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A Survey of the Union of European Neonatal and Perinatal Societies on Neonatal Respiratory Care in Neonatal Intensive Care Units
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Parental Satisfaction with the Quality of Care in an Early Intervention Service for Children with Visual Impairment: A Retrospective Longitudinal Study
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3D Back Contour Metrics in Predicting Idiopathic Scoliosis Progression: Retrospective Cohort Analysis, Case Series Report and Proof of Concept
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Examining the Association between Psychopathic Traits and Fearlessness among Maximum-Security Incarcerated Male Adolescents
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Congenital Deafness and Deaf-Mutism: A Historical Perspective
Journal Description
Children
Children
is an international, peer-reviewed, open access journal on children’s health published monthly online by MDPI.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within Scopus, SCIE (Web of Science), PubMed, PMC, Embase, and other databases.
- Journal Rank: JCR - Q2 (Pediatrics) / CiteScore - Q2 (Pediatrics, Perinatology and Child Health)
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 14.4 days after submission; acceptance to publication is undertaken in 2.7 days (median values for papers published in this journal in the first half of 2024).
- Recognition of Reviewers: reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
Impact Factor:
2.0 (2023);
5-Year Impact Factor:
2.1 (2023)
Latest Articles
Overview of the Treatment Goal, the Method of Evaluating Disease Activity/Physical Function, Activities of Daily Living, and Traditional Care for Systemic or Articular Juvenile Idiopathic Arthritis in Japan
Children 2024, 11(8), 952; https://doi.org/10.3390/children11080952 (registering DOI) - 6 Aug 2024
Abstract
Juvenile idiopathic arthritis (JIA) is a chronic arthritis of unknown cause that develops in patients younger than 16 years of age and persists for at least 6 weeks. It is an important cause of short- and long-term physical and mental impairments in children.
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Juvenile idiopathic arthritis (JIA) is a chronic arthritis of unknown cause that develops in patients younger than 16 years of age and persists for at least 6 weeks. It is an important cause of short- and long-term physical and mental impairments in children. The goal of treatment for JIA is remission. A T2T (treatment-to-target) has been proposed and practiced as a means of achieving remission. The method of evaluating the disease activity of JIA depends on the disease type. For systemic JIA, disease activity is determined by comprehensively considering joint findings, systemic inflammatory findings, changes in inflammatory and synovitis markers, imaging findings, and other factors. For articular JIA other than systemic JIA, the Juvenile Arthritis Disease Activity Score (JADAS-27) is used to evaluate disease activity. The CHAQ (Childhood Health Assessment Questionnaire) and the Japanese version of the modified Rankin Scale (mRS) are mainly used to assess the physical function and ADL. The CHAQ is a global standard assessment method with the advantage that it can be transitioned to the HAQ used in adults, making it useful for international comparisons. The mRS is used to classify the severity of JIA as a chronic disease, and is an indispensable evaluation method in the specific disease procedure in Japan. It is necessary to have pediatric-specific knowledge of growth and development and routine childhood immunizations and to consider transition support tailored to the patient’s situation. Ultimately, the goal is to foster the patient’s independence and to provide an uninterrupted follow-up in the adult care department. Continuous follow-up will be provided during the schooling (and later, employment) period, and the relationship with the patient will be tailored to their developmental stage. It is also important to understand and communicate the importance of contraception and the drugs that cannot be used during pregnancy.
Full article
(This article belongs to the Special Issue Childhood Arthritis and Rheumatology Research for Dreams Come True Remission)
Open AccessCase Report
Systemic Adverse Events Associated with Locally Administered Corticosteroids
by
Femke De Vleeschhauwer, Kristina Casteels, Ilse Hoffman, Marijke Proesmans and Anne Rochtus
Children 2024, 11(8), 951; https://doi.org/10.3390/children11080951 (registering DOI) - 6 Aug 2024
Abstract
Topical corticosteroids are a mainstay in the treatment of many pediatric disorders. While they have proven beneficial therapeutic effects and are generally considered safe, systemic adverse events may occur. This study presents four cases of children who experienced systemic adverse events after using
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Topical corticosteroids are a mainstay in the treatment of many pediatric disorders. While they have proven beneficial therapeutic effects and are generally considered safe, systemic adverse events may occur. This study presents four cases of children who experienced systemic adverse events after using inhaled and intranasal topical corticosteroids, as well as topical corticosteroids in other forms. A comprehensive literature review was performed to explore the existing evidence on this topic. The aim of this study is to raise awareness among healthcare providers about the possibility of systemic adverse events associated with the use of locally administered corticosteroids in pediatric patients. This information underscores the importance of careful monitoring, individualized treatment plans, and further research to better understand and mitigate the risks associated with corticosteroids, even those not given systemically.
Full article
(This article belongs to the Section Pediatric Endocrinology & Diabetes)
Open AccessArticle
A Pathway to Positive Youth Development: Unpacking the Asian American Youth Paradox and Cultural Orientations among Filipino American and Korean American Youth
by
Yoonsun Choi, Michael Park and Miwa Yasui
Children 2024, 11(8), 950; https://doi.org/10.3390/children11080950 (registering DOI) - 6 Aug 2024
Abstract
This study used longitudinal survey data of Filipino American and Korean American youth in the Chicago Metropolitan area (N = 786, MAGE= 15.00, SD = 1.91 at Wave 1 in 2014) to examine whether and how a set of organized
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This study used longitudinal survey data of Filipino American and Korean American youth in the Chicago Metropolitan area (N = 786, MAGE= 15.00, SD = 1.91 at Wave 1 in 2014) to examine whether and how a set of organized predictors (i.e., universal predictors of youth outcomes and cultural orientations) independently and collectively explains internalizing and externalizing problems and academic performance. The results were that universal predictors such as youth antisocial beliefs, peer antisocial behaviors, and the quality of parent–child relations, were extensively predictive of youth outcomes in the expected directions. The magnitudes of universal predictors were largely unchanged when bilinear and multidimensional cultural orientation variables were accounted for together. The magnitudes of cultural orientation variables were slightly attenuated in full models but showed independent associations with youth outcomes. Specifically, English and heritage language proficiencies were protective of externalizing and internalizing problems. Behavioral practices in respective cultures increased youth problems. In addition, ethnic identity, although beneficial to mental health, can increase externalizing problems. The findings of this study provide insights into understanding the mixed outcomes among Asian Americans and important empirical evidence that can inform intervention programs to prevent youth problems, ultimately toward a pathway to positive youth development among Asian American youth.
Full article
(This article belongs to the Special Issue Promoting Positive Development in Children and Adolescents: Social Emotional Skills, Internalizing Symptoms, and Externalizing Behaviors)
Open AccessSystematic Review
Child and Family Outcomes and Experiences Related to Family-Centered Care Interventions for Hospitalized Pediatric Patients: A Systematic Review
by
Christine R. Hodgson, Renee Mehra and Linda S. Franck
Children 2024, 11(8), 949; https://doi.org/10.3390/children11080949 (registering DOI) - 6 Aug 2024
Abstract
Background/Objectives: Family-centered care (FCC) is the recommended model for pediatric inpatient care. Our overall aim was to conduct a narrative synthesis of the contemporary published research on the effectiveness of FCC interventions for pediatric inpatients. Our specific objective was to critique studies of
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Background/Objectives: Family-centered care (FCC) is the recommended model for pediatric inpatient care. Our overall aim was to conduct a narrative synthesis of the contemporary published research on the effectiveness of FCC interventions for pediatric inpatients. Our specific objective was to critique studies of inpatient pediatric FCC interventions that evaluated child or parent outcomes. Methods: We searched five databases (Pubmed, CINAHL, Embase, PsychInfo, and Web of Science) for peer-reviewed research published from 1 January 2017 to 6 February 2024. Independent reviewers evaluated each study based on pre-specified inclusion and exclusion criteria, then extracted and narratively synthesized the data. Results: We found 16 studies of 15 interventions conducted in six countries. The studies were quantitative (n = 11), qualitative (n = 3), and mixed methods (n = 2), with most designs being of low to moderate quality based on a modified Mixed-Methods Appraisal Tool. Interventions included family-centered rounds, parent-focused health information technology, education, patient navigation, parent–peer support, partnership, and parent participation in caregiving. Most studies found significant improvements in parents’ well-being, knowledge, and participation, as well as decreased stress and anxiety with the FCC interventions compared to usual care. One study found no differences in child outcomes (infant feeding, length of stay) between usual care and a parent-participation intervention. Conclusions: Although FCC interventions led to many improved outcomes for parents, there were few well-designed comparison studies using validated tools and well-defined interventions. Higher quality research is needed to promote greater uptake and sustainability of FCC interventions globally.
Full article
(This article belongs to the Special Issue Family-Centered Care in Pediatric Health)
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Open AccessArticle
Physical, Cognitive, Emotional, and Social Health Outcomes of Parents in the First Six Months after Childhood Critical Illness: A Prospective Single Centre Study
by
Pei-Fen Poh, Jan Hau Lee, Rehena Sultana, Joseph C. Manning, Matthew C. Carey and Jos M. Latour
Children 2024, 11(8), 948; https://doi.org/10.3390/children11080948 - 6 Aug 2024
Abstract
Childhood critical illness can have long-term effects on families, but the extent and trajectory of recovery for parents are unknown. Using prospective longitudinal design, we describe the health outcomes of parents and their trajectory six months after paediatric intensive care unit (PICU) discharge.
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Childhood critical illness can have long-term effects on families, but the extent and trajectory of recovery for parents are unknown. Using prospective longitudinal design, we describe the health outcomes of parents and their trajectory six months after paediatric intensive care unit (PICU) discharge. Parents reported health outcomes at PICU discharge (baseline), and 1-, 3-, and 6-months post-discharge. We used the Pediatric Quality-of-Life Family Impact Module, Patient Health Questionnaire-4, and post-traumatic stress disorder (PTSD) Checklist for DSM-5. The group-based trajectory model was used to identify recovery patterns. We included 128 parents of children aged 1 month to 18 years, admitted to the PICU for ≥48 h. Three post-discharge composite health trajectory groups were classified: 54 mild (42%), 68 moderate (53%), and 6 severe (4%). Parents in the mild and moderate groups returned to baseline health within the first 3 months, but those in the severe group exhibited worse outcomes at 6-months. The mean (SD) PICU stay durations for mild, moderate, and severe groups were 9 (16), 7 (10), and 38 (61) days; days of mechanical ventilation were 4 (5), 4 (7), and 18 (25) days; and readmission rates were 12 (22%), 23 (34%), and 4 (66%), respectively. Identifying these trajectories enables novel, targeted interventions for at-risk parents, underscoring the significance of integrated PICU follow-up care.
Full article
(This article belongs to the Section Pediatric Emergency Medicine & Intensive Care Medicine)
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Open AccessFeature PaperArticle
Non-Suicidal Self-Injury in Eating and Feeding Disorder Patients: Characteristics and Clinical Implications in a Group of Referred Female Adolescents
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Gianluca Sesso, Cristina Mazzullo, Elena Valente, Francesca Ditaranto, Pamela Fantozzi, Vittorio Belmonti, Stefano Berloffa, Francesca Placini, Raffaella Tancredi, Gabriele Masi and Annarita Milone
Children 2024, 11(8), 947; https://doi.org/10.3390/children11080947 - 6 Aug 2024
Abstract
Background: Non-suicidal self-injury (NSSI) and Feeding or Eating Disorders (FEDs) often coexist during adolescence with reciprocal influences on their clinical picture. The present study aimed to identify differences and similarities in the clinical presentation of young patients with both conditions compared to those
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Background: Non-suicidal self-injury (NSSI) and Feeding or Eating Disorders (FEDs) often coexist during adolescence with reciprocal influences on their clinical picture. The present study aimed to identify differences and similarities in the clinical presentation of young patients with both conditions compared to those with the two non-comorbid disorders. Methods: We consecutively recruited forty-five female patients aged between 11 and 18 at our third-level hospital and subdivided them into three groups (NSSI: n = 15; FED: n = 15; NSSI + FED: n = 15). Patients underwent a full clinical assessment. Results: Based on our results, the NSSI + FED group was characterized by higher rates of binging/purging behaviors, greater prevalence of Cyclothymic Disorder, and a more severe clinical presentation compared to the non-comorbid groups. Moreover, higher levels of suicidal ideation were found in the NSSI + FED group. Pharmacological treatment patterns also differed, with SSRI being prescribed more frequently to NSSI + FED patients while mood stabilizers were prescribed more frequently to NSSI ones. A Principal Component Analysis identified four main dimensions: “Body Image” impairment was more pronounced in NSSI + FED patients, indicating negative attitudes towards their own body; “Metacognition” deficits were higher in NSSI than FED. Conclusions: The present study underscores distinctive clinical features in patients with comorbid NSSI and FED, emphasizing the urgent need for tailored intervention strategies focusing on specific symptom domains.
Full article
(This article belongs to the Collection Emotional and Behavioral Problems in Children and Adolescents: Assessment and Intervention)
Open AccessArticle
Analysis of the Energy Expenditure of Sports School Activities in Children
by
Daniel González-Devesa, Miguel Adriano Sanchez-Lastra, Carlos Ayán-Pérez, Nerea Blanco-Martínez, María Soutullo Rivas, María Vidal-Mariño and Silvia Varela
Children 2024, 11(8), 946; https://doi.org/10.3390/children11080946 - 5 Aug 2024
Abstract
(1) Background: This study explores the potential energy expenditure associated with participation in after-school sports activities among primary school children. (2) Methods: The study involved 129 children age (11.35 ± 0.55 years) recruited from eight different public after-school sport programs. (3) Results: Data
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(1) Background: This study explores the potential energy expenditure associated with participation in after-school sports activities among primary school children. (2) Methods: The study involved 129 children age (11.35 ± 0.55 years) recruited from eight different public after-school sport programs. (3) Results: Data analyses revealed significant differences between the eight sports in total calories per session, calories per minute, and METs (p < 0.05). All sports showed higher energy expenditure compared to chess (p < 0.05), with soccer and rugby exhibiting the highest energy expenditure per session. Team sports showed elevated energy consumption per session (p < 0.01, r > 0.30), calories per minute (p = 0.01, r > 0.40), and METs (p < 0.01, r > 0.40) in comparison with individual sports. (4) Conclusions: These findings enhance our understanding of the energy expenditure observed in primary school children following various after-school sports activities. The results indicate that team sports, in particular, are pivotal in elevating physical activity levels, thereby playing an essential role in fostering healthier lifestyles among children.
Full article
(This article belongs to the Special Issue Advances in Motor Competence and Physical Activity in School Children)
Open AccessArticle
Application of Galenic Strategies for Developing Gastro-Resistant Omeprazole Formulation for Pediatrics
by
Khadija Rouaz-El-Hajoui, Encarnación García-Montoya, Marc Suñé-Pou, Josep María Suñé-Negre and Pilar Pérez-Lozano
Children 2024, 11(8), 945; https://doi.org/10.3390/children11080945 - 5 Aug 2024
Abstract
Objectives: This study addresses a critical need in pediatric pharmacotherapy by focusing on the development of an enteric formulation of omeprazole for pediatric use. Omeprazole, a widely used proton pump inhibitor, is essential for treating various gastrointestinal disorders in children. The main objective
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Objectives: This study addresses a critical need in pediatric pharmacotherapy by focusing on the development of an enteric formulation of omeprazole for pediatric use. Omeprazole, a widely used proton pump inhibitor, is essential for treating various gastrointestinal disorders in children. The main objective is to design a compounding formula that can be prepared in hospital pharmacy services without the need for industrial equipment, which is often unavailable in these settings. Methods: The research applied different galenic strategies to overcome the challenges of omeprazole’s instability in acidic environments and its complex pharmacokinetic and physicochemical properties. The experiments were conducted sequentially, employing salting out, ionic gelation, and matrix granulation strategies. Based on the results obtained, the control conditions and parameters for the various trials were established. Results: Among the techniques used, wet granulation proved to be the most promising, achieving a gastro-resistance level of 44%. In contrast, the ionic gelation and salting-out techniques did not yield satisfactory results. Conclusions: The findings of this study underscore the need to adopt alternative formulation strategies to ensure the stability of omeprazole. This goal requires a multidisciplinary approach and continuous effort to design omeprazole formulations that meet quality standards and appropriate gastro-resistance requirements.
Full article
(This article belongs to the Special Issue Advances in Pediatric Formulations Update)
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Open AccessArticle
Child Migrants in Family Detention in the US: Addressing Fragmented Care
by
Shela Sridhar, Vasileia Digidiki, Leah Ratner, Dennis Kunichoff and Matthew G. Gartland
Children 2024, 11(8), 944; https://doi.org/10.3390/children11080944 - 5 Aug 2024
Abstract
Background/Objectives: Migrant children in family detention facilities often experience frequent relocations and prolonged stays in precarious living conditions. This frequent relocation results in fragmentation of necessary medical care, leading to delays and inadequate medical care. We aim to highlight the critical need for
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Background/Objectives: Migrant children in family detention facilities often experience frequent relocations and prolonged stays in precarious living conditions. This frequent relocation results in fragmentation of necessary medical care, leading to delays and inadequate medical care. We aim to highlight the critical need for comprehensive medical documentation in immigration detention facilities, a fragmented health care system and potential harm to these children without appropriate medical documentation. Methods: We conducted a retrospective review of 165 medical records from children detained at the Karnes County Family Residential Center between June 2018 and October 2020 to evaluate the adequacy of pediatric medical documentation in an Immigration and Customs Enforcement (ICE) family detention facility. Specific areas of interest included acute care, nutrition, immunization, developmental screening, and tuberculosis screening. Simple descriptive statistics were used to analyze the data. Results: Only 25% of 418 acute medical care visits included specific diagnoses. There was no documentation regarding follow-up recommendations upon release. 97% of children had a chest X-ray completed for tuberculosis screening, however no follow-up recommendations were documented for those with granulomas. Vaccination histories were inconsistently documented. No nutritional categorizations were completed despite 16% of children being at risk for malnutrition or already malnourished. Conclusions: Our findings revealed significant gaps in documentation, particularly in medical decision-making and clinical reasoning. In a fragmented medical system, inadequate documentation can result in avoidable errors in diagnosis and management. Improving documentation practices is crucial to ensure that all children, regardless of immigration status, receive quality healthcare aligned with national and international standards.
Full article
(This article belongs to the Section Global Pediatric Health)
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Open AccessArticle
Impact of Cyberbullying on Academic Performance and Psychosocial Well-Being of Italian Students
by
Antonio Ragusa, Sandra Núñez-Rodríguez, Paulo Vaz, José Silva, Virginia Caliciotti, Jerónimo J. González-Bernal, Alfonso J. López-Rivero, Ema Petrillo, Manuela Gatto, Ana Isabel Obregón-Cuesta and Josefa González-Santos
Children 2024, 11(8), 943; https://doi.org/10.3390/children11080943 - 5 Aug 2024
Abstract
Cyberbullying is a growing problem in the Italian educational sector, with a prevalence of 17%. This study analyzes its impact on the psychosocial well-being and academic performance of Italian adolescents. Method: A cross-sectional study was conducted with 502 students from six schools in
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Cyberbullying is a growing problem in the Italian educational sector, with a prevalence of 17%. This study analyzes its impact on the psychosocial well-being and academic performance of Italian adolescents. Method: A cross-sectional study was conducted with 502 students from six schools in different Italian regions, using the European Cyberbullying Intervention Project Questionnaire (ECIPQ) to assess cyberbullying, in addition to collecting data on satisfaction, friends, and academic performance. Chi-square and ANOVA analyses were conducted to identify significant associations between the variables. Results: The analyses showed significant associations between cyberbullying and gender and in psychosocial well-being, with significant differences in personal satisfaction and body satisfaction. On the other hand, there were no significant differences in academic performance or in the ability to make new friends, although victims showed a significantly lower ability to make new friends compared to those who were neither victims nor aggressors. Conclusions: Cyberbullying has a significant impact on students’ psychosocial well-being, especially on personal satisfaction and school happiness, making it essential to implement interventions that promote safe school environments to mitigate these negative effects.
Full article
(This article belongs to the Special Issue School Bullying during Childhood and Adolescence: 2nd Edition)
Open AccessFeature PaperArticle
Comparison of Titanium versus Resorbable Intramedullary Nailing in Pediatric Forearm Fractures
by
Ádám László Dávid, Flóra Mucsina, Eszter Antal, Anna Gabriella Lamberti, Aba Lőrincz and Gergő Józsa
Children 2024, 11(8), 942; https://doi.org/10.3390/children11080942 - 5 Aug 2024
Abstract
Pediatric forearm fractures, particularly involving the shaft or diaphysis, are common injuries typically resulting from accidental trauma during various activities. Traditional treatment involves closed reduction and casting; however, surgical intervention may be necessary in certain cases. The gold standard surgical approach utilizes elastic
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Pediatric forearm fractures, particularly involving the shaft or diaphysis, are common injuries typically resulting from accidental trauma during various activities. Traditional treatment involves closed reduction and casting; however, surgical intervention may be necessary in certain cases. The gold standard surgical approach utilizes elastic stable intramedullary nailing (ESIN), but a newer technique uses bioabsorbable intramedullary nails made of poly(lactic-co-glycolic acid) (PLGA). This study aims to compare the outcomes of these two surgical methods in pediatric diaphyseal forearm fractures. We retrospectively reviewed 86 patients who underwent operative treatment due to the diaphyseal fractures of the forearm in the Surgical Division, Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary between 2018 and September 2022. The mean age was 9.48 (ranging from 4 to 17). A total of 41 patients underwent surgery with PLGA implants (RESIN technique), while 45 patients were treated with titanium elastic nails (ESIN technique). Various factors including patient demographics, injury mechanisms, fracture characteristics, and complications were assessed. Both groups showed similar gender distribution, with a majority of fractures occurring in boys (the male–female ratio was 31:10 in the PLGA group, while in the titanium elastic nailing (TEN) group, this ratio was 29:16, with no statistical difference between the groups (p > 0.005). The average age of the patients treated with PLGA implants (8.439 years) was lower compared to those treated with titanium nails (10.422 years). A statistically significant difference was found regarding the average age of the two groups (p = 0.0085). Left-sided injuries were more prevalent in both groups (59% of the cases in the PLGA group and 69% in the TEN group, with no statistically significant difference, p = 0.716), and fractures typically involved both the radius and ulna. This represents 93% of the cases in the PLGA group and 80% in the TEN group. Regarding the involvement of bones, we also did not find a statistically significant difference (p = 0.123). The mechanisms of injury predominantly involved indirect force, such as falls (30 cases in the PLGA group and 27 cases in the TEN group), and no statistically significant difference was found (p = 0.139) regarding the mechanism of the injury. Complication rates were lower in the PLGA group (7%) compared to the titanium group (20%). The treatment of pediatric diaphyseal forearm fractures using PLGA implants appears to be a viable alternative to traditional titanium implants. Advantages include no need for secondary surgery and associated cost savings and reduced complication rate and stress associated with anesthesia and surgery. Prospective randomized trials are warranted to further validate these findings and explore long-term outcomes.
Full article
(This article belongs to the Special Issue New Trends in Pediatric Orthopedic Trauma)
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Open AccessArticle
Respiratory Status in Children and Exposure to Animal Allergens—The Problem of Reverse Causality in Cross-Sectional Studies
by
Agata Wypych-Ślusarska, Karolina Krupa-Kotara, Klaudia Oleksiuk, Joanna Głogowska-Ligus and Jerzy Słowiński
Children 2024, 11(8), 941; https://doi.org/10.3390/children11080941 - 5 Aug 2024
Abstract
Background: Some epidemiological studies suggest that early exposure to animal allergens during infancy reduces the risk of bronchial asthma in school-age children. However, the observed associations in some cases may be an effect of the study used (epidemiological observational studies, especially a cross-sectional
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Background: Some epidemiological studies suggest that early exposure to animal allergens during infancy reduces the risk of bronchial asthma in school-age children. However, the observed associations in some cases may be an effect of the study used (epidemiological observational studies, especially a cross-sectional study) and indicate reverse causality. Aim: This study aimed to determine the association between exposure to animal allergens and the prevalence of respiratory diseases, including bronchial asthma, considering the potential impact of reverse causality on the observed relationships. Material and methods: An analysis of data from a cross-sectional epidemiological study conducted in 2020 involving 3237 primary school students aged 7–15 years in the Silesian Province (Southern Poland) was carried out. The parents of students completed a questionnaire based on The International Study on Asthma and Allergies in Childhood (ISAAC). The relationship between the occurrence of chronic cough, wheezing, and dyspnea in the last 12 months, night waking due to dyspnea, and asthma in the presence of pets was assessed. Exposure to animal allergens was determined by answering the question, “Are there any furry or feathered animals in the home?” with three response options: “yes; they have been in the past; no” (Scenario 1). For the analyses and to reveal a potential reverse causality effect, the last two response categories regarding pet ownership were combined to form a “no” category in Scenario 2, and the first two answers were combined into a “yes” category in Scenario 3. A chi-square test was used to assess the relationship between variables, and a statistical significance level of p < 0.05 was adopted. Results: Chronic cough affected 9.5% of children, wheezing in the last 12 months—9.2%, night waking due to dyspnea—5.8%, dyspnea in the last 12 months—4.8%, bronchial asthma—9.2%. Analysis considering the category of having or not having pets (yes vs. no) showed that bronchial asthma was statistically significantly more common in children who did not have pets at home (10.9% vs. 7.9%, p = 0.002). A similar situation was observed for wheezing in the past 12 months (10.7% vs. 8.1%; p = 0.01) and nocturnal awakening due to dyspnea (6.8% vs. 5.1%, p = 0.03). No statistically significant differences were observed for the other symptoms. Analysis by time of pet ownership (a. present; b. present but in the past; c. not present) highlighted similar relationships. Asthma (a. 7.7% vs. b. 13.4% vs. c. 7.7%; p = 0.004), wheezing in the past 12 months (a. 8.1% vs. b. 8.9% vs. c. 10.9%, p = 0.03) and night waking (a. 5.0% vs. b. 4.5% vs. c. 7.1%; p = 0.04) were more common in children without pets and those who had owned pets in the past. The highest proportion of children with asthma was in homes where pets were present in the past. Conclusions: Analyses indicating a relationship between a higher prevalence of asthma and some respiratory symptoms, and the absence of pets cannot be considered as a casual association. The analysis conducted did not reveal a reverse causality effect. The results of observational epidemiological studies, especially a cross-sectional study, should always be interpreted with caution, considering possible distortions and conclusions drawn.
Full article
(This article belongs to the Special Issue Paediatric Allergic Asthma: Risk Factors, Diagnosis, Control and Treatment)
Open AccessArticle
The Motor Optimality Score—Revised Improves Early Detection of Unilateral Cerebral Palsy in Infants with Perinatal Cerebral Stroke
by
Natascia Bertoncelli, Lucia Corso, Luca Bedetti, Elisa Muttini Della Casa, Maria Federica Roversi, Greta Toni, Marisa Pugliese, Isotta Guidotti, Francesca Miselli, Laura Lucaccioni, Cecilia Rossi, Alberto Berardi and Licia Lugli
Children 2024, 11(8), 940; https://doi.org/10.3390/children11080940 - 4 Aug 2024
Abstract
Background: Neonatal cerebral stroke includes a range of focal and multifocal ischemic and hemorrhagic brain lesions, occurring in about one of 3000 live births. More than 50% of children with neonatal stroke develop adverse outcomes, mainly unilateral cerebral palsy. Asymmetries in segmental movements
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Background: Neonatal cerebral stroke includes a range of focal and multifocal ischemic and hemorrhagic brain lesions, occurring in about one of 3000 live births. More than 50% of children with neonatal stroke develop adverse outcomes, mainly unilateral cerebral palsy. Asymmetries in segmental movements at three months have been proven to be an early sign of CP in infants with unilateral brain damage. Recognition of additional early signs could enhance prognostic assessment and enable an early and targeted intervention. Aim: The aim of the study was to assess early signs of CP in infants with arterial cerebral stroke through the General Movements Assessment and the Motor Optimality Score—Revised (MOS-R). Method: Twenty-four infants born at term (12 females and 12 males) diagnosed with ACS, and 24 healthy infants (16 females and 8 males) were assessed. The GMs (fidgety movements) and MOS-R were assessed from videos recorded at 11–14 weeks of post-term age. Cognitive and motor outcomes were assessed at 24 months using the Griffiths III developmental quotient and Amiel-Tison neurological examination. The gross motor function classification system expanded and revised (GMFCS-E&R) was adopted to categorize CP. Results: Among infants with ACS, 21 (87.5%) developed unilateral CP. Most of them showed non-disabling CP (14 had GMFCS-E&R grade 1 [66.6%], 6 grade 2 [28.6%], and 1 grade 5 [4.8%]). Fidgety movements (FMs) were absent in 17 (70.8%), sporadic in 4 (16.7%) infants, and normal in 3 (12.5%). Segmental movement asymmetry was found in 22/24 (91.7%). According to the MOS-R, motor items (kicking, mouth movements), postural patterns (midline centered head, finger posture variability), and movement character (monotonous and stiff) were statistically different among infants with ACS and healthy infants. The MOS-R median global score was lower in the group with ACS compared to the control group (6 vs 26; p < 0.01). FMs, segmental movement asymmetry, and MOS-R global score were significantly correlated with abnormal outcome. MOS-R global scores less than or equal to 13 had 100% specificity and sensitivity in predicting GMFCS-E&R grade ≥ 2 CP in infants with ACS. Conclusions: The rate of CP was high among infants with ACS, but in most cases it showed low GMFCS-E&R grades. The study highlighted a significant correlation between MOS-R, together with absent FMs and unilateral CP in infants with ACS. Moreover, the MOS-R showed high sensitivity and specificity in the prediction of CP. Combined assessment of FMs and MOS-R could help to better identify infants at high risk of developing UCP in a population of infants with ACS. Early identification of precocious signs of unilateral CP is fundamental to providing an early individualized intervention.
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(This article belongs to the Section Pediatric Neurology & Neurodevelopmental Disorders)
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Open AccessArticle
How to Link Assessment and Suitable Interventions for Adolescents: Relationships among Mental Health, Friendships, Demographic Indicators and Well-Being at School
by
Rokas Šambaras, Agnė Butvilaitė, Justina Andruškevič, Natalja Istomina and Sigita Lesinskienė
Children 2024, 11(8), 939; https://doi.org/10.3390/children11080939 - 3 Aug 2024
Abstract
Background: Over the last 10 years, a noticeable deterioration in mental health has affected adolescents’ lives. Methods: This study was conducted in 12 secondary schools and 14 high schools located in different cities across Lithuania from October to December 2023. The survey included
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Background: Over the last 10 years, a noticeable deterioration in mental health has affected adolescents’ lives. Methods: This study was conducted in 12 secondary schools and 14 high schools located in different cities across Lithuania from October to December 2023. The survey included students aged 12 to 17 years. The adolescents filled out a questionnaire about the need for outside help, friendships, and well-being at school and the Strengths and Difficulties Questionnaire. The goal of our study was to analyze the risk factors that influence adolescents’ psycho-emotional state. Results: A total of 4124 students were involved in this study, with a mean age of 14.48 ± 1.15 years. The sample consisted of 50.9% males and 49.1% females. The boys showed a statistically significantly lower total difficulty score on the Strength and Difficulties Questionnaire (SDQ TDS) and internalizing score (IS) than the girls (12.45 ± 5.39 vs. 14.93 ± 5.76; 5.39 ± 3.30 vs. 7.49 ± 3.64, p < 0.001). Also, the SDQ TDS, IS, and externalizing score (ES) were statistically significantly lower in the group of adolescents who lived with both parents (13.50 ± 5.69 vs. 14.76 ± 5.72; 6.32 ± 3.61 vs. 6.98 ± 3.65; 7.18 ± 3.23 vs. 7.78 ± 3.35, p < 0.001). Linear regression analysis of the SDQ TDS (R2 = 0.406) indicated a significant impact on the feeling of safety at schools (β = −0.173, p < 0.001) and loneliness (β = 0.314, p < 0.001). Linear regression of the SDQ IS (R2 = 0.469) showed that there was a significant predictor effect of bullying (β = 0.170, p < 0.001) and loneliness (β = 0.345, p < 0.001). However, the linear regression of the SDQ ES (R2 = 0.256) showed that there was a significant predictor effect of the feeling of teacher care (β = −0.163, p < 0.001) and loneliness (β = 0.166, p < 0.001). We determined that gender (OR = 2.30) and loneliness (OR = 1.77) were the most significant factors associated with adolescents seeking help. Conclusions: It is crucial to determine specific risk factors and particular groups of teenagers who need psycho-emotional support the most. The findings of this study may offer valuable insights for advancing additional prevention or support programs aimed at adolescents within higher-risk groups.
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(This article belongs to the Collection Emotional and Behavioral Problems in Children and Adolescents: Assessment and Intervention)
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Open AccessArticle
Relationship between Body Mass Index and Health-Related Physical Fitness Components in HIV-Diagnosed Children and Adolescents
by
João Antônio Chula de Castro, Luiz Rodrigo Augustemak de Lima and Diego Augusto Santos Silva
Children 2024, 11(8), 938; https://doi.org/10.3390/children11080938 - 2 Aug 2024
Abstract
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Background/Objectives: There is a need to monitor physical fitness in HIV-diagnosed children and adolescents, and body mass index (BMI) could be an option for this due to its usability for assessing nutritional status and fat mass. The present study aimed to explore the
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Background/Objectives: There is a need to monitor physical fitness in HIV-diagnosed children and adolescents, and body mass index (BMI) could be an option for this due to its usability for assessing nutritional status and fat mass. The present study aimed to explore the relationship between BMI and physical fitness in HIV-diagnosed children and adolescents. Methods: A cross-sectional study was conducted with 86 HIV-diagnosed children and adolescents aged 5–15, with participants from two research protocols (Study I, n = 65; Study II, n = 21). Physical fitness was assessed through body composition (anthropometric measurements and dual energy X-ray absorptiometry), cardiorespiratory fitness (peak oxygen consumption [VO2peak]), muscle strength/endurance (handgrip strength, standing broad jump, and abdominal and modified push-up endurance), and flexibility (sit-to reach test). The relationship between BMI and physical fitness components was analyzed through correlation and simple and multiple linear regression analysis. Results: Eutrophic participants (mean age 11.44 ± 2.20) presented a normal fat mass percentage and overweight participants (mean age 11.50 ± 2.54) presented adequate handgrip strength. The adjusted models could explain 71% of fat-free mass, 57% of fat mass percentage, 70% of bone mineral content, 72% of bone mineral density, and 52% of handgrip strength. Conclusions: Increases in BMI were associated with increases in fat-free mass, fat mass percentage, bone mineral content, bone mineral density, and handgrip strength. BMI was capable of distinguishing those presenting a normal fat mass percentage and those presenting adequate handgrip strength.
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Open AccessArticle
Association of Maternal Air Pollution Exposure and Infant Lung Function Is Modified by Genetic Propensity to Oxidative Stress
by
Dwan Vilcins, Wen Ray Lee, Cindy Pham, Sam Tanner, Luke D. Knibbs, David Burgner, Tamara L. Blake, Toby Mansell, Anne-Louise Ponsonby, Peter D. Sly and Barwon Infant Study Investigator Group
Children 2024, 11(8), 937; https://doi.org/10.3390/children11080937 - 31 Jul 2024
Abstract
Background and objective: The association between air pollution and poor respiratory health outcomes is well established. Children are particularly at risk from air pollution, especially during the prenatal period as their organs and systems are still undergoing crucial development. This study investigated maternal
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Background and objective: The association between air pollution and poor respiratory health outcomes is well established. Children are particularly at risk from air pollution, especially during the prenatal period as their organs and systems are still undergoing crucial development. This study investigated maternal exposure to air pollution during pregnancy and oxidative stress (OS), inflammation, and infant lung function at 4 weeks of age. Methods: Data from the Barwon Infant Study were available for 314 infants. The exposure to NO2 and PM2.5 were estimated. Infant lung function (4 weeks) was measured by multiple-breath washout. Glycoprotein acetyls (GlycA) (36 weeks prenatal), cord blood, and OS biomarkers were measured in maternal urine (28 weeks). A genetic pathway score for OS (gPFSox) was calculated. Linear regression was used and potential modification by the OS genotype was tested. Results: There was no relationship between maternal exposure to air pollution and infant lung function, or with GlycA or OS during pregnancy. We found an association in children with a genetic propensity to OS between NO2 and a lower functional residual capacity (FRC) (β = −5.3 mls, 95% CI (−9.3, −1.3), p = 0.01) and lung clearance index (LCI) score (β = 0.46 turnovers, (95% CI 0.10, 0.82), p = 0.01). Conclusion: High prenatal exposure to ambient NO2 is associated with a lower FRC and a higher LCI score in infants with a genetic propensity to oxidative stress. There was no relationship between maternal exposure to air pollution with maternal and cord blood inflammation or OS biomarkers.
Full article
(This article belongs to the Special Issue Updates on Lung Function, Respiratory and Asthma Disease in Children)
Open AccessArticle
Child Motor Development before and after the COVID-19 Pandemic: Are There Social Inequalities?
by
Mariann Rigó and Simone Weyers
Children 2024, 11(8), 936; https://doi.org/10.3390/children11080936 - 31 Jul 2024
Abstract
Background: COVID-19 pandemic has influenced all children’s motor development. We examine whether this differs by social circumstances. We hypothesise that socially disadvantaged children experienced more pronounced motor problems compared with better-off children. Methods: Our trend study includes three representative waves of preschoolers (school
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Background: COVID-19 pandemic has influenced all children’s motor development. We examine whether this differs by social circumstances. We hypothesise that socially disadvantaged children experienced more pronounced motor problems compared with better-off children. Methods: Our trend study includes three representative waves of preschoolers (school years 2018/19, 2019/20, 2023/24) from a German school enrolment medical screening. Based on logistic regressions, we computed predicted prevalences of motor problems separately for children in different social circumstances (neighbourhood, migration background, family status). Results: Motor development of preschoolers slightly worsened by 2023 compared to pre-pandemic level (6.3 percent 2018 to 7.4 percent 2023). Results by neighbourhood highlight that preschoolers from well-off districts experienced a deterioration of motor development (4.9 percent 2018–6.4 percent 2023). The prevalence of motor problems is, however, below that of children from deprived neighbourhoods with consistently high prevalence (9.2–10 percent). Results by migration background show a worsening trend for children without migration background and the gap between the groups disappears in 2023. Results by family status do not indicate significant differences. Conclusion: Contrary to our hypothesis, socially disadvantaged children experienced smaller change in motor problems. However, our results highlight the potential of structured physical activities in daycare centres and sports facilities to enhance the motor development of these children.
Full article
(This article belongs to the Special Issue Advances in Motor Competence and Physical Activity in School Children)
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Open AccessArticle
Robotic-Assisted Surgery in Children Using the Senhance® Surgical System: An Observational Study
by
Rianne E. M. Killaars, Ruben G. J. Visschers, Marc Dirix, Olivier P. F. Theeuws, Roxanne Eurlings, Dianne J. H. Dinjens, Hamit Cakir and Wim G. van Gemert
Children 2024, 11(8), 935; https://doi.org/10.3390/children11080935 - 31 Jul 2024
Abstract
Background: Robotic-assisted surgery (RAS) holds many theoretical advantages, especially in pediatric surgical procedures. However, most robotic systems are dedicated to adult surgery and are less suitable for smaller children. The Senhance® Surgical System (SSS®), providing 3 mm and 5 mm
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Background: Robotic-assisted surgery (RAS) holds many theoretical advantages, especially in pediatric surgical procedures. However, most robotic systems are dedicated to adult surgery and are less suitable for smaller children. The Senhance® Surgical System (SSS®), providing 3 mm and 5 mm instruments, focuses on making RAS technically feasible for smaller children. This prospective observational study aims to assess whether RAS in pediatric patients using the SSS® is safe and feasible. Methods and Results: A total of 42 children (aged 0–17 years, weight ≥ 10 kg) underwent a RAS procedure on the abdominal area using the SSS® between 2020 and 2023. The study group consisted of 20 male and 22 female individuals. The mean age was 10.7 years (range 0.8 to 17.8 years), with a mean body weight of 40.7 kg (range 10.1 to 117.3 kg). The 3-mm-sized instruments of the SSS® were used in 12 of the 42 children who underwent RAS. The RAS procedures were successfully completed in 90% of cases. The conversion rate to conventional laparoscopy was low (10%), and there were no conversions to open surgery. One of the 42 cases (2%) experienced intraoperative complications, whereas six children (14%) suffered from a postoperative complication. Overall, 86% of the patients had an uncomplicated postoperative course. Conclusions: The results of the current observational study demonstrate the safety and feasibility of utilizing the SSS® for abdominal pediatric RAS procedures. The study provides new fundamental information supporting the implementation of the SSS® in clinical practice in pediatric surgery.
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(This article belongs to the Special Issue Cutting-Edge Laparoscopic and Thoracoscopic Surgery in Children)
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Open AccessArticle
Impact of the Choice of Diagnostic Criteria and Growth Reference on the Prevalence of Extrauterine Growth Restriction in Extremely-Low-Birthweight Infants
by
Clara González López, Gonzalo Solís Sánchez, Belén Fernández Colomer, Laura Mantecón Fernández, Sonia Lareu Vidal, Sara Fernández Castiñeira, Ana Rubio Granda, Alicia Pérez Pérez and Marta Suárez Rodríguez
Children 2024, 11(8), 934; https://doi.org/10.3390/children11080934 - 31 Jul 2024
Abstract
Background and objectives: Variable diagnostic criteria and growth charts have been used for extrauterine growth restriction (EUGR). The objective was to assess the prevalence and concordance of EUGR in extremely-low-birthweight (ELBW) infants with the most frequent diagnostic criteria and growth charts. Materials and
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Background and objectives: Variable diagnostic criteria and growth charts have been used for extrauterine growth restriction (EUGR). The objective was to assess the prevalence and concordance of EUGR in extremely-low-birthweight (ELBW) infants with the most frequent diagnostic criteria and growth charts. Materials and methods: An observational, retrospective and multicenter study was conducted from 2011 to 2020 including ELBW infants from the Spanish SEN1500 Network. EUGR prevalence was calculated at discharge using different definitions: cross-sectional (anthropometry less than the 10th centile), longitudinal (decrease of more than 1 SD from birth to discharge), “true” cross-sectional and “true” longitudinal (using the criteria previously described, excluding infants small for gestational age at birth). Concordance among Fenton, Olsen and INTERGROWTH-21st was assessed with Fleiss’ Kappa coefficient. Results: The prevalence of EUGR was variable with the different definitions and growth references studied in the 7914 ELBW infants included. Overall, it was higher with Fenton for all the EUGR criteria studied by weight and length. The agreement among growth charts was substantial (κ > 0.6) for all the definitions except for longitudinal EUGR by weight (moderate, κ = 0.578). Conclusions: The prevalence of EUGR was variable in our cohort with the different diagnostic criteria and growth charts. The agreement among charts was good for all the definitions of EUGR except longitudinal EUGR by weight.
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(This article belongs to the Section Pediatric Neonatology)
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Open AccessArticle
Relationship between Gross Motor Coordination and Health-Related Fitness in Serbian Preschool Children
by
Nenad Stojiljković, Nebojša Trajković, Doroteja Rančić, Mihai Olanescu, Adrian Suciu and Danut Popa
Children 2024, 11(8), 933; https://doi.org/10.3390/children11080933 - 31 Jul 2024
Abstract
Background: The relationship between motor coordination and physical fitness in preschool children is of significant interest due to its implications for overall health and development. This study aims to investigate the correlation between gross motor coordination, as assessed by the Körperkoordinationstest für Kinder
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Background: The relationship between motor coordination and physical fitness in preschool children is of significant interest due to its implications for overall health and development. This study aims to investigate the correlation between gross motor coordination, as assessed by the Körperkoordinationstest für Kinder (KTK), and health-related physical fitness components. Methods: A cross-sectional study, involving 139 preschool-aged children, was conducted. Physical fitness was assessed using the PREFIT fitness test battery, which includes measures of flexibility, muscular strength, speed/agility, and cardiorespiratory fitness. Motor coordination was evaluated using the KTK test, comprising four subtests. Results: Pearson correlation analysis revealed weak to strong positive and negative correlations between motor coordination and various physical fitness measures, including flexibility (r = 0.402; p = 0.01), muscular strength (r = 0.178; r = 0.487; r = 0.601; p < 0.05), speed/agility (r = −0.742; p = 0.01), and endurance (r = 0.539; p = 0.01). Additionally, hierarchical regression analysis demonstrated significant influence of motor coordination on physical fitness, explaining a notable percentage of the variance across different fitness components (3.2–55%). Conclusions: The findings underscore the importance of motor coordination in shaping physical fitness levels in preschool children. Promoting motor coordination skills early in childhood may have long-term benefits for overall health and fitness.
Full article
(This article belongs to the Special Issue Motor Development in Children)
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