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Children
Volume 9
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Children, Volume 9, Issue 10 (October 2022) – 179 articles

Cover Story (view full-size image): Fetal blood loss (e.g., feto-maternal hemorrhage) may contribute to perinatal asphyxia. Failure to recognize hypovolemia will delay volume replacement and may result in unsuccessful resuscitation due to lack of adequate cardiac preload. However, excess volume load in the presence of myocardial dysfunction from hypoxic-ischemic injury may precipitate pulmonary edema and intraventricular hemorrhage. Sankaran et al. (2022) is a narrative review of the causes and consequences of acute fetal blood loss and available evidence on volume replacement during resuscitation of asphyxiated neonates. Volume replacement should be reserved for neonates with evidence of hypovolemia or blood loss, and crystalloids or fresh blood are preferred over albumin. Further studies are warranted to investigate the indications, timing and role of volume replacement in neonatal resuscitation. View this paper
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9 pages, 245 KiB  
Article
Character Strength and Mental Health Problems among Children from Low-Income Families in South Korea
by Hyunjoo Na, Gyungjoo Lee, Euna Si, Won Hee Jun and Chang Park
Children 2022, 9(10), 1599; https://doi.org/10.3390/children9101599 - 21 Oct 2022
Viewed by 1339
Abstract
This study was conducted to understand the association between character strength and mental health problems among children in early adolescence from low-income families in South Korea. This study used a cross-sectional and descriptive study design with 214 fifth- and sixth-grade elementary school children [...] Read more.
This study was conducted to understand the association between character strength and mental health problems among children in early adolescence from low-income families in South Korea. This study used a cross-sectional and descriptive study design with 214 fifth- and sixth-grade elementary school children from low-income families enrolled in 20 community centers and receiving government financial assistance. A bivariate probit model was used to examine the association between character strength and mental health problems in the children. We found that character strength lowers the likelihood of developing hyperactivity–inattention and emotional symptoms among children from low-income families. Additionally, adverse life events were associated with increased mental health problems, whereas adverse life events were not significantly correlated with character strength in the current study. Specific interventions should be developed to cultivate character strength among children in early adolescence from low-income families who are at a high risk of mental health problems under cumulative adverse life events. Full article
(This article belongs to the Section Pediatric Nursing)
12 pages, 13855 KiB  
Article
Investigation on the Usefulness of Sulfamethoxazole Trimethoprim Combination Small Tablets in Pediatric Pharmacotherapy: A Single Center Observational Study Using a Questionnaire
by Jumpei Saito, Miho Yamaguchi, Seiichi Shimizu, Kyoko Chiba, Tomoyuki Utano, Akinari Fukuda, Seisuke Sakamoto, Mureo Kasahara and Akimasa Yamatani
Children 2022, 9(10), 1598; https://doi.org/10.3390/children9101598 - 21 Oct 2022
Cited by 2 | Viewed by 1500
Abstract
Sulfamethoxazole trimethoprim (ST) combinations are used to prevent infection in immunocompromised patients. In pediatric patients, conventional ST combination tablets (cTab) are large and granules are not preferred due to their rough and bitter taste in the mouth. Since a new formulation of smaller [...] Read more.
Sulfamethoxazole trimethoprim (ST) combinations are used to prevent infection in immunocompromised patients. In pediatric patients, conventional ST combination tablets (cTab) are large and granules are not preferred due to their rough and bitter taste in the mouth. Since a new formulation of smaller tablets (sTab, 1 cTab = 1-gram granules = 4 sTab) was approved, a study regarding the usability of sTab in pediatric patients was conducted. Children who started taking sTab of the ST combination at our hospital between August 2021 and August 2022 were included. Using an anonymous questionnaire, the dosage of ST combinations, the child’s response (3-point visual scale: positive, neutral, or negative), preparation and administration time, and method of taking the drug were asked. Twenty-two patients (median age: 11.0 years) receiving cTab. Median (range) number of tablets per dose was 1 (0.5–1.5) tablet, and was 4 tablets (1.0–4.0) after switching to sTab. Twenty patients (median age: 5.0 years) receiving granules. Median (range) single dose was 0.75 (0.2–2.0) gram, and was 2.0 (1.0–4.0) tablets after switching to sTab. Post-dose reactions were positive in 5, neutral in 7, and negative in 10 cases for cTab, and positive in 1, neutral in 7, and negative in 12 cases for granules. After switching to sTab, 9, 13 and 0 cases, and 10, 9 and 1 cases were positive, neutral, and negative, respectively. Median preparation and administration times were decreased after switching to sTab in both cTab and granules groups. The frequency of dosage manipulations was also decreased. The switch to sTab improved acceptability, and decreased burden of administration, suggesting that sTab is a user-friendly formulation in pediatric medications. Full article
(This article belongs to the Special Issue Global Collaboration in Pediatric Drug Development and Formulation: Toward Better and Safe, and Appropriate Formulation for Children)
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11 pages, 614 KiB  
Article
Birth Weight and Body Composition as Determined by Isotopic Dilution with Deuterium Oxide in 6- to 8-Year-Old South African Children
by Makama Andries Monyeki, Caroline Molete Sedumedi, John J. Reilly, Xanne Janssen, Herculina Salome Kruger, Ruan Kruger and Cornelia U. Loechl
Children 2022, 9(10), 1597; https://doi.org/10.3390/children9101597 - 21 Oct 2022
Viewed by 1207
Abstract
Low and high birth weight (BW) are associated with obesity later in life; however, this association has not been extensively studied in African countries. This study determines the association between BW and body composition derived from deuterium oxide (D2O) dilution in [...] Read more.
Low and high birth weight (BW) are associated with obesity later in life; however, this association has not been extensively studied in African countries. This study determines the association between BW and body composition derived from deuterium oxide (D2O) dilution in 6- to 8-year-old South African children (n = 91; 40 boys, 51 girls). BW was recorded retrospectively from the children’s Road-to-Health cards. Weight and height were measured using standard procedures, and D2O dilution was used to determine total body water and, subsequently, to determine body fat. Fatness was classified using the McCarthy centiles, set at 2nd, 85th, and 95th (underfat, overfat and obese). BW correlated with body composition measures, such as body weight (r = 0.23, p = 0.03), height (r = 0.33, p < 0.001), and fat free mass (FFM; r = 0.27, p = 0.01). When multiple regression analysis was employed, BW significantly and positively associated with FFM (β = 0.24, p = 0.013; 95% CI: 0.032; 0.441) and fat mass (β = 0.21, p = 0.02, 95%CI: 0.001; 0.412) in girls and boys combined. A total of 13% of the children had a low BW, with 21% being overweight and 17% obese. More girls than boys were overweight and obese. Intervention strategies that promote healthy uterine growth for optimal BW are needed in order to curb the global obesity pandemic. Full article
(This article belongs to the Special Issue New Research in Childhood Nutrition)
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10 pages, 577 KiB  
Article
Clinical Characteristics and Prognosis of the Modified Probable Pneumocystis jirovecii Pneumonia in Korean Children, 2001–2021
by Kyoung Sung Yun, Bin Anh, Sung Hwan Choi, Kyung Taek Hong, Jung Yoon Choi, Ki Wook Yun, Hyoung Jin Kang and Eun Hwa Choi
Children 2022, 9(10), 1596; https://doi.org/10.3390/children9101596 - 21 Oct 2022
Cited by 1 | Viewed by 1209
Abstract
There are few data about Pneumocystis jirovecii pneumonia (PCP) in children, particularly in developed countries. This study investigated the clinical characteristics and prognosis of the clinical PCP in non-HIV-infected Korean children. Children with positive results for the staining and/or polymerase chain reaction (PCR) [...] Read more.
There are few data about Pneumocystis jirovecii pneumonia (PCP) in children, particularly in developed countries. This study investigated the clinical characteristics and prognosis of the clinical PCP in non-HIV-infected Korean children. Children with positive results for the staining and/or polymerase chain reaction (PCR) for P. jirovecii between 2001 and 2021 were identified. Patients were grouped into clinical PCP, which comprised proven and modified probable cases, and non-PCP groups. Modified probable PCP (mp-PCP) indicate the case which P. jirovecii was detected by conventional PCR rather than real-time PCR test. The differences in demographic and clinical characteristics were analyzed between the groups. A total of 110 pneumonia cases with positive results for P. jirovecii PCR and/or stain were identified from 107 children. Of these, 28.2% were classified as non-PCP, 12.7% of proven PCP, and 59.1% of mp-PCP. Compared with the non-PCP group, the mp-PCP group had a significantly higher rate of solid organ transplantation (3.2% vs. 24.6%), fever (58.1% vs. 76.9%), tachypnea (25.8% vs. 66.2%), dyspnea (48.4% vs. 83.1%), desaturation (48.4% vs. 80.0%), and bilateral ground-glass opacity on chest radiograph (19.4% vs. 73.8%). However, when the mp-PCP group was compared with the proven PCP group, there was no statistically significant difference. For children with clinical PCP, age under 5 years of age (odds ratio [OR] 10.7), hospital-onset (OR 6.9), and desaturation as initial symptom (OR 63.5) were significant risk factors for death in multivariable analysis. Modified probable PCP might reliably reflect true PCP in terms of patient’s demographic, clinical features, treatment response, and prognosis. Immunocompromised children with hospital-onset pneumonia who are younger than 5 years of age and have desaturation would be more cautiously and aggressively managed for survival through the screening for P. jirovecii by conventional PCR on appropriate lower respiratory specimens. Full article
(This article belongs to the Section Pediatric Infectious Diseases)
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8 pages, 516 KiB  
Article
Quality of Diet of Patients with Coeliac Disease in Comparison to Healthy Children
by Sara Sila, Mario Mašić, Draženka Kranjčec, Tena Niseteo, Lucija Marić, Ana Radunić, Iva Hojsak, Oleg Jadrešin and Zrinjka Mišak
Children 2022, 9(10), 1595; https://doi.org/10.3390/children9101595 - 21 Oct 2022
Viewed by 1451
Abstract
A lifelong strict gluten-free diet is the only available treatment for patients with coeliac disease (CD). As with any restrictive diet, it may potentially lead to nutritional deficits. Seventy-six patients with CD (mean age 9.0 ± 4.3 years, 57% female) and 590 healthy [...] Read more.
A lifelong strict gluten-free diet is the only available treatment for patients with coeliac disease (CD). As with any restrictive diet, it may potentially lead to nutritional deficits. Seventy-six patients with CD (mean age 9.0 ± 4.3 years, 57% female) and 590 healthy controls (HC) (mean age 9.9 ± 0.1 years, 54% female) were recruited and requested to keep a 3-day food record (3DFR). In HC patients, anthropometric data were determined at the time when 3DFRs were collected. In CD patients, anthropometric data were determined at two time points: at diagnosis and at the time of 3DFRs collection. Intake of energy, macronutrients, and micronutrients was determined using PRODI expert 6.9 software and expressed as a percentage of recommended daily intake. In CD patients, all measured anthropometric measures (body weight (BW), body height (BH), and body mass index (BMI) z-scores) increased significantly after the mean duration of 34.1 months of a GFD. Overall, CD patients had significantly lower BW and BH z-scores compared to healthy controls. Patients with CD were generally more compliant with the recommended dietary intakes of macronutrients and some micronutrients, as compared to HC. Three participants were not compliant with the GFD; 42.1% of participants took oral nutritional supplements at the start of their GFD. Our study showed that patients with CD have better compliance with dietary recommendations compared to healthy controls, showing that a well-balanced GFD diet can provide necessary macro- and micronutrients. Full article
(This article belongs to the Special Issue Towards Children’s Healthy Growth: Improving Children’s Nutrition and Eating Behaviors)
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5 pages, 195 KiB  
Review
Extremely Preterm Babies—Legal Aspects and Palliative Care at the Border of Viability
by Reinhard Dettmeyer
Children 2022, 9(10), 1594; https://doi.org/10.3390/children9101594 - 21 Oct 2022
Viewed by 1169
Abstract
There are various legal considerations and rare decisions of courts in western countries concerning palliative care and the border of viability in cases of extremely preterm babies. Nevertheless, on the one hand, regulations and decisions of courts describe the conditions physicians have to [...] Read more.
There are various legal considerations and rare decisions of courts in western countries concerning palliative care and the border of viability in cases of extremely preterm babies. Nevertheless, on the one hand, regulations and decisions of courts describe the conditions physicians have to accept. On the other hand, courts are also able to accept that every case can be special, and needs a unique answer. Therefore, the framework can be described as well as the medical disciplines, which should be involved in a particular case. Full article
(This article belongs to the Special Issue Decision Making at the Border of Viability and in Critically Ill Newborn Infants)
7 pages, 218 KiB  
Article
Sudden Death in Patients with a History of Kawasaki Disease under School Supervision
by Mamoru Ayusawa, Hidemasa Namiki, Yuriko Abe, Rie Ichikawa and Ichiro Morioka
Children 2022, 9(10), 1593; https://doi.org/10.3390/children9101593 - 21 Oct 2022
Cited by 2 | Viewed by 1251
Abstract
We investigated the incidence of sudden death in students with a history of Kawasaki disease (KD) while under school supervision. Reports of sudden death in students with a history of KD during 1990–1999 and 2000–2009 were retrieved from the mutual aid system data. [...] Read more.
We investigated the incidence of sudden death in students with a history of Kawasaki disease (KD) while under school supervision. Reports of sudden death in students with a history of KD during 1990–1999 and 2000–2009 were retrieved from the mutual aid system data. The student’s grade, sex, circumstances at the time of sudden death, final diagnosis, recommended restrictions on school activities, and intensity of physical activity at the time of sudden death were investigated. There were 11 cases from 1990 to 1999 and 3 from 2000 to 2009; KD was complicated with coronary artery aneurysm (CAA) in nine and one cases, respectively. The incidence of sudden death decreased by approximately 50% for KD history and 80% for KD with CAA between the two decades; however, the difference was not statistically significant. Of the 14 cases, 12 occurred during moderate-to-strenuous exercise; the restriction on exercise for students with KD complicated with CAA was not followed in at least five cases during 1990–1999, while three cases during 2000–2009 occurred without recommended restriction. Cases of sudden cardiac death decreased during 2000–2009, compared with those during 1990–1999. Special attention is required for students with a history of KD, particularly when complicated with CAA. Full article
(This article belongs to the Special Issue Clinic Research on Kawasaki Disease in Children)
11 pages, 668 KiB  
Article
The Predictive Role of Perceived Autonomy Support in Elementary School Children Physical Activity
by Mikel Vaquero-Solís, Miguel Ángel Tapia-Serrano, Pedro Antonio Sánchez-Miguel, Rubén Llanos-Muñoz and Miguel Angel López-Gajardo
Children 2022, 9(10), 1592; https://doi.org/10.3390/children9101592 - 21 Oct 2022
Viewed by 1391
Abstract
The present article aimed to test a predictive model based on children’s perception of autonomy support exercised by their physical education teachers in establishing a state of high motivational quality, which in turn leads to greater intention and physical activity. Participants were 502 [...] Read more.
The present article aimed to test a predictive model based on children’s perception of autonomy support exercised by their physical education teachers in establishing a state of high motivational quality, which in turn leads to greater intention and physical activity. Participants were 502 elementary school students aged 9 to 11 years (52.59% males (9.47 ± 0.53 years old) and 47.41% females (9.54 ± 0.53 years old)), who completed a self-reported questionnaire of perceived autonomy support from physical education teachers, self-determination, intention to be physically active, and physical activity. Results showed that perceived autonomy support was positively related to autonomous motivation, which in turn was associated with intention and physical activity. In addition, the model did not present variations with respect to gender and confirmed the indirect effects of autonomous motivation on intention and practice of physical activity. Finally, we conclude on the importance of an adequate perception of autonomy support in students by their teachers for the establishment of an appropriate motivational state that could promote greater intention and physical activity. Thus, the motivational state acquired in physical education classes can be translated into intention and practice of physical activity in different contexts of students’ daily lives. Full article
(This article belongs to the Special Issue Physical Education, Physical Activity, and Health Education in Children and Adolescents)
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10 pages, 881 KiB  
Article
Incidence of Emergence Delirium in the Pediatric PACU: Prospective Observational Trial
by Eva Klabusayová, Tereza Musilová, Dominik Fabián, Tamara Skříšovská, Václav Vafek, Martina Kosinová, Michaela Ťoukálková, Adéla Vrtková, Jozef Klučka and Petr Štourač
Children 2022, 9(10), 1591; https://doi.org/10.3390/children9101591 - 21 Oct 2022
Cited by 6 | Viewed by 2280
Abstract
Emergence delirium (ED) is a postoperative complication in pediatric anesthesia characterized by perception and psychomotor disorder and has a negative impact on morbidity in the form of maladaptive behavior, which can last weeks after anesthesia. Patients with developed ED present with psychomotor anxiety, [...] Read more.
Emergence delirium (ED) is a postoperative complication in pediatric anesthesia characterized by perception and psychomotor disorder and has a negative impact on morbidity in the form of maladaptive behavior, which can last weeks after anesthesia. Patients with developed ED present with psychomotor anxiety, agitation, and are at higher risk of unintentional extraction of an intravenous cannula, self-harm and nausea and vomiting. The described incidence of ED varies between 25–80%, with a higher prevalence among children younger than 6 years of age. We aimed to determine the incidence of ED in pediatric patients (>1 month) after general anesthesia in the post-anesthesia care unit (PACU), using Paediatric Anaesthesia Emergence Delirium (PAED) score, Watcha score and Richmond agitation and sedation scale (RASS). The incidence of ED was the highest in the PAED score with cutoff ≥10 points (89.0%, n = 1088). When using PAED score >12 points, ED incidence was 19.3% (n = 236). The lowest incidence was described by Watcha and RASS scores, 18.8% (n = 230) vs. 18.1% (n = 221), respectively. The threshold for PAED ≥10 points seems to give false-positive results, whereas the threshold >12 points is more accurate. RASS scale, although intended primarily for estimation of the depth of sedation, seems to have a good predictive value for ED. Full article
(This article belongs to the Special Issue Intensive Care Medicine in Children: Current Concepts and Future Perspetives)
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9 pages, 411 KiB  
Article
Accumulation of Postoperative Unexpected Events Assessed by the Comprehensive Complication Index® as Prognostic Outcome Parameters for Kasai Procedure
by Omid Madadi-Sanjani, Julia Brendel, Marie Uecker, Eva-Doreen Pfister, Ulrich Baumann, Johanna Ohlendorf and Joachim F. Kuebler
Children 2022, 9(10), 1590; https://doi.org/10.3390/children9101590 - 20 Oct 2022
Viewed by 1336
Abstract
Introduction The Kasai procedure in children with biliary atresia (BA) is associated with several complications in the short-term. The Comprehensive Complication Index (CCI®) is a validated metric in adult surgery for the analysis of complications and morbidity in surgical patients. We [...] Read more.
Introduction The Kasai procedure in children with biliary atresia (BA) is associated with several complications in the short-term. The Comprehensive Complication Index (CCI®) is a validated metric in adult surgery for the analysis of complications and morbidity in surgical patients. We aimed to analyze the CCI® for the first time in BA infants and to correlate its association with outcomes. Material and Methods We conducted a retrospective review of medical records of infants with type III BA undergoing the Kasai procedure between January 2011 and December 2021 at our institution. All unexpected events were ranked according to the Clavien–Dindo classification, and the CCI® per patient was subsequently calculated. Clavien–Dindo grades, individual events, CCI®, and total event numbers per patient were correlated with one- and two-year outcomes post-surgery. Results A total of 131 events were identified in 101 patients (ranging 0–11 per patient). Forty-four Grade I (33.6%), 67 Grade II (51.1%), 18 Grade III (13.7%), and two sentinel events [>Grade IV] (1.5%) were documented according to Clavien–Dindo, including one death in a cardiac-associated BA patient. None of the complications significantly correlated with a poor outcome. Sixty-three (62.4%) CCI® scores were calculated (range 0–100). The mean CCI® score during the in-patient treatment post-surgery was significantly higher in patients with a poorer outcome than patients with native liver survival at one- and two-year follow-up (22.7 ± 21.7 vs. 13.2 ± 18.1; p = 0.02). Conclusion Not the severity of complications, but the accumulation of numerous events related to Kasai procedure were associated with a poorer outcome. Therefore, the CCI® is an excellent instrument for the postoperative morbidity assessment of BA patients. Full article
(This article belongs to the Special Issue Pediatric Hepatology and Liver Transplantation—How Can We Further Improve?)
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12 pages, 712 KiB  
Article
Parenting Styles Predict Future-Oriented Cognition in Children: A Cross-Sectional Study
by Saeid Sadeghi, Sajad Ayoubi and Serge Brand
Children 2022, 9(10), 1589; https://doi.org/10.3390/children9101589 - 20 Oct 2022
Cited by 2 | Viewed by 4177
Abstract
Parenting is a crucial environmental factor in children’s social and cognitive development. This study investigated the association between parenting styles and future-oriented cognition skills in elementary school-aged children. Cross-sectional data were collected from parents of 200 Iranian elementary school aged children (6–13 years), [...] Read more.
Parenting is a crucial environmental factor in children’s social and cognitive development. This study investigated the association between parenting styles and future-oriented cognition skills in elementary school-aged children. Cross-sectional data were collected from parents of 200 Iranian elementary school aged children (6–13 years), 139 boys and 61 girls. Baumrind’s Parenting Styles Questionnaire and Children’s Future Thinking Questionnaire (CFTQ) were administered to parents. There was a significant positive association between authoritative parenting and children’s abilities in prospective memory, episodic foresight, planning, delay of gratification, and future-oriented cognition total score. In contrast, authoritarian parenting was negatively correlated with children’s abilities in planning, delay of gratification, and future-oriented cognition. Increases in authoritative parenting scores predicted better future-oriented cognition abilities in children. Full article
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9 pages, 555 KiB  
Article
Under-Recognized Macrophage Activation Syndrome in Refractory Kawasaki Disease: A Wolf in Sheep’s Clothing
by Sangwon Rhee, Danbi Kim, Kyoungsoon Cho, Jung Woo Rhim, Soo-Young Lee and Dae Chul Jeong
Children 2022, 9(10), 1588; https://doi.org/10.3390/children9101588 - 20 Oct 2022
Cited by 3 | Viewed by 1462
Abstract
Recognition of macrophage activation syndrome (MAS) in patients with refractory Kawasaki disease (KD) can be challenging. This study aimed to investigate the incidence of MAS in patients with refractory KD and to compare the characteristics of refractory KD and MAS. Medical records of [...] Read more.
Recognition of macrophage activation syndrome (MAS) in patients with refractory Kawasaki disease (KD) can be challenging. This study aimed to investigate the incidence of MAS in patients with refractory KD and to compare the characteristics of refractory KD and MAS. Medical records of 468 patients diagnosed with KD from January 2010 to December 2019 were retrospectively reviewed. Of the 468 KD patients, 63 were enrolled in the study as a refractory KD group (n = 59) and an MAS group (n = 4). The incidence of MAS was 0.8% (4/468) in patients with KD and 6.3% (4/63) in patients with refractory KD. Compared to the refractory KD group, the MAS group had higher frequencies of incomplete KD, hepatosplenomegaly, third-line treatment, and MAS screening, and showed lower levels of albumin. No significant differences were found in other clinical and laboratory findings. In addition to four patients with MAS, five patients with refractory KD who received third-line treatment showed severe systemic inflammation and organ dysfunction, but only one in five patients underwent MAS screening, including ferritin levels. In conclusion, given the relatively high incidence of MAS in children with refractory KD and the similar phenotype between refractory KD and MAS, we propose that MAS screening should be included in routine laboratory tests for refractory KD. Full article
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10 pages, 456 KiB  
Article
Listening to Music and Playing Activities during Recreation between Lessons Regenerate Children’s Cognitive Performance at Different Times of Day
by Nourhen Mezghani, Achraf Ammar, Turki Mohsen Alzahrani, Atyh Hadadi, Salma Abedelmalek, Omar Trabelsi, Sabeh ben Abdallah, Cyrine H’mida, Omar Boukhris, Liwa Masmoudi, Khaled Trabelsi and Hamdi Chtourou
Children 2022, 9(10), 1587; https://doi.org/10.3390/children9101587 - 20 Oct 2022
Cited by 2 | Viewed by 2085
Abstract
The interruption of learning processes by breaks filled with diverse activities is common in everyday life. The purpose of this study was to investigate the effects of the time of day (TOD) of playing with or without music during recess on cognitive performance [...] Read more.
The interruption of learning processes by breaks filled with diverse activities is common in everyday life. The purpose of this study was to investigate the effects of the time of day (TOD) of playing with or without music during recess on cognitive performance regeneration among students aged between 11 and 12. Twenty-seven volunteer children (aged 12 ± 0.6 years) completed four trials at 09h45, 10h15, 14h45, and 15h15. Each test session was separated by recreation between classroom lessons with different conditions: music only (MSC), playing only (PAY), music and playing (MSC-PAY), and without music and playing (NON). During each session, oral temperature, reaction time (RT), and constant attention (CA) were measured. For all parameters, the ANOVA revealed a significant effect of the type of activity. However, no significant effect of the TOD and no significant interaction of type of activity × TOD were reported. The Bonferroni post hoc test revealed that Δ-core temperature was significantly higher during PAY and MSC-PAY compared to NON (p < 0.05). Δ-attention was higher during MSC, PAY, and MSC-PAY compared to NON (p < 0.001). Δ-attention was lower during MSC (p < 0.05), PAY (p < 0.05), and MSC-PAY (p < 0.01) compared to NON. Therefore, playing, listening to music, and playing while listening to music at recess improve the child’s ability to regenerate cognitive performance regardless of the TOD. Full article
(This article belongs to the Special Issue Physical Education, Physical Activity, and Health Education in Children and Adolescents)
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10 pages, 1092 KiB  
Review
Current Management of Generalized Convulsive Status Epilepticus in Children
by Štefania Aulická
Children 2022, 9(10), 1586; https://doi.org/10.3390/children9101586 - 20 Oct 2022
Viewed by 2956
Abstract
Generalized convulsive status epilepticus (GCSE) in pediatric patients is an emergency condition with high morbidity and mortality and potentially irreversible brain damage, leading to cognitive deterioration, psychomotor retardation, chronic epilepsy with recurring seizures, and other complications. Treatment must be initiated in the impending [...] Read more.
Generalized convulsive status epilepticus (GCSE) in pediatric patients is an emergency condition with high morbidity and mortality and potentially irreversible brain damage, leading to cognitive deterioration, psychomotor retardation, chronic epilepsy with recurring seizures, and other complications. Treatment must be initiated in the impending GCSE phase, within five minutes of the onset of a generalized convulsive seizure. Early initiation of treatment and adequate therapy is a prerequisite for a good patient outcome. Full article
(This article belongs to the Special Issue Intensive Care Medicine in Children: Current Concepts and Future Perspetives)
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11 pages, 403 KiB  
Systematic Review
Correlation between Pacifier Use in Preterm Neonates and Breastfeeding in Infancy: A Systematic Review
by Eirini Orovou, Maria Tzitiridou-Chatzopoulou, Maria Dagla, Panagiotis Eskitzis, Ermioni Palaska, Maria Iliadou, Georgios Iatrakis and Evangelia Antoniou
Children 2022, 9(10), 1585; https://doi.org/10.3390/children9101585 - 19 Oct 2022
Cited by 2 | Viewed by 2795
Abstract
Background: Breastfeeding is very important for the proper nutrition and growth of the child, as well as, the health of the mother. To start breastfeeding, the neonate must have extensive oral capacities for sucking functions but, premature neonates may not have the muscle [...] Read more.
Background: Breastfeeding is very important for the proper nutrition and growth of the child, as well as, the health of the mother. To start breastfeeding, the neonate must have extensive oral capacities for sucking functions but, premature neonates may not have the muscle strength needed to suck successfully. However, the non-nutritive sucking achieved by using a pacifier, has been identified by previous research as a factor associated with shorter duration and exclusivity of breastfeeding. This study aims to perform a systematic review to investigate the relationship between pacifier use in preterm neonates and breastfeeding in infancy. Methods: We included prospective studies, as well as randomized controlled studies that evaluated the association between pacifier use by preterm neonates and of breastfeeding in infancy. Ten research articles from PubMed/Medline, Google Scholar and Crossref were included in the review from a total of 1455 articles. The results differ depending on the type of study.Most prospective studies have shown a negative correlation between pacifier use and breastfeeding, while the randomized controlled studies found a positive correlation. Conclusions: Pacifier use in preterm infants helps transition from tube to oral feeding, breastfeeding, faster weight gain and earlier discharge from the NICU. However, the relationship between pacifiers and breastfeeding is more complicated, as it appears to be influenced by additional risk factors. Full article
(This article belongs to the Special Issue Infant Feeding: Advances and Future Challenges)
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18 pages, 1105 KiB  
Review
Interventions for Sensory Over-Responsivity in Individuals with Autism Spectrum Disorder: A Narrative Review
by Huan-Ling Yuan, Cynthia Y. Y. Lai, Mabel N. K. Wong, Tak Chun Kwong, Yat Sze Choy, Steve W. Y. Mung and Chetwyn C. H. Chan
Children 2022, 9(10), 1584; https://doi.org/10.3390/children9101584 - 19 Oct 2022
Cited by 5 | Viewed by 4211
Abstract
Individuals with autism spectrum disorder (ASD) often exhibit sensory over-responsivity (SOR), which is characterized by an overwhelmingly negative reaction to or avoidance of sensory stimulation. Despite the detrimental effects of SOR on people’s personal and social lives, the knowledge of and interventions for [...] Read more.
Individuals with autism spectrum disorder (ASD) often exhibit sensory over-responsivity (SOR), which is characterized by an overwhelmingly negative reaction to or avoidance of sensory stimulation. Despite the detrimental effects of SOR on people’s personal and social lives, the knowledge of and interventions for the issue remain limited. This paper collates and reviews studies on SOR and information on the potential for effective interventions for people with ASD. This review reveals evidence that SOR has a close relationship with anxiety, depression, insomnia, and family life impairment and an underlying mechanism related to SOR. Four interventions and their theoretical bases in sensory-motor processing are discussed in this paper, namely, physical activity (PA), sensory integration therapy (SIT), mindfulness-based cognitive therapy (MBCT), and cognitive behavioral therapy (CBT). These interventions focus on establishing coping strategies for regulating the emotional response to sensory information, and they have been found to be effective and to have the potential to help children with ASD reduce their SOR behaviors. This paper provides guidance for selecting appropriate interventions and for further investigation of more effective interventions in the future. Full article
(This article belongs to the Special Issue Sensory Impairments in Children with Neurodevelopmental Disabilities)
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10 pages, 1091 KiB  
Article
The Laparoscopic Cholecystectomy and Common Bile Duct Exploration: A Single-Step Treatment of Pediatric Cholelithiasis and Choledocholithiasis
by Zenon Pogorelić, Marko Lovrić, Miro Jukić and Zdravko Perko
Children 2022, 9(10), 1583; https://doi.org/10.3390/children9101583 - 19 Oct 2022
Cited by 8 | Viewed by 3215
Abstract
Background: In recent years, complicated biliary tract diseases are increasingly diagnosed in children. Laparoscopic exploration of the common bile duct (LCBDE) followed by laparoscopic cholecystectomy has gained popularity in children. The aim of this study was to investigate the outcomes of LCBDE in [...] Read more.
Background: In recent years, complicated biliary tract diseases are increasingly diagnosed in children. Laparoscopic exploration of the common bile duct (LCBDE) followed by laparoscopic cholecystectomy has gained popularity in children. The aim of this study was to investigate the outcomes of LCBDE in children and compare them with the treatment outcomes of previously used endoscopic retrograde cholangiopancreatography (ERCP). Methods: From January 2000 to January 2022, a total of 84 children (78.5% female) underwent laparoscopic cholecystectomy with a median follow-up of 11.4 (IQR 8, 14) years. Of these, 6 children underwent laparoscopic cholecystectomy (LC) + ERCP and 14 children underwent LCBDE for choledochiothiasis. The primary end point of the study was the success of treatment in terms of the incidence of complications, recurrence rate, and rate of reoperation. Secondary endpoints were stone characteristics, presenting symptoms, duration of surgery, and length of hospital stay. Results: The majority of patients were female in both groups (83.5% vs. 85.7%), mostly overweight with a median BMI of 27.9 kg/m2 and 27.4 kg/m2, respectively. Obstructive jaundice, colicky pain, acute pancreatitis, and obstruction of the papilla were the most common symptoms in both groups. The majority of patients (68%) had one stone, whereas two or more stones were found in 32% of patients. The median diameter of the common bile duct was 9 mm in both groups. The procedure was successfully completed in all patients in the ERCP group. In the group of patients treated with LCBDE, endoscopic extraction of the stone with a Dormia basket was successfully performed in ten patients (71.4%), while in the remaining four patients (28.6%) the stones were fragmented with a laser because extraction with the Dormia basket was not possible. The median operative time was 79 min in the LCBDE group (IQR 68, 98), while it was slightly longer in the ERCP group, 85 min (IQR 74, 105) (p = 0.125). The length of hospital stay was significantly shorter in the LCBDE group (2 vs. 4 days, p = 0.011). No complications occurred in the LCBDE group, while two (40%) complications occurred in the ERCP group: pancreatitis and cholangitis (p = 0.078). During the follow-up period, no conversions, papillotomies, or recurrences were recorded in either group. Conclusions: Exploration of the common bile duct and removal of stones by LCBDE is safe and feasible in pediatric patients for the treatment of choledocholithiasis. Through this procedure, choledocholithiasis and cholelithiasis can be treated in a single procedure without papillotomy or fluoroscopy. Compared with LC + ERCP, LCBDE is associated with a shorter hospital stay. The incidence of complications was rather low but not statistically significant. Full article
(This article belongs to the Section Pediatric Surgery)
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8 pages, 441 KiB  
Review
Treatment of Food Aversion and Eating Problems in Children with Short Bowel Syndrome: A Systematic Review
by Francesca Gigola, Virginia Carletti, Riccardo Coletta, Martina Certini, Marco Del Riccio, Caterina Bortolotti and Antonino Morabito
Children 2022, 9(10), 1582; https://doi.org/10.3390/children9101582 - 19 Oct 2022
Cited by 3 | Viewed by 2117
Abstract
Food Aversion (FA) is a strong refusing behaviour to the oral assumption of food that can affect children with Short Bowel Syndrome (SBS). Management includes behavioural and Messy Play treatments, with few reports on systematic strategies to return the patient to enjoyable eating. [...] Read more.
Food Aversion (FA) is a strong refusing behaviour to the oral assumption of food that can affect children with Short Bowel Syndrome (SBS). Management includes behavioural and Messy Play treatments, with few reports on systematic strategies to return the patient to enjoyable eating. We conducted a systematic review to better understand this complex and vital issue. (1) Materials and Methods: We investigated publications using MEDLINE, Embase, and the Web of Science to include articles published up to July 2022. The inclusion criteria were original articles including paediatric patients (aged < 18 years old) affected by SBS and Intestinal Failure (IF) who underwent treatment for FA. (2) Results: A total of 24 patients received treatment—15 (62.5%) patients were male and 9 (37.5%) were female. The age range was from 1 month to 16 years. Treatment of FA was carried out by behavioural therapy in 2 patients and Messy Play Therapy in 12 patients already surgically and pharmacologically managed for SBS. The treatment results showed complete weaning from Parenteral Nutrition in 9/14 cases (64%) using the behavioural treatment and 7/12 cases using Messy Play Therapy. (3) Conclusions: FA is a rare but disabling condition that often affects SBS patients, worsening their overall health and quality of life. This condition should be addressed in an Intestinal Rehabilitation Centre context. Our review sheds light on the literature gap regarding FA, and further studies are required to understand better which treatment options best suit SBS paediatric patients. Full article
(This article belongs to the Section Pediatric Surgery)
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8 pages, 233 KiB  
Article
Correlation between Cord Blood Vitamin D Levels and Problem-Solving Neurodevelopment in Early Childhood: A Cohort Study in Rural Indonesia
by Stephanie Supriadi, Djatnika Setiabudi, Anindita Noviandhari, Raden Tina Dewi Judistiani, Budi Setiabudiawan and Meita Dhamayanti
Children 2022, 9(10), 1581; https://doi.org/10.3390/children9101581 - 19 Oct 2022
Cited by 1 | Viewed by 1091
Abstract
Vitamin D influence on brain development and subsequent postnatal neurodevelopment remains controversial. We explored the correlation between cord blood vitamin D levels and longitudinal neurodevelopment in early childhood. A cohort study was conducted on term infants with no congenital abnormalities, born from pregnant [...] Read more.
Vitamin D influence on brain development and subsequent postnatal neurodevelopment remains controversial. We explored the correlation between cord blood vitamin D levels and longitudinal neurodevelopment in early childhood. A cohort study was conducted on term infants with no congenital abnormalities, born from pregnant women from a cohort study. Cord blood samples were collected to measure vitamin D. Neurodevelopment was examined three times in infants aged 6, 12 and 24 months using the Ages and Stages Questionnaire-3, which comprises 30 questions of five developmental domains: gross motor, fine motor, communication, problem-solving and social–personal. Statistical analysis was conducted with Spearman’s rank correlation and multiple linear regression. Of the 141 babies born from previous cohort studies, only 116 participants were included. The mean level of cord blood vitamin D was 16.2 ng/mL. The percentage participants with vitamin D deficiency and insufficiency were 12.9 and 65.5, respectively. Cord blood vitamin D and the problem-solving domain for infant aged 12 and 24 months were correlated (r = 0.217 and 0.414, respectively). Multiple linear regression showed a decreased problem-solving domain score of 0.641 associated with decreased vitamin D levels. In conclusion, cord blood vitamin D levels correlated with infant neurodevelopmental status. Full article
10 pages, 632 KiB  
Article
Psychometric Assessment of the Handwriting Proficiency Screening Questionnaire (HPSQ)—Thai Version for Primary School-Aged Children
by Peeradech Thichanpiang, Anuchart Kaunnil, Kerry Lee, Xiaozi Gao, Chutikorn Nopparat and Kannika Permpoonputtana
Children 2022, 9(10), 1580; https://doi.org/10.3390/children9101580 - 19 Oct 2022
Viewed by 2045
Abstract
In this study, the original Handwriting Proficiency Screening Questionnaire (HPSQ) was translated into Thai and cross-culturally adapted for use among school-aged children in Thailand. Additionally, the initial psychometric properties of the new Thai version were assessed, including internal consistency, construct validity, and content [...] Read more.
In this study, the original Handwriting Proficiency Screening Questionnaire (HPSQ) was translated into Thai and cross-culturally adapted for use among school-aged children in Thailand. Additionally, the initial psychometric properties of the new Thai version were assessed, including internal consistency, construct validity, and content validity. The original HPSQ was forward-translated by two independent translators from English to Thai and then back-translated. A final consolidation was conducted by an expert committee to develop the Thai HPSQ. In the psychometric evaluation, content validity was quantified using the item-objective congruence (IOC) value for each item. Intra-rater and inter-rater reliabilities were also assessed. Internal consistency was measured using Cronbach’s alpha coefficient, and confirmatory factor analysis models were used to examine its construct validity. The Thai version of the HPSQ had excellent internal consistency (α = 0.92), good construct, and content validity (IOC value > 0.6). Intra-rater reliability was good (intraclass correlation coefficient (ICC) = 0.98), and inter-rater reliability ranged from fair to good (ICC = 0.46−0.77). Factor analysis revealed that a three-factor model best fitted the data. Thus, the Thai version of the HPSQ is a reliable and valid instrument for handwriting evaluation among Thai school-aged children. It can be useful for teachers and therapists to identify students with handwriting problems. Full article
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12 pages, 264 KiB  
Article
Interview-Based Qualitative Descriptive Study on Risk Factors of School Withdrawal among Elementary School Children
by Sachiko Înoue
Children 2022, 9(10), 1579; https://doi.org/10.3390/children9101579 - 19 Oct 2022
Cited by 1 | Viewed by 1488
Abstract
With increasing school refusal among elementary school children, we qualitatively examined the associated factors. Elementary school teachers underwent semi-structured interviews, and the data generated were analyzed using SCAT. We conducted interviews with 27 teachers (18 men, nine women) responsible for children refusing to [...] Read more.
With increasing school refusal among elementary school children, we qualitatively examined the associated factors. Elementary school teachers underwent semi-structured interviews, and the data generated were analyzed using SCAT. We conducted interviews with 27 teachers (18 men, nine women) responsible for children refusing to attend school. We analyzed verbatim transcripts of the interviews and abstracted six constructs for school refusal: underdeveloped interpersonal skills; families having difficulty in supporting their children to attend school; low self-esteem; diverse views on school refusal; tenuous relationships among local community members; and an environment where games and media are easily accessible. Children refusing to attend school may be unable to relate well to other people owing to underdeveloped interpersonal skills, and they may have low self-esteem. Regarding the home environment of children who are not positive about school life, living in families having difficulty in supporting their children to attend school may make the children less likely to do so. Because of tenuous relationships with local community members, there has been a decline in the involvement of people around children other than family members in encouraging school attendance. Recently, diverse views on school refusal have been accepted; increasingly, parents and children are likely to choose to spend time outside school. An environment in which games and media are easily accessible may make it easy to relate to other people without attending school, undermining the need for school attendance. Full article
12 pages, 341 KiB  
Article
How Stressful Is Examining Children with Symptoms of Child Abuse?—Measurement of Stress Appraisal (SAM) in German Physicians with Key Expertise in Pediatrics
by Louisa Thiekötter, Peter Schmidt, Marie-Léne Scheiderer, Heidrun Lioba Wunram, Michael Paulussen, Daniela Reis and Oliver Fricke
Children 2022, 9(10), 1578; https://doi.org/10.3390/children9101578 - 19 Oct 2022
Viewed by 1626
Abstract
Background: Pediatricians frequently feel uncertain about their ability to detect early symptoms of child abuse and how to respond in suspected cases. Aim: This study investigated the transactional stress model in German pediatricians who experienced imagination stories with a child protection scenario and [...] Read more.
Background: Pediatricians frequently feel uncertain about their ability to detect early symptoms of child abuse and how to respond in suspected cases. Aim: This study investigated the transactional stress model in German pediatricians who experienced imagination stories with a child protection scenario and another potentially stress-triggering scenario. Methods: A two-part survey was conducted online. Each part included a different imagination story and evaluation of the Stress Appraisal Measure (SAM), as well as questions on child protection, current problematics, and suggested remedies. In total, 96 pediatricians participated. The child abuse scenario was perceived as significantly more threatening and more stressful than a medical emergency. The pediatricians declared moderate familiarity with the Child Protection Guidelines and the Federal Child Protection Act and an average confidence in their application. The greatest perceived problems were communication difficulties with parents and youth welfare services. Suggested improvements were concrete procedural directives, more training programs, better interdisciplinary networks, and greater exchange among colleagues. Conclusions: To optimize their potential in the child protection system, pediatricians need to be better supported in coping with the identified stressors in child abuse scenarios. Full article
(This article belongs to the Section Global and Public Health)
13 pages, 489 KiB  
Article
Screen Time of Preschool-Aged Children and Their Mothers, and Children’s Language Development
by Riikka Mustonen, Ritva Torppa and Suvi Stolt
Children 2022, 9(10), 1577; https://doi.org/10.3390/children9101577 - 18 Oct 2022
Cited by 7 | Viewed by 12104
Abstract
Although children’s increased screen time has been found to associate with poorer language development, it is open to question which part of language ability screen time specifically associates with. Our aim was to examine the association between children’s screen time (alone and together [...] Read more.
Although children’s increased screen time has been found to associate with poorer language development, it is open to question which part of language ability screen time specifically associates with. Our aim was to examine the association between children’s screen time (alone and together with a parent), mothers’ screen time, and the different domains of children’s language skills. Mothers reported their children’s (N = 164, aged 2.5 to 4.1 years) screen time and their own on a weekday and a day off. Children’s lexical, phonological, morphological, receptive, and general language abilities were measured using validated tests. The connections between children’s and mothers’ screen time and children’s language skills were analyzed using correlation analyses and linear regression models. The more the children used screen time alone, or the greater the amount of the mothers’ screen time, the weaker the children’s lexical and general language abilities when the children’s age, maternal education level, and birth order were controlled for. We also found cumulative, negative links to the children’s lexical and general language abilities when the amount of their screen time alone and the amount of the mothers’ screen time were simultaneously included in the regression model. The results suggest that it is important to restrict both children’s screen time spent alone and mothers’ screen time. Full article
(This article belongs to the Special Issue Cognitive and Linguistic Development in Children and Adolescents)
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25 pages, 1174 KiB  
Article
Ultra-Orthodox Parents’ Perceptions of Arts Therapies for Their Children
by Lali Keidar, Sharon Snir, Dafna Regev and Eliav Keidar
Children 2022, 9(10), 1576; https://doi.org/10.3390/children9101576 - 18 Oct 2022
Cited by 2 | Viewed by 1773
Abstract
Studies have underscored the complexity of psychotherapy for Ultra-Orthodox Jews, and cross-cultural therapy in particular, which evokes fear of disruption of basic values. Parents’ sense of responsibility for their child’s religious education exacerbates these problems in child therapy. However, there is scant research [...] Read more.
Studies have underscored the complexity of psychotherapy for Ultra-Orthodox Jews, and cross-cultural therapy in particular, which evokes fear of disruption of basic values. Parents’ sense of responsibility for their child’s religious education exacerbates these problems in child therapy. However, there is scant research on child therapy for the Ultra-Orthodox, especially in the field of arts therapies. The present study examined the perceptions of 17 Ultra-Orthodox parents whose children were receiving arts therapies (including art therapy, dance/movement therapy, music therapy, psychodrama and bibliotherapy). Semi-structured interviews were conducted with the parents and analyzed based on the principles of Consensual Qualitative Research. The study covered five domains: (1) The parents’ experiences in therapy; (2) The parents’ perceptions of the child’s experiences in therapy; (3) Implications of environmental-social factors on the parents’ perceptions and experiences of therapy; (4) Effects of intercultural aspects on therapy; (5) Perceptions of the use of the arts in therapy. The findings show that the experiences of ultra-Orthodox parents in the arts therapies of their children is complex due to the influence of the socio-cultural context, which involves dealing with stigma and tensions in their relationship with the education system. This context also shapes their perceptions of therapy, which can be characterized as purpose-oriented. The findings also highlight the parents’ challenges in coping with the intercultural therapeutic relationship, and emphasizes the parents’ preference for a therapist from a similar religious/cultural background and for cultural supervision of therapy. However, the results also suggest that there are benefits inherent to intercultural therapy in general and arts therapies in particular, including a sense of security, openness and acceptance of the parents and children. Full article
(This article belongs to the Special Issue Arts Therapies with Children and Adolescents)
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20 pages, 1007 KiB  
Review
Is Pediatric Intensive Care Trauma-Informed? A Review of Principles and Evidence
by Lauren A. Demers, Naomi M. Wright, Avi J. Kopstick, Claire E. Niehaus, Trevor A. Hall, Cydni N. Williams and Andrew R. Riley
Children 2022, 9(10), 1575; https://doi.org/10.3390/children9101575 - 18 Oct 2022
Cited by 8 | Viewed by 3159
Abstract
Pediatric critical illness and injury, along with the experience of recovering from critical illness are among the most potentially traumatic experiences for children and their families. Additionally, children often come to the Pediatric Intensive Care Unit (PICU) with pre-existing trauma that may sensitize [...] Read more.
Pediatric critical illness and injury, along with the experience of recovering from critical illness are among the most potentially traumatic experiences for children and their families. Additionally, children often come to the Pediatric Intensive Care Unit (PICU) with pre-existing trauma that may sensitize them to PICU-related distress. Trauma-informed care (TIC) in the PICU, while under-examined, has the potential to enhance quality of care, mitigate trauma-related symptoms, encourage positive coping, and provide anticipatory guidance for the recovery process. This narrative review paper first describes the need for TIC in the PICU and then introduces the principles of TIC as outlined by the American Academy of Pediatrics: awareness, readiness, detection and assessment, management, and integration. Current clinical practices within PICU settings are reviewed according to each TIC principle. Discussion about opportunities for further development of TIC programs to improve patient care and advance knowledge is also included. Full article
(This article belongs to the Special Issue Pediatric Neurocritical Care and Neurotrauma Recovery)
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11 pages, 288 KiB  
Article
We Are Concerned about the Future and We Are Here to Support the Change: Let’s Talk and Work Together!
by Cátia Branquinho, Luís Lobo Xavier, Catarina Andrade, Tomás Ferreira, Catarina Noronha, Tony Wainwright and Margarida Gaspar de Matos
Children 2022, 9(10), 1574; https://doi.org/10.3390/children9101574 - 18 Oct 2022
Viewed by 1193
Abstract
Scarcely explored, intergenerational dialogue may support the re-encounter between generations. Background: Focused on intergenerational sharing and on the identification of differences between generations, the project #GenerationsWithAVoice aims to identify generational inequalities, with the aim of promoting awareness of intergenerational challenges, boosting public debate [...] Read more.
Scarcely explored, intergenerational dialogue may support the re-encounter between generations. Background: Focused on intergenerational sharing and on the identification of differences between generations, the project #GenerationsWithAVoice aims to identify generational inequalities, with the aim of promoting awareness of intergenerational challenges, boosting public debate and interest in public policies. Methods: Twenty focus groups were developed, and an evaluation instrument was applied. Results: (i) Young people believe that they have more knowledge, but less propensity for action, leaving this task to the following generations; (ii) the family and housing emerge as the issues with the greatest number of problems identified, but also as important resources; (iii) government and politics, community and society, and the economy are of less interest and knowledge on the part of this generation; (iv) school seems to be the ideal scenario for the implementation of strategies that lead to change. Conclusions: We highlight the role of this work in the deconstruction of beliefs regarding previous generations, the development of knowledge, and the promotion of cohesion and social support. Full article
13 pages, 272 KiB  
Article
Are Mid to Late Adolescents with Asthma Ready for Transition of Care? A Qualitative Study
by Hyekyun Rhee, Lindsay Batek, Tanya Wallace-Farquharson and Laurene Tumiel-Berhalter
Children 2022, 9(10), 1573; https://doi.org/10.3390/children9101573 - 18 Oct 2022
Cited by 2 | Viewed by 1453
Abstract
This qualitative descriptive study explores experiences and perspectives of mid-to-late adolescents about growing up with asthma, and the roles of parents and providers as they transition. Purposeful sampling was used to recruit and enroll adolescents aged 16–20 years with asthma. Forty-one adolescents participated [...] Read more.
This qualitative descriptive study explores experiences and perspectives of mid-to-late adolescents about growing up with asthma, and the roles of parents and providers as they transition. Purposeful sampling was used to recruit and enroll adolescents aged 16–20 years with asthma. Forty-one adolescents participated in a focus group or individual interview, and content analysis was conducted to analyze the data. The mean age of participants was 17.7 years, the majority (56%) of whom were Black. Themes that emerged included concerns about becoming an adult with asthma and its self-management, parental involvement, and communication with providers. Adolescents felt burdened by asthma, few considered becoming adults with asthma, and their future outlook was pessimistic with concerns related to worsening symptoms, inadequacy in symptom self-management and limitations on career choices due to asthma. Deficiencies in self-management were noted, parents still played major roles in adolescents’ asthma care, and transition of care was seldom discussed with the providers. Mid-to-late adolescents with asthma are inadequately prepared for transition of care, and parents and providers insufficiently engage adolescents in the preparation. Parent, provider, and adolescent partnership is critical to achieve adolescent readiness for independence in asthma management and to ensure proper asthma care continuity post transition. Full article
(This article belongs to the Special Issue Asthma and Its Impact in Adolescents)
11 pages, 1648 KiB  
Review
Systematic Review and Meta-Analysis of the Efficacy and Safety of Metformin and GLP-1 Analogues in Children and Adolescents with Diabetes Mellitus Type 2
by Elisabeth Carydias, Andoneta Tasho, Chara Kani, Flora Bacopoulou, Charikleia Stefanaki and Sophia L. Markantonis
Children 2022, 9(10), 1572; https://doi.org/10.3390/children9101572 - 18 Oct 2022
Viewed by 2839
Abstract
Diabetes mellitus type 2 (DMT2) is one of the most frequent glucose metabolism disorders, in which serum glucose concentrations are increased. In most cases, changes in lifestyle and diet are considered as the first step in addressing its therapy. If changes in lifestyle [...] Read more.
Diabetes mellitus type 2 (DMT2) is one of the most frequent glucose metabolism disorders, in which serum glucose concentrations are increased. In most cases, changes in lifestyle and diet are considered as the first step in addressing its therapy. If changes in lifestyle and diet fail, drugs, such as metformin, must be added. Lately, apart from metformin or insulin, the FDA has approved the use of glucagon-like peptide-1 (GLP-1) analogues for children and adolescents. Little is known about their efficacy and safety at this young age. The main aim of this systematic review/meta-analysis was to assess the safety and efficacy of metformin and GLP-1 analogues, exenatide and liraglutide, compared with placebos or other antidiabetic drugs used for DMT2 in children and adolescents. Metformin did not seem to demonstrate pharmacologic superiority, while GLP-1 analogues were found superior to placebos. GLP-1 analogues may be considered a useful alternative for the treatment of DMT2 in children and adolescents. Full article
(This article belongs to the Special Issue Childhood and Adolescent Obesity and Weight Management: 2nd Edition)
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7 pages, 377 KiB  
Review
Ovarian Teratomas in Children and Adolescents: Our Own Experience and Review of Literature
by Fani Gkrozou, Orestis Tsonis, Anastasia Vatopoulou, Georgia Galaziou and Minas Paschopoulos
Children 2022, 9(10), 1571; https://doi.org/10.3390/children9101571 - 18 Oct 2022
Cited by 8 | Viewed by 2239
Abstract
Background: Ovarian teratomas are the most common type of ovarian mass during childhood and adolescence. There is no clear guidance for the management of the ovarian teratomas in children and adolescents. It is necessary, however, to understand the feature of these tumours [...] Read more.
Background: Ovarian teratomas are the most common type of ovarian mass during childhood and adolescence. There is no clear guidance for the management of the ovarian teratomas in children and adolescents. It is necessary, however, to understand the feature of these tumours and the indications for operating on them, and to put subjective criteria for the management in elective or emergency presentations. Methods: Medical records of patients between the age of 12 and 20 years old that underwent surgery for ovarian teratomas at the Department of Obstetrics and Gynaecology in University Hospital of Ioannina, between January 2000 and August 2022, were reviewed. A medical database was searched between January 2000 and August 2022 with the following keywords: ovarian teratoma, paediatrics and adolescents. Results: We present the results of forty patients, with a mean age of 11.8 years of age. All patients had surgery, where three out of four underwent oophorectomy and only one out of four underwent ovary-sparing operation; similar results were found in the literature. Conclusion: Ovary-sparing treatment is more common recently compared with the past, such as MIS compared with laparotomy. Better-organised and -planned prospective multi-centre studies are necessary to gain a deeper knowledge of the physiology and prognostic factors of teratomas in children. Full article
(This article belongs to the Special Issue New Research in Pediatric Surgical Oncology)
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7 pages, 554 KiB  
Article
Growth until Peak Height Velocity Occurs Rapidly in Early Maturing Adolescent Boys
by Toshiharu Tsutsui, Satoshi Iizuka, Wataru Sakamaki, Toshihiro Maemichi and Suguru Torii
Children 2022, 9(10), 1570; https://doi.org/10.3390/children9101570 - 18 Oct 2022
Cited by 3 | Viewed by 2237
Abstract
The timing and tempo of growth rate varies inter-individually during adolescence and can have an impact on athletic performance. This study aimed to determine the difference in growth rate for each maturity status. We combined data collected both retrospectively and prospectively from 78 [...] Read more.
The timing and tempo of growth rate varies inter-individually during adolescence and can have an impact on athletic performance. This study aimed to determine the difference in growth rate for each maturity status. We combined data collected both retrospectively and prospectively from 78 adolescent boys aged 12 years old; growth charts were collected from their elementary school records, and the height of each participant was subsequently measured every six months over a period of two years. Take Off Age (TOA), Peak Height Velocity Age (PHVA), and Final Height Age (FHA) were estimated using the AUXAL 3.1 program. Growth Tempo 1 and 2 were calculated by dividing the height increase by the time difference between TOA and PHVA, and FHA, respectively. Our results showed three group differences based on the maturation status of PHVA: Growth Tempo 1 and 2 were both higher in the early than during middle and late maturation. Additionally, entering the height at each event as a covariate, the group differences for Growth Tempo 1 did not change; however, for Growth Tempo 2, group differences were eliminated. Therefore, we conclude that during early maturation, growth from TOA to PHVA occurs rapidly and in a shorter period. Full article
(This article belongs to the Special Issue Clinical Research and Quality Improvement of Pediatric Orthopedics)
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