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Archives of Osteoporosis Jun 2024Muscular fitness plays a major role in bone health and body composition in overweight and obese children. It is key that the development of this muscle fitness is...
UNLABELLED
Muscular fitness plays a major role in bone health and body composition in overweight and obese children. It is key that the development of this muscle fitness is affected by absolute isometric strength and dynamic strength.
PURPOSE
To compare bone health and body composition between overweight/obese children considering muscular fitness (MF) levels, and to investigate whether weight-bearing dynamic or absolute isometric strength, both involved in the development of this muscular fitness, are more related with bone health.
METHODS
MF of 59 overweight or obese children (10.1 ± 0.9 years, 27 females) was measured by a countermovement jump (CMJ), handgrip, and maximal isometric strength of knee extension. Participants were divided into four groups depending on their MF level performing a cluster analysis: 16 children with high MF (HMF) in all tests, 18 with high performance in isometric strength (HIS), 15 with high performance in CMJ (HCMJ) and 10 low isometric and low dynamic force values (LMF). Body composition values were measured by dual energy X-ray absorptiometry, and bone strength values were assessed by peripheral quantitative computed tomography. Motor skills were evaluated using TGMD-3. Multivariate analysis of covariance test was applied to analyse bone strength differences between children in the different MF groups, using maturity offset, height and weight as covariates, and correlations were investigated.
RESULTS
HMF excelled in bone health. HIS had higher cortical bone area, periosteal circumference, bone mass, polar strength strain index and fracture load than LMF, while HCMJ only showed better results in trabecular bone area than LMF. HMF had significantly better values of fracture load and periosteal and endosteal circumferences than HCMJ, but not than HIS.
CONCLUSIONS
High MF level shows positive effects on bone health in overweight/obese children. Those with highest isometric strength had better bone health compared to those with higher dynamic strength.
TRIAL REGISTRATION
The research project was registered in a public database Clinicaltrials.gov in June 2020 with the identification number NCT04418713.
Topics: Humans; Male; Child; Female; Body Composition; Muscle Strength; Bone Density; Pediatric Obesity; Physical Fitness; Overweight; Absorptiometry, Photon; Hand Strength
PubMed: 38856950
DOI: 10.1007/s11657-024-01405-3 -
Frontiers in Oncology 2024We report a case of slipped capital femoral epiphysis (SCFE), an on target skeletal toxicity of a pan-FGFR TKI inhibitor, erdafitinib. A 13-year-old boy was diagnosed to...
We report a case of slipped capital femoral epiphysis (SCFE), an on target skeletal toxicity of a pan-FGFR TKI inhibitor, erdafitinib. A 13-year-old boy was diagnosed to have an optic pathway/hypothalamic glioma with signs of increased intracranial pressure and obstructive hydrocephalus requiring placement of ventriculo-peritoneal (VP) shunt. Sequencing of the tumor showed FGFR1-tyrosine kinase domain internal tandem duplication (FGFR1-KD-ITD). He developed hypothalamic obesity with rapid weight gain and BMI >30. At 12 weeks of treatment with erdafitinib, he developed persistent knee pain. X-ray of the right hip showed SCFE. Erdafitinib was discontinued, and he underwent surgical pinning of the right hip. MRI at discontinuation of erdafitinib showed a 30% decrease in the size of the tumor, which has remained stable at 6 months follow-up. Our experience and literature review suggest that pediatric patients who are treated with pan-FGFR TKIs should be regularly monitored for skeletal side effects.
PubMed: 38854731
DOI: 10.3389/fonc.2024.1399356 -
Vaccine Jun 2024Communities of color had higher rates of Coronavirus (COVID-19) infection and lower rates of COVID-19 vaccination during the pandemic. Parental concern about the safety...
INTRODUCTION
Communities of color had higher rates of Coronavirus (COVID-19) infection and lower rates of COVID-19 vaccination during the pandemic. Parental concern about the safety and necessity of pediatric COVID-19 vaccines contribute to low childhood vaccination. Enlisting parents and caregivers as trusted messengers is an evidence-based approach to mitigate this challenge. VaxUpPhillyFamilies was formed to engage parents and caregivers as vaccine ambassadors to increase vaccination rates in children of color. This study aimed to understand the key benefits, challenges, and lessons learned from the VaxUpPhillyFamilies program.
METHODS
Three online debriefing sessions with ambassadors were conducted between September 7 and October 24, 2022, to share best practices, address challenges, receive emerging vaccine information, and provide support. Thematic analysis was utilized to develop broad themes and subthemes.
RESULTS
Four themes with corresponding subthemes were identified: 1) Motivations to Become an Ambassador: a) improving the health of the community and b) personal satisfaction; 2) Defining Success: a) community interactions and b) influencing opinions; 3) Best Approaches: a) being mentally prepared with facts, b) addressing community health needs beyond COVID-19, c) demonstrating empathy, d) "meeting them where they're at" by motivational interviewing, and e) building trust and connection; 4) Challenges: a) changes in vaccine guidelines, b) vaccine misinformation, c) varied perceptions of severity of COVID-19 illness and benefits of the vaccine, d) breakdown of communication from trusted sources, and e) structural barriers to engagement.
CONCLUSION
Parents and caregivers were a resource for delivering evidence-based messaging about COVID-19 and other health challenges. To effectively equip parents and caregivers as public health ambassadors, it is critical to offer training in engagement strategies, to identify and combat misinformation, and to provide support in navigating challenges. VaxUpPhillyFamilies program is a model for future public health campaigns.
PubMed: 38853034
DOI: 10.1016/j.vaccine.2024.06.008 -
PloS One 2024Neonatal mortality during the first week of life is a global issue that is responsible for a large portion of deaths among children under the age of five. There are,...
INTRODUCTION
Neonatal mortality during the first week of life is a global issue that is responsible for a large portion of deaths among children under the age of five. There are, however, very few reports about the issue in sub-Saharan Africa. For the sake of developing appropriate policies and initiatives that could aid in addressing the issue, it is important to study the prevalence of mortality during the early neonatal period and associated factors. Thus, the aim of this study was to ascertain the prevalence of and pinpoint the contributing factors to early neonatal mortality in sub-Saharan Africa.
METHOD
Data from recent demographic and health surveys in sub-Saharan African countries was used for this study. The study included 262,763 live births in total. The determinants of early newborn mortality were identified using a multilevel mixed-effects logistic regression model. To determine the strength and significance of the association between outcome and explanatory variables, the adjusted odds ratio (AOR) at a 95% confidence interval (CI) was computed. Independent variables were deemed statistically significant when the p-value was less than the significance level (0.05).
RESULT
Early neonatal mortality in sub-Saharan Africa was 22.94 deaths per 1,000 live births. It was found to be significantly associated with maternal age over 35 years (AOR = 1.77, 95% CI: 1.34-2.33), low birth weight (AOR = 3.27, 95% CI: 2.16, 4.94), less than four ANC visits (AOR = 1.12, 95% CI: 1.01, 1.33), delivery with caesarean section (AOR = 1.81, 95% CI: 1.30-2.5), not having any complications during pregnancy (AOR = 0.76, 95% CI: 0.61, 94), and community poverty (AOR = 1.32, 95% CI: 1.05-1.65).
CONCLUSION
This study found that about twenty-three neonates out of one thousand live births died within the first week of life in sub-Saharan Africa. The age of mothers, birth weight, antenatal care service utilization, mode of delivery, multiple pregnancy, complications during pregnancy, and community poverty should be considered while designing policies and strategies targeting early neonatal mortality in sub-Saharan Africa.
Topics: Humans; Africa South of the Sahara; Infant Mortality; Infant, Newborn; Female; Health Surveys; Adult; Pregnancy; Male; Infant; Maternal Age; Young Adult; Risk Factors; Adolescent; Odds Ratio
PubMed: 38848390
DOI: 10.1371/journal.pone.0304065 -
Frontiers in Public Health 2024To analyze the epidemiological characteristics and wound healing conditions of common unintentional skin lacerations in children.
OBJECTIVE
To analyze the epidemiological characteristics and wound healing conditions of common unintentional skin lacerations in children.
METHODS
A retrospective analysis was conducted on data from 1,107 children, aged 0-12 years, with skin lacerations who received emergency treatment at Qilu Hospital of Shandong University from January 1, 2019, to December 30, 2022. Data on age, injury site, time from injury to suturing, and wound healing conditions were statistically analyzed.
RESULTS
Among the 1,107 cases, 714 (64.5%) were male and 393 (35.5%) were female, with a male-to-female ratio of 1.8:1; median age was 5 years (IQR, 3-7). Infants and toddlers (0-3 years old) constituted the highest proportion, accounting for 36.3% (402 cases). The number of children aged over 3 years gradually decreased with increasing age. In younger children, the most common injuries were to the forehead, scalp, and lower jaw; in school-aged children, the proportion of limb and trunk injuries significantly increased. Age (OR, 1.34; 95% CI, 1.23-1.46), outdoor injuries (OR, 2.21; 95% CI, 1.18-4.16), lower limb injuries (OR, 5.35; 95% CI, 2.86-10.00), and wound length greater than 3 cm (OR, 10.65; 95% CI, 5.02-22.60) were significant risk factors for poor wound healing. The risk of poor wound healing increased by 34% for each additional year of age.
CONCLUSION
In children, the common sites of unintentional skin lacerations show distinct age and gender distribution characteristics. Older age, outdoor injuries, longer wound lengths, and lower limb injuries are independent risk factors for poor wound healing.
Topics: Humans; Male; Female; Child, Preschool; Infant; Retrospective Studies; Child; Wound Healing; China; Lacerations; Infant, Newborn; Risk Factors; Accidental Injuries; Wounds and Injuries
PubMed: 38846603
DOI: 10.3389/fpubh.2024.1352176 -
BMC Nursing Jun 2024Countries abroad have implemented pediatric palliative treatment for several years; however, complete pediatric palliative treatment guidelines and legal guidance remain...
Differences in the knowledge, attitudes, and needs of caregivers and healthcare providers regarding palliative care: a cross-sectional investigation in pediatric settings in China.
BACKGROUND
Countries abroad have implemented pediatric palliative treatment for several years; however, complete pediatric palliative treatment guidelines and legal guidance remain lacking in China, making the implementation of palliative care difficult.
PURPOSE
This study aimed to understand the current situation, similarities, and differences in the knowledge, attitudes, and needs of caregivers and healthcare providers regarding palliative care for children.
METHODS
This cross-correlation study collected data from pediatric and neonatal intensive care units of four hospitals in China. The participants comprised 180 caregivers and 172 healthcare providers. The measurement tools included the palliative care knowledge scale, palliative care attitude scale, and pediatric palliative care needs scale. This study adhered to the STROBE reporting guidelines.
RESULTS
Significant differences in palliative care knowledge, attitudes, and needs were observed between caregivers and healthcare providers (p < 0.005). Pediatric healthcare providers demonstrated higher knowledge and positive attitudes regarding palliative care than caregivers. Needs for communication in general and relief from pain and other symptoms of caregivers were higher than those of healthcare providers (p < 0.001). Furthermore, palliative care attitude and needs of healthcare providers were positively correlated with each other (r = 0.212, p < 0.005).
CONCLUSION
Pediatric healthcare providers and caregivers demonstrated different perceptions of needs for palliative care. The results of this study can serve as a reference for the future development of guidelines related to children's needs and related interventions.
PubMed: 38844953
DOI: 10.1186/s12912-024-02052-2 -
Alternative Therapies in Health and... Jun 2024Diarrheal irritable bowel syndrome is a common functional intestinal disease in gastroenterology that can affect approximately 9% of children worldwide, and more than...
BACKGROUND
Diarrheal irritable bowel syndrome is a common functional intestinal disease in gastroenterology that can affect approximately 9% of children worldwide, and more than half of all affected children have abdominal pain into adulthood. Research has shown that scientific and effective nursing can play an important role in improving the condition and prognosis of diarrheal irritable bowel syndrome in children.
OBJECTIVE
To explore the effect of high-quality nursing intervention on clinical efficacy and prognosis of diarrheal irritable bowel syndrome in children.
DESIGN
This was a retrospective study.
SETTING
This study was performed in the department of Fourth Department of Pediatrics, Ningbo Women & Children's Hospital.
PARTICIPANTS
A total of 60 children with diarrheal irritable bowel syndrome admitted to the Pediatric Gastroenterology Department of our hospital from August 2017 to August 2019 were enrolled.
INTERVENTIONS
At the same time as symptomatic treatment, high-quality nursing intervention was implemented, including cognitive intervention, psychological intervention, dietary guidance, life coaching, and medication guidance.
PRIMARY OUTCOME MEASURES
(1) clinical efficacy (2) clinical symptom points (3) symptom relief time (4) incidence of adverse reactions (5) negative emotions (6) treatment compliance and (7) nursing satisfaction of family members. All theses primary outcome measures could indicate the impacts of high-quality nursing intervention on the overall treatment and prognosis of diarrheal irritable bowel syndrome in children.
RESULTS
The total effective rate was 98.33%. The scores of abdominal distension, abdominal pain, and diarrhea after treatment were significantly lower than those before treatment (P < .05). The anxiety and depression scores of children were lower after treatment than before treatment (P < .05). After treatment, the antipyretic time, antidiarrheal time, and correct dehydration time were (1.44±0.28) d, (1.46±0.33) d and (1.38±0.31) d. The treatment compliance and nursing satisfaction of the family members of the children was 100.00%, and the satisfaction score was 94.60±3.28 points. There were no obvious adverse reactions.
CONCLUSION
High-quality nursing intervention combined with treatment of children with diarrheal irritable bowel syndrome can effectively improve clinical treatment effect, improve clinical symptoms, improve children's negative emotions and promote children's treatment compliance and nursing satisfaction of families, and have no obvious adverse reactions, which is worthy of clinical promotion. Our study provides a clinical reference for the nursing of children with diarrheal irritable bowel syndrome.
PubMed: 38843431
DOI: No ID Found -
Alternative Therapies in Health and... Jun 2024To study the intervention effects of the health education and health promotion (PRECEDE-PROCEED) model on the health behaviors and quality of life of obese children and...
OBJECTIVE
To study the intervention effects of the health education and health promotion (PRECEDE-PROCEED) model on the health behaviors and quality of life of obese children and their parents.
METHODS
524 patients who attended our pediatric obesity clinic from January to December 2021 were selected and divided into two groups: the control group (n = 262) and the test group (n = 262). The control group was guided by conventional weight reduction instruction, while the test group implemented the PRECEDE-PROCEED model. Based on this model, interventions were developed following the 9 links of the model, with tendency factors, contributing factors, and reinforcing factors as the core and 6 aspects of health behaviors were focused upon, and were followed up for 12 months. A home-made questionnaire scale was used to assess the subjects at their initial visit and one year after the intervention.
RESULTS
After the intervention, the awareness rate of obesity-related knowledge, support rate of attitude toward improving childhood obesity, awareness rate of disease harm caused by obesity, and formation rate of controlling childhood obesity behavior had significantly improved among the parents of the test group compared to the control group, with significant differences between the two groups (P < .05).
CONCLUSION
The PRECEDE-PROCEED model can transform the way parents of obese children apply health education at home, improving health behaviors and quality of life.
PubMed: 38843427
DOI: No ID Found -
Translational Pediatrics May 2024In 2023, China witnessed an earlier and more widespread outbreak of pneumonia (MPP). To address this situation, an online training program was designed to enhance the...
BACKGROUND
In 2023, China witnessed an earlier and more widespread outbreak of pneumonia (MPP). To address this situation, an online training program was designed to enhance the knowledge of MPP among pediatricians in Shanghai, China.
METHODS
An online training program on the diagnosis and treatment of MPP, guided by Kern's six-step approach, was developed by the Shanghai Pediatric Clinical Quality Control Center. A pre- and post-training survey was conducted using a 20-item self-administered questionnaire to investigate the pediatricians' knowledge of MPP. A linkage mechanism was established to match pretest/posttest questionnaires using personal identifiers. Paired -tests and McNemar tests were performed to measure the differences, as appropriate, between pre- and post-training groups. A higher survey score indicated better knowledge.
RESULTS
There were 289 participants performed pre- and post-tests. The average age of the respondents was 38.7 years (standard deviation: 8.9). Over 80% of the participants were primary (32.5%) and intermediate (47.8%) pediatricians. Those from specialized hospitals accounted for the highest proportion (41.5%). The post-training group achieved significantly higher total scores than the pre-training group (91.3 67.7, =22.48, P<0.001), regardless of the professional titles or hospital levels (all P<0.001). The accuracy rates of each question increased significantly in the post-training group (all P<0.001).
CONCLUSIONS
The online training program effectively enhanced pediatricians' understanding of diagnosing and treating MPP. It is recommended to maintain continuous education and training targeting all healthcare providers.
PubMed: 38840684
DOI: 10.21037/tp-24-53 -
BMC Anesthesiology Jun 2024To investigate whether the surgical process information sharing system could alleviate the parental anxiety during a pediatric selective operation. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To investigate whether the surgical process information sharing system could alleviate the parental anxiety during a pediatric selective operation.
DESIGN
Randomized controlled trial.
METHODS
A questionnaire survey was conducted one day before surgery for the enrolled participants. Family members assigned to the intervention group received real-time process information sharing through service reminders during the surgical period, while the control group received standard perioperative education. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate sleep quality during the perioperative period, and the State of Cohesion-13 Scale (SOC-13) and Self-rating Anxiety Scale (SAS) were used to assess anxiety levels. Satisfaction levels during the perioperative period were assessed through a follow-up survey conducted one day after surgery.
RESULTS
The intervention group showed better scores in terms of PSQI, SOC-13, SAS, and postoperative satisfaction levels at various time points compared to the control group, with statistically significant differences observed (P < 0.05).
CONCLUSION
Real-time process information sharing is effective in reducing perioperative sleep disorders and anxiety among family members of pediatric patients, as well as improving satisfaction levels. This approach not only establishes a process and mechanism for effective doctor-patient communication but also helps implement continuous perioperative care, thereby optimizing internet healthcare services.
Topics: Humans; Male; Female; Elective Surgical Procedures; Anxiety; Child; Information Dissemination; Surveys and Questionnaires; Adult; Child, Preschool; Parents; Sleep Quality; Patient Satisfaction; Family; Perioperative Period
PubMed: 38840039
DOI: 10.1186/s12871-024-02581-y