Children

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 (registering DOI) - 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)

8 pages, 365 KiB

Open AccessArticle

Hyperlactataemia Following Crystalloid Cardiopulmonary Bypass Priming in Paediatric Cardiac Surgery—Benign or Malignant? A Retrospective Study

by Philippa Jane Temple Bowers, Michael Daley, Nicole Yvette Renee Shrimpton, Adrian Mattke, Fumiaki Shikata, Kim Betts, Anthony Black, Supreet Prakash Marathe, Prem Venugopal and Nelson Alphonso

Children 2024, 11(11), 1379; https://doi.org/10.3390/children11111379 - 13 Nov 2024

Abstract

Background: Various mechanisms leading to early hyperlactataemia post-cardiac surgery have been postulated. Specifically, in the paediatric population, benign early hyperlactataemia may be associated with crystalloid priming in the cardiopulmonary bypass circuit. The aim of this study was to review paediatric patients who had [...] Read more.

Background: Various mechanisms leading to early hyperlactataemia post-cardiac surgery have been postulated. Specifically, in the paediatric population, benign early hyperlactataemia may be associated with crystalloid priming in the cardiopulmonary bypass circuit. The aim of this study was to review paediatric patients who had crystalloid prime and assess their outcomes. Methods: A retrospective review of paediatric patients who underwent cardiac surgery with crystalloid prime at our institution between November 2014 and May 2018 was performed. Data were collected from medical and laboratory records. Results: Among 569 patients, 237 (42%) received a crystalloid prime; 51 (22%) were excluded due to intraoperative hyperlactataemia. Of the remaining 186 patients, 98 (53%) developed hyperlactataemia postoperatively. Patients with hyperlactataemia had longer cardiopulmonary bypass and aortic cross-clamp times but similar Aristotle complexity scores. Patients with postoperative hyperlactataemia had higher peak VIS [median 8 (IQR 0–8) vs. 5 (IQR 0–8)] within the first 24 h (p = 0.002). However, there was no difference in the duration of ventilation between the two groups (p = 0.14). Yet only 58% of patients with hyperlactataemia were discharged from the ICU within 24 h, compared to 78% without hyperlactataemia. Conclusions: In this study population, transient postoperative hyperlactataemia in paediatric patients with crystalloid prime may not necessarily indicate tissue hypoxaemia. Despite a similar duration of ventilation in patients with and without hyperlactataemia, patients with hyperlactataemia had a longer duration of inotropes and ICU stay. Consideration should be given to discontinuing inotropes in patients with crystalloid prime and postoperative early hyperlactataemia once they are extubated. Full article

(This article belongs to the Section Pediatric Cardiology)

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13 pages, 231 KiB

Open AccessArticle

Does Play-Based Learning Support Children’s Everyday Resiliency? A Cross-Case Analysis of Parents’ and Kindergarten Teachers’ Perceptions of Play-Based Learning as a Precedent to Young Children’s Coping During the Pandemic-Affected 2020–2021 School Year

by Lisa Fyffe and Angela Lewis

Children 2024, 11(11), 1378; https://doi.org/10.3390/children11111378 - 13 Nov 2024

Abstract

Background: Play has long been credited with fostering self-regulation in young children, though few studies have examined how children draw upon early childhood experiences with play to navigate adversity later in childhood. The purpose of this study is to describe the facets of [...] Read more.

Background: Play has long been credited with fostering self-regulation in young children, though few studies have examined how children draw upon early childhood experiences with play to navigate adversity later in childhood. The purpose of this study is to describe the facets of the children’s everyday resiliency that were attributed to their play-based experiences by parents and teachers as they reflected on the children’s kindergarten experiences during the COVID-19 pandemic. Methods: We used a cross-case study design to examine the positive coping strategies parents and teachers observed in three five-year-old girls and one six-year-old boy entering kindergarten during the 2020–2021 pandemic-affected school year. We recruited parent participants based on their child’s enrollment at a Reggio Emilia-inspired, play-based early childhood center in Northern Colorado for three or more years prior to entering kindergarten. Once parents enrolled in the study, we extended an invitation to their child’s kindergarten teacher to participate. Data included three one-hour interviews with each participant, field visits during remote learning, and artifact collection over the course of the school year. Results: Cross-case analysis revealed four themes: “Willing to Adjust”, “Understands the Situation”, “Uses Advanced Language”, and “Embraces Challenge”. Participants describe these children as willing to adjust to public health orders, having a deep understanding of the pandemic’s societal repercussions, using sophisticated language to process adversity, and embracing the challenge of becoming kindergarteners. Conclusions: Participants believed these children’s experiences with play-based learning promoted the interdisciplinary development of their social language, persistence, altruism, and cognitive flexibility; these traits fostered the children’s positive coping strategies throughout the pandemic-affected kindergarten year. Full article

(This article belongs to the Special Issue Early Childhood Education and Care Lays the Foundations for Learning and Wellbeing)

9 pages, 2483 KiB

Open AccessArticle

Pediatric Cranial Vault Lesions: A Tailored Approach According to Bony Involvement

by Arianna Barbotti, Ignazio G. Vetrano, Cecilia Casali, Tommaso F. Galbiati, Sabrina Mariani, Edoardo Porto, Alessandra Erbetta, Stefano Chiaravalli and Laura G. Valentini

Children 2024, 11(11), 1377; https://doi.org/10.3390/children11111377 - 13 Nov 2024

Abstract

Background: Cranial vault lesions are common in children, with dermoid and epidermoid cysts being the most frequent. Management is debated due to their slow growth, but early resection can prevent complications and provide a definitive histological diagnosis, which is sometimes linked to systemic [...] Read more.

Background: Cranial vault lesions are common in children, with dermoid and epidermoid cysts being the most frequent. Management is debated due to their slow growth, but early resection can prevent complications and provide a definitive histological diagnosis, which is sometimes linked to systemic diseases. Methods: A retrospective study of children treated surgically for cranial vault tumors from January 2011 to April 2023 was conducted. The data collected included age, gender, symptoms, comorbidities, lesion location, radiological features, surgical techniques, histopathology, and recurrence rates. Results: Eighty-eight children (mean age: 3.5 years, mean tumor size: 1.21 cm) underwent surgery. The most common locations were the frontal and occipital bones. The main diagnoses were dermoid cysts, myofibroma, and Langerhans cell histiocytosis. Gross total resection was achieved in 64 cases with simple skin incisions. In 13 cases, small cranioplasties with bone cement were used. Craniotomy and cranioplasty with autologous bone grafting were performed for 11 patients with lesions larger than 2 cm and full skull thickness erosion. Conclusions: Early resection is recommended for complete removal with minimally invasive surgery and to ensure histological diagnosis. For lesions larger than 2 cm with full skull erosion, cranioplasty with autologous bone is the preferred technique. Full article

(This article belongs to the Section Pediatric Surgery)

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16 pages, 729 KiB

Open AccessReview

Obstructive Sleep Apnea in Pediatrics and Adolescent Women: A Systematic Review of Sex-Based Differences Between Girls and Boys

by Sofía Romero-Peralta, Cristina Rubio, María Castillo-García, Pilar Resano, Miguel Alonso, Esther Solano-Pérez, Laura Silgado, Esther Viejo-Ayuso, Leticia Álvarez-Balado and Olga Mediano

Children 2024, 11(11), 1376; https://doi.org/10.3390/children11111376 - 12 Nov 2024

Abstract

Background/Objectives: Obstructive sleep apnea (OSA) is marked by repetitive occurrences of upper airway (UA) obstruction during sleep. Morbidities impacting the metabolic, cardiovascular (CV) and neurological systems are correlated with OSA. Only a few studies have described the existence of different characteristics depending on [...] Read more.

Background/Objectives: Obstructive sleep apnea (OSA) is marked by repetitive occurrences of upper airway (UA) obstruction during sleep. Morbidities impacting the metabolic, cardiovascular (CV) and neurological systems are correlated with OSA. Only a few studies have described the existence of different characteristics depending on sex and, to date, the girl phenotype in OSA pediatrics is not well known. The objective of this systematic review is to identify the specific phenotype of OSA in pediatric and adolescent females compared to males. Methods: A systematic review was performed. The terms “pediatric sleep apnea” and “sex differences” were used to look for publications using PubMed, the Cochrane Library and Web of Science. Inclusion criteria: (1) peer-reviewed journal articles written in English; (2) investigations conducted on individuals diagnosed with OSA; and (3) investigations providing information about sex differences. Exclusion criteria: (1) studies carried out with individuals aged 18 years and older; (2) studies involving a sample size of fewer than 10 patients; and (3) editorials, letters and case reports. Results: Fifteen studies were included and classified in sections related to sex-based differences. Conclusions: Limited information related to sex-based OSA differences in the pediatric population exists. These differences are conditioned by hormonal status, and are minimal in the premenarcheal period. Moreover, adolescent women present a lower prevalence of obesity and craniofacial alterations, lower OSA severity related to higher UA area and earlier tonsil regression. Hyperactivity is more frequent in boys. Some studies pointed to a higher risk of high diastolic blood pressure in girls than in boys. Full article

(This article belongs to the Special Issue Current Advances in Paediatric Sleep Medicine)

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18 pages, 3295 KiB

Open AccessSystematic Review

The Diagnosis and Management of Infraoccluded Deciduous Molars: A Systematic Review

by Gianna Dipalma, Alessio Danilo Inchingolo, Lucia Memè, Lucia Casamassima, Claudio Carone, Giuseppina Malcangi, Francesco Inchingolo, Andrea Palermo and Angelo Michele Inchingolo

Children 2024, 11(11), 1375; https://doi.org/10.3390/children11111375 - 12 Nov 2024

Abstract

The infraocclusion (IO) of primary molars, often seen in retained deciduous teeth, is a common condition that presents significant challenges for pediatric oral health. It occurs when primary molars are positioned below the occlusal plane due to the absence of permanent successors, leading [...] Read more.

The infraocclusion (IO) of primary molars, often seen in retained deciduous teeth, is a common condition that presents significant challenges for pediatric oral health. It occurs when primary molars are positioned below the occlusal plane due to the absence of permanent successors, leading to complications such as misaligned teeth, impaired chewing, and long-term dental health issues. Objectives: This study examines IO prevalence, diagnosis, and treatment approaches. Methods: A systematic review following PRISMA guidelines was conducted, searching PubMed, Web of Science, and Scopus for articles from the last 15 years. Nine articles were included for qualitative analysis. Results: IO was associated with several complications, including root resorption, altered eruption of adjacent teeth, and space loss within the dental arch. Clinical and radiographic evaluations are key to early detection. Severe cases often require invasive treatments, such as tooth extraction and space maintenance, while mild cases could be monitored. Conclusions: IO is prevalent in pediatric dentistry and can lead to significant dental issues if untreated. Early detection and intervention are crucial for preventing complications like tooth misalignment and impacted premolars. Tailored treatment strategies based on severity, along with increased awareness among dental practitioners, are essential to improve long-term outcomes for affected children. Full article

(This article belongs to the Collection Advance in Pediatric Dentistry)

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14 pages, 1538 KiB

Open AccessArticle

Exploring the Relationship of Paediatric Nutritional Status with Diarrhoeal Disease in Children Below Two Years of Age

by Asif Khaliq, Smita Nambiar-Mann, Yvette D. Miller and Darren Wraith

Children 2024, 11(11), 1374; https://doi.org/10.3390/children11111374 - 12 Nov 2024

Abstract

Background and objective: Paediatric malnutrition has a synergistic relationship with diarrhoea. In children under two years of age, diarrhoea occurs in more than half of malnutrition cases and is associated with increased duration of illness, increased length of hospital stays, increased morbidity, and [...] Read more.

Background and objective: Paediatric malnutrition has a synergistic relationship with diarrhoea. In children under two years of age, diarrhoea occurs in more than half of malnutrition cases and is associated with increased duration of illness, increased length of hospital stays, increased morbidity, and mortality. A well-established relationship exists between diarrhoeal and various standalone forms of malnutrition, but their association with coexisting forms of malnutrition (CFM) has not yet been investigated. Thus, this study assessed the association of CFM with diarrhoea among Pakistani children using datasets retrieved from Demographic Health & Survey and UNICEF. Study design: A pooled analysis of datasets of Pakistan Demographic & Health Surveys (PDHS) and Multiple Indicator Cluster Surveys (MICS) from the year 2010 to 2018 was conducted. Methods: Data of 70,723 children aged below two years were analysed after excluding those with incomplete anthropometry and outliers. Findings: Of the total study population, this study reported the presence of either diarrhoea or malnutrition or both in over half of Pakistani children aged between 0 and 23.9 months. Both standalone forms of undernutrition and coexisting forms of undernutrition were significantly associated with increased odds of diarrhoea by 1.07 (1.02 to 1.12) and 1.21 (1.16 to 1.27) times. The practice of breastfeeding, secondary/higher level of maternal education, and improvement in socioeconomic status reduced the risk of diarrhoea, while the children aged between 6 and 23.9 months residing in urban areas showed a high risk of diarrhoea. Conclusions: The presence of any type of undernutrition, i.e., standalone and/or coexisting forms were associated with increased risk of diarrhoeal diseases in children. An improvement in socioeconomic status, adherence to the continuation of breastfeeding, and maternal education are keys to reducing the burden of diarrhoea among children. Full article

(This article belongs to the Special Issue Optimizing Infant Nutrition to Support Gut Microbiota and Prevent Paediatric Nutritional Disorders)

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10 pages, 513 KiB

Open AccessArticle

Inequalities and Differences in Health Status of Pre- and Perinatal Periods in Hungarian Long-Term Series Analysis (1997–2019)

by Ágota M. Kornyicki and Anita R. Fedor

Children 2024, 11(11), 1373; https://doi.org/10.3390/children11111373 - 12 Nov 2024

Abstract

Objectives: The main goal of this study is to publish findings on the lifestyle factors of pregnant women in Hungary and their impact on early childhood health status by examining changes over time and regional/geographical disparities. Methods: The source of the data is [...] Read more.

Objectives: The main goal of this study is to publish findings on the lifestyle factors of pregnant women in Hungary and their impact on early childhood health status by examining changes over time and regional/geographical disparities. Methods: The source of the data is the raw indicators reported by health visitors as per mandatory annual report data for the period of 1997–2019. To examine the association, we used indicators of pregnant women’s states as explanatory variables (for example, pregnant women in very late care, prenatal smoking habits, and pregnant women without care), and the outcome indicators were prematurity, intrauterine malnutrition, and newborn babies with developmental disorders. A univariate Poisson regression was used to examine the correlations. Results: Our results show a decreasing trend in the proportion of pregnant women who smoke and of pregnant women who apply late for care (after 28 weeks of pregnancy), with an increasing indicator of regional differences. The research results of the prenatal and perinatal indicators show that the counties Borsod-Abaúj-Zemplén and Szabolcs-Szatmár-Bereg are the most critical areas in terms of health status in Hungary. The number of pregnancies attended very late (after 28 weeks) and the number of women who gave birth without health visitor care are associated with the number of preterm births (R² = 0.7313; p < 0.001; R² = 0.5519; p < 0.001) and intrauterine growth restrictions (R² = 0.3306; p < 0.001; R² = 0.2632; p < 0.001). Conclusion: Interventions to improve early childhood health in some counties of Hungary are urgently needed to reduce regional disparities. Such counties include Borsod-Abaúj-Zemplén, Szabolcs-Szatmár-Bereg, Heves, Somogy, Bács-Kiskun, and Nógrád. Health education for pregnant women and activities to strengthen the compliance of pregnant women are key to improving early childhood health outcomes. Full article

(This article belongs to the Special Issue Health Behaviour, Health Literacy and Mental Health in Children)

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13 pages, 2249 KiB

Open AccessArticle

Assessment of Sleep Quality in Adolescents with Overweight and Obesity Using the Adolescent Sleep Hygiene Scale (ASHS)

by Eleftheria Kampani, Eleni P. Kotanidou, Vasiliki Rengina Tsinopoulou, Evdoxia Sapountzi, Stergianna Ntouma, Evangelos Pavlou and Assimina Galli-Tsinopoulou

Children 2024, 11(11), 1372; https://doi.org/10.3390/children11111372 - 12 Nov 2024

Abstract

Background: Adolescent overweight and obesity are a public health problem with an epidemic trend. There is growing evidence that sleep quality correlates to body weight. The aim of this study was to investigate, sleep quality in adolescents with obesity/overweight. Methods: A total of [...] Read more.

Background: Adolescent overweight and obesity are a public health problem with an epidemic trend. There is growing evidence that sleep quality correlates to body weight. The aim of this study was to investigate, sleep quality in adolescents with obesity/overweight. Methods: A total of 100 adolescents with overweight/obesity aged 12–18 years were enrolled. Anthropometric parameters were recorded and a laboratory investigation in the fasting state [glucose, insulin, cholesterol (TC), high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), triglycerides, uric acid and glycated hemoglobin (HbA1c)] was performed. Insulin resistance was calculated by the Homeostasis Model Assessment of Insulin Resistance index (HOMA-IR). Sleep quality was assessed with the Adolescent Sleep Hygiene Scale (ASHS) questionnaire. Results: According to ASHS, 93% of the participants were classified as “Good Sleepers” (GSs) (score > 3.8) and 7% as “Poor Sleepers” (PSs) (score < 3.8). PSs had a statistically higher body mass index (BMI) compared to GSs (p = 0.026). Increased body mass index (BMI) (r = −0.306, p = 0.002), fast insulin (r = −0.224, p = 0.027), and HOMA-IR (r = −0.260, p = 0.010) exerted a negative effect on sleep quality. Controlling for lipids and uric acid, only TC levels appeared to have a statistically significant and specifically positive correlation with the ASHS score (r = 0.202, p = 0.045). HbA1c values and waist circumference tended to be negatively correlated, but not significant to adolescent sleep quality [(r = −0.101, p = 0.330), (r = −0.095, p = 0.359), respectively]. The influence of central obesity on the ASHS score was also explored, but no correlation was found (p = 0.566). Conclusions: Sleep quality, as reflected by the ASHS score, was associated negatively with BMI, fasting insulin levels, and insulin resistance. Furthermore, a gender difference was observed, as adolescent males were found to achieve a higher overall ASHS score compared to females. Full article

(This article belongs to the Special Issue Adolescent Weight Management: Advances and Future Challenges)

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11 pages, 1544 KiB

Open AccessArticle

Comparison of the Short Time Effect of an Oral Hygiene Education in Four Sessions via Quantitative Light-Induced Fluorescence Technology Versus Disclosing Agents in Children: A Randomized, Crossover Clinical Trial

by Sangkyu Han, Seong Jin Kim, Taeyang Lee, Hoi-In Jung, Ko Eun Lee and Je Seon Song

Children 2024, 11(11), 1371; https://doi.org/10.3390/children11111371 - 12 Nov 2024

Abstract

Objectives: The aim of this study is to compare the effectiveness of Qscan plus™ (AIOBIO, Seoul, Korea) based on quantitative light-induced fluorescence (QLF) technology and disclosing agents in oral health programs in children. Methods: A randomized crossover study was conducted for Korean children [...] Read more.

Objectives: The aim of this study is to compare the effectiveness of Qscan plus™ (AIOBIO, Seoul, Korea) based on quantitative light-induced fluorescence (QLF) technology and disclosing agents in oral health programs in children. Methods: A randomized crossover study was conducted for Korean children aged 6–11 years. Fifty-eight participants (29 to use Qscan plus™ first and 29 to use the disclosing agent first) were enrolled in this study. The participants were randomly divided into two groups. One group was assigned to brush with Qscan plus™, while the other group brushed with disclosed plaque visualization. One month later, the groups switched procedures. A total of 39 participants were analyzed, excluding those lost during the trial. There was no adverse event during the trial. The patient hygiene performance (PHP) index was used to assess oral hygiene status, and questionnaires about oral health behavior and attitude were completed. The data were analyzed using repeated-measure analysis of variance, with a significance level of p < 0.05. Results: The PHP score decreased significantly on post-brushing and follow-up compared to baseline in both methods (p < 0.001), but there was no significant difference between the two methods. After oral hygiene education, participants’ brushing time increased, and their oral care attitudes improved. More participants preferred the Qscan device to the disclosed plaque visualization because it is more easily noticeable. Conclusions: The Qscan device has a similar educational effect as disclosing agents, and can be used as a supplementary tool to encourage children in oral hygiene education. Full article

(This article belongs to the Section Pediatric Dentistry & Oral Medicine)

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18 pages, 1535 KiB

Open AccessArticle

Profiles of Primary School Children’s Sports Participation and Their Motor Competencies

by Johanna Kress, Kathrin Bretz, Christian Herrmann, Patricia Schuler and Ilaria Ferrari

Children 2024, 11(11), 1370; https://doi.org/10.3390/children11111370 - 12 Nov 2024

Abstract

Background/Objectives: Children participate in various organized and informal physical activities (PAs) in their leisure time, presenting diverse objectives and environments for motor and social development. However, current research often focuses on specific, mostly organized activities, overlooking the complexity of participation across different settings. [...] Read more.

Background/Objectives: Children participate in various organized and informal physical activities (PAs) in their leisure time, presenting diverse objectives and environments for motor and social development. However, current research often focuses on specific, mostly organized activities, overlooking the complexity of participation across different settings. This study aimed to (1) identify groups of children with similar characteristics based on their participation in five organized and informal sports activities and (2) examine how the groups differ regarding gender, age, BMI, motor competencies (MCs), and attendance in institutionalized care at school. Methods: The study included n = 1717 1st and 2nd graders (M = 7.60 years, SD = 0.59, 50.7% girls) and n = 1319 3rd and 4th graders (M = 9.46 years, SD = 0.57, 49.4% girls) from the “EMOKK” study, funded by the Swiss National Science Foundation. Data were collected via parent questionnaires on leisure sports participation, and MCs were assessed using MOBAK-1-2 and 3-4 tests. Latent profile analyses (LPAs) and univariate ANOVAs were used to identify group differences. Results: A three-profile LPA model best fits the data, revealing differences in participation across individual and team sports, optional school sports, free play on the school playground, and informal activities during leisure time. Children involved more in team sports (profiles: allrounder and very active sportsperson) participate more in informal play and present better MCs than children participating mainly in individual sports (profile: individual sportsperson). Girls were predominantly in the individual sports profile, while boys were more evenly spread across all groups. These findings highlight the importance of designing targeted interventions that promote participation in both organized and informal sports, particularly for children with lower levels of PA. Conclusions: Children show different patterns of engagement in different interrelated organized and informal leisure PA contexts. These specific patterns and the children’s MCs should be taken into account for the targeted promotion of PAs during leisure time. Full article

(This article belongs to the Special Issue Importance of Physical Activity in Children and Adolescents)

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10 pages, 848 KiB

Open AccessArticle

The Role of Affects and Emotional Styles in the Relationship Between Parents and Preschool Children

by Carolina Facci, Andrea Baroncelli and Enrica Ciucci

Children 2024, 11(11), 1369; https://doi.org/10.3390/children11111369 - 12 Nov 2024

Abstract

Background/Objectives: Parent–child relationships represent a key factor for the quality of developmental trajectories and impact on children’s social and emotional competence. Therefore, research has advanced the role of parenting by showing the significance of differentiating between distinctive aspects of a parent’s behaviors. This [...] Read more.

Background/Objectives: Parent–child relationships represent a key factor for the quality of developmental trajectories and impact on children’s social and emotional competence. Therefore, research has advanced the role of parenting by showing the significance of differentiating between distinctive aspects of a parent’s behaviors. This study aims to investigate the role of the feelings experienced in parent–child relationships (e.g., warmth and negative feelings), considering the moderating role of the parental styles toward children’s emotions (e.g., coaching and dismissing). Methods: A total of 136 mothers (M = 38.09 years, SD = 4.51 anni, 48.5% high school degree) with a preschool child (age range 3–5 years) in Central Italy have been involved in a survey during the pandemic period. Results: Multiple regression analyses show that warmth and negative feelings are associated with positive parenting; however, the moderation effect of the dismissing style on both warmth and negative feelings emerged. Conclusions: Despite the characteristics of the data collection period, the results suggest the importance of considering the emotion-related dimensions between parents and their children as they seem to influence parenting behaviors. Full article

(This article belongs to the Special Issue Child and Adolescent Psychiatry: A Post-COVID Era?)

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9 pages, 236 KiB

Open AccessArticle

How Family Structure Can Influence Adolescents’ Eating Habits: An Italian Health Behaviour in School-Aged Children (HBSC) 2022 Sample

by Bianca Maria Bocci, Dario Lipari, Andrea Pammolli, Rita Simi, Elena Frongillo, Antonella Miserendino, Ilaria Manini and Giacomo Lazzeri

Children 2024, 11(11), 1368; https://doi.org/10.3390/children11111368 - 12 Nov 2024

Abstract

Background/Objectives: Adolescence is an important period of psychophysical development. In this phase of life people acquire greater self-awareness and adopt behaviors that will later shape their lifestyle in adulthood. This study aimed to assess whether family structure can influence adolescents’ eating habits. Methods: [...] Read more.

Background/Objectives: Adolescence is an important period of psychophysical development. In this phase of life people acquire greater self-awareness and adopt behaviors that will later shape their lifestyle in adulthood. This study aimed to assess whether family structure can influence adolescents’ eating habits. Methods: Data were acquired from a survey titled ‘Italian Health Behaviour in School-aged Children’ (HBSC) given to a representative sample of Tuscan adolescents aged 11, 13, 15 and 17 years of age. Participants (3210) filled out a validated questionnaire answering questions about their eating habits and family structure. After adjusting for covariates, some interesting trends were highlighted in the survey results. Results: Adolescents living in single-mother families reported a lower intake of fruits (OR 0.68, 95% CI = 0.55–0.83) and vegetables (OR 0.66, 95% CI = 0.53–0.81) and a higher intake of sugar-added soft drinks (OR 1.33, 95% CI = 1.08–1.64). Living in a mother and stepfather family was associated with a higher intake of sugar-added soft drinks (OR 1.53, 95% CI = 1.02–2.28), whereas living in a father and stepmother family was associated only with a lower intake of fruits (OR 0.48, 95% CI = 0.26–0.87). Participants living with other family types reported a lower intake of vegetables (OR 0.68, 95% CI = 0.47–0.98). Conclusions: The results of this study show a correlation between family structure and adolescents’ eating habits. Full article

(This article belongs to the Section Pediatric Mental Health)

28 pages, 2702 KiB

Open AccessReview

A Systematic Review and Meta-Analysis of Conditioned Pain Modulation in Children and Young People with Chronic Pain

by Christina Liossi, Helen Laycock, Kanmani Radhakrishnan, Zara Hussain and Daniel Eric Schoth

Children 2024, 11(11), 1367; https://doi.org/10.3390/children11111367 - 11 Nov 2024

Abstract

Background/Objectives: Conditioned pain modulation (CPM) is a psychophysical experimental measure of the endogenous pain inhibitory pathway in humans, wherein one pain stimulus (the conditioning stimulus) is used to inhibit an individual’s perception of a second painful (test) stimulus. Research provides evidence of impaired [...] Read more.

Background/Objectives: Conditioned pain modulation (CPM) is a psychophysical experimental measure of the endogenous pain inhibitory pathway in humans, wherein one pain stimulus (the conditioning stimulus) is used to inhibit an individual’s perception of a second painful (test) stimulus. Research provides evidence of impaired endogenous inhibitory pain responses in adults with chronic pain. CPM is now increasingly applied in paediatric research and clinical practice. The primary aim of this systematic review was to examine the efficacy of CPM in paediatric chronic pain populations (6–24-year-olds) compared to pain-free children and young people (CYP). Methods: The protocol was registered on PROSPERO (CRD42020221927). A systematic search of seven databases was conducted from database inception to 20th June 2024. Study inclusion criteria were as follows: (i) recruited a sample of CYP aged 6 to 24 (inclusive) with chronic pain or who were pain-free; and (ii) applied a CPM paradigm comprising both a painful test and conditioning stimuli that were sufficiently detailed to allow for replication,(iii) adhered to a study design of randomised control trial, case control or cohort study, including cross-sectional or longitudinal; (iv) available in the English language. Study exclusion criteria were: (i) The CPM paradigm used a non-painful test or conditioning stimulus only; and (ii) was only available as an abstract, letter, poster, editorial, case report, or review with or without meta-analyses. Risk of bias was assessed using the Appraisal Tool for Cross Sectional Studies (AXIS). Meta-analyses were conducted in Comprehensive Meta Analysis 3.0 using random effects models to compare the overall CPM responses in CYP with chronic pain conditions to healthy control CYP. Results: Thirty-two studies were eligible for inclusion, six of which were included in one or more meta-analysis (n = 407 chronic pain, n = 205 control). Meta-analysis revealed significantly weaker CPM responses in CYP with a variety of chronic pain conditions compared to healthy controls (standardized mean difference (SMD) = 0.352), and significantly weaker CPM responses in CYP with abdominal pain conditions compared to healthy controls (SMD = 0.685). No significant difference in CPM response was found between CYP with migraine and healthy controls (SMD = −0.201). Conclusions: Variable results were found across individual studies, and the meta-analysis of the small number of eligible studies provides tentative evidence for impaired CPM in CYP with chronic pain compared to healthy controls. Further research is clearly needed. In particular, studies should present CPM results separately for different age groups, ethnic groups, and sexes, as these variables shape clinical pain responses. Full article

(This article belongs to the Special Issue Advances in Pediatric Anesthesia, Pain Medicine and Intensive Care)

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Graphical abstract

14 pages, 577 KiB

Open AccessReview

Infusion Reactions to Infliximab in Pediatric Patients with Inflammatory Bowel Disease

by Rajmohan Dharmaraj, Tess Pei Lemon, Rasha Elmaoued, Ricardo Orlando Castillo and Razan Alkhouri

Children 2024, 11(11), 1366; https://doi.org/10.3390/children11111366 - 10 Nov 2024

Abstract

Infliximab (IFX) is a recombinant DNA-derived chimeric IgG monoclonal antibody protein that inhibits tumor necrosis factor alpha (TNF-α). IFX, like other agents derived from foreign proteins, can cause infusion reactions both during and after the infusion. The incidence of infusion reactions ranges between [...] Read more.

Infliximab (IFX) is a recombinant DNA-derived chimeric IgG monoclonal antibody protein that inhibits tumor necrosis factor alpha (TNF-α). IFX, like other agents derived from foreign proteins, can cause infusion reactions both during and after the infusion. The incidence of infusion reactions ranges between 0% and 15% in pediatric patients. The potential underlying mechanisms for these reactions may include anaphylaxis and anaphylactoid reactions, cytokine release syndrome, serum sickness-like reactions, and the development of antibodies against IFX. Several precautions can help reduce the risk of a new infusion reaction, such as a gradual increase in the infusion rate, scheduled infusions, and administering premedication or immunomodulators alongside IFX. Acute mild to moderate reactions often resolve spontaneously after a temporary cessation of the infusion or reduction in the infusion rate. Strategies like graded dose challenges and premedication can be utilized to prevent recurrence. In cases of severe reactions, desensitization or switching to an alternative biologic may be considered. This article aims to review the most recent guidelines for managing IFX-related infusion reactions in pediatric patients with inflammatory bowel disease (IBD), relying on the best available evidence. Full article

(This article belongs to the Special Issue Inflammatory Bowel Disease in Children: Diagnosis, Treatment Status and Early Recognition)

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17 pages, 971 KiB

Open AccessArticle

The Relationship Between Psychological Factors and Nutritional Status in Adolescence

by Bojana Marinković, Bojan Ćorluka, Mile Vukajlović, Bojan Bjelica, Nikola Aksović, Saša Bubanj, Emilija Petković, Adem Preljević, Ljubiša Lilić, Tatiana Dobrescu and Adina-Camelia Şlicaru

Children 2024, 11(11), 1365; https://doi.org/10.3390/children11111365 - 10 Nov 2024

Abstract

Background: The aim of the research is to explore the relationship between psychological factors and nutritional status in adolescence. The issue of adolescent nutrition is related to several psychological problems, as well as to developmental changes during this period. Research on body image [...] Read more.

Background: The aim of the research is to explore the relationship between psychological factors and nutritional status in adolescence. The issue of adolescent nutrition is related to several psychological problems, as well as to developmental changes during this period. Research on body image dissatisfaction has confirmed that most adolescents are dissatisfied with their bodies. Developmentally oriented scientists are unique in their approach to explaining the problem of body image, focusing on multiple aspects and attempting to understand the intrapersonal and interpersonal factors that are important for the formation of body image. Methods: The sample included 260 adolescents aged 11 to 15. The assessment of sociodemographic factors, emotional states, physical activity levels, and eating habits was included in the questionnaires filled out by the parents (DASS-21 and the Physical Activity & Nutrition Behaviors Monitoring Form questionnaire). Body Mass Index (BMI) was calculated based on information about the height and weight of the adolescents. Results: The results of the correlation between psychological characteristics and BMI indicate a negative low correlation with all psychological aspects: depression (r = −0.25; p < 0.05), anxiety (r = −0.30; p < 0.05), and stress (r = −0.28; p < 0.05). Over 70% of adolescents are classified in the category of normal BMI. Conclusions: The results indicate that subjects who are of normal weight experience less pronounced depression, anxiety, and stress. Full article

(This article belongs to the Special Issue Childhood Physical Activity and Health)

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12 pages, 2168 KiB

Open AccessSystematic Review

Respiratory Physiotherapy Interventions in Paediatric Population with Atelectasis: A Systematic Review

by Carlota Beatriz Esteban-Gavilán, Patricia Rico-Mena, Javier Güeita-Rodríguez, Víctor Navarro-López and Raúl Escudero-Romero

Children 2024, 11(11), 1364; https://doi.org/10.3390/children11111364 - 10 Nov 2024

Abstract

Objective: This systematic review aims to assess the effectiveness of respiratory physiotherapy techniques in oxygenation, chest X-ray findings, and lung auscultation in paediatric patients aged 0 to 18 years diagnosed with atelectasis. Methods: A comprehensive search was conducted in the PubMed, PEDro, Web [...] Read more.

Objective: This systematic review aims to assess the effectiveness of respiratory physiotherapy techniques in oxygenation, chest X-ray findings, and lung auscultation in paediatric patients aged 0 to 18 years diagnosed with atelectasis. Methods: A comprehensive search was conducted in the PubMed, PEDro, Web of Science, and Cochrane Library databases. Results: Eight randomised clinical trials were included, involving 430 children ranging from 35 weeks of gestational age to 14 years. These trials evaluated various respiratory physiotherapy techniques and their effects on oxygenation and chest radiograph outcomes. The methodological quality of the studies ranged from acceptable to good, according to the PEDro scale. Conclusions: Recent evidence indicates that respiratory physiotherapy is effective and safe in the paediatric population with atelectasis. Both manual and instrumental techniques demonstrated efficacy, with instrumental techniques showing superior outcomes in many cases. Full article

(This article belongs to the Section Pediatric Nursing)

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12 pages, 836 KiB

Open AccessArticle

Health Disparities in Hospitalized Pediatric Patients with Autism Spectrum Disorder and COVID-19

by Janet Lee, Lisa Ferretti, Camden Nelson, Priya Nigam, Jessica Zawacki and Philip McCallion

Children 2024, 11(11), 1363; https://doi.org/10.3390/children11111363 - 9 Nov 2024

Abstract

Background/Objectives: Pediatric patients with autism spectrum disorder (ASD) face unique challenges, especially amongst individuals from historically minoritized racial groups. ASD has also been associated with an increased mortality from COVID-19. This study aims to explore the differences in sociodemographic factors and health outcomes [...] Read more.

Background/Objectives: Pediatric patients with autism spectrum disorder (ASD) face unique challenges, especially amongst individuals from historically minoritized racial groups. ASD has also been associated with an increased mortality from COVID-19. This study aims to explore the differences in sociodemographic factors and health outcomes (as measured by length of stay) amongst hospitalized pediatric patients with COVID-19 infections and a diagnosis of ASD compared to individuals with a COVID-19 infection alone; Methods: We performed a retrospective cohort study examining pediatric patients (ages birth to 21) who were hospitalized with a diagnosis of ASD and COVID-19 compared to patients with a diagnosis of COVID-19 alone between January 2019 and June 2023 using Epic Systems Corporation’s Cosmos, a de-identified dataset aggregated from electronic health record data. We examined differences in demographic factors and length of stay (LOS) between groups by utilizing chi-square and Wilcoxon rank sum tests. Multiple logistic regression models were utilized to assess the association between length of stay and diagnosis; Results: A total of 21,708 distinct pediatric patients with a diagnosis of ASD and COVID-19 or COVID-19 alone were included in the analytical dataset. Patients with ASD and COVID-19, compared to patients with COVID-19 alone, had a higher proportion of individuals identifying as male and White. Patients with COVID-19 alone, compared to individuals with ASD and COVID-19, had higher proportions of individuals identifying as Black or African American. Higher proportions of individuals with ASD and COVID-19 had public insurance, compared to individuals with COVID-19 alone. Having a diagnosis of ASD and COVID, after controlling for covariates, was associated with higher odds of having a length of stay greater than the three days (cutoff value determined by the median LOS of three days) compared to having a diagnosis of COVID alone (aOR 1.19, 95% CI 1.04–1.35); Conclusions: Our study highlights the health disparities experienced during hospitalizations by pediatric patients with ASD and COVID-19. Further studies should address barriers and support health outcomes for pediatric patients with ASD. Full article

(This article belongs to the Section Pediatric Mental Health)

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