Sahyun Sung, Seong-Hwan Moon, Kyung-Soo Suk, Hak-Sun Kim, Si-Young Park and Byung Ho Lee
Children 2024, 11(1), 118; https://doi.org/10.3390/children11010118 - 18 Jan 2024
Cited by 1 | Viewed by 1002
Abstract
Numerous adolescents diagnosed with adolescent idiopathic scoliosis (AIS) often manifest symptoms indicative of functional gastrointestinal disorders (FGIDs). However, the precise connection between FGIDs and AIS remains unclear. The study involved adolescents drawn from sample datasets provided by the Korean Health Insurance Review and [...] Read more.
Numerous adolescents diagnosed with adolescent idiopathic scoliosis (AIS) often manifest symptoms indicative of functional gastrointestinal disorders (FGIDs). However, the precise connection between FGIDs and AIS remains unclear. The study involved adolescents drawn from sample datasets provided by the Korean Health Insurance Review and Assessment Service spanning from 2012 to 2016, with a median dataset size of 1,446,632 patients. The AIS group consisted of individuals aged 10 to 19 with diagnostic codes for AIS, while the control group consisted of those without AIS diagnostic codes. The median prevalence of FGIDs in adolescents with AIS from 2012 to 2016 was 24%. When accounting for confounding factors, the analysis revealed that adolescents with AIS were consistently more prone to experiencing FGIDs each year (2012: adjusted odds ratio (aOR), 1.21 [95% confidence interval (CI), 1.10–1.35], p < 0.001; 2013: aOR, 1.31 [95% CI, 1.18–1.46], p < 0.001; 2014: aOR, 1.24 [95% CI, 1.12–1.38], p < 0.001; 2015: aOR, 1.34 [95% CI, 1.21–1.49], p < 0.001; and 2016: aOR, 1.35 [95% CI, 1.21–1.50], p < 0.001). These findings suggest that AIS is correlated with an elevated likelihood of FGIDs, indicating that AIS may function as a potential risk factor for these gastrointestinal issues. Consequently, it is recommended to provide counseling to adolescents with AIS, alerting them to the heightened probability of experiencing chronic gastrointestinal symptoms. Full article
(This article belongs to the Special Issue Advances in Gastrointestinal Diseases in Children and Adolescents)
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14 pages, 299 KiB  
Review
Statins—Beyond Their Use in Hypercholesterolemia: Focus on the Pediatric Population
by Elena Lia Spoiala, Eliza Cinteza, Radu Vatasescu, Mihaela Victoria Vlaiculescu and Stefana Maria Moisa
Children 2024, 11(1), 117; https://doi.org/10.3390/children11010117 - 17 Jan 2024
Viewed by 928
Abstract
Statins are a class of medications primarily used in adults to lower cholesterol levels and reduce the risk of cardiovascular events. However, the use of statins in children is generally limited and carefully considered despite the well-documented anti-inflammatory, anti-angiogenic, and pro-apoptotic effects, as [...] Read more.
Statins are a class of medications primarily used in adults to lower cholesterol levels and reduce the risk of cardiovascular events. However, the use of statins in children is generally limited and carefully considered despite the well-documented anti-inflammatory, anti-angiogenic, and pro-apoptotic effects, as well as their effect on cell signaling pathways. These multifaceted effects, known as pleiotropic effects, encompass enhancements in endothelial function, a significant reduction in oxidative stress, the stabilization of atherosclerotic plaques, immunomodulation, the inhibition of vascular smooth muscle proliferation, an influence on bone metabolism, anti-inflammatory properties, antithrombotic effects, and a diminished risk of dementia. In children, recent research revealed promising perspectives on the use of statins in various conditions including neurological, cardiovascular, and oncologic diseases, as well as special situations, such as transplanted children. The long-term safety and efficacy of statins in children are still subjects of ongoing research, and healthcare providers carefully assess the individual risk factors and benefits before prescribing these medications to pediatric patients. The use of statins in children is generally less common than in adults, and it requires close monitoring and supervision by healthcare professionals. Further research is needed to fully assess the pleiotropic effects of statins in the pediatric population. Full article
(This article belongs to the Section Pediatric Cardiology)
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8 pages, 2481 KiB  
Case Report
Case Report of a Unique Intra-Operative Finding in a Pediatric Distal Radius Non-Union: Does This Shed Light on Other Non-Unions or Malunions in Children?
by Marius Negru, Adrian Emil Lazarescu, Corina Maria Stanciulescu, Liliana Catan, Calin Marius Popoiu and Eugen Sorin Boia
Children 2024, 11(1), 116; https://doi.org/10.3390/children11010116 - 17 Jan 2024
Viewed by 814
Abstract
Non-unions are quite rare in closed fractures in children. Most distal radius fractures require orthopedic reduction and conservative treatment with very good radiological and clinical/functional results. In case of unsatisfactory reduction, surgical treatment is necessary to correct significant displacement. Surgical treatment consists of [...] Read more.
Non-unions are quite rare in closed fractures in children. Most distal radius fractures require orthopedic reduction and conservative treatment with very good radiological and clinical/functional results. In case of unsatisfactory reduction, surgical treatment is necessary to correct significant displacement. Surgical treatment consists of closed reduction and percutaneous fixation using K-wires. If closed reduction is not possible, open reduction and fixation is mandatory. Generally, fixation is obtained using K-wires, in most cases, even if open reduction is necessary, rarely locking plates, especially in adolescents. The present paper presents a case of non-union that eventually required open reduction and plating. During surgery, however, it became evident that the cause for non-union was the traumatic transposition of the long extensor radialis tendon, through the fracture site to the volar side of the distal forearm. The movement of the carpus translated to constant mobility in the fracture site, leading to non-union and a continuous tendency towards anterior angulation of the distal fragment. The tendon was reduced to its anatomical position, the fracture was reduced, and fixed using a locking plate, and union was achieved with no complications. Traumatic transpositions of tendons should be considered in pediatric non-unions, and restoring anatomy is essential. Full article
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19 pages, 1187 KiB  
Article
The Factorial Structure, Psychometric Properties and Sensitivity to Change of the Distress Tolerance Scale for Children with Emotional Disorders
by Brígida Caiado, Diana Santos, Bárbara Pereira, Ana Carolina Góis, Maria Cristina Canavarro and Helena Moreira
Children 2024, 11(1), 115; https://doi.org/10.3390/children11010115 - 17 Jan 2024
Viewed by 1393
Abstract
Background. The Distress Tolerance Scale (DTS) was adapted for American and Chinese youth, but never for European youth. Moreover, the factor structures found in these previous studies were not consistent. Methods. The DTS was adapted for Portuguese children and then validated among 153 [...] Read more.
Background. The Distress Tolerance Scale (DTS) was adapted for American and Chinese youth, but never for European youth. Moreover, the factor structures found in these previous studies were not consistent. Methods. The DTS was adapted for Portuguese children and then validated among 153 children aged 6–13 years with emotional disorders. A confirmatory factor analysis (CFA) was conducted; the DTS reliability and validity were analyzed, and sex and age differences were explored. A sub-sample of children who received a transdiagnostic CBT (Unified Protocol for Children) was used to analyze the DTS’s sensitivity to therapeutic change. Results. The five tested models (based on previous studies) exhibited adequate fit in the CFA. However, the model previously reported for use in American children with emotional disorders was selected as the most appropriate. The DTS demonstrated adequate psychometric properties, and its validity was established through significant negative associations with measures of anxiety, depression and negative affect, as well as positive associations with positive affect. Age and sex differences were discussed. The DTS scores significantly increased from pre- to post-treatment, demonstrating sensitivity to therapeutic change. Conclusions. The DTS is a suitable and useful measure for assessing children’s distress tolerance and to assess the efficacy of CBT. Full article
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10 pages, 1874 KiB  
Communication
Does Massive Bowel Resection in Newborns Affect Further Immunity in Children?
by Katarzyna Sznurkowska, Anna Borkowska, Agnieszka Zagierska, Magdalena Malanowska, Maciej Zieliński, Maciej Zagierski, Piotr Trzonkowski, Marcin Łosin and Agnieszka Szlagatys-Sidorkiewicz
Children 2024, 11(1), 114; https://doi.org/10.3390/children11010114 - 17 Jan 2024
Viewed by 768
Abstract
Background: The massive resection of the small intestine leading to short bowel syndrome (SBS) deprives an organism of many immunocompetent cells concentrated in gut-associated lymphoid tissue, the largest immune organ in humans. We have aimed to access the influence of bowel resection on [...] Read more.
Background: The massive resection of the small intestine leading to short bowel syndrome (SBS) deprives an organism of many immunocompetent cells concentrated in gut-associated lymphoid tissue, the largest immune organ in humans. We have aimed to access the influence of bowel resection on adaptive immunity in children, based on peripheral lymphocyte subsets and serum immunoglobulins. Methods: 15 children who underwent bowel resection in the first months of their life and required further home parenteral nutrition were enrolled into the study. Based on flow cytometry, the following subsets of lymphocytes were evaluated: T, B, NK, CD4+, C8+, and activated T cells. Results: Statistically significant differences were found for the rates of lymphocytes B, T, CD8+, and NK cells. The absolute count of NK cells was lower in the SBS group than in the control group. Absolute counts of lymphocytes, lymphocytes B, T, CD4+, and percentages of lymphocytes CD4+, and activated T cells inversely correlated with age in SBS group. Conclusions: Children with SBS do not present with clinical signs of immunodeficiency as well as deficits in peripheral lymphocyte subsets and serum immunoglobulins. The tendency of the lymphocyte subpopulations to decrease over time points out the necessity for longer follow- up. Full article
(This article belongs to the Special Issue 10th Anniversary of Children: Feature Papers in Pediatric Surgery)
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12 pages, 5122 KiB  
Article
Trends in the Incidence of Bronchopulmonary Dysplasia after the Introduction of Neurally Adjusted Ventilatory Assist (NAVA)
by Kashish Mehra and Mitchell Kresch
Children 2024, 11(1), 113; https://doi.org/10.3390/children11010113 - 17 Jan 2024
Viewed by 964
Abstract
Objective: This study investigates the difference in the rates of bronchopulmonary dysplasia in very low birth weight infants before and after the introduction of neurally adjusted ventilatory assist (NAVA). Study Design: A retrospective cohort study comparing rates of Bronchopulmonary dysplasia (BPD) before and [...] Read more.
Objective: This study investigates the difference in the rates of bronchopulmonary dysplasia in very low birth weight infants before and after the introduction of neurally adjusted ventilatory assist (NAVA). Study Design: A retrospective cohort study comparing rates of Bronchopulmonary dysplasia (BPD) before and after implementation of NAVA. Eligibility criteria included all very low birth weight VLBW neonates needing ventilation. For analysis, each cohort was divided into three subgroups based on gestational age. Changes in the rate of BPD, length of stay, tracheostomy rates, invasive ventilator days, and home oxygen therapy were compared. Results: There were no differences in the incidence of BPD in neonates at 23–25 6/7 weeks’ and 29–32 weeks’ gestation between the two cohorts. A higher incidence of BPD was seen in the 26–28 5/7 weeks’ gestation NAVA subgroup compared to controls (86% vs. 68%, p = 0.05). No significant difference was found for ventilator days, but infants in the 26–28 6/7 subgroup in the NAVA cohort had a longer length of stay (98 ± 34 days vs. 82 ± 24 days, p = 0.02), a higher percentage discharged on home oxygen therapy (45% vs. 18%, respectively, p = 0.006), and higher tracheostomy rates (3/36 vs. 0/60, p = 0.02), compared to the control group. Conclusions: The NAVA mode was not associated with a reduction in BPD when compared to other modes of ventilation. Unexpected increases were seen in BPD rates, home oxygen therapy rates, tracheostomy rates, and the length of stay in the NAVA subgroup born at 26–28 6/7 weeks’ gestation. Full article
(This article belongs to the Section Pediatric Neonatology)
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11 pages, 689 KiB  
Article
Robotic-Assisted Nissen Fundoplication in Pediatric Patients: A Matched Cohort Study
by Rianne E. M. Killaars, Omar Mollema, Hamit Cakir, Ruben G. J. Visschers and Wim G. van Gemert
Children 2024, 11(1), 112; https://doi.org/10.3390/children11010112 - 17 Jan 2024
Viewed by 1452
Abstract
Background: Nissen Fundoplication (NF) is a frequently performed procedure in children. Robotic-assisted Nissen Fundoplication (RNF), with the utilization of the Senhance® Surgical System (SSS®) (Asensus Surgical® Inc., Durham, NC, USA) featuring 3 mm instruments, aims to improve precision and [...] Read more.
Background: Nissen Fundoplication (NF) is a frequently performed procedure in children. Robotic-assisted Nissen Fundoplication (RNF), with the utilization of the Senhance® Surgical System (SSS®) (Asensus Surgical® Inc., Durham, NC, USA) featuring 3 mm instruments, aims to improve precision and safety in pediatric surgery. This matched cohort study assesses the safety and feasibility of RNF in children using the SSS®, comparing it with Laparoscopic Nissen Fundoplication (LNF). Methods and Results: Twenty children underwent RNF with the SSS® between 2020 to 2023 and were 1:1 matched with twenty LNF cases retrospectively selected from 2014 to 2023. Both groups were similar regarding male/female ratio, age, and weight. Two of the twenty RNF cases (10%) experienced intraoperative complications, whereas three in the LNF group of whom two required reinterventions. The observed percentage of postoperative complications was 5% in the RNF group compared to 15% in the LNF group (p = 0.625). The operative times in the RNF group significantly dropped towards the second study period (p = 0.024). Conclusions: Utilizing SSS® for NF procedures in children is safe and feasible. Observational results may tentatively suggest that growing experiences and continued development will lead to better outcomes based on more accurate and safe surgery for children. Full article
(This article belongs to the Special Issue Advances in Gastrointestinal Surgery in Children)
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19 pages, 1580 KiB  
Article
A Model for Effective Learning in Competition: A Pedagogical Tool to Enhance Enjoyment and Perceptions of Competency in Physical Education Lessons for Young Children
by Neil Castle and Kristy Howells
Children 2024, 11(1), 111; https://doi.org/10.3390/children11010111 - 17 Jan 2024
Viewed by 1404
Abstract
To date, little research on competition has focused on young children (6–7-year-olds). A total of ninety-seven participants (51 boys and 46 girls) from two English primary schools completed two physical education (PE) lessons, which included three different activity challenges. The control group undertook [...] Read more.
To date, little research on competition has focused on young children (6–7-year-olds). A total of ninety-seven participants (51 boys and 46 girls) from two English primary schools completed two physical education (PE) lessons, which included three different activity challenges. The control group undertook the same activities in both lessons. The experimental group did likewise but were set high-, low-, or mid-level targets in lesson two based on individual scores from lesson one. The children completed a post-session questionnaire to assess (i) enjoyment levels and (ii) which activity they perceived they performed best in. The results found that children both improved and enjoyed the lesson most when low- or mid-level targets were set. Indeed, when targets were absent (in the control group), children’s competency scores regressed. Likewise, children perceived that they performed best in the activity where lower targets were set. Their perceived competency included both tangible and intangible reasons. From these results, it is recommended that for practitioners working with 6–7-year-old children, the most effective learning in competition uses individualised and competitive targets and challenges as a means to garner greater enjoyment in PE. Understanding each child’s self-efficacy and motivation is key, which requires ongoing evaluation and assessment during PE lessons. Full article
(This article belongs to the Special Issue Movement Behaviors and Motor Skills in Early Years Children)
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14 pages, 279 KiB  
Article
Insights from a Qualitative Exploration of Adolescents’ Opinions on Sex Education
by María Victoria Díaz-Rodríguez, Vicent Bataller i Perelló, José Granero-Molina, Isabel María Fernández-Medina, María Isabel Ventura-Miranda and María del Mar Jiménez-Lasserrotte
Children 2024, 11(1), 110; https://doi.org/10.3390/children11010110 - 16 Jan 2024
Viewed by 1472
Abstract
Background: Adolescence is a crucial time in the development of young people’s identity, and sexuality is a key issue. Comprehensive sex education provides the knowledge and skills to help adolescents protect their sexual and reproductive health and rights. Policies on sex education in [...] Read more.
Background: Adolescence is a crucial time in the development of young people’s identity, and sexuality is a key issue. Comprehensive sex education provides the knowledge and skills to help adolescents protect their sexual and reproductive health and rights. Policies on sex education in secondary schools are highly influential in the development of quality programmes that support comprehensive sex education. The aim of this study was to explore, describe and understand adolescents’ experiences of sex education. Methods: A qualitative study based on Gadamer’s phenomenology was used. Two focus groups and four in-depth interviews were conducted with 12 private school students, followed by inductive data analysis using ATLAS.ti software 9.0. Results: Two main themes were identified in the analysis: (1) sex education is a challenge for secondary schools and (2) student expectations of sex education. Conclusion: It is essential for adolescents to have access to comprehensive sex education that is adapted to the different stages of their development, is provided by specialised teachers, and involves their families in the process. Full article
12 pages, 1491 KiB  
Article
Knowledge Gaps and Bridges: The Relationship between the Awareness of General Patient Rights and the Awareness of Minors’ Patient Rights in the Netherlands
by Charelity Adu-Gallant, Jaan Toelen, Judith Sluiter-Post, David De Coninck and Peter de Winter
Children 2024, 11(1), 109; https://doi.org/10.3390/children11010109 - 16 Jan 2024
Viewed by 819
Abstract
The major focus of this research is the level of awareness among Dutch parents of general patient rights in relation to minors’ patient rights. Moreover, this study is intended to highlight the most effective strategies to increase the awareness of general and minor [...] Read more.
The major focus of this research is the level of awareness among Dutch parents of general patient rights in relation to minors’ patient rights. Moreover, this study is intended to highlight the most effective strategies to increase the awareness of general and minor patient rights in the Netherlands. A survey was conducted among 1010 Dutch parents aged between 35 and 55 years who had at least one child. In this study, we described the relationship between the knowledge among parents of general patient rights and their understanding of the patient rights of minors. A significant connection was found between the knowledge levels of general patient rights and the knowledge levels of the patient rights of minors (p < 0.05 [95% CI: 0.019–0.183]). While age and sex (male/female) did not appear to be significant confounders in this association, the educational background of the participants may have played a role. This study provides comprehensive insights into the association between the knowledge of general patient rights and the patient rights of minors among Dutch parents. Furthermore, this study points out that there is a need for focused educational interventions to address specific areas of misunderstanding or uncertainty. Full article
(This article belongs to the Section Global and Public Health)
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11 pages, 1314 KiB  
Review
Clinical Diagnosis and Management of Fetal Alcohol Spectrum Disorder and Sensory Processing Disorder in Children
by Lorel Breuer, Jacob R. Greenmyer and Ted Wilson
Children 2024, 11(1), 108; https://doi.org/10.3390/children11010108 - 16 Jan 2024
Viewed by 1897
Abstract
Fetal alcohol spectrum disorder (FASD) is commonly misdiagnosed because of the complexity of presentation and multiple diagnostic criteria. FASD includes four categorical entities (fetal alcohol syndrome, partial fetal alcohol syndrome, alcohol related neurodevelopmental disorder, and alcohol related birth defects). The four FASD diagnostic [...] Read more.
Fetal alcohol spectrum disorder (FASD) is commonly misdiagnosed because of the complexity of presentation and multiple diagnostic criteria. FASD includes four categorical entities (fetal alcohol syndrome, partial fetal alcohol syndrome, alcohol related neurodevelopmental disorder, and alcohol related birth defects). The four FASD diagnostic criteria are facial dysmorphology, growth deficiency, central nervous system dysfunction, and prenatal alcohol exposure. Sensory processing disorders (SPDs) are common in FASD and are observed as inappropriate behavioral responses to environmental stimuli. These can be either a sensory-based motor disorder, sensory discrimination disorder, or sensory modulation disorder. A child with SPD may experience challenges with their fine motor coordination, gross motor coordination, organizational challenges, or behavioral regulation impairments. FASD requires a multidimensional approach to intervention. Although FASD cannot be cured, symptoms can be managed with sleep-based therapies, sensory integration, and cognitive therapies. This paper reviews SPDs in FASD and the interventions that can be used by practitioners to help improve their therapeutic management, although it is unlikely that any single intervention will be the right choice for all patients. Full article
(This article belongs to the Special Issue Advances in Fetal Alcohol Spectrum Disorders (FASD))
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