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Bone marrow is a highly cellular tissue undergoing significant developmental and physiologic changes with age. Indeed, with maturation from pediatric to the adult age there is a progressive, centrifugal conversion from red to yellow bone marrow. Histological characteristics of bone marrow are reflected in MR image signal. MR is therefore extremely sensitive in detecting pathological changes which are mostly characterized by increased free water causing high signal intensity on T2. Among the numerous diseases causing bone marrow edema in children chronic nonbacterial osteomyelitis (CNO) certainly has to be mentioned. This idiopathic inflammatory disorder is characterized by nonspecific migrating symptoms like skeletal pain with phases of exacerbations and relapses with alternating acute and chronic MR signs and it is often a diagnosis of exclusion. Hence, with bone marrow edema, various features at imaging should be considered to differentiate malignancies such as osseous lymphoma, osteosarcoma, and Ewing's sarcoma as well as benign lesions like osteomyelitis, post-traumatic, or post-treatment bone marrow edema. The aim of this review is to recall the main characteristics of CNO and provide an overview of its main mimickers highlighting similarities and differences. [ABSTRACT FROM AUTHOR]

The extent to which parents experience guilt related to their child's health may depend on their perceptions of their contribution to these outcomes. The impact of the child's "other" biological parent's (OBP) contribution to child health on guilt responses is understudied. Some models posit a diffusion-of-responsibility process, while others favor a heightened-risk-heightened-guilt model. The present study examines how perceived OBP contribution to child risk affects guilt among a sample of parents with self-reported overweight. Parents who perceived their child's OBP to also have overweight experienced more guilt for passing down genetic and family environment-based obesity risk to their child, which suggests that perceptions of shared risk contribution promote guilt-related outcomes. Additionally, risk information endorsing a gene-environment interaction liability framing was the most responsive to OBP weight status. These results support a heightened-risk-heightened-guilt process. Future work should consider guilt when developing child health interventions to avoid undesirable emotional outcomes among parents. [ABSTRACT FROM AUTHOR]

Stretch syncope (SS) is a benign, uncommon, distinct condition described mainly in adolescent males. It is responsible for paroxysmal events started by stereotyped stretching actions with neck hyperextension, culminating in alteration of consciousness. Motor manifestations are often present and may be associated with a generalized slowing of the electroencephalographic activity, challenging the diagnosis. Despite a few cases reported in the literature, different mechanisms have been implied in the pathogenesis, involving both local and systemic hemodynamic phenomena. Here, we report on an 8-year-old girl with self-induced SS, providing new insights into the related neurophysiological profile and discussing the possible etiology. Our evidence of transient and dynamic vascular impairment supports the hypothesis of SS as a multifactorial disorder. [ABSTRACT FROM AUTHOR]

Childhood dementias are a group of rare, fatal neurodegenerative disorders, characterised by global cognitive decline, loss of previously acquired developmental skills and behaviours and psychological symptoms of dementia (BPSD). Batten disease, or neuronal ceroid lipofuscinosis, and Sanfilippo syndrome, or mucopolysaccharidosis type III, are two of the more common forms of childhood dementia disorders worldwide. While psychosocial interventions are the best available therapeutic approach for BPSD management in adult-onset dementia, there is very limited literature or clinical experience in the context of childhood dementia. To address this gap, we conducted a descriptive case analysis of BPSD profiles, associated contributing factors and targeted psychosocial interventions in two cases with childhood dementia disorders (Sanfilippo syndrome and CLN3 (juvenile onset) Batten disease) who were referred to Dementia Support Australia, a national dementia behaviour support service in Australia. Primary BPSD identified in these disorders included physical and verbal aggression and irritability/lability. In these cases, contributing factors to the development of BPSD were not monolithic, encompassing pain, caregiver's approach and over or under-stimulation. Improvement in BPSD were observed using the Neuropsychiatric Inventory-Quesionnaire and globally noted as per the qualitative feedback reported by family and caregivers. Person-centred, multimodal psychosocial interventions were recognised as effective therapies in resolving BPSD in these cases. In conclusion, the case studies described the nature and presentation of BPSD in two common forms of childhood dementia and demonstrated the potential benefits of person-centred psychosocial interventions (delivered through national dementia-specific support programs) in alleviating BPSD such as irritability and aggression in these disorders. [ABSTRACT FROM AUTHOR]

COVID-19 infection is still a mystery in terms of its long-term effect on health and its consequences on hematological disorders. Prior studies including ours have shown the abnormal changes in hematopoietic cells in COVID-19 patients. In this article, we are presenting 2 cases of pediatric B-lymphoblastic leukemia (B-ALL) with a previous history of COVID-19 infection. The first case describes a 22-month-old boy presenting with lymphadenopathy, neutropenia, and anemia with concurrent COVID-19 infection without any evidence of a hematolymphoid neoplasm as per bone marrow and lymph node biopsy. However, he presented after 2 months with bone marrow biopsy confirming B-ALL. The second case is that of a 4-year-old girl presenting with B-ALL who has had asymptomatic COVID-19 infection 5 months before this current presentation. Both the cases had complete resolution of COVID-19 infection during the time of presentation with acute leukemia. There were notably 2 rare findings along the course of the patients' illnesses. First, the unusual plasmacytosis in the marrow during active COVID-19 infection in the first patient and the second, is predilection of development of B-ALL following COVID-19. In both the cases the fluorescence in situ hybridization (FISH) studies showed pathologic alteration of the RUNX1 gene. Overall, there are no literature to support a causal association between acute B-ALL and COVID-19. The diagnosis of B-ALL in these patients after COVID-19 infection may be totally unrelated. However, if we consider Greaves proposed 2-hit model for childhood acute leukemia, that an infectious agent can precipitate development of B-ALL in a genetically susceptible individual. Alteration of the RUNX1 gene in both the patients, opens a door for further exploration of the "second-hit" hypothesis regarding an infectious agent precipitating development of B-ALL in a genetically susceptible individual. [ABSTRACT FROM AUTHOR]

Background and aims: Autistic children can experience challenges in making and maintaining friendships, and middle childhood (ages 6–12) may be particularly challenging as social networks become more complex. However, a large proportion of research into these experiences is based on adult reports or focuses on the experiences of adolescents, meaning that the voices of younger children are absent. Due to the exclusion of younger children from research, we have a limited understanding of their first-hand experiences of their friendships and the support they receive, which has implications for friendship support and wellbeing. This study aimed to amplify the voices of younger autistic children to explore their first-hand experiences of friendships and highlight areas of social support which may be most beneficial to primary-aged autistic children. Methods: This study used novel creative methods to support interviews with 19 autistic primary school-aged children to explore their experiences of friendship. Parent-led interviews and scrapbooks supported the children in discussing the challenges and strengths of their friendships. Results: Children discussed the challenges and strengths of their friendships including the impact of social norms on the need to have friends and their support needs in this area of life. Children also discussed gaps in their current friendships and how they would like to see these filled. It was clear that not all children required or wanted neurotypical-style friendships, with many valuing companionship and gameplay over intimacy. Analysis highlighted the heterogeneity of autistic children's friendships, especially in relation to gender and age, calling for more tailored and individualized support. Conclusion and implications: Results from the current study show that autistic children can and do have successful friendships but that these friendships may differ from those of their non-autistic peers. The study further adds to the existing literature by showing that younger autistic children can be included in research by using differentiated, accessible and creative methods, and that they are able to voice their opinions on matters surrounding support. It also calls for a tailored approach to supporting autistic children in school and speaking with children to give them autonomy over the support they want to receive. [ABSTRACT FROM AUTHOR]

Objective: There are very few reports on the prevalence of diabetic retinopathy (DR) in children and youth with type-1 diabetes (T1D). Studies have also found very low rates of referral for DR screening in children and youth with T1D. We conducted this study to determine the prevalence of DR, to study the reliability of ISPAD screening recommendations and to identify predictors of DR, its progression and regression in Indian children and youth with T1D. Methods: This study included 882 children and youth with T1D. Demographic data, anthropometry, blood pressure, sexual maturity rating, ophthalmological examination (slit lamp for cataract) and biochemical measurements were performed using standard protocols. Fundus images were captured using the Forus Health 3netra classic digital non-mydriatic fundus camera by the same experienced operator. De-identified images were assessed by a senior grader and ophthalmologist (Belfast Ophthalmic Reading Center). Severity of DR was graded as per the UK National Health Service (NHS) DR classification scale. Result: We report 6.4% and 0.2% prevalence of DR and cataract in Indian children and youth with T1D, respectively. All the subjects with DR had early non-proliferative DR. We report that amongst subjects with DR, only 2 subjects were aged less than 11 years and had duration of illness less than 2 years. Presence of hypertension and older age were significant predictors of DR (P <.05). Subjects with DR had significantly higher triglyceride concentrations (P <.05), of these, 6.9% had progression and 2.9% had regression at 1 year follow up; the change in glycaemic control was a significant positive predictor of progression of DR (P <.05). None of the participants included in the study progressed to develop sight-threatening DR. Conclusion: DR is not uncommon in Indian children and youth with T1D, thus screening for DR needs to be initiated early, particularly in older individuals with higher disease duration. Controlling blood pressure and triglyceride concentrations may prevent occurrence of DR. Improving glycaemic control may prevent progression of DR in Indian children and youth with T1D. Plain Language Summary: Diabetic retinopathy in Indian children with Type 1 Diabetes We found that 6.4% and 0.2% Indian children and youth with type-1 diabetes had diabetic retinopathy and cataract respectively. We report that amongst subjects with DR, only 2 subjects were aged less than 11 years and had duration of illness less than 2 years. Thus, International Society for Paediatric and Adolescent Diabetes (ISPAD) screening criteria must be implemented by all centres to avoid missing cases. Presence of high blood pressure, high triglyceride levels and older age were significant predictors of DR. Of the subjects with DR, 6.9% had progression and 2.9% had regression at 1 year follow up; the change in glycaemic control was a significant positive predictor of progression of DR. None of the participants included in the study progressed to develop sight-threatening DR. DR is not uncommon in Indian children and youth with T1D, hence, screening for DR needs to be initiated early, particularly in older individuals with higher disease duration. Controlling blood pressure and triglyceride concentrations may prevent occurrence of DR. Improving glycaemic control may prevent progression of DR in Indian children and youth with T1D. [ABSTRACT FROM AUTHOR]

Background: DDH is 1 of the most important causes of childhood disability. A diagnosis of instability can be made in the neonatal period via the Ortolani and Barlow manoeuvres. However, clinical examination, although highly specific, has poor sensitivity as compared to ultrasound. There is controversy between the necessity of universal screening for dysplasia of all newborns or selective screening reserved for those with clinical signs of instability or known risk factors of DDH. Aim: To analyse the risk factors of congenital hip dysplasia in a consecutive case series of children referred for diagnosis and treatment of DDH. Materials and methods: This was a cross-sectional study on infants consecutively examined between January 2000 and December 2019 at the Marino Ortolani Centre in Ferrara, Italy. The first 3 types on Graf's classification were considered physiological (1A, 1B, 2A+), while the last 6 pathological (2A-, 2B, 2C, 2D, 3, 4). Results: 18,954 infants met the inclusion criteria and were therefore considered eligible for the study. Of these 18,954 infants, 56% (n = 10,629) were females and 44% (n = 8325) were males. According to Graf classification, 34.9% (n = 6621) were 1A, 52.7% (n = 9999) were 1B, 4.0% (n = 753) were 2A+, 2.5% (n = 478) were 2A-, 1.5% (n = 284) were 2B, 1% (n = 196) were 2C, 1.3% (n = 243) were 2D, 1% (n = 193) were 3 and 1.0% (n = 187) were 4. The most significant risk factor was the female gender (OR 5.36; 95% CI, 4.63–6.20) followed by a family history (OR 2.35; 95% CI, 2.08–2.65), then skeletal pathologies (OR 2.04; 95% CI, 1.21–3.42), oligohydramnios (OR 1.75; 95% CI, 1.44–2.13), and finally breech presentation (OR 1.42: 95% CI, 1.27–1.60). Conclusions: Based on our data, family history, musculoskeletal disease, oligohydramnios and breech presentation are the main risk factors for DDH development, as is the female sex. [ABSTRACT FROM AUTHOR]

Listeners adjust their perception to match that of presented speech through shifting and relaxation of categorical boundaries. This allows for processing of speech variation, but may be detrimental to processing efficiency. Bilingual children are exposed to many types of speech in their linguistic environment, including native and non-native speech. This study examined how first language (L1) Spanish/second language (L2) English bilingual children shifted and relaxed phoneme categorization along the cue of voice onset time (VOT) during English speech processing after three types of language exposure: native English exposure, native Spanish exposure, and Spanish-accented English exposure. After exposure to Spanish-accented English speech, bilingual children shifted categorical boundaries in the direction of native English speech boundaries. After exposure to native Spanish speech, children shifted to a smaller extent in the same direction and relaxed boundaries leading to weaker differentiation between categories. These results suggest that prior exposure can affect processing of a second language in bilingual children, but different mechanisms are used when adapting to different types of speech variation. [ABSTRACT FROM AUTHOR]

Functioning is a construct capturing how an individual's engagement in everyday life emerges from the interaction between the individual and their environment. The World Health Organization's International Classification of Functioning, Disability and Health (ICF) provides a biopsychosocial framework of functioning. Previously, the ICF was adapted for use in autism by developing Core Sets, a selection of ICF codes from the entire classification for specific conditions. Here, we present the first revision of the ICF of the Core sets for autism from a Delphi-like technique, based on evidence from Core Sets validation/linking studies, stakeholder feedback, and the development and piloting of the autism ICF Core Sets platform. Two ICF second-level codes were removed, and 12 were added to the comprehensive autism Core Set. The added codes reflect body functions in various sensory domains, fine hand use, and environmental factors. Changes were extensive for the age-appropriate brief Core Sets where ICF codes from the initial Core Sets were added or removed. The revisions conducted indicate a continued need for regularly updating Core Sets, based on empirical evidence and stakeholder involvement. We recommend the updated Core Sets for future use in autism research and practice in different age groups and contexts. Autistic people experience individual strengths and challenges as well as barriers and facilitators in their environment. All of these factors contribute to how well autistic people can cope in everyday life, fulfill the roles they choose, and meet their needs. The World Health Organization has developed a system aiming to capture the many factors within people (like how someone thinks and feels) and outside of people (things around a person) that influence their daily living, called the International Classification of Functioning, Disability and Health. The International Classification of Functioning, Disability and Health can be used for different purposes in research and practice to assess people's situations and plan support measures. Previously in 2019, the International Classification of Functioning, Disability and Health was adapted to autism by developing so-called Core Sets, which are shorter International Classification of Functioning, Disability and Health versions for use in specific conditions. Here, we present the first revisions of the International Classification of Functioning, Disability and Health Core Sets for autism, based on research, development results, and community feedback. Some factors influencing daily life for autistic people were added to the Core Sets, and other factors deemed less relevant were removed. Changes were also made in Core Sets designed for different age groups (0–5, 6–16, and ⩾17 years). Particularly, contents for sensory processing (like smell, touch, seeing, hearing) were added. We recommend these updated Core Sets for future use in autism research and practice. These changes to the Core Sets after 4 years indicate that there should be ongoing updates based on research and experience from practice and involvement of stakeholders. [ABSTRACT FROM AUTHOR]

In this article we provide a sociological analysis of parental choice in pre-school sports and physical activity, as a form of concerted cultivation, to understand the uptake of sports-based physical activity (PA) enrichment activities in England. Despite a growth in the under-five pre-school enrichment market, little is known about why parents pay for their under-five child(ren) to participate in sport and/or PA enrichment or how this relates to wider patterns seen in contemporary parenting. 24 semi-structured interviews with parents of early years children from across England were conducted. Findings suggest the reasons why parents enrol their child(ren) in sports-based enrichment activities can be considered a form of concerted cultivation. In particular, parents value routine and socialisation for themselves and their children. Parents look for paid-for activities that enhance their child's social and academic skills but do not emphasise the health benefits of being physically active as important in their decision making. Instead, they prioritise opportunities to enhance their child's social and cultural skills in ways that enable the child(ren) to be accepted and interact positively with adults and other children in key institutional settings. Parents also valued spaces where their young child(ren) could expend energy, although the importance of this was distinctly gendered. We conclude by outlining that paying for under-fives sport-based enrichment is linked to wider social and cultural expectations on parenting, and highlighting that more needs to be understood about the gendered, racialised and ableist spaces of commercial pre-school sport and PA. [ABSTRACT FROM AUTHOR]

Much discussion about large language models and language-and-vision models has focused on whether these models are intelligent agents. We present an alternative perspective. First, we argue that these artificial intelligence (AI) models are cultural technologies that enhance cultural transmission and are efficient and powerful imitation engines. Second, we explore what AI models can tell us about imitation and innovation by testing whether they can be used to discover new tools and novel causal structures and contrasting their responses with those of human children. Our work serves as a first step in determining which particular representations and competences, as well as which kinds of knowledge or skill, can be derived from particular learning techniques and data. In particular, we explore which kinds of cognitive capacities can be enabled by statistical analysis of large-scale linguistic data. Critically, our findings suggest that machines may need more than large-scale language and image data to allow the kinds of innovation that a small child can produce. [ABSTRACT FROM AUTHOR]

Jordan's Principle is a legal requirement for the Canadian government to address gaps in services for First Nations children and ensure timely services that meet their needs and best interests. This article synthesizes and discusses some of the key research findings described in a report on the implementation of Jordan's Principle in Manitoba, produced by a team of academic researchers in partnership with the Assembly of Manitoba Chiefs. Findings provide insights into a relational approach to the implementation of Jordan's Principle and inter-related structural factors that constrain the efficacy of this approach. Findings reinforce the need for First Nations–led processes and Jordan's Principle policies that fully fund and support First Nations in addressing high caseloads and growing waiting lists, complex responsibilities, stress and staff turnover, administrative burden, and inadequate physical and digital infrastructure. Sufficient resources for First Nations capacity enhancement initiatives and regional coordination and support are also identified priorities. [ABSTRACT FROM AUTHOR]

Children and adolescents (henceforth "children") with both attention-deficit/hyperactivity disorder (ADHD) and anxiety experience greater difficulties than children with either alone, though qualitative methodologies are yet to be used to understand the challenges this population experiences. We aimed to explore parent-reported daily impacts of co-occurring anxiety in children with ADHD (ages 8–13 years). Participants were enrolled in an Australian trial evaluating an adapted anxiety intervention and were eligible if their child met diagnostic criteria for ADHD plus separation, social, and/or generalized anxiety disorder. A baseline measure of life impacts associated with child anxiety captured situations parents reported were difficult, due to their child's anxiety. Reflexive thematic analysis of free-text responses (N = 203) facilitated new insights via inductively generating key themes. Three overarching themes highlighted (1) child difficulties with everyday situations and processes due to their anxiety; (2) the nature of the child's anxiety being pervasive and unrelenting; and (3) the strain placed on the child's family system. This study enhances understanding of daily impacts associated with co-occurring anxiety and ADHD and may contribute to an improved understanding of support needs. Results reiterate the need to identify co-occurring difficulties in children with ADHD and support both children and their families. [ABSTRACT FROM AUTHOR]

Children's ego-resilience (within-person capacities that facilitate psychological resistance) and irritability (increased proneness to experience negative affective states following environmental stressors) are critical determinants of their mental health. Here, we investigated how ego-resilience engages with irritability when linked to symptoms of anxiety and depression. We analyzed cross-sectional survey data from a combined clinical and nonclinical sample. Overall, 228 German children (M age = 12.52, SD age = 2.69; 41.7% female) reported on symptoms of depression/anxiety, ego-resilience, and irritability. Moderated hierarchical regression analyses showed that ego-resilience was negatively associated with symptoms of anxiety and depression and that irritability was positively related to heightened symptom levels. Ego-resilience and irritability had overall stronger associations with symptoms of depression than anxiety. Irritability moderated the association between ego-resilience and depression, such that the effects of ego-resilience were stronger among highly irritable children. We discuss our findings within environmental and biological sensitivity frameworks. Future research must substantiate our findings and determine whether sensitivity frameworks help better understand the potentially interrelated impact of ego-resilience with irritability on children's mental health. [ABSTRACT FROM AUTHOR]

Public library storytimes provide rich learning opportunities for young children and their caregivers, yet little is known about how inclusive they are for children with disabilities and developmental delays (CwD/DD). The purpose of this study was to identify and describe ways that librarians support the inclusion of CwD/DD and their caregivers in storytime programs. We conducted semi-structured interviews with 34 librarians who provide storytime programs in public libraries in three states and analyzed them using iterative and inductive coding processes. Findings indicate that librarians are aware of the acute need to support diverse populations within their service communities and are collectively using a wide range of accommodations and strategies to facilitate their inclusion. However, on an individual level, they feel under-equipped to do so. Findings from this study highlight the need for further training and raise important questions regarding the equity of storytime programs for children with invisible disabilities, the potential reduction of diversity within storytime programs, and the potential value of establishing formal avenues of knowledge sharing. [ABSTRACT FROM AUTHOR]

Language ability has been associated with emotion regulation (ER) ability. Children on the autism spectrum have greater rates of language delays and lower ER ability. Despite this, autism traits have not been considered or controlled for in past research. This study therefore examined the association between language ability and ER in young children with and without autism traits. An exploratory analysis was also conducted to examine the types of ER strategies used by young children with autism traits compared with young children without such traits. Ninety mother–toddler dyads participated in the study. Results showed greater receptive language ability was significantly associated with greater parent-reported ER ability both when children with, and children without, autism traits were included in the sample. Furthermore, greater expressive language ability was significantly associated with greater observed ER but only when children with autism traits were excluded from the analysis. These findings have clinical implications for early intervention development for both children with and without autism traits. [ABSTRACT FROM AUTHOR]

Preschoolers' language abilities are associated with their social interactions in early childhood classrooms. Few studies, however, have examined associations between social interactions and objective measures of children's real-time classroom language environments, information key to informing interventions to support preschool children at risk for language delays. In this pilot study, we examined associations between objective measures of real-time language environments (input and output) recorded via the Language ENvironment Analysis (LENA) system and observations of children's positive and negative interactions with peers and teachers in an early intervention classroom for children with developmental delays (n = 9, seven girls). Mixed effects regression models revealed associations between children's language environments (input and output) and their social interactions with peers and teachers. More talkative children were more likely to have a high number of positive peer interactions. Children who received more language input from teachers were more likely to have a higher number of positive teacher–child interactions, an effect that was stronger for children with the lowest language output. The results of this pilot study build on prior research by using real-time objective measurement to examine how children's language input from peers and teachers and children's own language output supports positive interactions within early intervention classrooms. [ABSTRACT FROM AUTHOR]

Mindfulness strategies can have a large impact on emotional regulation, emotional intelligence, and interpersonal relationships. Parents of children on the autism spectrum may experience greater stress, depression, and strained interpersonal relationships than those with typically developing children or those with children experiencing other developmental delays. The purpose of the current study was to evaluate the feasibility, acceptability, and initial effects of a virtual Mindful Self-Compassion workshop for parents of children on the autism spectrum and the impact on stress, self-compassion, parenting self-efficacy, and mindfulness. This pilot study used a mixed-method approach to test this hypothesis. Participants completed surveys before and after the brief workshop and participated in a 1-hr focus group within 1 week of completing the surveys. The findings indicate that a short, 3-day virtual workshop may be effective toward improving parents' mindfulness and self-compassion. Parents reported feeling more mindful in their day-to-day life, more self-compassionate during difficult times, and more patient with themselves and other people in their family. A brief, virtual workshop may be effective for short-term improvements in outcomes for parents of children on the autism spectrum. [ABSTRACT FROM AUTHOR]

This retrospective cohort study aimed to determine whether severe calcidiol deficiency [25-hydroxyvitamin (OH)D <30 nmol/L] improvement has a beneficial effect on cardiometabolic parameters in children and adolescents (5-17 years) with or without metabolic syndrome (MetS). Logistic regression analysis was performed to test for multivariate associations between potential confounders and changes in vitamin D (VD) status from baseline to follow-up care when predicting binary categorical outcomes. Of 562 participants, 146 (26%) had MetS. Individuals with severe VD deficiency (VDD) were more likely to have MetS with elevated blood pressure than those with sufficient (≥75 nmol) VD levels (adjusted odds ratio [AOR], 4.46; 1.08-18.43; p <.05) at follow-up. In the logistic regression model, every unit increase in VD across time decreased the odds of MetS (AOR, 0.98; 95% confidence interval: [0.96, 0.99]; p <.05). Improvement in VD status demonstrated a beneficial metabolic effect in children and adolescents with severe VDD. [ABSTRACT FROM AUTHOR]

The article presents a neonatal case where cardiac tamponade developed as a complication of a peripherally inserted central catheter (PICC). Topics discussed include the potential risks associated with PICC placement, the management of pericardial effusion, and the importance of timely detection and intervention to prevent severe outcomes.

The article provides a comprehensive overview of acne vulgaris, focusing on its pathophysiology and management strategies. Topics discussed include factors influencing acne such as androgen activity and genetic variants, the impact of lifestyle and dietary behaviors, and current treatment options ranging from topical and oral medications to isotretinoin.

The objective of this study was to investigate the relationship between mortality and the prognostic nutritional index (PNI) in the pediatric patient group with ventriculoperitoneal shunt (VPS) infection. A total of 63 pediatric patients with a VPS infection and positive cerebrospinal fluid (CSF) culture were retrospectively registered. The CSF specimens were analyzed to conduct culture and microscopic evaluation. A total of 44.4% of the cases were men and 55.6% of the cases were women. Patients were divided into 2 groups (survivor and non-survivor patients). When survivor and non-survivor patients were compared, it was found that CSF leukocytes, CSF glucose, CSF protein, CSF/blood glucose ratio, lymphocyte, albumin, and PNI levels were lower in the non-survivor patients' group. Nevertheless, blood glucose and CRP (C-reactive protein) were significantly higher in the non-survivor patients' group than in the survivor patients' group. In our investigation, we suggested that low PNI was related to high mortality in cases of VPS infection. [ABSTRACT FROM AUTHOR]

Marching band is both a sport and a performance art. Organized athletics like American football, soccer, and cheerleading all have established epidemiologic trends of injury, including stigmata from head trauma. Despite the potential for mild to severe injury, there is a paucity of data on marching band-related morbidity. We examined the National Electronic Injury Surveillance System from 2012 to 2021 to describe demographic information and injury patterns. There were an estimated 20 335 marching band injuries (95% confidence interval: 12 892-27 777). The majority of injuries occurred in females (70%), and those aged 14 to 18 years (85%). Fifty percent of all injuries occurred in the lower extremity, and soft tissue injuries were the most frequently observed diagnosis (49%). Mild traumatic brain injury accounted for 6% of all injuries. Of marching band injury, 98% did not require escalation of care. Based on these findings, we suggest targeted public health intervention by sports medicine teams. [ABSTRACT FROM AUTHOR]

The purpose of this study is to determine the frequency of irritable bowel syndrome (IBS) and the influencing factors in children aged 4 to 9. The cross-sectional descriptive study included 1176 children between the ages of 4 and 9 who applied for Family Medicine Centers between March 1, 2017 and April 30, 2017 for various reasons. Pediatric Gastrointestinal Symptoms Questionnaire, Roma III Version (QPGS-RIII) was applied to the volunteers (children's parents or caregivers), and Beck Anxiety Scale was applied to the mothers accompanying their children. A total of 603 (51.9%) of the children included in the study were female and 559 (48.1%) were male. When the applied QPGS-RIII was evaluated with IBS diagnostic criteria, IBS was found in 137 children and IBS frequency was found to be 11.8% (95% confidence interval [CI]). Significant differences were found in socioeconomic level, eating habits, TV-watching habits, and IBS status (P <.05). [ABSTRACT FROM AUTHOR]

Central diabetes insipidus (CDI) is a disorder in the pediatric population resulting from antidiuretic hormone deficiency. The excessive production of dilute urine characterizes it and manifests with polyuria, nocturia, and polydipsia. The diagnostics of CDI is often challenging, especially concerning the underlying condition of the disease. This article highlights the diverse clinical presentation of children with CDI and diagnostic difficulties among patients with polyuria and polydipsia. The article also reviews the etiology, symptoms, diagnostic workup, and management of CDI. We present 4 pediatric patients (aged 3-13.5 years) diagnosed with CDI of different etiology: 1 due to septo-optic dysplasia/optic nerve hypoplasia and 3 due to acquired processes such as Langerhans cell histiocytosis and germ cell tumor in 2 patients. Central diabetes insipidus was the first manifestation of a tumor or granuloma in all presented patients with acquired pathology. The patients sometimes need long-term follow-up to establish the proper final diagnosis. [ABSTRACT FROM AUTHOR]

After his 1944 thesis, Asperger continued to write about autism, but none of these texts have been translated. At a time when autism spectrum disorder faces many challenges (e.g. the nature and measurement of autism), this text tells us more about the particular population that Asperger worked with. He describes sensitive, intelligent, creative and rational children, a far cry from the Wing triad. Moreover, 'Asperger's Syndrome' was introduced after he had died, was included in the DSM-IV in 1994 and was omitted from the DSM-5 in 2013. The question posed by this last text, written before his death, is whether Asperger's descriptions of autistic children are really part of the autism spectrum disorder or whether they are outside the pathological field. [ABSTRACT FROM AUTHOR]

Functional communication training (FCT) provides an efficient means for reducing a variety of challenging behaviors while increasing social communication. After establishing a functional communication response (FCR), interventionists may need to design a program to thin the schedule of reinforcement to provide more durable effects and maintenance in the natural environment. Hanley et al. provided one means for thinning schedules that involved the systematic introduction of extinction (or denial trials) following a process of delaying reinforcement. This study evaluates a southeastern U.S. classroom application of this thinning process with three elementary age students who engaged in a variety of aggression, self-injury, disruption, and crying. The results indicate positive effects of the FCT program with systematic introduction of denial trials once the participants demonstrated proficiency with the FCR. In addition, data for two participants show prolonged effects post-intervention. Results are discussed in terms of extending Hanley et al. and how these procedures can be used within typical school-based settings. [ABSTRACT FROM AUTHOR]

Effective treatment of challenging behaviors in young children with autism spectrum disorder requires identifying consequences that maintain the behavior under specific environmental circumstances. Assessment strategies help to identify environmental factors setting the occasion for the behaviors to continue to occur. Many studies have used antecedent–behavior–consequence (ABC) data collection strategies, but few have examined its ability to effectively identify the function. Research supports the use of the trial-based functional analysis (TBFA) but few studies examine its effectiveness in the home setting. The current study attempted to answer which assessments might work best in the home setting. Treatment was implemented for each participant based on the results of their assessments. All assessments identified the function of behavior as verified by function-based treatments, but the ABC assessment identified additional functions for three of the participants while the TBFA was more precise. Implications and limitations are reviewed, along with future directions for behavioral assessment in the home. [ABSTRACT FROM AUTHOR]

Australian child protection systems are being challenged to find more effective ways of responding to the needs of children and families. This article describes legal processes that govern children's removal from their families and queries whether we are doing enough to prioritise children's relationships with their families. The court's capacity to review the decisions of state welfare authorities and evaluate risks of children being removed is considered with reference to research with stakeholders and a recent case in the NSW Children's Court. The authors argue that reforms which emphasise family inclusion and address power differentials could provide better outcomes for children. [ABSTRACT FROM AUTHOR]

Background: Psychological characteristics of eating behaviour may be related to dietary habits. Aim: We investigated the association between eating behaviour characteristics and nutrition and food intake adequacy in Japanese adolescents. Methods: This cross-sectional survey was conducted among 136 junior high school students (boys: 90, girls: 46) at a junior high school in Tokyo, Japan. Eating behaviour was categorised into three types (emotional, external, and restrained) using scores on the Japanese version of the Dutch Eating Behaviour Questionnaire. Dietary intake was assessed using a validated, brief self-administered diet history questionnaire. Inadequate nutrient intake was determined by counting the number of nutrients not meeting the dietary reference intake (DRI) for the Japanese population. The statistical analyses included Wilcoxon signed-rank tests, Spearman's rank correlation coefficient, and multiple regression analysis using JMP ver.14 (SAS Institute Inc., Cary, NC, USA). All reported p values are two-tailed, and p < 0.05 was regarded as statistically significant. Results: Multiple regression analysis showed that restrained eating score was inversely associated with the number of nutrients not meeting the DRI (β = − 0.28; p = 0.0027) and with total weight of snack intake (β = − 0.30; p = 0.0010). Neither emotional nor external eating was significantly associated with the number of nutrients not meeting the DRI and with total weight of snack intake. Conclusions: These results suggest that adolescents with low restrained eating scores may have less self-control over their eating behaviour and may therefore have inadequate dietary intake. [ABSTRACT FROM AUTHOR]

Background: In Germany, the nutritional situation of adults and children living in households at risk of poverty has been insufficiently studied so far. Aim: The aim of the mixed-methods study MEGA_kids is to gain a deeper understanding of the nutritional situation including socioeconomic, behavioral, and attitudinal factors and health characteristics among persons living in families at risk of poverty. Method: MEGA_kids is a mixed-methods cross-sectional study consisting of four modules combining quantitative and qualitative methods. The first module (A) applies self-administered questionnaires to assess the individual's diet, household food insecurity, and several other factors among adults and children of 500 households. Cash receipts are used to assess household's food expenses. For the second module (B), a semistructured interview guide is used to identify factors influencing food security and nutritional quality from the perspective of a subsample of module A (n = 20). The third module (C) applies the participatory World Café technique to explore experiences and generate ideas for tailored support measures for a healthy diet from the perspective of 40 parents participating in module A. Finally, the fourth module (D) investigates the knowledge and usage of existing nutrition-related preventive measures among 200 parents at risk of poverty by using an online questionnaire. Conclusion: By providing a comprehensive picture of nutritional aspects of families living at risk of poverty, MEGA_kids will guide officials to target and prioritize public health nutrition measures, inform policy makers to implement and improve healthy policies and, finally, identify research gaps to be prioritized. [ABSTRACT FROM AUTHOR]

Background: Under nutrition has been a major problem in developing countries including Tanzania; hence, contributing to about half of the deaths among young children. Objective: The current study aimed at identifying child feeding practices and determinants of stunting in children under the age of five years in Mvomero District. Methods: A cross-sectional study involving 150 mother-child pairs was carried out in Turiani ward, Mvomero district in Morogoro region. Bivariate and multivariate logistic regression models were used to identify factors associated with stunting. A p-value ≤ 0.05 was considered sta-tistically significant. Five focus group discussions comprising 5–9 mothers with children below five years participated in the study. Thematic analysis was used to analyse data from the in-depth interviews. Results: The prevalence of underweight, stunting and wasting in Mvomero district was 16.8, 42.2, and 6.2% respectively. Pre-lacteal feeding was common in the study area (40%). Children were introduced to complementary food too early (<6 months) with plain maize porridge being the first food introduced. About 57.2% of children were on the lowest tercile (≤3 food groups per day) dietary diversity score. Significant determinants of stunting were the family source of income (AOR 1.63, 95% CI: 1.99–2.3), age of a child (AOR 2.66, 95% CI: 1.03–3.50) and family size (AOR 3.22, 95% CI: 1.61–4.27). Other factors were consumption of animal foods (AOR 5.30, 95% CI: 0.26–0.60) and dietary diversity score (AOR 1.615, 95% CI: 1.014–2.574). Conclusion: Child feeding practices in the study area are sub-optimal. These findings have important implications for interventions to address stunting among children. [ABSTRACT FROM AUTHOR]

This article discusses the notion of a 'morally equipped' childhood and adolescence, and how such a notion can help us get a fresh perspective on the relation between young people's participation and empowerment, and the formation of personal and the collective moral repertoires of modern society. Utilising a mixed-methods approach inspired by the sociology of conventions (SC) and the sociology of regimes of engagement (SRE), we analyse letters to the editor of the Norwegian children's newspaper Aftenposten Junior, to investigate the formats of children's generalised moral arguments. We demonstrate that our informants exhibit a broad moral sensibility in the letters we have analysed, particularly showing keen engagement with issues related to civic rights. We discuss the young participants' expressions in the light of convention theory. We make a case for how becoming 'morally equipped' could be understood as being able to engage, challenge, and articulate the tensions and negotiations between personal formats of daily experiences and interactions, and collective formats, such as public expressions, throughout childhood and adolescence. [ABSTRACT FROM AUTHOR]

BACKGROUND: The psychological conditions of children exposed to earthquakes, such as somatization, obsessive–compulsive, hostility, and paranoid thought, have not been adequately studied. AIM: This study was conducted to examine the relationship between the mental states and sleep patterns of children who experienced the Kahramanmaraş earthquake. METHODS: This is a descriptive, cross-sectional, and relational study that included 867 children from 11 provinces of Turkey affected by the earthquake that occurred in Kahramanmaraş on February 6th. The Child Follow-up Form, Mental Symptom Screening Scale, and Child Sleep Habits Scale were used to collect data. RESULTS: The psychological symptoms (anxiety, depression, somatization, anger-hostility, obsessive-compulsive symptoms, interpersonal sensitivity, phobic anxiety, paranoid ideation, psychotic symptoms, and other issues) experienced by children after the earthquake explained 96.9% of their sleep disturbance. Some of the demographic characteristics, such as age, the status of experiencing loss in the earthquake, the survival status of their mother and father, the survival status of their siblings, the total number of losses after the earthquake, the total number of losses in the nuclear family, total hours spent under the rubble, the hours children waited for their father, mother, and siblings to come out of the rubble, accounted for 77.9% of the mental symptoms (SCL-90). CONCLUSIONS: These results showed the importance of early recognition and treatment of sleep disturbances to prevent possible psychiatric disorders after children have been exposed to natural disasters. It is of great importance to evaluate the mental states of children after the earthquake and to apply appropriate psychiatric interventions. [ABSTRACT FROM AUTHOR]

The aim of this study is to comprehensively evaluate the effect of smartphone use on the eye. Twenty-two children, aged 8-16 years, participated in this study. A self-administered questionnaire about smartphone usage time, outdoor activities, and sleep time to obtain dry eye was applied to the child and parents. An ocular surface disease index (OSDI), tear break-up time (TBUT), blink time, autorefractometer, optical biometry, accommodation, contrast sensitivity, and optical coherence tomography tests were applied before a 5-min video watching, and during the video session we counted the complete -incomplete blinks. After video watching, we did the tests. After the tests, we again applied a 5-min video watching and after the video we tested all the parameters again, and finally, following a 5-min resting period, we tested the parameters again. We found no difference between the groups in terms of OSDI scores. Children with punctate epithelial erosions and time spent on the phone have a statistical relation. TBUT also differs statistically before and after test periods (p =.014), since complete blinks did not differ but incomplete blinks differed before and after video watching. The nearpoint of convergence also differs after video watching (p =.008) and anterior chamber depth (ACD) decreases even after the short-time video watching period. On the contrary, we did not find any effect of short-time smartphone watching on auto-keratometer values and retinal-choroidal thickness. This is the first comprehensive study on the short-term effects of smartphone on the paediatric age group. Even 10 min of smartphone can have an effect on TBUT, incomplete blinks, nearpoint of convergence break-recovery, and ACD. During this coronavirus disease 2019 pandemic, we must be mindful of the time our children spend on the phone and keep in mind that even 10 min can have ocular effects. [ABSTRACT FROM AUTHOR]

Objective: Growing evidence suggests digital interventions may provide neurocognitive benefits for children with ADHD. This study aimed to investigate the efficacy of a digital attention intervention in children with ADHD. Method: In this double-blind randomized controlled trial 55 children with ADHD (5–9 years) were allocated to the intervention (N = 28) or control program (N = 27). Both programs were delivered via touchscreen tablets at home 5 days a week for 5 weeks. The primary outcome was change in the Test of Variables of Attention (TOVA) Attention Comparison Score (ACS) from pre- to post-intervention. Results: Participants who received the intervention had significantly greater improvements in the TOVA ACS from pre- to post-intervention than those in the control (p <.044). No intervention effects were observed on secondary outcomes assessing executive functioning, ADHD symptoms, or functional impairment. Conclusion: Collectively these findings provide insufficient evidence for the implementation of digital attention interventions for children with ADHD. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to compare the approval of medicines for attention deficit/hyperactivity disorder (ADHD) for pediatric patients across five countries. Method: A document analysis was completed, using the drug labeling for ADHD medicines from five countries; United Kingdom, Australia, New Zealand, Canada and United States (US). Comparisons of available formulations and approval information for ADHD medicine use in pediatric patients were made. Results: The US had the highest number of approved medicines and medicine forms across the studied countries (29 medicine forms for 10 approved medicines). Approved age and dosage variations across countries and missing dosage information were identified in several drug labeling. Conclusions: The discrepancies in approval information in ADHD medicine drug labeling and differing availability of medicine formulations across countries suggest variations in the management of ADHD across countries. The update of drug labeling and further research into reasons for variability and impact on practice are needed. [ABSTRACT FROM AUTHOR]

Objective: Our goal was to compare data collected from 3- and 7-day Infant with Clefts Observation Outcomes (iCOO) diaries. Design: Secondary data analysis of an observational longitudinal cohort study. Caregivers completed the daily iCOO for 7 days before cleft lip surgery (T0) and for 7 days after cleft lip repair (T1). We compared 3- and 7-day diaries collected at T0 and 3- and 7-day diaries collected at T1. Setting: United States. Participants: Primary caregivers of infants with cleft lip with and without cleft palate (N = 131) planning lip repair and enrolled in original iCOO study. Main Outcomes Measure(s): Mean differences and Pearson correlation coefficients. Results: Correlation coefficients were high for global impressions (>0.90) and scaled scores (0.80–0.98). Mean differences were small across iCOO domains at T0. T1 comparisons reflected the same pattern. Conclusions: Three-day diary data is comparable to 7-day diaries for measuring caregiver observations using iCOO across T0 and T1. [ABSTRACT FROM AUTHOR]

In the field of childhood pain, the knowledge and expertise of children has long been overlooked. Instead, adult knowledge has been privileged over child knowledge, despite contemporary understandings that the experience of pain is subjective in nature and can only be fully appreciated by the person experiencing it – regardless of age, stage, or status. In this paper, we report on a pilot study that combined virtual semi-structured interviewing methods with arts-based research methods (drawing or painting, produced offline in the time between virtual interviews) to explore children's experiences of chronic pain from their own perspectives. We use this study as a backdrop to make visible the 'behind the scenes' methodological work of arts-based research with children, paying particular attention to the ways in which our methodological approach created time and space for reflection, supported the co-production of knowledge, provided a means through which to visualize the effect of broader social influences on knowledge production, and provoked novel lines of analysis and inquiry. All these affordances call for deeply reflexive research practices. We suggest the methodological approach described in this paper can help amplify and add value to research with young children. The richness of the children's accounts concerning chronic pain add to the body of evidence demonstrating that 'even' young children have knowledge, expertise, and insights that should be elicited to expand understandings of children's pain and other similarly abstract topics, phenomenon, and lines of inquiry in health. [ABSTRACT FROM AUTHOR]

Chronic kidney disease (CKD) in children presents multifaceted challenges, impacting various aspects of health, including oral health. This narrative review provides a comprehensive synthesis of literature focusing on the oral health status of pediatric CKD patients, encompassing oral manifestations, dental considerations, and management challenges associated with hemodialysis and kidney transplantation. A comprehensive search strategy was employed, utilizing databases such as PubMed, Scopus, Web of Science, and Google Scholar, to identify relevant literature on oral manifestations in children with CKD, including those undergoing hemodialysis or renal transplantation. Search terms were carefully selected to capture studies examining enamel hypoplasia, dental caries, delayed tooth eruption, gingival diseases, periodontal diseases, radiographic alterations, craniofacial development, dry mouth, and changes in the oral mucosa. Our narrative review meticulously selected articles through a systematic process. Ultimately, 12 studies meeting the inclusion criteria were included in the review. Relevant data from each included study were independently extracted and synthesized, focusing on oral manifestations and their implications in pediatric CKD patients. The synthesized findings were organized and presented in a structured manner within the review article, considering their clinical implications and informing recommendations for dental management of children with CKD. This article highlights the importance of a coordinated effort between nephrologists, dentists, and other healthcare professionals in providing holistic care for pediatric CKD patients. A comprehensive understanding of the oral health status of these children, along with proactive dental management strategies, contributes to improved overall health outcomes and a better quality of life. This review aims to serve as a valuable resource for the oral healthcare providers involved in the care of pediatric CKD patients. [ABSTRACT FROM AUTHOR]

Background and aims: Current evidence shows that children with developmental language disorder (DLD) benefit from spaced retrieval during word learning activities. Word recall is quite good relative to recall with alternative word learning procedures. However, recall on an absolute basis can be improved further; many studies report that fewer than two-thirds of the words are learned, even with the assistance of spaced retrieval during the learning activities. In this article we identify details of spaced retrieval that are less well understood in an effort to promote more effective learning through retrieval practice. Main contribution: We discuss the importance of factors such as: (a) integrating immediate retrieval with spaced retrieval trials; (b) determining whether gradual increases in spacing have more than short-term benefits relative to equal spacing; (c) discovering the number of successful retrievals sufficient to ensure later recall; (d) using spaced retrieval to avoid erosion of phonetic details on later recall tests; and (e) whether the well-documented difficulties with learning word forms might be tied to a particular subgroup of children with DLD. We also speculate on some of the possible reasons why spaced retrieval is beneficial in the first place. Conclusions: Although many children with DLD make gains in word learning through procedures that incorporate spaced retrieval, there are numerous details involved in the process that can alter its success. Until we have a better understanding of the boundaries of spaced retrieval's effectiveness, we will not be taking full advantage of this promising addition to word learning procedures. Implications: Spaced retrieval activities can be an important addition to the resources that clinicians and educators have available to assist children in their word learning. With a deeper understanding of the issues discussed here, we should be able to put spaced retrieval to even greater use. [ABSTRACT FROM AUTHOR]

Introduction: Early identification of developmental dysplasia of the hip (DDH) is necessary to minimize its negative effects. Ultrasound screening is useful for detecting DDH in hospitals. Awareness about community-based screening systems is low in Japan. Despite established nationwide home visiting services and child health checkups in the country, more than 10% of DDH patients are diagnosed at the age of ≥1 year. This review aimed to clarify the status of universal ultrasound screening for DDH among infants in community settings in Japan. Methods: The electronic databases of Igaku Chuo Zasshi, MEDLINE, CHINAL, ERIC, and APA PsycInfo were searched for articles published between 2002 and 2022. Articles were evaluated with the reach, effectiveness, adoption, implementation, and maintenance framework. Results: In total, 148 articles were identified. Two articles were manually added, and 67 articles were excluded through abstract reviews, of which 20 were duplicates. Finally, 18 articles were included in the analysis. There are two types of universal ultrasound screening in community settings: municipality-led and hospital-led. Since 1992, municipality-led screening has been conducted during public infant health checkups in five municipalities. Six hospitals implemented ultrasound screening. The participation rate was around 90%. The Graf method is typically used for this purpose. The prevalence of abnormal hips was 3.6%–16.6%. Owing to limited human resources and skills in ultrasound, all studies mentioned the necessity of a universal screening system for the early detection of DDH. Conclusion: Embedding universal ultrasound screening in community health checkup systems enables collaboration between healthcare professionals and caregivers to improve health inequities and ensure early detection of DDH cases. [ABSTRACT FROM AUTHOR]

The current diagnostic criteria for the autism spectrum disorder (ASD) include the possibility to specify concomitant language difficulties. Purpose: Our main aim was to explore whether children with ASD-Level 1 (ASD-L1) present difficulties in the acquisition of structural language, as little work has been done in this regard so far. As a secondary aim we evaluated the degree to which the potential language impairment in ASD is directly associated with their social communication deficits or it represents a distinct deficit. Methods: To further clarify the nature and characteristics of putative language difficulties in ASD-L1, we evaluated language skills in 89 children and preadolescents diagnosed with ASD-L1, and a group of typically developing participants (TD). All of them were between 8 and 13 years old and had similar socioeconomic backgrounds. Results: Children with ASD-L1 obtained lower scores than those in TD group in repeating sentences, in finding the semantic relationships between words, and in applying word structure rules (morphology). Congruently, the core language standard score was lower in the ASD-L1 group, and the proportion of language delay was significantly higher in the ASD-L1 group than in the control group. Conclusion: Language scores were associated with autistic traits; thus, language performance in ASD-L1 is closely related to autistic symptoms. These results are discussed according to the literature on linguistic deficits in ASD-L1 and their relations with phonological working memory. [ABSTRACT FROM AUTHOR]

Gastrostomy feeding is a route of enteral nutrition for children with feeding difficulties. This study investigated caregiver experiences of the transition to gastrostomy feeding. A survey was administered to caregivers of children <18 years in a major pediatric center in Ireland. Experiences of decision-making, support, and adjusting to tube feeding were examined. Seventy-six caregivers participated. Median satisfaction with the information provided by the hospital was high. Almost half (48%) spoke to another caregiver of a child with a gastrostomy prior to their own child's gastrostomy insertion and most (88%) felt reassured by this. Concerns following insertion included managing the tube and their child's oral intake and feelings about the tube. The oral intake of 83% of children who had some intake prior to gastrostomy insertion did not change or increased following insertion. Most (89%) would make the same decision to insert the tube. Feelings associated with the transition included relief and stress. Gastrostomy tube insertion presents logistical and psychosocial challenges for caregivers. Peer support from other caregivers may alleviate some of these challenges. [ABSTRACT FROM AUTHOR]

Introduction/Objectives: Exposure to adverse social determinants of health (SDoH) in childhood is associated with poorer long-term health outcomes. Within structurally marginalized populations, there are disproportionately high rates of developmentally vulnerable children. The RICHER (Responsive, Intersectoral, Child and Community Health, Education and Research) social pediatric model was designed to increase access to care in marginalized neighborhoods. The purpose of this study was to describe the children and youth engaged with the RICHER model of service and characterize the needs of the population. Methods: A retrospective chart review was conducted on children and youth who accessed primary care services through the program between January 1, 2018 and April 30, 2021. Basic descriptive data analysis was done using Stata v15.1. Results: A total of 210 charts were reviewed. The mean age in years at initial assessment was 6.32. Patients most commonly identified their race/ethnicity as Indigenous (33%) and 15% were recent newcomers to Canada. Evidence of at least 1 adverse SDoH was noted in 41% of charts; the most common included material poverty (34%), food insecurity (11%), and child welfare involvement (20%). The median number of diagnoses per patient was 4. The most frequently documented diagnoses were neurodevelopmental disorders (50%) including developmental delay (39%), ADHD (32%), and learning disability (26%). The program referred 72% of patients to general pediatricians and/or other subspecialists; 34% were referred for tertiary neuropsychological assessments and 35% for mental health services. Conclusions: Our data suggests that this low-barrier, place-based primary care RICHER model was able to reach a medically, developmentally, and socially complex population living in disenfranchised urban neighborhoods. Half of the patients identified in our review had neurodevelopmental concerns and a third had mental health concerns, in contrast to an estimated 17% prevalence for mental health, behavioral, or developmental disorders in North American general pediatric aged populations. This highlights the impact adverse SDoH can have on child health and the importance of working with community partners to identify developmentally vulnerable children and support place-based programs in connecting with children who may be missed, overlooked, or disadvantaged through traditional models of care. [ABSTRACT FROM AUTHOR]

Background: Nurses play an integral role in the care of children hospitalised with a serious illness. Although information about diagnostics, treatments, and prognosis are generally conveyed to parents and caregivers of seriously ill children by physicians, nurses spend a significant amount of time at the child's bedside and have an acknowledged role in helping patients and families understand the information that they have been given by a doctor. Hence, the ethical role of the nurse in truth disclosure to children is worth exploring. Methods: A systematic academic database and grey literature search strategy was conducted using CINAHL, Medline Psych Info, and Google Scholar. Keywords used included truth, children, nurse, disclosure, serious illness, and communication. A total of 17 publications of varying types were included in the final data set. Ethical Considerations: As this was a review of the literature, there were no direct human participants. Empirical studies included in the review had received ethics approval. Results: Of the 17 articles included in the review, only one directly reported on the experiences of nurses asked to withhold the truth from patients. Empirical studies were limited to HIV-positive children and children diagnosed with cancer and the dying child. Conclusion: A paucity of literature exploring the experiences, attitudes, and beliefs of nurses with regard to truth-telling to seriously ill children is evident. Little consideration has been given to the role nurses play in communicating medical information to children in a hospital setting. The 17 articles included in the review focused on cancer, and HIV, diagnosis, and end-of-life care. Further research should be undertaken to explore the experiences and attitudes of nurses to clinical information sharing to children hospitalised with a wide range of serious illnesses and in diverse clinical scenarios. [ABSTRACT FROM AUTHOR]

A best-evidence synthesis and meta-analysis were conducted to evaluate interventions designed to decrease noncompliance in early childhood settings. Studies were examined for quality, intervention components, and outcomes for young children (ages 2–8 years) across settings. Results indicated most designs were high-quality and produced desired outcomes. However, participant inclusion criteria were commonly underreported, and social and ecological validity data were absent. Thus, for whom noncompliance interventions are effective, appropriate, feasible, or preferred is largely unknown. Contrary to prior evidence from the broader challenging behavior literature, function-based assessments had no impact on intervention outcomes. Reasons for this finding are explored, including the narrow application of function-based assessment findings to compliance interventions. Future implications for research and practice are presented. [ABSTRACT FROM AUTHOR]

Challenging behavior (CB) is a common occurrence in early childhood and frequently occurs in young children with disabilities. CB is also culturally perceived and includes differences in how caregivers understand and define the topography of CB. Despite the cultural interpretation, CB is known to impact the child and their family but there has been little exploration of what marginalized caregivers perceive as the impact of the CB that their young children with disabilities exhibit. We used semi-structured interviews to explore the perceptions of 24 caregivers, who identified as Black, Mexican American, and White, about the impact of their child's CB. Caregivers shared how the CB impacted themselves, their families, their child, and others. Although much of the impact was similar among caregivers, we discuss nuanced differences across ethnic groups. [ABSTRACT FROM AUTHOR]

The role of children's caregiving has received substantial attention in studies on care in old age. Previous research shows that children's care provision is strongly intertwined with both their individual and siblings' situation regarding employment and geographic parent-child distance. This study uses data from six waves of the Survey of Health, Ageing and Retirement in Europe (SHARE), taking a within-family approach, to examine how caregiving is (re-)distributed between siblings over time. The provision of continuous parent care is observed more frequent and volatile in European countries with a family-based care system. The results from family fixed-effects regression models demonstrate that children working less than siblings persist in caregiving more. Living closest to parents facilitates children to keep up care efforts, while changing to living closest enhances the start of parent care. This study suggests that geographic distance is vital in the long-term organization of parent care between siblings. [ABSTRACT FROM AUTHOR]