Children

13 pages, 425 KiB

Open AccessArticle

Executive Functions and Special Educational Needs and Their Relationship with School-Age Learning Difficulties

by Juan Manuel Núñez, Ana Soto-Rubio and Marián Pérez-Marín

Children 2024, 11(11), 1398; https://doi.org/10.3390/children11111398 (registering DOI) - 19 Nov 2024

Background/Objectives: The relationship between executive functions, special educational needs (SEN), and learning difficulties in school-aged children is critical for developing effective educational interventions. This study explores the connection between executive functions and SEN in primary school students, examining differences in executive function profiles [...] Read more.

Background/Objectives: The relationship between executive functions, special educational needs (SEN), and learning difficulties in school-aged children is critical for developing effective educational interventions. This study explores the connection between executive functions and SEN in primary school students, examining differences in executive function profiles between those with and without SEN and their impact on learning difficulties. Methods: In total, 123 primary school students aged 6 to 12 and their teachers and parents participated in this study. The Behavior Rating Inventory of Executive Function (BRIEF-2) and the Prediscal test were used to assess difficulties in reading and mathematics, and sociodemographic and clinical data were collected through ad hoc records. Results: The results indicated that students with SEN exhibited significantly more affected executive function profiles compared to their peers without SEN in both family and school contexts, highlighting areas such as cognitive flexibility, initiative, working memory, planning and organisation, task supervision, and material organisation. Additionally, significant negative correlations were found between executive functions and performance in reading and mathematics, suggesting that deficits in executive functions are strongly associated with SEN. Conclusions: These findings underscore the critical role of executive functions in understanding and addressing SEN and learning difficulties, emphasising the need for comprehensive assessment programmes and early intervention targeting executive function deficits to support the academic and overall development of students with SEN. Full article

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

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12 pages, 1034 KiB

Open AccessReview

Diagnosis and Treatment of Infantile Hemangioma from the Primary Care Paediatricians to the Specialist: A Narrative Review

by Francesco Bellinato, Maria Marocchi, Luca Pecoraro, Marco Zaffanello, Micol Del Giglio, Giampiero Girolomoni, Giorgio Piacentini and Erika Rigotti

Children 2024, 11(11), 1397; https://doi.org/10.3390/children11111397 - 18 Nov 2024

Abstract

Infantile haemangiomas (IHs) affect 3–10% of infants, 10% of whom need topical or systemic beta-blocker therapy. Propranolol is the first choice for IHs with a high risk of complications. Since more than half of IHs leave a permanent mark, to reduce outcomes, it [...] Read more.

Infantile haemangiomas (IHs) affect 3–10% of infants, 10% of whom need topical or systemic beta-blocker therapy. Propranolol is the first choice for IHs with a high risk of complications. Since more than half of IHs leave a permanent mark, to reduce outcomes, it is essential to start oral propranolol (2–3 mg/kg/day in 2 doses/day) within the 5th month of life (i.e., during the proliferative phase) and to complete the therapy cycle for at least 6 months. This review aims to summarise the epidemiology, clinical presentation, diagnosis, and treatment of IHs and to highlight the importance of proper referral to specialised hub centres. Patients with vascular anomalies, particularly those suspected of having IH, should be referred to a specialised centre for accurate diagnosis, management by a multidisciplinary team, and timely treatment. IHs may pose life-threatening, functional, and aesthetic risks or may ulcerate. Segmental infantile haemangioma of the face/neck and the lumbosacral regions can be associated with various malformations. To ensure timely specialist evaluation and treatment to reduce the potential risk of complications, it is essential to identify high-risk IHs rapidly. The Infantile Haemangioma Referral Score (IHReS) scale is an important tool to assist primary care paediatricians and general dermatologists. Full article

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13 pages, 892 KiB

Open AccessArticle

Voices of Hope: Leveraging Think-Aloud Cognitive Interviews to Develop a Hope Assessment Tool for Young People Living with Chronic Health Conditions

by Emily von Scheven, Mitchell Braun, Bhupinder Nahal, Emily R. Perito, Paul Brakeman, William Daniel Soulsby, Laura Quill, Addison Cuneo and Linda S. Franck

Children 2024, 11(11), 1396; https://doi.org/10.3390/children11111396 - 18 Nov 2024

Abstract

Background/Objectives: Hope is a universal, multidimensional, and nuanced concept that may have specific meaning for young people living with chronic health conditions anticipated to last into adulthood. We previously identified definitions of hope for youth living with chronic health conditions derived from young [...] Read more.

Background/Objectives: Hope is a universal, multidimensional, and nuanced concept that may have specific meaning for young people living with chronic health conditions anticipated to last into adulthood. We previously identified definitions of hope for youth living with chronic health conditions derived from young people’s and their caregivers’ own words. Here, we aimed to develop a hope assessment tool to facilitate the future evaluation of interventions to support wellness and health for young people growing up with chronic health conditions; Methods: We developed Likert-type scale questions using the young people’s and caregivers’ definitions of hope and applied the think-aloud cognitive interview method to assess understanding and to inform sequential iteration. Interviews were recorded and insights from participant interviews were analyzed thematically. Results: In total, 11 youth (age 12–16 years) with various chronic health conditions completed surveys and interviews over three iteration cycles. Responses to the six-point Likert-scale questions ranged from 1 (none of the time) to 6 (all of the time) (median 5). All of the young people (n = 11) reported that they do things they enjoy, either all of the time or most of the time. In contrast, only 36% felt energetic, either all or most of the time. Three themes were identified: my body and hope; my identity, self-image, and hope; and my world and hope. Conclusions: In addition to gaining important feedback that allowed us to improve item word choice to maximize assessment tool understanding, we gained valuable insights into the multidimensional construct of hope. Thematic analysis revealed the importance of physical symptoms and identity to the meaning of hope in the context of a young person’s life. Our new hope assessment tool derived from the young people’s own definition of hope has face and content validity for use in clinical and research settings to evaluate hope among pediatric patients living with chronic health conditions. Full article

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9 pages, 1991 KiB

Open AccessCase Report

Broadening the PHIP-Associated Neurodevelopmental Phenotype

by Giulia Pascolini, Giovanni Luca Scaglione, Balasubramanian Chandramouli, Daniele Castiglia, Giovanni Di Zenzo and Biagio Didona

Children 2024, 11(11), 1395; https://doi.org/10.3390/children11111395 - 17 Nov 2024

Abstract

Background: Monoallelic damaging variants in PHIP (MIM*612870), encoding the Pleckstrin Homology Domain Interacting Protein, have been associated with a novel neurodevelopmental disorder, also termed Chung–Jansen syndrome (CHUJANS, MIM#617991). Most of the described individuals show developmental delay (DD)/intellectual disability (ID), obesity/overweight, and variable congenital [...] Read more.

Background: Monoallelic damaging variants in PHIP (MIM*612870), encoding the Pleckstrin Homology Domain Interacting Protein, have been associated with a novel neurodevelopmental disorder, also termed Chung–Jansen syndrome (CHUJANS, MIM#617991). Most of the described individuals show developmental delay (DD)/intellectual disability (ID), obesity/overweight, and variable congenital anomalies, so the condition can be considered as an ID–overweight syndrome. Case Description: We evaluated a child presenting with DD/ID and a craniofacial phenotype reminiscent of a Pitt–Hopkins syndrome (PTHS)-like condition. We performed a clinical exome analysis on his biological sample, as well as an in silico prediction of the obtained data. At the same time, we interrogated the DeepGestalt technology powered by Face2Gene (F2G), using a frontal image of the proband, and clinically reviewed the earlier CHUJANS patients. In this child, we found a novel PHIP pathogenetic variant, which we corroborated through a protein modeling approach. The F2G platform supported the initial clinical hypothesis of a PTHS-like condition, while the clinical review highlighted the lack of the main frequent CHUJANS clinical features in this child. Conclusions: The unusual clinical presentation of this novel patient resembles a PTHS-like condition. However, a novel variant in PHIP has been unexpectedly detected, expanding the phenotypic spectrum of CHUJANS. Notably, PTHS (MIM#610954), which is a different ID syndrome caused by heterozygous variants in TCF4 (MIM*610954), is not classically considered in the differential diagnosis of CHUJANS nor has been cited in the previous studies. This could support other complex diagnoses and invite further patients’ descriptions. Full article

(This article belongs to the Special Issue Neurodevelopmental Disorders in Pediatrics)

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9 pages, 224 KiB

Open AccessArticle

Incidence of and Risk Factors for Central Venous Catheter Thrombosis: Results from a Single-Center Pediatric Intensive Care Unit

by Maha Azzam, Yousef M. AlTalhi, Hani Alsawadi, Mohamed Humoodi, Abdullah Alzahrani, Amir Shehzad Hayat, Mohammed Bakhsh and Sara Osman

Children 2024, 11(11), 1394; https://doi.org/10.3390/children11111394 - 17 Nov 2024

Abstract

Background: Central Venous Catheter (CVC) is a necessary and important tool in managing acutely ill children and those needing complex care. CVC enables infusing venous medication, fluids, blood products, chemotherapy, total parental nutrition, and painless withdrawal of blood for laboratory testing when needed. [...] Read more.

Background: Central Venous Catheter (CVC) is a necessary and important tool in managing acutely ill children and those needing complex care. CVC enables infusing venous medication, fluids, blood products, chemotherapy, total parental nutrition, and painless withdrawal of blood for laboratory testing when needed. Objective: To identify the incidence and risk factors for Central Venous Catheter-Related Thrombosis (CVC-RT) among patients admitted to the Pediatric Intensive Unit. Method: This was a prospective, observational, single-center study that was conducted over 17 months from September 2019 to January 2021 at King Abdulaziz Medical City, Jeddah. Design: Prospective observational study. Setting: King Abdulaziz Medical City, a tertiary care center in the western region of Saudi Arabia. Patients: Pediatric patients aged 1 to 168 months who were admitted to the PICU and required central line insertion (whether inserted centrally or peripherally) for more than 48 hours were included. Screening for thrombosis was performed within day 4–7 post-line insertion and again on the 14th day. Results: A total of 255 patients were enrolled over 17 months. The incidence rate of CVC-RT was 5.4%. The type of CVC was significantly different between the two groups; in the no thrombosis group, 59.2% had a central line while in the CVC-RT groups, 51.9% had a PIC line (p = 0.027). In a multivariate regression analysis including patients’ clinical profile, high D-dimer as baseline and low platelets were both significant risk factors for CVC-RT [adjusted OR = 3.22, CI (1.25–8.28), p = 0.015 and adjusted OR = 7.38, CI (2.18–25.02), p = 0.001], respectively. Conclusions: The current study found that PIC line was associated with an increased risk of CVC-RT, which is congruent with the literature. As children with CVC can have multiple risk factors for developing CVC-RT, it is important to conduct further large prospective studies to identify such factors and decrease the incidence of CVC-RT. Full article

(This article belongs to the Section Pediatric Emergency Medicine & Intensive Care Medicine)

19 pages, 483 KiB

Open AccessArticle

Night Sleep, Parental Bedtime Practices and Language Development in Low-Risk Preterm and Full-Term Late Talkers: A Longitudinal Study in the Third Year of Life

by Mariagrazia Zuccarini, Martina Riva, Arianna Aceti, Luigi Corvaglia, Anat Scher, Annalisa Guarini and Alessandra Sansavini

Children 2024, 11(11), 1393; https://doi.org/10.3390/children11111393 - 16 Nov 2024

Abstract

Background: Studies on night sleep and parental bedtime practices and their associations with language development in populations at risk of language delay and neonatal conditions, such as late talkers and preterm children, are scarce. Objectives: Our objective was to longitudinally examine [...] Read more.

Background: Studies on night sleep and parental bedtime practices and their associations with language development in populations at risk of language delay and neonatal conditions, such as late talkers and preterm children, are scarce. Objectives: Our objective was to longitudinally examine the development of night sleep (total night sleep difficulties, settling, night waking, and co-sleeping), parental bedtime practices (total parental bedtime practices, active physical comforting, encouraging autonomy, and leaving to cry), and expressive language (word and sentence production), and their associations in low-risk preterm and full-term late talkers from 31 to 37 months of age. Methods: Parents of 38 late talkers, 19 low-risk preterm and 19 full-term children, completed the Italian versions of the Infant Sleep Questionnaire, the Parental Interactive Bedtime Behavior Scale, and the MacArthur-Bates Communicative Development Inventory Words and Sentences Long Form. Results: Late talkers’ night sleep difficulties, such as settling to sleep and night waking, decreased over time, with low-risk preterm late talkers experiencing more night waking and co-sleeping than full-term peers. Parents reported that instances of active physical comforting and leaving to cry also decreased, with parents of low-risk preterm late talkers reporting higher active physical comforting scores than parents of full-term peers. Improvements in parental practices of encouraging autonomy were significantly associated with increased sentence production from 31 to 37 months. Conclusions: Findings highlight the importance of monitoring night sleep in preterm and full-term late talkers. They also suggest that populations vulnerable to sleep and language delays may particularly benefit from targeted interventions promoting autonomy in their bedtime routines, which, in turn, could support their language development trajectories. Full article

(This article belongs to the Special Issue Early Interventions for Children with Language Developmental Disabilities)

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11 pages, 3317 KiB

Open AccessArticle

Reimagining Kangaroo Care for Preterm Infants: A Novel Garment for Safe and Comfortable Bonding

by Alexandra McMillin, Aviva Presser Aiden, Jules P. Sherman, Ruth Ann Crystal and William D. Rhine

Children 2024, 11(11), 1392; https://doi.org/10.3390/children11111392 (registering DOI) - 16 Nov 2024

Abstract

Background/Objectives: Kangaroo Care (KC) has been proven to enhance physiological stability, growth, and bonding in preterm, low-birthweight infants. Despite its benefits, KC is underutilized in Level IV Neonatal Intensive Care Units (NICUs) due to challenges in managing medical equipment. This study introduces the [...] Read more.

Background/Objectives: Kangaroo Care (KC) has been proven to enhance physiological stability, growth, and bonding in preterm, low-birthweight infants. Despite its benefits, KC is underutilized in Level IV Neonatal Intensive Care Units (NICUs) due to challenges in managing medical equipment. This study introduces the Kangarobe™, a novel garment designed to facilitate safe, comfortable, and efficient KC for medically fragile infants in high-acuity NICUs. Methods: From 2021 to 2023, a feasibility study was conducted involving 25 infant-parent dyads in a Level IV NICU. The Kangarobe™ was designed using human-centered design principles and tested on infants dependent on respiratory support. Surveys employing a 5-point Likert scale were administered to parents and nursing staff to assess safety, comfort, ease of use, and procedural access. Results: Survey results showed positive feedback from both parents and nursing staff, particularly in the areas of safety and comfort. For example, 72–80% of parents and nurses responded positively regarding ease and comfort. High level of agreement (76%) on the security of medical line management, with minimal negative feedback. In addition, parents using the Kangarobe™ held their infants for an average of 171 min per session, with a notable increase compared to the typical 75 min, indicating enhanced comfort and feasibility for extended KC sessions. The Kangarobe™ successfully enabled the secure management of medical lines and tubes, with the vertical access window improving procedural efficiency without interrupting KC. Conclusions: The Kangarobe™ demonstrates promise in addressing barriers to KC in high-acuity NICUs. By enhancing safety, comfort, and ease of use, it supports wider adoption of KC practices, potentially improving patient safety, staff efficiency, and family-centered care. Full article

(This article belongs to the Special Issue Providing Care for Preterm Infants)

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Graphical abstract

13 pages, 238 KiB

Open AccessArticle

Nursing Students’ Volunteer Experiences of Interacting with Children Receiving Pediatric Palliative Care: A Qualitative Study

by Eunju Jin and Hyunju Kang

Children 2024, 11(11), 1391; https://doi.org/10.3390/children11111391 - 16 Nov 2024

Abstract

Background/Objectives: Pediatric palliative care refers to active, holistic care that provides support not only for families but also for the physical, psychological, social, and spiritual needs of pediatric patients with severe life-threatening diseases. Nursing students’ volunteer work for pediatric patients requiring palliative care [...] Read more.

Background/Objectives: Pediatric palliative care refers to active, holistic care that provides support not only for families but also for the physical, psychological, social, and spiritual needs of pediatric patients with severe life-threatening diseases. Nursing students’ volunteer work for pediatric patients requiring palliative care is a unique and special experience with which to understand them as prospective medical personnel and that allows them to directly experience and feel the needs and reality related to emotional support. This study aimed to explore the experiences of nursing students who volunteer in pediatric in palliative care settings. Methods: The participants, selected through purposive sampling, were 20 nursing undergraduate students who volunteered at a pediatric palliative care medical center or a private community organization providing a support program for pediatric patients receiving palliative care. Individual in-depth interviews were conducted, and data were analyzed using content analysis. Data were collected from 7 August to 27 November 2023. Results: Five major categories were derived: (1) meeting with children—the process of facing and overcoming challenges; (2) the journey of changing through interactions with children; (3) parting with the child—anticipation, shock, and remembering; (4) new insights into pediatric palliative care; (5) and growing as a nursing student. Conclusions: The volunteer activities enabled the nursing students to interact with pediatric patients undergoing palliative care outside the sphere of clinical education. It increased these students’ awareness of palliative care and provided an opportunity for self-reflection and growth. It also provided an opportunity to improve empathy and provide emotional support. Full article

(This article belongs to the Section Pediatric Nursing)

20 pages, 1199 KiB

Open AccessArticle

Identifying Facilitators and Barriers to Neonatal Intensive Care Unit Visitation in Mothers of Low Socioeconomic Status: A Qualitative Investigation

by Dana B. McCarty, Renée M. Ferrari, Shelley Golden, Bharathi J. Zvara, Wylin D. Wilson and Meghan E. Shanahan

Children 2024, 11(11), 1390; https://doi.org/10.3390/children11111390 - 16 Nov 2024

Abstract

Background/Objectives: The experience of parenting in a highly medicalized, unnatural environment can result in impaired mother–infant bonding, but increased maternal presence at the infant’s bedside has been associated with improved infant and maternal outcomes. The primary objective of this study was to explore [...] Read more.

Background/Objectives: The experience of parenting in a highly medicalized, unnatural environment can result in impaired mother–infant bonding, but increased maternal presence at the infant’s bedside has been associated with improved infant and maternal outcomes. The primary objective of this study was to explore barriers and facilitators during the NICU Experience in regard to maternal presence in an NICU. Methods: We interviewed 12 mothers (7 Black, 5 white) of low socioeconomic status (SES) whose preterm infants (average birth gestational age of 27 weeks) were currently hospitalized in an NICU. We engaged the NICU Family Advisory Board in all steps of the research process. Results: Barriers and facilitators to maternal presence spanned all levels of the Socioecological Model; however, barriers were mostly at the societal, community, and institutional levels, while facilitators varied based on interpersonal and individual-level factors. Assets that mothers accessed to facilitate visits, such as free housing and shuttle services, were not available to all mothers based on individual circumstances (e.g., caregiving responsibilities). While a few mothers identified negative interactions with health care practitioners, these encounters were not attributed to racism or described as barriers to visitation. Conclusions: Hospitals can support families with infants in an NICU by providing free or inexpensive short-term sibling support, alleviating the burden of parking costs, and communicating early and frequently about available institutional resources during the hospital stay. Full article

(This article belongs to the Topic Risk and Protective Factors in Social Interactions: Behavioral and Neural Evidence)

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10 pages, 853 KiB

Open AccessArticle

Hasn’t Child Abuse Been Overlooked? An Evaluation of Abused Children Who Visited the Emergency Department with Sentinel Injuries

by Han Bit Kim and Hyun Noh

Children 2024, 11(11), 1389; https://doi.org/10.3390/children11111389 - 15 Nov 2024

Abstract

Objective: Effective child abuse intervention requires understanding its prevalence. While obtaining a comprehensive national estimate of child abuse cases is challenging, sentinel injuries—minor yet unusual injuries like bruises or wounds in pre-cruising-age children—can provide an indicative measure. Using the National Emergency Department Information [...] Read more.

Objective: Effective child abuse intervention requires understanding its prevalence. While obtaining a comprehensive national estimate of child abuse cases is challenging, sentinel injuries—minor yet unusual injuries like bruises or wounds in pre-cruising-age children—can provide an indicative measure. Using the National Emergency Department Information System (NEDIS) data, this study aimed to gauge the prevalence of sentinel injuries using diagnostic codes in children under 12 months who visited emergency centers in South Korea and to evaluate the extent of child abuse screening in these cases. Methods: This cross-sectional study used diagnostic codes indicative of sentinel injuries previously defined using the Delphi method. This study, using NEDIS data, included children under 12 months who visited emergency centers nationwide from 2014 to 2021 for reasons of injury. Children injured in car accidents were excluded. Independent variables included patient demographics, the injury mechanism, intentionality, the route of arrival, the emergency center level, the triage level, and specialist consultation. Dependent variables were the presence of a sentinel injury code, and whether diagnostic tests for child abuse were conducted. Results: Based on NEDIS and national statistical data, the frequency from 2014 to 2021 averaged 2501 per 100,000 of the population. Of the 186,065 patients studied, 63,131 (33.9%) had a diagnostic code corresponding to a sentinel injury. The proportion of patients undergoing diagnostic tests for suspected child abuse was 36.9% for those with sentinel injuries and 43.8% for those with other codes. The percentage of children with sentinel injuries receiving diagnostic tests increased annually, from 32.4% in 2014 to 54.4% in 2021. By institution, the rates were 36.4% for regional emergency centers, 38.4% for local emergency centers, and 20.0% for local emergency institutions. Conclusions: A significant proportion of children presenting to emergency departments had sentinel injury codes. However, the rate of diagnostic tests conducted for suspected child abuse in these cases remains suboptimal. Although there has been an upward trend in testing rates in recent years, there is a pressing need for increased attention to and enhancement in screening for child abuse among children with sentinel injury codes. Full article

(This article belongs to the Special Issue Growing Up Unequal: Family Complexity, Child Maltreatment and Child Well-Being)

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10 pages, 665 KiB

Open AccessArticle

Pain-Associated Diagnoses in Childhood Before the Diagnosis of Attention-Deficit/Hyperactivity Disorder: A Population-Based Study

by Eugene Merzon, Eli Magen, Yaniv Levy, Shai Ashkenazi, Iris Manor, Abraham Weizman, Beth Krone, Stephen V. Faraone, Ilan Green, Avivit Golan-Cohen, Shlomo Vinker and Ariel Israel

Children 2024, 11(11), 1388; https://doi.org/10.3390/children11111388 - 15 Nov 2024

Abstract

Background: Pediatric pain significantly affects children’s lives, leading to school absenteeism, impaired social interactions, and psychological distress. The perception of sensory signals as pain is influenced by the brain’s noradrenergic system, and recent evidence suggests that chronic pain may impact cognitive functioning and [...] Read more.

Background: Pediatric pain significantly affects children’s lives, leading to school absenteeism, impaired social interactions, and psychological distress. The perception of sensory signals as pain is influenced by the brain’s noradrenergic system, and recent evidence suggests that chronic pain may impact cognitive functioning and emotional regulation. Attention-Deficit/Hyperactivity Disorder (ADHD) is associated with alterations in the dopaminergic/noradrenergic systems, which could affect pain perception. Pain-associated conditions and frequent analgesic use in childhood may be linked to ADHD development and could serve as early indicators, yet data on this potential association remain limited. Study Aim: This population-based case-control study in Israel aimed to assess the prevalence of pain-related diagnoses prior to ADHD diagnosis in children aged 5 to 18. The study included children registered with Leumit Health Services (LHS) between 1 January 2006, and 30 June 2021. Children diagnosed with ADHD were compared to matched controls, selected based on age, gender, socioeconomic status, and other sociodemographic factors, who were never diagnosed with ADHD during the study period. Results: Children with ADHD (N = 18,756) and controls (N = 37,512) were precisely matched for sociodemographic characteristics. Individuals with ADHD exhibited significantly higher frequencies of diverse pain conditions, including those associated with illness [headache, earaches, and throat pain (odds ratios [OR] = 1.156 [95%CI 1.085, 1.232], 1.295 [95%CI 1.217, 1.377], and 1.080 [95%CI 1.019, 1.145], respectively; p < 0.01)] and injury [sprains and strains (OR = 1.233 [95% CI 1.104,1.376)]. Analgesics were more frequently purchased by individuals with ADHD, particularly paracetamol (OR = 1.194 [95%CI 1.152, 1.237], p < 0.001) and ibuprofen (OR = 1.366 [95%CI 1.318, 1.416], p = 0.001). Conclusions: This study highlights a potential connection between ADHD and pediatric pain. The elevated rates of pain diagnoses and analgesic usage among children with ADHD underscore the need for further research. Full article

(This article belongs to the Section Pediatric Neurology & Neurodevelopmental Disorders)

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10 pages, 241 KiB

Open AccessReview

Developmental Origins of Non-Communicable Chronic Diseases: Role of Fetal Undernutrition and Gut Dysbiosis in Infancy

by Manju Chandra

Children 2024, 11(11), 1387; https://doi.org/10.3390/children11111387 - 15 Nov 2024

Abstract

There is an increasing prevalence of non-communicable chronic diseases (NCCDs) like obesity, metabolic syndrome, type 2 diabetes mellitus (T2DM), hypertension, allergic asthma, and neuro-developmental/psychiatric problems in many parts of the world. A suboptimal lifestyle as an adult is often blamed for the occurrence [...] Read more.

There is an increasing prevalence of non-communicable chronic diseases (NCCDs) like obesity, metabolic syndrome, type 2 diabetes mellitus (T2DM), hypertension, allergic asthma, and neuro-developmental/psychiatric problems in many parts of the world. A suboptimal lifestyle as an adult is often blamed for the occurrence of NCCDs. This review discusses the developmental origin of health and disease theory and how suboptimal nutrition in intrauterine life and the establishment of a suboptimal gut microbiome during infancy can influence the predisposition to NCCDs. Full article

(This article belongs to the Section Pediatric Gastroenterology and Nutrition)

15 pages, 275 KiB

Open AccessArticle

Is There an Association Between Cesarean Section Delivery with Specific Learning Disabilities (SLD) or/and Attention-Deficit/Hyperactivity Disorder (ADHD)? A Cross-Sectional Study in Greek Population

by Maria A. Makri, Dimitrios Chaniotis, Victoria G. Vivilaki and Effie G. Papageorgiou

Children 2024, 11(11), 1386; https://doi.org/10.3390/children11111386 - 14 Nov 2024

Abstract

Background/Objective: Learning difficulties (LDs) are lifelong neurodevelopmental disorders with multifactorial causes, including perinatal factors like mode of delivery. This study aims to explore whether cesarean section (CS) delivery is linked to the occurrence of specific learning disabilities (SLDs), attention-deficit/hyperactivity disorder (ADHD), or their [...] Read more.

Background/Objective: Learning difficulties (LDs) are lifelong neurodevelopmental disorders with multifactorial causes, including perinatal factors like mode of delivery. This study aims to explore whether cesarean section (CS) delivery is linked to the occurrence of specific learning disabilities (SLDs), attention-deficit/hyperactivity disorder (ADHD), or their comorbidity. Methods: An online questionnaire was distributed via Google Forms to Greek mothers and parents of children with and without diagnoses, shared through school-related groups and various Greek pages focused on child development, special education, and learning difficulties. Conducted over eight months (October 2023–May 2024), this cross-sectional study involved 256 children, 137 with LDs diagnoses, and 119 controls. Results: In total, 59.9% of CS-born children had a diagnosis, compared to 40.1% of those born vaginally (X²(1) = 4.19, p = 0.045). CS delivery was associated with a 68% increased likelihood of LDs (OR = 1.68, 95% CI [1.02, 2.76]), with higher risks for ADHD (OR = 2.25, 95% CI [1.06, 4.79]) and comorbid SLD/ADHD diagnoses (OR = 2.75, 95% CI [1.17, 6.46]). Stratified analyses showed birthweight and gestational age as effect modifiers rather than confounders. Key postnatal risk factors identified were family history (OR = 4.65, 95% CI [2.41, 8.94]) and language acquisition difficulties (OR = 5.28, 95% CI [1.36, 20.47]). Conclusions: The findings suggest a possible association between CS and LDs, along with a novel link between CS and increased comorbidities. These results underscore the need for further research and provide valuable insights into how CS delivery may influence the risk of LDs, depending on the type of diagnosis. Full article

(This article belongs to the Section Pediatric Neurology & Neurodevelopmental Disorders)

9 pages, 558 KiB

Open AccessArticle

Risk Factors for Postoperative Intra-Abdominal Abscess in Pediatric Perforated Appendicitis Following Laparoscopic Appendectomy: A Multicenter Analysis

by Joonhyuk Son, Ji-Won Han and Chaeyoun Oh

Children 2024, 11(11), 1385; https://doi.org/10.3390/children11111385 - 14 Nov 2024

Abstract

Background: Perforated appendicitis in children is a frequently encountered and significant surgical condition. The treatment of choice is laparoscopic appendectomy, but this carries a risk of postoperative intra-abdominal abscess (IAA). The purpose of this study was to determine risk factors linked to the [...] Read more.

Background: Perforated appendicitis in children is a frequently encountered and significant surgical condition. The treatment of choice is laparoscopic appendectomy, but this carries a risk of postoperative intra-abdominal abscess (IAA). The purpose of this study was to determine risk factors linked to the occurrence of IAA following laparoscopic surgery in pediatric perforated appendicitis. Methods: This retrospective cohort study analyzed 137 children with perforated appendicitis who received laparoscopic appendectomy at four tertiary hospitals between March 2018 and December 2022. Data on patient demographics, preoperative clinical characteristics, and surgical details were collected. Independent risk factors for IAA formation were determined using logistic regression analysis. Results: The overall incidence of postoperative IAA was 10.9%. Prolonged symptom duration and elevated CRP levels were associated with higher IAA rates. Patients who developed IAAs experienced prolonged postoperative fevers and longer hospital stays. Significant risk factors for IAA identified through multivariable analysis included a higher severity grade of appendicitis (≥Grade IV, OR 5.9, p = 0.034) and the presence of a free appendicolith during surgery (OR 5.549, p = 0.01). Of the patients who developed IAAs, nine (60%) improved with conservative treatment, while six (40%) required invasive procedures. Conclusions: A higher severity grade of appendicitis (≥Grade IV) and the presence of a free appendicolith are significant predictors of postoperative IAAs in pediatric perforated appendicitis. Recognizing these factors can help guide clinical management and postoperative care, potentially reducing the incidence of this complication. Full article

(This article belongs to the Special Issue Cutting-Edge Laparoscopic and Thoracoscopic Surgery in Children)

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11 pages, 261 KiB

Open AccessArticle

High Serum Irisin Concentration Is Associated with More Disturbed Behavioural Eating Pattern in Adolescent Rhythmic Gymnasts

by Liina Remmel, Jaak Jürimäe, Anna-Liisa Tamm, Priit Purge and Vallo Tillmann

Children 2024, 11(11), 1384; https://doi.org/10.3390/children11111384 - 14 Nov 2024

Abstract

Background/Objectives: There are strict demands on body weight and shape in highly trained adolescent female athletes, and they are in the highest risk group for the development of eating disorders. This study aims to compare the behavioural eating patterns between highly trained [...] Read more.

Background/Objectives: There are strict demands on body weight and shape in highly trained adolescent female athletes, and they are in the highest risk group for the development of eating disorders. This study aims to compare the behavioural eating patterns between highly trained female adolescent athletes and untrained controls (UCs), and to describe the associations between behavioural eating patterns and different energy homeostasis hormones. Methods: A total of 33 rhythmic gymnasts (RGs), 20 swimmers (SWs), and 20 UCs (n = 20) that were 14 to 18 years old participated in this investigation. Anthropometric measurements, body composition, training volume, 3-consecutive-day energy intake, and different energy homeostasis hormones were measured. For the evaluation of the individual behavioural eating pattern, an eating disorders assessment scale (EDAS) questionnaire with different subscales was used. Results: The mean EDAS subscale of restrained eating score was significantly higher in the RG group compared to the UC group (17.2 ± 7.4 vs. 11.5 ± 5.8; p < 0.05). The EDAS total score (r = 0.380) and the subscale score of preoccupation with body image and body weight (r = 0.371) were both positively correlated (p < 0.05) with serum irisin concentrations in the RG group. Conclusions: In conclusion, female rhythmic gymnasts reported a more often restrained eating pattern than untrained controls, and their more disturbed behavioural eating pattern was associated with a higher serum irisin concentration. Full article

(This article belongs to the Special Issue Nutritional Status and Eating Patterns in Children and Adolescents: Prevalence, Screening and Prevention of Metabolic Disorders)

17 pages, 3244 KiB

Open AccessArticle

Insights from Team Clinic: A Person-Centered Virtual Peer Group Care Model Adapted for Marginalized and Historically Excluded Youth with Type 1 Diabetes (T1D)

by Jaquelin Flores Garcia, Mark W. Reid, Alejandra Torres Sanchez, Valerie Ruelas, Sarah-Jeanne Salvy, Alex Thomas, Gary Ashwal, D. Steven Fox and Jennifer K. Raymond

Children 2024, 11(11), 1383; https://doi.org/10.3390/children11111383 - 14 Nov 2024

Abstract

Background: Despite advancements in T1D care regimens, racially and ethnically diverse youth with low income continue to experience worse health outcomes, more psychosocial challenges, and higher barriers to care. Alternative care models are needed to address the needs of this population. Methods: Team [...] Read more.

Background: Despite advancements in T1D care regimens, racially and ethnically diverse youth with low income continue to experience worse health outcomes, more psychosocial challenges, and higher barriers to care. Alternative care models are needed to address the needs of this population. Methods: Team Clinic is a person-centered virtual peer group (VPG) care model that was assessed in a 15-month, pragmatic randomized controlled trial. Youth (ages 10–17) and their families were assigned to study arms based on their clinician’s group (standard care or person-centered care, PCC) and then randomized to VPGs or no groups. Results: Data from 79 youth and their families were examined. While positive outcomes were seen across all study groups, youth that participated in Team Clinic (PCC + VPG) reported the largest increases in resilience at the end of the study (+7.42, to 51.63, p = 0.009). These participants also reported the lowest levels of depressive symptoms as assessed by PHQ-8 scores (−5.07, p = 0.002) at the end of the study. Conclusion: Team Clinic can serve as an alternative care model for racially and ethnically diverse youth with T1D and their families. VPGs can provide unique benefits, including an increase in resilience, a decrease in depressive symptoms, and a safe space for families to connect, learn, and receive support. Full article

(This article belongs to the Special Issue Innovative Psychosocial Interventions in Children and Adolescents Living with Type 1 Diabetes)

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10 pages, 837 KiB

Open AccessArticle

Bladder and Bowel Dysfunction Rehabilitation in Children with Acquired Brain Injury

by Rita Chiminello, Chiara Pellegrino, Noemi Deanesi, Giulia Barone, Ida Barretta, Gaia Paolella, Maria Luisa Capitanucci, Antonio Maria Zaccara, Maria Laura Sollini, Giacomo Esposito, Donatella Lettori, Gessica Della Bella, Enrico Castelli and Giovanni Mosiello

Children 2024, 11(11), 1382; https://doi.org/10.3390/children11111382 - 14 Nov 2024

Abstract

Objective: To evaluate neurogenic bladder and bowel dysfunction (NBBD) in children with cerebral palsy (CP) and acquired brain injury (ABI), a condition considered less frequent in those patients than in children with spinal cord injury (SCI), and to study the relationship between NBBD [...] Read more.

Objective: To evaluate neurogenic bladder and bowel dysfunction (NBBD) in children with cerebral palsy (CP) and acquired brain injury (ABI), a condition considered less frequent in those patients than in children with spinal cord injury (SCI), and to study the relationship between NBBD and disability grade in this population. Study Design: We retrospectively reviewed the clinical data of all patients (aged 3–18 years old) admitted during a three-month observation in our neurorehabilitation department. Data collected were as follows: demographic parameters; disability status (Wee-FIM Scale, Gross Motor Function Classification System (GMFCS) and the Communication Function Classification System); and gastrointestinal and urological symptoms (diaries, Bristol scale, Pad Test and International Consultation on Incontinence Modular Questionnaire). Results: Sixty patients were enrolled (31 females, 29 males): 30 CP, 17 ABI, 3 SCI, and 10 others with neurological diseases. All presented urinary incontinence without gender differences. CP and ABI had major incidences of bowel dysfunction (50% and 64.7%, respectively) and SCI of urinary tract infections (66.6%) and enuresis (100%). A major incidence of symptoms was recorded in patients with higher GMFCS levels (level 3-4-5). Conclusions: NBBD has a high frequency in children with CP and ABI, as in SCI. More attention is needed from pediatricians and pediatric urologists for this clinical entity. Further studies are needed to better understand clinical relevance and, therefore, to establish specific management. Full article

(This article belongs to the Section Pediatric Nephrology & Urology)

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13 pages, 246 KiB

Open AccessArticle

Refugee Caregivers’ Perceptions of Using Mindfulness-Based Interventions to Support Coping Skills in Children with Disability in Jordan

by Zeina Fayad, Hadeel R. Bakhsh and Rawan AlHeresh

Children 2024, 11(11), 1381; https://doi.org/10.3390/children11111381 - 13 Nov 2024

Abstract

Background: Refugee children with disabilities are vulnerable to developing dysfunctional coping skills due to barriers in accessing health care services, including occupational therapy (OT). This study investigated the perceptions of refugee caregivers regarding the use of mindfulness-based interventions (MBIs) as a treatment for [...] Read more.

Background: Refugee children with disabilities are vulnerable to developing dysfunctional coping skills due to barriers in accessing health care services, including occupational therapy (OT). This study investigated the perceptions of refugee caregivers regarding the use of mindfulness-based interventions (MBIs) as a treatment for coping skills among their children with disabilities. Methods: A qualitative survey was used to analyse the coping mechanisms and access to services among refugee children with disabilities, as well as their caregivers’ perceptions regarding the use of MBIs. The caregivers were recruited using convenience sampling from a database of individuals at the Al-Baqa’a refugee camp in Jordan via their community-based rehabilitation (CBR) centre. A demographic survey was sent to 156 refugees using WhatsApp. Refugees above the age of 18 years identifying as the caregivers of children with disabilities were eligible. Twenty-eight individuals completed the survey, and twenty-six were eligible. Open-ended questions asked about their child’s struggles, supports, barriers to support, and perceptions of MBIs. The data were collected via Google Sheets. Three researchers coded the responses using a descriptive coding method and line-by-line analysis. Results: Five themes were derived from the responses: “Daily Challenges”, “Support and Strategies”, “barriers to accessing support”, “MBIs: Caregiver Perceptions”, and “MBIs: Barriers”. The participants identified the behavioural, emotional, and cognitive challenges impacting their child’s participation. Financial and environmental constraints, stigma, and timing were the reported barriers to services. The participants felt positive about the potential of MBIs to support their children. Conclusions: Overall, this study obtained foundational data to establish accessible mental health programmes for refugees with disabilities. Further research is needed to transcend the barriers and maintain MBI programmes in the community and the home settings. Full article

(This article belongs to the Special Issue Behavioral and Mental Health Problems in Children: 2nd Edition)

16 pages, 304 KiB

Open AccessArticle

Twelve-Year Changes in Pre-Schoolers’ Oral Health and Parental Involvement in Children’s Dental Care: Results from Two Repeated Cross-Sectional Surveys in Lithuania

by Apolinaras Zaborskis, Jaunė Razmienė, Augustė Razmaitė, Vilija Andruškevičienė, Julija Narbutaitė, Eglė Aida Bendoraitienė and Aistė Kavaliauskienė

Children 2024, 11(11), 1380; https://doi.org/10.3390/children11111380 - 13 Nov 2024

Abstract

Background and objectives: The role of parents and the family in promoting children’s oral health is increasingly acknowledged in the dental literature. This study aimed to investigate twelve-year changes in pre-schoolers’ oral health and parental involvement in children’s dental care using data from [...] Read more.

Background and objectives: The role of parents and the family in promoting children’s oral health is increasingly acknowledged in the dental literature. This study aimed to investigate twelve-year changes in pre-schoolers’ oral health and parental involvement in children’s dental care using data from two repeated cross-sectional surveys. The objectives were (1) to assess the temporal changes in children’s dental health status and oral health-related behaviours, (2) to examine temporal changes in parental attitudes toward their children’s oral health care, and (3) to analyze the associations between observed changes. Materials and methods: Two identical cross-sectional surveys were conducted in 2010/2011 (n = 294) and 2023 (n = 304). In both surveys, parents answered questions regarding their children’s oral health care and completed the 38-item ‘Parental Attitudes toward Children’s Oral Health’ (PACOH) scale, while the dental health of their 3–7-year-old children was clinically assessed. Changes in the examined characteristics were analyzed using general linear models. Results: Significant positive changes (p < 0.001) were observed when comparing the surveys: the dmf-t (decayed, missing, filled teeth) score for deciduous teeth decreased from 5.56 to 3.31; the Silness–Löe Plaque Index decreased from 1.45 to 1.15; the percentage of children brushing their teeth regularly increased from 33.0% to 55.3%; the percentage of parents assisting their child with tooth brushing increased from 19.2% to 85.1%; and regular visits to a children’s dentist increased from 36.4% to 85.1%. Moreover, the study revealed better parental attitudes toward their children’s oral health care, as reflected by a change in the total score of the PACOH scale from 112 to 122. Conclusions: It was concluded that changes in parental attitudes played a crucial role in driving positive trends in oral health-related behaviours, which likely contributed to the improvement of dental health in children. Therefore, understanding and influencing parental attitudes can be essential for promoting good oral health skills and good oral health in young children. Full article

(This article belongs to the Section Global Pediatric Health)

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