Objective: To investigate the impact of an instructional program based on the Transformational-Generative (TG) Theory on improving the writing skills of eleventh-grade female students in Jordan. This may lead to designing an instructional program to improve the writing skills of secondary school students. Methods: The study sample consisted of 76 female students, purposefully selected from a school affiliated with the Directorate of Education in the University District. Through random assignment, the experimental group (11/A), comprising 39 students, was taught using the program based on the TG Theory. In contrast, the control group (11/B), consisting of 37 students, received instruction through the conventional curriculum. To achieve the objectives of the study, the researchers developed a teacher's guide based on the TG Theory, a list of writing skills and their criteria, and a writing test administered to both groups before and after instruction. To answer the research questions, descriptive statistical methods, multivariate analysis of covariance (MANCOVA), and ANCOVA were employed. Results: There are statistically significant differences between the mean scores of both groups on the writing test, attributed to the effectiveness of the program based on the TG Theory in favor of the experimental group. Except for "style" and "rhetoric" dimensions, there are statistically significant differences between the mean scores of both groups across other writing test dimensions in favor of the experimental group. Conclusions: The researchers recommend designing instructional activities grounded in the TG Theory to enhance writing and other Arabic language skills among students of all grade levels.
Background: High pre-pregnancy BMI, excessive gestational weight gain, and postpartum weight retention are modifiable risk factors for childhood obesity, but are often studied singly, limiting understanding of their combined impact. Our objective was to characterize maternal weight trajectories across pregnancy until 18 months' postpartum and examine associations with child overweight or obesity. Methods: We analyzed data from 299 mother-child dyads enrolled in the Play & Grow study (Ohio, USA). Mother's weight and height were measured at study enrollment at 18 months' postpartum. Pre-pregnancy weight and height and weight at delivery were obtained through linkage to birth certificate data. Group-based trajectory modeling was used to characterize maternal weight trajectories using BMI values at pre-pregnancy, delivery, and postpartum. Modified Poisson regression was used to assess associations between maternal BMI trajectories and child overweight or obesity (sex and age-specific WHO BMI z-score >= 2) at age 24 months. Results: Approximately 46% of the mothers identified as non-white and 12% smoked. Three maternal BMI trajectories were identified: "Normal then increase and modest decrease" (57%, n=171), "Class 1 Obesity then increase and plateau" (32%, n=95), and "Class 3 Obesity then increase and plateau" (11%, n=33). Effect estimates comparing the latter two groups to the normal group suggested a moderately increased risk of child overweight or obesity which was inconsistently attenuated upon adjustment for confounders (e.g., adjusted risk ratio for "Class 3 Obesity then increase and plateau" =1.32, 95% confidence interval: 0.58, 3.00). All confidence intervals were wide and included null. Conclusion: Excess weight before, during, and after pregnancy may collectively impact childhood obesity. Additional studies are needed because these results were imprecise.
This descriptive cross-sectional study was conducted with 584 students aged 14-18 attending high school in Tokat province in the 2023-2024 academic year in order to determine attachment and influencing factors in high school students. Data collection tools included a Descriptive Information Form and the Inventory of Parent and Peer Attachment (IPPA). Data were analyzed on the SPSS 24.0 software by using descriptive statistics, t-test, One-Way ANOVA, Mann-Whitney U, and Kruskal-Wallis tests. Of the students, 29.6% were 12th-graders, 28.9% were 17 years old, and 55.8% were female. Participants' mean score was 66.23 +/- 12.92 on the attachment to the mother sub-dimension, 58.84 +/- 16.03 on the attachment to the father sub-dimension, and 72.14 +/- 12.78 on the attachment to peers sub-dimension. It was determined that some factors, such as gender, chronic disease, perceived health, family and friend relationships, presence of close friends, school success, school absenteeism, family type, parents' status, income status, and social security, created significant differences in attachment scores (p<0.05). Adolescents' attachment levels are affected by many factors, such as social relationships, academic success, health status, gender, economic conditions, and family structure. In this context, it is recommended to organize educational programs to raise awareness about attachment for adolescents and their families and to support healthy attachment.
There is a rise in invasive fungal infections (IFI) in neonates and children. Mucormycosis is the third most common cause of IFI following Candida and Aspergillus, with a notable increase in incidence in recent years. We present the case of a 15 year old immunocompetent boy who presented with acute gastric fundus perforation, requiring emergency surgical intervention. Histopathological examination and culture of the resected specimen showed evidence of Mucormycosis. Despite appropriate antifungal therapy and surgical interventions, his condition progressed and ultimately proved fatal. The recognition of Mucormycosis can be challenging and requires a high level of suspicion. The infection can have fatal consequences and carries a grave prognosis even with aggressive treatment, including combination antifungal agents and surgical treatment.
Background: Nephrotic syndrome, characterized by glomerular damage, primarily affects children. While renal symptoms have been extensively studied, there is growing concern about cardiac complications, particularly the prolongation of the QTc interval, which can increase the risk of ventricular arrhythmias and sudden cardiac death. This study aimed to assess the QTc interval in children diagnosed with nephrotic syndrome and explore the factors affecting QTc prolongation. Methods: A descriptive cross-sectional study was conducted on 42 children aged 2-10 years diagnosed with nephrotic syndrome in Mashhad from 2019 to 2020. Data on age, gender, and blood samples to measure the levels of albumin, calcium, and magnesium were taken. Electrocardiograms were used to measure QTc intervals, which were calculated using Bazett's formula. Statistical analyses were performed to determine the relationships between QTc intervals and various clinical parameters. Results: The mean age of participants was 77.54 +/- 31.34 months, with 66.7% male and 33.3% female. The mean QTc interval was 0.449 +/- 0.053 seconds, with 52.4% of participants exhibiting prolonged QTc intervals. There was no significant difference in QTc interval based on age, duration of disease, albumin, calcium, or magnesium levels. However, females had a significantly higher mean QTc interval compared to males (0.460 s vs. 0.440 s). Conclusion: A significant proportion of pediatric patients with nephrotic syndrome exhibited prolonged QTc intervals. While QTc prolongation was not associated with age, duration of disease, or levels of albumin, calcium, and magnesium, it was significantly higher in females. These results underscore the importance of QTc interval monitoring in children with nephrotic syndrome, particularly among female patients.
Purpose: To describe how rehabilitation care is organized for young patients (4-25 years) with acquired brain injury (ABI) in Dutch outpatient rehabilitation centers (RCs). Due to differences between RCs in terms of history/culture, team composition/expertise, and collaborative networks, variations in de provision and content of care between RCs are expected. Methods: Inthis cross-sectional-survey-study, professionals from RCs were invited to complete a 21-item-questionnaire (12 yes/no-& 9 corresponding open-ended-questions) on the organization of rehabilitation care for young patients with ABI. Three topics were: admission/discharge criteria (n=2&2), rehabilitation treatment (n=7&5), and aftercare (n=3&2). Answers to yes/no-questions were descriptively analyzed, and open-ended-questions were thematically categorized. Items being present or absent and thematically analyzed answers were noted as numbers/percentages per RC. Results: Twelve RCs participated. Regarding admission/discharge criteria, only the item "having an ABI diagnosis" was present in all RCs (100%), whereas the other five admission criteria were present in 25-42% of RCs. Discharge criterium "attainment of goals" was present in 83% of RCs. Regarding rehabilitation treatment, all RCs (100%) described the presence of "specialized teams" and "diagnosis-specific consultation appointments". Sixty-seven percent of RCs have "general ABI-treatment protocols" and "young adult transition-teams". Concerning aftercare, structural end-reports, standard appointments at discharge and follow-up with physicians were present in all RCs (100%), but discharge and follow-up timing (between 6 weeks-12 months) and frequency (e.g., once a year) all differed. Conclusions: Despite similarities across Dutch RCs, there were differences in the provision and content of rehabilitation care regarding admission/discharge criteria, organization of rehabilitation treatment, and aftercare. Gaining insight into differences may help to reach consensus regarding 'best practice' on the organization of rehabilitation care for young patients with ABI.
Background and Clinical Significance: This case report explicates the implementation and outcomes of the Homeostasis-Enrichment-Plasticity (HEP (R)) Approach in a 10-month-old male infant with an increased risk of Autism Spectrum Disorder (ASD) who exhibited challenges in sensory functioning and motor development. Case Presentation: The intervention was carried out utilizing the eleven-step HEP (R) Approach process. The Peabody Developmental Motor Scale-2 (PDMS-2), Test of Sensory Function in Infants (TSFI), Adaptive Behavior Assessment System-3 (ABAS-3), and Goal Attainment Scale (GAS) were used as outcome measures before and after the intervention. A pediatric physical therapist conducted an hour-long intervention weekly for 10 weeks using the HEP (R) Approach implementation guide. Post-intervention, the infant's fine and gross motor skill scores in the PDMS-2 and General Adaptive Composite in the ABAS-3 exhibited significant improvement, as determined by the 95% confidence interval overlap analysis. The TSFI total score also improved categorically. An overall GAS score of +1.6 corresponded to a t-score of 74.12, indicating significant progress towards the individualized intervention goals. Conclusions: The HEP (R) Approach enhanced motor development, sensory functioning, general adaptive skills, and parental goals in a 10-month-old infant at risk for ASD. The results support further examination of the HEP approach's effectiveness in infants at risk for ASD.
Our objective was to explore the factors associated with the prognosis of allergic asthmatic children with poor compliance with subcutaneous immunotherapy (SCIT). A telephonic follow-up was conducted in 616 asthmatic children who received SCIT treatment from June 2005 to October 2010. The status of asthmatic controlled was based on their level of asthma symptom control when they were followed-up. Seven factors, including sex, age, family history of allergic disease, severity of mite allergy, times of SCIT, whether inhaled corticosteroids regularly, and with rhinitis or not, were analyzed. In total, 322 asthmatic children discontinued the 3-year course of SCIT. Of the 127 children included in the final analysis, 85 (66.9%) were asthmatic controlled patients and 42 (33.1%) were asthmatic uncontrolled patients. The median (interquartile range) age of the 127 asthmatic children was 7.1 +/- 4.8 years. The proportion of male and female was 87/40. In the seven factors, family history of allergic diseases ( p = 0.035), whether inhaling corticosteroids regularly ( p = 0.007), were significantly related to the level of asthma symptom control, whereas the age of these asthmatic children, severity of mite allergy, times of SCIT, and asthma with rhinitis or not had no relation to the level of asthma symptom control. Our findings revealed that the family history of allergic diseases was an important factor affecting the prognosis of childhood asthma, and inhaling corticosteroids regularly after discontinuing SCIT could significantly improve their prognosis. These results could provide value in clinical asthma treatment.
A significant etiological factor for upper respiratory tract infections and community-acquired pneumonia is Mycoplasma pneumoniae . The incidence of extrapulmonary neurological problems in infected patients has been shown to range from 0.1 to 7%, often manifesting within a timeframe of 2 to 14 days following the onset of respiratory symptoms. Acute disseminated encephalomyelitis, Guillain-Barr & eacute; syndrome, and transverse myelitis are among the immune-mediated illnesses encompassed under the syndrome. A 3-year-old male child exhibited symptoms of acute encephalopathy and behavioral disruption subsequent to an infection caused by M. pneumoniae . He presented with irritability, sleep disturbance, slurred speech, increased appetite, episodes of unresponsiveness, moving in circles, staring, and laughing episodes lasting for up to 15 to 30 minutes over a week. He lost his previous toilet training. Abnormal jerks were noted while awake and asleep. Symptoms were preceded by exposure to vague febrile illness 3 weeks prior to presentation. The patient's brain magnetic resonance imaging was normal. Electroencephalography showed a slow background with no epileptiform discharges. Cerebrospinal fluid analysis and polymerase chain reaction for viruses were negative. The workup for autoimmune encephalitis was negative. Mycoplasma serology IgM was detected. Marked improvement was noted after methylprednisolone pulse therapy, intravenous immunoglobulin, valproic acid, and azithromycin. In conclusion, our report serves as a reminder that M. pneumoniae infection is a possible cause of encephalopathy and behavioral disturbance in children. Early recognition and promotion of immunomodulatory and antimicrobial treatment can prevent the affected child from experiencing different levels of long-lasting impairments in cognitive, physical, or visual abilities.
Ureaplasma urealyticum (Uu) has rarely been described as a cause of ventriculitis in preterm infants. We report a preterm infant in whom Uu was detected in the tracheal secretion. Concurrent intraventricular hemorrhage III° with posthemorrhagic hydrocephalus occurred, necessitating the bilateral insertion of ventriculostomy access devices for treatment. Persisting high cerebrospinal fluid (CSF) protein and pleocytosis in the otherwise clinically unremarkable neonate subsequently led to the targeted detection of Uu in the CSF. Normalization of CSF parameters occurred only after prolonged intravenous and oral macrolide therapy.
Sleep is a complex biological and physiological process that allows the body to rest in addition to playing an important role in proper homeostasis in different body systems such as immune, metabolic, cardiovascular, neurological, and hormonal. It is important to preserve the quality of sleep, for adequate vitality, since the alterations that occur in any of the phases of sleep have repercussions on several systems of an organism, whether they are short or long term, such as the negative effect of sleep deprivation on the hormonal and metabolic regulation of various pathophysiological processes that will contribute to the development of obesity in pediatric patients. It has been found that sleep-related problems are common in children, being a frequent reason for medical consultations. In addition to the aforementioned, there may also be alterations at the level of the cortex, which is associated with the nonregulation of emotions in preadolescent and adolescent pediatric patients. Finally, sleep could depend on polymorphisms that become risk alleles for having short-term sleep; likewise, there are genes that have a greater expression at the time of rest, which allows a relationship to be made with diseases developed in the face of sleep depletion. This article describes the clinical implications in pediatric patients as a consequence of sleep deprivation and its genetic bases.
Premature infants with respiratory distress syndrome (RDS) are typically administered surfactant via the intubation and extubation procedure (INSURE). A variety of surfactant administration practices are available today. The term “SURE” (surfactant without endotracheal intubation) refers to any approach that requires direct laryngoscopy but uses a narrow catheter instead of an endotracheal tube. They include Take Care, LISA (least invasive surfactant administration), and MIST (minimally invasive surfactant therapy). MIST approaches avoid intubation while minimizing airway damage and barotrauma. This study sought to determine the practicality, effectiveness, and security of using the MIST approach to administer surfactant to premature infants with RDS. The study examined 90 preterm infants who were born before 36 weeks with respiratory distress and were able to breathe on their own. They were divided into two groups of 45 infants each: the MIST and INSURE groups. Both surfactant administration procedures were tested to determine their impact on morbidity and mortality in newborns. The study revealed no noticeable differences between both groups in maternal or newborn factors. Still, the MIST group exhibited a significantly decreasing necessity of mechanical ventilation (MV), had shorter MV and continuous positive airway pressure durations, and significantly reduced periventricular–intraventricular hemorrhage (PIVH) and death. The MIST procedure is pragmatic and reliable, and it decreases the need for MV and mortality in preterm infants who need surfactant treatment. It decreases the occurrence of PIVH in susceptible subgroups.
Background In patients with complicated appendicitis, interval appendectomy (IA) with a single broad-spectrum antibiotic sometimes fails. We reviewed our experience of adding metronidazole (MNZ) in such situations. Methods Medical records of children with an appendiceal mass treated with broad-spectrum antibiotics followed by IA from March 2009 to May 2019 were reviewed. In the latter period (after April 2015, Group L, n = 14), MNZ was added if symptoms were not improved by a 3- to 4-day course of antibiotics. The body temperature, white blood cell count (WBC), serum C-reactive protein (CRP), treatment failure, and hospital stay for the initial treatment were collected in the earlier period (Group E, n = 14) and Group L. Results There was no treatment failure. Group E tended to require a longer hospital stay (14.0 vs. 11.1 days, p = 0.099); however, the temperature, WBC, and CRP on admission were not significantly different. In the MNZ-added group (n = 8), the mean rate of change (per day) in WBC before and after the addition of MNZ were −288 ± 1,155 and −3,870 ± 1,634, respectively (p = 0.001). All patients underwent IA in about 3 months. Conclusions This preliminary study may indicate the efficacy of MNZ combined with a broad-spectrum antibiotic followed by IA for intractable appendiceal masses.
Attention deficit hyperactivity disorder (ADHD) is the most common developmental disorder among school-aged children. A multimodal treatment approach is the most effective approach for ADHD children. Parent intervention group activities help parents with ADHD children develop a good mindset toward their child and help develop skills to design appropriate parenting strategies. Our objective was to study the effect of growth mindset activities on reducing behavioral problems of ADHD children and factors associated with stress among parents of children with ADHD. A randomized controlled trial was conducted and parents of ADHD children aged 7 to 15 years were divided into the experimental and the control groups. The experimental group participated in mindset and communication intervention activities for 3 hours each, while the control group received only initial knowledge and guidance. Baseline data were collected in the beginning of the trial and at 2 and 6 months after starting the trial. Fifty parents with a mean age of 40.14 +/- 8.28 years were divided into two groups. After 6 months, the mean mindset scores of the experimental group were statistically significantly higher than those of the control group (p-value = 0.014) and the impulsiveness score decreased by 2.46 +/- 1.19 points (p-value = 0.05). The associated factors affecting parenting stress are their own mindset and their child's rebellious behavior. Parent intervention group activities help adjusting parents' mindsets and reduce impulsive behavior in children at 6 months of the trial. A child's rebellious behavior is the best predictor of parental stress, followed by the parents mindset.
The coronavirus disease 2019 (COVID-19) pandemic has raised concerns regarding food availability and access. The aim of this study is to describe feeding practices and associated factors in Colombian families with members younger than 18 years at the beginning of the 2020 quarantine. This is an observational, descriptive, cross-sectional study. An online survey was administered to parents or caregivers of minors younger than 18 years in Colombia, focusing on feeding practices. The analysis consisted of three steps: first, estimation of descriptive statistics; second, multiple correspondence analysis to derive an index for each main meal; and finally, generalized linear models were applied to each main meal index, incorporating predictors to explain changes in food consumption. A total of 1,419 participants were included. Among them, 654 (46%) indicated changes in their feeding practices during the quarantine due to reasons such as lack of funds, portion reduction to stretch food, difficulty in shopping, and perception of limited variety in the market. The perceived lack of variety while shopping significantly affected the breakfast index ( p = 0.037), lunch index ( p = 0.037), and dinner index ( p = 0.001). Socioeconomic level influenced the breakfast index ( p = 0.012) and lunch index ( p = 0.012) but not the dinner index. Nearly half of the surveyed families perceived changes in their feeding practices during the COVID-19 pandemic, which were linked to socioeconomic status and the perceived lack of variety while shopping.
Encephalitis, a severe central nervous system infection, poses significant morbidity and mortality risks. Etiologically, this condition can arise from infections or immune-mediated mechanisms, with varying causative agents across regions. Despite limited studies on pediatric encephalitis in Thailand, our retrospective cohort study aimed to discern the characteristics, outcomes, and prognostic factors influencing clinical results. We examined patients under 15 years of age admitted to Maharat Nakhon Ratchasima Hospital from January 1, 2007 to December 31, 2022, recording baseline data encompassing clinical manifestations, etiology, investigations, and treatments. The study defined outcomes in terms of morbidity, subsequent epilepsy incidence, and mortality rates evaluated via the modified Rankin Scale. Among 183 enrolled patients (age range 5 days to 15 years, mean age 7.4 years), males comprised 54.1%. Viral encephalitis (35.52%) and immune-mediated encephalitis (22.4%) emerged as the prevailing etiologies, with herpes simplex, dengue, and influenza virus as prominent viral pathogens. Anti-N-methyl-D-aspartame receptor encephalitis (56.1%) led among immune-mediated cases. Initially, 94.53% of patients displayed moderate-to-severe disability, while 45.7% exhibited clinical improvement within 6 months. Subsequent epilepsy ensued in 38.8% of cases, with an overall mortality rate of 19%, notably higher in viral encephalitis instances. Our findings underscore a predilection for viral pathogens in pediatric encephalitis cases, contributing to inferior prognoses. This study accentuates the necessity of understanding etiological patterns and prognostic markers to enhance clinical outcomes in this vulnerable population segment.
Preeclampsia (PE) is a prevalent disease especially in developing countries. PE influences maternal immune cells and cytokines, with prevailing of proinflammatory cytokines and reduction of regulatory cells. It has a short- and long-term impact on newborn mortalities and morbidities. The aim of this study is to provide an overview of previous literature discussing the effect of PE on infant immunity to help design future research. A comprehensive search was done on three databases including PubMed, Medline, and EMBASE with mesh and text terms. We could identify 851 titles published from 2000 to the time of search. Twenty-four studies met the inclusion criteria, and they were included in the quality assessment. Twenty-four studies were identified, covering the impact of PE on various neonatal immune cells and cytokines. PE is associated with a decrease in the number of several immune cells in newborns, particularly neutrophils, with enhancing cytotoxic effect of both neutrophils and natural killer (NK) cells. Treg cells were considerably reduced with increase of cytotoxic T cells CD8+ and memory cells CD45RO+ in both CD4+ and CD8 + . Proinflammatory cytokines like IL6, IL8, and TNF were raised in severe PE. PE is linked to a decrease in regulatory immune cells and an increase in the immune cells' cytotoxic capability, as well as the prevalence of proinflammatory cytokines in newborns. These changes were observed in cord blood and peripheral blood samples; however, future research should investigate the long-term effect of PE on neonatal immunity.
Retraction An investigation by the publisher found a number of articles, including this one, published in Journal of Child Science in Volume 13, Number 01, e62–e64, on May 04, 2023 (DOI: 10.1055/s-0043-1768636), with a number of concerns, including but not limited to undeclared conflicts of interest and manipulated peer review procedures. As a result, the publisher has retracted and removed this article.
