Showing papers in "Children today in 2020"

Multi-System Inflammatory Syndrome in Children (MIS-C) Following SARS-CoV-2 Infection: Review of Clinical Presentation, Hypothetical Pathogenesis, and Proposed Management

Abstract: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may result in the multisystem inflammatory syndrome in children (MIS-C). The clinical presentation of MIS-C includes fever, severe illness, and the involvement of two or more organ systems, in combination with laboratory evidence of inflammation and laboratory or epidemiologic evidence of SARS-CoV-2 infection. Some features of MIS-C resemble Kawasaki Disease, toxic shock syndrome, and secondary hemophagocytic lymphohistiocytosis/macrophage activation syndrome. The relationship of MIS-C to SARS-CoV-2 infection suggests that the pathogenesis involves post-infectious immune dysregulation. Patients with MIS-C should ideally be managed in a pediatric intensive care environment since rapid clinical deterioration may occur. Specific immunomodulatory therapy depends on the clinical presentation. The relationship between the immune response to SARS-CoV-2 vaccines in development and MIS-C requires further study.

COVID-19 Impact on Behaviors across the 24-Hour Day in Children and Adolescents: Physical Activity, Sedentary Behavior, and Sleep

Abstract: In the wake of the COVID-19 pandemic, social restrictions to contain the spread of the virus have disrupted behaviors across the 24-h day including physical activity, sedentary behavior, and sleep among children (5–12 years old) and adolescents (13–17 years old). Preliminary evidence reports significant decreases in physical activity, increases in sedentary behavior, and disrupted sleep schedules/sleep quality in children and adolescents. This commentary discusses the impact of COVID-19-related restrictions on behaviors across the 24-h day in children and adolescents. Furthermore, we suggest recommendations through the lens of a socio-ecological model to provide strategies for lasting behavior change to insure the health and well-being of children and adolescents during the COVID-19 pandemic.

Prevalence and Associated Factors of Emotional and Behavioural Difficulties during COVID-19 Pandemic in Children with Neurodevelopmental Disorders

Abstract: Children and young people (CYP) with neurodevelopmental disorders (NDDs) may be particularly vulnerable to adverse mental health effects due to the COVID-19 pandemic. We conducted a cross-sectional U.K. parent-reported study from 2nd April-2nd June 2020, using the Strengths and Difficulties Questionnaire. CYP with NDDs (n = 371), compared to neurotypical controls, had a higher prevalence of emotional symptoms (42% vs. 15%) and conduct problems (28% vs. 9%), and fewer prosocial behaviours (54% vs. 22%). All groups had worse emotional symptoms than pre-COVID groups, and those with attention-deficit/hyperactivity disorder showed inflated conduct problems, while those with autism spectrum disorder exhibited decreased prosocial behaviours. Females with ASD had higher emotional symptoms compared to males. CYP with NDDs, and those without, showed higher levels of parent-reported mental health problems than comparable cohorts pre-COVID-19.

Risk Perception of COVID-19 Infection and Adherence to Preventive Measures among Adolescents and Young Adults

Abstract: To explore factors influencing adolescents and young adults' (AYAs) risk perception of COVID-19 and adherence to public health measures, we conducted a cross-sectional online survey of AYAs (14-22 years old) from Quebec (Canada) recruited through school and community partners in April 2020 during the first wave of the COVID-19 pandemic. The study included 3037 participants (mean age = 17.7 years, 74.6% female). AYAs had higher mean (standard deviation (SD)) risk perception of COVID-19 for their relatives (8.2 (1.9)) than for themselves (5.6 (2.6)) (p < 0.001). Factors associated with higher risk perception included higher disease knowledge (adjusted odds ratio (aOR) 1.06, 95% CI 1.01-1.11), presence of chronic disease (aOR 2.31, 95%CI 1.82-2.93) and use of immunosuppressants (aOR 2.53, 95%CI 1.67-3.87). AYAs with a higher risk perception (aOR 1.06, 95%CI 1.02-1.10) those wishing to help flatten the disease curve (aOR 1.18, 95%CI 1.12-1.25) or to protect their family/friends (aOR 1.14, 95%CI 1.05-1.24) were more likely to engage in preventive behaviors. Self-perceived risk and desire to protect others were significantly associated with adherence to preventive measures among youth. These findings may help inform public health messaging to AYAs in the current and future pandemics.

COVID-19: Neurological Considerations in Neonates and Children

Abstract: The ongoing worldwide pandemic of the novel human coronavirus SARS-CoV-2 and the ensuing disease, COVID-19, has presented enormous and unprecedented challenges for all medical specialists. However, to date, children, especially neonates, have been relatively spared from the devastating consequences of this infection. Neurologic involvement is being increasingly recognized among adults with COVID-19, who can develop sensory deficits in smell and taste, delirium, encephalopathy, headaches, strokes, and peripheral nervous system disorders. Among neonates and children, COVID-19-associated neurological manifestations have been relatively rare, yet reports involving neurologic dysfunction in this age range are increasing. As discussed in this review, pediatric neurologists and other pediatric specialists should be alert to potential neurological involvement by this virus, which might have neuroinvasive capability and carry long-term neuropsychiatric and medical consequences.

Contextualizing Parental/Familial Influence on Physical Activity in Adolescents before and during COVID-19 Pandemic: A Prospective Analysis.

Abstract: Parental and familial factors influence numerous aspects of adolescents' lives, including their physical activity level (PAL). The purpose of this study was to evaluate the changes in PAL which occurred during the COVID-19 pandemic, and to evaluate influence of sociodemographic and parental/familial factors on PAL levels before and during pandemic in adolescents from Bosnia and Herzegovina. The sample included 688 adolescents (15-18 years of age; 322 females) who were tested on two occasions: in January 2020 (baseline; before the COVID-19 pandemic) and in April 2020 (follow-up; during the COVID-19 pandemic lockdown). Variables included PAL (measured by the Physical Activity Questionnaire for Adolescents-PAQ-A) as well as sociodemographic-, parental-, and familial factors. A significant decline in PALs was recorded between baseline and follow-up (t-test: 11.88, p < 0.001). Approximately 50% of adolescents underwent sufficient PAL at baseline, while only 24% of them were achieving sufficient PAL at the time of follow-up measurement. Paternal education was positively correlated (OR (95%CI): baseline: 6.63 (4.58-9.96), follow-up: 3.33 (1.19-7.01)), while familial conflict was negatively correlated (baseline: 0.72 (0.57-0.90), follow-up: 0.77 (0.60-0.99)) with PALs before and during the pandemic. This study highlights the importance of the parent-child relationship and parental/familiar support in promoting physical activity both during regular life and during crises and health challenging situations like the COVID-19 pandemic.

Family Socioeconomic Status and Exposure to Childhood Trauma: Racial Differences

Abstract: Background: Minorities’ diminished returns (MDRs) refer to weaker effects of socioeconomic status (SES) indicators such as parental educational attainment and family income in generating tangible childhood outcomes for racial and ethnic minorities compared to the majority group, a pattern prevalent in the US. Our existing knowledge is minimal, however, about diminished returns of family SES on reducing exposure to childhood trauma. Aim: To determine if there was a difference between non-Hispanic whites (NHW) and non-Hispanic blacks (NHB) in the effect of SES on exposure to childhood trauma among children ages 8–11 years old. Materials and methods: In this cross-sectional study, we analyzed data from 4696 NHW or NHB American 8–11-year-old children who were participants in the Adolescent Brain Cognitive Development (ABCD) Study. The independent variables were parental educational attainment and family income. The primary outcome was exposure to 1 or 2+ childhood traumas, measured by the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) semi-structured interview. Polynomial regression was used for data analysis. Results: Parental education and family income had statistically significant protective (negative) effects on childhood trauma, indicating children from high income and highly educated families were exposed to a lower level of childhood trauma. However, race/ethnicity showed statistically significant interactions with parental education and family income on exposure to childhood trauma, indicating weaker protective effects of parental education and family income on reducing exposure to trauma for NHB compared to NHW children. Race-specific models showed protective effects of parental education and family income on exposure to childhood trauma for NHW but not NHB children. Conclusion: The protective effects of parental education and family income against exposure to childhood trauma are systematically diminished for NHBs compared to NHWs. To minimize the racial/ethnic health gaps, diminished returns of parental education and family income should be addressed. There is a need for programs and interventions that equalize not only SES but also the marginal returns of SES for ethnic groups. Such efforts require addressing structural and societal barriers that hinder NHB families from translating their SES resources into tangible outcomes. There is a need for studies that can minimize MDRs for NHB families, such that SES can similarly secure tangible outcomes in the presence of SES resources.

High Levels of Stress Due to the SARS-CoV-2 Pandemic among Parents of Children with and without Chronic Conditions across the USA

Abstract: Background: The 2020 SARS-CoV-2 pandemic led to community-wide measures affecting parents and children such as school/daycare closures, job losses, and interruptions in medical care for children with chronic diseases. This is the first study to describe the level of stress and mental health of parents of either healthy children or children with chronic conditions, during the 2020 pandemic. Methods: A representative sample of US parents was recruited from 10–17 April 2020. Parents completed online questionnaires about the past 7 days, including the Perceived Stress Scale, Resilient Coping Scale, Self-Efficacy Scale, Kansas Marital Satisfaction Scale, Parental Stress Scale, PROMIS Anxiety and Depression scales and various other pandemic-related stress questions Results: Levels of stressors (e.g., job loss, school closures, etc.) were high during this time (e.g., 79% of children attended home/online school) and parents reported being moderately to highly stressed. Rates of clinical anxiety (44.6%) and depression (42.2%) were high. Parents of children with chronic conditions reported higher levels of stress and worse mental health, but did not differ from other parents in dealing with stress or interruptions in work, child schooling, and marital satisfaction. Discussion: The COVID-19 pandemic has introduced unprecedented levels of stress for parents, especially those of children with chronic conditions. Mental health effects are expected to continue for months/years and preparation is needed to meet an increasing demand for mental health care.

Parental Educational Attainment and Social Environment of Urban Public Schools in the U.S.: Blacks’ Diminished Returns

Abstract: Background: Recent research has documented marginalization-related diminished returns (MDRs) of socioeconomic status (SES), defined as weaker effects of SES indicators, such as parental educational attainment, on securing tangible outcomes for the members of socially marginalized (e.g., racial and ethnic minority) groups, compared to privileged social groups (e.g., non-Hispanic Whites). Aims: To explore race/ethnic differences between non-Hispanic Blacks vs. non-Hispanic Whites who attend urban public schools on the effect of parental education on lower school environmental risk among American high schoolers. Methods: For this cross-sectional study, we borrowed the Education Longitudinal Study (ELS-2002) baseline data, a nationally representative study that enrolled 1706 10th grade youths who were attending urban public schools. From this number, 805 (47.2%) were non-Hispanic Black and 901 (52.8%) were non-Hispanic White youths. The dependent variable was the level of school social environmental risk measured using 18 items as self-reported, and was treated as a continuous variable. The independent variable was parental educational attainment, treated as a continuous measure. Gender, region, and parental marital status were the covariates. Race/ethnicity was the moderating variable. Linear regressions were applied to perform our data analysis. Results: Black students were found to attend schools with higher levels of social environmental risk. Youths with parents with a higher educational attainment were found to attend schools with a lower social environmental risk. We found a significant interaction between race (non-Hispanic Black vs. non-Hispanic White) and parental educational attainment on the level of school social environmental risk, suggesting that the protective effect of high parental education on reducing the school social environmental risk was smaller for non-Hispanic Black than for non-Hispanic White youths. Conclusions: Although high parental educational attainment is protective against social environmental risk for American youths, this protective effect is weaker for non-Hispanic Black than non-Hispanic White youths. The diminished returns of parental education in reducing school social environmental risk may explain why the effects of parental education on educational outcomes are smaller for non-Hispanic Black than non-Hispanic White youths (i.e., MDRs). The social environment indirectly generates racial youth educational disparities through deteriorating non-Hispanic Black youth educational outcomes across all SES levels. To prevent the confounding effects of private, suburban, rural, and Catholic schools, we limited this analysis to public urban schools. More research is needed on other settings.

An Autoencoder-Based Deep Learning Classifier for Efficient Diagnosis of Autism

Abstract: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by a lack of social communication and social interaction. Autism is a mental disorder investigated by social and computational intelligence scientists utilizing advanced technologies such as machine learning models to enhance clinicians' ability to provide robust diagnosis and prognosis of autism. However, with dynamic changes in autism behaviour patterns, these models' quality and accuracy have become a great challenge for clinical practitioners. We applied a deep neural network learning on a large brain image dataset obtained from ABIDE (autism brain imaging data exchange) to provide an efficient diagnosis of ASD, especially for children. Our deep learning model combines unsupervised neural network learning, an autoencoder, and supervised deep learning using convolutional neural networks. Our proposed algorithm outperforms individual-based classifiers measured by various validations and assessment measures. Experimental results indicate that the autoencoder combined with the convolution neural networks provides the best performance by achieving 84.05% accuracy and Area under the Curve (AUC) value of 0.78.

Effects of social media and smartphone use on body esteem in female adolescents: Testing a cognitive and affective model

Abstract: We examined the predictive relations of social media and smartphone use to body esteem in female adolescents and the mechanism that underlies these relations. As a result of frequent social media and smartphone use, adolescents are continually exposed to appearance-related media content. This likely reinforces a thin ideal and fosters appearance-based comparison and increases fear of external evaluation. Hence, we investigated a cognitive-affective framework in which the associations of social media and smartphone use with body esteem are serially mediated by cognitive internalization of an ideal body image, appearance comparisons, and social appearance anxiety. By testing female adolescents (N = 100) aged 13 to 18, we found that excessive social media use leads to unhealthy body esteem via intensified cognitive internalization, which aggravates appearance comparisons and anxiety regarding negative appearance evaluation. Further, we found that screen time for specific smartphone activities also harmed body esteem, independent of social media use. However, overall smartphone screen time did not affect body esteem when social media use was taken into consideration. Our findings underscore the multifactor mechanism that elucidates the negative impacts of social media and smartphone activities on body esteem in female adolescents, who are developmentally susceptible to poor body esteem.

Difficult and Severe Asthma in Children.

Abstract: Asthma is the most frequent chronic inflammatory disease of the lower airways affecting children, and it can still be considered a challenge for pediatricians. Although most asthmatic patients are symptom-free with standard treatments, a small percentage of them suffer from uncontrolled persistent asthma. In these children, a multidisciplinary systematic assessment, including comorbidities, treatment-related issues, environmental exposures, and psychosocial factors is needed. The identification of modifiable factors is important to differentiate children with difficult asthma from those with true severe therapy-resistant asthma. Early intervention on modifiable factors for children with difficult asthma allows for better control of asthma without the need for invasive investigation and further escalation of treatment. Otherwise, addressing a correct diagnosis of true severe therapy-resistant asthma avoids diagnostic and therapeutic delays, allowing patients to benefit from using new and advanced biological therapies.

The Role of the Microbiome in Food Allergy: A Review

Abstract: Food allergies are common and estimated to affect 8% of children and 11% of adults in the United States. They pose a significant burden—physical, economic and social—to those affected. There is currently no available cure for food allergies. Emerging evidence suggests that the microbiome contributes to the development and manifestations of atopic disease. According to the hygiene hypothesis, children growing up with older siblings have a lower incidence of allergic disease compared with children from smaller families, due to their early exposure to microbes in the home. Research has also demonstrated that certain environmental exposures, such as a farming environment, during early life are associated with a diverse bacterial experience and reduced risk of allergic sensitization. Dysregulation in the homeostatic interaction between the host and the microbiome or gut dysbiosis appears to precede the development of food allergy, and the timing of such dysbiosis is critical. The microbiome affects food tolerance via the secretion of microbial metabolites (e.g., short chain fatty acids) and the expression of microbial cellular components. Understanding the biology of the microbiome and how it interacts with the host to maintain gut homeostasis is helpful in developing smarter therapeutic approaches. There are ongoing trials evaluating the benefits of probiotics and prebiotics, for the prevention and treatment of atopic diseases to correct the dysbiosis. However, the routine use of probiotics as an intervention for preventing allergic disease is not currently recommended. A new approach in microbial intervention is to attempt a more general modification of the gut microbiome, such as with fecal microbiota transplantation. Developing targeted bacterial therapies for food allergy may be promising for both the treatment and prevention of food allergy. Similarly, fecal microbiota transplantation is being explored as a potentially beneficial interventional approach. Overall, targeted bacterial therapies for food allergy may be promising for both the treatment and prevention of food allergy.

Dietary Diversity and Nutritional Status of Preschool Children in North West Province, South Africa: A Cross Sectional Study.

Abstract: Preschool children consume diets inadequate to meet their macro and micronutrient requirements, which ultimately affect their nutritional status due to lack of dietary diversity. A cross sectional study was conducted to investigate the association between dietary diversity scores (DDS) and the nutritional status of 379 preschool children in North West Province of South Africa. A 24 h qualitative recall by mothers of their children's food consumption was used to calculate DDS based on 12-foods groups following Food and Agriculture Organization protocols. DDS was calculated by counting each of 12-food groups and classified as low (≤4), medium (5-8) and high (9-12). The weight and height of children were measured and height-for-age (HAZ), weight-for-age (WAZ) and BMI-for-age (BAZ) z-scores were calculated based on 2006 WHO standards. Stunting, underweight and thinness were defined as HAZ, WAZ and BAZ < -2SD, respectively. Linear and logistic regression analyses were used to assess the association between DDS and the nutritional indicators. Mean age for children was 4 ± 0.7 years, and the prevalence of stunting (29%), underweight (13%) and thinness (6%) was observed. Mean DDS was 4.39 ± 1.55 out of 12-food groups, with a prevalence of 61% and 39% for low and medium DDS, respectively. Cereals (100%) accounted for the main food group consumed, while fish and other seafood (17%) were the least consumed. Consumption of a diversified diet was associated with lower odds of being stunted [AOR = 0.25, 95%CI: 0.10 to 0.92] among the four-year olds, while in the unadjusted model, 5-year-olds had lower odds of being underweight [OR = -0.32, 95%CI: -0.57 to 0.07]. The findings of this study reinforce the importance of continued nutrition education of mothers, caregivers and preschool staff on the need to ensure consumption of diverse food sources in order to improve the nutritional status of children. Further studies are recommended on the association of DDS with the nutritional status, and factors associated with low dietary diversity among preschool children.

Acute Disseminated Encephalomyelitis: Current Perspectives.

Abstract: Acute disseminated encephalomyelitis (ADEM) is an immune-mediated central nervous system (CNS) disorder, characterized by polyfocal symptoms, encephalopathy and typical magnetic resonance imaging (MRI) findings, that especially affects young children. Advances in understanding CNS neuroimmune disorders as well as the association of myelin oligodendrocyte glycoprotein antibody (MOG-Ab) with both monophasic and recurrent forms of ADEM have led to new insights into its definition, management and outcome. In this review, we aim to provide an update based on current epidemiologic, clinical, radiological and immunopathological aspects and clinical outcome of ADEM.

New and Emerging Targeted Therapies for Pediatric Acute Myeloid Leukemia (AML).

Abstract: The relapse rate for children with acute myeloid leukemia (AML) remains high despite advancements in risk classification, multi-agent chemotherapy intensification, stem cell transplantation, and supportive care guidelines. Prognosis for this subgroup of children with relapsed/refractory AML remains poor. It is well known that the ceiling of chemotherapy intensification has been reached, limited by acute and chronic toxicity, necessitating alternative treatment approaches. In the last several years, our improved understanding of disease biology and critical molecular pathways in AML has yielded a variety of new drugs to target these specific pathways. This review provides a summary of antibody drug conjugates (ADCs), small molecule inhibitors, and tyrosine kinase inhibitors with an emphasis on those that are currently under clinical evaluation or soon to open in early phase trials for children with relapsed/refractory AML.

Fundamental movement skills and accelerometer-measured physical activity levels during early childhood: a systematic review

Abstract: Early childhood is a key period for children to begin developing and practicing fundamental movement skills (FMS), while aiming to perform sufficient physical activity (PA). This study reviews the current evidence for the levels of achievement in FMS and PA measured using accelerometers among 4–5-year-old children and examines differences by gender. This review was conducted using the PRISMA framework. Keyword searches were conducted in Pubmed, Medline, Google Scholar and SPORTDiscus. Inclusion criteria included age: 4–5 years old; FMS measurement: Test of Gross Motor Development 2 and 3; PA measurement: objective methods; balance measurement: static single limb; study design: cross-sectional observational/descriptive, randomised control trials, intervention studies; language: English. Twenty-eight articles from twenty-one countries met the inclusion criteria and were split into either FMS and PA articles (n = 10) or balance articles (n = 18). Three articles showed children achieving 60 min of moderate to vigorous PA per day, two articles demonstrated significant differences between girls’ and boys’ performance of locomotor skills and five reported locomotor skills to be more proficient than object control skills at this age for both genders. Balance was measured in time (n = 12), points score (n = 3) or biomechanical variables (n = 3), displaying heterogeneity of not only measurement but also outcomes within these data, with static single limb balance held between 6.67 to 87.6 s within the articles. Four articles reported girls to have better balance than boys. There is little conclusive evidence of the current levels for FMS, PA and balance achievement in young children 4–5 years of age. The academic literature consistently reports low levels of FMS competence and mixed evidence for PA levels. Inconsistencies lie in balance measurement methodology, with broad-ranging outcomes of both low and high achievement at 4–5 years old. Further research is required to focus on increasing practice opportunities for children to improve their FMS, increase PA levels and establish sufficient balance ability. Consistent and comparable outcomes during early childhood through more homogenous methodologies are warranted.

Minorities' Diminished Returns of Parental Educational Attainment on Adolescents' Social, Emotional, and Behavioral Problems.

Abstract: Aim: To compare racial groups for the effect of parental educational attainment on adolescents' social, emotional, and behavioral problems. Methods: In this cross-sectional study, 10,762 youth from the Adolescent Brain Cognitive Development (ABCD) study were included. The independent variable was parental educational attainment. The main outcomes were 1) anxious and depressed mood, 2) withdrawn and depressed affect, 3) somatic complaints, 4) social and interpersonal problems, 5) thought problems, 6) rule-breaking behaviors, 7) attention problems, and 8) violent and aggressive behaviors. These scores were generated based on parent-reported behavioral problems measured using the Child Behavior Checklist (CBCL). Race and ethnicity were the moderators. Linear regression was used to analyze the ABCD data. Results: Overall, high parental educational attainment was associated with lower scores across all domains. Race and ethnicity showed statistically significant interactions with parental educational attainment on adolescents' fewer social, emotional, and behavioral problems (all domains), net of all confounders, indicating smaller tangible gains from their parental educational attainment for Black and Hispanic compared to non-Hispanic White adolescents. Conclusion: The protective effects of parental education against social, emotional, and behavioral problems are systematically diminished for Hispanic and Black than non-Hispanic White adolescents.

Early Intervention with Parents of Children with Autism Spectrum Disorders: A Review of Programs.

Abstract: The aim of this article was to analyze the evidence regarding the effectiveness of intervention programs for children with autism based on the participation of their parents. To obtain the data, a systematic search was carried out in four databases (PsycARTICLES (ProQuest), ERIC (ProQuest), PubMed (ProQuest), and Scopus). The retrieved documents were refined under the inclusion/exclusion criteria, and a total of 51 empirical studies were selected. These studies were first classified according to the function of the intervention objective and, later, by the methodology applied (19 studies were based on comprehensive interventions, 11 focused on the nuclear symptoms of autism spectrum disorder (ASD), 12 focused on the promotion of positive parenting, and nine interactions focused on child play). Once all of the documents had been analyzed, the evidence indicated scientific efficacy in most studies, mainly in those based on child development and the application of behavioral analysis principles. Moreover, the positive influence of parent participation in such programs was demonstrated.

The Influence of Social Support on Physical Activity in Chinese Adolescents: The Mediating Role of Exercise Self-Efficacy

Abstract: The purpose of this study was to examine the associations of social support and self-efficacy with physical Activity (PA) and the mediating effect of self-efficacy on the relationship between social support and PA in Chinese adolescents. Participants included a total of 2341 Chinese adolescents (aged 12.75 ± 1.46 years). Self-reported instruments, including the physical activity questionnaire for adolescents, the social support revalued scale and the exercise self-efficacy scale, were used to measure physical activity, social support and exercise self-efficacy. Results showed that social support (r = 0.29, p < 0.05) and exercise self-efficacy (r = 0.43, p < 0.05) were significant and positive predictors of PA among Chinese adolescents, and exercise self-efficacy was a significant mediator in the relationship between social support and PA (standardized effect size = 0.15, p < 0.001). Such findings were evident with similar patterns in both male and female adolescents. The findings of this study have indicated the importance of social support and exercise self-efficacy on PA promotion in adolescents, which will aid the development of effective interventions in this population.

Gastroschisis: A State-of-the-Art Review.

Abstract: Gastroschisis, the most common type of abdominal wall defect, has seen a steady increase in its prevalence over the past several decades. It is identified, both prenatally and postnatally, by the location of the defect, most often to the right of a normally-inserted umbilical cord. It disproportionately affects young mothers, and appears to be associated with environmental factors. However, the contribution of genetic factors to the overall risk remains unknown. While approximately 10% of infants with gastroschisis have intestinal atresia, extraintestinal anomalies are rare. Prenatal ultrasound scans are useful for early diagnosis and identification of features that predict a high likelihood of associated bowel atresia. The timing and mode of delivery for mothers with fetuses with gastroschisis have been somewhat controversial, but there is no convincing evidence to support routine preterm delivery or elective cesarean section in the absence of obstetric indications. Postnatal surgical management is dictated by the condition of the bowel and the abdominal domain. The surgical options include either primary reduction and closure or staged reduction with placement of a silo followed by delayed closure. The overall prognosis for infants with gastroschisis, in terms of both survival as well as long-term outcomes, is excellent. However, the management and outcomes of a subset of infants with complex gastroschisis, especially those who develop short bowel syndrome (SBS), remains challenging. Future research should be directed towards identification of epidemiological factors contributing to its rising incidence, improvement in the management of SBS, and obstetric/fetal interventions to minimize intestinal damage.

Effects of a Need-Supportive Motor Skill Intervention on Children’s Motor Skill Competence and Physical Activity

Abstract: A need-supportive environment can provide various motivational benefits to impact children’s psychomotor developmental levels. However, very little is known about the effects of need-supportive motor skill intervention on children’s motor skill competence and physical activity by gender. Guided by self-determination theory (SDT), this study aimed to (a) investigate the effect of a need-supportive fundamental movement skill (FMS) program on children’s FMS competence and moderate-to-vigorous physical activity (MVPA), and (b) explore potential gender differences in these effects. Thirty-six children (63.8% girls; Mage = 6.52 ± 0.97) participated and were divided into two groups: an intervention group (24 need-supportive FMS sessions over eight weeks) and a control group. A repeated-measures multivariate analysis of variance (MANOVA) was used to examine the influence of the motor skill intervention on FMS competence and MVPA over time by group (intervention, control) and gender (boys, girls). The results showed (a) significant group differences between the intervention and control group in FMS competence and MVPA (p < 0.001), (b) non-significant gender differences between boys and girls in FMS competence and MVPA (p = 0.85), and (c) non-significant interaction effects over time (p = 0.52). The findings highlight that a need-supportive FMS program may enhance FMS development and daily physical activity for both genders during the early school years.

Prevalence and Selected Sociodemographic of Movement Behaviors in Schoolchildren from Low- and Middle-Income Families in Nanjing, China: A Cross-Sectional Questionnaire Survey.

Abstract: Background: To investigate the prevalence of meeting the 24-h movement guidelines and its sociodemographic correlates in youth from low- and middle-income families (LMIFs) in Nanjing, China. Methods: Cross-sectional data on moderate to vigorous physical activity (MVPA), screen time (ST), and sleep (SLP) were collected using the Chinese version of Health Behavior School-Aged Children questionnaire among grade schoolchildren of 4th–12th (mean age 13.6 years). The prevalence of meeting the 24-h movement guidelines was in line with the recommendations of the Canadian 24-h movement guidelines. Generalized linear models were used to explore the relationships of correlates with the prevalence of meeting the movement guidelines. Results: The prevalence of meeting the MVPA, ST, and SLP guidelines and their combination was 9.9%, 65.2%, 37.2%, and 2.9%, respectively. As for the prevalence of meeting the MVPA guidelines, boys, younger schoolchildren, and those living in urban areas had a higher chance of meeting them. With regards to the prevalence of meeting the ST guidelines, girls, urban schoolchildren, and the oldest participants were more likely to meet the guidelines. Residential areas and grades were two correlates of meeting the SLP guidelines as well as 24-h movement guidelines. Conclusions: The majority of schoolchildren from LMIFs in Nanjing, China had unhealthy movement behaviors. This concerning situation was mainly predicted by schoolchildren’s grades, indicating older schoolchildren exhibited lower levels of movement behavior. Improved studies are encouraged to identify the correlates of movement behaviors in schoolchildren, which in turn designs and implements effective interventions.

Nutritional Status of Pediatric Cancer Patients at Diagnosis and Correlations with Treatment, Clinical Outcome and the Long-Term Growth and Health of Survivors

Abstract: Malnutrition is caused either by cancer itself or by its treatment, and affects the clinical outcome, the quality of life (QOL), and the overall survival (OS) of the patient. However, malnutrition in children with cancer should not be accepted or tolerated as an inevitable procedure at any stage of the disease. A review of the international literature from 2014 to 2019 was performed. Despite the difficulty of accurately assessing the prevalence of malnutrition, poor nutritional status has adverse effects from diagnosis to subsequent survival. Nutritional status (NS) at diagnosis relates to undernutrition, while correlations with clinical outcome are still unclear. Malnutrition adversely affects health-related quality of life (HRQOL) in children with cancer and collective evidence constantly shows poor nutritional quality in childhood cancer survivors (CCSs). Nutritional assessment and early intervention in pediatric cancer patients could minimize the side effects of treatment, improve their survival, and reduce the risk of nutritional morbidity with a positive impact on QOL, in view of the potentially manageable nature of this risk factor.

Diminished Returns of Parental Education in Terms of Youth School Performance: Ruling out Regression toward the Mean.

Abstract: Background: Minorities’ Diminished Returns (MDRs) refer to systemically weaker effects of socioeconomic status (SES) indicators on various developmental, behavioral, and health outcomes of ethnic minorities compared to non-Hispanic (non-Latino) Whites. Similar MDRs also exist for the effects of parental education on the school performance of ethnic minority youth. Aim: To assess whether regression toward the mean (RTM) has any role in explaining the diminished effects of parental education on the school performance of Black and Hispanic youth relative to non-Hispanic White youth. Materials and methods: Data for this cross-sectional study came from the Monitoring the Future survey (MTF, 2017), a nationally representative survey of American youth in 12th grade. The sample included 10,262 youth who were 12th graders (typically 17–18 years old). The independent variable was parental education with five categories: Some high school, High school graduate, Some college, College graduate, and Graduate school. The outcome was self-reported school performance measured as grade point average (GPA). Ethnicity was the effect modifier. Analysis of variance (ANOVA) and the Tukey Post Hoc test was used to analyze the data. Data visualization (line graphs) was used to visualize the shape of youth GPA as a function of parental education levels across ethnic groups. Results: While a perfect stepwise increase was seen in youth school performance as a result of parental education improvement, this pattern differed considerably across ethnic groups. Such a perfect stepwise increase in youth school performance as a result of the incremental increase in parental education was missing for Black and Hispanic youth. The shape of the association between parental education and youth school performance ruled out regression toward the mean (RTM) as an explanation for the observed diminished effects of parental education on the school performance of Black and Hispanic youth. Conclusion: Diminished returns of parental education on the school performance of Black and Hispanic youth cannot be explained by regression toward the mean. Other factors and contextual processes, such as segregation, discrimination, racism, and poor quality of schools in urban areas, should be investigated in future research.

Subjective Family Socioeconomic Status and Adolescents' Attention: Blacks' Diminished Returns.

Abstract: Background: Racial minorities, particularly non-Hispanic blacks (NHBs) in the US, experience weaker effects from their families' socioeconomic status on tangible outcomes, a pattern called the Minorities' Diminished Returns (MDRs) theory. These MDRs are frequently shown in the effects of the families' socioeconomic status (SES) on NHB adolescents' school performance. As a result of these MDRs, NHB adolescents from high SES families show a worse than expected school performance. The existing knowledge is, however, minimal about the role of attention in explaining the diminished returns of the families' SES with regard to the adolescents' outcomes. Aim: To investigate the racial differences in the effects of the subjective family SES on adolescents' attention, we compared non-Hispanic white (NHW) and NHB adolescents to assess the effect of the subjective family SES on adolescents' attention. Methods: This was a cross-sectional analysis that included 4188 adolescents from the Adolescent Brain Cognitive Development (ABCD) Study. The independent variable was the subjective family SES. The primary outcome was the adolescents' attention to be measured by the stop-signal task (SST). The attention domain of the Child Behavior Checklist (CBCL) was also measured. Results: Overall, a high subjective family SES was associated with a higher task-based and CBCL-based attention. Race showed statistically significant interactions with subjective family SES in terms of adolescents' attention outcomes. These interactions suggested that a high subjective family SES has smaller tangible effects on increasing the attention of NHB than NHW adolescents. Conclusion: The boosting effect of subjective family SES on attention is diminished for NHB rather than NHW adolescents. To minimize the racial gap in attention-related behaviors, such as school performance, we need to address the diminished returns of resources in the lives of NHB families. Not only should we equalize SES, but also increase the marginal returns of SES for racial minorities, particularly NHB families. Such efforts require public policies that empower NHB families to better leverage their SES resources and turn them into tangible outcomes. In addition, social policies should directly aim to alter the societal barriers that limit NHB families' ability to effectively utilize their resources. Discrimination, segregation, and racism should be targets of our policy solutions.

Talking to Children and Families about Chronic Pain: The Importance of Pain Education-An Introduction for Pediatricians and Other Health Care Providers.

Abstract: Chronic pain in children and adolescents is a common and debilitating health problem. This narrative review will give a brief overview on what pediatric chronic pain is and what treatment options there are for children and adolescents. The specific emphasis will be on pediatric chronic pain education and communication: this narrative review aims to show how important a good patient-health care provider relationship is-it builds the foundation for successful communication-and how this relationship can be established. In addition, we will present five steps that health care providers can perform to explain pediatric chronic pain to patients and their parents and what to keep in mind in their clinical routine. Our review is intended for pediatricians and other health care providers who treat pediatric patients with chronic pain but might feel uncertain on how to best communicate with them.

The Effectiveness of Hippotherapy to Recover Gross Motor Function in Children with Cerebral Palsy: A Systematic Review and Meta-Analysis

Abstract: Cerebral palsy (CP) is a permanent disorder of the posture and movement, which can result in impairments of gross motor function, among others. Hippotherapy (HPT) is an emerging intervention to promote motor recovery in patients with neurological disorders, providing a smooth, precise, rhythmic, and repetitive pattern of movement to the patient. The main objective of this systematic review and meta-analysis of randomized controlled clinical trials was to analyze the effectiveness of HPT interventions on gross motor function in subjects with CP. The following databases were searched in May 2019: PubMed, Scopus, Embase, and Web of Science. The methodological quality of the randomized controlled trials was assessed using the Physiotherapy Evidence Database (PEDro) scale. A total of 10 studies were analyzed in this review, involving 452 participants. Favorable effects were obtained on the gross motor function (Gross Motor Function Measure-66, standardized mean difference (SMD) = 0.81, 95% confidence interval (CI) = 0.47–1.15, Gross Motor Function Measure-88 dimension A SMD = 0.64, 95% CI = 0.30–0.97, dimension B SMD = 0.42, 95% CI = 0.09–0.75, and dimension E SMD = 0.40, 95% CI = 0.06–0.73). The results obtained in the present review show the potential benefit of HPT intervention in improving gross motor function in children with CP.

Neonatal COVID-19 Pneumonia: Report of the First Case in a Preterm Neonate in Mayotte, an Overseas Department of France

Abstract: We report the first case of COVID-19 pneumonia in a preterm neonate in Mayotte, an overseas department of France. The newborn developed an acute respiratory distress by 14 days of life with bilateral ground glass opacities on a chest CT scan and a 6-week-long stay in the neonatal intensive care unit (NICU). This case report emphasizes the need for a cautious and close follow-up period for asymptomatic neonates born to mothers with COVID-19 infection. Vertical transmission cannot be excluded in this case.

Effects of ASL Rhyme and Rhythm on Deaf Children's Engagement Behavior and Accuracy in Recitation: Evidence from a Single Case Design.

Abstract: Early language acquisition is critical for lifelong success in language, literacy, and academic studies. There is much to explore about the specific techniques used to foster deaf children’s language development. The use of rhyme and rhythm in American Sign Language (ASL) remains understudied. This single-subject study compared the effects of rhyming and non-rhyming ASL stories on the engagement behavior and accuracy in recitation of five deaf children between three and six years old in an ASL/English bilingual early childhood classroom. With the application of alternating treatment design with initial baseline, it is the first experimental research of its kind on ASL rhyme and rhythm. Baseline data revealed the lack of rhyme awareness in children and informed the decision to provide intervention as a condition to examine the effects of explicit handshape rhyme awareness instruction on increasing engagement behavior and accuracy in recitation. There were four phases in this study: baseline, handshape rhyme awareness intervention, alternating treatments, and preference. Visual analysis and total mean and mean difference procedures were employed to analyze results. The findings indicate that recitation skills in young deaf children can be supported through interventions utilizing ASL rhyme and rhythm supplemented with ASL phonological awareness activities. A potential case of sign language impairment was identified in a native signer, creating a new line of inquiry in using ASL rhyme, rhythm, and phonological awareness to detect atypical language patterns.