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The current study examined the acquisition, retention, and transfer effects of a motor program. Children with autism spectrum disorder participated in a 9-week program that targeted 13 fundamental motor skills based upon the Test of Gross Motor Development-3. Assessments were conducted before and after the program, as well as at 2-month follow-up. Significant improvements were found on not only the trained fundamental motor skills (acquisition) but also the untrained tasks on balance (transfer). The follow-up tests revealed continuous improvement on the trained locomotor skills (retention), as well as the untrained skills on balance (retention + transfer). These findings highlight the importance of continuous support and long-term participation on motor practices. [ABSTRACT FROM AUTHOR]

Aim Method Results Conclusion We aimed to investigate the frequency of vitamin C deficiency scurvy in the Australian paediatric context, describe cohorts at risk, and identify factors associated with development of symptoms in children with vitamin C deficiency. We also aimed to propose a management guideline for children with features of scurvy.A retrospective study was done at a tertiary paediatric hospital in Australia over a three‐year period, from August 2019 to July 2022. Children from birth to 18 years old, whose vitamin C levels were low (<23 μmol/L), were included. Data extracted from hospital medical records included demographics, weight, co‐morbidities, eating disorder diagnoses, clinical features, investigations and treatment. Descriptive statistics and risk statistics were performed.In a cohort of 887 patients who had their vitamin C levels checked, we identified 272 (31%) who had a vitamin C level <23 μmol/L. Of these, 13 (5%) were symptomatic of vitamin C deficiency and 19 (7%) may have been symptomatic. In patients with vitamin C deficiency, 248 (91%) had comorbidities, neurodevelopmental disorders being most common, and 176 (65%) had restricted eating. When the asymptomatic and symptomatic groups were compared, in the symptomatic group, there was a significantly lower vitamin C level and disordered eating related to autism spectrum disorders was more common.In order to avoid delayed diagnoses and unnecessary investigations, clinicians should be familiar with symptoms of scurvy and perform a dietary assessment, vitamin C assay, and commence empiric vitamin C supplementation where appropriate. [ABSTRACT FROM AUTHOR]

To examine and categorize individual outcomes after the "Intensity matters!"-program, a new, cross-professional intensive intervention for children with disabilities across Norway. 84 children and their parents/legal guardian were enrolled in this multicase study. Participants were active in defining goals, and hereby the content of the intervention. The pre-settled goals were grouped into the categories of body functions and structure, activities and participation inspired by the components of the International Classification of Functioning, Disability, and Health (ICF). The pre-settled goals were assessed pre- and post-intervention by using The Canadian Occupational Performance Measure (COPM). A clinically important change was predefined as a change ≥2 points. 1004 pre-settled goals were categorized into focus areas, where 62.4% were categorized as activity; functional mobility (n = 626). Post-intervention assessment of the COPM ratings of child performance and satisfaction showed a mean change of 3.7 (range −0.25;8.5) and 3.8 (range 0.25;10), respectively. The majority of participants in the "Intensity Matters!"-program had a clinically important change in their individual goals after only three weeks of intervention. This study supports the use of client-centered measures in rehabilitation for children with disabilities, but a further examination of long-term outcome is warranted. The "Intensity matters!"-program is a cross-professional, goal-directed, and intensive intervention with a high degree of user involvement. In a sample of 84 individual participants, this study shows that the majority of focus areas were found to be of clinically relevant improvement post intervention. Individual structured programs with high intensity in a group setting are likely to be successful for children with different health conditions, including cerebral palsy and other neurological or genetic disorders. Areas of concern formulated ahead of a three-week, intensive, goal-directed program were mainly linked to the ICF domain activity, and more specifically related to personal care and functional mobility. Rehabilitation professionals should emphasise participants' priorities and involvement of children when planning and evaluating a therapeutic intervention. [ABSTRACT FROM AUTHOR]

A common methodological limitation of research that guides surgical procedure selection for children's elective lower limb orthopaedic surgeries is inconsistent outcome selection. Improving outcome consistency can be achieved through the development of a core outcome set (COS). The aim of this study is to identify which outcomes are considered important for children's elective lower limb orthopaedic surgeries by allied health professionals (AHPs) and explore why they select these outcomes, to inform a COS development project. Online semi-structured interviews were conducted with relevant AHPs. Participants were selected using maximum variation purposive sampling; selection was based on profession and inpatient/outpatient role. The data set was analysed using an inductive and deductive approach to thematic analysis. Four physiotherapists, three orthotists, three prosthetists, and two occupational therapists were interviewed. Most identified outcomes of importance related to "activities and participation". From the data, we conceptualised that AHPs with effective multidisciplinary communication focused on child-centred outcomes, while clinicians with limited multidisciplinary teamwork focused on role-based outcomes. There is concurrence between outcomes identified as important in this study, and other qualitative studies in similar populations. These important outcomes were seldom measured in previous studies or in routine clinical practice. Allied health professionals (AHPs) prioritise activity and participation outcomes after children's elective lower limb orthopaedic surgery. It is important to the rehabilitation of children after elective lower limb orthopaedic surgery that all involved AHPs collaborate with the wider multidisciplinary team. Multidisciplinary team communication encourages collaborative outcome identification, and discourages role defined outcome focus. [ABSTRACT FROM AUTHOR]

Exploring the temporal and bi-directional relationship between device-based measures of physical activity and sleep in ambulatory children with cerebral palsy (CP). 24-hour activity data were collected from children with CP (n = 51, 43% girls, mean age (range); 6.8 (3–12) years; Gross Motor Function Classification System levels I to III). Nocturnal sleep parameters and daily physical activity were measured for seven consecutive days and nights using ActiGraph GT3X accelerometers. Linear mixed models were constructed to explore the relationships between sleep and activity. Light and moderate-to-vigorous activity were negatively associated with sleep efficiency (SE) (resp. p = 0.04, p = 0.010) and total sleep time (TST) (resp. p = 0.007, p = 0.016) the following night. Sedentary time was positively associated with SE and TST the following night (resp. p = 0.014, p = 0.004). SE and TST were positively associated with sedentary time (resp. p = 0.011, p = 0.001) and negatively with moderate-to-vigorous physical activity (resp. p < 0.001, p = 0.002) the following day. Total bedtime and TST were negatively associated with light physical activity (resp. p = 0.046, p = 0.004) the following day. The findings from this study suggest that ambulatory children with CP may not sleep better after physical activity, and vice versa, indicating that the relationship is complex and needs further investigation. The use of device-based accelerometry is a feasible method to measure 24-hour activity patterns with sleep and physical activity in ambulatory children with cerebral palsy. The relationships between sleep and physical activity in children with cerebral palsy are not as expected based on patterns shown in peers with typical development. Interventions for sleep in children with cerebral palsy require a holistic approach, focusing on daily physical activity patterns and relevant child- and contextual factors. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to systematically review epidemiological evidence on associations between screen time exposure and myopia in children and adolescents, and to quantitatively evaluate summary effect estimates from existing literature. Method: There were three online databases including PubMed, Embase, and Web of Science, for epidemiological studies on screen time exposure and myopia published before June 1, 2023. The risk of bias was assessed by the Newcastle Ottawa Scale (NOS) checklist. Summary odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to evaluate the correlation between screen time exposure and myopia using random or fixed-effect models by exposure type (categorical/continuous). We also performed subgroup analysis by screen device type, study quality, geographic region, and research period. Results: We searched 7,571 records from three databases and identified 19 eligible studies, including 14 high-quality studies and 5 moderate-quality studies. Meta-analyses suggested that there was a statistically significant correlation between screen time (high vs. low) and myopia. The pooled ORs with 95%CIs were respectively 2.24 (1.47–3.42) for cross-sectional studies, and 2.39 (2.07–2.76) for cohort studies. We also found a significant association between continuous exposure to screen time (per 1 h/d increase) and myopia in cohort studies. The pooled ORs with 95%CIs were 1.07 (1.01–1.13). In subgroup analysis stratified by screen device type in cross-sectional studies, screen time exposures from computers (categorical: OR = 8.19, 95%CI: 4.78–14.04; continuous: OR = 1.22, 95%CI: 1.10–1.35) and televisions (categorical: OR = 1.46, 95%CI: 1.02–2.10) were associated with myopia, while smartphones were not. Although publication bias was detected, the pooled results did not show significant changes after adjustment using the trim and fill method. Conclusion: Our findings support that screen time exposure was significantly associated with myopia in children and adolescents. Notably, screen time exposure from computers may have the most significant impact on myopia. [ABSTRACT FROM AUTHOR]

Background: Mycoplasma pneumoniae pneumonia is a common respiratory infection among children. However, the occurrence of thromboembolism with plastic bronchitis in association with Mycoplasma pneumoniae pneumonia is extremely rare. This case series presents five cases of children with Mycoplasma pneumoniae pneumonia who developed thromboembolism and plastic bronchitis. The clinical presentation, diagnostic approach, and management strategies are discussed. Methods: A retrospective analysis was conducted on medical records from a pediatric hospital. Patient demographics, clinical features, laboratory findings, imaging results, treatment modalities, and outcomes were collected. Results: The patients in our case series presented with varying degrees of respiratory distress, cough, and fever. Imaging studies revealed evidence of thromboembolism based on pulmonary artery occlusion. Bronchial casts were observed by bronchoscopy. Laboratory tests demonstrated elevated D-dimer levels and fibrinogen degradation products. All patients received a combination of low molecular weight heparin anticoagulation and supportive care. Conclusion: Thromboembolism with plastic bronchitis associated with Mycoplasma pneumoniae pneumonia is a rare but potentially serious complication in children. Prompt recognition and management are crucial for improving patient outcomes. This case series highlights the diverse clinical presentations, diagnostic challenges, and treatment strategies for this unique clinical entity. Further research is needed to better understand the pathogenesis and optimal management of this condition. [ABSTRACT FROM AUTHOR]

Background: Anemia is a common complication of tuberculosis (TB), and there is evidence that its prevalence is higher in patients with TB. Although TB is very important in epidemiology, careful investigation of TB-related anemia in children has not been carried out systematically. This study aimed to describe the details of anemia in children with TB and its association with clinical characteristics and the severity of inflammation. Methods: In this retrospective study, we explored Hb levels in 103 children with pulmonary TB (PTB) and they were divided into anemic or non-anemic groups. Logistics regression analysis was used to study the associations between anemia and demographic characteristics. Spearman correlations analysis was performed to analyse the associations between the biochemical parameters and hemoglobin levels in blood. Results: The prevalence of anemia in children with TB was 37.9% (48.7% showed microcytic hypochromic anemia, and 5.1% showed normal cell anemia). Compared with the anemia (n = 39) group, the non-anemic group (n = 64) had longer fever duration and increased respiratory rate (P < 0.05). In logistic regression analysis, anemia was associated with lower levels of Alb and higher levels of WBC, CRP, LDH, and ESR (P < 0.05). Spearman correlations analysis showed a significant negative correlation between hemoglobin (Hb) levels and inflammatory markers. After one month of antitubercular therapy (ATT), the Hb levels of 76.9% children returned to normal. Conclusions: Anemia is common among children with TB at diagnosis. The majority of children with TB-related anemia are mild to moderate microcytic hypochromic anemia. There is a strong correlation between the severity of anemia and the inflammation induced by TB. This suggests that anemia is a biomarker of the severity of TB in clinical practice among children. [ABSTRACT FROM AUTHOR]

Background: Eating disorders (ED) are one of the most common psychiatric illnesses that may lead to physical and psychosocial morbidity in children. Our study aimed to determine the prevalence and factors associated with a positive screening for ED among children and young adolescents in multiple Lebanese schools. Method: This cross-sectional study included a convenience sample of 253 students (45.5% females; 76.3% Syrian refugees) aged between 8 and 13 years and recruited from Lebanese private schools. Students were interviewed between February and June 2018 to collect information about sociodemographic factors and health characteristics. Logistic regression analyses were performed, using the SCOFF questionnaire for screening ED as the dependent variable. Results: Among the students, 36.4% tested positive for SCOFF. Logistic regression analyses revealed significant associations between a positive screening for ED and the following factors: being between 8 and 9 years old (p = 0.029), obesity (p = 0.010), experiencing fatigue (p = 0.017), encountering a stressful accident (p = 0.027), undergoing changes in residence, school, or country (p = 0.01), consuming meals from restaurants ≥3/week (p = 0.013), consuming ≤2 fruits/week (p = 0.01) and consuming ≥5 eggs/week (p = 0.01). Approximately 13.4% of students were underweight, while 24.5% were classified as overweight or obese. One-third (32.1%) of students spent between 2 and 5 h/day using digital devices. Half of the students (54.1%) purchased fast food ≥3/week from school cafeterias, and over three-quarters reported fluctuating their food intake in response to emotions such as sadness, fear, anger, or happiness. Conclusion: These findings emphasize the importance of early detection and intervention in addressing abnormal eating behaviors among children. [ABSTRACT FROM AUTHOR]

Introduction: Quality of life (QOL) and health-related quality of life (HRQOL) in children and adolescents with food allergies have been an important and steadily growing field of research for the past 20 years. There seem to be conceptual and methodological challenges that might influence the face validity of QOL and HRQOL research in general health research, but this has not been investigated in pediatric and adolescent food allergy research up until now. The aim of this study was to perform a systematic review of the QOL and HRQOL studies on food allergy in children and adolescents under the age of 18. Methods: The systematic review was conducted on studies purporting to measure QOL or HRQOL in children and adolescents with food allergies. The literature search was developed in Ovid MEDLINE and databases used in the review were Embase, Cochrane Database of Systematic Reviews, CINAHL, and Scopus. Studies were evaluated based on a set of face validity criteria developed by Gill and Feinstein in 1994 and refined by Moons et al. in 2004. Results: Out of 61 studies eligible for the review, 11 (18%) defined QOL or HRQOL and two distinguished QOL from HRQOL. The Food Allergy Quality of Life (FAQLQ) instrument series is the most frequently used HRQOL measurement among the studies included. QOL and HRQOL were employed interchangeably in half of the studies, some of them also using a third term in addition. Conclusion: Our findings lead to the conclusion that the research field investigated contains methodological and conceptual shortcomings regarding QOL and HRQOL. An increased awareness toward the terminology as well as consideration of points to reflect upon will be beneficial, as this will also improve the validity of future studies. [ABSTRACT FROM AUTHOR]

Background Asymptomatic SARS-CoV-2 infection in children is highly prevalent but its acute and chronic implications have been minimally described. Methods In this controlled case-ascertained household transmission study, we recruited asymptomatic children <18 years with SARS-CoV-2 nucleic acid testing performed at 12 tertiary care pediatric institutions in Canada and the United States. We attempted to recruit all test-positive children and 1 to 3 test-negative, site-matched controls. After 14 days' follow-up we assessed the clinical (ie, symptomatic) and combined (ie, test-positive, or symptomatic) secondary attack rates (SARs) among household contacts. Additionally, post–COVID-19 condition (PCC) was assessed in SARS-CoV-2–positive participating children after 90 days' follow-up. Results A total of 111 test-positive and 256 SARS-CoV-2 test-negative asymptomatic children were enrolled between January 2021 and April 2022. After 14 days, excluding households with co-primary cases, the clinical SAR among household contacts of SARS-CoV-2–positive and –negative index children was 10.6% (19/179; 95% CI: 6.5%–16.1%) and 2.0% (13/663; 95% CI: 1.0%–3.3%), respectively (relative risk = 5.4; 95% CI: 2.7–10.7). In households with a SARS-CoV-2–positive index child, age <5 years, being pre-symptomatic (ie, developed symptoms after test), and testing positive during Omicron and Delta circulation periods (vs earlier) were associated with increased clinical and combined SARs among household contacts. Among 77 asymptomatic SARS-CoV-2–infected children with 90-day follow-up, 6 (7.8%; 95% CI: 2.9%–16.2%) reported PCC. Conclusions Asymptomatic SARS-CoV-2–infected children, especially those <5 years, are important contributors to household transmission, with 1 in 10 exposed household contacts developing symptomatic illness within 14 days. Asymptomatic SARS-CoV-2–infected children may develop PCC. [ABSTRACT FROM AUTHOR]

Background There are limited data on the viral dynamics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in children. Understanding viral load changes over the course of illness and duration of viral shedding may provide insight into transmission dynamics to inform public health and infection-control decisions. Methods We conducted a prospective cohort study of children aged 18 years and younger with polymerase chain reaction–confirmed SARS-CoV-2 between 1 February 2022 and 14 March 2022. SARS-CoV-2 testing occurred on daily samples for 10 days; a subset of participants completed daily rapid antigen tests (RATs). Viral RNA trajectories were described in relation to symptom onset and resolution. The associations between both time since symptom onset/resolution and non-infectious viral load were evaluated using a Cox proportional hazards model. Results Among 101 children aged 2 to 17 years, the median time to study-defined non-infectious viral load was 5 days post–symptom onset, with 75% meeting this threshold by 7 days and 90% by 10 days. On the day of and day after symptom resolution, 43 (49%) and 52 (60%) of 87 had met the non-infectious thresholds, respectively. Of the 50 participants completing a RAT, positivity at symptom onset and on the day after symptom onset was 67% (16/24) and 75% (14/20). On the first day where the non-infectious threshold was met, 61% (n = 27/44) of participant RAT results were positive. Conclusions Children often met the study-defined non-infectiousness threshold on the day after symptom resolution. The RATs were often negative early in the course of illness and should not be relied on to exclude infection. Clinical Trials Registration. clinicaltrials.org; NCT05240183. [ABSTRACT FROM AUTHOR]

Connective tissue diseases are a heterogeneous group of autoimmune diseases that can affect a variety of organ systems. Lung parenchymal involvement is an important contributor to morbidity and mortality in children with connective tissue disease. Connective tissue disease-associated lung disease in children often manifests as one of several radiologic-pathologic patterns of disease, with certain patterns having a propensity to occur in association with certain connective tissue diseases. In this article, key clinical, histopathologic, and computed tomography (CT) features of typical patterns of connective tissue disease-associated lung disease in children are reviewed, with an emphasis on radiologic-pathologic correlation, to improve recognition of these patterns of lung disease at CT and to empower the pediatric radiologist to more fully contribute to the care of pediatric patients with these conditions. [ABSTRACT FROM AUTHOR]

Background: PTEN-related hamartoma tumor syndrome results from a mutation in the PTEN gene located at 10q23.31. This syndrome represents a spectrum of different phenotypes of variable expressions, now recognized as part of the same condition. Patients with this mutation have an increased risk of developing a wide range of findings, including malignancies. Although widely described in adults, there are no large series describing the imaging findings in patients before adulthood. Knowledge of the findings seen in children and adolescents with PTEN-related hamartoma tumor syndrome can help guide further management and improve surveillance recommendations. Objective: To describe the spectrum of imaging abnormalities in pediatric patients with PTEN-related hamartoma tumor syndrome. Materials and methods: We performed a retrospective, cross-sectional, multicenter study conducted between January 2000 and October 2021 in three tertiary pediatric institutions evaluating the imaging findings in children and adolescents (≤ 18 years) with confirmed diagnoses of a PTEN mutation. For each patient, the imaging findings, histopathology reports, and at least a 2-year follow-up of clinical outcomes for non-operative cases were documented. Results: The cohort included 78 children (37 girls), with a mean age at diagnosis of 7.5 years (range 0 days to 18 years). Benign brain findings included enlarged Virchow-Robin perivascular spaces, white matter changes, developmental venous anomalies, and cerebellar hamartomas. Benign thyroid findings were common, but 5/45 (11.1%) with thyroid abnormalities had a malignant nodule. Soft tissue adipocytic tumors, GI/GU polyps, other soft tissue abnormalities, along with vascular anomalies in various anatomic locations were common. Conclusion: Brain abnormalities, benign non-vascular soft tissue abnormalities, and vascular anomalies are commonly seen in children and adolescents with PTEN-related hamartoma tumor syndrome. However, malignancies involving the thyroid gland are not uncommon. Familiarity with the phenotype of PTEN-related hamartoma tumor syndrome in the pediatric population can improve diagnosis and prompt appropriate clinical surveillance of abnormal findings that warrant further management. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND CONTRIBUTIONS TO THEORY IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY CONCLUSIONS Unintentional injuries are the leading cause of morbidity and mortality among children and adolescents in the United States. Traditional injury education interventions for children often are inaccessible due to cost and logistics in underserved communities, exacerbating injury disparities. A new approach is needed to close this gap for families with preschool children.Collaborating with Head Start preschools optimizes engagement and accessibility to families in underserved communities. Involving caregivers and community organizations addresses the limitations of conventional interventions and community‐specific injury prevention concerns.Pop‐up Safety Town offers a more affordable model for injury prevention education, particularly in underserved regions. The model's approach, using adaptable education, mobile and reusable materials, and volunteer staffing, offers greater potential for achieving sustainable impact in these underserved communities.Pop‐up Safety Town presents a novel upstream solution to address disparities in injury prevention education in underserved communities. [ABSTRACT FROM AUTHOR]

Background Objective Methods Results Conclusions Mandibular range of motion (MROM) variables are widely used to evaluate oral function.The aim of this study was to establish the reliability of MROM variables in healthy children.In this cross‐sectional study, healthy children were examined 2 weeks apart. The following MROM variables were established: active maximum interincisal opening (AMIO), passive maximum interincisal opening (PMIO), protrusion and left and right laterotrusion. The reliability of the MROM measurements was determined by analysing the intra‐class correlation coefficient (ICC), standard error of measurement (SEM), smallest detectable change (SDC) and limits of agreement (LoA).A total of 167 healthy children were examined. The ICC indicated good reliability for AMIO (0.885); excellent reliability for PMIO (0.925); and moderate reliability for protrusion (0.578), laterotrusion left (0.601) and laterotrusion right (0.634). The SDC was 0.9 mm for AMIO, 0.4 mm for PMIO, 2.2 mm for protrusion, 1.6 mm for laterotrusion left and 1.4 mm for laterotrusion right. The LoA was −5.67 to 5.82 for AMIO, −3.90 to 3.57 for PMIO, −3.89 to 3.55 for protrusion, −2.99 to 2.77 for laterotrusion left, and − 2.71 to 2.77 for laterotrusion right.AMIO and PMIO measurements are both highly reliable in healthy children. The low SDC indicate that AMIO and PMIO are promising longitudinal measurements. Protrusion and laterotrusion measurements had moderate reliability. These results support our clinical recommendation to measure AMIO rather than PMIO, as PMIO is more difficult and more time‐consuming to perform than AMIO. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Given the growing reliance on digital devices, an increasing number of studies have examined the effects of text medium on reading outcomes in development; however, the results have been mixed. The goal of this systematic review is to look at how print and digital formats affect reading comprehension, engagement and other reading outcomes (e.g. vocabulary, reading speed) in children and adolescents aged 1–17 years old while also considering the influence of several participant, task and study characteristics.A comprehensive search strategy involving seven electronic databases yielded 88 eligible articles comparing digital and print formats on reading outcomes published between 2000 and 2023 (3 reviewer inter‐rater reliability: k = .54–.78). Three major characteristics were coded: participant‐level (grade/age, diverse populations, testing language); task‐level (text‐genre, shared reading, digital comparability); study‐level (publication recency, study quality) characteristics. Contingency tables were created for all studies, then for each reading outcome and for participant, task, and study characteristics separately to classify the percentage of studies that demonstrated outcomes favouring print, digital, no difference or reliance on specific reading measures or other factors.Except in the case of engagement as an outcome, the most common finding was no difference between digital and print. When participant, task and study characteristics were examined separately for the various reading outcomes, the results varied. More studies examining reading comprehension (particularly of informational text and in older children) found ‘print is better’, whereas ‘digital is better’ was more common in studies examining engagement, other outcomes such as vocabulary and diverse learners.This review highlights the importance of examining multiple interacting factors when studying the impact of print versus digital mediums on reading outcomes in children and adolescents. [ABSTRACT FROM AUTHOR]

This article explores the establishment of a sense of community within a girls‐only sports‐based intervention targeting social inclusion in a socially disadvantaged area of Sweden. Employing an ethnographic approach involving participant observations and interviews, the study shows how moral socialization, through practices of discipline, teaching and care, fosters a sense of community. Through detailed observations, the study illustrates that community formation is an active, relational construct rather than a pre‐existing entity, shaped significantly by both leaders and participants. Our findings reveal that the girls, through reflective engagement with norms and moral values, co‐create a community that promotes social inclusion. [ABSTRACT FROM AUTHOR]

Autism spectrum disorder (ASD) affects one in 66 children in Canada, and its symptoms may be particularly challenging for parents from a Chinese background. Further, when working with Chinese families, Western-educated service providers may experience difficulty in applying culturally relevant and family-centered care. This study examined the experiences of one Chinese-Canadian family as they receive intervention services for their two children with ASD. This pilot, single-case design, qualitative case study included semi-structured interviews with the parents, grandparents, as well as three service providers' views. Three major themes emerged from the data in the form of tensions: (1) within the family members; (2) within the therapeutic relationships, and (3) in addressing culture in therapy. Results suggested that although the family identified key cultural differences, service providers did not sufficiently address these within the therapeutic relationship, and the need for culturally-relevant and family-centered care was not fulfilled. Chinese-Canadian parents for children with autism spectrum disorder adopt both Chinese and Western values that fit best for their circumstances. Service providers and family members can have conflicting priorities, making family-centered care, culturally-relevant care challenging. Culture plays an important role in family expectations, and should be incorporated with more intention in the rehabilitation process. [ABSTRACT FROM AUTHOR]

Children and adolescents with developmental challenges may rely on their parents for assistance with everyday tasks to a greater extent than typically developing children. The objective of this study was to examine family members' perspectives regarding family relationships related to participation in an adapted summer camp for children and adolescents living with a disability. A collective case study was conducted with eleven families who had a child living with a disability who participated in an adapted physical activity (PA) summer camp. A focus group was conducted with each family and thematically analyzed. Families experienced changes in perspectives and pride surrounding adapted PA, more family conversations about disability, less parental worry, more independence of the child living with a disability, and enhanced family bonds through PA. The children who participated in the camp saw impacts on their self-confidence and independence. COVID-19-related program suspension was associated with frustration, worry, and strained family relationships. These findings elucidate how participation in adapted PA for children and youth with disabilities can impact family relationships. Future interventions allow for space for family interactions and create opportunity for children and adolescents with disabilities to be independent. Practitioners could make sure they have resources to recommend and be aware of programs that are available for this population. Practitioners could talk to families about benefits of recreation programs for both children and families in terms of benefits for children and family relationships and parental stress. Knowing the potential benefits to the family as a whole may impact parents' decisions about their child participating in recreation programs. Practitioners could talk to families about benefits of physical activity participation in terms of experiencing independence. Understanding potential benefits regarding independence may give children living with a disability a better understanding of how recreation programs may impact their lives. [ABSTRACT FROM AUTHOR]

This study aims to investigate whether the treatment effects, in terms of goal attainment, transfer effects and impact on executive functions, of an intervention in children with cerebral palsy or spina bifida using the Cognitive Orientation to daily Occupational Performance (CO-OP) Approach are maintained over time, from immediately after the intervention to three months afterwards. A three-month follow-up study, from an intervention using CO-OP. Thirty-four children (7–16 years) each identified four goals (one untrained to examine transfer) and participated in an eleven-session intervention. Assessments were performed at baseline, immediately after the intervention and at a three-month follow-up using the Canadian Occupational Performance Measure and the Performance Quality Rating Scale. Executive function and self-rated competence were assessed at the same timepoints. Statistically significant and clinically relevant improvements in goal achievement were demonstrated for both trained and untrained goals after the intervention and were maintained at follow-up. The clinically relevant improvement in untrained goals continued to increase until follow-up. Self-rated competence increased after the intervention and was maintained at follow-up. The CO-OP intervention was effective in achieving and maintaining the children's own goals over time. The transfer effect was confirmed by higher goal attainment for the untrained goals. The children's self-defined goals were achieved after the Cognitive Orientation to daily Occupational Performance (CO-OP) intervention and remained so at the three-month follow-up. The CO-OP Approach is useful for children with cerebral palsy or spina bifida. A transfer effect was demonstrated for untrained goals by both subjective and objective assessments. Using children's self-defined goals is effective. [ABSTRACT FROM AUTHOR]

In the context of a pandemic that has had wide-ranging negative impacts on preschool children's socioemotional development it is important to consider uses of technology to support children re-engaging socially with peers. In this article, we review the landscape of systems to support children's face-to-face collaboration and identify an underexplored approach that could be well suited for the current context: using technology in a peripheral role to support activities where the focus is on other children and non-electronic objects and where children are free to engage with the physical space around them with the support of adults. We then present a pre-pandemic evaluation of StoryCarnival, a system with these underexplored characteristics, designed to support preschool children's sociodramatic play, for which there is evidence of numerous benefits that can positively impact children's socioemotional development. The results of the evaluation comparing sociodramatic play with and without StoryCarnival's support suggest that while not being the focus of the activity, StoryCarnival's components changed the dynamics of play for the children in the study during our observations, such that children displayed more mature play characteristics. Our discussion includes implications for child-computer interaction and considerations for the pandemic context. [ABSTRACT FROM AUTHOR]

Down syndrome (DS) is characterized by varying degrees of mental retardation and delay in neurocognitive functions. Herein, we analyzed the morphometric shape of the corpus callosum (CC) in children with DS. Twenty-three DS cases underwent magnetic resonance imaging and have grossly normal CC, and 23 control group cases were included in this retrospective study (2012-2020). The CC was obtained from T2-weighted mid-sagittal images, and certain anatomical points were marked on the CC. Statistical geometric shapes and deformations of CC were evaluated for both groups. The age range of patients with DS and control group was 6 to 42 months. A statistically significant difference was found in the shape of CC between the groups (P <.001). Deformation was most evident in the splenium in the DS group. [ABSTRACT FROM AUTHOR]

The article focuses on a rare case of acute lymphoblastic leukemia (ALL) in a pediatric patient presenting with hypercalcemia and lytic lesions, which can be diagnostically challenging. Topics include the association of these symptoms with higher-risk leukemias and the need for further research to understand this relationship better.

The article focuses on the role of osteoclasts in bone resorption and the use of denosumab, a monoclonal antibody targeting the RANKL pathway, in treating osteolytic disorders like giant cell tumors of bone (GCTB) and central giant cell granuloma (CGCG). Topics include the effectiveness of denosumab in pediatric patients with various bone disorders and the management of rebound hypercalcemia following denosumab discontinuation in children.

There is still no evidence-based guideline and consensus on the treatment Sydenham's Chorea (SC). The first-line medication preference of specialists depends on personal experience and is variable. In this study, we evaluate the treatment results of pediatric patients who were treated with valproic acid (VPA). The medical records of 17 patients diagnosed with SC were reviewed retrospectively. The mean time to clinical improvement was found as approximately 5 days, the mean duration of remission as 13.60 ± 3.94 weeks and the mean duration of medication use was found as 17.96 ± 3.81 weeks. No side effects were observed in any of the patients and relapse occurred in 2 patients. A positive correlation was found between the initial C-reactive protein (CRP) level and the duration of medication use. Until evidence-based guidelines are established, VPA can be used as an effective, safe, and inexpensive first-line treatment option, especially in pediatric patients. [ABSTRACT FROM AUTHOR]

Vitiligo is a common disorder; however, its management is unknown by many primary-care doctors and pediatricians. Most articles focus on adults; we analyze the characteristics and impact on children. A single-center retrospective study was conducted over 10 years on 254 children diagnosed with vitiligo. About 50.4% were male with a mean age of 8.24 years. There was a slight predominance of nonsegmented vitiligo. About 12.59% had family history of vitiligo and 11.4% of autoimmune diseases. Around 15.7% patients presented other dermatological diseases and 9.05%, autoimmune diseases. No significant statistical differences were found when comparing age, sex, and type of vitiligo with other variables. Almost 96.06% received treatment with calcineurin inhibitors and 66.53% topical steroids. Around 77% obtained repigmentation, and out of the initial nonresponders, 16% responded to phototherapy. In general, our results concur with the scarce literature. A long-term follow-up of children with vitiligo is needed to identify treatment side effects and diseases associated. [ABSTRACT FROM AUTHOR]

The article focuses on a 12-year-old with juvenile absence epilepsy discovered to have elevated blood pressure during a sports physical, prompting further evaluation. Topics include the patient's clinical presentation, including asymptomatic hypertension, and diagnostic findings such as abnormal electrocardiogram (ECG) and echocardiogram results indicating left ventricular hypertrophy.

The article focuses on the birth and subsequent health concerns of a newborn delivered to a mother with an uncomplicated prenatal course. Topics include the infant's feeding regimen, initial discharge with a presumptive diagnosis, and his presentation to the emergency department with symptoms such as fever and hematochezia.

The article focuses on the use of intravenous immunoglobulin (IVIg) in treating conditions like Kawasaki disease and multisystem inflammatory syndrome in children (MIS-C), highlighting its potential adverse effects including hypothermia, a rare occurrence. It presents cases of two children who developed hypothermia during IVIg infusion, prompting further discussion about this phenomenon, although the exact mechanism behind it remains unclear.

The opioid epidemic has heavily affected adults of childbearing age, leading to thousands of children impacted by parental substance use. Few programs provide longitudinal support to these children. This article describes an innovative pediatric medical home model for substance-impacted children and their families, at an urban safety-net hospital. The team-based program directly serves children, and also devotes significant resources to parental health and recovery. In the program's first 3 years, 95% of enrollees were engaged in care, meeting the American Academy of Pediatrics' recommended periodicity schedule for preventive health visits. On-time receipt of childhood vaccines ranged from 95% (pneumococcal conjugate) to 100% (human papilloma virus). The program's high engagement in care shows promise in engaging vulnerable families over time. Future work should explore how to engage children from more diverse backgrounds, and should examine whether the model impacts other indicators of health and well-being for children impacted by parental substance use. [ABSTRACT FROM AUTHOR]

Sleep is essential for maintenance and restoration of health, yet studies exploring this in hospitalized children are scarce. In a qualitative study, we assessed the perceived quality of sleep, factors affecting sleep, and the role of health care professionals in the sleep environment for hospitalized children aged 1 to 12 years. Data were obtained from 11 semi-structured, audio-recorded, and verbatim-transcribed interviews with parents, and analyzed using a systematic thematic analysis. The interviews were coded based on iterative assessment of transcripts. Subsequently, categories and interpretative main themes were identified. Four themes emerged: (1) being informed, keeping informed; (2) coordination of care; (3) parents as main advocates for their child's sleep; and (4) environmental disturbers. Parents reported differences in their child's sleep quality during hospital compared with home. Sleep is substantially affected during hospitalization, prompting the need for interventions to improve the quality of sleep of children. Parents provided valuable suggestions for improvements. [ABSTRACT FROM AUTHOR]

Background Aims Methods & Procedures Outcomes & Results Conclusions & Implications What this paper adds What is already known on this subject What this study adds to existing knowledge What are the potential or actual clinical implications of this work? The Alouette‐R (2005) by Lefavrais is one of the most widely used tools to assess reading skills in French. However, this instrument does not have normative data specific to the French‐speaking population of Quebec, Canada.The validity of an assessment being strongly compromised when using inappropriate norms, the first objective of this study was to establish local norms for the Alouette‐R. The second objective was to provide sensitivity and specificity data for each Alouette‐R measure in the French‐speaking Quebec population. The third objective was to compare Quebec and French normative data and their sensitivity to better understand the applicability and effectiveness of the Alouette‐R test at the regional level.A total of 347 fluent readers and 48 children with dyslexia from 3rd to 6th grades were recruited from different regions in Quebec. Participants had to read aloud the 265‐word text of the Alouette‐R in a maximum of 3 min.Norms (means, standard deviations and percentiles) by school grades were created for each test measure: reading time, number of words read, number of errors, number of words correctly read, reading accuracy index and reading fluency index. The sensitivity (i.e., the ability to correctly identify children with dyslexia) and specificity (i.e., the ability to correctly identify children without dyslexia) of these measurements were also documented. The norms and their sensitivity were then compared with those of the original French study by Lefavrais in 2005.The presence of differences between European and Quebec norms supports the importance of using local norms when assessing language skills. The reading accuracy and fluency indexes are the measurements that best discriminated children with dyslexia from those without a reading disorder in our study. This study will allow clinicians working in Quebec to have a better interpretation of the Alouette‐R measurements and ultimately avoid erroneous conclusions resulting from the use of foreign normative data. The Alouette‐R is a reading test validated and standardized in France to screen for dyslexia in children. The validity of existing norms with the Quebec population in Canada is questionable due to socio‐linguistic differences with the population of France. This study provides for the first time normative and sensitivity/specificity data of the Alouette‐R for French‐speaking school‐aged children living in Quebec. Differences were noted with the normative data from France, which supports the importance of using local normative data when administering reading tests in Quebec. When administering the Alouette‐R, clinicians in Quebec will now be able to use normative data adapted to the local population, which will limit erroneous conclusions resulting from the use of foreign normative data. In addition, the sensitivity and specificity values reported in the article will allow these clinicians to better interpret their results when screening for a developmental reading disorder. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Appendicitis is the commonest paediatric surgical emergency. Adult studies suggest non‐operative management (NOM) may have a place in care. There have been no adequately powered randomized controlled trials in children. Objective: to determine the safety and efficacy of NOM for paediatric simple appendicitis.A non‐inferiority randomized controlled trial was conducted comparing operative (OM) to NOM of SA in children aged five‐15 years. Primary outcome was treatment success (no unplanned or unnecessary operation, or complication) at 30 days and 12 months, with a non‐inferiority margin of 15%. (anzctr.org.au: ACTRN12616000788471).From 11 June 2016 to 30 November 2020, 222 children were randomized: 94 (42.34%) to OM and 128 (57.66%) to NOM. Non‐inferiority of NOM was not demonstrated at either time point, with 45.67% of NOM patients subsequently undergoing operation. There was no significant difference in complications.While noninferiority was not shown, NOM was safe, with no difference in adverse outcomes between the two groups. Further research to refine the place of NOM of simple appendicitis in children is required, including nuanced patient selection, longer term evaluation, the place of choice, and the acceptability of the treatment for children and their carers. [ABSTRACT FROM AUTHOR]

Background Objectives Methods Results Conclusions Orofacial myofunctional disorders (OMD) are often associated with limitations of oral ingestion of solid food. The Test of Masticating and Swallowing Solids (ToMaSS) is a simple diagnostic tool to assess and quantify oropharyngeal efficiency while eating a standardised cracker.The objective of this study was to investigate the applicability and clinical utility of the ToMaSS in children with OMD.In this case–control study, data were collected from 18 children between 4 and 11 years with confirmed OMD. Inter‐rater reliability and age effects on the ToMaSS parameters were investigated and the specific performance profile of the OMD children was identified.Inter‐rater reliability was excellent for the ToMaSS parameters ‘bites’ (ICC = .999), ‘masticatory cycles’ (ICC = .961), ‘time’(ICC≧ .999) and good for ‘number of swallows’ (ICC = .810). ‘Masticatory cycles’ and ‘time’ decreased as a function of age with a significant difference in the ‘number of masticatory cycles’ between the youngest (4–6 years) and oldest (10–14 years) participants (p = .006, Z = −2.739). Deviations from normative data in at least one of the four ToMaSS parameters were found in 90% of the OMD children with ‘bites’, and ‘masticatory cycles’ predominantly corresponding to the performances expected in typically‐developing children in younger age groups.The ToMaSS is a reliable diagnostic instrument and clinically useful to detect limited efficiency of oral solid bolus intake and specific impairments in chewing function and duration of food intake in children with OMD. Our data suggest that OMD is associated with delayed development of efficient solid bolus preparation. [ABSTRACT FROM AUTHOR]

It has been suggested that expressive and creative activities have great potential for the development of several areas of human development. Therefore, this study aimed to know students’ views on creativity, social relationships, and affectivity after participating in expressive activities (dance, drama, and rhythm) based on a creative approach within Physical Education. Seventy-three children aged 11 participated in these activities, and 19 (58% boys) responded to a semi-structured interview. Results revealed three main themes: 1) greater creativity and transference to other contexts; 2) self-confidence, loss of shame, and greater expression of emotions; 3) closer and new social relationships among peers. Children felt more creative and imaginative after the intervention and tried to transfer their acquired creative skills to other contexts. Regarding affectivity, they gained self-confidence during the sessions and felt less embarrassed to express their emotions. Their social skills also improved: they felt comfortable playing and being creative with their classmates, discovered new skills among their peers, and made new friendships. These findings suggest that expressive and creative activities in Physical Education can contribute positively to cognitive, affective, and social domains. [ABSTRACT FROM AUTHOR]

Objectives Methods Results Conclusions Following disaster exposure, a significant proportion of children/adolescents will develop levels of post‐traumatic stress symptoms (PTSS) that do not meet diagnostic threshold for PTSD, but which cause ongoing distress. This paper describes the development and pilot testing of a brief, scalable, psychosocial intervention. SOLAR‐Kids/Teens has been designed to be delivered by non‐mental health professionals (‘coaches’) to children/adolescents experiencing moderate levels of PTSS following disasters.An international collaboration of experts developed The Skills fOr Life Adjustment and Resilience (SOLAR) for Kids and Teens programs. The programs were piloted—using a pre‐post mixed methods design—with 10 children and adolescents (8–18 years), with the aims of examining the feasibility of the program's delivery model as well as the program's potential usefulness.The pilot data indicated that after 1 day of training and with ongoing supervision, the SOLAR program was safe and feasible for coaches to deliver to children/adolescents experiencing PTSS. Coaches reported increased knowledge (p = .001), confidence (p = .001) and skills (p = .006). The programs were acceptable to coaches, children/adolescents and parents. Parents and children/adolescents reported reductions in trauma and anxiety symptoms from pre‐ to post‐treatment, with moderate to large effect sizes.The preliminary findings demonstrate that the SOLAR‐Kids/Teens program is feasible, acceptable and safe to be delivered by trained non‐mental health professionals to children and adolescents experiencing PTSS and anxiety following disaster exposure. Randomized controlled trials are required to evaluate the efficacy of the SOLAR‐Kids/Teens programs. [ABSTRACT FROM AUTHOR]

Background: Islamic leaders, staff, and Muslim parents in the UK are supportive of healthy lifestyle intervention delivery through Islamic Religious Settings. Such interventions are necessary given high obesity rates in British South Asian (40%) compared to White British (32%) children of equivalent age. Co-production can facilitate the development of culturally appropriate health interventions, however it can be theoretically and practically challenging, and evaluation of co-production within an Islamic Religious Setting context is lacking. The aim of this study was to examine the feasibility and acceptability of taking a co-production approach to develop an obesity-prevention toolkit for Islamic Religious Settings. Methods: An obesity-prevention toolkit for use in Islamic Religious Settings, incorporating physical activity, healthy diet, and organisational change, has been co-produced to be evidence-informed and contextually relevant. A qualitative process evaluation was employed to examine experiences of co-production. Semi-structured interviews (n = 15) and a focus group (n = 5) were conducted with toolkit co-production stakeholders, e.g., subject experts, an Islamic scholar, and Islamic Religious Setting staff. Transcripts were analysed inductively using reflexive thematic analysis. Results: The analysis revealed four major themes regarding stakeholders' experiences of co-producing a childhood obesity-prevention toolkit for Islamic Religious Settings. These themes are: (1) attitudes towards obesity-prevention through Islamic Religious Settings, (2) benefits of co-production including capacity building and ownership (3) negotiating involvement, power, and perspectives within the co-production process, and (4) the complexities of effective communication in co-production. Conclusion: This study adds to the evidence-base in support of delivering health promotion through faith settings. Taking a co-production approach to develop an obesity-prevention toolkit for Islamic Religious Settings provided benefit to the toolkit product and local stakeholders. The toolkit is currently being implemented across Bradford, UK and there is potential to adapt the toolkit to other geographical contexts, and for evaluating effectiveness for preventing obesity in British Muslim families. [ABSTRACT FROM AUTHOR]

Background: Bacterial infections (BIs) are widespread in ICUs. The aims of this study were to assess compliance with antibiotic recommendations and factors associated with non-compliance. Methods: We conducted an observational study in eight French Paediatric and Neonatal ICUs with an antimicrobial stewardship programme (ASP) organised once a week for the most part. All children receiving antibiotics for a suspected or proven BI were evaluated. Newborns < 72 h old, neonates < 37 weeks, age ≥ 18 years and children under surgical antimicrobial prophylaxis were excluded. Results: 139 suspected (or proven) BI episodes in 134 children were prospectively included during six separate time-periods over one year. The final diagnosis was 26.6% with no BI, 40.3% presumed (i.e., not documented) BI and 35.3% documented BI. Non-compliance with antibiotic recommendations occurred in 51.1%. The main reasons for non-compliance were inappropriate choice of antimicrobials (27.3%), duration of one or more antimicrobials (26.3%) and length of antibiotic therapy (18.0%). In multivariate analyses, the main independent risk factors for non-compliance were prescribing ≥ 2 antibiotics (OR 4.06, 95%CI 1.69–9.74, p = 0.0017), duration of broad-spectrum antibiotic therapy ≥ 4 days (OR 2.59, 95%CI 1.16–5.78, p = 0.0199), neurologic compromise at ICU admission (OR 3.41, 95%CI 1.04–11.20, p = 0.0431), suspected catheter-related bacteraemia (ORs 3.70 and 5.42, 95%CIs 1.32 to 15.07, p < 0.02), a BI site classified as "other" (ORs 3.29 and 15.88, 95%CIs 1.16 to 104.76, p < 0.03), sepsis with ≥ 2 organ dysfunctions (OR 4.21, 95%CI 1.42–12.55, p = 0.0098), late-onset ventilator-associated pneumonia (OR 6.30, 95%CI 1.15–34.44, p = 0.0338) and ≥ 1 risk factor for extended-spectrum β-lactamase-producing Enterobacteriaceae (OR 2.56, 95%CI 1.07–6.14, p = 0.0353). Main independent factors for compliance were using antibiotic therapy protocols (OR 0.42, 95%CI 0.19–0.92, p = 0.0313), respiratory failure at ICU admission (OR 0.36, 95%CI 0.14–0.90, p = 0.0281) and aspiration pneumonia (OR 0.37, 95%CI 0.14–0.99, p = 0.0486). Conclusions: Half of antibiotic prescriptions remain non-compliant with guidelines. Intensivists should reassess on a day-to-day basis the benefit of using several antimicrobials or any broad-spectrum antibiotics and stop antibiotics that are no longer indicated. Developing consensus about treating specific illnesses and using department protocols seem necessary to reduce non-compliance. A daily ASP could also improve compliance in these situations. Trial Registration: ClinicalTrials.gov: number NCT04642560. The date of first trial registration was 24/11/2020. [ABSTRACT FROM AUTHOR]

Background Aim/s Study Design Results Conclusions Relevance to Clinical Practice Internationally, there is an increasing trend in using Rapid Response Systems (RRS) to stabilize in‐patient deterioration. Despite a growing evidence base, there remains limited understanding of the processes in place to aid the early recognition and response to deteriorating children in hospitals across Europe.To describe the processes in place for early recognition and response to in‐patient deterioration in children in European hospitals.A cross‐sectional opportunistic multi‐centre European study, of hospitals with paediatric in‐patients, using a descriptive self‐reported, web‐based survey, was conducted between September 2021 and March 2022. The sampling method used chain referral through members of European and national societies, led by country leads. The survey instrument was an adaptation to the survey of Recognition and Response Systems in Australia. The study received ethics approval. Descriptive analysis and Chi‐squared tests were performed to compare results in European regions.A total of 185 questionnaires from 21 European countries were received. The majority of respondents (n = 153, 83%) reported having written policies, protocols, or guidelines, regarding the measurement of physiological observations. Over half (n = 120, 65%) reported that their hospital uses a Paediatric Early Warning System (PEWS) and 75 (41%) reported having a Rapid Response Team (RRT). Approximately one‐third (38%) reported that their hospital collects specific data about the effectiveness of their RRS, while 100 (54%) reported providing regular training and education to support it. European regional differences existed in PEWS utilization (North = 98%, Centre = 25%, South = 44%, p < .001) and process evaluation (North = 49%, Centre = 6%, South = 36%, p < .001).RRS practices in European hospitals are heterogeneous. Differences in the uptake of PEWS and RRS process evaluation emerged across Europe.It is important to scope practices for the safe monitoring and management of deteriorating children in hospital across Europe. To reduce variance in practice, a consensus statement endorsed by paediatric and intensive care societies could provide guidance and resources to support PEWS implementation and for the operational governance required for continuous quality improvement. [ABSTRACT FROM AUTHOR]

In Spain, children's sexuality is a sensitive topic, and pleasure is its most controversial aspect, contradicting the notion of children's innocence. Through a new feminist materialist approach, I analyse the narratives of primary school children (aged 9–11) about pleasant bodily sensations to explore their capacity for pleasure and the assemblage of elements that facilitate it. Additionally, I describe the forces that stabilise these assemblages and those that destabilise them. The findings suggest that leaving pleasure out of relationships and sex education reproduces gender and age inequalities, making visible the need to recognise children as subjects of sexuality and pleasure. [ABSTRACT FROM AUTHOR]

Background: Digital behaviour change interventions aiming to improve dietary intakes; specifically fruit and vegetable intake, in low-socioeconomic children are being developed and tested. However there is currently no synthesis of the characteristics or reported effectiveness of these interventions. This systematic review aims to: (1) identify existing digital interventions targeting fruit and vegetable intake in low-socioeconomic status children, (2) identify and synthesise characteristics and reported effectiveness of these interventions using the Behaviour Change Intervention Ontology. Method: CINAHL, ERIC, PubMed, Cochrane Library, ACM Digital Library and Scopus were searched in December 2021 – February 2022 and in February–March 2024. Inclusion criteria for studies were: 1) children of low-SES families, aged between 5–11 years old; 2) Digital intervention to improve fruit and vegetable intake; 3) Comparison groups could be digital or non-digital; 4) Outcome measures were fruit and vegetable intake and antecedents to diet behaviours; 5) Randomised controlled trials (cluster and parallel designs). Characteristics of identified studies were coded using the Behaviour Change Techniques Taxonomy and Modes of Delivery, Setting and Source ontologies of the Behaviour Change Intervention Ontology. Results: Five studies met all inclusion criteria, with majority reporting significant effects of interventions on improving fruit and vegetable intake. Most common Behaviour Change Techniques found were Goal Setting (k = 4), Problem Solving (k = 3), Instruction on how to perform a Behaviour (k = 3), and Prompts and Cues (k = 3). Characteristics relating to intervention source were unclear. Conclusions: Digital interventions had positive outcomes in fruit and vegetable intake in children; particularly more for fruit than vegetable intake. Characteristics in digital interventions which have direct effects on child fruit and vegetable intake in low-socioeconomic families should be further investigated. Furthermore, clearer reporting on intervention characteristics is needed. [ABSTRACT FROM AUTHOR]

ABSTRACT BACKGROUND METHODS RESULTS CONCLUSION The emergence of COVID‐19 resulted in a substantial loss of education because of global school closures. Face masks are a potential measure to restrain the COVID‐19 spread; therefore, this paper evaluated the effectiveness of face masks in reducing COVID‐19 incidence in school settings.A systematic review was conducted by searching the literature in the Cochrane COVID‐19 Study Register and the World Health Organization COVID‐19 global literature. Data were summarized in tabular forms, and the findings were presented as narrative synthesis.A total of 15,709 records were retrieved. The screening and selection led to the inclusion of 12 observational and 2 quasi‐experimental studies. Nine studies were conducted in different states, counties, or districts of the United States, and the remaining 5 were reported from Germany, Finland, Spain, and the United Kingdom. The results of 10 out of 14 studies favored mask use in reducing school COVID‐19 incidence. Three studies found no link between mask use and COVID‐19 incidences, whereas 1 quasi‐experimental study noted a higher COVID‐19 incidence with mask use in students aged 6‐11 years than no use of mask among preschool children aged 3‐5 years.Mask mandates may lessen the incidence of respiratory infectious diseases in school settings during a pandemic; more well‐designed studies are warranted to clarify further the evidence regarding mask use in school settings. [ABSTRACT FROM AUTHOR]

The present study explores the dominant storylines of 10 young adults’ descriptions of growing up with attention-deficit hyperactivity disorder (ADHD). The aim of this study was to gain a deeper understanding of the processes that generate, maintain and transform certain positions and conditions. The findings suggested that limited positions, particularly those arising from experiences of positions such as ‘not as expected’ and ‘not good enough’, are uniquely formed and upheld, with schools standing out as a key environment where these positions are notably evident. However, findings argues that these positions do not inherently possess stability. By gaining insights, employing improved strategies, and becoming more familiar with alternative perspectives – some of which may be hidden from the individual – these positions can undergo transformation into positions that appear more suitable for mental wellbeing. We argue that exploring individuals` storylines might give insight into the forces that can support practice to increase the possibility of joint efforts around the individual and equip itself to engage with the complex movements in the salient transition from childhood into young adulthood. [ABSTRACT FROM AUTHOR]

This piece reviews the evidence on the effect that engaging with nature has on school-age children's future attitudes and behaviour towards nature. It also looks into the impact engaging with nature has on children and young people's physical, mental and personal development and the evidence on how much time children in England are spending in natural environments. It then presents a UK Government project, the National Education Nature Park (NENP), intended to increase children in England's access to nature by developing nature spaces within the grounds of educational institutions. It concludes with suggestions for how the implementation of the NENP could be used to learn more about the effect that engaging with nature has on children alongside understanding how school-based nature projects could benefit the local environment. This article is part of the theme issue 'Bringing nature into decision-making'. [ABSTRACT FROM AUTHOR]

Increasing uptake of the metaphor of a “tsunami” of mental health problems related to COVID-19, reflects widespread concern for pandemic-related mental distress. Mental health may be compromised by such things as loneliness and depression linked to social isolation, as well as fear of infection from coronavirus. Of interest to question is the veracity of this concern and how the alleged decline in mental wellness might affect one of society’s most important issues: Namely, the issue of parenting. Owing to the novel nature of this subject matter, scoping review was selected to substantiate critical commentary in this paper surrounding parenting, the COVID-19 pandemic and the disabling effects of mental health difficulties. Findings suggest that there is no linear, formulaic or conclusive relationship between the pandemic, mental health and parenting. Rather, present discourses, such as those that embrace a tsunami metaphor, ought to attain more nuance and balance, in the context of protective factors, opportunities and strengths also at play. [ABSTRACT FROM AUTHOR]

Interest in school-age educare has been growing internationally. School-age educare in Sweden emphasises learning and participation in aesthetic and creative learning activities. This study aims to critically examine how dance as a learning activity is constructed by educators in Swedish school-age educare. Discourse analysis is used to shed light on discursive constructions made by school-age educators when they reason about dance and learning in their educational practices. The empirical material consists of six focus-group interviews with 18 school-age educators. Three discourses are identified: (1) dance as a joy-filled activity, (2) digital tools as prerequisites for dancing, and (3) pre-choreographed dances as a preference. The results show that there is a lack of aesthetic and creative aspects in dance in school-age educare. School-age educators include dance because it is fun and is carried out by imitating movements without a focus on learning. The educators who appreciate dance lack the know-how to develop pupils’ dance skills beyond what they already know. There are holistic ambitions in school-age educare to let care, play, and learning intersect, but creative dance still has an untapped potential to engage pupils in cultural activities and to contribute to gender repositioning. [ABSTRACT FROM AUTHOR]

Aim: To assess the impact of endoscopic stone surgeries on renal perfusion and blood flow in children. Materials and methods: Children who underwent percutaneous nephrolithotomy (PCNL), retrograde intrarenal surgery (RIRS), ureterorenoscopy (URS), endoscopic combined intrarenal surgery (ECIRS) were included to the study. Renal Doppler ultrasonography (RDUS) was performed one day before the operation, and on the postoperative 1st day and 1st month. Peak systolic velocity (PSV) and end-diastolic velocity (EDV) were measured, and resistive index (RI) was calculated with the (PSV-EDV)/PSV formula. RDUS parameters were compared before and after surgery and between ipsilateral and contralateral kidneys. Results: A total of 45 children with a median age was 8 (2–17) years were included (15 (33.3%) girls, 30 (66.7%) boys). PCNL was performed in 13 children (28.9%), RIRS 11 (24.4%), URS 12 (26.7%), and ECIRS 9 (20%). There was no significant difference in renal and segmental PSV, EDV and RI values of operated kidney in the preoperative, postoperative periods. There was no significant difference between RDUS parameters of the ipsilateral and contralateral kidneys in preoperative or postoperative periods. PSV and EDV values were significantly higher in the 1st postoperative month in the group without preoperative DJ stent than in the group with DJ stent (p = 0,031, p = 0,041, respectively). However, RI values were similar. The mean RI were below the threshold value of 0.7 in each period. Conclusion: RDUS parameters didn't show a significant difference in children. Endoscopic surgeries can be safely performed in pediatric stone disease. [ABSTRACT FROM AUTHOR]

Several risk factors including environmental exposures, socioeconomic status, and dietary factors including dietary patterns have been considered for childhood Asthma. The present study tried to examine the association between a western-style pattern and the likelihood of asthma and its symptoms in Yazd, Iran. In the present cross-sectional study, dietary intakes of elementary and high-school children were obtained through a validated GAN questionnaire. The GAN questionnaire, derived from the ISAAC questionnaire was used to assess the symptoms of allergic diseases and their related risk factors. A western dietary pattern score considered 9 food groups including chicken eggs, margarine, butter, sugar, fast foods, soft drinks, snacks, sauce, and chocolate. In total 7667 children aged 10.9 ± 3.35 years were included in the current investigation. Boys with higher adherence to western dietary pattern had a higher risk of wheezing in the past 12 months (OR 1.37, 5% CI 1.01–1.87, P = 0.04) and this association was also observed in the whole population (OR 1.30, 5% CI 1.05–1.60, P = 0.01). However, after adjustment for confounders this relation did not remain significant in boys. Our results support the hypothesis that a western dietary pattern is associated with an increased risk of wheezing in the past 12 months in children with asthma. Future prospective studies are needed to confirm this finding. [ABSTRACT FROM AUTHOR]

The purpose of this study was to review the literature on the clinical use of voriconazole (VRC) in pediatric patients. MEDLINE, Embase, PubMed, Web of Science, and Cochrane Library were searched from January 1, 2000, to August 15, 2023 for relevant clinical studies on VRC use in pediatric patients. Data were collected based on inclusion and exclusion criteria, and a systematic review was performed on recent research related to the use of VRC in pediatric patients. This systematic review included a total of 35 observational studies among which there were 16 studies investigating factors influencing VRC plasma trough concentrations (Ctrough) in pediatric patients, 14 studies exploring VRC maintenance doses required to achieve target range of Ctrough, and 11 studies focusing on population pharmacokinetic (PPK) research of VRC in pediatric patients. Our study found that the Ctrough of VRC were influenced by both genetic and non-genetic factors. The optimal dosing of VRC was correlated with age in pediatric patients, and younger children usually required higher VRC doses to achieve target Ctrough compared to older children. Establishing a PPK model for VRC can assist in achieving more precise individualized dosing in children. [ABSTRACT FROM AUTHOR]