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Button battery ingestion is potentially fatal, especially in children less than 6 years of age, most commonly due to esophageal perforation. The number of ingestions and complications has risen significantly in recent decades. Impacted button batteries should ideally be removed urgently within 2 hours of ingestion. However, many ingestions go unwitnessed, and children may present with variable, vague symptoms. The recommendation now is that children over the age 12 months consume honey when a button battery ingestion is witnessed or diagnosed, if less than 12 hours have elapsed. Importantly, though, honey should not be consumed if perforation is suspected. Induction of general anesthesia and battery removal should not be delayed to satisfy NPO guidelines, even if the child has eaten. [ABSTRACT FROM AUTHOR]

BACKGROUND: Intensive blood pressure (BP) control in youth with chronic kidney disease (CKD) slows progression, delaying the need for kidney replacement therapy (KRT). Most youth with CKD have hypertension and BP control is difficult to achieve outside of controlled experimental settings. Implementing effective BP control strategies in this population may be cost-saving despite requiring additional resources. Our objective was to determine the economic and clinical impact of intensive versus usual care for BP management in youth with CKD in a microeconomic model. METHODS: We developed a decision tree from the US payer perspective to estimate the total costs and clinical effect of an intensified BP intervention over 5 years, modeled after the ESCAPE trial (Effect of Strict Blood Pressure Control and Angiotensin-Converting Enzyme [ACE] Inhibition on Progression of Chronic Renal Failure in Pediatric Patients) protocol. We compared this intervention to usual care in a hypothetical population of youth with mild-to-moderate CKD. Probabilities were informed by published literature; cost estimates were informed by publicly available data. Our outcomes were the net discounted cost of an intensive BP intervention, number needed to treat with the intervention to prevent 1 KRT episode, and incremental cost per KRT episode avoided. RESULTS: An intensive BP intervention, with a goal of an average 24-hour mean arterial pressure <50th percentile, improved outcomes with net cost savings of $9440 per participant over 5 years compared with usual care. To prevent 1 episode of KRT over 5 years, 13 participants need to receive intensive BP intervention. CONCLUSIONS: Routine use of the ESCAPE protocol for intensive BP control in youth with CKD could save overall costs for the payer and improve clinical outcomes. [ABSTRACT FROM AUTHOR]

Anxiety disorders are among the most prevalent mental health conditions in childhood, affecting an estimated 10 % to 20 % of children. Cognitive Behavioral Therapy (CBT) is the most commonly employed treatment for these disorders. This study utilizes a meta-analytic approach to evaluate the effectiveness of CBT interventions in reducing anxiety levels among children diagnosed with anxiety disorders. A comprehensive search was conducted in the "PubMed," "Science Direct," "Scopus," and "Web of Science" databases to identify randomized controlled and quasi-experimental studies that investigated the impact of CBT on children's anxiety levels. Studies that met the inclusion criteria were selected for analysis. The methodological quality of the selected studies was assessed using the "Critical Appraisal Checklists" developed by the Joanna Briggs Institute (JBI). Meta-analytic procedures were performed using the Review Manager 5.4.1 software. Twenty-nine studies published between 2015 and 2024 met the inclusion criteria and were included in the meta-analysis. The results indicate that CBT interventions are significantly effective in reducing anxiety levels in children with anxiety disorders (SMD: -1.51, 95 % CI: −2.07, −0.95, Z = 5.28, p < 0.00001). Among the various types of CBT, cognitive behavioral play therapy emerged as the most effective in reducing anxiety (SMD: -2.41, 95 % CI: −2.95, −1.88, Z = 8.84, p < 0.00001). Additionally, follow-up assessments at 3, 6, and 12 months post-intervention demonstrated that CBT has a sustained effect in lowering children's anxiety levels over time. This meta-analysis offers a valuable update to the existing literature by reinforcing the efficacy of CBT interventions in treating anxiety disorders in children. • Anxiety disorders are among the most common mental health problems in childhood, affecting an estimated 10 % to 20 % of children. • Cognitive Behavioral Therapy (CBT) is the most commonly used treatment method for these disorders. • Among the various types of CBT, cognitive behavioral play therapy stands out as the most effective therapy for reducing anxiety. [ABSTRACT FROM AUTHOR]

This study was conducted as a randomized controlled trial to examine the effect of toys made from medical materials on anxiety among hospitalized children. This study was conducted with pediatric patients aged 4–6 years who were hospitalized in the pediatrics department of a teaching and research hospital in the Southeastern Anatolia Region. The study was completed with 90 children, allocated to the toys made of medical materials group (45) and the control group (45). Children, in the toys made of medical materials group, were given medical materials and asked to make toys. The anxiety levels of children in both the toys made of medical materials and control groups were assessed using the Children's State Anxiety (CSA) scale. Analysis based on children's self-reports revealed a significant reduction in the post-test anxiety scores of children in the toys made of medical materials group. No significant difference was observed in the anxiety scores of children in the control group. In the comparison between groups based on mothers' reports, it was found that the post-test anxiety scores of children in the toys made of medical materials group were significantly lower than those of children in the control group. Our study found that toys made from medical materials were effective in reducing children's anxiety. Healthcare workers can relieve children's anxieties by making toys using medical materials that are easily accessible in the clinic. • Hospitalization is a situation that causes anxiety in children. • Reducing a child's anxiety is essential to improving their adjustment to hospitalization and treatment. • Play is an important tool for alleviating a child's anxiety. Our study determined that playing with toys made of medical materials reduced children's anxiety. • It is recommended to use toys made of medical materials in clinics to alleviate children's anxiety. [ABSTRACT FROM AUTHOR]

Invasive procedures are commonly used in pediatric healthcare, and storybooks can be used as an adjunct analgesic method. This study was conducted to evaluate the effectiveness of using storybooks as a distraction technique to reduce fear and anxiety in pediatric healthcare. This study was conducted with the aim of revealing the level of effect of storybook use on children's fear and anxiety level in pediatric health services. For this meta-analysis study, the studies were obtained by searching PubMed, Web of Scıence, Scopus, EBSCOhost, Google Scholar and YÖK Thesis Center databases in April–June 2024 without any year limitation. After the reviews, 15 studies were included in the study. The data were synthesized by meta-analysis and narrative methods. In this meta-analysis, it was found that storybook use in pediatric health services was effective on children's anxiety (SMD: −4.412, 95 % CI: −7.727 to −1.097; Z = −2.608, p = 0.009; I2 = 99.890 %) and fear (SMD: −1.13, 95 % CI: −1.71 to −0.54; Z = −3.78, p = 0.000; I2 = 83.065 %) levels. In addition, it was determined that the characteristics of the intervention group, age group, the characteristics and content of the storybook, the duration of the intervention and the time of the intervention played a role in the effectiveness of the storybook use intervention in pediatric health services on children's anxiety and fear levels. The use of story books in children's health services reduces the level of fear and anxiety in children. • This study proves the effectiveness of storybooks as a distraction technique during child health services. • The use of innovative techniques can increase job satisfaction in professionals. • Reading storybooks can reduce anxiety and fear in children while providing health care. [ABSTRACT FROM AUTHOR]

This study examined parenting stress and child special healthcare needs to child neurocognitive development (NCD). This secondary analysis used data from the primary study, a longitudinal cohort study of mother-child dyads. Multivariable regression models examined the associations between parenting stress and child special healthcare needs with NCD. Mothers completed the Children with Special Health Care Needs Screener and the Parenting Stress Index-Short Form. The outcome, child NCD, was evaluated using the Bayley Scales of Infant and Toddler Development-Third Edition (Bayley-III) Cognitive and Language Scales. Covariates included maternal and child sociodemographic factors and maternal knowledge of child development, depression, and IQ. Of the 1040 mother-child dyads in this analysis, 171 (16.4 %) mothers reported that their child had one or more special healthcare needs and reported higher levels of parenting stress (PS) compared to those not experiencing health needs. Models including clinically significant PS along with identified child health needs showed the effect of 0.515 reduction (CI = 0.11, 0.92, p =.013) in Bayley-III Receptive Scaled scores. Clinically significant parenting stress and the presence of child special healthcare needs were associated with lower child NCD, specifically receptive communication skills. Healthcare providers, including pediatric nurses, should support NCD in young children by identifying children with special healthcare needs early on, recognizing and providing support to decrease parenting stress, and delivering needed medical and developmental support to young children and their families. • Standardized scores demonstrate decreased child neurocognitive development (NCD). • Increased parenting stress was significantly associated with lower child NCD. • Parenting stress and child health could cause lower child receptive communication. • Early screening of parenting stress and child health needs can support children. • Providers can intervene to mitigate negative effects on child development. [ABSTRACT FROM AUTHOR]

Venipuncture is a commonly performed but distressing procedure for children, often leading to significant pain and anxiety. This study aimed to evaluate the effect of Pranic Healing, based on Rogers' Therapeutic Touch Nursing Theory, on the cardiorespiratory indices and pain associated with venipuncture in children. This double-blind, randomized clinical trial was conducted on a cohort of 46 school-aged children, selected via convenience sampling, at a hospital in Northern Cyprus. Participants were randomly allocated into the experimental group (n = 23) and the control group (n = 23). The experimental group received Pranic Healing. The Pranic Healing protocol was administered for 5 min before, during, and after venipuncture, while the control group received standard care. Pain levels were assessed using the Wong-Baker Facial Pain Scale, and physiological parameters including heart rate, respiratory rate, and oxygen saturation were measured at three specific time points. Data analysis was performed using SPSS version 25.0, employing independent t -tests, chi-square tests, and repeated measures ANOVA to assess differences between groups, with a significance level set at P < 0.05. The study revealed a significant reduction in pain scores (P < 0.001) and improved cardiorespiratory indices, including heart rate (P = 0.004), respiratory rate (P = 0.001), and oxygen saturation (P = 0.005) in the intervention group compared to the control group. These findings suggest that Pranic Healing is effective in reducing pain and stabilizing physiological responses during venipuncture in children. Pranic Healing, based on Rogers' Therapeutic Touch Nursing Theory, may serve as an effective, non-invasive method for managing pain and promoting physiological stability during painful medical procedures like venipuncture in children. Pranic Healing could be a valuable addition to pediatric care protocols, particularly for procedures that induce pain and discomfort. • Pranic Healing significantly alleviated pain during venipuncture in pediatric patients (P < 0.001). • Enhanced cardiorespiratory parameters: reduced heart rate, respiratory rate, and increased oxygen saturation. • Affirms the effectiveness of Pranic Healing based on Rogers' Therapeutic Touch Nursing Theory. • Highlights Pranic healing as a valuable non-pharmacological approach in pediatric pain management. [ABSTRACT FROM AUTHOR]

To determine the digital game addiction levels of secondary school students and to examine the parental awareness against digital game addiction levels of students. This is a descriptive and correlational study. The population of the study consisted of students in a secondary school and 392 students were included in the study. The data were collected using the "Digital Parenting Awareness Scale (DPAS)," and "Digital Game Addiction Scale for Children (DGAS-child form). In the study, Kurtosis and Skewness coefficients were used for normal distribution; mean, standard deviation, percentage, and frequency were used to evaluate quantitative data; and Pearson chi-square analysis was used to make correlational inferences. The DGAS mean score of the students was 47.31 ± 16.19. The results of the study showed that the parents had high level of digital awareness. It was found that the students' DGAS mean score had a weak positive correlation with RM subscale of DPAS and a moderate positive correlation with DN subscale of DPAS. DGAS mean score had a weak negative correlation with EU and PR subscales of DPAS. Parents-children's age did not affect the levels of DGAS and DPAS. Raising parents' digital awareness reduces digital game addiction in their children. One of the most important roles of nurses is education. Parent trainings for children to use digital devices correctly and efficiently contribute to improving digital awareness of parents and protecting/promoting child health. • The digital world is a popular and highly preferred medium for children today. • Parents assume important roles in protecting their children from the negative impacts of the digital world. • As parents' digital awareness levels elevate, their children' digital game addiction decreases. [ABSTRACT FROM AUTHOR]

The process of caregivers learning to implement clean intermittent catheterization (CIC) affects both children and caregivers negatively. The aim of this study was to examine the experiences of caregivers performing CIC on their children with spina bifida (SB). This study was conducted with a qualitative design between June 5 and September 25, 2022, with the caregivers of 17 children. The data were collected using a semi-structured questionnaire and analyzed using a thematic analysis technique. The COREQ guidelines were followed in the study. The data were grouped under fourteen sub-themes: "not knowing CIC, having knowledge about CIC, positive and supportive, negative and compelling, family support, health personnel support, loneliness, sharing responsibility, taking on the role of caregiver, satisfaction, sadness, indecisiveness, limitation of social life, change in social life routine". Caregivers had both positive and negative experiences in this period. Caregivers face various challenges during the implementation of CIC for children with SB. The results reveal the importance of identifying the performance of caregivers. Nurses who are aware of the difficulties faced by caregivers in this period can be actively involved in personalized care-oriented health education, counseling, and support for caregivers. Failure to provide adequate support to caregivers during the CIC application process causes both children and caregivers to be negatively affected in this process. For this reason, protocols or guidelines should be created by nurses in order to reduce the negative experiences of caregivers who apply CIC to their children. [ABSTRACT FROM AUTHOR]

To assess the effectiveness of a therapeutic bath combined with analgesic medication versus the use of analgesic medication alone in alleviating generalized acute pain in hospitalized children with respiratory conditions. A randomized controlled clinical trial, with parallel groups, with children aged 28 days to 3 years who were hospitalized for respiratory conditions with associated pain. Participants were allocated into two groups: 40 children to a control group (CG), which received isolated analgesic medication at same time, and 40 children to an intervention group (IG), which received both a therapeutic bath and analgesic medication. In the IG, baths were administered by a family member, the researcher, or a staff member. Each bath lasted a minimum of 5 min, with the water temperature maintained between 37 and 39 °C and 2/3 of the child's body submerged. The child was removed from the bath before the water temperature reached 36 °C. Pain was assessed in both groups at T0 (initial assessment by the researcher), T1 (15 min), T2 (30 min), and T3 (60 min) after medication. Data received descriptive and inferential analysis. International ethical recommendations were followed. Eighty children were recruited, 40 allocated to each group, with no statistical differences at the pretest. The IG exhibited a faster and more pronounced decrease in pain scores at various reevaluation times, including a significant reduction at T1. This decrease was consistent across all assessment scale parameters. A therapeutic bath combined with analgesic medication effectively relieved pain in hospitalized children with respiratory conditions. Trial and Protocol Registration: Brazilian Clinical Trials Registry. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the association between the severity of possible sleep bruxism (PSB) and possible awake bruxism (PAB) and attrition tooth wear facets (ATWF) in children/adolescents. Methods: Four hundred-thirty-four children/adolescents enrolled in schools in Lavras, Brazil, participated in this cross-sectional study. Caregivers answered a questionnaire about their childrens' PSB. Children/adolescents answered a questionnaire about the occurrence of PAB. Results: ATWF among individuals without PSB and PAB was lower than those with moderate/severe PSB (p = 0.038) and moderate/severe PAB (p = 0.003). ATWF in anterior teeth was lower among individuals without PSB compared to those with mild (p = 0.015) and moderate/severe PSB (p = 0.032). ATWF in posterior teeth was lower among individuals without PAB compared to those with mild (p = 0.046) and moderate/severe PAB (p = 0.017). Conclusion: The number of attrition tooth wear facets is proportional to the severity of PSB and PAB. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to assess grating visual acuity and functional vision in children with congenital Zika syndrome. Methods: Initial and final grating visual acuity was measured using Teller acuity cards. Cerebral vision impairment standardized tests were used to assess functional vision. Patients were referred to the early visual intervention program for visually disabled children. Neuroimaging was performed. Results: In this study, 10 children were included with an age range of 1–37 months. Eight patients presented with macular atrophic scars. Neuroimaging revealed microcephaly and cerebral abnormalities in all patients. Low vision and cerebral vision impairment characteristics were observed in all children. The final grating visual acuity in this group varied from 3.00 to 0.81 logMAR. Conclusions: The grating visual acuity test revealed low vision in all children with congenital Zika syndrome. Functional vision evaluation revealed cerebral vision impairment characteristics in all patients, who were referred to the early visual intervention program. Visual acuity improved in six children. [ABSTRACT FROM AUTHOR]

Copyright of Biomédica: Revista del Instituto Nacional de Salud is the property of Instituto Nacional de Salud of Colombia 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 Biomédica: Revista del Instituto Nacional de Salud is the property of Instituto Nacional de Salud of Colombia 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 Biomédica: Revista del Instituto Nacional de Salud is the property of Instituto Nacional de Salud of Colombia 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.)

SARS coronavirus (SARS-CoV-2) since the year 2020 has been affecting people of all age groups involving all systems possible. The effect of COVID-19 on hematological system has been commonly seen in the form of cytopenia, prothrombotic states, or disorders of coagulation, but it has been rarely implicated as a causal factor for hemolytic anemia in children. We present a 12-year-old male child who presented in congestive cardiac failure due to severe hemolytic anemia caused by SARS-CoV-2, with hemoglobin falling to a nadir of 1.8 g/dL. Child was diagnosed as a case of autoimmune hemolytic anemia and managed with supportive management and long-term steroids. This case highlights one of the lesser known effects of the virus, causing severe hemolysis and the role of steroids in its treatment. [ABSTRACT FROM AUTHOR]

Purpose. Previous research indicates that physical education (PE) classes frequently fail to meet the recommended levels of moderate to vigorous physical activity (MVPA). This study aimed to compare the intensity levels achieved through different PE strategies, and, as a secondary objective, to evaluate students' perceptions of fun, motivation, and engagement. Materials and Methods. A total of 52 students (23 girls and 29 boys) participated in the study. The children were healthy and none of them were taking medication continuously or presented any orthopedic physical inability that would prevent them from performing the tests. All the children attended three PE classes on separate days; a recreational strategy, a circuit-based high-intensity interval training (circuit/HIIT) class, and a traditional class. All classes included games and activity content that followed the country's guidelines. Intensity levels were measured using portable heart rate (HR) monitors, and perceived exertion was assessed using the rate of perceived exertion (RPE) scale. For comparisons between each class strategy, the Kruskal-Wallis test and Dunn's test were used to identify significant differences (P<0.05). Qualitative data are presented as percentages of interview responses. Results. All strategies led to a level of engagement in MVPA for more than 50% of the total class duration. The circuit/HIIT and recreational strategies demonstrated significantly higher proportions of time spent in MVPA compared to the traditional class (P<0.01). The qualitative results showed that the recreational class received the highest number of positive responses, followed by the traditional class, while the circuit/HIIT received fewer positive responses. In addition, the RPE values aligned with the quantitative HR results, reflecting the class intensities. Conclusion: The circuit/HIIT strategy achieved the highest percentage (93.2%) of time in MVPA, followed by the recreational (91.8%) and traditional classes (77.6%). The results highlight the excellent percentage of time spent in MVPA in the recreational strategy, and qualitatively, the higher levels of fun, motivation, and engagement among students in this model. Thus, the recreational strategy led to excellent intensity of activity during the class, as well as positive responses in relation to the students' motivation and engagement. [ABSTRACT FROM AUTHOR]

Copyright of Revista Ciência & Saúde Coletiva is the property of Associacao Brasileira de Pos-Graduacao em Saude Coletiva 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.)

The reader will be able to: • Review the main features of necrotising pneumonia in children. • Understand the areas where there is a need for more evidence to guide management. • Realise that long-term evolution is favourable, and deaths are rare. The objective of the review was to determine the long-term outcomes of necrotising pneumonia (NP). Studies published since 1990 in English, Portuguese, or Spanish, published on PubMed and Scielo were evaluated. Our findings showed ultrasound scanning is the diagnostic modality of choice. Despite prolonged hospitalisation (median 13–27 days) and fever (median 9–16 days), most patients recover completely. Empyema and bronchopleural fistulae are frequent in bacterial NP. Streptococcus pneumoniae is the most prevalent cause. Seventeen studies with 497 patients followed for 30 days to 8.75 years showed that most patients were clinically asymptomatic and had normal lung function. X-ray or CT chest imaging demonstrated that almost all lung lesions recovered within 4–6 months. We suggest that it is not necessary to request frequent chest X-rays during the treatment and recovery process. Chest CT scans should be reserved for specific cases not following the expected clinical course. [ABSTRACT FROM AUTHOR]

Selective mutism (SM) and autism frequently co-occur together, exacerbating social communication deficits and associated anxiety. However, professionals have lacked a readiness to diagnose SM and autism together, making the need to understand parental experiences of caring for a child with SM and autism crucial. The current study utilised Interpretative Phenomenological Analysis (IPA) to explore parents' experience of caring for children with SM and autism. Semi-structured interviews were conducted with eleven mothers and one father of children aged between 5 and 18 years. All children were diagnosed with SM and had undertaken, or were currently undertaking, an autism diagnostic process. Analysis of the transcripts resulted in the following themes: Complexities from co-occurring issues; The overwhelming impact of SM; The diagnostic journey; Finding solutions and advocacy. Judgements and minimisation of symptoms from educational and healthcare systems exacerbated delays in diagnosis preventing appropriate intervention. The complexities of caring for a child with SM and autism, alongside wider misunderstandings, exacerbated parental stress, impacting the family. Parental advocacy and safe environments provided opportunities for children to better manage contextually based mutism. Improvements in identification and compassionate understanding from wider systems by involving parents as key stakeholders are essential to improve this situation. [ABSTRACT FROM AUTHOR]

Chronic kidney disease (CKD) is a disorder that causes numerous problems for children and affects many organs, as oral hard and soft tissues. The purpose of this study was to summarize the relationship between oral and dental health status and CKD in children. A systematic search of texts from 2000 to 2023 was conducted to gather all case control studies published in the English language related to the subject of this study in PubMed, Web of Science, Scopus and Cochrane electronic databases. The title, abstract and full text of the articles were examined according to inclusion criteria until relevant studies were selected. This process was carried out independently by two researchers. The quality of the selected studies was assessed by the National Institutes of Health (NIH) checklist. A total of 768 articles were identified in electronic databases during the search process. Articles inconsistent with inclusion criteria and duplicate articles were removed and 8 studies were selected for meta -analysis. The results found no statistically significant difference in mean of decayed, missing and filled teeth in permanent (DMFT index) and primary teeth (dmft index) in CKD and healthy children with a mean difference of −0.433 (95 % CI: −1.689 to 0.823; p-value = 0.500) and-0.095 (95 % CI: −2.240 to 2.051; p-value = 0.931) respectively. However, CKD had a significant effect on the developmental defects of enamel (DDE) index in children with an effect size of 4.916 (95 % CI: 1.752 to 13.799; p-value = 0.002). The presence of CKD can increase the incidence of DDE by 4.9 times, but it has no significant effect on the prevalence of dental caries in primary and permanent teeth. [ABSTRACT FROM AUTHOR]

Obwohl die suprakondyläre Humerausfraktur die häufigste Ellenbogenverletzung bei Kindern zwischen 4-10 Jahren ist, kommen transkondyläre Y- Frakturen im Wachstumsalter selten vor. Die meisten Kinder, die in der Literatur mit transkondylären Y- oder T-Frakturen präsentiert werden, sind älter als 10 Jahre. Wir stellen im Folgendem unsere Versorgung bzw. die postoperativen Ergebnisse von zwei kleinen Kindern mit Y-Fraktur des distalen Humerus vor. Although supracondylar humerus fracture is the most common injury of elbow joint in children aged 4-10 years, the Y-type fracture of distal humerus is rare. The most children reported with T-condylar or Y-type fracture of the elbow are older than 10 years. We present our management of two cases of Y-condylar fracture of the distal humerus in young children and the results of our supply. [ABSTRACT FROM AUTHOR]

• Ictal changes in heart rate (HR) have been shown as useful biomarkers in the development of automatic seizure detection devices, in order to alert the patients' caregivers and improve their safety. • They may provide important information about the pathophysiological mechanisms contributing to sudden unexpected death in epilepsy (SUDEP). • Knowing the differences in the frequency and mode of presentation of ictal tachycardia in children at different ages could help design detection algorithms more appropriate for these age groups. Likewise, it could help understand the mechanisms and the lower incidence of SUDEP in children. • Ictal tachycardia occur frequently in children: it was present in at least one seizure in 70.3 % of patients and in 51.1 % of all seizures. >30 % of patients had ictal tachycardia in all of their seizures, this being significantly more frequent (>40 %) in children older than 6 years. • Ictal tachycardia was significantly more frequent in focal seizures, in seizures longer than 1 min and in seizures occurring in sleep. Early ictal tachycardia was significantly more frequent in seizures with motor signs and in seizures during sleep. • Children older than 6 years especially with focal seizures during sleep could be ideal candidates for warning devices or stimulation therapies triggered by tachycardia detection. Changes in heart rate (HR) may provide an extracerebral indicator of seizure onset. The purpose of this study is to assess the frequency and timing of presentation of ictal tachycardia in a larger series of children with epilepsy grouped in different age groups as well as the influence of seizure characteristics. We retrospectively reviewed 732 seizures of 195 patients aged 0 to 14 (median 6.91) years with epilepsy of any cause. Patients were grouped according to the age in groups (1) <1 year (n = 18); (2) 1–2 years (n = 26); (3) 2–6 years (n = 43); (4) 6–10 years (n = 44); and (5) 10–14 years (n = 64). HR was assessed visually during the seizures and compared with HR 1 min before seizure onset. The time from seizure onset to ictal tachycardia, defined as an increase in HR by at least 33 %, was described. Ictal tachycardia was considered early if occurring in the first 10 s. Ictal tachycardia occurred in at least one seizure in 70.3 % of patients and in 51.1 % of seizures. It was more frequent and earlier in focal seizures and in seizures occurring in sleep. >30 % of patients had ictal tachycardia in all of their seizures, this being more frequent in the age groups 6–10 and 10–14 years. Children older than 6 years especially with focal seizures during sleep could be ideal candidates for warning devices or stimulation therapies triggered by tachycardia detection. Future studies should aim to assess the implications in relation to the risk of SUDEP. [ABSTRACT FROM AUTHOR]

Childcare services such as preschools and long day care centres have been identified as a key setting to promote physical activity in early childhood as they provide access to large numbers of children for prolonged periods. Yet, specific standards for the type and amount of physical activity (PA) children accumulate whilst attending childcare are lacking. The purpose of this study was to derive population-referenced percentile values for children's total movement and energetic play whilst attending early childhood education and care services. We analysed accelerometer data collected in four Australian studies involving over 150 long day care services and 3893 accelerometer records from 1945 children to derive population-referenced percentile values for total movement and energetic play whilst attending formal early childhood education and care. Accelerometer data were processed into time spent in total movement and energetic play using a random forest physical activity classification model. Total movement and energetic play estimates were transformed to a standard normal distribution and percentiles were calculated for a 4-, 6-, 8-, and 10-hour early childhood education and care day. On an average 8-hour early childhood education and care day (50th percentile), Australian pre-schoolers spend between 269 and 292 min, or 60 % of their day in movement. In contrast, Australian pre-schoolers only accumulate between 15 and 29 min of energetic play. The percentile reference values can be used to monitor young children's physical activity and energetic play levels whilst attending childcare. Educators can use the percentiles to assign norm-referenced ratings to identify children who could benefit from additional support for physical activity. [ABSTRACT FROM AUTHOR]

Paediatric foot deformities are common and can have a significant impact on function and quality of life. They represent a diverse group of clinical presentations from benign normal variants to complex deformity. It is crucial to have a good understanding of this subject matter, as they present commonly and early diagnosis can often improve outcomes. There has been an evolution in the management foot deformities, with surgeons moving from large open procedures to less invasive and non-surgical procedures, such as serial casting. However, there remains a role for open surgery, particularly in complex, rigid and severe cases. Common deformities that affect the paediatric foot are discussed in terms of their aetiology, clinical presentation, diagnosis and management. [ABSTRACT FROM AUTHOR]

To describe the intermediate-term incidence of hypertension following pediatric renal trauma relative to that in an extremity (control group) trauma cohort. This was a single-institution matched cohort study of pediatric patients presenting to a Level I trauma center between 2010 and 2019. The primary cohort included patients who sustained renal trauma, and a comparator cohort of sex- and age-matched patients with isolated extremity fracture was identified. The primary outcome was new hypertension, and a sensitivity analysis was conducted of any elevated blood pressure (EBP). Conditional logistic regression was performed and adjusted for overweight/obese status. There were 62 renal trauma patients included, representing 35% of all eligible patients seen in the study period. Hypertension was not found to be more prevalent with renal trauma (OR 1.18, 95% CI: 0.41, 3.39). The incidence of hypertension (9.7–11.3%) and EBP (22.6–32.3%) was comparable between renal trauma and control groups. Despite a high incidence of EBP and hypertension in pediatric patients after renal or extremity trauma, we did not observe an association between renal trauma and postinjury hypertension. We identified no cases of malignant or symptomatic hypertension, and no surgical interventions for renovascular hypertension was performed. Our findings suggest that only select patients, rather than most renal trauma patients, may benefit from monitoring for postinjury hypertension. [ABSTRACT FROM AUTHOR]

Prior meta-analysis suggested a low incidence of local adverse events after infusion of vasoactive agents via a peripheral venous catheter in children. However, the number of included patients was relatively low, and the vasoactive agents used were mostly dopamine. We performed an updated systematic review with meta-analysis using databases of MEDLINE (via PubMed) and Cochrane Central Register of Controlled Trials to explore the safety of infusing vasoactive agents, including epinephrine and norepinephrine, through peripheral venous catheters or intraosseous access in critically ill children. The primary outcome was the occurrence of local adverse events associated with peripheral vasoactive infusion, such as extravasation or infiltration. Twelve observational studies and 1 randomized controlled trial were finally included. The pooled incidence rates of local adverse events associated with infusion of vasoactive agents through peripheral venous catheters or intraosseous access, peripheral venous catheters only, and intraosseous access only were 2.1% (95% confidence interval [CI]: 0.8%–3.9%), 2.3% (95% CI: 1.0%–4.0%), and 1.1% (95% CI: 0.0%–9.8%), respectively. Based on the findings of this meta-analysis, the incidence rate of local adverse events associated with peripheral vasoactive infusion appears to be low. Peripheral infusion of vasoactive agents, including epinephrine and norepinephrine, can be considered when necessary. [ABSTRACT FROM AUTHOR]

The perioperative period is a stressful experience for both the child and their parents. Anesthesia staff generally have a positive attitude to the parental presence in the operating room. They can be a powerful resource in creating a caring environment, but they are challenged by limited time to establish a relationship. The present study describes the anesthesia staff's experience of parental presence during their child's anesthesia induction. A descriptive design with a phenomenological approach. A total of 22 anesthesia staff from four Swedish hospitals were interviewed. The study has been carried out using a reflective lifeworld research (RLR) approach. The following four constituents describe anesthesia staff's experiences of parental presence: a conditional presence; a relationship that is secondary; a shared but two-part responsibility; and a need to demonstrate professionalism. Parental presence is natural and essentially irreplaceable, as it creates security for the child. However, the results show that parental presence is not free of obligations and expectations. Designing for good perioperative care is important, and the staff plays a key role in cooperating with the parents to improve the quality of care. [ABSTRACT FROM AUTHOR]

Copyright of Biomédica: Revista del Instituto Nacional de Salud is the property of Instituto Nacional de Salud of Colombia 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.)

Coordination can be tested through different outcomes, which provide a platform for clinical and research purposes. The psychometric properties of the outcomes aid clinicians/researchers in appropriately selecting the measure. To investigate the coordination outcomes measures for children aged 4–17. A literature search was made using PubMed/Medline, Scopus, Cochrane, Ovid-SP, and PEDro from inception to August 2021. Experimental studies involving children, written in English with coordination as one of the variables, were included. An adapted version of the COSMIN checklist was used for psychometric properties. Quality assessment of included articles was evaluated through the risk of bias, Level of Evidence, Grades, and PEDro. 1082 articles were screened, of which 12 trials were included. Gross motor coordination has been observed as a part of the coordination tests. Meta-analysis of Korperkoordinationtests fur Kinder (KTK) showed high heterogeneity (I 2 = 93%) among intervention effects. 93% of outcome measures are reliable, but only 46% have criterion validity, while responsiveness is found in 73%. The KTK showed excellent methodological quality, while other outcome measures had limitations in their psychometric properties. Therefore, there is a need to refine and develop coordination scales with excellent psychometric properties that could be useful for children aged 4–17 years. [ABSTRACT FROM AUTHOR]

Purpose: Although Brazil has a high prevalence of retinoblastoma, there is a lack of epidemiological data on the disease. Thus, in this study, we aimed to evaluate the epidemiological profile of patients diagnosed with retinoblastoma in the ophthalmology department of a pediatric tertiary referral hospital in Ceara, Brazil. Methods: A descriptive and crosssectional study was conducted by retrospectively analyzing the clinical and socioeconomic data from the medical records of pediatric patients followed-up at the hospital between 2007 and 2021. Retinoblastoma was diagnosed on the basis of a fundoscopic or histopathologic examination. Results: The data of 105 patients were included in the study, and the mean patient age at the time of diagnosis was 1.7 years. Most of the patients were women (50.5%) and hailed from rural areas (57.4%), which was associated with a higher tumor stage. Of the 150 patients, 57.1% initially presented with leukocoria. Ocular hyperemia was associated with more advanced stages of retinoblastoma (p=0.004). Bilateral involvement was observed in 25.7% of the patients and at a significantly younger age (p=0.009). The presence of retinal detachment, vascularized lesions, and vitreous seeds significantly increased the likelihood of requiring enucleation. Discussion: This study presents an epidemiological description of retinoblastoma in Brazil, which highlights the significance of early detection. Delayed diagnosis is associated with a poorer visual prognosis and higher mortality rate, particularly in patients with unilateral disease. Risk factors for a more severe disease were retinal detachment, vascularized lesions, and vitreous seeds. The correlation between histopathological features and clinical outcomes was limited. Conclusion: Further studies are required to assess the influence of ocular hyperemia, fundoscopic assessment, and histopathologic findings on the prognosis of retinoblastoma. Moreover, it is critical to devise interventions to reduce the time-to-diagnosis in rural areas. [ABSTRACT FROM AUTHOR]

Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca 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.)

Vaccination is an invasive procedure that causes pain. Uncontrolled pain negatively affects all aspects of life, including health. This study aimed to determine the effects of the Helfer skin tap technique and Buzzy® application on the levels of pain and fear experienced by 4-year-old children during measles–mumps–rubella (MMR) vaccination. This study adopted a randomized controlled experimental design. The study sample consisted of 96 children (Helfer skin tap technique group: n = 32, Buzzy® group: n = 32, control group: n = 32) who received MMR vaccination. Children in the Buzzy® and Helfer skin tap technique groups received their respective interventions before and after vaccine injection, while children in the control group received routine vaccine injection. Based on the parents' and nurse's observations, the pain and fear scores after vaccine injection were lowest in the Buzzy® group and highest in the control group. Based on the children's assessments, the pain scores after vaccine injection were lower in the Buzzy® group than in the Helfer skin tap technique group. Buzzy® application and the Helfer skin tap technique have beneficial effects on children's pain and fear during MMR vaccination. Buzzy® application is more effective in reducing pain and fear during vaccine injection in children than the Helfer skin tap technique. Nurses can increase the comfort of children by reducing pain during vaccination using Buzzy®. • Vaccination can be uncomfortable and distressing for infants and children • Non-pharmacological methods used during vaccine administration can effectively reduce pain and fear in children. • The Buzzy® device effectively reduces pain and fear during MMR vaccination in 4-year-olds [ABSTRACT FROM AUTHOR]

The effectiveness of pediatric care is made more challenging to analyze by the need for specialist nursing and by the specific characteristics of pediatric patients, as opposed to adult patients, such as ongoing rapid growth and development, and different physical, cognitive, and emotional demands. Previous research has identified "Pediatric Nursing-Sensitive Outcomes" (PNSOs) in intensive care unit settings, though pediatric intensive care beds only represent a very limited percentage of hospital beds. To improve care quality and safety for a larger population of patients, this study aims to identify PNSOs in lower and medium-complexity care units (LMCCUs). This study uses the Delphi method to gather expert opinion on priority PNSOs in LMCCUs, with a 75 % consensus pass threshold. A preliminary list of PNSOs was identified from a literature review and used as inputs for two Delphi rounds conducted between January and March 2023. 27 panelists were recruited and passed 17 PNSOs: pressure injury; failure to rescue; patient/family experiences; central line-associated bloodstream infections; surgical site infections; healthcare-associated infections; medication errors; hospitalization breastfeeding continuity; peripheral intravenous infiltrate or extravasation; pediatric falls; pain assessment and management; vital sign monitoring; nutrition; discharge planning; family-centered care practice; healthcare environment; nurse voluntary turnover. This study contributes to research on PNSOs and builds consensus on priorities for LMCCUs. Future research should clinically evaluate these PNSOs and their association with organizational and professional variables often investigated in an adult but not a pediatric setting. [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess physical activity (PA) levels in children and adolescents with Down syndrome (DS) using a commercially available activity tracker (Fitbit) and a parental proxy questionnaire. This cross-sectional study included two groups of individuals with DS (school-age children and adolescents) and one parent per child/adolescent. The school-age children and adolescents with DS wore the Fitbit for seven consecutive days. Parents completed the parental proxy questionnaire on the seventh day. Weekday and weekend PA levels for the two groups of individuals with DS were compared. In addition, PA levels obtained with the Fitbit were compared to parental responses. Complete data sets were available for 32 child-parent dyads. Sedentary time was higher for the adolescent group (p =.022), while light PA time was lower (p =.020). All measured PA patterns, excluding sedentary behavior, decreased on weekends in both groups: steps (p =.002), light PA time (p =.028), and moderate-to-vigorous PA time (p =.004). Parental proxy questionnaires underestimated actual PA levels. PA was lower in the adolescent group and during the weekend for both groups. Findings from this study suggest a need for tailored programs designed to increase weekend PA levels in school-age children and adolescents with DS in pediatric nursing research. The use of commercial activity trackers, such as the Fitbit, which are user-friendly and relatively affordable, is effective for pediatric nurses to monitor PA levels of children and adolescents with DS in clinical settings. • Adolescents had less light physical activity (PA) compared to school-age children. • Weekend PA levels decreased in children and adolescents with Down syndrome (DS). • Parents notably underestimated their child's actual PA level. • Children with DS had a low refusal rate for wearing the user-friendly Fitbit. • The Fitbit is useful for self-monitoring and management after the study ends. [ABSTRACT FROM AUTHOR]

This study was carried out to adapt the child forensic attitude scale into Turkish and evaluate its validity and reliability. This methodological, descriptive, and correlational study was conducted with a total of 363 professionals, including 40 physicians, 87 nurses, 79 lawyers, 81 law enforcement officers, 20 psychologists, and 56 social service experts, between January 2023 and February 2023. The study data were collected online using a "Personal Information Form" and the "Child Forensic Attitude Scale". Explanatory and confirmatory factor analysis, Cronbach's alpha, item-total score analysis were used for the evaluation of the data. It was determined that the scale consisted of 28 items and three sub-dimensions, namely fear of not identifying abuse, fear of overcalling abuse, skepticism, which explained 44.11 % of the total variance. In confirmatory factor analysis, all fit indices were greater than 0.85. Cronbach's alpha coefficient was determined as 0.80 for the total scale. According to the results of the analyses and evaluations in this study, the child forensic attitude scale is a valid and reliable measurement tool for the Turkish sample. Child sexual abuse is a serious problem globally and the fields of justice, security, health, social services need to collaborate to protect and guarantee victims' rights. Professionals working in this field have difficulties in evaluating children who have been abused. For this reason, it is very important to evaluate the attitudes of professionals, especially pediatric nurses, in this process and will guide the shaping of the initiatives to be taken. [ABSTRACT FROM AUTHOR]

Pain Neuroscience Education (PNE) is a commonly used technique applied by physical therapists in the rehabilitation of chronic pain. The aim of this study was to culturally adapt an existing PNE for children with chronic pain (PNE4Kids) to Turkish children with chronic pain (PNE4Kids-Turkish). A three-round modified Delphi-study was conducted between September 2023 and February 2024. Experts completed questionnaire with 5 items to elicit demographic data and 16 closed and 7 open-ended questions to assess relevance of information, feasibility of stories, visual information, and clarity of message in the 4 main areas of 'normal pain biology', 'pain modulation', 'chronic pain, adaptations, central sensitization', and 'the application and implications of PNE4Kids. MAXQDA software was used for qualitative analysis of open-ended questions. A total of 38 experts (mean age: 36.6 ± 9.05 years, 6 male, 32 female) were recruited for this study. The results of the first round indicated that 84–100 % of Delphi experts strongly agreed or agreed on the relevance of information, feasibility of stories, visual information, and clarity of message in respect of the 4 main areas. During second and third round, an acceptable degree of agreement with clinical usefulness of PNE4Kids-Turkish materials was obtained. PNE4Kids was culturally adapted for Turkish children suffering from chronic pain. The findings of this study mainly highlight the viewpoints of the experts. This is the first study to have developed and culturally adapted the PNE4Kids for Turkish children with chronic pain. The PNE4Kids-Turkish is crucial, valuable, helpful, and understandable for Turkish children with chronic pain. In addition, the PNE4Kids-Turkish has the potential to close the gap in research and clinical areas for Turkish children with chronic pain. • The PNE4Kids is one of the interactive educational tools specially designed for pediatric pain education. • Many of experts agreed that PNE4Kids-Turkish is crucial, valuable, helpful, and understandable for children with chronic pain. • The PNE4Kids-Turkish has the potential to close the gap in research and clinical areas for children with chronic pain. [ABSTRACT FROM AUTHOR]

This study was conducted to determine the relationship between mothers' phubbing behaviors and the parental role. The study was conducted as a cross-sectional correlational design with the mothers of 340 babies hospitalized in the pediatric clinics of a training and research hospital in Çorum between March 2023 and September 2023. An introductory information form, the Generic Scale of Phubbing and the Self-Perception of Parental Scale were used in the study. Mothers filled out the data collection forms face to face within 15-20 minutes. It was found that the mean age was 29.65 ± 4.38 years, the mean hours of using social media per day was 6.86 ± 1.64, and the mean hours spent with the baby was 20.40 ± 3.78 for mothers. There was a negative relationship between The Generic Scale of Phubbing- Interpersonal Conflict sub-dimension mean score (−0.264; <0.001), Problem Acknowledgement sub-dimension mean score (−0.118; 0.030) and total mean score (−0.145; 0.007) with the Self-Perception of Parental Scale-Competence sub-dimension mean score. This study found a relationship between mothers' phubbing behavior and their parental roles. It suggests investigating this important issue with different variables. Pediatric nurses can provide training to reduce mothers' phubbing behaviors or develop practices to change phubbing behaviors. • This study provides information on mothers' phubbing behaviors, parental role and the relationship between them. • Social media usage of mothers was determined 6.86 ± 1.64 hours per day. • It was found that as mother phubbing increased, their perception of competence in the parenting role decreased. • Pediatric nurses should educate mothers about the risks that may arise as a result of smartphone use. [ABSTRACT FROM AUTHOR]

Advances in medical sciences have contributed to the increase in children living with chronic diseases. The diagnosis of a chronic disease in a child can affect the quality of life of all family members, including siblings. Therefore, this study aimed to identify the predictors of quality of life among siblings aged 8 to 12 years who have a brother or sister with chronic diseases. In this case-control study conducted in Rasht, 85 siblings of children with chronic diseases as the case group and 172 siblings of healthy children as the control group were recruited using cluster sampling. The two groups were matched for age and gender. Data were collected using the Pediatric Quality of Life Inventory (PedsQL TM) and a demographic questionnaire. The collected data were analyzed using Mann-Whitney U, Kruskal-Wallis, and logistic regression analysis tests via SPSS version 16. The mean quality of life scores in the case and control groups were 88.86 ± 10.33 and 87.39 ± 10.89, respectively, indicating a desirable level within both groups. No statistically significant difference was found in this regard between the two groups. Based on the logistic regression analysis, three variables of number of family members (P = 0.03), mother's education level (P = 0.025), and family's income level (P = 0.023) were identified as significant predictors of quality of life. In this regard, it was found that the number of family members and the mother's education level were positively related to the quality of life, increasing the mean scores by 2.32 and 1.48, respectively. Conversely, a higher family income level was associated with a decrease in quality of life scores by 0.543. The study found that the quality of life among siblings of children with chronic diseases is good, comparable to that of their peers. The findings imply that the chronicity of the disease does not significantly impair siblings' adaptation and overall well-being. The findings of this study can be used in various fields, including healthcare management, nursing clinical services, nursing education, and nursing research. • The quality of life of siblings of children with chronic diseases may undergo changes. • The quality of life of siblings of children with chronic diseases is not much different from siblings of healthy children. • Various predictors affect the quality of life of siblings of children with chronic diseases. [ABSTRACT FROM AUTHOR]

• PNPs regularly counsel for body weight, physical activity, and nutrition. • PNPs do not regularly counsel for muscle strengthening. • Counseling for weight management increases the odds for behavioral counseling. This study assessed counseling by pediatric nurse practitioners (PNPs) for management of overweight and obesity. Using a cross-sectional design, 1,058 PNPs completed a one-time survey regarding counseling for healthy body weight, physical activity, and consumption of protein, fruits and vegetables. Study findings suggest PNPs are using behavioral counseling for weight management in pediatric patients. Counseling was more frequent for healthy body weight, fruit and vegetable intake, and physical activity than for protein consumption and muscle strengthening. Furthermore, when PNPs counseled for healthy body weight they were also more likely to counsel for physical activity (OR = 25.99 [95% CI: 19.25, 35.11]), fruit and vegetable intake (OR = 22.35 [95% CI: 16.71, 29.88]), protein intake (OR = 9.82 [95% CI: 7.60, 12.69]), and muscle strengthening (OR = 6.41 [95% CI: 4.98, 8.24]). PNPs are counseling for healthy body weight and necessary behavioral tools, but increased emphasis on muscle strengthening may benefit overweight and obese youth. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to determine age-based reference values for the Gastrointestinal and Gastroesophageal Reflux (GIGER) Scale for Infants and Toddlers. Study Design and Methods: GIGER data from healthy, full-term born children under 2 years of age were used to determine reference values. For each age group, median, interquartile range, 90th, and 95th percentile scores were calculated for each subscale and the total score. 90th percentile scores were also calculated for each of the 36 items based on the full sample. Results: Data from 625 children were used to determine reference values for children 0-2, 2-4, 4-6, 6-8, 8-10, 10-12, and 12-24 months. In healthy, full-term infants, gastrointestinal and gastroesophageal reflux symptoms improved over the first 24 months of life, with the most improvement occurring over the first 2 months. Clinical Implications: The GIGER is a 36-item measure of gastrointestinal and gastroesophageal reflux symptoms for children under 2 years old that has evidence of adequate psychometrics for clinical practice and research. The age-based reference values established in this study can be used to guide score interpretation and determine when a child's symptoms warrant further investigation. This may help identify infants and toddlers with significant symptoms earlier so that they can obtain the care they need. Gastrointestinal and gastroesophageal reflux symptoms are a common concern for parents of infants and young children. It can be difficult for pediatric nurses and nurse practitioners caring for infants and toddlers to determine when symptoms are of a frequency or severity to warrant further investigation or referral. The Gastrointestinal and Gastroesophageal Reflux (GIGER) Scale for Infants and Toddlers is a valid and reliable parent-reported assessment. Reference values for the GIGER Scale established in this study can help clinicians determine whether a child's symptoms fall within the range of typical for their age or are outside of the range of typical and thus warrant further investigation. [ABSTRACT FROM AUTHOR]

Helicopter emergency medical services (HEMS) have become widespread around the world. However, previous studies of the influence of HEMS on mortality were limited to adult patients only and showed inconsistent and heterogeneous results. This study aimed to examine the association between HEMS and mortality among pediatric emergencies compared to ground emergency medical service (GEMS). We searched relevant databases (MEDLINE, EMBASE, The Cochrane Central Register of Controlled Trials) and included articles in any language. The most recent search was on January 4th, 2024. We included prospective observational cohort studies or clinical trials that compared HEMS with GEMS in pediatric patients. We excluded any study that did not compare two or more groups of participants. Two pairs of researchers blindly screened studies and evaluated risk of bias using the Risk of Bias in Nonrandomized Studies of Interventions tool. We conducted this systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Data were extracted by four independent reviewers. We calculated the odds ratio using the random-effects model. The primary outcome was mortality. Our search strategy yielded 1454 results. Of these, seven observational studies met our eligibility criteria; no RCT met the criteria. All studies targeted trauma patients only. HEMS was associated with lower mortality (Odds ratio 0.66, 95 % CI 0.59 to 0.74). Inconsistency between trials was determined to be low due to low heterogeneity (I2 = 0 %). In a subgroup analysis conducted with and without physicians on the HEMS staff, we found no significant differences (I2 = 0 %, p = 0.71). Our systematic review and meta-analysis, which was limited to trauma pediatric trauma patients, revealed that HEMS deployment correlated with decreased mortality. Further research is necessary to more effectively measure the potential influence and applicability of HEMS for pediatric emergencies. [ABSTRACT FROM AUTHOR]

Copyright of Arquivos Brasileiros de Oftalmologia is the property of Arquivos Brasileiros de Oftalmologia 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.)

Objectives Based on case reports, researchers have observed the incidence and clinical manifestations of Guillain-Barré Syndrome (GBS) following COVID-19 infection. Current hypotheses suggest that the risk of GBS may increase with COVID-19, and worsening GBS could elevate the risk of infection and exposure to the virus. This study aimed to assess the cognitive epidemic and mortality of children under 15 years of age with GBS during the COVID-19 pandemic and to compare them to two years earlier without addressing the etiology. Materials & Methods This cross-sectional study was conducted on all children admitted to Iranian hospitals with a diagnosis of GBS and whose clinical information was available in the national flaccid paralysis patient information registration system between April 2018 and April 2021. Results The total number of registered cases of GBS in the pre-COVID-19 period and during this period was 778 cases and 504 cases, respectively (total N=1282), indicating a decrease in registered GBS during COVID-19. The mean age of the patients in the pre-COVID-19 period was 9.00 ± 2.78 years, and during the COVID-19, it was 8.99 ± 2.03 years (P-value =0.998). No significant difference was found in gender distribution between the two periods (P-value =0.427). The total number of paralysis cases studied after 60 days was 14.3% before the COVID-19 period and 17.3% during the pandemic (P-value =0.216). The mortality rate in patients with GBS was 0.13% in the pre-COVID-19 period and 0.19% in the COVID-19 period (P-value =0.757). Conclusion Despite the decline in the frequency of diagnosis and referrals of patients with GBS during the COVID-19 period, no difference was found in the demographic characteristics and clinical outcomes of children with GBS in the pre-COVID-19 period and during this pandemic. [ABSTRACT FROM AUTHOR]

Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca 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 Journal of Society & Social Work is the property of Journal of Society and Social Work 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.)

The law relating to consent for medical interventions in children is complex. Children, when they are old or mature enough can consent for themselves, but the legal rules around this vary by jurisdiction. When they are unable to consent, this must be sought from someone with parental responsibility. This article discusses consent, and its refusal, to medical interventions by children, adolescents and parents. [ABSTRACT FROM AUTHOR]

• Six-months of physical exercise improved quality of life in children with epilepsy. • Seizure frequency did not increase with the exercise program. • A Six-month of exercise program improved motor and Cardiorespiratory Fitness. • Monitoring by the researchers stimulated the performance of physical exercise. to investigate the effects of a physical exercise (PE) program, supported by wearable technology (WT), in children with drug-resistant epilepsy (DRE). 29 children with DRE were randomized to experimental (EG) and control (CG) groups. To encourage PE, the EG performed one hour of aerobic activity three days a week for six months, outside the school setting. Compliance was monitored using activity wristbands, with data reported weekly by parents. Health - related quality of life (HRQoL), seizure frequency, physical activity (PA), physical fitness (musculoskeletal, motor, and Cardiorespiratory Fitness), and body composition, were assessed at baseline, at three and six months. Seizure frequency in the last six months evolved from 10.5 seizures/week at baseline, to 4.5 at the end of the study in the EG, and from 5.2 seizures/week to one in the CG. Significant differences were found in weekly hours-PE (η2= 0.49); motor fitness (η2= 0.08); Cardiorespiratory Fitness (η2= 0.19); weight (η2= 0.003); Triceps skinfold thickness (η2= 0.05); lower limb muscular strength (η2= 0.03); HRQoL (η2= 0.02); and PA (η2= 0.22). Post-hoc ANOVA revealed that EG improved significantly (p < 0.05) between baseline and six months. Negative correlations were observed between PA and seizure frequency. Supported by WT, children with DRE increased the weekly hours of PE at three and six months, with no increase in seizure frequency. Our study provides evidence of the effectiveness of PE for improving HRQoL. [ABSTRACT FROM AUTHOR]

Aim: To investigate the association between presence of caries in anterior teeth and bullying victimization in schoolchildren. Methods: A cross-sectional study was conducted in Brazil with a sample of 387 schoolchildren aged 6 to 10 years. The presence of moderate/extensive dental caries was assessed using the International System for the Evaluation and Detection of Dental Caries (ICDAS-II). The children answered the "Olweus Bullying" (QBO). Descriptive analyses were performed, and the associations between bullying victimization and independent variables collected were determined by univariate and multivariate Poisson regression. Results: The prevalence of bullying victimization was 66.4%. Bullying victimization was higher among children who had moderate/extensive caries in some anterior teeth (p = 0.010). 8-year-old (p = 0.048), 9-year-old (p = 0.001), and 10-year-old (p = 0.002) children reported greater bullying victimization when compared to 6-year-olds. Conclusion: The presence of moderate/extensive dental caries in anterior teeth is associated with bullying victimization in schoolchildren. [ABSTRACT FROM AUTHOR]

Purpose: To analyze the functions of the stomatognathic system in children with or without molar-incisor hypomineralization (MIH). Methods: For this cross-sectional study, 72 children aged 6–12 years were recruited and divided in two groups: with MIH (G1) and without MIH (G2). T-SCAN was used to verify the distribution of occlusal contacts, gnathodynamometer to measure maximum molar bite force, and Iowa Oral Pressure Instrument (IOPI) to assess the strength of facial expression muscles. The t test and paired t test (p ≤ 0.05) were used for statistical comparisons. Results: The molars affected by MIH exhibited lower distribution of occlusal forces (p < 0.001) and lower maximum molar bite force (p < 0.05) compared to the molars in the control group. However, there was no difference between the MIH-affected sides compared to the unaffected side, nor between the molars affected by MIH and their antagonists (p > 0.05). There were no differences in the forces of the facial expression muscles between the groups. Conclusions: These findings suggest that MIH significantly impacts occlusal force distribution and bite force, but not facial expression musculature. [ABSTRACT FROM AUTHOR]