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Children
Volume 7
Issue 10
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Children, Volume 7, Issue 10 (October 2020) – 45 articles

Cover Story (view full-size image): Wildfires have been affecting California, and vulnerable patients in neonatal intensive care units (NICUs) are not exempt. Our aim was to learn how personnel working in California NICUs handled neonatal transfer during wildfire disasters in recent years, with the goal of sharing lessons learned with healthcare teams. While describing disaster preparedness, strategies to optimize equipment, ambulance access/transport, and documentation/charting were noted as essential. Teamwork, willingness to perform tasks that are not part of typical job descriptions, and unconventional strategies keep NICU babies safe when California wildfire strikes. Overall, our qualitative interviews taught us that healthcare teams developed innovative and surprising ways to evacuate NICU babies. View this paper
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10 pages, 252 KiB  
Article
High Levels of Stress Due to the SARS-CoV-2 Pandemic among Parents of Children with and without Chronic Conditions across the USA
by Miranda A.L. van Tilburg, Emily Edlynn, Marina Maddaloni, Klaas van Kempen, Maria Díaz-González de Ferris and Jody Thomas
Children 2020, 7(10), 193; https://doi.org/10.3390/children7100193 - 21 Oct 2020
Cited by 33 | Viewed by 8906
Abstract
Background: The 2020 SARS-CoV-2 pandemic led to community-wide measures affecting parents and children such as school/daycare closures, job losses, and interruptions in medical care for children with chronic diseases. This is the first study to describe the level of stress and mental health [...] Read more.
Background: The 2020 SARS-CoV-2 pandemic led to community-wide measures affecting parents and children such as school/daycare closures, job losses, and interruptions in medical care for children with chronic diseases. This is the first study to describe the level of stress and mental health of parents of either healthy children or children with chronic conditions, during the 2020 pandemic. Methods: A representative sample of US parents was recruited from 10–17 April 2020. Parents completed online questionnaires about the past 7 days, including the Perceived Stress Scale, Resilient Coping Scale, Self-Efficacy Scale, Kansas Marital Satisfaction Scale, Parental Stress Scale, PROMIS Anxiety and Depression scales and various other pandemic-related stress questions Results: Levels of stressors (e.g., job loss, school closures, etc.) were high during this time (e.g., 79% of children attended home/online school) and parents reported being moderately to highly stressed. Rates of clinical anxiety (44.6%) and depression (42.2%) were high. Parents of children with chronic conditions reported higher levels of stress and worse mental health, but did not differ from other parents in dealing with stress or interruptions in work, child schooling, and marital satisfaction. Discussion: The COVID-19 pandemic has introduced unprecedented levels of stress for parents, especially those of children with chronic conditions. Mental health effects are expected to continue for months/years and preparation is needed to meet an increasing demand for mental health care. Full article
(This article belongs to the Section Global Pediatric Health)
13 pages, 2719 KiB  
Article
Identification of and Associations among Low, Middle, and High Body Composition Trajectories from Age 5- to 17-Years
by Teresa A. Marshall, Alexandra M. Curtis, Joseph E. Cavanaugh, John J. Warren and Steven M. Levy
Children 2020, 7(10), 192; https://doi.org/10.3390/children7100192 - 20 Oct 2020
Cited by 1 | Viewed by 2110
Abstract
Our objective was to identify sex-specific age 5- to 17-year body composition (body mass index (BMI), % body fat, fat mass index, fat-free mass index) trajectories, compare trajectories assigned using age 5 (AGE5) data to those assigned using all available (ALL) data, and [...] Read more.
Our objective was to identify sex-specific age 5- to 17-year body composition (body mass index (BMI), % body fat, fat mass index, fat-free mass index) trajectories, compare trajectories assigned using age 5 (AGE5) data to those assigned using all available (ALL) data, and compare BMI assignments to other body composition assignments. Cluster analysis was used to identify low, medium, and high trajectories from body composition measures obtained from dual energy x-ray absorptiometry (DXA) scans at 5, 9, 11, 13, 15, and 17 years in a birth cohort followed longitudinally (n = 469). Moderate agreement was observed for comparisons between AGE5 data and ALL data cluster assignments for each body composition measure. Agreement between cluster assignments for BMI and other body composition measures was stronger using ALL data than using AGE5 data. Our results suggest that BMI, % body fat, fat mass index, and fat free mass index trajectories are established during early childhood, and that BMI is a reasonable predictor of body composition appropriate to track obesity in public health and clinical settings. Full article
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11 pages, 257 KiB  
Article
Attitude towards People with Disability of Nursing and Physiotherapy Students
by Petronila Oliva Ruiz, Gloria Gonzalez-Medina, Alejandro Salazar Couso, María Jiménez Palomares, Juan Rodríguez Mansilla, Elisa María Garrido Ardila and María Nieves Merchan Vicente
Children 2020, 7(10), 191; https://doi.org/10.3390/children7100191 - 20 Oct 2020
Cited by 6 | Viewed by 3073
Abstract
Background: Attitudes are a component of our behaviour. Health professionals should have a global perspective of disability. They must provide treatment to people with disability and care for them, but they also should accept them with no judgements or discrimination. The general objective [...] Read more.
Background: Attitudes are a component of our behaviour. Health professionals should have a global perspective of disability. They must provide treatment to people with disability and care for them, but they also should accept them with no judgements or discrimination. The general objective of this study was to know the attitude towards people with disability of nursing and physiotherapy students at the University of Cadiz. Methods: This was a descriptive, correlational, transversal and synchronous study. A total of 200 students participated in the study (91 from the bachelor’s degree in nursing and 109 from the bachelor’s degree in physiotherapy). The ‘Attitudes towards people with disability scale’ was used. Results: The mean score for both groups of students was 157.05 (SD = 14.14). Conclusions: Attitudes towards disability of nursing and physiotherapy students at the University of Cadiz tend to be positive. However, this was considered not sufficient since they will be health professionals in the future. Full article
7 pages, 500 KiB  
Case Report
Neuro-Behavioral Phenotype in 16p11.2 Duplication: A Case Series
by Annio Posar and Paola Visconti
Children 2020, 7(10), 190; https://doi.org/10.3390/children7100190 - 19 Oct 2020
Cited by 3 | Viewed by 2440
Abstract
Duplications of chromosome 16p11.2, even though rare in the general population, are one of the most frequent known genetic causes of autism spectrum disorder and of other neurodevelopmental disorders. However, data about the neuro-behavioral phenotype of these patients are few. We described a [...] Read more.
Duplications of chromosome 16p11.2, even though rare in the general population, are one of the most frequent known genetic causes of autism spectrum disorder and of other neurodevelopmental disorders. However, data about the neuro-behavioral phenotype of these patients are few. We described a sample of children with duplication of chromosome 16p11.2 focusing on the neuro-behavioral phenotype. The five patients reported presented with very heterogeneous conditions as for characteristics and severity, ranging from a learning disorder in a child with normal intelligence quotient to an autism spectrum disorder associated with an intellectual disability. Our case report underlines the wide heterogeneity of the neuropsychiatric phenotypes associated with a duplication of chromosome 16p11.2. Similarly to other copy number variations that are considered pathogenic, the wide variability of phenotype of chromosome 16p11.2 duplication is probably related to additional risk factors, both genetic and not genetic, often difficult to identify and most likely different from case to case. Full article
(This article belongs to the Special Issue Neurodevelopmental Disorders: Diagnosis, Psychiatric Comorbidities and Treatment)
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10 pages, 2707 KiB  
Article
Ultrastructural Changes of Blood Cells in Children with Generalized Purulent Peritonitis: A Cross-Sectional and Prospective Study
by Ulyana Halyuk, Olena Lychkovska, Oksana Mota, Vasyl Kovalyshyn, Natalia Kech, Petro Pokotylo, Olena Trutiak, Bożena Zboina, Grzegorz Józef Nowicki and Barbara Ślusarska
Children 2020, 7(10), 189; https://doi.org/10.3390/children7100189 - 17 Oct 2020
Cited by 1 | Viewed by 2627
Abstract
In conditions of abdominal sepsis with indications of first- or second-stage shock, blood cells undergo significant ultrastructural changes that cause impaired gas exchange, changes in reactivity, and decompensation of organs and systems functions. This paper presents a cross-sectional prospective study aimed at researching [...] Read more.
In conditions of abdominal sepsis with indications of first- or second-stage shock, blood cells undergo significant ultrastructural changes that cause impaired gas exchange, changes in reactivity, and decompensation of organs and systems functions. This paper presents a cross-sectional prospective study aimed at researching the ultrastructure of blood cells in children experiencing abdominal septic shock against the background of generalized purulent peritonitis of appendicular origin. This study was conducted with 15 children aged 6–12 who were undergoing treatment for generalized appendicular purulent peritonitis, with first- or second-stage abdominal septic shock, in emergency care. The changes in the ultrastructure of erythrocytes did not correspond to changes characteristic of eryptosis, which confirms their occurrence under the influence of such pathogenic factors as intoxication, metabolic, water–electrolyte balance, and acid–base disorders. Ultrastructural changes of granulocytes indicate their hyperactivation, which leads to the exhaustion of membrane synthetic resources, membrane destruction, ineffective expenditure of bactericidal factors on substrates that are not subject to destruction. In lymphocytes, disorganization of the nuclear membrane and intracellular membranes, uneven distribution of chromatin, the hypertrophied Golgi apparatus, and a large number of young mitochondria, lysosomes, ribosomes, vesicles manifesting the disruption of metabolism, stress and decompensation of energy supply and protein synthesis systems, have been demonstrated. In conditions of abdominal sepsis with indications of first- or second-stage shock, blood cells undergo substantial ultrastructural changes causing gas exchange disruption, changes in reactivity, as well as decompensation of organs and system functioning. Full article
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15 pages, 267 KiB  
Review
Parent and Family Functioning in Pediatric Inflammatory Bowel Disease
by Grace Cushman, Sharon Shih and Bonney Reed
Children 2020, 7(10), 188; https://doi.org/10.3390/children7100188 - 17 Oct 2020
Cited by 13 | Viewed by 2896
Abstract
Although the impact of pediatric inflammatory bowel disease (IBD) extends beyond the patient to their parents and families, the focus of previous literature has largely been on investigating the patient’s medical and psychosocial functioning, with less consideration of the family system. Having a [...] Read more.
Although the impact of pediatric inflammatory bowel disease (IBD) extends beyond the patient to their parents and families, the focus of previous literature has largely been on investigating the patient’s medical and psychosocial functioning, with less consideration of the family system. Having a comprehensive understanding of parent and family functioning within the context of pediatric IBD is important given the role parents and family members have in the successful management of the disease and caring of the child. The current review paper aggregates the empirical research regarding parent and family functioning, including comparisons to normative samples, other illness groups, and how functioning relates to child psychosocial and health outcomes. Extant literature on parents and families in pediatric IBD has largely focused on the variables of parenting stress, parent psychosocial functioning, parent quality of life, and family functioning. Summary findings elucidate the complex relationships between parents, families, and children affected by IBD and highlight the importance of assessing parent and family functioning within pediatric IBD. The current review also offers implications for clinical practice, notes the limitations of the present literature, and provides recommendations for future research. Full article
(This article belongs to the Special Issue Psychogastroenterology: The Connection between the Brain and the Gut)
18 pages, 885 KiB  
Article
Primary Transverse Closure Compared to Open Wound Treatment for Primary Pilonidal Sinus Disease in Children
by Michèle Pfammatter, Tobias E. Erlanger and Johannes Mayr
Children 2020, 7(10), 187; https://doi.org/10.3390/children7100187 - 17 Oct 2020
Cited by 9 | Viewed by 4928
Abstract
We aimed to compare the outcome of two different operative methods to correct pilonidal sinus disease (PSD) in children, i.e., excision and open wound care (OW) versus excision and primary transverse closure (PC) of the wound. In this retrospective, observational study, we extracted [...] Read more.
We aimed to compare the outcome of two different operative methods to correct pilonidal sinus disease (PSD) in children, i.e., excision and open wound care (OW) versus excision and primary transverse closure (PC) of the wound. In this retrospective, observational study, we extracted data from the medical records of 56 patients who underwent surgery for PSD at our institution between 1 January 2006 and 31 December 2016. To test whether the primary variable, i.e., rate of PSD recurrence, differed between the two surgical groups, a logistic regression model was fitted. Secondary explanatory variables were total length of stay (LOS) at the hospital, complications, sex and age of patients, seniority of the surgeon in charge, and volume of excised specimen. Overall, 32 (57%) children and young adults underwent OW, while 24 (43%) patients were treated by PC. Mean age at operation was 15.5 years in either group. PSD recurred in 12 of 32 (37.5%) children in the OW group and in 3 of 24 (12.5%) children in the PC group (ratio: 0.19, 95% confidence interval [95% CI] 0.03–1.07). Thus, treatment of primary PSD by PC proved superior with respect to PSD recurrence. Moreover, our study did not bring to light any high-grade complications in the PC group, and postoperative pain was minimal. Less invasive treatment approaches for chronic PSD are typically performed in an outpatient setting and offer reduced morbidity, low rates of PSD recurrence, and shortened periods of time to return to work or social activities. More radical operations of PSD should be reserved for recurrent PSD where less invasive approaches have failed several times. Full article
(This article belongs to the Section Pediatric Surgery)
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12 pages, 574 KiB  
Article
Longitudinal Predictors of Self-Regulation at School Entry: Findings from the All Our Families Cohort
by Erin Hetherington, Sheila McDonald, Nicole Racine and Suzanne Tough
Children 2020, 7(10), 186; https://doi.org/10.3390/children7100186 - 16 Oct 2020
Cited by 9 | Viewed by 3630
Abstract
Self-regulation is the ability to manage emotions, modulate behaviors, and focus attention. This critical skill begins to develop in infancy, improves substantially in early childhood and continues through adolescence, and has been linked to long-term health and well-being. The objectives of this study [...] Read more.
Self-regulation is the ability to manage emotions, modulate behaviors, and focus attention. This critical skill begins to develop in infancy, improves substantially in early childhood and continues through adolescence, and has been linked to long-term health and well-being. The objectives of this study were to determine risk factors and moderators associated with the three elements of self-regulation (i.e., inattention, emotional control, or behavioral control) as well as overall self-regulation, among children at age 5. Participants were mother–child dyads from the All Our Families study (n = 1644). Self-regulation was assessed at age 5. Risk factors included income, maternal mental health, child sex, and screen time, and potential moderation by parenting and childcare. Adjusted odds ratios of children being at risk for poor self were estimated using multivariable logistic regression. Twenty-one percent of children had poor self-regulation skills. Risk factors for poor self-regulation included lower income, maternal mental health difficulties, and male sex. Childcare and poor parenting did not moderate these associations and hostile and ineffective parenting was independently associated with poor self-regulation. Excess screen time (>1 h per day) was associated with poor self-regulation. Self-regulation involves a complex and overlapping set of skills and risk factors that operate differently on different elements. Parenting and participation in childcare do not appear to moderate the associations between lower income, maternal mental health, male sex, and screen time with child self-regulation. Full article
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11 pages, 408 KiB  
Article
The Impact of Moderate-Dose Acetylsalicylic Acid in the Reduction of Inflammatory Cytokine and Prevention of Complication in Acute Phase of Kawasaki Disease: The Benefit of Moderate-Dose Acetylsalicylic Acid
by Jung Eun Kwon, Da Eun Roh and Yeo Hyang Kim
Children 2020, 7(10), 185; https://doi.org/10.3390/children7100185 - 16 Oct 2020
Cited by 6 | Viewed by 2793
Abstract
Background: Acetylsalicylic acid (ASA) is part of the recommended treatment of Kawasaki disease (KD). Controversies remain regarding the optimal dose of ASA. We aimed to evaluate the impact of different doses of ASA on inflammation control while minimizing adverse effects in the acute [...] Read more.
Background: Acetylsalicylic acid (ASA) is part of the recommended treatment of Kawasaki disease (KD). Controversies remain regarding the optimal dose of ASA. We aimed to evaluate the impact of different doses of ASA on inflammation control while minimizing adverse effects in the acute phase treatment of KD. Methods: The enrolled 323 patients with KD were divided into three groups according to ASA dose: moderate-dose (30–50 mg/kg/day), high-dose (80–100 mg/kg/day), and non-ASA. Results: High-dose ASA group showed a significantly shorter duration of fever from the start of treatment to remission than other groups. Baseline level and delta score of interleukin (IL)-1, IL-6, IL-10, tumor necrosis factor-α, and transforming growth factor β were not statistically different among the groups. The number of patients who received additional treatments in the non-ASA group was more than other groups. Coronary artery dilatation was not significantly different among the groups. One patient with high-dose ASA was diagnosed with Reye syndrome. Conclusion: Different doses of ASA did not show any differences in changes of inflammatory bio-makers and cytokines. However, high-dose ASA showed occurrence of Reye syndrome, and non-ASA showed intravenous immunoglobulin refractoriness. We suggest that moderate-dose ASA may be beneficial for the treatment of patients in the acute phase of KD. Full article
(This article belongs to the Special Issue Advances in Pediatric Infection and Immunity)
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12 pages, 268 KiB  
Review
Communicating with Youth about Pain: Developmental Considerations
by Natacha D. Emerson and Brenda Bursch
Children 2020, 7(10), 184; https://doi.org/10.3390/children7100184 - 15 Oct 2020
Cited by 16 | Viewed by 3927
Abstract
Background: Pain experiences can negatively impact children and adolescents, leading to trauma symptoms and nonadherence to important health behaviors. Developmentally-tailored communication strategies may mitigate this risk. Methods: This article reviews cognitive and linguistic developmental factors, within the familial and cultural context, that are [...] Read more.
Background: Pain experiences can negatively impact children and adolescents, leading to trauma symptoms and nonadherence to important health behaviors. Developmentally-tailored communication strategies may mitigate this risk. Methods: This article reviews cognitive and linguistic developmental factors, within the familial and cultural context, that are important to consider when communicating with youth about acute, procedural, and/or chronic pain. Results: Youth undergoing acute or procedural pain benefit from pain education, truthful information about the procedure, and advance preparation. The use of analogies may be particularly helpful for patient understanding of chronic pain development, maintenance, and treatment. Youth with developmental disabilities may express pain differently than their normative peers, requiring adaptation of communication strategies. Conclusion: Developmentally-tailored pain communication is an important tool for caregivers and healthcare providers that may foster adaptive functioning in youth who experience pain. Full article
(This article belongs to the Special Issue Information Provision and Preparation in the Context of Children’s Pain)
15 pages, 589 KiB  
Review
Cognitive Assessment and Rehabilitation for Pediatric-Onset Multiple Sclerosis: A Scoping Review
by Wei-Sheng Lin, Shan-Ju Lin and Ting-Rong Hsu
Children 2020, 7(10), 183; https://doi.org/10.3390/children7100183 - 15 Oct 2020
Cited by 4 | Viewed by 3193
Abstract
Cognitive impairment is increasingly recognized as an important clinical issue in pediatric multiple sclerosis (MS). However, variations regarding its assessment and remediation are noted in clinical arena. This scoping review aims to collate available evidence concerning cognitive assessment tool and cognitive rehabilitation for [...] Read more.
Cognitive impairment is increasingly recognized as an important clinical issue in pediatric multiple sclerosis (MS). However, variations regarding its assessment and remediation are noted in clinical arena. This scoping review aims to collate available evidence concerning cognitive assessment tool and cognitive rehabilitation for pediatric MS. We performed a systematic search of electronic databases (MEDLINE, PubMed, CINAHL Plus, and Web of Science) from inception to February 2020. Reference lists of included articles and trial registers were also searched. We included original studies published in English that addressed cognitive assessment tools or cognitive rehabilitation for pediatric-onset MS. Fourteen studies fulfilled our inclusion criteria. Among them, 11 studies evaluated the psychometric aspects of various cognitive assessment tools in the context of pediatric MS, and different neuro-cognitive domains were emphasized across studies. There were only three pilot studies reporting cognitive rehabilitation for pediatric-onset MS, all of which used home-based computerized programs targeting working memory and attention, respectively. Overall, more systematic research on cognitive assessment tools and rehabilitation for pediatric MS is needed to inform evidence-based practice. Computer-assisted cognitive assessment and rehabilitation appear feasible and deserve further studies. Full article
(This article belongs to the Special Issue Disorders of Motor, Somatic and Cognitive Development in Children with Neurodysfunctions)
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18 pages, 8189 KiB  
Article
An Autoencoder-Based Deep Learning Classifier for Efficient Diagnosis of Autism
by Harshini Sewani and Rasha Kashef
Children 2020, 7(10), 182; https://doi.org/10.3390/children7100182 - 14 Oct 2020
Cited by 47 | Viewed by 6962
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by a lack of social communication and social interaction. Autism is a mental disorder investigated by social and computational intelligence scientists utilizing advanced technologies such as machine learning models to enhance clinicians’ ability to [...] Read more.
Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by a lack of social communication and social interaction. Autism is a mental disorder investigated by social and computational intelligence scientists utilizing advanced technologies such as machine learning models to enhance clinicians’ ability to provide robust diagnosis and prognosis of autism. However, with dynamic changes in autism behaviour patterns, these models’ quality and accuracy have become a great challenge for clinical practitioners. We applied a deep neural network learning on a large brain image dataset obtained from ABIDE (autism brain imaging data exchange) to provide an efficient diagnosis of ASD, especially for children. Our deep learning model combines unsupervised neural network learning, an autoencoder, and supervised deep learning using convolutional neural networks. Our proposed algorithm outperforms individual-based classifiers measured by various validations and assessment measures. Experimental results indicate that the autoencoder combined with the convolution neural networks provides the best performance by achieving 84.05% accuracy and Area under the Curve (AUC) value of 0.78. Full article
(This article belongs to the Special Issue New Research in Children with Neurodevelopmental Disorders)
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7 pages, 2057 KiB  
Article
Preliminary Study on the Echo-Assisted Intersphincteric Autologous Microfragmented Adipose Tissue Injection to Control Fecal Incontinence in Children Operated for Anorectal Malformations
by Giovanni Parente, Valentina Pinto, Neil Di Salvo, Simone D’Antonio, Michele Libri, Tommaso Gargano, Vincenzo Davide Catania, Giovanni Ruggeri and Mario Lima
Children 2020, 7(10), 181; https://doi.org/10.3390/children7100181 - 13 Oct 2020
Cited by 9 | Viewed by 5059
Abstract
Aim of the study: To assess the efficacy of a novel technique (echo-assisted intersphincteric autologous microfragmented adipose tissue injection, also called “anal-lipofilling”) in the management of non-responsive fecal incontinence in children born with anorectal malformations (ARMs). Methods: Following ethical committee approval (CHPED-MAR-18-02), anal-lipofilling [...] Read more.
Aim of the study: To assess the efficacy of a novel technique (echo-assisted intersphincteric autologous microfragmented adipose tissue injection, also called “anal-lipofilling”) in the management of non-responsive fecal incontinence in children born with anorectal malformations (ARMs). Methods: Following ethical committee approval (CHPED-MAR-18-02), anal-lipofilling was proposed to patients with fecal incontinence not responsive to medications or bowel management (bowel enema and/or transanal irrigation automatic systems), then a prospective study was conducted. Anal-lipofilling consisted of three phases: lipoaspiration from the abdominal wall, processing of the lipoaspirate with a Lipogems system and intersphincteric injection of the processed fat tissue via endosonographic assistance. A questionnaire based on Krickenbeck’s scale (KS) was administered to the patients to evaluate the clinical outcome. Main Results: Four male patients (three recto-urethral fistula, and one recto-perineal fistula) underwent the anal-lipofilling procedure at a mean age of 13.0 ± 4.2 yrs. There were no complications during or after the procedure. From an initial assessment of the patients there was an improvement in the bowel function at a median follow up of 6 months, with better scores at KS (100% Soiling grade three pre-treatment vs. 75% grade one post-treatment). Conclusions: Even if our Study is preliminary, echo-assisted anal-lipofilling could be considered as a feasible and safe alternative technique in the management of the fecal incontinence in non-responding ARMs patients. More studies are still necessary to support the validity of the implant of autologous adipose tissue in the anal sphincter as a therapy for fecal incontinence in children born with ARMs. Full article
(This article belongs to the Special Issue Pediatric Gastroenterology and Nutrition)
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11 pages, 2728 KiB  
Review
How Do We Monitor Oxygenation during the Management of PPHN? Alveolar, Arterial, Mixed Venous Oxygen Tension or Peripheral Saturation?
by Praveen Chandrasekharan, Munmun Rawat and Satyan Lakshminrusimha
Children 2020, 7(10), 180; https://doi.org/10.3390/children7100180 - 13 Oct 2020
Cited by 15 | Viewed by 11354
Abstract
Oxygen is a pulmonary vasodilator and plays an important role in mediating circulatory transition from fetal to postnatal period. Oxygen tension (PO2) in the alveolus (PAO2) and pulmonary artery (PaO2) are the main factors that influence hypoxic [...] Read more.
Oxygen is a pulmonary vasodilator and plays an important role in mediating circulatory transition from fetal to postnatal period. Oxygen tension (PO2) in the alveolus (PAO2) and pulmonary artery (PaO2) are the main factors that influence hypoxic pulmonary vasoconstriction (HPV). Inability to achieve adequate pulmonary vasodilation at birth leads to persistent pulmonary hypertension of the newborn (PPHN). Supplemental oxygen therapy is the mainstay of PPHN management. However, optimal monitoring and targeting of oxygenation to achieve low pulmonary vascular resistance (PVR) and optimizing oxygen delivery to vital organs remains unknown. Noninvasive pulse oximetry measures peripheral saturations (SpO2) and a target range of 91–95% are recommended during acute PPHN management. However, for a given SpO2, there is wide variability in arterial PaO2, especially with variations in hemoglobin type (HbF or HbA due to transfusions), pH and body temperature. This review evaluates the role of alveolar, preductal, postductal, mixed venous PO2, and SpO2 in the management of PPHN. Translational and clinical studies suggest maintaining a PaO2 of 50–80 mmHg decreases PVR and augments pulmonary vasodilator management. Nevertheless, there are no randomized clinical trials evaluating outcomes in PPHN targeting SpO2 or PO2. Also, most critically ill patients have umbilical arterial catheters and postductal PaO2 may not be an accurate assessment of oxygen delivery to vital organs or factors influencing HPV. The mixed venous oxygen tension from umbilical venous catheter blood gas may assess pulmonary arterial PO2 and potentially predict HPV. It is crucial to conduct randomized controlled studies with different PO2/SpO2 target ranges for the management of PPHN and compare outcomes. Full article
(This article belongs to the Special Issue Pulmonary Hypertension in Neonates and Infants)
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14 pages, 1390 KiB  
Review
Talking to Children and Families about Chronic Pain: The Importance of Pain Education—An Introduction for Pediatricians and Other Health Care Providers
by Helen Koechlin, Cosima Locher and Alice Prchal
Children 2020, 7(10), 179; https://doi.org/10.3390/children7100179 - 12 Oct 2020
Cited by 19 | Viewed by 7823
Abstract
Chronic pain in children and adolescents is a common and debilitating health problem. This narrative review will give a brief overview on what pediatric chronic pain is and what treatment options there are for children and adolescents. The specific emphasis will be on [...] Read more.
Chronic pain in children and adolescents is a common and debilitating health problem. This narrative review will give a brief overview on what pediatric chronic pain is and what treatment options there are for children and adolescents. The specific emphasis will be on pediatric chronic pain education and communication: this narrative review aims to show how important a good patient–health care provider relationship is—it builds the foundation for successful communication—and how this relationship can be established. In addition, we will present five steps that health care providers can perform to explain pediatric chronic pain to patients and their parents and what to keep in mind in their clinical routine. Our review is intended for pediatricians and other health care providers who treat pediatric patients with chronic pain but might feel uncertain on how to best communicate with them. Full article
(This article belongs to the Special Issue Pediatric Pain Management)
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18 pages, 1763 KiB  
Article
Tracking Children’s Physical Activity Patterns across the School Year: A Mixed-Methods Longitudinal Case Study
by Irfan Khawaja, Lorayne Woodfield, Peter Collins, Adam Benkwitz and Alan Nevill
Children 2020, 7(10), 178; https://doi.org/10.3390/children7100178 - 12 Oct 2020
Cited by 5 | Viewed by 3467
Abstract
Despite the breadth of health benefits associated with regular physical activity (PA), many children in the UK are not sufficiently active enough to meet health guidelines, and tend to become less active as they mature into and throughout adolescence. Research has indicated that [...] Read more.
Despite the breadth of health benefits associated with regular physical activity (PA), many children in the UK are not sufficiently active enough to meet health guidelines, and tend to become less active as they mature into and throughout adolescence. Research has indicated that children’s school, home and neighbourhood environments can all significantly influence their opportunities to engage in moderate-to-vigorous physical activity (MVPA). However, less is known about how children’s MVPA patterns within these key environments may change across the school year. The current mixed-methods case study aims to explore this issue by tracking key stage 2 (KS2) and key stage 3 (KS3) children’s MVPA patterns across the school year. Fifty-eight children (29 boys, 29 girls, KS2 = 34, KS3 = 24) wore an integrated global positioning systems (GPS) and heart rate (HR) monitor over four consecutive days in the first term of school (autumn), before these measurements were repeated in the two remaining school terms (winter–summer). A subsample of children (n = 6–8 per group) were invited to take part in one of six focus groups each term to further explore their PA behaviours and identify the barriers and facilitators to PA. The children’s MVPA was significantly lower (p = 0.046) in term 2 (winter/spring term) than during the warmer terms (autumn and summer). All the locations showed reductions in MVPA in term 2, except indoor MVPA, which increased, and MVPA on foot in the neighbourhood, which remained consistent. Focus groups revealed location, friends, and the variety of options to be associated with MVPA, and poor weather, parental permission, and time limitations to be barriers to MVPA. This mixed-methodological, repeated-measures design study highlights differences in the activity patterns and perceptions of children over the school year. Future studies should implement longitudinal, multi-method approaches to gain deeper insight into how children’s PA behaviours differ over time. Consequently, this can inform future health policies promoting children’s PA throughout the year. Full article
(This article belongs to the Special Issue Active Transportation and Independent Mobility in Children and Adolescents)
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12 pages, 1480 KiB  
Commentary
Building the First Statewide Quality Improvement Collaborative, the CPQCC: A Historic Perspective
by Jeffrey B. Gould
Children 2020, 7(10), 177; https://doi.org/10.3390/children7100177 - 12 Oct 2020
Cited by 8 | Viewed by 2745
Abstract
The California Perinatal Quality Improvement Collaborative (CPQCC), founded in 1997, was the country’s first statewide perinatal quality improvement collaborative. Our goal was to improve the quality and outcomes of perinatal healthcare in California by developing a collaborative network of public and private obstetric [...] Read more.
The California Perinatal Quality Improvement Collaborative (CPQCC), founded in 1997, was the country’s first statewide perinatal quality improvement collaborative. Our goal was to improve the quality and outcomes of perinatal healthcare in California by developing a collaborative network of public and private obstetric and neonatal providers, insurers, public health professionals, and business groups to support a system for benchmarking and performance improvement activities for perinatal care. In this presentation, we describe how viewing the CPQCC as a complex value-driven organization, committed to identifying and addressing the needs of both its stakeholder partners and neonatal intensive care unit (NICU) members, has shaped the course of its development. Full article
(This article belongs to the Special Issue Neonatal Health Care)
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11 pages, 1188 KiB  
Article
Making a Decision between Acute Appendicitis and Acute Gastroenteritis
by Yi-Ting Lu, Po-Cheng Chen, Ying-Hsien Huang and Fu-Chen Huang
Children 2020, 7(10), 176; https://doi.org/10.3390/children7100176 - 11 Oct 2020
Cited by 7 | Viewed by 3514
Abstract
Acute appendicitis is one of the most common pediatric abdominal emergencies. Early diagnosis is vital for a positive outcome. However, it may initially present with diarrhea and vomiting, mimicking acute gastroenteritis, thus delaying prompt surgery. Differentiating appendicitis from gastroenteritis in a timely manner [...] Read more.
Acute appendicitis is one of the most common pediatric abdominal emergencies. Early diagnosis is vital for a positive outcome. However, it may initially present with diarrhea and vomiting, mimicking acute gastroenteritis, thus delaying prompt surgery. Differentiating appendicitis from gastroenteritis in a timely manner poses a challenge. Therefore, we aim to investigate the predictors that help distinguish acute appendicitis from acute gastroenteritis. We conducted a retrospective case-control study, evaluating children admitted due to abdominal pain with diarrhea. Subjects were divided into two groups according to the final diagnoses: acute appendicitis and acute gastroenteritis. We adopted multiple logistic regression analysis and the area under the receiver operating characteristic curve to identify independent predictors of acute appendicitis and select the best model. A total of 32 patients diagnosed with appendicitis and 82 patients with gastroenteritis were enrolled. Five independent predictors of acute appendicitis included vomiting, right lower quadrant (RLQ) pain, stool occult blood (OB), white blood cell (WBC) count, and C-reactive protein (CRP). The revised combined model exhibited a higher degree of discrimination and outperformed the pediatric appendicitis score (PAS) model. In conclusion, our study was proved to be helpful for assessing cases with abdominal pain and diarrhea in order to more accurately distinguish appendicitis from gastroenteritis in children in a timely manner. Full article
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10 pages, 265 KiB  
Article
Psychometric Analyses of the Indian (Hindi) Version of the Child Perception Questionnaire (CPQ11–14)
by Santosh Kumar Tadakamadla, Garima Mangal, Mir Faeq Ali Quadri, Maryam Nayeem and Jyothi Tadakamadla
Children 2020, 7(10), 175; https://doi.org/10.3390/children7100175 - 9 Oct 2020
Cited by 8 | Viewed by 2759
Abstract
The current research aims to evaluate the reliability and validity of the Hindi Child Perception Questionnaire (CPQ11–14) in a child population of India. A randomly selected sample of children aged 11–14 years (n = 331) and their parents completed the [...] Read more.
The current research aims to evaluate the reliability and validity of the Hindi Child Perception Questionnaire (CPQ11–14) in a child population of India. A randomly selected sample of children aged 11–14 years (n = 331) and their parents completed the Hindi translation of CPQ11–14 and the Parental-Caregiver Perceptions Questionnaire (P-CPQ), respectively, in this cross-sectional study. Children also provided a self-rating of oral health and were examined for dental caries. Exploratory Factor Analysis (EFA) was conducted to assess the dimensionality of the Hindi-CPQ11–14. Internal consistency and reliability on repeated administration were evaluated. Convergent and divergent validities were determined by estimating correlation coefficients between items and the hypothesised subscales. Concurrent validity was assessed using multiple linear regression analyses. The four factors extracted in EFA had a total variance of 38.5%, comprising 31 items. Cronbach’s alpha for the internal consistency of the overall scale was 0.90; reliability on repeated administration was 0.92. All the Hindi CPQ11–14 items had an item-hypothesised subscale correlation coefficient of ≥0.4, and these were greater than item-other hypothesised subscale correlations, demonstrating good convergent and divergent validities respectively. Hindi-CPQ11–14 was associated with self-ratings of the oral health and overall P-CPQ scores demonstrating good concurrent validity. Hindi-CPQ11–14 showed a factor structure different from the English CPQ11–14 and exhibited good validity and reliability. Full article
(This article belongs to the Special Issue Dental Caries and Oral Health in Children)
14 pages, 853 KiB  
Article
Dietary Diversity and Nutritional Status of Preschool Children in North West Province, South Africa: A Cross Sectional Study
by Perpetua Modjadji, Dineo Molokwane and Patricia Ogechi Ukegbu
Children 2020, 7(10), 174; https://doi.org/10.3390/children7100174 - 9 Oct 2020
Cited by 38 | Viewed by 8945
Abstract
Preschool children consume diets inadequate to meet their macro and micronutrient requirements, which ultimately affect their nutritional status due to lack of dietary diversity. A cross sectional study was conducted to investigate the association between dietary diversity scores (DDS) and the nutritional status [...] Read more.
Preschool children consume diets inadequate to meet their macro and micronutrient requirements, which ultimately affect their nutritional status due to lack of dietary diversity. A cross sectional study was conducted to investigate the association between dietary diversity scores (DDS) and the nutritional status of 379 preschool children in North West Province of South Africa. A 24 h qualitative recall by mothers of their children’s food consumption was used to calculate DDS based on 12-foods groups following Food and Agriculture Organization protocols. DDS was calculated by counting each of 12-food groups and classified as low (≤4), medium (5–8) and high (9–12). The weight and height of children were measured and height-for-age (HAZ), weight-for-age (WAZ) and BMI-for-age (BAZ) z-scores were calculated based on 2006 WHO standards. Stunting, underweight and thinness were defined as HAZ, WAZ and BAZ < −2SD, respectively. Linear and logistic regression analyses were used to assess the association between DDS and the nutritional indicators. Mean age for children was 4 ± 0.7 years, and the prevalence of stunting (29%), underweight (13%) and thinness (6%) was observed. Mean DDS was 4.39 ± 1.55 out of 12-food groups, with a prevalence of 61% and 39% for low and medium DDS, respectively. Cereals (100%) accounted for the main food group consumed, while fish and other seafood (17%) were the least consumed. Consumption of a diversified diet was associated with lower odds of being stunted [AOR = 0.25, 95%CI: 0.10 to 0.92] among the four-year olds, while in the unadjusted model, 5-year-olds had lower odds of being underweight [OR = −0.32, 95%CI: −0.57 to 0.07]. The findings of this study reinforce the importance of continued nutrition education of mothers, caregivers and preschool staff on the need to ensure consumption of diverse food sources in order to improve the nutritional status of children. Further studies are recommended on the association of DDS with the nutritional status, and factors associated with low dietary diversity among preschool children. Full article
(This article belongs to the Special Issue Selected Papers from the 2nd Ellisras Longitudinal Study and Other Non-Communicable Diseases Studies Intenational Conference)
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12 pages, 1577 KiB  
Article
Good Subjective Outcomes, Stable Knee and High Return to Sport after Tibial Eminence Avulsion Fracture in Children
by Stefano Stallone, Filippo Selleri, Giovanni Trisolino, Alberto Grassi, Luca Macchiarola, Marina Magnani, Eleonora Olivotto, Stefano Zaffagnini, Stefano Stilli and Fabio Catani
Children 2020, 7(10), 173; https://doi.org/10.3390/children7100173 - 9 Oct 2020
Cited by 4 | Viewed by 2700
Abstract
Avulsion fracture of the tibial spine (TSA) is uncommon in children, although its incidence is increasing with the earlier practice of competitive sport activities. This study aims to report mid to long term outcomes in children who sustained a TSA, with a special [...] Read more.
Avulsion fracture of the tibial spine (TSA) is uncommon in children, although its incidence is increasing with the earlier practice of competitive sport activities. This study aims to report mid to long term outcomes in children who sustained a TSA, with a special focus on a return to sport activities. Skeletally immature patients with a TSA, treated in two orthopedic hospitals, were evaluated for range of motion and knee laxity using KT1000, KiRA and Rolimeter. The pediatric International Knee Documentation Committee score (Pedi-IKDC) and the Hospital for Special Surgery pediatric Functional Activity Brief Scale (Pedi-FABS) questionnaires were recorded during the latest visit. Forty-two children were included. Twenty-six were treated nonoperatively and 16 underwent surgery. At a mean follow-up of 6.9 ± 3.6 years, 36 patients completed the questionnaires and 23 patients were tested with arthrometers. Among them, 96% had normal knee laxity. The Pedi-IKDC score averaged 96.4 ± 5.7 points, while the mean Pedi-FABS was 22.2 ± 5.9 points, without statistically significant differences between groups. Twenty-eight patients (78%) returned to their previous level of sport activity (eight amateur, 13 competitive, seven elite athletes). Eight patients (22%) quit sport, mostly because of re-injury fear. If properly treated, pediatric TSAs achieve a high rate of successful healing, with complete restoration of knee stability and an early return to sport activities. Full article
(This article belongs to the Section Pediatric Surgery)
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14 pages, 2730 KiB  
Article
Trunk Lateral Flexor Endurance and Body Fat: Predictive Risk Factors for Low Back Pain in Child Equestrian Athletes
by Antonio Cejudo, Angélica Ginés-Díaz, Olga Rodríguez-Ferrán, Fernando Santonja-Medina and Pilar Sainz de Baranda
Children 2020, 7(10), 172; https://doi.org/10.3390/children7100172 - 9 Oct 2020
Cited by 13 | Viewed by 3220
Abstract
Low back pain (LBP) is the most common overuse musculoskeletal injury suffered by child equestrian athletes (CEA). Despite this, little is known about the risk factors related to LBP in these athletes, and very limited research has been conducted on this topic. This [...] Read more.
Low back pain (LBP) is the most common overuse musculoskeletal injury suffered by child equestrian athletes (CEA). Despite this, little is known about the risk factors related to LBP in these athletes, and very limited research has been conducted on this topic. This study was designed to investigate predictive risk factors for LBP in CEA. The purposes of this research were to determine whether anthropometric, range of motion (ROM), core endurance and sagittal spinal morphotype measures are risk factors for LBP and to establish a diagnostic cutoff value for those factors associated with LBP. Nineteen CEA between the ages of 12 and 17 years were voluntarily recruited. Potential risk factors evaluated included corporal composition, lower limb ROM, core endurance and sagittal spinal measures. Associations and predictions were calculated between these risk factors and the LBP during the last 12 months. Almost half of the CEA have suffered at least one episode of LBP. Two risk factors and cutoff values were identified as predictors of LBP in CEA: having a high body fat higher than 23% (p = 0.01) and trunk lateral flexor endurance lower to 65 s (p = 0.021), body fat being the strongest predictor. Full article
(This article belongs to the Special Issue Effects of Exercise on Children Physical Development)
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10 pages, 1974 KiB  
Article
Non-Contact Video-Based Neonatal Respiratory Monitoring
by Scott L. Rossol, Jeffrey K. Yang, Caroline Toney-Noland, Janine Bergin, Chandan Basavaraju, Pavan Kumar and Henry C. Lee
Children 2020, 7(10), 171; https://doi.org/10.3390/children7100171 - 6 Oct 2020
Cited by 22 | Viewed by 4216
Abstract
Respiratory rate (RR) has been shown to be a reliable predictor of cardio-pulmonary deterioration, but standard RR monitoring methods in the neonatal intensive care units (NICU) with contact leads have been related to iatrogenic complications. Video-based monitoring is a potential non-contact system that [...] Read more.
Respiratory rate (RR) has been shown to be a reliable predictor of cardio-pulmonary deterioration, but standard RR monitoring methods in the neonatal intensive care units (NICU) with contact leads have been related to iatrogenic complications. Video-based monitoring is a potential non-contact system that could improve patient care. This iterative design study developed a novel algorithm that produced RR from footage analyzed from stable NICU patients in open cribs with corrected gestational ages ranging from 33 to 40 weeks. The final algorithm used a proprietary technique of micromotion and stationarity detection (MSD) to model background noise to be able to amplify and record respiratory motions. We found significant correlation—r equals 0.948 (p value of 0.001)—between MSD and the current hospital standard, electrocardiogram impedance pneumography. Our video-based system showed a bias of negative 1.3 breaths and root mean square error of 6.36 breaths per minute compared to standard continuous monitoring. Further work is needed to evaluate the ability of video-based monitors to observe clinical changes in a larger population of patients over extended periods of time. Full article
(This article belongs to the Special Issue Neonatal Health Care)
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20 pages, 287 KiB  
Article
Preschool Teachers’ Beliefs towards Children with Autism Spectrum Disorder (ASD) in Yemen
by Sahar Mohammed Taresh, Nor Aniza Ahmad, Samsilah Roslan and Aini Marina Ma’rof
Children 2020, 7(10), 170; https://doi.org/10.3390/children7100170 - 6 Oct 2020
Cited by 8 | Viewed by 5482
Abstract
It is perplexing that some preschool teachers not only advise parents who have children with autism spectrum disorder (ASD) to go to religious healers, but also attribute such neurological disorders to the curse of the “evil eye” or vaccines. Although it is now [...] Read more.
It is perplexing that some preschool teachers not only advise parents who have children with autism spectrum disorder (ASD) to go to religious healers, but also attribute such neurological disorders to the curse of the “evil eye” or vaccines. Although it is now the twentieth century, this behavior simply reflects the concerns of over-protective teachers and the cultural misperceptions about the actual definition of ASD. In Yemen, the term “ASD”, with its wide range of symptoms, is still ambiguous among preschool teachers. Thus, in a rather insightful piece for the education community, this study has attempted to look beneath the surface of the beliefs (religious belief–social belief–personal belief) of Yemeni preschool teachers regarding ASD. Based on the data collected from 213 teachers (20–30\31–40-~≥40 age) in the Taiz district, this study found that misconceptions specific to autism spectrum disorder were strongly evidenced among teachers who taught preschoolers. Due to personal ignorance and growing superstitions, these teachers tend to believe the society’s perceptions of ASD, thus resulting in the ignorance of scientific views. However, the mass media can increase this group’s awareness of ASD by continually assessing the inaccurate views on ASD, and correcting them. And by influencing the teachers to take a more conceptual scientific approach in serving their special needs students, furthermore, by informing preschool teachers of children’s rights in normal life in the future through providing children with an optimal chance of development by early intervention. Full article
(This article belongs to the Special Issue New Research in Children with Neurodevelopmental Disorders)
6 pages, 616 KiB  
Case Report
Pulmonary Exacerbation of Undiagnosed Toxocariasis in Intensively-Treated High-Risk Neuroblastoma Patients
by Szymon Janczar, Monika Bulas, Justyna Walenciak, Dobromila Baranska, Marek Ussowicz, Wojciech Młynarski and Beata Zalewska-Szewczyk
Children 2020, 7(10), 169; https://doi.org/10.3390/children7100169 - 5 Oct 2020
Cited by 3 | Viewed by 2820
Abstract
Toxocariasis is one of the most common zoonoses, with high seroprevalence in apparently healthy individuals. Neuroblastoma is an aggressive childhood cancer. The cure rates are improving due to dose-dense chemotherapy, progress in surgical practice, myeloablative therapy with autologous stem cell transplantation, and recently, [...] Read more.
Toxocariasis is one of the most common zoonoses, with high seroprevalence in apparently healthy individuals. Neuroblastoma is an aggressive childhood cancer. The cure rates are improving due to dose-dense chemotherapy, progress in surgical practice, myeloablative therapy with autologous stem cell transplantation, and recently, anti-GD2 immunotherapy. This is associated with a burden of complications, some of which are relatively specific for neuroblastoma treatment. Based on previous reports of Toxocara canis infection in high-risk neuroblastoma patients and cases of pulmonary exacerbation from our center in this disease, we propose that toxocariasis is a specific complication of intensive pediatric cancer treatment and advocate for active surveillance. Full article
(This article belongs to the Section Pediatric Hematology & Oncology)
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6 pages, 727 KiB  
Article
Randomized Longitudinal Study Comparing Three Nasal Respiratory Support Modes to Prevent Intermittent Hypoxia in Very Preterm Infants
by Maximilian Gross, Anette Poets, Renate Steinfeldt, Michael S. Urschitz, Katrin Böckmann, Bianca Haase and Christian F. Poets
Children 2020, 7(10), 168; https://doi.org/10.3390/children7100168 - 5 Oct 2020
Cited by 1 | Viewed by 2331
Abstract
Nasal continuous positive airway pressure (NCPAP) devices using variable (vf-) and continuous (cf-) flow or synchronized nasal intermittent positive pressure ventilation (s-NIPPV) are used to prevent or treat intermittent hypoxia (IH) in preterm infants. Results concerning which is most effective vary. We aimed [...] Read more.
Nasal continuous positive airway pressure (NCPAP) devices using variable (vf-) and continuous (cf-) flow or synchronized nasal intermittent positive pressure ventilation (s-NIPPV) are used to prevent or treat intermittent hypoxia (IH) in preterm infants. Results concerning which is most effective vary. We aimed to investigate the effect of s-NIPPV and vf-NCPAP compared to cf-NCPAP on the rate of IH episodes. Preterm infants with a gestational age of 24.9–29.7 weeks presenting with IH while being treated with cf-NCPAP were monitored for eight hours, then randomized to eight hours of treatment with vf-NCPAP or s-NIPPV. Data from 16 infants were analyzed. Due to an unexpectedly low sample size, the results were only reported descriptively. No relevant changes in the rate of IH events were detected between cf- vs. vf-NCPAP or between cf-NCPAP vs. s-NIPPV. Although limited by its small sample size, s-NIPPV, vf- and cf-NCPAP seemed to be similarly effective in the treatment of IH in these infants. Full article
(This article belongs to the Special Issue Neonatal Health Care)
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14 pages, 256 KiB  
Review
Headache in Children: Selected Factors of Vascular Changes Involved in Underlying Processes of Idiopathic Headaches
by Joanna Sordyl, Ewa Małecka-Tendera, Beata Sarecka-Hujar and Ilona Kopyta
Children 2020, 7(10), 167; https://doi.org/10.3390/children7100167 - 4 Oct 2020
Cited by 3 | Viewed by 2621
Abstract
Headaches are common complaints in children. The International Classification of Headache Disorders, 3rd edition (beta version), defines more than 280 types of headaches. Primary headaches refer to independent conditions that cause pain and include migraine, tension-type headaches (TTH), and trigeminal autonomic cephalalgias [...] Read more.
Headaches are common complaints in children. The International Classification of Headache Disorders, 3rd edition (beta version), defines more than 280 types of headaches. Primary headaches refer to independent conditions that cause pain and include migraine, tension-type headaches (TTH), and trigeminal autonomic cephalalgias (TACs). Several agents are involved in the pathogenesis of headaches. The factors associated with predisposition to atherosclerosis seem to be particularly important from the clinical point of view. The influence of obesity on the incidence of headaches has been well established. Moreover, idiopathic headaches, especially migraine, are thought to be one of the first signs of disorders in lipid metabolism and atherosclerosis. The risk of migraine increases with increasing obesity in children. Another factor that seems to be involved in both obesity and headaches is the adiponectin level. Recent data also suggest new potential risk factors for atherosclerosis and platelet aggregation such as brain-derived neurotrophic factor (BDNF), sCD40L (soluble CD40 ligand), serpin E1/PAI I (endothelial plasminogen activator inhibitor), and vascular endothelial growth factor (VEGF). However, their role is controversial because the results of clinical studies are often inconsistent. This review presents the current knowledge on the potential markers of atherosclerosis and platelet aggregation, which may be associated with primary headaches. Full article
(This article belongs to the Section Pediatric Neurology & Neurodevelopmental Disorders)
12 pages, 727 KiB  
Article
Identifying Downregulation of Autophagy Markers in Kawasaki Disease
by Fu-Chen Huang, Ying-Hsien Huang, Ho-Chang Kuo and Sung-Chou Li
Children 2020, 7(10), 166; https://doi.org/10.3390/children7100166 - 4 Oct 2020
Cited by 12 | Viewed by 2279
Abstract
Kawasaki disease (KD) is the most common cause of heart disease acquired in childhood. Even if treated with high-dose intravenous immunoglobulin G (IVIG) at the early stage; children are still at risk of developing coronary artery lesions. Accumulating evidence suggests that autophagy is [...] Read more.
Kawasaki disease (KD) is the most common cause of heart disease acquired in childhood. Even if treated with high-dose intravenous immunoglobulin G (IVIG) at the early stage; children are still at risk of developing coronary artery lesions. Accumulating evidence suggests that autophagy is enhanced in various heart diseases. Evaluating the pathogenic role of autophagy in KD and coronary artery lesions (CAL) may aid in identifying a potential therapeutic target for the treatment or prevention of the disease. Blood samples were obtained from 20 children with KD at the onset of disease and 21 days after IVIG therapy. Twenty children with other causes of febrile disease and 20 healthy children were included as controls. Total RNA was extracted from white blood cells; and autophagy-related gene mRNA expression levels were measured using real-time polymerase chain reaction. The patients with KD had downregulated levels of LC3B mRNA (0.50 ± 0.06 vs. 1.67 ± 0.15; p < 0.001), BECN1 mRNA (0.70 ± 0.08 vs. 1.43 ± 0.23; p < 0.05), and ATG16L1 mRNA (0.28 ± 0.04 vs. 0.96 ± 0.16; p < 0.01) compared to the febrile control group. The values of these parameters all increased significantly 21 days after the IVIG therapy as follows: LC3B mRNA (1.77 ± 0.29 vs. 0.50 ± 0.06; p < 0.001), BECN1 mRNA (1.67 ± 0.36 vs. 0.70 ± 0.08; p < 0.05), and ATG16L1 mRNA (2.96 ± 0.43 vs. 0.28 ± 0.04; p < 0.001), while the level of ATG16L1 mRNA persists low in KD patients with CAL. Our results showed the autophagy-related genes expressions in KD and their change after IVIG administration. This suggests that autophagy may have a protective effect on KD. Full article
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14 pages, 505 KiB  
Article
Something Else Going On? Diagnostic Uncertainty in Children with Chronic Pain and Their Parents
by Vivek Tanna, Lauren C. Heathcote, Marissa S. Heirich, Gillian Rush, Alexandra Neville, Melanie Noel, Joshua W. Pate and Laura E. Simons
Children 2020, 7(10), 165; https://doi.org/10.3390/children7100165 - 4 Oct 2020
Cited by 13 | Viewed by 4023
Abstract
Diagnostic uncertainty, the perceived lack of an accurate explanation of the patient’s health problem, remains relatively unstudied in children. This study examined the prevalence, familial concordance, and correlates of diagnostic uncertainty in children and their parents presenting to a multidisciplinary pain clinic in [...] Read more.
Diagnostic uncertainty, the perceived lack of an accurate explanation of the patient’s health problem, remains relatively unstudied in children. This study examined the prevalence, familial concordance, and correlates of diagnostic uncertainty in children and their parents presenting to a multidisciplinary pain clinic in the United States. One hundred and twenty-six parents and 91 of their children (Mage = 13.93 years, range = 8–18 years) completed a brief three-item measure of diagnostic uncertainty, as well as measures of pain-related distress and functioning. Forty-eight percent of children and 37% of parents believed something else was going on with the child’s pain that doctors had not found out about yet. Across the three items, 66%–77% of children and their parents agreed in their endorsement of diagnostic uncertainty. Parents who believed that something else was going on with their child’s pain had children with higher avoidance of pain-related activities (F = 5.601, p = 0.020) and lower pain willingness (F = 4.782, p = 0.032). Neither parent nor child diagnostic uncertainty was significantly related to the child’s pain-related functioning. Diagnostic uncertainty, particularly in parents, is relevant in the experience of pediatric chronic pain and warrants further investigation as both a risk factor and therapeutic target. Full article
(This article belongs to the Special Issue Information Provision and Preparation in the Context of Children’s Pain)
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18 pages, 1364 KiB  
Article
Effect of Scaling Task Constraints on the Learning Processes of Under-11 Badminton Players during Match-Play
by Enrique Ortega-Toro, Juan Carlos Blanca-Torres, José María Giménez-Egido and Gema Torres-Luque
Children 2020, 7(10), 164; https://doi.org/10.3390/children7100164 - 4 Oct 2020
Cited by 13 | Viewed by 4820
Abstract
Scaling equipment and the playing space according to junior badminton players’ characteristics and needs is a key aspect to design optimal learning environments. The purpose of the study is to analyze the incidence of reducing the court size (from 13.40 m × 5.18 [...] Read more.
Scaling equipment and the playing space according to junior badminton players’ characteristics and needs is a key aspect to design optimal learning environments. The purpose of the study is to analyze the incidence of reducing the court size (from 13.40 m × 5.18 m to 11.88 m × 5.18 m) and net height (from 1.55 m to 1.30 m) for under-11 badminton players on the following technical and tactical variables: (a) service area; (b) stroke effectiveness; (c) kinds of technical strokes; (d) players’ hitting area; (e) shuttle landing area; (f) shuttle flight; and (g) rally length. Twenty-eight badminton players (mean age of players: 9.81 ± 0.93) were selected and played a badminton competition (B) with the current federative rules and a mini-badminton competition (MB) with the altered net height and court dimensions. The results showed that a lower net height and a shorter court would increase the frequency and variability of strokes and play patterns, introducing quantifiable changes considered beneficial for children in their first stages, both in training and competition. Full article
(This article belongs to the Special Issue Effects of Exercise on Children Physical Development)
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