Children

16 pages, 2073 KiB

Open AccessReview

Nutrient and Hormonal Effects on Long Bone Growth in Healthy and Obese Children: A Literature Review

by Sazid Hasan, Shahrukh Naseer, Mazen Zamzam, Hashem Mohilldean, Colin Van Wagoner, Ahmad Hasan, Ehab S. Saleh, Virginia Uhley and Suzan Kamel-ElSayed

Children 2024, 11(7), 817; https://doi.org/10.3390/children11070817 (registering DOI) - 3 Jul 2024

Abstract

Longitudinal bone growth is mediated through several mechanisms including macro- and micronutrients, and endocrine and paracrine hormones. These mechanisms can be affected by childhood obesity as excess adiposity may affect signaling pathways, place undue stress on the body, and affect normal physiology. This [...] Read more.

Longitudinal bone growth is mediated through several mechanisms including macro- and micronutrients, and endocrine and paracrine hormones. These mechanisms can be affected by childhood obesity as excess adiposity may affect signaling pathways, place undue stress on the body, and affect normal physiology. This review describes the physiology of the epiphyseal growth plate, its regulation under healthy weight and obesity parameters, and bone pathology following obesity. A literature review was performed utilizing PubMed, PMC, NIH, and the Cochrane Database of Systematic Reviews pertinent to hormonal and nutritional effects on bone development, child obesity, and pathologic bone development related to weight. The review indicates a complex network of nutrients, hormones, and multi-system interactions mediates long bone growth. As growth of long bones occurs during childhood and the pubertal growth spurt, pediatric bones require adequate levels of minerals, vitamins, amino acids, and a base caloric supply for energy. Recommendations should focus on a nutrient-dense dietary approach rather than restrictive caloric diets to maintain optimal health. In conclusion, childhood obesity has profound multifaceted effects on the develo** musculoskeletal system, ultimately causing poor nutritional status during development. Weight loss, under medical supervision, with proper nutritional guidelines, can help counteract the ill effects of childhood obesity. Full article

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15 pages, 693 KiB

Open AccessReview

Oral Health and Caries Prevention: How Tongue Hygiene Helps Maintain Balance of Microbiota and Overall Health in Pediatric Patients

by Giovanna Mosaico, Mara Pinna, Roberta Grassi, Germano Orrù, Andrea Scribante, Carolina Maiorani, Cinzia Casu, Gianna Maria Nardi and Andrea Butera

Children 2024, 11(7), 816; https://doi.org/10.3390/children11070816 (registering DOI) - 3 Jul 2024

Abstract

Background/Objectives: The tongue harbors about two-thirds of the microorganisms present in the mouth; the stable bacterial population consists mainly of aerobic and facultative anaerobic streptococci. These bacterial colonies, found more frequently on the tongue than on the outside of the hard part of [...] Read more.

Background/Objectives: The tongue harbors about two-thirds of the microorganisms present in the mouth; the stable bacterial population consists mainly of aerobic and facultative anaerobic streptococci. These bacterial colonies, found more frequently on the tongue than on the outside of the hard part of the dental enamel in children younger than 18 months, suggest that the tongue is a potential bacterial reservoir. The aim of this review is to examine the scientific literature to clarify whether the mechanical removal of bacterial biofilm on the tongue can have a positive effect on caries prevention, with the reduction in colony-forming unit (CFU) of salivary streptococcus and the whole-mouth plaque index (FMPS). Methods: An open literature search was conducted by using PubMed (MEDLINE), Cochrane Library and Google Scholar. The most studied age range was 9 to 12 years, with groups of children with no caries and groups with a minimum number of two teeth that were reconstructed, decayed and/or missing (DMFS/dmfs > 2) who experienced different tongue hygiene methods for the first time. Results: Four randomized trials met the search criteria and were included in this review. Conclusions: The results obtained suggest that specific tongue hygiene protocols, combined with a healthy diet and lifestyle, could be considered the gold standard to enable more effective primary prevention and improve the health of pediatric patients. This review improves the understanding of the impact of tongue hygiene in controlling the bacteria responsible for the onset of carious disease and its systemic correlates; however, further research with more data is needed to further confirm the findings of this research. Full article

(This article belongs to the Special Issue New Research Progress of Clinical Pediatric Dentistry)

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25 pages, 710 KiB

Open AccessSystematic Review

Muscle Mass as a Biomarker for Health Status and Function in Pediatric Individuals with Neuromuscular Disabilities: A Systematic Review

by Isabella R. Ferrara and Cristina L. Sadowsky

Children 2024, 11(7), 815; https://doi.org/10.3390/children11070815 (registering DOI) - 3 Jul 2024

Abstract

This systematic review aims to investigate the relationship between muscle mass and specific health outcomes in pediatric populations with neuromuscular disorders. A search was performed for any relevant studies published in English from 1996 to 2023 in five databases. To be included in [...] Read more.

This systematic review aims to investigate the relationship between muscle mass and specific health outcomes in pediatric populations with neuromuscular disorders. A search was performed for any relevant studies published in English from 1996 to 2023 in five databases. To be included in this analysis, articles must have had participants with an average age ≤21, focus on children with neuromuscular disabilities, and primarily examine relationships between muscle mass and any functional or health outcomes measure. Studies including typically develo** children were used to contrast and enhance findings. Thirty-two studies were included, with 10,129 unique individuals represented: seventeen studies focused on healthy/typically develo** children; seven on children with cerebral palsy; three on children with Duchenne muscular dystrophy; two on children with sarcopenia; and one study each on children with osteoporosis, congenital muscular dystrophy, and other various neurologic disorders. Thirteen studies assessed functional outcomes, ten assessed bone outcomes, and nine assessed other cardiovascular/metabolic outcomes. All of the included studies demonstrated relationships between muscle mass and respective outcomes in varying measures. The results of this review demonstrate that there is a consistently recognized relationship between muscle mass and important health outcomes in children, supporting clinically targeting muscle mass as a means to optimize desired outcomes. Full article

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15 pages, 824 KiB

Open AccessArticle

Analysis of YouTube-Based Therapeutic Content for Children with Cerebral Palsy

by Yerim Do, Yunjae Oh, Na Young Kim and Juntaek Hong

Children 2024, 11(7), 814; https://doi.org/10.3390/children11070814 (registering DOI) - 2 Jul 2024

Viewed by 89

Abstract

Background/Objectives: Cerebral palsy (CP) causes movement and posture challenges due to central nervous system damage, requiring lifelong management. During the COVID-19 pandemic, there was limited access to facility-based treatments, which increased the demand for home-based therapies and digital resources. We analyzed the qualitative [...] Read more.

Background/Objectives: Cerebral palsy (CP) causes movement and posture challenges due to central nervous system damage, requiring lifelong management. During the COVID-19 pandemic, there was limited access to facility-based treatments, which increased the demand for home-based therapies and digital resources. We analyzed the qualitative and quantitative aspects of YouTube videos focusing on CP therapy for children. Methods: A total of 95 videos were evaluated for content quality using the modified DISCERN (mDISCERN) tool and Global Quality Scale (GQS). The therapeutic program efficacy was assessed via the International Consensus on Therapeutic Exercise and Training (i-CONTENT) tool, Consensus on Therapeutic Exercise Training (CONTENT) scale, and Consensus on Exercise Reporting Template (CERT), and popularity was measured by the video power index (VPI). Results: YouTube-based therapeutic videos for children with CP generally exhibit reliability in video content and effectiveness in therapeutic programming, and no correlations were found between video popularity and quality. However, the qualitative analysis reveals insufficient mention of uncertainty in the treatment principles within the video content as well as a lack of detailed treatment descriptions encompassing aspects such as intensity, frequency, timing, setting, outcome measurement during and post-treatment, and safety considerations within therapeutic programs. In particular, this tendency was consistent regardless of the uploader’s expertise level and the classification of the neuromotor therapy type in contrast to that of the exercise type. Conclusions: YouTube-based content for CP children still has significant limitations in how substantive viewers, such as caregivers, can acquire tailored information and apply practical information to their exercise and treatment programs. Full article

(This article belongs to the Special Issue Advancements in Rehabilitation for Children with Cerebral Palsy or Acquired Brain Injury)

13 pages, 258 KiB

Open AccessArticle

Investigating the Sociodemographic and Health Characteristics of Non-Sugar Sweeteners Consumption in Greek School-Aged Children: A Cross-Sectional Study

by Kyriaki Apergi, Olga Malisova, Antonis Vlassopoulos, Philippa Fidanoglou, Aikaterini Kandyliari and Maria Kapsokefalou

Children 2024, 11(7), 813; https://doi.org/10.3390/children11070813 (registering DOI) - 2 Jul 2024

Viewed by 140

Abstract

Background/Objectives: The childhood consumption of non-sugar-sweetened (NSS) soft drinks is a growing concern due to its potential health implications. This study investigated demographic, anthropometric, and lifestyle factors influencing NSS soft drink consumption among children. Methods: A sample of 1304 children and their parents [...] Read more.

Background/Objectives: The childhood consumption of non-sugar-sweetened (NSS) soft drinks is a growing concern due to its potential health implications. This study investigated demographic, anthropometric, and lifestyle factors influencing NSS soft drink consumption among children. Methods: A sample of 1304 children and their parents were surveyed. Results: Analysis revealed that nearly 60% reported consuming NSS soft drinks at least once a week. Also, positive associations were found between NSS soft drink consumption and lower socioeconomic status, increased total beverage consumption, higher maternal BMI, and parental soft drink habits. However, upon employing multivariable models, only the association between total and NSS soft drinks consumption remained statistically significant (OR = 18.925, p < 0.05 for children; OR = 3.801, p < 0.05 for parents), highlighting the pivotal role of parental behavior in sha** children’s consumption patterns. Conclusions: These findings emphasize the importance of tracking parental habits, revealing a strong correlation between parental behavior and children’s soft drink consumption patterns. Understanding these factors is crucial for develo** effective public health strategies for children, which should prioritize not only individual behaviors but also parental modeling and household dynamics. Full article

(This article belongs to the Special Issue Advances in the Management of Children and Adolescents with Obesity)

9 pages, 453 KiB

Open AccessArticle

Feasibility and Acceptability of Yoga for Adolescents with Juvenile Idiopathic Arthritis

by Adina Dawoud, Jill Blitz, Steffany Moonaz and Leah Grout

Children 2024, 11(7), 812; https://doi.org/10.3390/children11070812 (registering DOI) - 2 Jul 2024

Viewed by 138

Abstract

Background/Objectives: Yoga is effective for adults with arthritis but unstudied in adolescents with juvenile idiopathic arthritis (JIA). Methods: A pilot study assessed the feasibility and acceptability of an 8-week group yoga intervention for adolescents ages 14–18 with JIA. Each 75-min session included breathing [...] Read more.

Background/Objectives: Yoga is effective for adults with arthritis but unstudied in adolescents with juvenile idiopathic arthritis (JIA). Methods: A pilot study assessed the feasibility and acceptability of an 8-week group yoga intervention for adolescents ages 14–18 with JIA. Each 75-min session included breathing techniques, relaxation, mindfulness, and modified yoga postures, using yoga props and a rope wall. An online video was available for home practice. The outcome measures administered at the baseline and at 8 weeks were physician global assessment with joint count, visual assessment with a joint damage assessment index, the Pediatric Quality of Life Arthritis Module 3.0 (Peds QL), and the visual analog scale for pain. Results: Thirteen out of 25 participants attended ≥1 class with a mean of 5.7 ± 2.2 classes. Common reasons for non-enrollment included distance, schedule, and lack of interest. The average distance to classes was 29.0 ± 41.7 miles. There was a trend toward improvement for joint count (p = 0.07), global assessment (p = 0.10), and the Pain and Hurt domain of the Peds QL (p = 0.13), but no other outcomes approached significance. Satisfaction data from an anonymous survey (n = 8) were high in all areas. Conclusions: Adolescents with JIA who attended yoga reported enjoyment, pain reduction, and interest in continued practice with no adverse events. Future studies should consider stakeholder engagement to reduce barriers and larger sample sizes to test the effectiveness. Full article

(This article belongs to the Topic Children’s Diseases, Family Management, and Quality of Life)

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16 pages, 256 KiB

Open AccessArticle

A Comparison of Three Executive Function Batteries in a Preschool-Aged Sample

by Laura J. Kuhn, Marie Camerota, Michael T. Willoughby and Clancy Blair

Children 2024, 11(7), 811; https://doi.org/10.3390/children11070811 (registering DOI) - 2 Jul 2024

Viewed by 120

Abstract

There is great interest in the development of executive function (EF) in the preschool period. Accordingly, multiple performance-based measures of EF have been developed for this age group, yet little is known about how they compare to one another. This study used a [...] Read more.

There is great interest in the development of executive function (EF) in the preschool period. Accordingly, multiple performance-based measures of EF have been developed for this age group, yet little is known about how they compare to one another. This study used a large and diverse sample of 3-to-5-year-old children (N = 846), who completed subtests of the National Institutes of Health’s Toolbox Cognition Battery (NTCB), the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-IV), and the EF Touch battery. Scores across the three batteries were compared and associations with age, income, and race/ethnicity were examined. Results revealed that (1) the three tasks were moderately correlated (r = 0.44–0.51, all p < 0.001), but children had higher mean accuracy scores on EF Touch than on the NTCB or the WPPSI-IV. (2) Mean accuracy scores on all batteries were linearly associated with child age (all F > 32.68, all p < 0.0001). (3) Comparisons by income and race/ethnicity showed lower accuracy for low-income children on the WPPSI-IV and lower accuracy for White children on the NTCB. Across all batteries, there was consistently lower accuracy for Hispanic children. In conclusion, the three batteries we examined performed similarly across several metrics. EF Touch may be more appropriate for younger children, while the NTCB performed well with older children. Full article

(This article belongs to the Special Issue Cognitive and Linguistic Development in Children and Adolescents)

16 pages, 279 KiB

Open AccessArticle

Machine Learning Approach for Predicting the Impact of Food Insecurity on Nutrient Consumption and Malnutrition in Children Aged 6 Months to 5 Years

by Radwan Qasrawi, Sabri Sgahir, Maysaa Nemer, Mousa Halaikah, Manal Badrasawi, Malak Amro, Stephanny Vicuna Polo, Diala Abu Al-Halawa, Doa’a Mujahed, Lara Nasreddine, Ibrahim Elmadfa, Siham Atari and Ayoub Al-Jawaldeh

Children 2024, 11(7), 810; https://doi.org/10.3390/children11070810 (registering DOI) - 2 Jul 2024

Viewed by 127

Abstract

Background: Food insecurity significantly impacts children’s health, affecting their development across cognitive, physical, and socio-emotional dimensions. This study explores the impact of food insecurity among children aged 6 months to 5 years, focusing on nutrient intake and its relationship with various forms of [...] Read more.

Background: Food insecurity significantly impacts children’s health, affecting their development across cognitive, physical, and socio-emotional dimensions. This study explores the impact of food insecurity among children aged 6 months to 5 years, focusing on nutrient intake and its relationship with various forms of malnutrition. Methods: Utilizing machine learning algorithms, this study analyzed data from 819 children in the West Bank to investigate sociodemographic and health factors associated with food insecurity and its effects on nutritional status. The average age of the children was 33 months, with 52% boys and 48% girls. Results: The analysis revealed that 18.1% of children faced food insecurity, with household education, family income, locality, district, and age emerging as significant determinants. Children from food-insecure environments exhibited lower average weight, height, and mid-upper arm circumference compared to their food-secure counterparts, indicating a direct correlation between food insecurity and reduced nutritional and growth metrics. Moreover, the machine learning models observed vitamin B1 as a key indicator of all forms of malnutrition, alongside vitamin K1, vitamin A, and zinc. Specific nutrients like choline in the “underweight” category and carbohydrates in the “wasting” category were identified as unique nutritional priorities. Conclusion: This study provides insights into the differential risks for growth issues among children, offering valuable information for targeted interventions and policymaking. Full article

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Graphical abstract

8 pages, 1979 KiB

Open AccessReview

Challenges and Insights: Cervical Spine Injuries in Children with Traumatic Brain Injury

by Hannah K. Weiss and Richard C. E. Anderson

Children 2024, 11(7), 809; https://doi.org/10.3390/children11070809 (registering DOI) - 2 Jul 2024

Viewed by 144

Abstract

Cervical spine injuries (CSIs) in pediatric patients with traumatic brain injury (TBI) pose unique diagnostic and management challenges. Current studies on the intricate overlap between pediatric TBI and CSI are limited. This paper explores the existing literature as well as the epidemiology, mechanisms [...] Read more.

Cervical spine injuries (CSIs) in pediatric patients with traumatic brain injury (TBI) pose unique diagnostic and management challenges. Current studies on the intricate overlap between pediatric TBI and CSI are limited. This paper explores the existing literature as well as the epidemiology, mechanisms of injury, diagnostic criteria, treatment strategies, and outcomes associated with CSI in pediatric TBI patients. Full article

(This article belongs to the Special Issue Developments in the Management of Cranial Injury in Children)

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8 pages, 402 KiB

Open AccessReview

Chronic Kidney Disease and Growth Failure in Children

by Tommaso Todisco, Grazia Maria Ubertini, Carla Bizzarri, Sandro Loche and Marco Cappa

Children 2024, 11(7), 808; https://doi.org/10.3390/children11070808 (registering DOI) - 1 Jul 2024

Viewed by 159

Abstract

Chronic kidney disease (CKD) is a significant challenge for pediatric endocrinologists, as children with CKD may present a variety of endocrine complications. Growth failure is common in CKD, and its severity is correlated with the degree of renal insufficiency. Management strategies include addressing [...] Read more.

Chronic kidney disease (CKD) is a significant challenge for pediatric endocrinologists, as children with CKD may present a variety of endocrine complications. Growth failure is common in CKD, and its severity is correlated with the degree of renal insufficiency. Management strategies include addressing reversible comorbidities, optimizing nutrition, and ensuring metabolic control. Kidney replacement therapy, including transplantation, determines a significant improvement in growth. According to a recent Consensus Statement, children with CKD stage 3—or on dialysis older >6 months—are eligible for treatment with recombinant growth hormone (rGH) in the case of persistent growth failure. Treatment with rGH may be considered for those with height between the 3rd and 10th percentile and persistent growth deceleration. In children who received kidney transplantation but continue to experience growth failure, initiation of GH therapy is recommended one year post-transplantation if spontaneous catch-up growth does not occur and steroid-free immunosuppression is not an option. In children with CKD, due to nephropathic cystinosis and persistent growth failure, GH therapy should be considered at all stages of CKD. Potential adverse effects and benefits must be regularly assessed during therapy. Treatment with GH is safe in children with CKD. However, its general efficacy is still controversial. All possible problems with a negative impact on growth should be timely addressed and resolved, whenever possible with a personalized approach to the patient. GH therapy may be useful in promoting catch-up growth in children with residual growth potential. Future research should focus on refining effective therapeutic strategies and establishing consensus guidelines to optimize growth outcomes in this population. Full article

(This article belongs to the Special Issue New Research Progress on Endocrine Disorders in Infants, Children, and Adolescents)

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11 pages, 440 KiB

Open AccessArticle

Evaluation of Problem-Based Learning Experiences Addressing Health Promotion in the Fourth Grade of Primary School

by Beatriz Mederer-Hengstl, Pilar Núñez-Delgado and Aurora Bueno-Cavanillas

Children 2024, 11(7), 807; https://doi.org/10.3390/children11070807 (registering DOI) - 1 Jul 2024

Viewed by 157

Abstract

Background: The global issues of overweight and sedentary lifestyles require comprehensive responses from health systems. Despite this, health education remains fragmented and sporadic. This study aims to target primary school children to instil healthy habits using active learning strategies, with a specific focus [...] Read more.

Background: The global issues of overweight and sedentary lifestyles require comprehensive responses from health systems. Despite this, health education remains fragmented and sporadic. This study aims to target primary school children to instil healthy habits using active learning strategies, with a specific focus on promoting a healthy diet and physical activity. Methods: This study employed problem-based learning (PBL) projects with fourth-grade primary students to encourage the acquisition of healthy habits. Conducted over four consecutive years at a two-line school, the study utilised an opportunity sample, evaluating intervention and control groups by comparing their corresponding scores. The control groups consisted of 54 students, while the intervention group included 159 students. Data collection involved pre-test and post-test questionnaires to measure outcomes. Results: Differential evaluation scores revealed significantly higher results in the intervention groups compared to the control groups, with an average score increase of 3.62 points in control groups and 6.94 points in intervention groups, particularly in attitudinal competencies. The strategies employed facilitated the development of crucial skills such as information search, synthesis, representation, analysis, decision making, teamwork, and intrapersonal awareness. Additionally, they significantly broadened the knowledge acquired regarding healthy habits. Conclusions: The problem-based learning approach proved effective in hel** children understand the importance of making healthy choices and encouraged the integration of such habits into their daily lives. These findings suggest that active learning strategies can significantly enhance health education and promote long-term healthy behaviours among primary school children. Full article

(This article belongs to the Special Issue Sedentary Behavior and Too Little Exercise: Linked to Childhood Health)

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15 pages, 2070 KiB

Open AccessSystematic Review

Effects of Schroth 3D Exercise on Adolescent Idiopathic Scoliosis: A Systematic Review and Meta-Analysis

by Chenting Chen, Jialu Xu and Haifeng Li

Children 2024, 11(7), 806; https://doi.org/10.3390/children11070806 (registering DOI) - 1 Jul 2024

Viewed by 258

Abstract

(1) Background: This meta-analysis aims to systematically assess the effect size of Schroth three-dimensional exercise training on adolescent idiopathic scoliosis, especially for Cobb angles, angles of trunk rotation, and quality of life. (2) Methods: Randomized controlled trials (RCTs) focused on the effect of [...] Read more.

(1) Background: This meta-analysis aims to systematically assess the effect size of Schroth three-dimensional exercise training on adolescent idiopathic scoliosis, especially for Cobb angles, angles of trunk rotation, and quality of life. (2) Methods: Randomized controlled trials (RCTs) focused on the effect of Schroth exercise on patients with adolescent idiopathic scoliosis (AIS) were retrieved from six databases, including PubMed, Embase, Cochrane Library, Web of Science, CNKI, and Wanfang. All publications until July 2023 were searched. Two researchers screened and evaluated the literature. Review manager (RevMan 5.3) statistical software was used for meta-analyses, and subgroup analysis and sensitivity analysis of the literature with high heterogeneity were further conducted. (3) Results: In total, 14 studies were included, including 538 adolescent idiopathic scoliosis patients. Compared with conventional physical therapy, Schroth 3D exercise training is more effective at reducing the Cobb angle (WMD = −3.32, 95%CI [−4.15, −2.50], p < 0.001) and improving the trunk rotation angle (WMD = −2.24, 95%CI [−3.00, −1.48], p < 0.001), quality of life (SMD = 2.80, 95%CI [1.53, 4.06], p < 0.001), and WRVAS (WMD = −2.92, 95%CI [−3.25, −2.60], p < 0.001), as well as enhancing the strength of the lumbar extensor (SMD = 1.79, 95%CI [1.46, 2.12], p < 0.001). (4) Conclusion: Compared with traditional therapy, Schroth 3D exercises are more effective at decreasing the Cobb angle and ATR in adolescent idiopathic scoliosis, improving patients’ quality of life, as well as enhancing the strength of the lumbar extensor. Full article

(This article belongs to the Section Pediatric Orthopedics & Sports Medicine)

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10 pages, 264 KiB

Open AccessArticle

Self-Perception Profile, Body Image Perception and Satisfaction in Relation to Body Mass Index: An Investigation in a Sample of Adolescents from the Campania Region, Italy

by Giada Ballarin, Francesca Gallè, Lucia Dinacci, Federica Liberti, Antonia Cunti and Giuliana Valerio

Children 2024, 11(7), 805; https://doi.org/10.3390/children11070805 (registering DOI) - 30 Jun 2024

Viewed by 226

Abstract

(1) Background: Body image dissatisfaction has been commonly reported in adolescents with overweight/obesity and has been related to a lack of motivation to change lifestyle behaviors. Plus, a better perception of physical fitness has been related to a higher self-perception in physical aspect [...] Read more.

(1) Background: Body image dissatisfaction has been commonly reported in adolescents with overweight/obesity and has been related to a lack of motivation to change lifestyle behaviors. Plus, a better perception of physical fitness has been related to a higher self-perception in physical aspect and social items in youths. (2) Methods: A total of 120 (59.2% males, mean age of 12.3 ± 0.9 years) middle-school adolescents participated in the present study. Anthropometric measurements were assessed following the standard procedures. Body weight perception and body image satisfaction were assessed using the Silhouette Figure Body Images Test. Self-perception profile, perceived physical fitness, and perceived difficulties in conducting physical tasks were assessed by using structured questionnaires. (3) Results: Overweight was present in 27.5% adolescents and obesity in 32.5%. A total of 89.7% of adolescents with obesity did not have a real perception of his/her weight status and 84.6% of adolescents with obesity were not satisfied with his/her body image. The self-perception of physical appearance, perceived difficulties in running, perceived overall fitness, and perceived speed/agility were lower in adolescents who were unsatisfied with their body image. Body image satisfaction was positively associated with the self-perception of physical appearance and overall fitness and negatively associated with perceived difficulties in running, independently of sex, age, and BMI. (4) Conclusions: Adolescents with obesity did not have a real perception of their weight status and were unsatisfied with their body image. The positive association between body satisfaction, a better perception of overall fitness, and less difficulties in conducting physical tasks suggests the protective role of the components of physical activity and health-related fitness on body acceptance in a critical period of life. Full article

(This article belongs to the Special Issue Motor Competence and Physical Activity in School Children)

11 pages, 2290 KiB

Open AccessArticle

by André Luiz de Góes Pacheco, Willian Motta Bocanegra, Élida Karina de Lira Ferreira, Rayssa Temudo dos Santos, Patrícia Miller Simões, Eulálio Malinga, Euclides da Conceição Guiliche, Arsénio Fernando José Isaías, Isabele Góes Nobre, João Henrique da Costa Silva, Wylla Tatiana Ferreira e Silva, Eduardo Padrón-Hernandez, Luciano Pirola, Rafael dos Santos Henrique and Carol Góis Leandro

Children 2024, 11(7), 804; https://doi.org/10.3390/children11070804 (registering DOI) - 30 Jun 2024

Viewed by 220

Abstract

Background/Objectives: Brazil and Mozambique face similar socioeconomic challenges, including common indicators of undernutrition and overnutrition among children. This study evaluated the similarity degree of the anthropometric and body composition variables of Brazilian and Mozambican children by using the Jaccard index. Methods: A total [...] Read more.

Background/Objectives: Brazil and Mozambique face similar socioeconomic challenges, including common indicators of undernutrition and overnutrition among children. This study evaluated the similarity degree of the anthropometric and body composition variables of Brazilian and Mozambican children by using the Jaccard index. Methods: A total of 1831 children of both genders aged 7–10 years from three Brazilian cities (Recife, Vitoria de Santo Antao, and Lagoa do Carro) and three Mozambican cities (Maputo, Boane, and Inhambane) participated in this study. Anthropometric (height, body mass, and waist circumference) and body composition (body fat percentage [%BF], lean mass, and fat mass) variables were measured and the Smoothed Jaccard Index Surface (SJIS) was used to evaluate the similarity degree. Results: Brazilian children were taller and heavier and had a higher %BF and fat mass than Mozambican children. Children living in urban areas were taller than those living in rural zones in both countries. Brazilian and Mozambican children showed high similarity only between %BF and lean mass. Children from Recife and Maputo had high similarities among waist circumference, body mass, fat mass, height, and %BF. Finally, a high SJIS degree was observed among height and %BF for schoolchildren from rural and urban zones. Conclusion: Brazilian and Mozambican children exhibit differences in growth characteristics but a high degree of similarity when children from rural and urban zones are compared. Full article

(This article belongs to the Special Issue Associations between Physical Activity and Fitness, Body Composition and Cognitive Skills during Growth and Maturation)

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23 pages, 349 KiB

Open AccessArticle

“Our Generation Is Trying to Break Some of That Resistance to Emotions”—A Mixed-Methods Pilot Examination of Tuning in to Kids for Black Parents of Preschoolers in the United States

by Briana J. Williams and John S. Carlson

Children 2024, 11(7), 803; https://doi.org/10.3390/children11070803 (registering DOI) - 30 Jun 2024

Viewed by 211

Abstract

Background: A growing body of literature examines the utility of emotion-focused parenting programs, as behaviorally based programs currently dominate the parenting literature. Few of those studies examine differences in how Black parents may benefit. This mixed-methods pilot study examined preliminary fidelity, efficacy, and [...] Read more.

Background: A growing body of literature examines the utility of emotion-focused parenting programs, as behaviorally based programs currently dominate the parenting literature. Few of those studies examine differences in how Black parents may benefit. This mixed-methods pilot study examined preliminary fidelity, efficacy, and acceptability of Tuning in to Kids (TIK), an emotion-focused parenting program targeting parenting practices and children’s emotion regulation through a strengths-based approach. Methods: Pre, post, and one-month follow-up measurements were collected from 21 parents in the United States who were randomly assigned to a treatment (i.e., TIK) or waitlist control group. They were assessed across several self-report parent measures (parental emotion regulation, emotion socialization parenting practices and beliefs) and parent-report of children’s social-emotional competence. Parents in the TIK group completed interviews to further understand their experience participating in the intervention. Results: Descriptive analyses showed general improvements and positive change in parenting practices, beliefs, parental emotion regulation, and children’s self-regulation. Large effect sizes indicate reductions of parents emotion dismissing and distressed reactions to children’s negative emotions. TIK was overall rated as a highly acceptable intervention. Parent interviews offer essential information to provide context to Black parents’ experiences utilizing TIK as well as themes related to challenges in raising Black children with self-regulation difficulties. Conclusions: Overall, these preliminary mixed-methods outcomes suggest that TIK is a promising parenting program to improve Black parents’ emotion regulation, emotion coaching beliefs and positive parenting practices. Further research is needed to investigate the effectiveness of TIK and other emotion-focused parenting programs with Black parents and assess the necessity of future cultural adaptations. Full article

(This article belongs to the Special Issue Evidence-Based Mental Health Practices for School-Age Children)

13 pages, 286 KiB

Open AccessArticle

Determinants of Creativity in Migrant versus Urban Children: A Case Study in China

by Yiqi Dai, Shunan Chen, Fengqian Mao and Junfang Xu

Children 2024, 11(7), 802; https://doi.org/10.3390/children11070802 (registering DOI) - 29 Jun 2024

Viewed by 194

Abstract

Objective: This study examines the current status and variations in creativity between migrant and urban children, exploring the influencing factors affecting creativity. Methods: We selected children from local households in Hangzhou City and non-local migrant households as participants. Their basic demographic information and [...] Read more.

Objective: This study examines the current status and variations in creativity between migrant and urban children, exploring the influencing factors affecting creativity. Methods: We selected children from local households in Hangzhou City and non-local migrant households as participants. Their basic demographic information and creative tendencies were assessed using the Children’s Basic Situation Questionnaire and Williams’ Creativity Tendency Measurement Scale, respectively. A multi-model regression analysis was conducted to analyze factors influencing creativity. Results: This study included 1047 children. Significant differences were observed between urban and migrant children regarding age, family type, number of siblings, parental education, parental presence at home, parental guidance in learning, experience of changing schools, having their own room, and academic performance. In addition, migrant children exhibited significantly lower creativity levels compared to urban children. The multi-model regression analysis showed that migrant status, a good parent–child relationship, having parents who often guide learning, having their own room, and excellent academic performance significantly influenced children’s creativity. Conclusions: Migrant children display lower levels of creativity than their urban counterparts, with notable differences across several factors. Full article

13 pages, 668 KiB

Open AccessSystematic Review

A Systematic Review on Ketamine and Esketamine for Treatment-Resistant Depression and Suicidality in Adolescents: A New Hope

by Simone Pardossi, Andrea Fagiolini, Simona Scheggi and Alessandro Cuomo

Children 2024, 11(7), 801; https://doi.org/10.3390/children11070801 (registering DOI) - 29 Jun 2024

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Abstract

Treating depression in adolescents is a significant challenge, and major depressive disorder (MDD) with suicidal ideation and treatment-resistant depression (TRD) are common and potentially devastating to optimal psychological and physical development in this age group. Suicide is among the leading causes of youth [...] Read more.

Treating depression in adolescents is a significant challenge, and major depressive disorder (MDD) with suicidal ideation and treatment-resistant depression (TRD) are common and potentially devastating to optimal psychological and physical development in this age group. Suicide is among the leading causes of youth mortality, and TRD occurs in up to 40% of adolescents with MDD. TRD involves severe, persistent symptoms that are hard to treat, significantly reducing functioning and quality of life. We conducted a literature search focusing on key terms related to ketamine and esketamine for MDD with suicidal ideation and TRD in adolescents, aiming to review the potential utility of these molecules in adolescents for these conditions. Ketamine has shown efficacy in reducing depressive symptoms in adolescents with TRD. Esketamine has shown efficacy in reducing depressive symptoms and treating suicidal ideation in adolescents. Both ketamine and esketamine have demonstrated favorable safety and tolerability profiles. Using these drugs for serious conditions like adolescent MDD with suicidal thoughts and TRD can effectively treat symptoms, reduce self-harm and suicide risks, and provide a window for longer-term therapeutic interventions. The prompt and effective treatment of TRD could improve adolescents’ quality of life. However, more research is needed to optimize treatment protocols and evaluate long-term effects. Full article

11 pages, 962 KiB

Open AccessArticle

Agony of Choice: Caudal Block versus Ilioinguinal/Iliohypogastric Nerve Block in Unilateral Orchidopexy

by Aybike Hofmann, Bernhard Koller, Franziska Vauth, Pirmin I. Zöhrer, Gregor Badelt and Wolfgang H. Rösch

Children 2024, 11(7), 800; https://doi.org/10.3390/children11070800 (registering DOI) - 29 Jun 2024

Viewed by 147

Abstract

Objective: This prospective study aimed to compare the efficacy of caudal block (CB) and ilioinguinal/iliohypogastric nerve block (IINB) for providing additional analgesia during unilateral orchidopexy. Methods: Seventy-one boys aged <48 months, classified as ASA I/II, were assigned into CB (n = 37) [...] Read more.

Objective: This prospective study aimed to compare the efficacy of caudal block (CB) and ilioinguinal/iliohypogastric nerve block (IINB) for providing additional analgesia during unilateral orchidopexy. Methods: Seventy-one boys aged <48 months, classified as ASA I/II, were assigned into CB (n = 37) and IINB (n = 34) groups. Outcome measures included intra- and postoperative analgesic requirements, pain scores, and administration duration. Additional intraoperative analgesia was administered for a 10% increase in heart rate, while postoperative pain was assessed using the Children’s and Infants Postoperative Pain Scale (CHIPPS), with scores >4 prompting supplementary analgesia. Monitoring was extended for 24 h post-surgery. Results: CB significantly reduced the need for intraoperative (p < 0.001) and early postoperative (p = 0.008) analgesia compared to IINB. However, the CB group exhibited a slightly higher but non-significant analgesic requirement on the ward. No clinically relevant side effects were observed in either group. Conclusions: Both CB and IINB are effective and safe methods for providing regional analgesia during orchidopexy. CB demonstrates superior efficacy intraoperatively and in the early postoperative period, while IINB may offer advantages in the later recovery phase. However, additional analgesia is often required for orchidopexy, especially in outpatient settings. Full article

(This article belongs to the Special Issue State-of-Art in Pediatric Anesthesia)

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14 pages, 444 KiB

Open AccessArticle

Hemostatic Status of Neonates with Perinatal Hypoxia, Studied via NATEM in Cord Blood Samples

by Marina Tsaousi, Rozeta Sokou, Abraham Pouliakis, Marianna Politou, Nicoletta Iacovidou, Theodora Boutsikou, Alma Sulaj, Eleni Karapati, Andreas G. Tsantes, Argirios E. Tsantes, Serena Valsami and Zoi Iliodromiti

Children 2024, 11(7), 799; https://doi.org/10.3390/children11070799 (registering DOI) - 29 Jun 2024

Viewed by 177

Abstract

Background: Perinatal hypoxia may result in coagulation dysfunction. Diminished blood flow or oxygen to the fetus/neonate during the perinatal period can cause bone marrow and liver function impairment, leading to thrombocytopenia, impaired synthesis of clotting and fibrinolytic factors, and increased destruction of platelets [...] Read more.

Background: Perinatal hypoxia may result in coagulation dysfunction. Diminished blood flow or oxygen to the fetus/neonate during the perinatal period can cause bone marrow and liver function impairment, leading to thrombocytopenia, impaired synthesis of clotting and fibrinolytic factors, and increased destruction of platelets in the small blood vessels. The goal of the present study was to evaluate the hemostatic status of newborns with perinatal hypoxia via the non-activated thromboelastometry (NATEM) assay in cord blood samples. Methods: 134 hypoxic neonates born in our maternity unit over a 1.5-year period were enrolled in this observational cohort study, and 189 healthy neonates served as the control group. Participation in the study was voluntary and parents signed informed consent prior to recruitment. Demographic and clinical data were recorded on admission, and the NATEM method was performed on cord blood samples. The following NATEM values were evaluated: clotting time (CT), alpha angle (α-angle), clot formation time (CFT), clot amplitude at 5 and 10 min. (A5, A10), maximum clot firmness (MCF), clot lysis index at 60 min. after CT (LI60), and maximum clot elasticity (MCE). Statistical analysis was conducted utilizing the SAS for Windows 9.4 software platform. Results: Neonates with perinatal hypoxia exhibited decreased fibrinolytic potential in comparison to healthy neonates, as indicated by increased LI60, and this difference was statistically significant (LΙ60: 94 (92–96) Vs 93 (91–95), p value = 0.0001). There were no statistically significant differences noted among the remaining NATEM variables. Conclusion: Our findings indicate decreased fibrinolytic potential in hypoxic neonates in comparison to healthy neonates, suggesting that NATEM could serve as an effective tool for promptly identifying hemostasis dysfunction in this group of neonates. Full article

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11 pages, 512 KiB

Open AccessArticle

Two Physiotherapy Methods to Improve the Physical Condition of Children with Autism Spectrum Disorder

by Lina Draudvilienė, Justas Draudvila, Simona Stankevičiūtė and Laura Daniusevičiūtė-Brazaitė

Children 2024, 11(7), 798; https://doi.org/10.3390/children11070798 (registering DOI) - 28 Jun 2024

Viewed by 178

Abstract

This study presents two simple physiotherapy programs that were implemented for five weeks and showed positive changes in balance, coordination, and motor skills in kindergarteners with ASD. Physiotherapy programs in a gym and games on a smart board with balance plates and an [...] Read more.

This study presents two simple physiotherapy programs that were implemented for five weeks and showed positive changes in balance, coordination, and motor skills in kindergarteners with ASD. Physiotherapy programs in a gym and games on a smart board with balance plates and an unstable base were applied to improve the physical condition of children with ASD. Thirty children with ASD (4–6 years old) attending special needs kindergarten were enrolled in the study. Three tests were used to assess participants’ physical condition before and after the study: the modified Berg Balance Scale, the Imbalance Coordination Sample, and the Bruininks–Oseretsky Motor Proficiency Test (BOTMP). The resulting mean change, calculated from each group’s scores, shows that the participants who received physical therapy sessions at the smart board had the greatest change of 1.58 points. It shows that the opportunity to play games on a smart board motivates children with ASD to work harder; therefore, it is a simple and easy way to engage children in different types of physical exercise. A slightly smaller change of 1.51 was obtained in the group that received gym sessions. However, working in the gym was more psychologically challenging for the children with ASD due to their lack of desire and motivation. Both methods are relatively simple and easy to apply at home; therefore, parents can make a significant contribution to improving children’s physical condition and that can be an effective tool to assist these individuals with activities in daily life. Full article

(This article belongs to the Topic Influence of Physical Activity, Nutrition, Educators and Parents on Children's Health Development)

14 pages, 502 KiB

Open AccessArticle

Prenatal and Postnatal Diagnosis and Genetic Background of Corpus Callosum Malformations and Neonatal Follow-Up

by Virág Bartek, István Szabó, Ágnes Harmath, Gábor Rudas, Tidhar Steiner, Attila Fintha, Nándor Ács and Artúr Beke

Children 2024, 11(7), 797; https://doi.org/10.3390/children11070797 (registering DOI) - 28 Jun 2024

Viewed by 188

Abstract

Introduction: The corpus callosum is one of the five main cerebral commissures. It is key to combining sensory and motor functions. Its structure can be pathological (dysgenesis) or completely absent (agenesis). The corpus callosum dys- or agenesis is a rare disease (1:4000 live [...] Read more.

Introduction: The corpus callosum is one of the five main cerebral commissures. It is key to combining sensory and motor functions. Its structure can be pathological (dysgenesis) or completely absent (agenesis). The corpus callosum dys- or agenesis is a rare disease (1:4000 live births), but it can have serious mental effects. Methods: In our study, we processed the data of 64 pregnant women. They attended a prenatal diagnostic center and genetic counseling from 2005 to 2019 at the Department of Obstetrics and Gynecology at Semmelweis University. Results: The pregnancies had the following outcomes: 52 ended in delivery, 1 in spontaneous abortion, and 11 in termination of pregnancy (TOP) cases (n = 64). The average time of detection with imaging tests was 25.24 gestational weeks. In 16 cases, prenatal magnetic resonance imaging (MRI) was performed. If the abnormality was detected before the 20th week, a genetic test was performed on an amniotic fluid sample obtained from a genetic amniocentesis. Karyoty** and cytogenetic tests were performed in 15 of the investigated cases. Karyoty** gave normal results in three cases (46,XX or XY). In one of these cases, postnatally chromosomal microarray (CMA) was later performed, which confirmed Aicardi syndrome (3q21.3–21.1 microdeletion). In one case, postnatally, the test found Wiedemann–Rautenstrauch syndrome. In other cases, it found X ring, Di George syndrome, 46,XY,del(13q)(q13q22) and 46,XX,del(5p)(p13) (Cri-du-chat syndrome). Edwards syndrome was diagnosed in six cases, and Patau syndrome in one case. Conclusion: We found that corpus callosum abnormalities are often linked to chromosomal problems. We recommend that a cytogenetic test be performed in all cases to rule out inherited diseases. Also, the long-term outcome does not just depend on the disease's severity and the associated other conditions, and hence proper follow-up and early development are also key. For this reason, close teamwork between neonatology, developmental neurology, and pediatric surgery is vital. Full article

(This article belongs to the Special Issue New Trends in Perinatal and Pediatric Epidemiology)

26 pages, 487 KiB

Open AccessReview

Neurodevelopmental Disorders Associated with Gut Microbiome Dysbiosis in Children

by Alejandro Borrego-Ruiz and Juan J. Borrego

Children 2024, 11(7), 796; https://doi.org/10.3390/children11070796 (registering DOI) - 28 Jun 2024

Viewed by 190

Abstract

The formation of the human gut microbiome initiates in utero, and its maturation is established during the first 2–3 years of life. Numerous factors alter the composition of the gut microbiome and its functions, including mode of delivery, early onset of breastfeeding, exposure [...] Read more.

The formation of the human gut microbiome initiates in utero, and its maturation is established during the first 2–3 years of life. Numerous factors alter the composition of the gut microbiome and its functions, including mode of delivery, early onset of breastfeeding, exposure to antibiotics and chemicals, and maternal stress, among others. The gut microbiome–brain axis refers to the interconnection of biological networks that allow bidirectional communication between the gut microbiome and the brain, involving the nervous, endocrine, and immune systems. Evidence suggests that the gut microbiome and its metabolic byproducts are actively implicated in the regulation of the early brain development. Any disturbance during this stage may adversely affect brain functions, resulting in a variety of neurodevelopmental disorders (NDDs). In the present study, we reviewed recent evidence regarding the impact of the gut microbiome on early brain development, alongside its correlation with significant NDDs, such as autism spectrum disorder, attention-deficit/hyperactivity disorder, Tourette syndrome, cerebral palsy, fetal alcohol spectrum disorders, and genetic NDDs (Rett, Down, Angelman, and Turner syndromes). Understanding changes in the gut microbiome in NDDs may provide new chances for their treatment in the future. Full article

18 pages, 814 KiB

Open AccessArticle

Impact of Digital Media, School Problems, and Lifestyle Factors on Youth Psychosomatic Health: A Cross-Sectional Survey

by Verena Barbieri, Giuliano Piccoliori, Adolf Engl and Christian J. Josef Wiedermann

Children 2024, 11(7), 795; https://doi.org/10.3390/children11070795 (registering DOI) - 28 Jun 2024

Viewed by 139

Abstract

Background: Post-pandemic psychosomatic complaints in children and adolescents have been underreported. This study investigated psychosomatic complaints in children and adolescents in Northern Italy in 2023, with the aim of identifying changes in predictors and vulnerable subgroups. Methods: Cross-sectional data representative of scholars from [...] Read more.

Background: Post-pandemic psychosomatic complaints in children and adolescents have been underreported. This study investigated psychosomatic complaints in children and adolescents in Northern Italy in 2023, with the aim of identifying changes in predictors and vulnerable subgroups. Methods: Cross-sectional data representative of scholars from a northern Italian province were analyzed using the Health Behavior in School-aged Children (HBSC) checklist. The sum scores, count data, and dichotomized data were examined, and predictor effects were expressed using a linear regression model for the sum scores. Results: Data from 4525 participants (aged 7–19 years, 50.5% girls) were analyzed. Psychosomatic symptoms remained unchanged after the pandemic. Significant gender differences were noted, especially in older age groups, with girls reporting more complaints. Factors such as children’s health, digital media use, and school problems significantly influence psychosomatic outcomes. While migration background negatively affected girls’ psychosomatic well-being, boys showed improvement through sports. Conclusion: The psychosomatic well-being of children and adolescents did not improve after the pandemic. These findings indicate the need for targeted interventions, improved health literacy, and ongoing monitoring to support the mental well-being of this vulnerable population. Reducing screen time remains a critical strategy for enhancing youth well-being. Full article

(This article belongs to the Special Issue Children’s Self-Regulation and Health in the Context of Digital Technology Use)

15 pages, 484 KiB

Open AccessReview

Epidemiology of Endocrine Dysfunctions in Pediatric Patients with Previous Central Nervous System Infection: A Sco** Review of the Literature

by Giorgio Sodero, Clelia Cipolla, Laura Martino, Carolina Gentili, Claudia Rendeli and Danilo Buonsenso

Children 2024, 11(7), 794; https://doi.org/10.3390/children11070794 (registering DOI) - 28 Jun 2024

Viewed by 167

Abstract

Purpose The incidence of endocrine sequelae following central nervous system (CNS) infections in pediatric age is not known. We conducted this sco** review to assess the incidence of endocrinological alterations in patients with prior CNS infections in pediatric age. Methods Our screening process [...] Read more.

Purpose The incidence of endocrine sequelae following central nervous system (CNS) infections in pediatric age is not known. We conducted this sco** review to assess the incidence of endocrinological alterations in patients with prior CNS infections in pediatric age. Methods Our screening process included both randomized and non-randomized controlled trials. All types of observational studies, prospective and retrospective, have been included. Results Ten studies were included in our review. The cumulative number of patients in all of the studies was 211, the mean age of the population study was 4.9 (+/− 5 years). The included papers described the following acute CNS infections: meningitis (nine studies reported eighty-five cases) and encephalitis (three studies described sixty-five cases). Two case reports and one retrospective study reported hypopituitarism as a consequence of Mycobacterium tuberculosis CNS infection. In five studies the patients developed endocrine comorbidities at the time of infection. Another study analyzed 49 young adults who previously had tuberculous meningitis at a mean age of 5.9 +/− 5.0 years: seven patients had growth hormone deficiency, four of whom also had gonadotropin deficiency; the other three had gonadotropin deficiency, corticotropin deficiency, and mild hyperprolactinemia. Conclusion Standardized multidisciplinary follow-up and research of patients with prior CNS infection is crucial. Although pituitary reserve screening is not commonly performed in these patients, clinical and research centers should set up an endocrinological evaluation with monitoring of auxological parameters to detect the signs and symptoms of hypopituitarism early and to initiate the appropriate care in children with previous CNS infections. Full article

(This article belongs to the Special Issue Short- and Long-Term Outcomes of Central Nervous Systems in Pediatric Patients)

15 pages, 1811 KiB

Open AccessArticle

A Randomized Controlled Simulation Trial of a Neonatal Resuscitation Digital Game Simulator for Labour and Delivery Room Staff

by Christiane Bilodeau, Georg M. Schmölzer and Maria Cutumisu

Children 2024, 11(7), 793; https://doi.org/10.3390/children11070793 (registering DOI) - 28 Jun 2024

Viewed by 173

Abstract

Background: Healthcare providers (HCPs) working in labour and delivery rooms need to undergo regular refresher courses to maintain their neonatal resuscitation skills, which are shown to decline over time. However, due to their irregular schedules and limited time, HCPs encounter difficulties in readily [...] Read more.

Background: Healthcare providers (HCPs) working in labour and delivery rooms need to undergo regular refresher courses to maintain their neonatal resuscitation skills, which are shown to decline over time. However, due to their irregular schedules and limited time, HCPs encounter difficulties in readily accessing refresher programs. RETAIN is a digital game that simulates a delivery room to facilitate neonatal resuscitation training for HCPs. Objective: This study aims to ascertain whether participants enjoyed the RETAIN digital game simulator and whether it was at least as good as a video lecture at refreshing and maintaining participants’ neonatal resuscitation knowledge. Methods: In this randomized controlled simulation trial, n = 42 labour and delivery room HCPs were administered a pre-test of neonatal resuscitation knowledge using a manikin. Then, they were randomly assigned to a control or a treatment group. For 20–30 min, participants in the control group watched a neonatal resuscitation lecture video, while those in the treatment group played the RETAIN digital game simulator of neonatal resuscitation scenarios. Then, all participants were administered a post-test identical to the pre-test. Additionally, participants in the treatment group completed a survey of attitudes toward the RETAIN simulator that provided a measure of enjoyment of the RETAIN game simulator. After two months, participants were administered another post-test identical to the pre-test. Results: For the primary outcome (neonatal resuscitation performance), an analysis of variance revealed that participants significantly improved their neonatal resuscitation performance over the first two time points, with a significant decline to the third time point, the same pattern of results across conditions, and no differences between conditions. For the secondary outcome (attitudes toward RETAIN), participants in the treatment condition also reported favourable attitudes toward RETAIN. Conclusions: Labour and delivery room healthcare providers in both groups (RETAIN simulator or video lecture) significantly improved their neonatal resuscitation performance immediately following the intervention, with no group differences. The findings suggest that participants enjoyed interacting with the RETAIN digital game simulator, which provided a similar boost in performance right after use to the more traditional intervention. Full article

(This article belongs to the Special Issue New Insights in Neonatal Resuscitation)

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27 pages, 616 KiB

Open AccessReview

Cephalometric Evaluation of Children with Short Stature of Genetic Etiology: A Review

by George Paltoglou, Nickolas Ziakas, George P. Chrousos and Christos Yapijakis

Children 2024, 11(7), 792; https://doi.org/10.3390/children11070792 - 28 Jun 2024

Viewed by 201

Abstract

Introduction: A plethora of biological molecules regulate chondrogenesis in the epiphyseal growth plate. Disruptions of the quantity and function of these molecules can manifest clinically as stature abnormalities of various etiologies. Traditionally, the growth hormone/insulin-like growth factor 1 (IGF1) axis represents the etiological [...] Read more.

Introduction: A plethora of biological molecules regulate chondrogenesis in the epiphyseal growth plate. Disruptions of the quantity and function of these molecules can manifest clinically as stature abnormalities of various etiologies. Traditionally, the growth hormone/insulin-like growth factor 1 (IGF1) axis represents the etiological centre of final stature attainment. Of note, little is known about the molecular events that dominate the growth of the craniofacial complex and its correlation with somatic stature. Aim: Given the paucity of relevant data, this review discusses available information regarding potential applications of lateral cephalometric radiography as a potential clinical indicator of genetic short stature in children. Materials and Methods: A literature search was conducted in the PubMed electronic database using the keywords: cephalometric analysis and short stature; cephalometric analysis and achondroplasia; cephalometric analysis and hypochondroplasia; cephalometric analysis and skeletal abnormalities; cephalometr* and SHOX; cephalometr* and CNP; cephalometr* and ACAN; cephalometr* and CNVs; cephalometr* and IHH; cephalometr* and FGFR3; cephalometr* and Noonan syndrome; cephalometr* and “Turner syndrome”; cephalometr* and achondroplasia. Results: In individuals with genetic syndromes causing short stature, linear growth of the craniofacial complex is confined, following the pattern of somatic short stature regardless of its aetiology. The angular and linear cephalometric measurements differ from the measurements of the average normal individuals and are suggestive of a posterior placement of the jaws and a vertical growth pattern of the face. Conclusions: The greater part of the existing literature regarding cephalometric measurements in short-statured children with genetic syndromes provides qualitative data. Furthermore, cephalometric data for individuals affected with specific rare genetic conditions causing short stature should be the focus of future studies. These quantitative data are required to potentially establish cut-off values for reference for genetic testing based on craniofacial phenotypes. Full article

(This article belongs to the Section Pediatric Endocrinology & Diabetes)

12 pages, 462 KiB

Open AccessArticle

Complications and Outcomes of Surgically Treated Pediatric Supracondylar Humerus Fractures

by Sebastian G. Hahn, Andrea Schuller, Lorenz Pichler, Anna Hohensteiner, Thomas Sator, Oskar Bamer, Britta Chocholka, Manuela Jaindl, Elisabeth Schwendenwein, Bikash Parajuli, Sanika Rapole, Thomas Tiefenboeck and Stephan Payr

Children 2024, 11(7), 791; https://doi.org/10.3390/children11070791 - 28 Jun 2024

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Abstract

This study describes the outcome of supracondylar humerus fractures in children using crossed K-wires after closed or open reduction with the medial, lateral or bilateral approach. Patients treated between January 2000 and December 2019 were classified according to the Von Laer classification, complications [...] Read more.

This study describes the outcome of supracondylar humerus fractures in children using crossed K-wires after closed or open reduction with the medial, lateral or bilateral approach. Patients treated between January 2000 and December 2019 were classified according to the Von Laer classification, complications were classified according to the Sink classification and clinical outcomes were classified according to modified Flynn criteria. In total, 364 patients with a mean age of 5.23 ± 2.45 years were included. The majority were type IV fractures (156; 42.9%) and 94 (60.3%) needed an open reduction for which the medial approach (53; 56.4%) was predominantly used. Overall, of 50 complications (31 using closed reduction, 19 open reduction), 17/50 (34%) needed revision surgery. An excellent clinical outcome was achieved in 348/364 (95.6%) patients. The approach used for open reduction as such had no influence on the complication rate or clinical outcome. For severely displaced fractures, the data showed that an open approach for crossed K-wires tended to result in fewer complications and better clinical outcomes than a closed reduction. If an open reduction is indicated, the required approach (medial, lateral or bilateral) should be primarily selected according to the requirements of the fracture pattern and eventual cosmetic considerations. Full article

(This article belongs to the Special Issue Research in Paediatric Orthopaedic Surgery (Volume II))

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15 pages, 833 KiB

Open AccessArticle

Causal Factors Contributing to Youth Cyberbullying in the Deep South of Thailand

by Kasetchai Laeheem

Children 2024, 11(7), 790; https://doi.org/10.3390/children11070790 - 28 Jun 2024

Viewed by 184

Abstract

Background: Violence against each other via social media has increased and caused cyberbullying that can happen anytime through electronic communication tools that everyone can access easily. Cyberbullying is sending, posting, and sharing negative, harmful, and false information about another, causing embarrassment online on [...] Read more.

Background: Violence against each other via social media has increased and caused cyberbullying that can happen anytime through electronic communication tools that everyone can access easily. Cyberbullying is sending, posting, and sharing negative, harmful, and false information about another, causing embarrassment online on social media. Objectives: This study aims to investigate causal factors contributing to youth cyberbullying in Thailand’s deep south. Methods: A cross-sectional survey was conducted among 340 youths in Thailand’s deep south, consisting of 220 males and 120 females. The subjects were divided by age range: 22–23 years old (40.6%), 24–25 years old (26.8%), 18–19 years old (17.1%), and 18–19 years old (15.5%). The data were analyzed with structural equation modeling (SEM). Results: The results were that the model of the causal factors resulting in youth cyberbullying in the deep south of Thailand was consistent with the empirical data (the relative chi-square (χ²/df) was 1.77). The goodness-of-fit index (GFI) was 0.95. The root-mean-square error of approximate (RMSEA) was 0.049). Cyberbullying was positively influenced directly and indirectly by negative upbringing, the influence of personal violence, and the influence of media violence at a statistically significant level of 0.001, with total effect sizes of 1.13, 0.74, and 0.64, respectively. Additionally, cyberbullying was positively influenced directly by negative mental traits with a statistically significant level of 0.05 and a total effect size of 0.17. Conclusions: This study suggests that the results could be beneficial in concretely forming policies and strategies to prevent and mitigate the problem of youth cyberbullying. Full article

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13 pages, 543 KiB

Open AccessArticle

Consensus Guidelines for the Use of Vosoritide in Children with Achondroplasia in Australia

by Louise Tofts, Penny Ireland, Tracy Tate, Supriya Raj, Theresa Carroll, Craig F. Munns, Stephen Knipe, Katherine Langdon, Lesley McGregor, Fiona McKenzie, Andreas Zankl and Ravi Savarirayan

Children 2024, 11(7), 789; https://doi.org/10.3390/children11070789 - 28 Jun 2024

Viewed by 218

Abstract

Background: Achondroplasia, the most prevalent skeletal dysplasia, stems from a functional mutation in the fibroblast growth factor receptor 3 gene, leading to growth impairment. This condition presents multifaceted medical, functional and psychosocial challenges throughout childhood, adolescence and adulthood. Current management strategies aim to [...] Read more.

Background: Achondroplasia, the most prevalent skeletal dysplasia, stems from a functional mutation in the fibroblast growth factor receptor 3 gene, leading to growth impairment. This condition presents multifaceted medical, functional and psychosocial challenges throughout childhood, adolescence and adulthood. Current management strategies aim to minimise medical complications, optimise functional capabilities and provide comprehensive supportive care. Vosoritide (trade name: VOXZOGO^®, BioMarin Pharmaceuticals) is the first disease-modifying pharmaceutical treatment approved for the management of patients with achondroplasia and became available in Australia in May 2023. Methods: Standardised clinical guidelines for its optimal use are not yet widely available. To address this gap, a multidisciplinary Australian Vosoritide Working Group, comprising 12 experts with experience in achondroplasia management from across Australia, developed recommendations to guide the use of vosoritide in clinical practice. Results: The recommendations, which are expert opinions of the Australian Vosoritide Working Group, aim to (i) standardise the use of vosoritide across Australia, (ii) support the safe clinical rollout of vosoritide and (iii) support universal access. Conclusions: These recommendations have been developed for healthcare professionals and institutions that are engaged in using vosoritide in the management of achondroplasia and will be revised using a formal framework for clinical guideline development once more evidence is available. Full article

(This article belongs to the Special Issue Pediatric Growth and Skeletal Disorders)

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13 pages, 709 KiB

Open AccessArticle

Factors Predicting In-School and Electronic Bullying among High School Students in the United States: An Analysis of the 2021 Youth Risk Behavior Surveillance System

by Tran H. Nguyen, Gulzar H. Shah, Ravneet Kaur, Maham Muzamil, Osaremhen Ikhile and Elizabeth Ayangunna

Children 2024, 11(7), 788; https://doi.org/10.3390/children11070788 - 28 Jun 2024

Viewed by 283

Abstract

Background: Bullying is a global public health problem with severe adverse effects on behavioral health. Understanding the predictors of victimization by bullying is essential for public policy initiatives to respond to the problem effectively. In addition to traditional in-person bullying, electronic bullying has [...] Read more.

Background: Bullying is a global public health problem with severe adverse effects on behavioral health. Understanding the predictors of victimization by bullying is essential for public policy initiatives to respond to the problem effectively. In addition to traditional in-person bullying, electronic bullying has become more prevalent due to increasing social interaction and identity formation in virtual communities. This study aims to determine the predictors of in-school and electronic bullying. Methods: We employed multivariable logistic regression to analyze a nationally representative sample of 17,232 high school students in the United States, the 2021 Youth Risk Behavior Surveillance System national component. The survey was conducted during the COVID-19 pandemic, from September through December 2021. The factors examined included sociodemographic characteristics (age, gender, race), appearance (obesity), physically active lifestyles (being physically active, spending a long time on digital games), and risk-taking behavior (using marijuana). Results: Our results indicated that sociodemographic characteristics were strong predictors of being bullied in school and electronically. Being obese is more likely to result in bullying in school (AOR = 1.32, p = 0.003) and electronically (AOR = 1.30, p = 0.004). Adolescent students showing marijuana use had higher odds of being bullied in school (AOR = 2.15, p < 0.001) and electronically (AOR = 1.81, p < 0.001). While spending a long time on digital devices raises the risk of being electronically bullied (AOR = 1.25, p = 0.014), being physically active is not associated with being bullied. Neither of the two lifestyle factors was associated with in-school bullying. Conclusions: Interventions addressing violence among adolescents can benefit from empirical evidence of risk factors for bullying victimization in high school. Full article

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