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Purpose: The aim of this study was to investigate the effect of agility ladder training combined with plyometric or multidirection speed drills, on performance in young female volleyball players. Methods: Seventy-six young female volleyball players were randomly distributed into 3 maturity-matched groups: (1) the agility ladder + plyometric drills group, (2) the agility ladder + multidirection speed drills group, and (3) the control group. Both experimental groups followed a 6-week training program, twice weekly, in addition to the regular volleyball training sessions, while the control group participated only in the regular volleyball training sessions. Assessments pretraining and posttraining included countermovement jump, 20-m sprint, and agility T test. Results: Both experimental groups improved T-test performance (P <.005) but only agility ladder + multidirection speed drills group outperformed the control group (P <.05). Conclusions: Agility ladder training programs combined with either plyometric or speed drills can improve change of direction performance in young female volleyball players but only the combination of agility ladder with multidirection speed drills is more effective than volleyball training per se. The small effectiveness of these protocols may be attributed to the short training period, or to the fact that training elements were combined in a single session. This hypothesis remains to be further investigated. [ABSTRACT FROM AUTHOR]

Background: There is limited evidence from globally diverse samples on the prevalence and correlates of meeting the global guideline of 180 minutes per day of total physical activity (TPA) among 3- to 4-year-olds. Methods: Cross-sectional study involving 797 (49.2% girls) 3- to 4-year-olds from 17 middle- and high-income countries who participated in the pilot phases 1 and 2 of the SUNRISE International Study of Movement Behaviours in the Early Years. Daily step count was measured using thigh-worn activPAL accelerometers. Children wore the accelerometers for at least one 24-hour period. Children were categorized as meeting the TPA guideline based on achieving ≥11,500 steps per day. Descriptive analyses were conducted to describe the proportion of meeting the TPA guideline for the overall sample and each of the sociodemographic variables, and 95% CIs were calculated. Multivariable logistic regression was used to determine the sociodemographic correlates of meeting the TPA guideline. Results: Mean daily step count was 10,295 steps per day (SD = 4084). Approximately one-third of the sample (30.9%, 95% CI, 27.6–34.2) met the TPA guideline. The proportion meeting the guideline was significantly lower among girls (adjusted OR [aOR] = 0.70, 95% CI, 0.51–0.96) and 4-year-olds (aOR = 0.50, 95% CI, 0.34–0.75) and higher among rural residents (aOR = 1.78, 95% CI, 1.27–2.49) and those from lower middle-income countries (aOR = 1.35, 95% CI, 0.89–2.04). Conclusions: The findings suggest that a minority of children might meet the TPA guideline globally, and the risk of not meeting the guideline differed by sociodemographic indicators. These findings suggest the need for more surveillance of TPA in young children globally and, possibly, interventions to improve childhood health and development. [ABSTRACT FROM AUTHOR]

The detrimental impact of extreme heat exposure on the health and well-being of children is widely acknowledged. The direct and indirect effects of climate change have led to an increased risk of certain cardiovascular events which may be particularly harmful to children who are born with, or develop, heart disease. Purpose: To highlight the worrying paucity of investigative research aimed at differentiating how higher ambient temperatures further tax an already compromised cardiovascular system in children. Methods: This commentary describes basic thermoregulatory concepts relevant to the healthy pediatric population and summarizes common heart diseases observed in this population. Results: We describe how heat stress and exercise are important factors clinicians should more readily consider when treating children with heart disease. Countermeasures to physical inactivity are suggested for children, parents, clinicians, and policymakers to consider. Conclusions: As sudden, excessive heat exposures continue to impact our rapidly warming world, vulnerable populations like children with underlying heart conditions are at greater heat health risk, especially when coupled with the negative physical activity and fitness trends observed worldwide. [ABSTRACT FROM AUTHOR]

Many consumers are caregivers and, as part of caregiving, frequently make food choices for their dependents. This research examines how food choices made for children influence the healthiness of parents' subsequent self-choices. Whereas prior work focuses on choices for the self (others) as based on self-needs (other-needs), the authors theorize when and why self-choices involve consideration of other-needs. Five studies, including a nursery school field study, test the effect of choosing healthy food for a child on the healthiness of parents' self-choices, focusing on the role of anticipating potentially sharing self-choices with one's child. Potential sharing increased parents' likelihood of making an unhealthy subsequent self-choice if they first made a healthy choice for their child. This effect was driven by parents' present-focused parenting concerns about whether one's child would eat and enjoy healthy options chosen for them. This effect was mitigated when parents instead had future-focused parenting concerns. Additionally, this effect was mitigated after making an initial choice for the child that was (1) unhealthy or (2) healthy but relatively liked by the child. This research contributes to understanding how choices for others shape choices for the self and offers important marketing and policy implications. [ABSTRACT FROM AUTHOR]

Background: This study examined the after-school activities of Japanese elementary school children in which little information is available for understanding the process by which participation in organized activities leads to the decrease in children's independent mobility. Methods: One thousand eight hundred and twenty-four mothers of elementary school children participated in an online survey. The mothers responded to the questions on the number of lessons (or cram schools) their children attended weekdays, as well as their children's behavior after classes, and parents providing transportation when their children go out to play. Results: The proportion of children attending lessons and/or cram schools increased as their grades progressed. A significant interaction existed between the degree of parental transportation and grade in terms of whether or not the children attended lessons and/or cram schools. Parental involvement included pick up or drop-off for a large percentage of younger children without lessons, whereas the degree of parental involvement was greater for older children attending lessons. In other words, parents of children without attending lessons or cram schools tended to allow children to engage in independent activities when they reached the higher grades, whereas parents of children who frequently attended lessons and cram schools tended to remain involved in transporting their children, even when they reached the higher grades. Conclusions: The results suggested that the participation of children in organized activities leads to a routine of parental pickup and/or drop-off, which renders difficult the facilitation of opportunities for children to independently participate in play activities. [ABSTRACT FROM AUTHOR]

Background: Around 40% of Australian children do not participate in sport. Cost is a major barrier to participation, particularly for children from low socioeconomic backgrounds. This study aimed to evaluate the uptake of a population-level children's sports subsidy scheme, including sociodemographic differences in uptake. Methods: A state-wide cross-sectional analysis comparing sports voucher claimants (primary school-aged children with a valid Medicare or Australian visa number) from the 2019 financial year with population census data from South Australia. Chi-square was used to examine whether the percentage of eligible children who claimed a voucher differed based on age, sex, socioeconomic status (SES), and geographical remoteness. Subgroup analyses were conducted for the lowest 2 socioeconomic disadvantage deciles, split by gender. Scatterplots were used to compare sports between high and low SES children. Results: A total of 74,668 children claimed sports vouchers (45.5% of eligible children). Children who were relatively younger, female, from low socioeconomic backgrounds, and from major cities were least likely to claim the voucher. The 5 most common sports were Australian rules football (30.2%), netball (13.6%), soccer (13.1%), gymnastics (10.4%), and basketball (5.7%), with the popular sports similar for high and low SES children. Conclusions: Future work is needed to understand how Sports Voucher, and sport participation rates have changed over time, and to improve voucher uptake among girls, city dwellers, and low SES children. [ABSTRACT FROM AUTHOR]

Purpose: This paper aimed to examine moderate-to-vigorous physical activity (MVPA) levels in physical education. Method: A review of reviews was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The screening process, data extraction, assessment of the risk of bias, and analysis of the results were carried out independently by two reviewers. A total of eight systematic reviews from six databases, which included 224 studies, involving more than 80,000 students (elementary, middle, and high school), enrolled in more than 450 schools worldwide were unpacked. Results: Students fail to meet the 50% recommendation of MVPA lesson time, irrespective of country, school stage, gender, or MVPA measures. Physical education-based interventions increased students' MVPA during lessons (range 14.3%–24%) compared with control groups. Conclusion: Physical education is uniquely positioned to provide physical activity opportunities for students, but teachers must target the provision of adequate MVPA levels, which is not currently happening. [ABSTRACT FROM AUTHOR]

The article emphasizes that in order to improve the protection of children's rights during military conflicts and combat domestic violence, to identify facts of domestic violence against children, to improve and unify the forms of collecting, analyzing, summarizing and taking into account statistical data on cases of all forms of violence based on gender and domestic violence and the effectiveness of measures taken in these cases. Domestic violence is one such phenomenon that only worsens in the period of military aggression, while it can remain invisible or have an inadequate level of response from society due to many reasons. The problem of domestic violence is not new. This is especially true for children and teenagers. However, just as before the war, so now, children who are witnesses of domestic violence are not always recognized as victims. They are recognized as victims only if physical violence was directly directed against the child. Which, after all, a child who has witnessed domestic violence is obviously wrong, because the child who has witnessed domestic violence has at least already been harmed, in particular to his mental health. Different statistical forms in the subjects of prevention and counteraction to domestic violence, as well as their failure to take into account the features of today's global challenges, make it impossible to qualitatively analyze data on the effectiveness of the system of prevention and counteraction to domestic violence / gender-based violence and lead to a lack of comprehensive scientific research on the impact of the pandemic and war on the situation of domestic violence / gender-based violence. At the same time, it is important to take into account in statistical forms vulnerable categories of affected persons, such as women, children, persons with disabilities, for the purpose of further analysis of such information and formation of effective assistance programs for such categories of persons based on the received data. [ABSTRACT FROM AUTHOR]

The article analyzes the norms of family legislation of Ukraine regarding the determination of the child’s place of residence in case of divorce. The purpose of the research is to study the process of decision-making by guardianship and guardianship bodies, to evaluate the effectiveness of their activities, which will contribute to ensuring the best interests of the child and equal rights of parents. Particular attention is paid to determining the role of guardianship and care authorities in this process. It has been established that their participation is possible in two forms: 1) resolution by the body of guardianship and custody of the dispute on the determination of the child’s place of residence; 2) provision of a written opinion of the body of guardianship and guardianship during the consideration of cases by the court on the determination of the child’s place of residence. It has been proven that the role of guardianship and guardianship authorities in determining the place of residence of a child is significant, as they are involved in the event of a lack of consensus between parents regarding the residence of a minor child. The process of decision-making by guardianship and guardianship bodies is characterized. The main stages in solving the issue of determining the child’s place of residence with the participation of the guardianship and guardianship authorities are highlighted: 1. Appeal to the parents’ guardianship and guardianship authorities. 2. Conducting by guardianship and care authorities a conversation with the parents and drawing up a certificate of examination of the child’s living conditions. 3. Decision-making by guardianship and guardianship bodies is based on the analysis of conditions and consideration of the child’s opinion and is formed in the form of a conclusion. Important evaluation criteria are the parents’ attitude towards the fulfillment of parental duties, the child’s personal attachment to each parent, the child’s health and other circumstances of significant importance. The main principles that guardianship and guardianship authorities should be guided by when determining a child’s place of residence are analyzed, such as ensuring the best interests of the child and equal rights of parents. Special attention is paid to problematic aspects that arise during decision-making by guardianship and guardianship bodies, which include the establishment of the child’s true psycho-emotional state by a psychologist, ensuring the child’s appearance in court or the guardianship body and custody at a permanent pre-war place of residence. [ABSTRACT FROM AUTHOR]

This systematic review aims to report on the use of Statement Validity Analysis (SVA) with minors involved in criminal justice proceedings. We conducted a literature search of six bibliographic databases up to March 2024. Additional searches were performed using citation tracing strategies. Nineteen studies published between 1991 and 2023 were retained. Most were published between 1991 and 2000, mainly in the USA. A scientific gap was observed for 10 years before studies resumed between 2011 and 2022. These 19 studies involved 2931 children; most were girls (n = 2080; 71%). The mean age was 9.4 years (SD = 2.40; min = 2; max = 17.5). Most studies did not mention the nature of the relationship between the child and the alleged perpetrator of sexual violence, three studies involved intra‐family violence and six studies involved victims of intra‐ and extra‐family violence. Nearly 75% of the interviewers were trained with SVA methods. Most were mental health professionals (52.6%) or police officers (15.8%). No study used the SVA as a whole, 10 studies used 19 criteria of the Criteria‐Based Content Analysis (CBCA), and no study used the Validity Check List (VCL). Most studies performed SVA on interview transcripts (n = 8), and two studies performed their analysis on both verbatims and video. The conclusion of our literature review highlights the methodological weaknesses of these studies and encourages more research about the use of SVA in the judicial field to reduce the risk of misleading the judiciary. [ABSTRACT FROM AUTHOR]

Background: Earthquakes are potentially traumatic natural disasters due to their destructive nature, and huge impacts, producing scenes of horror, undesirable and uncontrollable results. Children are affected mainly by earthquakes not only physically but also psychologically. We aimed to evaluate the rates of probable PTSD and related factors in children and adolescents after the February 6 Kahramanmaras earthquake. Methods: In this cross-sectional study, 246 children and adolescents were included. The research was conducted in Hatay, one of the most affected provinces, between 06/07/2023-06/08/2023. Sociodemographic form, Children's Depression Inventory, Children's Posttraumatic Response Reaction Index, Screen for Child Anxiety Related Emotional Disorders, Child and Youth Resilience Measure and Social Support Appraisals Scale for Children were applied by face-to-face survey method. Results: The median age of the participants was 12 (8-18). 133 (54%) of the participants were girls. Probable depression rate was 98%, and probable anxiety disorder rate was 63%. Probable mild, moderate, severe and very severe PTSD rates were 18%, 29%, 43% and 8%, respectively. The probable severe PTSD rate was higher in children who were injured in the earthquake (p = 0.032), who received outpatient treatment (p = 0.016), and who saw people trapped under the collapse (p = 0.012). Also, the children whose sleep routines have changed post-earthquake were found to have more probable severe PTSD (p < 0.001). Access time to the potable water supply (p = 0.045), toilet facilities (p = 0.045), shelter facilities (p = 0.004), heating facilities (p = 0.001), clothing supply (p < 0.001) and healthcare services (p = 0.009) were found to be associated with probable severe PTSD right after the earthquake. In the fifth month of the earthquake, inadequate meeting of clothing needs (p = 0.018), educational services (p = 0.028) and social activity opportunities (p < 0.001) were significantly associated with probable severe PTSD. In the multivariate analysis, the risk of probable severe PTSD was increased 2.9 times in those with post-earthquake sleep changes (p = 0.001) and 11.1 times in those with probable anxiety disorders (p < 0.001). Also, it has been shown that each unit increase in the APP-family score reduces probable severe PTSD risk by 2% (p = 0.002). Conclusion: In the current study, the rates of probable PTSD, depression and anxiety disorders were considerably high. Probable anxiety disorder and sleep disturbance were significant predictors of probable severe PTSD. On the other hand, social support from family was found to be a significant protective factor for severe PTSD risk. We conclude that the lack of meeting needs that increase the risk of probable severe PTSD differs in the acute and subacute phases. [ABSTRACT FROM AUTHOR]

Background Darunavir is a potent HIV protease inhibitor with a high barrier to resistance. We conducted a nested pharmacokinetic sub-study within CHAPAS-4 to evaluate darunavir exposure in African children with HIV, taking once-daily darunavir/ritonavir for second-line treatment. Methods We used data from the CHAPAS-4 pharmacokinetic sub-study treating children with once-daily darunavir/ritonavir (600/100 mg if 14–24.9 kg and 800/100 mg if ≥25 kg) with either tenofovir alafenamide fumarate (TAF)/emtricitabine (FTC), abacavir/lamivudine or zidovudine/lamivudine. Steady-state pharmacokinetic sampling was done at 0, 1, 2, 4, 6, 8, 12 and 24 hours after observed darunavir/ritonavir intake. Non-compartmental and population pharmacokinetic analyses were used to describe the data and identify significant covariates. Reference adult pharmacokinetic data were used for comparison. We simulated the World Health Organization (WHO) recommended 600/100 mg darunavir/ritonavir dose for the 25–34.9 kg weight band. Results Data from 59 children with median age and weight 10.9 (range 3.8–14.7) years and 26.0 (14.5–47.0) kg, respectively, were available. A two-compartment disposition model with transit absorption compartments and weight-based allometric scaling of clearance and volume best described darunavir data. Our population achieved geometric mean (%CV) darunavir AUC0–24h, 94.3(50) mg·h/L and C max, 9.1(35) mg/L, above adult reference values and C trough, 1.5(111) mg/L, like adult values. The nucleoside reverse-transcriptase inhibitor backbone was not found to affect darunavir concentrations. Simulated WHO-recommended darunavir/ritonavir doses showed exposures equivalent to adults. Higher alpha-1-acid glycoprotein increased binding to darunavir and decreased apparent clearance of darunavir. Conclusions Darunavir exposures achieved in our trial are within safe range. Darunavir/ritonavir can safely be co-administered with TAF/FTC. Both WHO-recommended 600/100 mg and CHAPAS-4 800/100 mg darunavir/ritonavir doses for the 25–34.9 kg weight band offer favourable exposures. The choice between them can depend on tablet availability. [ABSTRACT FROM AUTHOR]

Background Drug-resistant tuberculosis (DR-TB) is one of the challenging forms of TB to treat, not only in adults but also in children and adolescents. Further, there is a void in the treatment strategy exclusively for children due to various reasons, including paucity of pharmacokinetic (PK) data on anti-TB drugs across the globe. In this context, the present study aimed at assessing the PK of some of the anti-TB drugs used in DR-TB treatment regimens. Method A multicentre observational study was conducted among DR-TB children and adolescents (n  = 200) aged 1–18 years (median: 12 years; IQR: 9–14) treated under programmatic settings in India. Steady-state PK (intensive: n  = 89; and sparse: n  = 111) evaluation of moxifloxacin, levofloxacin, cycloserine, ethionamide, rifampicin, isoniazid and pyrazinamide was carried out by measuring plasma levels using HPLC methods. Results In the study population, the frequency of achieving peak plasma concentrations ranged between 13% (for rifampicin) to 82% (for pyrazinamide), whereas the frequency of suboptimal peak concentration for pyrazinamide, cycloserine, moxifloxacin, levofloxacin and rifampicin was 15%, 19%, 29%, 41% and 74%, respectively. Further, the frequency of supratherapeutic levels among patients varied between 3% for pyrazinamide and 60% for isoniazid. In the below-12 years age category, the median plasma maximum concentration and 12 h exposure of moxifloxacin were significantly lower than that of the above-12 years category despite similar weight-adjusted dosing. Conclusions Age significantly impacted the plasma concentration and exposure of moxifloxacin. The observed frequencies of suboptimal and supratherapeutic concentrations underscore the necessity for dose optimization and therapeutic drug monitoring in children and adolescents undergoing DR-TB treatment. [ABSTRACT FROM AUTHOR]

Introduction: This work aimed to establish the largest UK and Ireland consensus on myopia management in children and young people (CYP). Methods: A modified Delphi consensus was conducted with a panel of 34 optometrists and ophthalmologists with expertise in myopia management. Results: Two rounds of voting took place and 131 statements were agreed, including that interventions should be discussed with parents/carers of all CYP who develop myopia before the age of 13 years, a recommendation for interventions to be publicly funded for those at risk of fast progression and high myopia, that intervention selection should take into account the CYP's hobbies and lifestyle and that additional training for eye care professionals should be available from non‐commercial sources. Topics for which published evidence is limited or lacking were areas of weaker or no consensus. Modern myopia management contact and spectacles are suitable first‐line treatments. The role and provision of low‐concentration atropine needs to be reviewed once marketing authorisations and funding decisions are in place. There is some evidence that a combination of low‐concentration atropine with an optical intervention can have an additive effect; further research is needed. Once an intervention is started, best practice is to monitor non‐cycloplegic axial length 6 monthly. Conclusion: Research is needed to identify those at risk of progression, the long‐term effectiveness of individual and combined interventions, and when to discontinue treatment when myopia has stabilised. As further evidence continues to emerge, this consensus work will be repeated to ensure it remains relevant. [ABSTRACT FROM AUTHOR]

Purpose: An observational study of children with severe traumatic brain injury (TBI) (Approaches and Decisions in Acute Pediatric TBI [ADAPT] Trial) demonstrated the benefits of inpatient rehabilitation on functional outcomes for those with more severely impaired consciousness when medically stable. We conducted a secondary analysis to assess whether using an inpatient rehabilitation or skilled nursing facility after acute hospitalization was associated with better motor, neuropsychological, and behavioral outcomes compared to receiving only non-inpatient rehabilitation among children with severe TBI. Materials and methods: We included 180 children who used an inpatient rehabilitation or skilled nursing facility and 74 children who only received non-inpatient rehabilitation from the ADAPT trial. At 12 months post-injury, children underwent tests of motor skills, intellectual functioning, verbal learning, memory, processing speed, and cognitive flexibility. Parents/guardians rated children's executive function and behaviors. We performed inverse probability weighting to adjust for potential confounders. Results: No significant differences were found in any motor, neuropsychological, or behavioral measures between children receiving inpatient rehabilitation and children receiving only non-inpatient rehabilitation. Conclusions: Analyses of comprehensive outcomes did not show differences between children receiving inpatient rehabilitation and children receiving only non-inpatient rehabilitation, suggesting a need for more research on specific components of the rehabilitation process. IMPLICATIONS FOR REHABILITATION: Our study showed no differences in motor, neuropsychological, or behavioral outcomes at 12 months after severe traumatic brain injury (TBI) between children using an inpatient rehabilitation or skilled nursing facility and children receiving only non-inpatient rehabilitation after acute hospitalization. Children surviving severe TBI should be evaluated for the need of inpatient and outpatient rehabilitation therapies at discharge from an acute care hospital. Children with rehabilitation requirements after severe TBI should be followed up periodically to ensure the continuity of care and reduce the gaps to the needed rehabilitation therapies. [ABSTRACT FROM AUTHOR]

Background: Oral sensory hypersensitivity has been linked with fussy eating predominantly in non-typically developing children. We hypothesized that child 'Oral' (touch, smell and taste in the mouth) and 'Social-Emotional' (response to social expectations) sensory processing are associated with child appetitive traits in typically developing preteen children. Additionally, we explored relationships between maternal sensory profiles and their offspring's sensory profile. Methods: This is secondary analysis of 130 mother-child dyads from the 9–11-year-old follow-up of the ROLO longitudinal birth cohort study. The Dunn Sensory Profile (Adolescent/Adult) and the Dunn Child Sensory Profile 2 were used to assess maternal and child sensory profiles, respectively. The Children's Eating Behaviour Questionnaire was used to assess child appetitive traits. Multiple linear regression examined associations between 'Oral' and 'Social-Emotional' segments of the child sensory profile and child appetitive traits. Associations between maternal and child sensory profiles were examined using sensory profile quadrants (Dunn's sensory processing framework). These refer to four distinct patterns of sensory processing that indicate how an individual responds to sensory input. Results: In total, 130 mother-child dyads were included. In adjusted analysis child 'Oral' sensory processing was associated with higher mean scores in the appetitive traits 'Desire to Drink' (B = 0.044, 95% CI = 0.025,0.062) and 'Food Fussiness' (B = 0.080, 95% CI = 0.059,0.101) and with lower mean scores in 'Enjoyment of Food' (B=-0.038, 95% CI -0.055,-0.022). Child 'Social-Emotional' responses were associated with higher mean scores in 'Desire to Drink' and 'Food Fussiness'. Higher scores in the maternal sensory profile quadrants of 'Sensitivity', 'Avoiding' and 'Registration' were positively associated with higher scores in the corresponding child sensory profile quadrants. Conclusion: Our findings suggest that in typically developing children presenting with fussy eating, oral sensory hypersensitivity and higher scores in social-emotional responses to sensory processing may be an underlying determinant. The relationship observed between 'Oral' and 'Social-Emotional' sensory processing segments and 'Desire to Drink' requires further research to ascertain the type of drinks being consumed and how this impacts appetite. Further research is also required to explore the influence of maternal sensory profile on their offsprings response to sensory input. [ABSTRACT FROM AUTHOR]

Objective: To describe the experience of implementing social robotics as an adjuvant during the hospitalization process in pediatric oncology patients. Methods: Before and after cohort study, applying an intervention with the Lego Mindstorms EV3 kit in patients between 8 and 17 years old that are hospitalized with a cancer diagnosis. We excluded patients from the intensive care unit or when their treating physician recommended so. The intervention consisted of a three-phase workshop: an open architecture story, building a car robot using the Lego Mindstorm EV3 kit, and cooperative playing activities such as races and passing obstacles. Results: Thirteen patients received the intervention with robotic lego. The median age was 15 years (IQR = 3), and 84.6% of the population (n = 11) were male. We found significant improvement in the language (topic management p =.011 and communicative intention p =.034). Other characteristics improved, but not significantly (self-care activities index, catching). No adverse events occurred during the intervention. Conclusions: The results of this pilot study suggest that implementing social robotics during hospitalization in children with cancer is a therapeutic adjuvant and safe intervention that promotes better communication, self-care, and a physical activity improvement. For future studies, the impact of this intervention could be measured in hospitalized pediatric cancer patients. [ABSTRACT FROM AUTHOR]

There is emerging evidence of the detrimental impact of the pandemic and associated restrictions on young people's mental health in the UK, but to date, these data have been largely quantitative. The aim of the current study was to gain a deeper understanding of young people's experiences in relation to their mental health and wellbeing during the pandemic. Seventeen young people, aged 11 to 16 years, sampled for diverse characteristics, and living in the UK, were interviewed virtually between December 2020 and February 2021. Reflexive thematic analysis was carried out by the research team, which included two young people, and five themes were developed: (1) positives; (2) worries and anxiety; (3) sadness and anger about losses; (4) mental exhaustion; and (5) support from others. Aspects of young people's individual circumstances (e.g., pre-existing mental health difficulties, special educational needs, and neurodevelopmental disorders) appeared to play a role in their experiences. Continued measurement of young people's mental health, initiatives to identify young people who have been struggling, and the provision of support (including evidence-based and accessible interventions) will be important for protecting young people from future adversities as we emerge from the pandemic. [ABSTRACT FROM AUTHOR]

Aim: To examine the long‐term results and treatment effectiveness of liver transplantation (LT) in the treatment of homozygous familial hypercholesterolemia (HoFH) in children and adolescents. Method: Patients who underwent LT due to HoFH between 2007 and 2023 were included in the study. The patients' demographic data, clinical findings, preoperative and postoperative laboratory examinations, transplantation complications, and postoperative disease courses were evaluated. Results: There were five boys with an average age of 6.2 (median: 6, range 4–10) years in the study. The average total cholesterol level of the patients before transplantation was 923 (median: 950, range: 780–1002) mg/dL and the average LDL‐cholesterol level was 864 (median: 852, range: 770–957) mg/dL. No patients died of transplant‐related complications. After an average follow‐up of 9.2 (median: 9, range: 1.5–16) years, the average total cholesterol level of the patients was 197 (median: 164, range: 137–359) mg/dL, and the average LDL‐cholesterol level was 138 (median: 92, range: 85–313) mg/dL. Four (80%) patients developed atherosclerotic cardiovascular disease during follow‐up, and two (40%) died of this cause. Conclusion: LT in the treatment of HoFH did not help our patients reach the target LDL‐cholesterol level after transplantation and did not prevent the development of cardiovascular disease. Therefore, LT alone is not curative in the treatment of HoFH. [ABSTRACT FROM AUTHOR]

Background: The survival of pediatric chronic kidney disease (CKD) patients has improved in recent decades due to advances in dialysis and transplantation. However, cardiovascular disease (CVD) emerges as the main cause of mortality in patients with CKD. Objectives: To estimate cardiovascular risk in children with CKD at least 1 year after kidney transplantation. In addition, the possible association of cardiovascular risk with classic biochemical markers and potential new markers of this outcome was investigated. Methods: An observational ambidirectional (retrospective capture of risk factors and prospective study of outcomes) research including 75 patients who underwent renal transplant between 2003 and 2013 with postoperative follow‐up of at least 1 year was conducted. The outcome variables adopted were the LV mass Z‐score and the presence of coronary calcification on computed tomography using calcium Agatston score. Result: Only one patient had an elevated calcium score, and three children (4%) had an LV mass Z‐score ≥ 2.0. After multivariable analysis, only gender, serum triglyceride, and serum renalase concentration remained significantly associated with LV mass. Conclusion: The low incidence of cardiovascular changes in the population studied confirms the benefit of transplantation for the cardiovascular health of children. Nevertheless, long‐term follow‐up of these patients is recommended, given the limited duration of kidney function provided by transplantation and the high likelihood of further dialysis and kidney transplants being required in these children. [ABSTRACT FROM AUTHOR]

Extracorporeal membrane oxygenation (ECMO) support of critically ill pediatric patients is associated with increased risk of thromboembolic events, and unfractionated heparin is used commonly for anticoagulation. Given reports of acquired antithrombin (AT) deficiency in this patient population and associated concern for heparin resistance, AT activity measurement and off‐label AT replacement have become common in pediatric ECMO centers despite limited optimal dosing regimens. We conducted a retrospective cohort study of pediatric ECMO patients (0 to <18 years) at a single academic center to characterize the pharmacokinetics (PK) of human plasma‐derived AT. We demonstrated that a two‐compartment turnover model appropriately described the PK of AT, and the parameter estimates for clearance, central volume, intercompartmental clearance, peripheral volume, and basal AT input under non‐ECMO conditions were 0.338 dL/h/70 kg, 38.5 dL/70 kg, 1.16 dL/h/70 kg, 40.0 dL/70 kg, and 30.4 units/h/70 kg, respectively. Also, ECMO could reduce bioavailable AT by 50% resulting in 2‐fold increase of clearance and volume of distribution. To prevent AT activity from falling below predetermined thresholds of 50% activity in neonates and 80% activity in older infants and children, we proposed potential replacement regimens for each age group, accompanied by therapeutic drug monitoring. [ABSTRACT FROM AUTHOR]

Background: Paediatric acute kidney injury (AKI) is associated with significant adverse outcomes such as increased mortality, progression to chronic kidney disease and longer length of stay in hospital. Postoperative AKI is a common and recognized complication after surgery in adults. In the paediatric population, AKI postoperatively to cardiac surgery has been extensively studied. However, the incidence of postoperative AKI after non‐cardiac surgery is less clear. Therefore, we aim to assess the available literature on this topic. Methods: We will conduct a systematic review of observational and randomized controlled trials assessing the incidence of paediatric postoperative AKI after non‐cardiac surgery. Pairs of reviewers will independently screen the literature and extract data and assess risk of bias from eligible studies. The databases Pubmed, Cochrane and Web of Sciences will be searched. We will conduct the review in accordance with the Preferred Reporting Items for Systematic Review and Meta‐Analysis (PRISMA) guidelines and the Grading of Recommendation, Assessment, Development and Evaluation (GRADE) approach. If sufficient homogeneity within the included trials we will conduct meta‐analyses. Discussion: This systematic review aims to investigate the incidence of postoperative AKI in the paediatric non‐cardiac surgery population. The results of this review will provide a foundation for future research in the field of paediatric postoperative AKI. [ABSTRACT FROM AUTHOR]

Objective This study experimentally evaluated how well lay individuals could interpret and use 4 types of electronic health record (EHR) patient-facing immunization visualizations. Materials and Methods Participants (n  = 69) completed the study using a secure online survey platform. Participants viewed the same immunization information in 1 of 4 EHR-based immunization visualizations: 2 different patient portals (Epic MyChart and eClinicWorks), a downloadable EHR record, and a clinic-generated electronic letter (eLetter). Participants completed a common task, created a standard vaccine schedule form, and answered questions about their perceived workload, subjective numeracy and health literacy, demographic variables, and familiarity with the task. Results The design of the immunization visualization significantly affected both task performance measures (time taken to complete the task and number of correct dates). In particular, those using Epic MyChart took significantly longer to complete the task than those using eLetter or eClinicWorks. Those using Epic MyChart entered fewer correct dates than those using the eLetter or eClinicWorks. There were no systematic statistically significant differences in task performance measures based on the numeracy, health literacy, demographic, and experience-related questions we asked. Discussion The 4 immunization visualizations had unique design elements that likely contributed to these performance differences. Conclusion Based on our findings, we provide practical guidance for the design of immunization visualizations, and future studies. Future research should focus on understanding the contexts of use and design elements that make tables an effective type of health data visualization. [ABSTRACT FROM AUTHOR]

Background: Because of controversial results from clinical studies comparing different dental local anesthesia methods in children, the primary objective of this randomized, split‐mouth, crossover, controlled trial was to compare pain intensity during local anaesthesia (LA) performed with a computer‐controlled LA delivery system (C‐CLADS) versus a conventional syringe (CONV). Secondary objectives included comparisons during dental treatment. Methods: Participants (4–8 years) with tooth pair requiring similar treatment were recruited from five French hospitals. The right primary molar, which was treated at the first visit, was randomly allocated to one of the anaesthesia groups (either intraosseous with C‐CLADS or infiltration with CONV), whereas the contralateral molar (treated at the second visit) was assigned to the other group. Pain intensity and behaviour outcomes, assessed with the Faces Pain and Venham revised scales, respectively, were compared between groups using Proc mixed. Stratified analyses were performed on dentition and location. Results: Among 107 participants, the analysis revealed reduced pain perception during LA in the C‐CLADS group compared with the CONV group (−0.72, 95% CI: −1.43, −0.006), but not during dental treatment. Stratified analyses showed that this effect was observed only in primary dentition (p =.006) and mandibular molars (p =.005). Behavioural issues were fewer in the C‐CLADS group than in the CONV group (p =.05) only during injection. Conclusion: C‐CLADS emerged as the preferable system in primary dentition. [ABSTRACT FROM AUTHOR]

This systematic review evaluated accuracy of ureteric jet angles on color Doppler sonography in diagnosing vesico‐ureteric reflux (VUR) in children, using voiding cystourethrogram as the reference standard. Six databases were searched, yielding 13 eligible studies of an initial 429, 7 with comparable data. Risk of bias and applicability were assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS‐2) tool. Most studies demonstrated a correlation between increasing jet angle and VUR severity, but reporting and techniques varied, preventing meta‐analysis. Ureteric jet angle sonography may have potential as a VUR triaging tool. Further investigations with rigorous methodology are required. Funding support was obtained from Queensland University of Technology. PROSPERO Registration CRD42020159799. [ABSTRACT FROM AUTHOR]

Aim: To explore how overcrowding affects children's health, environment and schooling. Methods: A qualitative study was conducted with individual interviews among 20 participants with occupational experience from overcrowded Stockholm areas but diverse in professions, locations and employers. The interviews were recorded, transcribed and analysed with Systematic Text Condensation. Results: Almost all participants expressed that overcrowding has a negative impact on children's health, environment and schooling – based on perceptions of precarious and different living conditions for children in overcrowded areas, for example, substandard homes, vulnerability, stress, exclusion, limited resources, lack of learning opportunities, gender differences, confinement, shame, insecurity, conflicts, risk of criminality, and bodily impact, both physical and psychological. Conclusions: Our qualitative evidence suggest that overcrowding has a negative impact on children's health, environment and schooling. [ABSTRACT FROM AUTHOR]

The aim of this study is to evaluate the feasibility and acceptability of a newly developed online psychoeducation intervention on childhood anxiety for school staff using a within groups pre‐post design. The intervention is informed by cognitive behavioural therapy principles. Seventy six participants volunteered to attend a brief online training, and complete two brief questionnaires pre and post the training. Following the intervention, school staff reported that they were significantly less likely to respond to children's anxious behaviours with anxiety‐promoting responses (i.e., sanctions, avoidance reinforcement and overprotection), and were more likely to respond with autonomy‐promoting responses in line with cognitive behavioural theory (i.e., problem‐solving, reward and encouragement). On average, participants found the intervention engaging, useful, suitable, appropriate and easy‐to‐access. Participants also reported that they felt more confident in understanding childhood anxiety and implementing anxiety strategies in their work following the intervention. Areas of development were noted regarding the drop‐out rates of the online intervention. Overall, the novel, online intervention appears to be a feasible and acceptable method for those who participated. In addition, the preliminary outcomes show promise and warrant further investigation. Limitations of the study are discussed with suggestions for future research and areas for improvement. Practitioner points: School staff reported that they were significantly more likely to respond with actions in line with Cognitive‐Behavioural Theory following the psychoeducation training.School staff felt more confident in understanding childhood anxiety and implementing anxiety strategies in their work following the psychoeducation training.The novel, online psychoeducation training appears to be a feasible and acceptable method for those who participated. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to interpret plasma renin concentrations (PRCs) correctly in a clinical setting, it is essential to understand to what extent physical activity influences the concentration. Reference values for different postural positions exist for adults, but data for children are sparse. In this study, the effect of 30 min of rest on plasma renin concentrations in paediatric patients was examined. Methods: In total, 41 paediatric patients, undergoing either arginine or clonidine provocation tests for growth hormone deficiency, were included. For each stimulation test, two blood samples were drawn. One at time 0 min and one after 30 min of rest. In total, renin concentrations were determined in 86 serum samples. Results: Renin concentrations decreased from 0 to 30 min with a median value of −20.5% (inter‐quartile range: −33.0% to −12.8%). This decrease was not dependent on sex, age, medication or comorbidity, and the variance of renin did not differ between 0 and 30 min. Conclusion: Renin concentrations in children differ according to postural position, which is comparable to adults. Thus, the clinical interpretation of renin results needs to consider the preanalytical conditions applied in the local reference population. [ABSTRACT FROM AUTHOR]

Objective: To compare efficacy of proximal and distal laparoscopic ureteroureterostomy (UU) for complete duplex kidneys in children. Methods: Patients who underwent laparoscopic UU for complete duplex kidneys between December 2016 and July 2022 were reviewed retrospectively. 71 patients who had normal lower pole moiety without vesicoureteral reflux (VUR) were recruited. All of them underwent ultrasound, voiding cystourethrography (VCUG), renal scintigraphy, and magnetic resonance urography preoperatively. Proximal laparoscopic UU was performed in 35 patients and distal laparoscopic UU in 36 patients. Double J stents were placed in normal lower pole moieties. Clinical data, including general information, diagnosis, surgical management, imaging characteristics, clinical symptoms and postoperative complications (classified according to the modified Clavien–Dindo classification), and length of stay were recorded. Measurement date comparisons between groups were performed by t test, counting date were analyzed by chi-square test. Results: The study consisted of 71 patients (56 females and 15 males) with complete duplex kidneys (41 in left kidney and 30 in right kidney). The patients' mean age was 34 m (range 3–161 m) and follow-up ranged from 25 to 81 m. No significant difference was found in age and follow-up time between the two groups. Laparoscopic UU was performed in all patients successfully. The operation time of the two groups was 108.42 ± 26.95 min for distal UU vs 121.46 ± 35.15 min for proximal UU(p = 0.14). No significant difference in postoperative complications was seen between the two groups (22.2% vs 31.4%, p = 0.345). However, in terms of the grading of postoperative complications, the proximal UU group had a higher grade (3 of them had a grade of IV) and more serious complications. Conclusions: There was no significant difference in the overall incidence of complications between distal and proximal UU. Compared with proximal laparoscopic UU, distal laparoscopic UU is easier to perform with less injury to the peripheral tissues. Postoperative complications of proximal UU are more serious and more difficult to manage. We recommend complete duplex kidney ureteral reconstruction with distal UU. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the perceptions of parents/caregivers about the impact of oral conditions on the oral health-related quality of life (OHRQoL) of children/adolescents with autism spectrum disorder (ASD) compared to the perceptions of parents/caregivers of children/adolescents without ASD. Methods: A comparative cross-sectional study was conducted involving 80 children/adolescents with ASD three to 16 years of age matched by sex and age with 80 children/adolescents without ASD and their parents/caregivers. Clinical examinations were performed for the diagnosis of dental caries experience (DMFT/dmft), clinical consequences of untreated dental caries (PUFA/pufa), visible plaque (VPI), bleeding on probing (BPI), malocclusion and traumatic dental injury (TDI). Parents/caregivers answered a questionnaire addressing sociodemographic characteristics and the Brazilian version of the Parental-Caregiver Perceptions Questionnaire (P-CPQ), which measures OHRQoL from the perspective of parents/caregivers. Data analysis involved the Wilcoxon test, chi-squared test and Poisson regression. Results: Dental caries experience impacted OHRQoL in the group with ASD regarding the total P-CPQ score (p < 0.001) as well as the "oral symptoms" (p = 0.011) and "wellbeing" (p < 0.011) domains. No differences were found between the perceptions of parents/caregivers of children/adolescents with ASD and perceptions of parents/caregivers of children/adolescents without ASD (p = 0.721). Conclusion: Dental caries experience can have a negative impact on the OHRQoL of children/adolescents with ASD. [ABSTRACT FROM AUTHOR]

Objectives: To survey, analyze and discuss the scientific evidence supporting the use of acupuncture and related techniques in the management of chronic pain in the pediatric population. Sources: A survey of databases (MEDLINE, Scopus and Scielo) was carried out with search strategies, following the PRISMA statement, without limits on publication dates and languages. Clinical studies (clinical trials, single-arm, and case series) were accepted for review if they included participants aged up to 22 years. Study quality was assessed by MMAT, and the randomized clinical trial was analyzed under the STRICTA criteria. Summary of the findings: 2369 articles were retrieved. After excluding repetitions, 1335 underwent the initial selection. Only 16 articles were selected for full reading, of which 5 were included in the review, being two case series, two single-arm studies, and one randomized clinical trial. The articles were considered of good quality by the adopted criteria. Conclusion: The analyzed studies showed important clinical results such as the reduction of pain intensity, and improvement in school attendance and social life. However, there are many limitations in study design and sample size. Therefore, there is weak evidence to support the use of acupuncture in the context of pediatric chronic pain, but the positive results reinforce the need for further investigation of the topic with the conduct of larger and well-designed studies, to obtain more data and greater scientific conviction of the findings. [ABSTRACT FROM AUTHOR]

During Ukraine's independence, the state has consistently taken measures to shape, implement, and strengthen policies in the field of protecting the rights and freedoms of children. The article provides a criminal-law characterization of domestic violence against children. Emphasizing that human life and health, honor and dignity, inviolability and safety are recognized in Ukraine as the highest social value (part 1 of Article 3 of the Constitution of Ukraine), and the rights and freedoms of individuals and their guarantees determine the content and direction of the state's activity, and the assertion and protection of the rights and freedoms of individuals are the main duty of the state (part 2 of Article 3 of the Constitution of Ukraine), it can be confidently stated that the object of domestic violence is an absolute value, and encroachments on it have a socially dangerous nature. Ukrainian criminal legislation protects social relations involving children or in their interests, with the aim of providing criminal-law means to create conditions for the normal physical, mental, and moral-spiritual development of the child. The unlawfulness of parents' actions is mostly associated with their child-rearing and stems from contradictions between the upbringing process in the actions of parents and permissible actions in legal norms. The nature of the family upbringing process requires formulating the issue of using physical force against the will of the child not as permissible but as a necessary measure. It is emphasized that physical punishments are recognized as violence based on the presence of signs of actions against the will of the child and those that degrade dignity based on causing harm to the feeling of one's own dignity. The resolution of the issue of applying force to a child as a method of upbringing is based on recognizing the child as an absolutely autonomous subject, which contradicts the existing partial legal capacity and parental responsibility. [ABSTRACT FROM AUTHOR]

Earlier reviews to discover research on interventions for children after neglect have concluded little was available, despite the well-documented prevalence and harmful effects of neglect on children. We revisited this question through a systematic literature review to discover the state of research on interventions for children who have experienced neglect. We searched MEDLINE, PsycINFO, ERIC, Sociological Abstracts and EMBASE for studies published between 2003 and 2021. Studies were included if neglect could be distinguished, and child outcomes reported. Eight reports describing six studies about six interventions were identified. These studies differed in interventions, age-groups, definitions of neglect, and outcomes. Four studies reported positive child outcomes though with varying degree of quality. More research is needed to inform a coherent theory of change following neglect. There remains an urgent need for research on interventions to help children recover from neglect. [ABSTRACT FROM AUTHOR]

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: This study explored the extent to which an interactive computer play system, Bootle Blast, supports motor learning in a clinical context and examined clinicians' perceptions of their therapeutic role in the system's use as an intervention tool. Methods: In this observational sequential explanatory mixed methods study, five children with cerebral palsy [mean age 9.4 years (SD, 0.5), Gross Motor Function Classification System Levels I-III] used Bootle Blast during a single videorecorded therapy session with their treating clinicians (physical therapists, occupational therapists, and therapy assistants). Children played one Bootle Blast mini game independently (without clinician involvement) before clinicians carried out therapy sessions with the game as per usual care. The type and extent of motor learning strategies (MLS) delivered by Bootle Blast and clinicians were rated from video recordings by a trained assessor using the 22-item Motor Learning Strategies Rating Instrument. Semi-structured interviews with clinicians were conducted to gain insights into MLS use and clinicians' perceived role during Bootle Blast use. Interviews were audio recorded, transcribed verbatim, and analyzed independently by two researchers using thematic analysis. Quantitative and qualitative data were merged and reported using narrative and joint display approaches. Results: Bootle Blast provided eight MLS, with clinicians adding or enhancing another eight. Four themes reflected clinicians' perspectives: (1) Bootle Blast disguises therapy as play, (2) clinicians give Bootle Blast the human touch; (3) home use of Bootle Blast is promising; and (4) Bootle Blast is not always the right fit but some shortcomings could be addressed. Agreement was found for nine MLS and disagreement for four MLS when quantitative and qualitative findings were merged. Discussion: Bootle Blast delivers several MLS as part of game play and clinicians can enhance and provide additional MLS to suit the child's needs/abilities. Further game refinements that were identified in this study may optimize its clinical use. [ABSTRACT FROM AUTHOR]

Background: Oral sensory hypersensitivity has been linked with fussy eating predominantly in non-typically developing children. We hypothesized that child 'Oral' (touch, smell and taste in the mouth) and 'Social-Emotional' (response to social expectations) sensory processing are associated with child appetitive traits in typically developing preteen children. Additionally, we explored relationships between maternal sensory profiles and their offspring's sensory profile. Methods: This is secondary analysis of 130 mother-child dyads from the 9–11-year-old follow-up of the ROLO longitudinal birth cohort study. The Dunn Sensory Profile (Adolescent/Adult) and the Dunn Child Sensory Profile 2 were used to assess maternal and child sensory profiles, respectively. The Children's Eating Behaviour Questionnaire was used to assess child appetitive traits. Multiple linear regression examined associations between 'Oral' and 'Social-Emotional' segments of the child sensory profile and child appetitive traits. Associations between maternal and child sensory profiles were examined using sensory profile quadrants (Dunn's sensory processing framework). These refer to four distinct patterns of sensory processing that indicate how an individual responds to sensory input. Results: In total, 130 mother-child dyads were included. In adjusted analysis child 'Oral' sensory processing was associated with higher mean scores in the appetitive traits 'Desire to Drink' (B = 0.044, 95% CI = 0.025,0.062) and 'Food Fussiness' (B = 0.080, 95% CI = 0.059,0.101) and with lower mean scores in 'Enjoyment of Food' (B=-0.038, 95% CI -0.055,-0.022). Child 'Social-Emotional' responses were associated with higher mean scores in 'Desire to Drink' and 'Food Fussiness'. Higher scores in the maternal sensory profile quadrants of 'Sensitivity', 'Avoiding' and 'Registration' were positively associated with higher scores in the corresponding child sensory profile quadrants. Conclusion: Our findings suggest that in typically developing children presenting with fussy eating, oral sensory hypersensitivity and higher scores in social-emotional responses to sensory processing may be an underlying determinant. The relationship observed between 'Oral' and 'Social-Emotional' sensory processing segments and 'Desire to Drink' requires further research to ascertain the type of drinks being consumed and how this impacts appetite. Further research is also required to explore the influence of maternal sensory profile on their offsprings response to sensory input. [ABSTRACT FROM AUTHOR]

Background: Video-assisted thoracoscopic surgery (VATS) is considered useful for the treatment of parapneumonic empyema in children. However, thoracoscopic management of empyema due to esophageal leakage as an operative complication has not been well described in the literature. Case presentation: We successfully decorticated severe empyema using uniport VATS in 2 children (a 2-year-old boy who suffered esophageal perforation after laparoscopic anti-reflux surgery, and a 7-month-old girl who had anastomotic leakage after thoracoscopic repair of esophageal atresia). In these patients, we noticed that pleural effusion rapidly progressed to empyema and caused respiratory insufficiency due to wide-range coverage by fibrotic pleural rind that was successfully decorticated under video-assisted vision from a mini-thoracotomy, followed by spontaneous healing of the leakage. Conclusions: We did not attempt to closely approach or try to repair the esophageal leakage. We believe that this is an important tip for these situations. [ABSTRACT FROM AUTHOR]

Background: Forearm shaft fractures are common injuries, often caused by falling from a fully-upright position or falling off a bike. They can be treated nonoperatively or surgically with intramedullary nailing or plates. The method of choice for treating pediatric forearm shaft fractures is the application of elastic stable intramedullary nailing (ESIN)|. The aim of the study was to evaluate ESIN in pediatric patients with forearm shaft fractures based on radiological images, and determine the etiology and complication rate associated with the injury. Methods: The study included 201 patients, 30.5% female 69.5% male, aged 1 to 17 years (mean 9.1 years; SD = 3.2), all had been diagnosed with a fracture of the forearm shaft and had been treated surgically with ESIN. In addition, all possessed a complete set of X-ray images and had attended a minimum six-month follow-up examination of the forearm. Axial alignment was evaluated retrospectively in the anatomical (AP) and lateral (LAT) positions. In total, 402 radiographs were examined. Of the injuries, 68% occurred during sports activity and 75% involved both the radius and the ulna. Results: Union was observed in all cases. Mean axial alignment values in AP and LAT X-ray or both the ulna and radius were satisfactory. Axial alignment values were not influenced significantly by age, type of surgery, type of fracture or etiology. Plaster cast application (9.8% of cases) significantly influenced radius axial alignment. The complication rate was 11.4% (n = 23). Significantly more complications were observed in patients receiving open reduction internal fixation (ORIF) (p = 0.0025). Conclusion: The ESIN technique is an effective treatment for forearm diaphyseal fractures in children, with good results regarding reduction and bone healing, indicated by x-ray. [ABSTRACT FROM AUTHOR]

Objectives: This study examined the impact of web-based education on enhancing mothers' awareness of oral health care for children aged 9 and 12 years. It focused on the crucial role of mothers in educating about oral health to prevent dental diseases and reduce long-term healthcare costs. Methods: Mothers were divided into three groups: control, intervention with a web system, and intervention with a brochure. Over one month, their knowledge about their children's oral health was assessed before and after the intervention. Results: Data were analyzed using parametric t-tests and non-parametric Mann-Whitney U tests. The findings indicated a significant increase in parental awareness in both intervention groups. Conclusion: It is recommended that parent education be done using web-based systems or mobile apps, which are better choices due to greater accessibility and interactivity. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to compare the acceptability of removable acrylic appliances (RA) and Invisalign First (IF) clear aligners (Aligntech, USA) among children undergoing orthodontic treatment during the mixed dentition period, considering the severity of malocclusions. Methods: A total of 40 patients, aged 6 to 13 years, were recruited for the study. Malocclusion severity was evaluated using the Index of Orthodontic Treatment Need-Dental Health Component (IOTN-DHC). Patients completed the "Acceptance of Orthodontic Appliance Scale (AOAS)" via a face-to-face Google survey. To assess the reliability of the AOAS, the survey was resent to five patients after three months for a second response, and reliability analysis was conducted. Additionally, inter-rater reliability was evaluated by having all patients independently assessed by a second researcher. Data were analyzed using SPSS Statistics version 26 (IBM Corp., Armonk, NY, USA), with statistical significance set at p < 0.05. Results: Although no significant difference was found in IOTN-DHC scores, the IF group demonstrated significantly higher AOAS scores compared to the RA group (p = 0.014). Survey responses revealed noticeable distinctions between groups regarding speaking discomfort, preference for orthodontic appliances, and facial appearance comfort. A negative correlation (r = -0.477, p = 0.034) was observed between malocclusion severity and appliance acceptance. Clinical significance: This study underscores the significant superiority and advantage of IF over RA among pediatric orthodontic patients during the mixed dentition period. [ABSTRACT FROM AUTHOR]

Background: Psychiatric symptoms directly associated with SARS-CoV-2 virus infection have been reported sporadically in children. More cases of new-onset psychosis without severe cardinal symptoms, altered consciousness level, and psychogenic drug usage would offer compelling grounds for the association between the virus infection and psychosis. Methods: We collected the clinical data of pediatric patients with new onset psychiatric symptoms after the SARS-CoV-2 virus infection from December 2022 to Feb 2023 and followed up with them for 1 year. These children did not have severe respiratory, cardiovascular, or systemic symptoms. They were not given psychogenic drugs. We also searched Pubmed to identify previously reported acute onset psychiatric cases related to SARS-CoV-2 virus infection in children. We summarized these patients' clinical symptoms, laboratory examination, treatment, and prognosis. Results: We reported 11 new cases of psychiatric disease directly related to SARS-CoV-2 virus infection and reviewed 12 previously reported cases among children and adolescents. They had various psychiatric symptoms within 3 weeks after the virus infection. Brain MRI and EEG recording did not reveal remarkable abnormalities. The cerebrospinal fluid analysis (CSF) could find increased protein, immunoglobulin, and IL-8 levels, disrupted blood-brain barrier, and positive oligoclonal band in a minority of the patients. Most of the patients had good outcomes. Conclusion: New-onset psychiatric symptoms directly related to SARS-CoV-2 virus infection are not rare phenomena among pediatric patients. CSF tests support the presence of central immune responses in some patients. Although these patients received different treatments, most of them had good prognoses. [ABSTRACT FROM AUTHOR]

Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can cause diverse clinical manifestations in multiple organ systems. Child-onset SLE (cSLE) is associated with significantly higher morbidity and mortality than adult-onset SLE. The traditional treatments for SLE (glucocorticoids, antimalarials, conventional and biological diseasemodifying antirheumatic drugs) often have significant adverse effects and may not fully control disease activity. Tofacitinib is an oral Janus kinase (JAK) inhibitor that inhibits the JAK-STAT pathway and has the potential to reduce SLE severity. Methods: cSLE patients who received tofacitinib and had at least one follow-up visit were retrospectively examined. Case histories, laboratory test results, and treatment regimens were analyzed at disease onset, initiation of tofacitinib treatment, and 1, 3, 6, 9, 12, 18, and 24 months after starting tofacitinib. Results: We examined 9 patients with refractory cSLE. All patients were female and the average age at diagnosis was 10.67 years. At initiation of tofacitinib, the average age was 13.28 years and the average disease duration was 2.62 years. Four patients experienced alleviation of symptoms and reduced their daily prednisone dosages; one of them also discontinued cyclosporine A and two of them also discontinued belimumab. The other 5 patients experienced no apparent benefit. Conclusion: Tofacitinib may provide clinical benefits for some patients with refractory cSLE, and can also allow reduction in the glucocorticoid dosage. Tofacitinib has the potential as an adjunctive treatment for some patients with cSLE. [ABSTRACT FROM AUTHOR]

Background: Latinx children in the United States experience disparities in asthma control and asthma-related functional outcomes compared to non-Latinx White children, including more school absences, emergency department visits, and hospitalizations for asthma. Stress appears to play a role in asthma control, but interventions designed to address the role of stress in asthma control for Latinx children are limited. Method: The current randomized controlled trial tests the effects of Adapt 2 Asthma (A2A), a family-based coping skills and asthma management intervention tailored to the stressors, strengths, and cultural beliefs of Latinx families, compared to an asthma self-management control arm (the Asthma Plan for Kids; APK). Latinx families of children ages 8 to 14 years old with asthma (target N = 280) are identified and enrolled from primary care clinics and randomly assigned to either A2A or APK. The intervention is delivered by lay health workers trained and receiving ongoing consultation from the study team. The primary outcome is child- and parent-reported asthma control, while secondary outcomes are child's quality of life, lung function, school absences, and emergency department visits, and child and parent coping and family asthma management behaviors. Participants will be assessed at baseline, post-intervention, and at 6- and 12-month follow-up timepoints. Discussion: This study has the potential to provide new evidence regarding the effects of culturally relevant coping and asthma management intervention strategies for Latinx children with asthma. Trial Registration: Clinicaltrials.gov NCT05118282. Registered on 11 November 2021. [ABSTRACT FROM AUTHOR]

In the past few years, a significant decline in vaccination coverage has been noted, leading to measles outbreaks. Mothers' adherence or reluctance to undergo childhood immunization is a major contributing factor to a substantial population of children who remain unvaccinated or inadequately vaccinated. This study aimed to investigate adherence to children's vaccination by investigating mothers' personal and contextual factors in addition to knowledge and attitudes scores. A cross-sectional analytical design was employed, and data were collected from a sample of 533 mothers in Jordan between May and July 2023. The statistical analysis included descriptive analysis, t-test, ANOVA, and Pearson r correlation. The results demonstrated that adherence to vaccination was associated with several factors, including knowledge score (r = 0.33, p < 0.01), the ability to access and understand health information (r = 0.16, p < 0.01), income level (F = 11.88, p < 0.01), education level (F = 5.71, p < 0.01), employment (t = 2.41, p < 0.05), and working in a medical field (t = 4.5, p < 0.01). Scheffe post hoc analysis was performed to evaluate adherence outcomes according to the different categories of education and income levels. Mothers' adherence to vaccination needs improvement, with special attention given to contributing factors. Strategies should be developed to target mothers with low incomes and educational levels and limited ability to access and understand health information to enhance maternal knowledge and eventually adherence to children's vaccination. [ABSTRACT FROM AUTHOR]

Introduction: This study explored the extent to which an interactive computer play system, Bootle Blast, supports motor learning in a clinical context and examined clinicians' perceptions of their therapeutic role in the system's use as an intervention tool. Methods: In this observational sequential explanatory mixed methods study, five children with cerebral palsy [mean age 9.4 years (SD, 0.5), Gross Motor Function Classification System Levels I-III] used Bootle Blast during a single videorecorded therapy session with their treating clinicians (physical therapists, occupational therapists, and therapy assistants). Children played one Bootle Blast mini game independently (without clinician involvement) before clinicians carried out therapy sessions with the game as per usual care. The type and extent of motor learning strategies (MLS) delivered by Bootle Blast and clinicians were rated from video recordings by a trained assessor using the 22-item Motor Learning Strategies Rating Instrument. Semi-structured interviews with clinicians were conducted to gain insights into MLS use and clinicians' perceived role during Bootle Blast use. Interviews were audio recorded, transcribed verbatim, and analyzed independently by two researchers using thematic analysis. Quantitative and qualitative data were merged and reported using narrative and joint display approaches. Results: Bootle Blast provided eight MLS, with clinicians adding or enhancing another eight. Four themes reflected clinicians' perspectives: (1) Bootle Blast disguises therapy as play, (2) clinicians give Bootle Blast the human touch; (3) home use of Bootle Blast is promising; and (4) Bootle Blast is not always the right fit but some shortcomings could be addressed. Agreement was found for nine MLS and disagreement for four MLS when quantitative and qualitative findings were merged. Discussion: Bootle Blast delivers several MLS as part of game play and clinicians can enhance and provide additional MLS to suit the child's needs/abilities. Further game refinements that were identified in this study may optimize its clinical use. [ABSTRACT FROM AUTHOR]

Introduction: Current evidence suggests that early maladaptive schemas are affected in attention deficit hyperactivity disorder (ADHD). Most of the studies on the subject have been conducted with adults, but the number of studies conducted with adolescents with ADHD is quite limited. The aim of this study was to evaluate early maladaptive schemas in adolescents diagnosed with ADHD. Methods: The study included 66 patients diagnosed with ADHD and 70 healthy adolescents who were similar to the case group in terms of age and gender. Clinical evaluation of the case and control groups were performed with "The Schedule for Affective Disorders and Schizophrenia for School-Age Children- Present and Lifetime Version, DSM-5 November 2016-Turkish Adaptation (K-SADS-PL-DSM-5-T)". "Conners-Wells Adolescent Self-Report Scale - Revised Short Form (CASS-RS)" and "Set of Early Maladaptive Schema Questionnaires for Children and Adolescents between the ages of 10-16" were administered to all participants. Results: It was determined that the schema scores of "dependence/incompetence", "vulnerability to harm or illness", "entitlement/grandiosity", "insufficient self-control", "subjugation" were significantly higher in the ADHD group than in the control group. A negative, significant relationship was found between age and "enmeshment/undeveloped self", "entitlement/grandiosity" and "insufficient self-control" schema scores. There was no significant difference between schema scores in terms of gender in the ADHD group. Additionally, no significant relationship was found between the education level of the parents, family income levels and schema scores. A significant positive relationship was found between the CASS-RS scores and all schema scores. As a result of the regression analysis, it was determined that CASS-RS scores positively predicted all schema scores, while the age variable negatively predicted only the schema scores of "enmeshment/undeveloped self". Discussion: Results of this study showed that there were significant differences in adolescents in the ADHD group compared to the control group in terms of early maladaptive schemas, and that ADHD symptom levels was associated with early maladaptive schemas. [ABSTRACT FROM AUTHOR]

Introduction: Childhood malnutrition is a complex issue with a range of contributing factors. The consequences of malnutrition are severe, particularly for children. This study aims to identify the factors contributing to inequality gaps in childhood malnutrition. Our study provides insights into modifiable elements to inform interventions targeted at distinct contexts and populations to improve child nutrition. Methods: This study utilized data from the Demographic and Health Surveys (DHS) of 27 countries. First, the risk differences (RDs) between the prevalence of childhood malnutrition among the determinant variables, household income, and maternal education categories were calculated. The Blinder‒Oaxaca decomposition was subsequently used to determine the extent to which the difference in childhood malnutrition prevalence between low-income and high-income groups and maternal education levels results from the contributory effects of the explanatory variables: child and maternal individual-level compositional factors. Results: We examined data from 138,782 children in 27 countries from 2015 to 2020. The prevalence of childhood malnutrition (10.5%) varied across countries, ranging from 6.5% in Burundi to 29.5% in Timor Leste. On average, the prevalence of childhood malnutrition was 11.0% in low-income households and 10.7% among mothers without education. Some nations had pro-low-income (i.e., malnutrition concentrated among children from poor households) or pro-no-maternal education (i.e., malnutrition concentrated among children from mothers with no formal education) inequality in childhood malnutrition, but most did not. We found a complex interplay of compositional effects, such as the child's age, maternal education, maternal health behavior, and place of residence, that influence the inequality in childhood malnutrition rates across 10 pro-low-income countries. In addition, we also found that a complex mix of compositional effects, such as the household wealth index, maternal health behavior, and maternal age, contribute to childhood malnutrition inequality between educated and uneducated mothers across the 7 pro-no maternal education countries. Conclusion: The prevalence of childhood malnutrition varies among low-income, high-income, and no maternal education-maternal education groups. This study highlights the need for a country-specific approach to addressing childhood malnutrition, with policies and interventions tailored to each country's specific context. [ABSTRACT FROM AUTHOR]

Objective: To review the current literature about surgical treatments of pediatric bilateral vocal fold paralysis (PBVFP). Methods: A systematic review of the current literature in PubMed, Scopus, and Cochrane Library regarding etiologies and management of PBVFP was performed until November 2023 according to PRISMA statements. Quality assessment was assessed with Methodological Index for Non-Randomized Studies (MINORS) tool. Results: Of the 211 screened articles, 26 were included accounting for 320 patients. The etiologies included idiopathic (42.2%), congenital (19.7%), neurological (16.9%), or post-surgical (9.5%) pediatric bilateral vocal cord paralysis (PBVCP). Patients were decannulated in 76.7% of cases without laryngeal procedure. Decannulation was achieved in 84.6%, 66.6%, 83.3%, 80.0%, and 62.5% of cases of laterofixation of the vocal fold, cricoid split approaches, partial or total arytenoidectomy, uni- or bilateral transverse cordotomy, and selective laryngeal reinnervation, respectively. Dyspnea/stridor relief, swallowing, or voice quality outcomes were used in some studies, which reported conflicting results. Revision and complications varied between studies, with complications mainly involving edema, granuloma, or aspirations. Revision was required in 6.4%, 12.9%, and 40.0% of cases that underwent laterofixation of the vocal fold, arytenoidectomy, and cricoid split procedures, respectively. There was substantial heterogeneity across studies in inclusion criteria, procedures, and outcomes. Conclusion: The management of PBVFP may involve several temporary or permanent surgical procedures that are associated with overall subjective improvements of symptoms, and laryngeal findings. The retrospective design of studies, the small number of cohorts, the lack of objective outcomes, and the differences between teams regarding procedure timing and features limit drawing reliable conclusions about the superiority of one technique over others. [ABSTRACT FROM AUTHOR]

Introduction: Children diagnosed with endocrine disorders may exhibit atypical development and may encounter challenges in language, academic, and cognitive skills, as well as social-emotional issues. The objective of this study was to identify potential therapeutic requirements in the areas of language, cognition, and mathematical skills among children with endocrine disorders who experience school failure. This will enable an early evaluation of speech and language disorders and the planning of interventions to be possible. Methods: In this study, children with endocrine disorders were compared with their normally developing peers in terms of language, cognition, mathematical skills, and psychosocial characteristics. In this study, 15 children diagnosed with endocrine disorders (8 females, 7 males; mean age: 10, SD: 2) and 15 children with normal development (8 females, 7 males; mean age: 10, SD: 2) participated. The participants were subjected to the Test of Language Development-Primary: Fourth Edition Turkish Revision (TOLDP-4:T), the Turkish Nonword Repetition Test (TNRT), the Turkish Multilingual Sentence Repetition Test (LITMUS-TR), the Wechsler Intelligence Scale for Children (WISC-R), the Problem-Solving Test (PST), the Revised Child Anxiety and Depression Scale-Child Version (RCADS-CV), the Coopersmith Self-Esteem Inventory (CSEI), and the Child Behavior Checklist (CBCL). Results: The findings of the study indicate that children with endocrine disease have lower performance in language, cognition, and mathematical skills compared to their healthy peers. Otherwise, they do not differ in terms of social-emotional status assessed by psychological scales. Discussion: These findings suggest that while children with endocrine disorders face challenges in academic and cognitive domains, their social-emotional development remains relatively unaffected. Early identification and intervention in language, cognition, and mathematical skills may help address the academic struggles of these children, potentially improving their school performance and overall well-being. [ABSTRACT FROM AUTHOR]