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Children, Volume 7, Issue 3 (March 2020) – 8 articles

Cover Story (view full-size image): Postoperative pain treatment affects immediate and long-term outcomes in children undergoing cardiac surgery. Opioids, as part of multimodal analgesia, are effective in treating pain, however, they can be disadvantageous due to adverse side effects. Therefore, we assessed whether the local anesthetic bupivacaine as a parasternal nerve block in children post-cardiac surgery is an effective adjunct to pain management. This was a retrospective cohort study of all patients who underwent cardiothoracic surgery via median sternotomy at a large children’s hospital between November 2011 and February 2014 with and without bupivacaine following the introduction of perioperative bupivacaine in late 2012 on a single unit. 62 out of 148 patients (age 3–17 years) who received bupivacaine demonstrated decreased postoperative opioid use. View this paper.
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11 pages, 1345 KiB  
Article
The Influence of Social Support on Physical Activity in Chinese Adolescents: The Mediating Role of Exercise Self-Efficacy
by Zhanbing Ren, Linlin Hu, Jane Jie Yu, Qian Yu, Sitong Chen, Yudan Ma, Jingyuan Lin, Lin Yang, Xiaoyun Li and Liye Zou
Children 2020, 7(3), 23; https://doi.org/10.3390/children7030023 - 20 Mar 2020
Cited by 37 | Viewed by 8263
Abstract
The purpose of this study was to examine the associations of social support and self-efficacy with physical Activity (PA) and the mediating effect of self-efficacy on the relationship between social support and PA in Chinese adolescents. Participants included a total of 2341 Chinese [...] Read more.
The purpose of this study was to examine the associations of social support and self-efficacy with physical Activity (PA) and the mediating effect of self-efficacy on the relationship between social support and PA in Chinese adolescents. Participants included a total of 2341 Chinese adolescents (aged 12.75 ± 1.46 years). Self-reported instruments, including the physical activity questionnaire for adolescents, the social support revalued scale and the exercise self-efficacy scale, were used to measure physical activity, social support and exercise self-efficacy. Results showed that social support (r = 0.29, p < 0.05) and exercise self-efficacy (r = 0.43, p < 0.05) were significant and positive predictors of PA among Chinese adolescents, and exercise self-efficacy was a significant mediator in the relationship between social support and PA (standardized effect size = 0.15, p < 0.001). Such findings were evident with similar patterns in both male and female adolescents. The findings of this study have indicated the importance of social support and exercise self-efficacy on PA promotion in adolescents, which will aid the development of effective interventions in this population. Full article
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14 pages, 1265 KiB  
Article
The Transport and Outcome of Sick Outborn Neonates Admitted to a Regional and District Hospital in the Upper West Region of Ghana: A Cross-Sectional Study
by Edem M. A. Tette, Benjamin D. Nuertey, Dominic Akaateba and Naa Barnabas Gandau
Children 2020, 7(3), 22; https://doi.org/10.3390/children7030022 - 20 Mar 2020
Cited by 15 | Viewed by 4398
Abstract
Optimum care of sick neonates often involves transporting them across different levels of care. Since their condition may deteriorate over time, attention needs to be paid to travel distances and how they are transferred. We examined the mode of transport, distances travelled, condition [...] Read more.
Optimum care of sick neonates often involves transporting them across different levels of care. Since their condition may deteriorate over time, attention needs to be paid to travel distances and how they are transferred. We examined the mode of transport, distances travelled, condition on arrival and outcome of outborn neonates admitted to a district and a regional hospital in Ghana using a cross-sectional study involving caregivers of neonates admitted to these hospitals. Information on referral characteristics and outcome were obtained from questionnaires and the child’s case notes. Overall, 153 caregivers and babies were studied. Twelve deaths, 7.8%, occurred. Neonates who died spent a median duration of 120 min at the first health facility they visited compared with 30 min spent by survivors; they travelled mostly by public buses, (41.7%), compared with 36.0% of survivors who used taxis. Majority of survivors, 70.2%, had normal heart rates on arrival compared with only 41.7% of neonates who died; hypothermia was present in 66.7% compared with 47.6% of survivors. These findings indicate that the logistics for neonatal transport were inadequate to keep the neonates stable during the transfer process, thus many of them were compromised especially those who died. Further studies are warranted. Full article
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13 pages, 863 KiB  
Article
Effects of a Need-Supportive Motor Skill Intervention on Children’s Motor Skill Competence and Physical Activity
by Joonyoung Lee, Tao Zhang, Tsz Lun (Alan) Chu and Xiangli Gu
Children 2020, 7(3), 21; https://doi.org/10.3390/children7030021 - 17 Mar 2020
Cited by 37 | Viewed by 7434
Abstract
A need-supportive environment can provide various motivational benefits to impact children’s psychomotor developmental levels. However, very little is known about the effects of need-supportive motor skill intervention on children’s motor skill competence and physical activity by gender. Guided by self-determination theory (SDT), this [...] Read more.
A need-supportive environment can provide various motivational benefits to impact children’s psychomotor developmental levels. However, very little is known about the effects of need-supportive motor skill intervention on children’s motor skill competence and physical activity by gender. Guided by self-determination theory (SDT), this study aimed to (a) investigate the effect of a need-supportive fundamental movement skill (FMS) program on children’s FMS competence and moderate-to-vigorous physical activity (MVPA), and (b) explore potential gender differences in these effects. Thirty-six children (63.8% girls; Mage = 6.52 ± 0.97) participated and were divided into two groups: an intervention group (24 need-supportive FMS sessions over eight weeks) and a control group. A repeated-measures multivariate analysis of variance (MANOVA) was used to examine the influence of the motor skill intervention on FMS competence and MVPA over time by group (intervention, control) and gender (boys, girls). The results showed (a) significant group differences between the intervention and control group in FMS competence and MVPA (p < 0.001), (b) non-significant gender differences between boys and girls in FMS competence and MVPA (p = 0.85), and (c) non-significant interaction effects over time (p = 0.52). The findings highlight that a need-supportive FMS program may enhance FMS development and daily physical activity for both genders during the early school years. Full article
(This article belongs to the Section Global Pediatric Health)
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12 pages, 543 KiB  
Article
Post-Cardiotomy Parasternal Nerve Block with Bupivacaine May Be Associated with Reduced Post-Operative Opioid Use in Children: A Retrospective Cohort Study
by Francis X. Moga, Mark D. Lo Galbo, David M. Overman and Stefan J. Friedrichsdorf
Children 2020, 7(3), 20; https://doi.org/10.3390/children7030020 - 11 Mar 2020
Cited by 4 | Viewed by 4426
Abstract
Postoperative pain treatment affects immediate and long-term outcomes in children undergoing cardiac surgery. Opioids, as part of multimodal analgesia, are effective in treating pain, however, they can be disadvantageous due to adverse side effects. Therefore, we assessed whether the local anesthetic bupivacaine as [...] Read more.
Postoperative pain treatment affects immediate and long-term outcomes in children undergoing cardiac surgery. Opioids, as part of multimodal analgesia, are effective in treating pain, however, they can be disadvantageous due to adverse side effects. Therefore, we assessed whether the local anesthetic bupivacaine as a parasternal nerve block in children post-cardiac surgery is an effective adjunct to pain management. This was a retrospective cohort study of all patients who underwent cardiothoracic surgery via median sternotomy at a large children’s hospital between November 2011 and February 2014 with and without bupivacaine following the introduction of perioperative bupivacaine in late 2012 on a single unit. 62 out of 148 patients (age 3–17 years) who received bupivacaine demonstrated decreased postoperative opioid use. Within one day of surgery, patients who received bupivacaine required, on average, 0.57 mg/kg (95% CI, 0.46 to 0.68) of total morphine equivalent compared to 0.93 mg/kg (95% CI, 0.80 to 1.06) for patients who did not receive bupivacaine. This difference was statistically significant after adjusting for potential confounders (p-value = 0.002). Length of stay and intubation were shorter on average among patients who received bupivacaine, but these differences were not statistically significant after adjusting for potential confounders. The study results seem to suggest that the perioperative administration of bupivacaine may reduce opioid usage among children post-cardiotomy. Full article
(This article belongs to the Section Pediatric Surgery)
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19 pages, 6579 KiB  
Review
Fat Mass Index (FMI) as a Trustworthy Overweight and Obesity Marker in Mexican Pediatric Population
by Melchor Alpízar, Tamara Daniela Frydman, José de Jesús Reséndiz-Rojas, Miguel Alejandro Trejo-Rangel and Jesús Manuel De Aldecoa-Castillo
Children 2020, 7(3), 19; https://doi.org/10.3390/children7030019 - 10 Mar 2020
Cited by 14 | Viewed by 6092
Abstract
Predictive formulas to estimate body composition in children have been explored for some time, to this date, the most accurate obesity diagnostic tool is to determine fat mass. The aim of this study is to establish cutoff points that allow for a precise [...] Read more.
Predictive formulas to estimate body composition in children have been explored for some time, to this date, the most accurate obesity diagnostic tool is to determine fat mass. The aim of this study is to establish cutoff points that allow for a precise interpretation of nutritional status using the Fat Mass Index (FMI) in a Mexican pediatric population. A literature review using PubMed and Cochrane databases was made, searching for research articles on childhood obesity that compared BMI, FM percentage, and FMI, as well as those proposing diagnostic cutoff points. Mathematic formulas and linear regressions were then used to make a proposal on accurate cutoff points for this population. Our findings show that FM percentage is less precise than BMI and FMI in diagnosing obesity, and FMI seems to be a more complete tool for assessment as it differentiates fat and muscle mass of the total body weight. Both BMI and FMI should be considered when clinical evaluations regarding weight, with BMI complementing FMI by establishing fat-free mass. Our proposed cutoff points need to be validated in this population. Full article
(This article belongs to the Section Global Pediatric Health)
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10 pages, 3170 KiB  
Article
A Non-Invasive Investigation into the Prevalence of Higher than Normal Blood Pressure, Hypertension and the Association between Blood Pressure and Body Weight in Male and Female Adolescents in the Polokwane Local Municipality, Limpopo-South Africa: A Cross-Sectional Study
by Thato Tshepo Raphadu, Marlise Van Staden, Winnie Maletladi Dibakwane and Kotsedi Daniel Monyeki
Children 2020, 7(3), 18; https://doi.org/10.3390/children7030018 - 4 Mar 2020
Cited by 9 | Viewed by 4660
Abstract
Background: Hypertension (HT) is one of the greatest non-communicable diseases affecting both sexes in all human populations; and it is a major cause of death and morbidity across the world. The purpose of this study was to investigate the prevalence of pre-hypertension, hypertension [...] Read more.
Background: Hypertension (HT) is one of the greatest non-communicable diseases affecting both sexes in all human populations; and it is a major cause of death and morbidity across the world. The purpose of this study was to investigate the prevalence of pre-hypertension, hypertension and investigate the association between blood pressure (BP) and body weight (looking into body mass index (BMI) and body surface area (BSA)). Method: A cross-sectional study of adolescents aged 13–19 years was conducted at three secondary schools consisting of 121 females and 97 males. Data on height; weight; and blood pressure was collected from all participants. BMI and BP percentiles were calculated for each participant. Results: The prevalence of pre-hypertension and hypertension in males was 28.9% and 10.3% compared to 25.6% and 7.4% in females. The prevalence of pre-hypertension and hypertension in adolescents who are overweight/obese was 7.3% and 2.7%. A weak positive association between BMI; systolic blood pressure (SBP) and diastolic blood pressure (DBP) was found (r = 0.254 and 0.216; p-value = 0.001) for the whole population. A significant, moderate correlation was found between BSA on SBP was found (r = 0.407, p-value = 0.001); and a significant, weak correlation between BSA and DBP was found (r = 0.183, p-value = 0.007. In conclusion, the prevalence of pre-hypertension and hypertension was higher in males as compared to females. Results highlight the need for screening for blood pressure and body weight in adolescents; especially in adolescents who were found to have pre-hypertension as they are at high risk of developing hypertension. Full article
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9 pages, 2161 KiB  
Article
Using the SITAR Method to Estimate Age at Peak Height Velocity of Children in Rural South Africa: Ellisras Longitudinal Study
by Chris Nembidzane, Maseka Lesaoana, Kotsedi Daniel Monyeki, Alexander Boateng and Phuti J. Makgae
Children 2020, 7(3), 17; https://doi.org/10.3390/children7030017 - 3 Mar 2020
Cited by 7 | Viewed by 5765
Abstract
Various studies have been conducted on children using the Ellisras Longitudinal Study Survey in South Africa, but none of these has addressed growth variations of children in this rural location. The aim of this paper is to assess the age at peak height [...] Read more.
Various studies have been conducted on children using the Ellisras Longitudinal Study Survey in South Africa, but none of these has addressed growth variations of children in this rural location. The aim of this paper is to assess the age at peak height velocity using the superimposition by translation and rotation (SITAR) method for both boys and girls in rural South Africa. The study is part of the on-going Ellisras Longitudinal Study, and has employed secondary data during the period from November 1996 to November 2003. The data was collected biannually in May and November each year. The Ellisras study initially followed a cluster sampling method. All participating children underwent a series of anthropometric measurements of height and weight according to the standard procedures recommended by the International Society for the Advancement of Kinanthropometry. The analysis was done using the SITAR model. Age at peak height velocity for Ellisras rural children was at 14.45 years for boys at 11.82 years for girls. Ellisras rural girls had their age at peak height velocity way earlier than Ellisras rural boys did by an estimated 2.63 years. Ellisras rural children and their growth variations were comparable to other studies. Full article
(This article belongs to the Section Global Pediatric Health)
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9 pages, 821 KiB  
Article
Reliability, Consistency and Temporal Stability of Alberta Infant Motor Scale in Serbian Infants
by Milan Lackovic, Dejan Nikolic, Dejan Filimonovic, Ivana Petronic, Sladjana Mihajlovic, Zoran Golubovic, Polina Pavicevic and Dragana Cirovic
Children 2020, 7(3), 16; https://doi.org/10.3390/children7030016 - 2 Mar 2020
Cited by 15 | Viewed by 5079
Abstract
Our study aimed to analyze the reliability, consistency, and temporal stability of the Alberta Infant Motor Scale (AIMS) in Serbian infants. Additionally, we aimed to present a percentile distribution of AIMS in the tested population. The prospective study included 60 infants that were [...] Read more.
Our study aimed to analyze the reliability, consistency, and temporal stability of the Alberta Infant Motor Scale (AIMS) in Serbian infants. Additionally, we aimed to present a percentile distribution of AIMS in the tested population. The prospective study included 60 infants that were divided into three age groups: 0–3 months, 4–7 months, and 8–14 months. The Serbian version of AIMS was tested by two raters on two different occasions (test/retest) with a five day period between tests. The observed inter-rater reliability (intraclass correlation coefficient (ICC)) was more than 0.75 for all AIMS scores, except for standing (ICC 0.655 = moderate) in the age group of 4–7 months on retest between raters. The observed intra-rater reliability (ICC) was more than 0.75 for all AIMS scores except standing (ICC 0.655 = moderate) in the age group 4–7 months in test–retest for Rater One, and for sitting (ICC 0.671 = moderate) and standing (ICC 0.725 = moderate) in the age group between 0–3 months on test–retest for Rater Two. The Serbian version of AIMS was shown to have high consistency and high reliability with good to high temporal stability. Thus, it can be used in the evaluation of infants’ motor development in Serbia. Full article
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