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Aim Methods Results Conclusions Few reports have shown Quality‐of‐Life long‐term outcomes in children with congenital diaphragmatic hernia (CDH) who received extracorporeal membrane oxygenation (ECMO) support. We reviewed the short‐ and long‐term outcomes in CDH patients that were supported with ECMO during their neonatal treatment.Telephone interviews of parents of CDH children were performed. The Functional Status Scale (FSS) and the Paediatric Quality of Life Inventory (PedQL, Version 4.0) were completed with the parents. All children with a CDH and supported with ECMO from 2010 to 2023 were included in the study.Twenty children were identified, with two having two ECMO runs. Birth weight was 3.2 kg (median). ECMO support lasted for (median) 13.6 days (range 3.8 to 39). Twelve patients were alive at the time of the survey. The age (median) at time of the interview was 6.3 years (range 1 to 12). The FSS score showed no impairment (FSS score 6) in any domain in eight patients. Two patients had a score of 7, and two patients had a score of 8 and 9, respectively. The PedQL showed a median score 84.5, with a physical health summary score of 92.5 and a psychosocial health summary score of 78.7. The cardiac specific PedQL inventory score was 77.ECMO support for CDH patients is associated with functional and Quality of Life outcomes that are similar to that in other PICU discharge populations. Denying ECMO support to CDH patients on the basis of predicted poor long‐term outcomes does not appear to be justified. [ABSTRACT FROM AUTHOR]

Background Aim Methods Results Conclusion In situations where a child's mental well‐being is threatened, the parents also need support. The available support has been perceived as insufficient by both parents and professionals.To explore the views of experts‐by‐experience of the support needed by parents when a child's mental well‐being is threatened.A qualitative study with a phenomenological approach was conducted in Finland. The data were collected in six focus group interviews during the autumn of 2022. The participants (n = 26) were adult experts‐by‐experience who had experienced either mental well‐being challenges in their own childhood (before the age of 18 years) or experienced the mental well‐being challenges of a child from the role of a parent. The data were analysed using inductive content analysis.The support needed by parents in situations where the mental well‐being of their child is at risk consists of support for parenting, support for sharing and support for surviving.Parents whose child's mental well‐being is at risk, need support both for their own well‐being and for their ability to support their child's well‐being. Support is needed not only from professionals but also from peers. [ABSTRACT FROM AUTHOR]

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

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

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

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

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

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

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

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

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

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

This study investigates the effect of problem‐solving training on the interpersonal problem‐solving skills of mothers of children with special needs. The parallel randomised controlled trial was conducted between August 2021 and March 2022. A priori power analysis was conducted, and 98 mothers who met the inclusion criteria were included in the study. The analysis indicated that a sample size of 39 participants per group was required. Data were collected using a personal information form and the Interpersonal Problem Solving Inventory. The mothers were divided into control and experimental groups. The participants in the experimental group were given a problem‐solving training program, while the control group was not exposed to any intervention. There was no significant difference in the pre‐training test scores for any of the dimensions (p > 0.05). However, the post‐training test scores in the experimental group were significantly higher than post‐training test scores in the control group (p < 0.05). There were significant differences between the pre‐training and post‐training test scores in the experimental group (p < 0.05). Interpersonal problem‐solving skills can be improved by providing problem‐solving training to the mothers of children with special needs. Based on the findings of this study, it is recommended that psychiatric nurses provide training to protect and improve the wellbeing of children with special needs and their families. [ABSTRACT FROM AUTHOR]

ABSTRACT Objectives Methods Results Conclusions Childhood primary dentition caries prevalence and experience is higher among Qatari than non‐Qatari nationality children in Qatar but only this bivariate association has been described.There were two objectives. First, to understand the variation of primary dentition caries among 4‐ to 8‐year‐old children in Qatar across nationality classified into four groups, and second, to explore whether the association persisted in the presence of socio‐demographic and behavioural indicators.The study used data from the Qatar Child Oral Health Survey 2017 (QCOHS 2017). Detailed information was collected through a parental dual‐language questionnaire and an oral epidemiological examination conducted by calibrated dentist examiners. Children in 20 kindergartens and 40 schools across Qatar were recruited. Data were weighted to represent the Qatar child population.Overall, 1154 children aged 4–8 years old (48.9% female, 51.1% male) participated. Qatari children made up 26.3%, Non‐Qatari (N‐Q) Arabic children 44.2% N‐Q Indian sub‐continent 16.4% and N‐Q Other 13.1%. There were no significant differences by nationality for age or sex, but differences existed for kindergarten/school type and parents' highest level of education. Among behavioural indicators, Qatari and N‐Q Arabic children began toothbrushing later, and more N‐Q Other children brushed 2+ times a day and had made a check‐up visit in the last 12 months. More Qatari children were in the highest tertial for sugar intake and drank bottled water with no fluoride. All N‐Q children had a significantly lower prevalence and experience of caries. The means ratio (95% CI) for N‐Q Arabic (0.78; 0.65–0.94), Indian (0.58; 0.46–0.72) and other children (0.61; 0.42–0.88) were all significant against Qatari nationality children. Multivariable models showed an attenuation of the association with caries with the means ratio for N‐Q Arabic (0.92; 0.73–1.16), Indian (0.79; 0.57–1.11) and other children (0.94; 0.61–1.44) being non‐significant compared to Qatari nationality children. The variables which were significantly associated with caries were parental education, toothbrushing frequency, sugar intake and check‐up visiting in the last 12 months in the multivariable models.Primary dentition caries in children resident in Qatar differed by nationality. The association of primary dentition caries with nationality was markedly attenuated and non‐significant in the presence of socio‐demographic and behavioural variables, pointing towards the importance of these variables as the pathways to improving primary dentition caries prevalence and experience of children in Qatar. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the relationship between the amount of ultra‐processed food (UPF) in the diet and low‐grade inflammation in children. This cross‐sectional study was conducted in 50 healthy children recruited from children attending the Social Paediatrics Outpatient Clinic for follow‐up of normal developmental stages. Low‐grade inflammation was calculated by INFLA‐score, dietary intake by three 24‐h dietary recalls and dietary content analyses by BeBiS™ software. The mean age of the 50 children included in our study was 10.18 ± 3.98 years (5–17 years). UPF accounted for 24.5% of the total daily energy intake of children. In children with higher inflammation scores (INFLA‐score ≥ 2), the amount in grams of UPF and the percentage of total energy from UPF were found to be significantly higher (p = 0.030 and p = 0.015, respectively). A weak positive correlation was found between the INFLA‐score and the percentage of daily dietary energy intake coming from UPFs (r = 0.350, p < 0.01), the average daily energy intake from UPFs (r = 0.313, p < 0.05), and the average daily amount of UPF consumed (r = 0.260, p < 0.05). The linear regression model revealed that every one‐unit increase (1%) in the percentage of total daily energy intake coming from UPF caused an increase in β = 0.154‐unit in the INFLA‐score. It was found that obesity was not a mediator in the association between the percentages of total energy intake from UPF on the INFLA‐score, instead, the energy intake from UPF had a significant direct association with the INFLA‐score. The average amount of UPF consumed daily showed an increasing pattern in parallel with inflammation‐score quartile classes (Q1 to Q4) with 33.3% in Q1, 38.5% in Q2, 53.8% in Q3 and 66.7% in Q4 (p = 0.049). In conclusion, a positive association was found between low‐grade inflammation and UPF consumption in children, independent of obesity. [ABSTRACT FROM AUTHOR]

Summary To explore the association between the severity of sleep‐disordered breathing, different types of respiratory events, peripheral oxygen saturation (SpO2), age and sleep stage on cerebral oxygen saturation (rSO2) in children. We enrolled children aged 4–14 years who were treated for snoring or mouth breathing at the Sleep Center of Beijing Children's Hospital, from February 2022 to July 2022. All children completed polysomnography, and SpO2, rSO2, and heart rate (HR) were recorded synchronously. A total of 70 children were included, including 16 (22.9%) with primary snoring, 38 (54.3%) with mild obstructive sleep apnea (OSA), and 16 (22.9%) with moderate‐to‐severe OSA. There were no significant differences in the mean rSO2 or minimum rSO2 among the primary snoring, mild OSA, and moderate‐to‐severe OSA groups (all p > 0.05). A total of 1119 respiratory events were included in the analysis. Regardless of the type of respiratory event, rSO2 and HR changes occur prior to fluctuations in SpO2. A mixed‐effects model showed that ΔrSO2 was positively correlated with ΔSpO2, duration of respiratory event, mixed and obstructive apnea, central apnea, while negatively correlated with age and rapid eye movement (REM) sleep stage (all p < 0.05). Larger rSO2 fluctuations were impacted by a greater ΔSpO2, longer duration of respiratory events, younger age, apnea‐related respiratory events and non‐REM sleep stage. Thus, sleep disordered breathing in younger children warrants more attention. More research is needed to determine whether REM sleep has special protective effects on rSO2. [ABSTRACT FROM AUTHOR]

Introduction Aim Methods Results Conclusions The Child Hemophilia Treatment Experience Measure (Child Hemo‐TEM) was developed to capture the treatment burden experience of children with haemophilia (CwH).Describe the development of this novel haemophilia‐specific measure.Interviews were conducted with clinical experts, CwH and CwH's caregivers. Interviews were analysed according to adapted grounded theory principles. Based on the analysis, a preliminary measure was developed and debriefed. Psychometric analyses were performed according to an a priori analysis plan using data collected in a cross‐sectional web survey and a final measure was generated.Interviews with four clinical experts, 25 CwH ages 8 to <12 years, and 25 caregivers of CwH <12 years were conducted. Concepts endorsed by ≥10% of CwH and caregivers were: adherence, ease of use, emotional impacts, physical impacts, treatment concerns, and interference with daily life. Cognitive debriefing assessments were conducted to ensure participant understanding and item relevance. Caregivers found the measure to be understandable, comprehensive, and relevant. However, several issues with CwH completing the measure were identified and it was decided to only develop an observer‐reported outcome version. Data for psychometric validation was collected in a web survey (N = 187). Item reduction dropped 12 items. Factor analysis generated a single, 7‐item, internally consistent (α = .855) factor, which consisted of items covering all relevant a priori concepts. The majority of a priori convergent and all known groups validity hypotheses were confirmed.The study findings provide evidence that the Child Hemo‐TEM is a brief, well‐designed, and valid and reliable measure of haemophilia treatment burden. [ABSTRACT FROM AUTHOR]

Objectives Methods Results Conclusions Limited evidence exists to guide the management of children with possible spinal injuries in the prehospital setting. As a first step to address this, we set out to describe the epidemiology and management of children <18 years presenting with possible cervical spinal injuries to EMS in Victoria, Australia.Retrospective case record review of all children with concerns of head or neck trauma and/or documented cervical spine collar use presenting to the statewide Ambulance Victoria (AV) EMS service, Victoria, Australia, between 1 July 2019 and 30 June 2020. Demographic, clinical features, mechanism of injury and spinal immobilisation practices were extracted.2100 children were included; 61% were male and the median age was 13 years (interquartile range: 9–15). Over half of the children were transported to suburban (32.2%) and rural/regional (22.9%) EDs, with 37.5% taken to designated trauma centres. The most common mechanisms of injury were sports/activity, motor vehicle accidents and falls in 35.4%, 27.9% and 26.3%, respectively. Spinal precaution use was recorded in 93.7% of cases; cervical collar use was the most common procedure recorded (87.1%). Younger age groups were less likely to have spinal precautions initiated; 51% of children aged 0–3 years, compared to 96.3% of children aged 12 and older (odds ratio = 23.8; 95% confidence interval = 14.5–37; P < 0.001).Prehospital spinal precautions were initiated commonly in children, with use increasing with age, and most were transported to suburban, regional and rural hospitals, not trauma centres. These data will inform the integration of emerging paediatric‐specific evidence into prehospital guidelines to risk stratify children. [ABSTRACT FROM AUTHOR]

Purpose: To explore actions taken by health care professionals during a procedure with a child with autism spectrum disorder Design and Method: Critical incident technique was used, which is a technique with a qualitative descriptive retrospective design, to capture situations experienced by health care professionals during a procedure in an anaesthesia or radiology department. Health care professionals from anaesthesia and radiology departments (n = 20) were interviewed about situations affecting the procedure. Results: The findings revealed a broad range of actions (n = 205) taken by the health care professionals during a procedure with a child with autism spectrum disorder. The analysis resulted in two main areas: Finding a way to facilitate a procedure in a high technology environment and Creating a trustful relationship with a child with autism spectrum disorder. The most common action in the first area, was to adjust routines. In the second area the most common action was to take one step at a time and not force or rush the child during the procedure. Practice Implications: The health care professionals used a broad range of different actions to facilitate a procedure in the high technology environment for a child with ASD, which indicates the need for a flexible approach. The actions taken included both adjustments to the environment and enhancing interactions with the child. [ABSTRACT FROM AUTHOR]

Background: Parvalbumin Gad c1 is a major cod allergen used as a follow‐up marker of fish‐allergic children. However, the diagnostic efficacy of recombinant Gad c 1 (rGad c 1) for fish allergy diagnosis remains controversial. This study aimed to evaluate the efficacy of rGad c1 for diagnosing cod and horse mackerel allergy. Methods: This single‐centered, retrospective study obtained oral food challenges (OFCs) information performed for cod and horse mackerel. Cod‐, horse mackerel‐, and rGad c1‐specific immunoglobulins (sIgEs) were investigated. Diagnostic performances of these parameters were compared using areas under the curve (AUC). Results: We enrolled 45 and 38 children with suspected cod and horse mackerel allergies, respectively. The median age (interquartile range) of children with suspected cod allergy was 5.7 (0.7–11.7) years and that of children with suspected horse mackerel allergy was 6.0 (1.0–12.3) years. Fourteen and 22 children reacted to OFCs with 25 (10–40) g of cooked pacific cod and 40 (10–40) g of cooked horse mackerel, respectively. The cod sIgE and rGad c 1 sIgE AUCs for cod allergy diagnosis were 0.85 and 0.90, respectively. For horse mackerel allergy diagnosis, AUCs of horse mackerel and rGad c 1 sIgE were 0.76 and 0.72, respectively. Both AUCs for cod and mackerel allergy were significantly different. Conclusion: rGad c 1 sIgE is more effective than cod sIgE as a diagnostic marker of cod allergy, but less effective than horse mackerel sIgE as a diagnostic marker of horse mackerel allergy. Further studies are warranted to explore the potential applications of rGad c 1 sIgE in the diagnosis of various fish allergies. [ABSTRACT FROM AUTHOR]

Issue Addressed: This paper aims to explore Victoria parents' perceptions of their current practices and barriers in providing school lunches for their primary school children. Methods: Respondents were asked via an online survey about their lunch provision practices, perceptions of the healthiness of school lunches, and barriers to providing healthy school lunches. Data were analysed using different statistical techniques: Chi‐square test, Spearman correlation analysis, Mann–Whitney U test, and Kruskal–Wallis test. Results: In total, 359 respondents completed the survey. Most respondents (84%) reported their child takes a home‐packed lunch to school every day. Most respondents provided fruits (94%), vegetables (57%), and sandwiches (54%) every day for school lunches, whilst other core food items such as milk, meats, and legumes were provided less frequently. A substantial proportion of respondents provided some discretionary food items frequently (e.g., the proportion of respondents providing selected discretionary food items daily or 3–4 times/week: salty crackers—50%, sweet cookies/biscuits—40%, chips—20%). Respondents strongly agreed or agreed with several barriers; examples include not packing certain foods due to food spoilage concerns (50%) (school‐related), the allocated time at their child's school is not enough to eat and enjoy school lunch (48%) (school‐related), need more meal ideas (61%) (parent‐related), healthy foods take more time to prepare (51%) (parent‐related), and children request easy‐to‐eat food for school lunches (50%) (child‐related). Core food score (an indicator of frequency of preparing/packing core food) was negatively correlated with parent‐related and child‐related barrier scores, whilst discretionary food score (an indicator of frequency of preparing/packing discretionary food) was positively correlated with these barrier scores. Conclusions: Overall, home‐packed lunches remain the main option in primary schools in Victoria, and parents face several challenges in providing healthy lunches for their primary school children. So What?: The findings suggest the need for strategies from school leaders, education authorities, and policymakers to improve the quality of lunch content and address the barriers faced by parents. [ABSTRACT FROM AUTHOR]

Youth and families impacted by legal systems now resoundingly attest to the systems' lasting harm, echoed by interdisciplinary research. Lawyering thus requires a vastly renewed outlook, boldness, and honest inquiry about the limits of what the law and public systems can (and should) attempt as purported problem‐solving amidst broader socioeconomic forces and injustice. This report synthesizes recommendations from a groundswell of diverse, dedicated voices following an October 2023 convening hosted by the American Bar Association Commission on Youth at Risk, the ABA Center on Children and the Law, and Hofstra University's Maurice A. Deane School of Law. Entitled "Renewal and Revolution: Recommitting the Legal Profession to Serving Children and Youth, Their Families, and Communities," the convening engaged various professionals—many with firsthand experience in foster and justice systems— and other advocates. Since the 2006 ABA Youth At Risk Initiative Planning Conference, the ABA Commission on Youth At Risk has elevated the representation and voice of youth through ethical practice standards, expanded access, and national initiatives. This report recounts findings of the 2023 convening's four working groups which met for two‐days of (often tense) discussions to chart a path for the legal profession, law, and policy for the next decade and beyond. Priorities include: transcending conceptions of youth "at risk" towards recognition of harms done, a strengths‐based lens, and lived experience leadership and expertise; cultivating next generation attorneys; prioritizing early family defense and diversion; divesting from systems and re‐investing directly with youth and families; and further eliminating racial disparities. Key points for the family court community: Attorneys and advocates representing youth and families require a bold paradigm shift towards legal strategies that minimize harm and trauma, divert from courts and facilities, and empower those directly impacted by systems.Lived experience expertise on the part of youth and families should be better compensated and leveraged, towards the advocacy goals of improved legal representation and divestment from public systems which cause harm.Constitutional and civil rights protections for youth and parents in family courts, and other systems like the immigration system, need to be strengthened and formalized.Judges, attorneys and advocates require more extensive training on eliminating racial and ethnic disparities. Jurisdictions should prioritize this as a matter of professional ethics (and/or continue doing so). Additional measures are often needed to counter inevitable resistance to change, and retrenchment of biases.While the next generation of attorneys representing youth and families may benefit from being further mentored and supported, it is also an honor and an asset for the legal profession to have and mentor emerging attorneys with firsthand experience in youth‐serving systems themselves. [ABSTRACT FROM AUTHOR]

Respiratory syncytial virus (RSV) is the leading cause of acute lower respiratory tract infections (LRTIs) and hospital admissions in early childhood. Recent advancements in novel preventive therapies, including extended half‐life monoclonal antibodies and antenatal vaccination, have afforded new opportunities to significantly reduce the burden of this infection. Nirsevimab is a novel monoclonal antibody that provides sustained protection against RSV for at least 5 months among newborns and young children. It has received regulatory approval in numerous countries and is being implemented across various settings. Two pivotal Phase 3 trials (MELODY, HARMONIE) demonstrated significant reductions in RSV‐associated LRTI hospitalisations following nirsevimab administration, with treatment efficacy of 62.1% and 83.2%. Emerging real‐world data from early adopters of nirsevimab corroborates these findings. Studies from Spain, Luxembourg, France and the USA report effectiveness rates between 82% and 90% in preventing RSV‐associated hospitalisations among infants entering their first RSV season. Current implementation strategies for nirsevimab have primarily focused on seasonal administration for all infants, aligned to local RSV seasons, and often include catch‐up doses for those born before the season begins. Available cost‐effectiveness analyses indicate that while nirsevimab offers significant potential public health benefits, its adoption must carefully consider economic factors such as treatment costs, implementation strategies tailored to local viral epidemiology, and logistics for vaccine delivery. Overall, nirsevimab presents a promising opportunity to alleviate the burden of severe RSV infections in young children. However, ongoing surveillance and refinements in implementation strategies are crucial to optimise its impact and ensure sustainability across diverse health‐care settings. [ABSTRACT FROM AUTHOR]

Aims: Children with neuro‐developmental disorders faced significant challenges in accessing services during the COVID‐19 pandemic. Telehealth has been adopted by health services globally to facilitate access to clinical services. Our aims were to evaluate the utility of the telehealth modality for providing developmental assessment services and explore enablers and barriers to using telehealth, in a culturally diverse and socioeconomically disadvantaged population in Sydney. Methods: We reviewed telehealth developmental assessments in South Western Sydney conducted between 1 April and 30 June 2020. Data were collated on demographics; telehealth modality; diagnostic formulation; recommendations; and requested follow up. We conducted retrospective semi‐structured telephone interviews with 79 families and 11 clinicians about their telehealth experience. Thematic analysis was carried out on the open text responses. Results: Of 205 children assessed across six sites, median age was 48 months; 45% were assessed with video and 55% with telephone only. Diagnostic formulation and therapeutic recommendations were provided for 203 (99%) children and 138 (67%) were asked to come for face‐to‐face follow‐up. The majority of families (76%) were satisfied or extremely satisfied with telehealth. Median clinician satisfaction was 3.5 out of 5, whilst clinician confidence with diagnostic formulation was 4 out of 5. Qualitative data revealed a range of barriers and enablers. Conclusion: Telehealth was a successful modality for contributing to the assessment journey for children with neuro‐developmental disorders in our culturally, linguistically and socioeconomically diverse clinical population in the context of a pandemic lockdown. We discuss the potential for telehealth modalities in child developmental assessments beyond the pandemic. [ABSTRACT FROM AUTHOR]

Aim: To identify the barriers and facilitators for timely detection and optimal management of otitis media (OM) in Aboriginal children in a primary care setting from the perspective of carers of Aboriginal children. Methods: A qualitative, Aboriginal co‐designed, participatory action research study with interviews and focus groups in a large town in the Kimberley, Western Australia. The Consolidated Framework for Implementation Research informed stakeholder group identification and interview framework development. Data underwent thematic analysis using NVivo software. Results: Thirty‐two carers of Aboriginal children participated. Key barriers identified for the detection of OM were limited information about OM provided to carers and carers feeling disempowered to express their concerns. Key facilitators identified were the provision of health information through health promotion and the use of culturally secure resources. Having a culturally secure clinical environment was identified as essential, with Aboriginal Health Workers playing a vital role in clinical care. No barriers to management of OM in primary care were reported. Facilitators included health care practitioners (HCPs) emphasising the importance of completing antibiotic course and the clinic providing necessary medications. Conclusions: A culturally secure health promotion strategy with health promotion teams, campaigns and resources is needed to increase community awareness of OM signs and symptoms and facilitate appropriate health seeking. It is essential that the local Aboriginal community co‐lead and co‐develop these initiatives to ensure the unique wisdom and knowledge of Aboriginal people are captured. HCPs and the clinic effectively facilitate management of OM by providing medications and emphasising completion of antibiotics. [ABSTRACT FROM AUTHOR]

Automated EEG pre‐processing pipelines provide several key advantages over traditional manual data cleaning approaches; primarily, they are less time‐intensive and remove potential experimenter error/bias. Automated pipelines also require fewer technical expertise as they remove the need for manual artefact identification. We recently developed the fully automated Reduction of Electroencephalographic Artefacts (RELAX) pipeline and demonstrated its performance in cleaning EEG data recorded from adult populations. Here, we introduce the RELAX‐Jr pipeline, which was adapted from RELAX and designed specifically for pre‐processing of data collected from children. RELAX‐Jr implements multi‐channel Wiener filtering (MWF) and/or wavelet‐enhanced independent component analysis (wICA) combined with the adjusted‐ADJUST automated independent component classification algorithm to identify and reduce all artefacts using algorithms adapted to optimally identify artefacts in EEG recordings taken from children. Using a dataset of resting‐state EEG recordings (N = 136) from children spanning early‐to‐middle childhood (4–12 years), we assessed the cleaning performance of RELAX‐Jr using a range of metrics including signal‐to‐error ratio, artefact‐to‐residue ratio, ability to reduce blink and muscle contamination, and differences in estimates of alpha power between eyes‐open and eyes‐closed recordings. We also compared the performance of RELAX‐Jr against four publicly available automated cleaning pipelines. We demonstrate that RELAX‐Jr provides strong cleaning performance across a range of metrics, supporting its use as an effective and fully automated cleaning pipeline for neurodevelopmental EEG data. [ABSTRACT FROM AUTHOR]

The Senhance® robotic system (Senhance [Asensus Surgical Inc., Naderhan, NC, USA]) is a new surgical assistive robot following the da Vinci Surgical System that has been demonstrated to be safe and efficacious. Herein, we report the first case series of pediatric pelvic surgery using Senhance. Two anorectoplasties and one rectal pull‐through coloanal anastomosis for rectal stenosis were performed in three children (5–9 months, 7–9 kg) using a 10‐mm three‐dimensional (3D) 4K camera and 3 and 5 mm forceps operated with Senhance. None of the patients had intraoperative complications or a good postoperative course. Pediatric pelvic surgery with Senhance could be performed precisely and safely with a small body cavity. With its beautiful 3D images, motion of forceps with reduced tremor, and availability of 3‐mm forceps, Senhance may be better suited for children compared with other models. [ABSTRACT FROM AUTHOR]

In therapy, the child is mainly seen as a problem to be labeled or as a victim of various forms of abuse. The idea of the child as a therapeutic resource is the central point of my article where children's symptoms are quickly reframed and get a relational meaning in the family. Once the relational competence of the child is appreciated and his voice is heard, the child becomes a special guide to explore the emotional world of his family, and the genogram can provide a wonderful platform to start this therapeutic journey. Using a multigenerational lens, I describe how to explore family development with a "bottom‐up approach." Intergenerational questions can be asked to the child and with his help relevant family events can emerge and broken bonds repaired. The therapeutic results I expect are the resolution of children's problems and family transformation. [ABSTRACT FROM AUTHOR]

Background: Food allergy (FA) is associated with poor health‐related quality of life and high levels of psychological distress. Psychological support is extremely important but not always available. As part of the Global Access to Psychological Services for Food Allergy (GAPS) study, we aimed to assess psychological distress and service use among adults, caregivers and children with FA in a global survey. Methods: Participants (n = 1329 adults with FA; n = 1907 caregivers of children with FA) from >20 countries were recruited through patient organisations, social media advertisements and online survey panels to complete an online survey. Surveys were available in six languages. Results: A total of 67.7% of adults and 77.2% of caregivers reported direct experience, and 51.6% of caregivers said their child had experienced FA‐related psychological distress. The most commonly reported issue was anxiety about having an allergic reaction. Less than 20% had been assessed for FA‐related psychological distress. There were significant differences across countries for levels of distress, screening for distress, seeing a mental health professional and being diagnosed with a FA‐related mental health disorder (all p <.001). The United Kingdom, Australia and Brazil had the highest number of participants reporting distress. The most commonly reported barrier to seeing a mental health professional was cost. Conclusions: FA‐related distress is common across countries, but with substantial country‐to‐country variability. Allergy providers are encouraged to routinely assess families for psychological distress and provide access to appropriate mental health resources. Development and implementation of evidence‐based, patient‐informed accessible, affordable FA interventions in multiple languages is urgently needed. [ABSTRACT FROM AUTHOR]

Aim: A young child's abnormal birth weight (BW) can affect a mother's misperceptions of her child's weight, potentially hindering the child's health management. Therefore, this study investigated the impact of children's BW on maternal misperceptions of children's weight during early childhood. Methods: A retrospective study was conducted for 485,095 children who were 54–60 months of age, born between 2011 and 2013, and participated in South Korea's Sixth National Health Screening Program for Infants and Children (NHSPIC). Data on BW, weight, sex, birth year, preterm birth, breastfeeding history, maternal age, mothers' perceptions of the child's weight, and socioeconomic status were collected and incorporated in the final analysis via data linkage between the NHSPIC and Korean healthcare claims information. Multiple logistic regression analysis was applied to identity the impact of BW on mothers' misperceptions of children's weight, after adjustment for all variables. Results: Low BW (LBW) children had the lowest proportion (57.1%) of mothers who accurately identified their child's weight compared to normal or high BW. LBW was an independent factor affected maternal misperception of the child's weight (underestimation: adjusted odds ratio [aOR]: 1.46, 95% confidence interval [CI]: 1.41–1.52; overestimation: aOR: 0.84, 95% CI: 0.73–0.97). Overweight or underweight status, male gender, preterm birth, a younger mother, and low socioeconomic status were also associated with both underestimation and overestimation. Conclusion: LBW emerged as an important risk factor for maternal misperception of a child's weight. Therefore, pediatric nurses need to apply interventions to improve perceptions of children's weight among mothers of young LBW children. [ABSTRACT FROM AUTHOR]

Introduction: Occupational therapy handwriting studies have shown cognitive instructional techniques are effective methods to assist beginning or challenged handwriters. However, information about how children's cognitive (thinking) skills impact their handwriting development is scarce. This study examined the cognitive strategy efficiency of early learners while writing the alphabet‐letters from memory. Methods: Participants included 408 mainstream children in their first two years of formal schooling (Year 1 and Year 2). Children were asked to write the 26‐lowercase alphabet‐letters from memory. Data were collected using alphabet‐letters generated by the children and observation of their cognitive strategy use while writing. The measurement tool employed was the Perceive, Recall, Plan, and Perform (PRPP) System of Task Analysis (Stage Two). Results: The results found that Year 1 and Year 2 children had difficulties applying cognitive strategies across all four PRPP quadrants while writing the lowercase alphabet‐letters from memory. Application of the cognitive strategies from the Plan and Recall quadrants showed the most inefficiencies. The lowest PRPP subquadrant scores were observed in Evaluating, Recall Facts, Sensing, and Programming. Except for the Attending subquadrant and the descriptor 'Regulates', Year 2 children were significantly better than Year 1 children at applying cognitive strategies from all other PRPP quadrants and subquadrants. Conclusion: The findings provide beginning evidence that efficient use of cognitive strategies from all four PRPP quadrants is important for children achieving proficiency in accurate and automatic alphabet‐letter‐writing skills. Recommendations for occupational therapy handwriting assessment and intervention are provided. Plain Language Summary: Research suggests that occupational therapists can best help children with handwriting difficulties by using a cognitive approach. This approach involves instructing children how to form letters correctly, encouraging self‐evaluation, and providing opportunities to practice handwriting. However, the cognitive (thinking) skills required for children to write alphabet‐letters accurately are not well understood. To investigate this, a study was conducted on 408 mainstream children in their first two years of formal schooling (Year 1 and Year 2). The study examined how accurately the children could write lowercase alphabet‐letters from memory and which cognitive skills they used to do so. The cognitive skills investigated were related to attention, perception, recalling, planning, and performing. The assumption tested was that mistakes in correctly writing alphabet‐letters could be attributed to difficulties in using these cognitive skills effectively. The study found that Year 1 and Year 2 children made errors in over half of the 26‐lowercase alphabet‐letters they wrote. The cognitive skills, which scored the lowest were children's ability to evaluate their writing, recall how and where to write letters, gather information from their vision, and think carefully to ensure accuracy while writing. This implied that these thinking skills had the most impact on the children's ability to write alphabet‐letters correctly. More research is needed to confirm these findings and determine the reliability of the tool used in this study to measure the children's thinking skills. [ABSTRACT FROM AUTHOR]

Objectives: Naturally exfoliated primary teeth are being increasingly collected in child development studies. Most of these odontological collections and tooth biobanks use parent‐reported information from questionnaires or tooth checklists to collect data on offspring teeth. To the best of the authors' knowledge, no studies have assessed parental engagement in tooth checklists, nor parental accuracy in identifying their child's baby tooth. This study aimed to evaluate these dimensions by analysing data from the about this tooth checklist returned with donated primary teeth in a natural experimental study called STRONG (the Stories Teeth Record of Newborn Growth). Methods: Parental self‐reported information were analysed on checklists returned with 825 primary teeth belonging to 199 children. The percentage of blank answers was calculated for each question. The accuracy of parents‐reported tooth identification was evaluated by comparing parental ratings to researchers' ratings. Reliability of researchers' tooth identification was first evaluated by calculating intra‐observer and inter‐observer agreements, as well as Cohen's Kappa values. The percentage of accuracy of parents' tooth identification (relative to researcher's) was then calculated, and logistic regressions were used to evaluate if time elapsed between when exfoliation occurred and the checklist was completed associated with parental accuracy in tooth identification. Results: Parents returned 98.4% of the checklists and completed 74.9% to 97.7% of the questions. Excellent reliability was demonstrated for researchers' intra‐ and inter‐rater tooth identification (agreement percentages >90%; Cohen's Kappa values >.83). Moderate accuracy of parents‐reported tooth identifications was found, with parents correctly identifying 49.5% of the donated tooth. Better parental accuracies were highlighted for partial identifications (87.1% of correct jaw, 75.6% of correct tooth type, and 65.8% of correct lateralization). Logistic regressions showed the odds of correct parental identifications decreased on average by 1.8% every 30 days of distance between tooth exfoliation and checklist completion. Conclusions: While parental engagement is high, parents‐reported tooth identifications have moderate accuracy, which decreases over time. High accuracy is however found for partial identifications. Parent‐reported information on the accompanying questionnaire of naturally exfoliated primary teeth collection or tooth biobanks, even when filled in a long time after exfoliation took place, should be encouraged. However, expert identifications of teeth should remain best practice. [ABSTRACT FROM AUTHOR]

Objectives: To synthesize and appraise the evidence regarding the relationship between food insecurity and behaviours associated with dental caries development in adults and children in high‐income countries. Methods: A systematic review including observational studies assessing the association between food insecurity and selected dietary (free sugar consumption) and non‐dietary factors (tooth brushing frequency; use of fluoridated toothpaste; dental visiting; oral hygiene aids; type of toothbrush used; interdental cleaning frequency and mouthwash use) related to dental caries development in adults and children in high‐income countries. Studies specifically looking at food insecurity during the COVID‐19 pandemic were excluded. Searches were performed in MEDLINE, Embase, Global Health and Scopus from inception to 25 May 2023. Two authors screened the search results, extracted data and appraised the studies independently and in duplicate. Study quality was assessed using the Newcastle–Ottawa Scale (with modifications for cross‐sectional studies). Vote counting and harvest plots provided the basis for evidence synthesis. Results: Searches identified 880 references, which led to the inclusion of 71 studies with a total of 526 860 participants. The majority were cross‐sectional studies, conducted in the USA and reported free sugar consumption. Evidence for the association between food insecurity and free sugar intake from 4 cohort studies and 61 cross‐sectional studies including 336 585 participants was equivocal, particularly in the sugar‐sweetened beverage (SSB) consumption post‐hoc subgroup, where 20 out of 46 studies reported higher SSB consumption in food insecure individuals. There was consistent, but limited, evidence for reduced dental visiting in adults experiencing food insecurity compared to food secure adults from 3 cross‐sectional studies including 52 173 participants. The relationship between food insecurity and dental visiting in children was less clear (3 cross‐sectional studies, 138 102 participants). A single cross‐sectional study of 3275 children reported an association between food insecurity and reported failure to toothbrush the previous day. Conclusions: This review did not identify clear associations between food insecurity and behaviours commonly implicated in the development of dental caries that would explain why individuals experiencing food insecurity are more likely to have dental caries than those who have food security. There was some evidence of decreased dental visiting in adults experiencing food insecurity. Common methodological weaknesses across the evidence base related to the selection of participants or control of potentially confounding variables. Consequently, the quality of evidence for all outcomes was downgraded to very low. More research is needed to explore access to oral hygiene products and household environments conducive to habitual oral self‐care in food insecure populations. [ABSTRACT FROM AUTHOR]

Autistic children, as well as their primary caregivers (e.g., parents), experience greater health disparities when compared with the general population. Despite this reality, there has been relatively little priority placed on promoting positive trajectories of health in either of these underserved populations. The primary purpose of this study was to examine the impact of participation in a 12‐month, longitudinal health promotion program designed for both autistic children and their parent. A total of 27 families participated in the intervention, including 29 autistic children (83% male, M = 8.28 ± 3.60 years) and 27 parents (93% female, M = 40.04 ± 7.95). Families attended in‐person health promotion programming for 90 min per week. Children and parents were evaluated at four time points across the program, including baseline (0‐months), 4‐months, 8‐months, and 12‐months. Children were measured on fundamental motor competence, physical fitness, body composition, and proxy‐reported physical activity. Parents were measured on body composition, physical fitness, and self‐reported physical activity. Significant improvements were observed for autistic children in motor competence (p < 0.001) and grip strength (p = 0.006), and for parents in body mass index (p = 0.004) and aerobic capacity (p = 0.003) across the 12‐month intervention. Differing trajectories of improvement were noted between urban‐ and suburban‐dwelling families on multiple outcomes. The knowledge acquired from this research may offer initial support for the need to bolster opportunities for accessible and ongoing health promotion programs for both autistic children and their parents. Lay Summary: Autistic children and their parents face more health challenges than the general population, but not enough attention has been given to improving their well‐being. This study aimed to understand the effects of a 1 year long health promotion program for autistic children and their parents. Autistic children experienced significant improvements in motor competence and grip strength, while parents experienced positive changes in body mass index and aerobic capacity. This research highlights the importance of accessible and ongoing health promotion programs for both autistic children and their parents. [ABSTRACT FROM AUTHOR]

Background Aims Study Design Results Conclusions Relevance to Clinical Practice Tracheal intubation can be used for ventilation to ensure an unobstructed respiratory tract, and it is the most common respiratory support technique used in paediatric intensive care unit (PICU) patients. Orotracheal intubation is usually the preferred method of tracheal intubation. However, it can cause stress‐related damage to the oral mucosa. Identifying the factors that cause oral mucosal pressure injury (OMPI) can prevent its occurrence in children with oral endotracheal intubation.To examine the characteristics of OMPI in children who underwent orotracheal intubation in the PICU and to assess their influencing factors.An observational, prospective study. Data were gathered from the PICU of a tertiary hospital in China between January 2023 and October 2023. The patient data were obtained from the ‘General Information Questionnaire’, ‘Paediatric Critical Illness Score’, ‘STRONGkids Scale’ and ‘OMPI Staging and Assessment Tools’. Data analysis was subsequently performed using univariate and logistic regression analyses.A total of 187 children who underwent orotracheal intubation were analysed. During the observation period, 44.92% (n = 84) of the children developed OMPI. It comprised 63.10% (n = 53) of stage I injuries, 33.33% (n = 28) of stage II injuries and 3.57% (n = 3) of stage III injuries. The common injury sites were the lower jaw (48.81%), upper jaw (29.76%), tongue (20.24%) and joints (10.71%). The logistic regression analysis results revealed that high critical illness (OR = 0.835, 95% CI: 0.726–0.961), long intubation time (OR = 1.043, 95% CI: 1.021–1.067), prone ventilation (OR = 6.708, 95% CI: 1.421–31.670), hypothermia (OR = 5.831, 95% CI: 1.208–28.149), use of dental pads (OR = 5.520, 95% CI: 1.150–26.487) and low albumin levels (OR = 6.238, 95% CI: 1.285–30.281) were the main contributing factors for OMPI in children with orotracheal intubation (p < .05).The occurrence of OMPI in children who underwent orotracheal intubation in the PICU was notable and was predominantly observed in stages I and II. Consequently, clinical nursing personnel should proactively recognize risk factors and administer timely interventions to mitigate the occurrence of OMPI in such children.The incidence of OMPI in children who underwent orotracheal intubation was relatively high. Nurses and doctors should closely monitor the risk factors for orotracheal intubation in children to prevent the occurrence of OMPI. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Method Results Conclusions To assess incidence rates of clinically diagnosed eating disorders among Danish youth before, during, and after the COVID‐19 pandemic.This study used a population‐based time series analysis with individual‐level data from Danish healthcare registries. Participants included all Danish individuals aged 6–24 years from January 1, 2015, to December 31, 2023. Monthly incident cases of any eating disorder, anorexia nervosa, and bulimia nervosa were analyzed using interrupted time‐series analysis. We estimated the cumulative number of excess cases of incident eating disorder diagnoses and risk ratios (RR) associated with the pandemic and post‐pandemic periods compared with pre‐pandemic predictions.The study population encountered a mean of 1,310,542 individuals during the study period. The study included 11,693 individuals diagnosed with an eating disorder, median age 17 (IQR 14–20 years). Incident cases increased during the pandemic (RR 1.29, 95% CI 1.15–1.45) and normalized post‐pandemic (RR 1.07, 95% CI 0.91–1.25) compared with pre‐pandemic predictions. Similar patterns were seen for anorexia and bulimia. Increases were significant for ages 13–16 (RR 1.19, 95% CI 1.02–1.38), 17–19 (RR 1.51, 95% CI 1.25–1.83), and 20–24 (RR 1.35, 95% CI 1.12–1.64). Post‐pandemically, a continued increase was observed only for ages 20–24 (RR 1.32, 95% CI 1.02–1.71).The study documents a temporary increase in diagnosed eating disorders among Danish youths during the COVID‐19 pandemic, with rates later returning to pre‐pandemic levels. These results provide insights into the pandemic's impact on adolescents and youths. [ABSTRACT FROM AUTHOR]

Kidney transplant (KT) requires long‐term glucocorticoid (GC) treatment against acute and/or chronic rejection. Glucocorticoid‐induced osteoporosis (GIOP) is one of the major concerns in kidney transplant recipients (KTRs). Therefore, it is essential to accumulate GIOP data from paediatric KTRs to aid in their healthy growth. A serial observational study of bone strength was carried out in an 8‐year‐old girl with bilateral hypoplastic kidney who underwent ABO‐compatible living‐donor KT and GC treatment over 2 years. Bone strength was evaluated by bone mineral density (BMD) and serum bone turnover markers (BTMs), including serum alkaline phosphatase (S‐ALP), serum tartrate‐resistant acid phosphatase 5b (S‐TRACP‐5b), and serum undercarboxylated osteocalcin (S‐ucOC). All the levels of BTMs and BMD from 1 M to 4 M remained lower than the levels at 0 months (0 M: baseline). After gradual reduction of GC dose (4 M–24 M), S‐ALP levels increased from baseline and S‐TRACP‐5b levels remained lower than the baseline level, but BMD recovered to baseline and increased. The S‐ucOC levels did not increase from baseline. The patient's height growth velocity SDS was +3.99 for 23 months, and no fracture occurred during this observation period. A consistent, predominantly formative state of bone, which maintained higher S‐ALP levels and lower S‐TRACP‐5b levels compared to baseline, could contribute to increased BMD. In addition, no increase in S‐ucOC levels from baseline could be associated with no deterioration of bone strength. This case suggests that measurement of BMD and, S‐ALP, TRACP‐5b and ucOC could be useful for evaluating the trend on bone strength in a paediatric KTR. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusion Height velocity is considered a key auxological tool to monitor growth, but updated height velocity growth charts are lacking. We aimed to derive new French height velocity growth charts by using a big‐data approach based on routine measurements.We extracted all growth data of children aged 1 month–18 years from the electronic medical records of 42 primary care physicians, between 1 January 1990 and 8 February 2018, throughout the French metropolitan territory. We derived annual and biannual height velocity growth charts until age 15 years by using the Lambda‐Mu‐Sigma method. These new growth charts were compared to the 1979 French and 2009 World Health Organisation (WHO) ones.New height velocity growth charts were generated with 193 124 and 209 221 annual and biannual values from 80 204 and 87 260 children, respectively, and showed good internal fit. Median curves were close to the 1979 French or 2009 WHO ones, but SD curves displayed important differences. Similar results were found with the biannual height velocity growth charts.We produced new height velocity growth charts until age 15 years by using a big‐data approach applied to measurements routinely collected in clinical practice. These updated growth charts could help optimise growth‐monitoring performance. [ABSTRACT FROM AUTHOR]

ABSTRACT Objectives Methods Results Conclusion Childhood cancer often presents with non‐specific signs and symptoms that might mimic non‐malignant disorders including musculoskeletal diseases, potentially leading to rheumatic and orthopaedic misdiagnoses. We aimed to compare clinical presentation, diagnostic interval and survival in paediatric acute myeloid leukaemia (AML) with and without initial musculoskeletal symptoms.This nationwide retrospective, cohort study reviewed medical records of 144 children below 15 years diagnosed with AML in Denmark from 1996 to 2018.Musculoskeletal symptoms occurred in 29% (42/144) of children with AML and 8% (11/144) received an initial musculoskeletal misdiagnosis, being mainly non‐specific and pain‐related. The children with and without musculoskeletal symptoms did not differ markedly up to the diagnosis of AML and blood counts were affected equally in both groups. However, the children with prior musculoskeletal symptoms were more likely to have elevated levels of LDH and ferritin. Furthermore, they revealed a tendency towards a longer total interval (median 53 days vs. 32 days, p = 0.07), but the overall survival did not differ.AML should be considered as an underlying cause in children with unexplained musculoskeletal symptoms and abnormal blood counts. Concomitant elevation of LDH and ferritin should strengthen the suspicion. [ABSTRACT FROM AUTHOR]

Neurofibromatosis type 1 (NF1) is an autosomal dominant genetic disorder that caused by NF1 mutations. NF1 gene encodes neurofibromin (a GTPase‐activating protein) and plays a regulatory role in many signalling pathway such as the Ras/MAPK pathway, which is important for regulating cell growth, proliferation and neural development. Therefore, NF1 gene mutations causes the excessive activation of signalling pathways and uncontrolled cell growth. NF1 exhibits complete genetic penetrance and clinical heterogeneity. Glomerular disease has rarely been reported in patients with NF1, especially in children. Currently, the relationship between NF1 and nephrotic syndrome is unclear. Here, we present a case of NF1 with nephrotic syndrome and further explore the association between NF1 and glomerular diseases. It also reminds clinicians that NF1 has complex and highly variable clinical manifestations and that a comprehensive workup is essential for patients. [ABSTRACT FROM AUTHOR]

This article explores the potential of feminist new materialisms for rethinking enduring debates that cohere around children, sexuality, age and ‘childhood innocence’. A new materialist ontology of sexuality and Karen Barad's concept of spacetimemattering are employed to conceptualise sexuality as an emergent becoming of relational material‐discursive forces. Within this paradigm, mobilisation of arguments about ‘sexual innocence and readiness’ become a matter of entanglement of contingent ‘things’, ‘spaces’ and ‘ideas’, that includes young people's own sexual knowledge. We consider how this reorientation shifts the contours, debates and possibilities of sexuality education beyond restrictive ‘age‐appropriate’ narratives. [ABSTRACT FROM AUTHOR]

ABSTRACT Dissecting cellulitis of the scalp (DCS) is a rare inflammatory condition that progresses from papules and pustules to nodules and abscesses, ultimately leading to cicatricial alopecia. It primarily affects African men between the ages of 15 and 62, with exceptionally low prevalence in children. A milder form, described as “alopecic and aseptic nodules of the scalp” (AANS), presents as aseptic nodules associated with non‐scarring alopecia and has a good prognosis. We report two atypical cases of DCS in Hispanic pediatric patients: an 18‐month‐old female infant and an 11‐year‐old male child who had a rapid and favorable clinical resolution consistent with AANS. [ABSTRACT FROM AUTHOR]

ABSTRACT This review aims to consolidate and appraise evidence exploring the caregiver burden of parents of children with mental disorders. A mixed‐studies review structure was adopted and six electronic databases (PubMed, CINAHL, PsycINFO, Embase, Scopus and ProQuest Dissertations and Theses Global) were searched from each database's inception date until September 2023. Thomas & Harden's thematic analysis framework was utilised for data analysis. Twenty‐three studies were included in this review. The results‐based convergent integration method identified an overarching theme titled ‘hiding behind the walls on fire, engulfed in chaos: dark and alone’, three main themes named ‘Invisible scars’: role of psychological factors on caregiver burden, navigating through social and economic influences on caregiving burden, and influence of illness‐related variables and nine subthemes. This review highlighted that the parents perceived insufficient support from healthcare providers and a lack of insight regarding their children's medical condition as the primary contributors to the burden experienced. It is imperative for healthcare professionals to collaboratively engage with parental caregivers, offering accessible treatment options for their children with mental disorders and providing comprehensive educational resources to facilitate a profound understanding of their children's mental health conditions. In addition to addressing caregivers' informational needs, the establishment of an integrated support system is advocated, one involving active participation from healthcare professionals, healthcare institutions, community resources, social services and policymakers. This holistic approach could better meet the multifaceted needs of caregivers, encompassing psychosocial, emotional and financial aspects.Trial Registration: International Prospective Register of Systematic Reviews: PROSPERO ID: CRD42022363420 [ABSTRACT FROM AUTHOR]

ABSTRACT Background Objectives Materials and Methods Results Conclusions Bruxism is a behaviour that has several consequences in an individual's life, especially when it starts in childhood. However, bruxism can be a potential protective factor, which is an attribute that reduces the chance of a negative health outcome.To evaluate the incidence of sleep bruxism (SB) and dental wear in children and adolescents.This longitudinal study began in 2014 and 2016 (baseline) with initial 1816 children followed for 5 and 3 years, respectively. The follow‐up data collection started in 2019. The diagnosis of SB was parents report (baseline) and self‐report (follow‐up) due to age groups of each phase, and questions related to symptoms of SB were collected. Five calibrated examiners (kappa >0.7) collected the clinical data. The clinical variables were dental erosion and dental wear. Contextual, individual, behaviour and clinical characteristics were collected. A multilevel logistic regression model was used to investigate the association of contextual, individual, behaviour and clinical characteristics with SB. Poisson regression for repeated measures was performed to evaluate the incidence of SB and dental wear (incidence rate ratio—IRR and confidence interval—95% CI).Two hundred and fifty‐three children and adolescents answered questionnaires and were clinically examined. The mean age of the follow‐up in 2019 was 11.25 years old (±2.19). There was no increase in the incidence of SB (95% CI: 0.74–1.35). Children/adolescents had a 2.2 higher risk to present dental wear (95% CI: 1.89–2.60). SB at the follow‐up was associated with the contextual variable, earache, erosion and awake bruxism.In this population, children with SB remained with this behaviour and showed higher dental wear over the years. [ABSTRACT FROM AUTHOR]

Objectives Methods Results Conclusions To explore the dermoscopic features of lichen sclerosus in different parts of the external genitalia in children.A retrospective analysis of the dermoscopic features of 42 female children with vulvar lichen sclerosus treated in the Department of Dermatology of Shanxi Children's Hospital from January 2020 to May 2023.Among the 42 female children, aged 3–14 years (mean: 7.24 ± 2.43 years), the duration of vulvar lichen sclerosus ranged from 3 months to 2 years (mean: 9.83 ± 4.93 months). Clinical lesions occurred in the labia minora in 18 cases (42.9%), labia majora in 38 cases (90.5%), posterior fourchette in 36 cases (85.7%), perianal area in 13 cases (31.0%), anterior fourchette in 17 cases (40.5%), clitoris in seven cases (16.7%), and interlabial sulcus in 11 cases (26.2%). Dermoscopic findings common in the labia majora included follicular keratotic plugs, cloverleaf‐like structures, comedo‐like openings, and linear vessels (p < .05); however, purple–red globules and patches and white linear streaks were more common in the posterior fourchette (p < .05), whereas dotted vessels were more common in the labia minora (p < .05).Common dermoscopic findings in pediatric vulvar lichen sclerosus were yellow‐white structureless areas, white linear streaks, follicular keratotic plugs, and cloverleaf‐like structures; yellow‐white structureless areas and white linear streaks showed the highest specificity. The dermoscopic findings varied among different affected areas, which provides a basis for further understanding of the characteristics of different sites of vulvar lichen sclerosus in the pediatric population. [ABSTRACT FROM AUTHOR]

Objective: This study aims to enhance the management of Epstein‐Barr Virus (EBV) infections by analyzing the correlation between laboratory indicators and clinical manifestations in children, thereby proposing more precise diagnostic and treatment strategies. Methods: In this retrospective study included 163 pediatric patients with EBV infections treated at the Children's Hospital of Soochow University from December 2017 to December 2019. Data collected through retrospective analysis included gender, age, clinical symptoms, signs, liver function tests, T‐cell subset distribution, EBV‐DNA copy numbers in plasma, and treatment outcomes. Patients were grouped based on EBV‐DNA copy numbers in plasma and hospital stay duration to compare clinical indicators across different groups. Results: The dichotomous results of EBV‐DNA copy numbers in plasma showed that the two groups of children were significantly different in the number of days of fever (p =.0022), platelet count (p =.0212), ALT (p =.001), immunoglobulin IgM (p =.0039), IgG (p =.0195), TBiL (p =.025), LDH (p = 0.0001), and length of hospital stay (p <.001) were significantly different, indicating that EBV‐DNA copy numbers in plasma may be correlated with these characteristic variables. The dichotomous results of the length of hospital stay showed that the two groups were significantly increased in tonsil enlargement (p =.0024), platelet count (p =.0059), LDH (p =.0394), and ferritin (p =.0106) and EBV‐DNA copy numbers in plasma (p = 0.0361) were significantly different, This suggests a potential correlation between EBV‐DNA copy numbers in plasma and these clinical indicators. Conclusion: Variations in platelet counts and lactate dehydrogenase (LDH) levels in children with EBV infections may serve as indicators of clinical outcomes. [ABSTRACT FROM AUTHOR]

Cutaneous tuberculosis is a rare manifestation of extrapulmonary tuberculosis caused by Mycobacterium tuberculosis in most cases and rarely by Mycobacterium bovis. Diagnosis may be challenging due to a wide range of clinical findings and similarities to other chronic dermatoses, leading to delayed treatment. We present a case of scrofuloderma in a 4‐year‐old girl that arose from a contiguous spread from the anterior mediastinum with associated pulmonary involvement. [ABSTRACT FROM AUTHOR]

Pulmonary sequestration with torsion is a rare condition. We describe a seven‐month‐old baby presenting excessive crying for pulmonary sequestration with torsion. Contrast‐enhanced chest computed tomography demonstrated an oval‐shaped mass in the posteromedial right lower chest, no systemic arterial supply was evident. The edge of the mass showed slight linear reinforcement, and its interior had no reinforcement. Thoracoscopic segmentectomy was carried out and histology confirmed pulmonary sequestration with torsion. [ABSTRACT FROM AUTHOR]

Thompson et al., 2023 (Generalized models for quantifying laterality using functional transcranial Doppler ultrasound. Human Brain Mapping, 44(1), 35–48) introduced generalised model‐based analysis methods for determining cerebral lateralisation from functional transcranial Doppler ultrasound (fTCD) data which substantially decreased the uncertainty of individual lateralisation estimates across several large adult samples. We aimed to assess the suitability of these methods for increasing precision in lateralisation estimates for child fTCD data. We applied these methods to adult fTCD data to establish the validity of two child‐friendly language and visuospatial tasks. We also applied the methods to fTCD data from 4‐ to 7‐year‐old children. For both samples, the laterality estimates from the complex generalised additive model (GAM) approach correlated strongly with the traditional methods while also decreasing individual standard errors compared to the popular period‐of‐interest averaging method. We recommend future research using fTCD with young children consider using GAMs to reduce the noise in their LI estimates. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to identify clinical guidelines that provide recommendations on prescribing refractive error correction in children, evaluate the overall quality of these guidelines using the Appraisal of Guidelines for REsearch and Evaluation II (AGREE II) tool and subsequently gain consensus on the prescribing recommendations from high‐quality guidelines using the modified Delphi technique. Methods: A comprehensive search for prescribing guidelines was conducted using databases and professional websites. The quality appraisal of eligible guidelines was undertaken by scoring the six AGREE II domains. Subsequently, the modified Delphi technique was used by 10 experts (sub‐specialist optometrists, ophthalmologists and orthoptists) to gain consensus on the prescribing recommendation statements extracted from guidelines that had been identified as high quality. Three rounds were conducted in which agreement of these statements were scored using a 9‐point Likert scale with a free‐text option for any additional comments. Results: Five eligible guidelines were identified. The AGREE II tool demonstrated that the guidelines varied substantially in quality, with only one guideline identified as being of high quality. A total of 168 prescribing statements were reviewed in the Delphi procedure. Of these, 95 statements reached expert consensus as being appropriate prescribing recommendations. Conclusion: There is significant scope for improving current guidelines for prescribing refractive error correction in children. We used the modified Delphi technique to find points of agreement on prescribing recommendations to support professionals prescribing refractive error correction in children. We recommend that further work is needed to address gaps in the guidelines. [ABSTRACT FROM AUTHOR]