Childhood Research Articles

Health-related quality of life among survivors of cancer in children

Over the past decades, substantial improvements in diagnostics, treatment, techniques and pharmacotherapy have resulted in a steadily increasing population of childhood cancer survivors.Health-related quality of life (HRQoL) of survivors has gradually become the focus of attention.Survivors of cancer in children will face a range of problems, such as physical, psychological and social pressure brought by the disease, growth and development disorders, gonadal dysfunction and late effects (organ dysfunction and secondary cancer). Previous studies have shown that the HRQoL of cancer survivors is significantly lower than that of the normal people, but some studies dedicated that the cancer experience may have a positive impact on the HRQoL of survivors.The quality of life questionnaires is widely used to evaluate HRQoL from the aspects of physical health, mental health and social health.Information from observational, cross-sectional, but particularly longitudinal studies, is needed to further describe HRQoL of cancer survivors in children, as well as provide a foundation for the development of intervention studies.More relevant studies are expected to provide evidence-based basis in making clinical decisions. Key words: Cancer; Survivors; Health-related quality of life; Child

Infant Sleep Problems Linked to Later Emotional Disorders in Children

Sleep problems, common in infancy, have been associated with emotional and behavioral issues in early childhood. However, it is unknown whether such

The Association of Sleep Habits and Obesity in Children

Abnormal sleep habits are associated with childhood obesity in some studies, but most focus on sleep duration only and suffer from a lack of

Update on Worldwide Trends in Occurrence of Childhood Type 1 Diabetes in 2020.

Epidemiological data on pediatric type 1 diabetes (T1D), mainly incidence, have become increasingly available since the second half of the 20th century. Comparative incidence data across populations were only obtained since the 1980s. The 2019 IDF Atlas provides T1D incidence, prevalence and mortality estimates for children < 15 years for all 211 countries, but actual data were available for only 94 countries (only 3 low-income). The estimated prevalent cases were 600,900 and incident cases 98,200. Incidence remains highest in Finland (60/100,000/ year), Sardinia and Sweden, followed by Kuwait, some other northern European countries, Saudi Arabia, Algeria, Australia, New Zealand, USA and Canada. The lowest incidence is seen across East and South-East Asia. Globally, the average increase in incidence has been 3-4%/year over past decades, being steeper in low-incidence countries. Although T1D mortality has drastically decreased, there is still a higher risk compared with the non-diabetic population, especially in people with diabetic nephropathy.

Lateralized exanthem in childhood: let's recognize it!

Lateralized exanthem in childhood: let's recognize it!

Is High-Dose Vitamin D Supplementation During Pregnancy Beneficial for Childhood Bone Health?

Prenatal supplementation with 400 to 600 IU vitamin D is currently recommended — but is high-dose maternal supplementation even better for skeletal and

Trauma-informed care for people presenting to the emergency department with mental health issues.

There is a high prevalence of exposure to traumatic events in childhood among people who have mental health issues. Presentation to the emergency department (ED) can be challenging for these patients because the environment and their experience of care can trigger traumatic memories. Trauma-informed care is an approach to practice that is guided by knowledge of how trauma affects people's lives and their healthcare needs. Despite the increasing prevalence of mental health care delivery in EDs, the level of translation of trauma-informed care into nursing practice in this setting is largely unknown. Therefore, the authors undertook a narrative literature review, the aim of which was to gather evidence relevant to trauma-informed care in the ED and provide guidance on this practice for emergency nurses. Several databases were searched, and the relevant articles found were thematically analysed. Three emergent themes were identified from the literature: an access point for mental health care; staff attitudes; and the ED experience. Emergency nurses need to be aware of the effects of childhood trauma on people presenting with mental health issues and plan their approach to care to avoid potentially re-traumatising patients.

Clinical characteristics and prognosis of childhood acute lymphoblastic leukemia complicated with EB virus infection

Objective To explore the clinical features and prognosis of childhood acute lymphoblastic leukemia(ALL) complicated with EB virus (EBV) infection. Methods The results of detection of EBV antibody and EBV-DNA in peripheral blood mononuclear cells of 196 children with ALL diagnosed in Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from January 2015 to January 2019 were collected. According to the results, 196 children with ALL were divided into EBV infection group and non-EBV infection group. The hepatomegaly and splenomegaly, chromosome, peripheral blood routine, immunophenotyping, clinical risk, secondary infection during chemotherapy, minimal residual disease (MRD) of day 46 after chemotherapy, karyotype, and prognosis were compared between the two groups. The children were followed up until April 30, 2019. Results Among 196 children with ALL, EBV infection rate was 72.96% (143/196). The EBV-DNA level [median (P25, P75)] of peripheral blood mononuclear cells was 3.7×103 copies/L(1.6×103 copies/L, 8.8×103 copies/L). The incidence of hepatosplenomegaly (subcostal ≥ 5 cm) in EBV infection group was higher than that in non-EBV infected group [14.69% (21/143) vs. 3.77% (2/53), χ 2= 4.45, P= 0.035]. There was no significant difference in the number of white blood cells and the incidence of abnormal karyotype between EBV infection group and non-EBV infection group (both P > 0.05). The secondary infection rate in EBV infection group was higher than that in the non-EBV infection group [41.96% (60/143) vs.24.53% (13/53), χ2= 5.03, P= 0.025], and the remission rate of day 46 in EBV-infection group was lower than that in non-EBV infection group [80.42% (115/143) vs. 98.11% (52/53), χ2= 9.60, P= 0.020]. The recurrence rate in EBV-infection group was higher than that in non-EBV infectious group [11.89% (17/143) vs. 1.89% (1/53), χ2= 4.64, P= 0.031], and there was a significant difference in the component ratio of immunophenotyping and clinical risk between the two groups (both P < 0.05). Conclusions The hepatosplenomegaly in children with ALL complicated with EBV infection is obvious, the secondary infection rate is high, the remission rate is low, the recurrence rate is high, and the prognosis is poor. EBV infection may be related to immunophenotyping and clinical risk in children with ALL, and has nothing to do with the abnormal karyotypes. Key words: Leukemia, lymphoid; Herpesvirus 4, human; Epstein-Barr virus; Child; Clinical features; Prognosis

Secondary therapy-related acute megakaryocytic leukemia in childhood acute lymphocytic leukemia: report of one case and review of literature

Objective To explore the laboratory characteristics and diagnostic methods for therapy-related acute megakaryocytic leukemia (t-AMKL). Methods The data of one child with acute lymphoblastic leukemia (ALL) in the Blood Disease Hospital of Chinese Academy of Medical Sciences & Peking Union Medical College in September 2014 was retrospectively analyzed. After inducing remission for more than 43 months, the child was diagnosed as t-AMKL. Results After the diagnosis of ALL, the child was given chemotherapy with standard childhood ALL regimen. After 43 months, t-AMKL was diagnosed by comprehensive morphology, cytogenetics, and molecular biology. Bone marrow morphology showed that the proportion of primitive cells was 0.44; flow cytometry showed the phenotype was abnormal myeloid primitive cells; the pathology result showed that the abnormal cells weakly expressed CD42b and CD61; the electron microscopy showed platelet peroxidase (PPO)-positive and myeloperoxidase (MPO)-negative; the bone marrow immunohistochemistry showed the positive rate of CD41 was 34%; the child had a complex karyotype. After reviewing his medical history, he was diagnosed as t-AMKL. Conclusion The t-AMKL is relatively rare, and it is helpful to improve the prognosis of patients by completing the relevant examinations for early diagnosis. Key words: Leukemia, lymphoid; Child; Leukemia, megakaryoblastic, acute; Neoplasms, second primary; Diagnosis

Analysis of clinical efficacy and prognosis of childhood T-cell acute lymphoblastic leukemia

Objective To evaluate the treatment efficacy of children with T-cell acute lymphoblastic leukemia (T-ALL) and to explore the prognostic risk factors. Methods The clinical and laboratory data of children with newly diagnosed T-ALL in Children's Hospital of Fudan University and Children's Hospital of Shanghai from January 2002 to December 2014 were retrospectively analyzed and compared with children with newly diagnosed B-cell acute lymphoblastic leukemia (B-ALL) in the same period. The treatment protocols were based on the combination of the Berlin-Frankfurt-Munster (BFM)-ALL regimen with chemotherapy. The treatment response and infection of the children were observed. Cox proportional hazard regression model single-factor and multifactor analysis were used to evaluate the prognostic factors. Results Seventy-one children with T-ALL and 333 children with B-ALL were enrolled. The clinical features including gender, age, central nervous system leukemia as well as the white blood cell count at first diagnosis were significantly different between the two groups (all P 0.05). The difference of EFS curves between children with early T-precursor (ETP)-ALL and non-ETP ALL was statistically significant (P= 0.044). The most common infection site was respiratory tract [63.9% (186/291)], and the gram-negative bacteria accounted for 43.5% (20/46). Cox univariate analysis showed that prednisone poor response, bone marrow non-remission on day 33 of induction-therapy, relapse and sepsis were prognostic risk factors for children with T-ALL (all P < 0.05), and Cox multivariate analysis showed that the latter three were independent prognostic risk factors (all P < 0.05). Conclusions The prognosis of children with T-ALL is worse than children with B-ALL, and T-ALL patients are prone to early relapse. The EFS of children with ETP-ALL is poor. Non-remission at the end of induction-therapy, relapse and sepsis are independent risk factors for prognosis. Key words: Leukemia, T-cell; Child; Prognosis; Clinical feature

Adherence to Growth Monitoring Procedures by Health Workers at Primary Health Care Clinics in Mopani District, South Africa

The inconsistency in performing growth-monitoring procedures leads to faulty interpretation of children’s growth patterns, resulting in unreliable statistics and inaccurate information being forwarded to policy makers. The aim was to evaluate the growth monitoring procedures for children under the age of five in the Mopani District using the Integrated Management of Childhood Illnesses (IMCI) protocol. The study took place in the Mopani District situated in Limpopo Province. The study was descriptive and observational and used quantitative techniques. Twenty-four (23.5%) clinics were randomly selected from 85 clinics in the study area. The researcher observed and recorded growth monitoring and other child health procedures used by health workers at the primary health care (PHC) clinics on the day of the visit, using an observation checklist. One of the health workers involved in the services for the under-five on the day was interviewed. Basic equipment needed for growth monitoring at PHC clinics was available and health workers knew exactly what was expected from them when implementing the IMCI protocol. There was inconsistencies in conducting anthropometric measurements. Recording the information of the weight on the Road-to-Health charts was done erroneously. In conclusion norms and standards as set out in the IMCI protocol are clear and the majority of health workers, had the necessary skills to conduct growth monitoring. The study recommends training of health workers on the completion of Road-to-Health charts.

“SHE DOES NOT CONTROL ME ANYMORE BUT I CAN HEAR HER VOICE SOMETIMES” - A PHENOMENOGRAPHIC RESEARCH ON THE RESILIENCE PERCEPTIONS OF CHILDREN WHO HAVE SURVIVED FROM UPBRINGING BY A NARCISSISTIC PARENT

This study researched how to survive and lead a healthy life after exposing to a narcissistic parent’s upbringing. The especial focus was to analyze survival and coping in the light of resilience. This was a phenomenographic research in which adults (N=13) who had lived their childhood with a narcissist parent wrote about their experiences and perceptions of survival. The following research question was set for this study: How do the perceptions of adults, who have survived from narcissistic upbringing, evince resilience? The analysis showed that resilience appeared in five categories according to the research participants’ perspectives. The categories were academic, functional, emotional, social, and physical resilience which all had specific sub-categories. An illustration about resilience in children of narcissistic parents is introduced as conclusion. Article visualizations:

Application effect of Omaha system in the whole-path management of childhood asthma

Objective To explore the effect of Omaha system in the whole pathway management of childhood asthma. Methods A total of 120 children with asthma admitted to this hospital from January 2016 to March 2018 were selected and divided into study group and control group with 60 cases each by random number table method.The control group was given basic management, while the research group was given Omaha-based full-path management.The management effect of the two groups was compared. Results The total satisfaction rate of the two groups was significantly higher than that of the control group(P<0.05). The C-ACT score of the study group after intervention(25.82±2.06) was significantly higher than that of the control group, the levels of PEF(82.32±2.32)% and FEV1(87.66±1.74)% were significantly higher than those of the control group, and the difference between the two groups was statistically significant(P<0.05). After intervention, the C-ACT score(25.82±2.06) in the study group was significantly higher than that in the control group, and the levels of PEF(82.32±2.32)% and FEV1(87.66±1.74)% in the study group were significantly higher than those in the control group, with significant differences between the two groups(P<0.05). The scores of quality of life including emotional function(44.25±8.96), activity(25.68±4.17) and symptoms(40.43±9.29) in the study group were significantly higher than those in the control group, with a significant difference between the two groups(P<0.05). Conclusions The application of Omaha system in the whole-path management is beneficial to the control of asthma in children, significantly improve the respiratory function of children, and significantly improve their quality of life, and the management effect is good, worthy of recommendation. Key words: Childhood asthma; Full-path management; Omaha system

Evaluation of Speech Processing Capability in Computer Games to Improve the Process of Learning English Pronunciation: An Action Research

Introduction: Computer games are a proper approach for information transfer and education. Childhood is the best time to learn a second language and computer games are an attractive interactive tool for this purpose. The purpose of this study is to investigate the ability of speech processing in computer games to improve the process of English language learning and design a game in this regard. Materials and Methods: This was a library-based study to retrieve English and Persian studies in this field and, on the basis of previous studies, a game was designed for children on android platform in the Unity environment using C # language. The child was able to choose a group of words based on color, object, and so on. The game was able to analyze the child’ pronunciation and provide feedback to correct it. Results: 50 popular smartphone-specific commercial language learning applications were comprehensively analyzed and three main characteristics were identified for them: the programs were designed to teach words independently, were tailored to the learner’s least skill, and rarely provided learners with corrective feedback. Conclusion: The proposed software seems to be able to be suggested for correcting English pronunciation of individual words in children aged 8 to 10 years in educational centers and language institutes and even at home.

Efficacy and safety of vitamin D as adjuvant therapy for childhood pneumonia: a Meta analysis

To study the efficacy and safety of vitamin D as an adjuvant therapy for childhood pneumonia through a systematic review. Cochrane Library, PubMed, EMbase, CNKI, Wanfang Data, and Weipu Data were searched for randomized controlled trials (RCTs) of vitamin D as the adjuvant therapy for childhood pneumonia published up to August 2019. Literature screening, quality assessment, and data extraction were performed based on inclusion and exclusion criteria. Revman 5.3 was used to perform the Meta analysis of outcome indicators. A total of 7 RCTs with 1 527 children were included, with 762 children in the vitamin D adjuvant therapy group and 765 children in the control group. The results of the Meta analysis showed that vitamin D adjuvant therapy had no effect on recovery time (P=0.67), length of hospital stay (P=0.73), and time to relief of fever (P=0.43). Furthermore, it did not reduce the recurrence rate (P=0.14), rate of adverse events (P=0.20), and mortality rate (P=0.98) of childhood pneumonia. Current evidence shows that vitamin D adjuvant therapy has no marked efficacy in the treatment of childhood pneumonia.

Early mortality from malignant mesothelioma in Italy as a proxy of environmental exposure to asbestos in children.

Malignant mesothelioma (MM) is a rare neoplasm caused by asbestos. Mortality from MM in ≤50 years old people, considering the long latency, is likely related to asbestos exposure in childhood. Mortality from MM (C45, ICD10 code) is described among ≤50 years (ys) old people in Italy, in 2003-2016. National and regional Standardized Rates (SRs) were computed by age-class. The North-South trend of regional SRs, increasing in >50ys age-class, showed a flat cline in ≤50ys old people. Municipal Standardized Mortality Ratios (SMRs) were computed, with respect to regional figures, for ≤50 ys old population. In Italy, 487 people ≤50 ys old died from MM, in 2003-2016 (2.5% of all MM deaths), corresponding to 35/year. The highest SMRs were observed in Northern Regions, the most industrialized areas. Exceeding SMRs were found in 10 municipalities where former asbestos-cement plants, shipyards, and a quarry contaminated by fluoro-edenite fibres were present. Early mortality from MM, proxy of childhood environmental asbestos exposure, deserves particular concern.

Wake-up call: 10 years remaining to address inequalities on right to health for all

The millennium development goals sought to create a global movement to achieve targets in key areas of health and development. The problem is, we failed to reach most of them.1 Among those missed were important health related targets: reductions in undernutrition, mortality in children under 5, maternal mortality, and incidence of HIV, malaria, and tuberculosis as well as improvements in reproductive health. Inequalities between women and men and uneven progress between wealthy and poor populations largely account for the failure. The sustainable development goals (SDGs) provide a second opportunity to improve health outcomes around the globe.2 If current trends persist, however, we will miss the mark again. For example, although we have achieved progress in reducing under 5, neonatal, and maternal mortality in the past two decades, in recent years maternal mortality has been stagnant in many high burden countries and neonatal mortality has declined at a slower pace.34 The BMJ and BMJ Global Health collection Leaving No One Behind (www.bmj.com/leaving-no-one-behind) shows the improvements we have made in expanding the coverage of key interventions in sexual, reproductive, maternal, newborn, child, and adolescent health and highlights our ongoing challenges. For example, progress has slowed in immunisation and the treatment of childhood illnesses such as pneumonia and diarrhoea, and little progress has been made on curbing gender based violence. An overall lack of data is a further barrier, inhibiting our ability to make evidence based investments in healthcare systems. Although delivery of these key health interventions is largely based on improving primary healthcare services, overall we are still far behind our …

Pathogenesis and management of non-alcoholic fatty liver disease in children

Non-alcoholic fatty liver disease(NAFLD)refers to a wide spectrum of liver diseases ranging from simple fatty liver to non-alcoholic steatohepatitis, which in turn can evolve into cirrhosis and end stage of liver disease.With the prevalence of childhood obesity worldwide, obesity and its related complications have become important factors endangering children′s health.As a manifestation of metabolic syndrome in the liver, NAFLD has become one of the most common liver diseases in children.Its occurrence and development may be the result of genetic susceptibility, genetic polymorphism, obesity, insulin resistance, cytokines, intestinal flora imbalance and other factors.Current treatments for NAFLD include lifestyle changes, medications, and surgery.This article reviews the epidemic trend, possible pathogenesis and treatment progress of NAFLD in children. Key words: Non-alcoholic fatty liver disease; Obesity; Children; Pathogenesis; Management

Nephrotic syndrome and atopic diseases in children

Nephrotic syndrome is a common glomerular disease in childhood and easy to recur.It has been found that children with nephrotic syndrome are often accompanied by atopic manifestations and there is high co-morbidity between nephrotic syndrome and atopic diseases.This article reviewed the pathogenesis, cytokines and treatment of nephrotic syndrome and atopic diseases in children to explore the similarity between them to provide new clues and methods for the treatment of nephrotic syndrome in children. Key words: Children; Nephrotic syndrome; Atopic diseases; Similarity

Childhood IQ and mortality during 53 years’ follow-up of Swedish men and women

背景 儿童时期以智商水平（IQ）测试为标准的认知能力和死亡率之间的相关性有了正式的研究报告。然而，这种相关性在女性中的研究很少，且有争议，而且其内在相关性的机制也不明确。 方法 本研究收集了出生于1948年和1953年的19 919名男性和女性13岁时在学校的IQ数据。通过国家登记注册，收集了这些参加者的儿童期社会经济地位信息，以及截至2013年，参加者的中年时期的社会经济地位、社会环境状况和死亡率信息。 结果 较低的IQ水平与成年期全因死亡率增高有关，其中男性有1 070名参加者[危害比（HR）1.31，95%可信区间1.23~1.39，针对智商水平每下降一个标准差而言]，女性有703名受试者（HR 1.16，95%可信区间1.08~1.25）。IQ水平与男性由于严重事件导致的死亡率有关，与女性由于癌症和心血管疾患导致的死亡率有关。用儿童期的社会经济学因素进行校正后发现，成年人时期，在男性中这种相关性显著减小，在女性中这种相关性几乎完全消失。 结论 更低的IQ水平与男性和女性的死亡率增加有关。可以解释的社会经济学因素对成年人时期的影响，是促成IQ水平和死亡率相关性的重要因素，特别是在女性中。