Children Aged Years Research Articles

Effect of oral bad habit breath through the mouth with face shape in children

Habit is a pattern of behavior that is repeated; in the oral cavity is also known as oral bad habit and naturally occurs at the age of less than six years. Oral habit cancontinue at the age of more than six years which can cause abnormalities in the dentofacial structure. This article discusses the influence of the habit of breathing through the mouth on the shape of the face in children. With a literature review design, articles were collected using Google Scholar, Pubmed and ScienceDirectusing the keywords oral bad habit, mouth breathing, malocclusion. The selected articles are publications in 2015-2022, research subjects are children aged 6-12years, full-text available, and written in English and Indonesian. It was concluded that oral bad habits often occur in children and even in infants. Oral bad habitsinclude thumb sucking, nail biting, lip sucking, tongue pushing, and mouth breath-ing. Oral bad habits such as mouth breathing have an influence on theoccurrence of malocclusion, especially in children who are still in the growth and development stage, namely elementary school children.

Exploring Undergraduate Medical Student Experiences of Training Within a Community-Based Paediatric Clinic.

Undergraduate medical education in Ireland comprises ofclinical training largely within teaching hospitals, with less emphasis on training in community settings. Studies show a move beyond traditional models of training is needed, particularly in the domain of community child health. A multi-agency, inter-disciplinary community paediatric clinic was established in a disadvantaged area of southern Ireland. Kidscope provides health and developmental assessment for children aged 0-6years and acts as a training clinic for medical students who complete aone day placement during the final year of their undergraduate medical degree. The aim of this study was to capture student experiences and to understand the perceived impact of community-based training on undergraduate medical education. A descriptive study design was used. Research tools included a mixed-methods online questionnaire and qualitative reflective essays. Microsoft Excel generated descriptive statistics from quantitative questionnaire responses. Braun and Clarke's framework guided thematic analysis of qualitative data. Data integration and reporting were conducted in line with mixed-methods research design standards. Fifty-two medical students consented to participate. Thirty-two (62%) responded to the online questionnaire. Twenty reflective essays were randomly selected. Ninety-four percent felt the clinic provided an opportunity to apply knowledge and skills, 96% reported the experience strongly improved their understanding of child health and development, and 90% reported the experience was extremely valuable to their overall learning. Qualitative analysis showed engagement with a vulnerable population in the community increased student knowledge, informed practice, and heightened awareness of social deprivation and its impact on child development. Exposure to a community-based paediatric clinic influenced undergraduate medical student training through experiential and transformative learning. Our experience of teaching clinical skills in the community could be replicated across medical fields to the benefit of the wider community. The online version contains supplementary material available at 10.1007/s40670-022-01699-3.

A cross-sectional survey among parents to report challenges and barriers in the administration of drugs to children.

Background: Lack of knowledge among parents can result in inappropriate administration practices. After analyzing different studies among children, there was no data on challenges and barriers in the administration of drugs among children in this region because of the diverse environmental issues and challenges in the UAE. The objective of this study was to determine the reported administration practices of parents and challenges and barriers in the administration of drugs among children in UAE. Methods: A questionnaire-based survey was conducted. A convenience sampling technique was used to collect the data. An online Raosoft® sample size calculator was applied (n = 248). The inclusion criteria were parents who had a child under 10 years of age and gave consent to participate in this study. Children with vision problems, cognitive/physical disabilities, and caregivers other than parents were excluded from this study. Results: The study reported response rate of 73.2%. The mean ± S.D age of the parents in years was 35.5 ± 7.8, and the mean ± S.D of children aged years was 2.60 ± 1.54. The majority of parents (83.9%) completing the survey were mothers and resided in the city (97.2%). When the children did not like taking tablet drugs 41.9% used multiple practices and 26.2% of parents reported treatment failure due to oral drug administration. Around 47.6% of those who were interviewed reported that their children had swallowing problems during the administration of oral medication. A total of 22.2% of parents reported that they gave drugs in doses higher than prescribed by the doctor to treat their children more quickly. Similarly, a total of 64.5% of the parents reported self-medication without consultation from a healthcare provider. Conclusions: The study concluded that there were inappropriate drug administration practices among parents. Parents reported administration of higher doses to treat their children quickly.

Haematological Indices and Serum Ferritin as Diagnostic Tools for Anaemia among Village Primary Pupils in Kaduna state, Nigeria

Background: Anaemia is one of the major public health issues worldwide. Children in the developing world are vulnerable to iron deficiency anaemia (IDA) and iron deficiency (ID) because they are rising at a fast pace and consume diets low in iron. This study aims at assessing the level of anaemia in children aged 6-12years in rural Nigeria, using hematological indices and serum ferritin as diagnostic tools. Methods: This is a cross-sectional study carried out in two primary schools in Kumin Masara Kataf village in Kaduna state on schoolchildren aged 6-12years. Data collected include personal information and laboratory data such as haemoglobin content, and serum ferritin to determine iron status. Data analysis was done using IBM-SPSS Inc., Chicago, IL, USA version-25.0. Results: The overall mean haemoglobin was 10.11±1.02g/dl with 10.37±0.97g/dl and 10.02±1.02g/dl for children aged 10-12 and 6-9 years respectively (p=0.033). The overall serum ferritin was 15.37±4.87mg/L with 17.20±5.23mg/L among subjects aged 10- 12 and 14.72±4.58mg/L for 6-9 years (p=0.002). The prevalence of anaemia was 13.6%, IDA (50.3%), ID (30.9%), and iron depletion (5.8%). There was a significant difference between the prevalence of iron status according to age group (6- 9vs.10-12), P<0.05. Males had a higher prevalence of anaemia (69.2%) than females but females recorded a higher prevalence of IDA (51.6%) and ID (61.0%). Conclusion: This study found a high prevalence of IDA and ID among the rural schoolchildren in Nigeria. We recommend that healthcare providers should focus more on prevention of IDA at childhood rather than during pregnancy.

The Incidence and Risk Factors for Dry Eye After Pediatric Strabismus Surgery.

This study aimed to investigate the incidence and risk factors for dry eye after pediatric strabismus surgery. Children aged 5-12years who underwent strabismus surgery were included in this single-center, prospective, cohort study. The ocular surface assessments were conducted 1day before and 1, 4, and 8weeks after surgery. The main outcome measures were the incidence of dry eye after strabismus surgery and associated risk factors. A total of 84 eyes (48 children) that underwent strabismus surgery were included in the study. The mean age at surgery was 7.21years. The incidence of dry eye was 47.62% at 1week, 10.71% at 4weeks, 0% at 8weeks after surgery. The preoperative tear breakup time (BUT) was lower in the dry eye group than that in the non-dry eye group (P ≤ 0.01). The univariate analysis showed that preoperative BUT was significantly associated with the incidence of dry eye after pediatric strabismus surgery (odds ratio [OR] 0.647, confidence interval [CI] 0.503-0.833, P ≤ 0.01). Dry eye commonly occurs after pediatric strabismus surgery. Tear film instability is more common than deficient aqueous tear production in patients with dry eye after surgery. Children with a low preoperative BUT are more likely to develop dry eye after strabismus surgery.

Short-term effects of meteorological factors on childhood atopic dermatitis in Lanzhou, China.

Atopic dermatitis (AD) is one of the leading burdens of skin disease in children globally. Meteorological factors are involved in the onset and development of AD. Several studies have examined the effects of meteorological factors on AD, but their results are inconsistent, and the understanding of the link between AD and meteorological factors remains inadequate. In this study, a total of 19,702 children aged 0 to 14 visited the outpatient clinic for AD from 2015 to 2019 in Lanzhou, China. A distributed lag nonlinear model (DLNM) applies to evaluate effects of meteorological factors on childhood AD in Lanzhou, China, and further explored age and gender differences. It was found that extremely high or low temperatures, extremely high diurnal temperature range (DTR), extremely low relative humidity (RH), and extremely high wind speed (WS) increased the risk of outpatient visits for childhood AD. Effects of extremely high DTR and extremely high WS were more intense, with maximum cumulative risks of 2.248 (95% CI 1.798, 2.811) and 3.834 (95% CI 3.086, 4.759) at lag 0-21, respectively. Furthermore, the combination of low temperature and low RH can also contribute to the higher risk of childhood AD. For extreme temperatures, children aged 7-14years were more vulnerable. For extremely low RH, extremely high DTR and WS, boys and children aged 0-3years were more vulnerable. Public health departments should strengthen publicity and education about how meteorological factors affect childhood AD and develop sex- and age-specific preventative measures.

Effectiveness of Clinic-Based Brief Behavioral Intervention (BBI) in Long-term Reduction of ADHD Symptoms Among Preschoolers.

Preschoolers commonly experience symptoms of ADHD and disruptive behavior problems. Behavioral parent management training (PMT) is an evidence-based intervention for addressing both ADHD and disruptive behaviors in this population; however, many PMT programs are burdensome in length and have limited data regarding long-term effectiveness for ADHD specific outcomes. This study examined outcomes up to 1year following completion of a brief behavioral intervention (M = 6.51 sessions) for preschoolers. Participants were children aged 2-6years with clinically significant disruptive behaviors and their parents. Results demonstrated significant improvements in parent-reported child hyperactivity and inattention from pre-to-post intervention, with sustained improvement at 6months and 1year post intervention. Teacher-reported hyperactivity and inattention also showed significant improvements from pre-to-post intervention, which were maintained across time points. These results were also found among a subset of participants with clinically significant ADHD symptoms at baseline. This study highlights the long-term effectiveness of a brief PMT program to address symptoms of ADHD and disruptive behaviors in preschoolers. Findings support the recommendation to offer PMT as a first-line intervention for preschoolers with ADHD symptoms to reduce the need for early intervention with stimulant medication and address comorbid disruptive behaviors.

Emergence agitation in children: A comparison of effect of intravenous midazolam and ketamine

Background- Emergence agitation (EA) is one of the most challenging conditions to manage in pediatric patients undergoing general anesthesia with sevoflurane as it can even lead to physical harm. Various pharmacological interventions are being used in anesthesia to manage this condition. So, the objective of this study is to compare the effects of intravenous midazolam and intravenous ketamine given as premedication, on the incidence and severity of EA and to assess parent separation anxiety and postoperative pain and analgesic requirement in the 2 groups. Methodology- This is a randomized control trial consisting of 70 children aged 3-7years, 35 in each midazolam and ketamine group that received 0.05mg/kg of i.v. inj. midazolam and 1mg/kg of i.v. inj. ketamine respectively, undergoing general anesthesia with sevoflurane. Emotional status of the child assessed and then allocated into either group through a computer-generated programme. A blinded anesthesiologist assessed the incidence and severity of emergence agitation based on WATCHA scale and Children and Infant Postoperative Pain Scale (CHIPPS). Results- The mean WATCHA and CHIPPS scores were lower in ketamine group at all timepoints versus midazolam group (p<0.05 which is statistically significant).

Application of validated mapping algorithms between generic PedsQL scores and utility values to individuals with sickle cell disease.

There is a paucity of empirically estimated health state utility (HSU) values to estimate health-related quality of life among individuals with sickle cell disease (SCD). This study aims to map the Pediatric Quality of Life Inventory generic core scales (PedsQL GCS) to HSUs for children and adolescents with SCD in the United States, using published algorithms, and to assess the construct validity of these HSUs against SCD-specific PedsQL scores. We used the published mapping algorithms identified in four published articles, in which the PedsQL GCS was mapped to either the EuroQol-5 Dimension 3-Level, Youth Version or the Child Health Utility 9-Dimension to obtain HSUs. We employed the algorithms to calculate HSUs for a sample of children and adolescents from the Sickle Cell Clinical Research and Intervention Program. To assess the construct validity of the mapped HSUs in SCD patients, we computed Spearman's correlation coefficient comparing the HSUs with the PedsQL SCD total score and separately with each PedsQL SCD dimension-specific score. The mean mapped HSU across published algorithms was 0.792 (95% CI: 0.782-0.801). It was significantly higher among children aged 5-12years than children aged 13-17years. The Spearman's correlation coefficient for HSUs versus PedsQL SCD total scores was 0.64 (95% CI: 0.57-0.71). Correlations ranged from 0.40 (95% CI: 0.32-0.48) to 0.60 (95% CI: 0.54-0.66) for HSUs versus PedsQL SCD dimension-specific scores. The existing mapping algorithms show acceptable construct validity in children and adolescents with SCD. Additional algorithms are needed for adults and for specific SCD comorbidities.

An examination of effects of intimate partner violence on children: A cross-sectional study conducted in a paediatric emergency unit in Turkey.

Intimate partner violence (IPV) against women causes inadequate and unbalanced nutrition in children aged 0-5years and adversely affects their growth. To examine the impact of intimate partner violence on a child's growth regarding the medical diagnosis in paediatric patients under 5years of age, growth of the child, and the mother's exposure to intimate partner violence. This descriptive cross-sectional study included 166 children admitted to a paediatric emergency department, and their mothers. Women exposed to emotional violence and controlling behaviour during pregnancy had children prone to being overweight and obese. A mothers lifetime exposure to physical violence had an adverse effect on their children's wasting and moderate wasting. In contrast, mothers' exposure to emotional violence had a direct impact on a child's wasting and moderate wasting. The lifetime effect of domestic violence may begin at birth. This vulnerability leads to negative outcomes in both children and women regarding biopsychosocial development. Nurses and midwives in primary health care services and one-on-one care should be trained to evaluate prospective mothers and children aged 0-5 regarding violence and its effects on the child's growth.

Live-attenuated influenza vaccine effectiveness against hospitalization in children aged 2-6years, the first three seasons of the childhood influenza vaccination program in England, 2013/14-2015/16.

IntroductionIn 2013, the United Kingdom began to roll‐out a universal annual influenza vaccination program for children. An important component of any new vaccination program is measuring its effectiveness. Live‐attenuated influenza vaccines (LAIVs) have since shown mixed results with vaccine effectiveness (VE) varying across seasons and countries elsewhere. This study aims to assess the effectiveness of influenza vaccination in children against severe disease during the first three seasons of the LAIV program in England.MethodsUsing the screening method, LAIV vaccination coverage in children hospitalized with laboratory‐confirmed influenza infection was compared with vaccination coverage in 2–6‐year‐olds in the general population to estimate VE in 2013/14–2015/16.ResultsThe overall LAIV VE, adjusted for age group, week/month and geographical area, for all influenza types pooled over the three influenza seasons was 50.1% (95% confidence interval [CI] 31.2, 63.8). By age, there was evidence of protection against hospitalization from influenza vaccination in both the pre‐school (2–4‐year‐olds) (48.1%, 95% CI 27.2, 63.1) and school‐aged children (5–6‐year‐olds) (62.6%, 95% CI 2.6, 85.6) over the three seasons.ConclusionLAIV vaccination in children provided moderate annual protection against laboratory‐confirmed influenza‐related hospitalization in England over the three influenza seasons. This study contributes further to the limited literature to date on influenza VE against severe disease in children.

The development of training model of backstroke swimming skills for children age 8-10 years old

The research aims to result in the development of training model of backstroke swimming skills for children aged 8-10years. The subjects in this research and development were trainees of children aged 8-10 years in Elsa Nasution Swimming Club and Tirta Jaya Banten. The research method used was the research and development model from Borg and Gall. The data collection technique used was the result of expert validation and effectiveness test through an assessment instrument with t-test statistical data analysis. The results of research and development of Training Model of Backstroke Swimming Skills for Children Age 8-10 Years Old showed that (1) The Development of Training Model of Backstroke Swimming Skills for Children Age 8-10 Years Old Children significantly improved the backstroke swimming skills of trainees, (2) Based on data analysis the average pre-test value was 9.9 and the post-test average was 17.2, 2.233 t-value -20,679 with a significance level of 0.05, it can be said that the Development of Training Model of Backstroke Swimming Skills for Children aged 8-10 Years can improve backstroke swimming skills and effective to be applied in the process of backstroke swimming training for children age 8-10 years old.

Evaluation of electric pulp test thresholds and correct probe tip placement site in developing incisors: a clinical study in 1200 teeth.

Although electric pulp tests (EPT) may play a valuable diagnostic role in traumatized immature permanent teeth, the EPT threshold values which can be used as reference are not known. The aim of this study was to determine the average range of EPT threshold values in healthy permanent incisors according to their stage of root development. A total of 1200 permanent incisors were examined in 273 children (142 girls, 131 boys) aged 6-12years. Panoramic radiographs were used to group teeth according to the stage of root development. A digitest II pulp vitality tester (Parkell, Inc, Edgewood, NY) was used along with toothpaste as the conducting medium to determine sensibility on three different sites (incisal, middle and cervical third). In all teeth, mean EPT values showed a tendency to decrease along with advanced root development. Irrespective of the stage of root development, the lowest EPT values were obtained when measurements were made on the incisal third of the crown (p < 0.001). Mandibular incisors had lower mean response thresholds than their maxillary counterparts. The present findings provide reference EPT threshold values according to stage of tooth development to monitor the post traumatic pulp status of permanent incisors.

Effectiveness of Virtual Reality Interactive Play for Children During Intravenous Placement: A Randomized Controlled Trial

This study aimed to evaluate the effectiveness of an interactive virtual reality (VR) play intervention including instructional play and emotional catharsis play sessions in reducing children's pain and fear during intravenous placement. A randomized controlled trial with parallel groups was conducted. The sample consisted of 134 hospitalized children aged 6-12years (intervention group: n=69; comparison group: n=65). The intervention involved one immersive intravenous scene in VR before the actual intravenous placement and one emotional catharsis VR play after injection. The comparison group received an educational photo book about intravenous placement before receiving intravenous placement. The children and their caregivers rated their pain and fear by using the Wong-Baker FACES Pain Rating Scale and the Children's Fear Scale. The time required for successful intravenous insertion was also compared between the two groups. Children's pain (p = .028) and fear scores (p = .004) were significantly lower in the intervention group than in the comparison group. Their caregivers' pain and fear scores (both p<.001) were significantly lower in the intervention group. The time required for successful intravenous insertion did not differ significantly between the intervention and comparison groups. The interactive play intervention with VR effectively reduced children's levels of pain and fear during the intravenous placement procedure. The results of this study can serve as a reference for the implementation of a feasible, child-friendly care practice for clinical intravenous placement in school-aged children.

Pediatric neurological cancer incidence and trends in the United States, 2000-2018.

To characterize the epidemiological trends and sociodemographic variation of pediatric and adolescent neurological cancers by histological subtypes over time in the USA. A total of 16,511 patients aged 0-19years diagnosed with neurological cancers between 2000 and 2018, including 13,024 with central nervous system (CNS) neoplasms and 3,487 with neuroblastomas, were identified from 18 registries of the National Cancer Institute's Surveillance, Epidemiology, and End Results Program. Incidence trends over time and incidence rate ratios by race/ethnicity, sex, and age were calculated for histological subtype. Age-standardized incidence rates (ASIR) by year of diagnosis and average annual percent changes (AAPC) were calculated to measure incidence rates. ASIR by race/ethnicity, sex, and age were calculated to examine the incidence variation by these factors. Overall, age-standardized annual incidence per 100,000 person-years increased from 2.20 in 2000 to 3.21 in 2018 with an AAPC of 1.4% (95% confidence interval or CI: 0.5% to 2.4%); however, that of Hispanic decreased from 2.93 in 2000 to 2.59 in 2018 with an AAPC of -0.8% (95% CI: -1.2% to -0.3%). Non-Hispanic Black children and adolescents had a statistically significantly lower incidence than non-Hispanic White peers both for CNS neoplasms (incidence rate ratio or IRR: 0.67; 95% CI: 0.63 to 0.71) and neuroblastomas (IRR: 0.75; 95% CI: 0.68 to 0.83). Females generally had a lower incidence than males, especially among those with intracranial and intraspinal embryonal tumors (IRR: 0.69; 95% CI: 0.64 to 0.75). The highest incidence rate of neuroblastoma was among newborns aged less than 1year, and the highest incidence rate of CNS neoplasms was among children aged 1-4years. The incidence of neurological cancers has increased among children and adolescents from 2000 to 2018, with wide variation across demographic groups.

Assessment of the determinants of changes and test-retest reliability in the 6-min walk test performance over a 4-month period in healthy 6-12-year-old children.

The purpose of the study is to establish the determinants of change in 6-min walk test (6MWT) performance observed in children aged 6-12years over a 4-month period, and to provide test-retest reliability (4months) to establish the minimal detectable change (MDC). Healthy children aged 6-12years performed two 6MWT trials separated by a period of 4months. Multiple linear regression analysis was performed to estimate the percentage of variance explained by the variables potentially predictive of the change in the 6MWT. We employed the intraclass correlation coefficient to assess test-retest reliability. Fifty-nine children (28 boys and 31 girls) were assessed. The change in distance covered during the 6MWT was significantly correlated with the growth in their height (r = 0.679; p < 0.05) and the change in their weight (r = 0.473; p < 0.05). Multiple linear regression analysis shows that the change in distance covered in the 6MWT was only explained by its growth in height (46.0% explained variance). The test-retest reliability was fair-good. After 4months, we established a 12% change from the initial measurement (79.69m) as the MDC for a 90% confidence level (MDC90). The distance covered in the 6MWT improved as the children's age, weight and height increased. The growth children's height was the most important predictor of change in distance covered in the 6MWT. An increase of at least 79.69m (MDC90) in distance covered in the 6MWT is necessary to attribute the improvement to an intervention and not to the individual's growth.

Flexible Intramedullary Nail Versus Submuscular Locked Plate with the Cluster Technique in Pediatric Femoral Shaft Fractures Fixation.

The aim of this study is the comparison between the flexible intramedullary nail and submuscular Locked Plate with the cluster technique in fixation of pediatric femoral shaft fractures at the age group between 6 and 12years old with simple diaphyseal closed or Gustilo open grade I fractures. Fifty children aged 6-12years with femoral fractures were enrolled in this study. The children were randomly assigned equally to the two groups for fractures fixation. The follow-up period was 1year. A comparison of various parameters and outcomes between both groups was documented. No significant differences were detected between both groups regarding the age, gender, affected side, mechanisms of fracture, or fracture classifications. The operative time and radiation time were longer in the plating group, while the amount of blood loss was lesser in the nail group. The patients treated with plating had better results concerning knee range of motion, weight-bearing, malalignment, and length discrepancy, with fewer complications and better functional outcomes. The result of the present study supports the use of submuscular locked plate with cluster technique in the treatment of studied fractures over flexible IMN.

The Effect of Price Changes and Teaspoon Labelling on Intention to Purchase Sugar-Sweetened Beverages: A Discrete Choice Experiment.

Childhood obesity is a major public health concern and sugar-sweetened beverages (SSBs) are a known contributor. SSB taxation and food labelling have been proposed as policies to reduce consumption by changing purchasing behaviours. The study aimed to analyse caregivers' preferences on commonly purchased SSBs in Australia and to determine the effect of price increases and teaspoon labelling on their purchasing intentions. We used a discrete choice experiment (DCE) to obtain data about choices between SSB and non-SSB alternatives. 563 caregivers, who had young children aged 3-7years, completed the experiment online. 286 were randomly allocated to receive choice sets with plain labelling while 277 were assigned to teaspoon labelling. Each participant completed nine choice scenarios where they chose between six SSB and non-SSB beverage options or a no-beverage option, with beverage prices varying between scenarios. While hypothetical, price and teaspoon labelling for sugar content for each beverage was obtained from an informal market survey. Responses from the DCE were modelled using random parameters logit within a random utility theory framework. Household income and children's consumption volumes of soft drink were used to explore preference heterogeneity. Using mixed logit as the final model, we found that higher reduction in intended purchases was observed for soft drink and fruit drink in teaspoon labelling than it was in plain labelling. Participants exposed to teaspoon labelling intended to purchase less of flavoured milk and fruit juice compared to those exposed to plain labelling. Compared to baseline prices, a hypothetical 20% increase in SSB prices and the presentation of 'teaspoons of sugar' labelling were predicted to reduce intentional SSB purchases and increase intentional non-SSB purchases. Within each labelling group, there were no significant differences of intentional purchases between the highest and the lowest income quintile, high and low consumers of soft drinks. However, compared to plain labelling, teaspoon labelling was predicted to strongly influence intentional purchases of SSBs and non-SSBs. This study suggests that a policy to increase SSB price and include teaspoon labelling would lead to a reduced consumption of SSBs and increased consumption of non-SSBs.

Health-related quality of life in infants, toddlers and young children with sickle cell disease.

Little is known about health-related quality of life (HRQoL) in young children with sickle cell disease living in a European country. A retrospective cross-sectional evaluation of TNO-AZL Preschool Children Quality of Life questionnaire (TAPQOL, 0-1year) and Pediatric Quality of Life Inventory (PedsQL, 2-7years) data was conducted. Study participants included caregivers of children with sickle cell disease aged 0-7years attending the sickle cell centre at the Erasmus Medical Center or the Amsterdam University Medical Centers between April 2012 and October 2020. Comparisons were made with normative data on HRQoL in the general paediatric population. The study enrolled 136 caregivers of 136 children. In children aged 0-5years, no significant differences emerged between children with sickle cell disease and the general population. However, in children aged 5-7years, children with sickle cell disease scored significantly lower on all subscales except for emotional functioning. Multiple regression models showed a negative association between age and HRQoL. No association was found between HRQoL and disease severity or sociodemographic characteristics. This study demonstrates that HRQoL is negatively correlated with age in young children with sickle cell disease with a significantly lower HRQoL in 5- to 7-year-olds when compared to the general population. Our study underlines the importance of measuring HRQoL in young children to identify patients with impaired HRQoL early in life in order to be able to intervene accordingly. Future research should focus on deepening the knowledge of factors influencing HRQoL in children with sickle cell disease.

Effect of treatment of transverse maxillary deficiency using rapid palatal expansion on oral health-related quality of life in children: A randomized controlled trial

This trial aimed to longitudinally evaluate the effect of the treatment of transverse maxillary deficiency using rapid palatal expansion (RPE) on self-perceived oral health-related quality of life (OHRQOL) in children. Eighty participants aged 8-10years with transverse maxillary deficiency and bilateral posterior crossbite were randomly assigned to 2 groups (n=40 each): a group treated with RPE using hyrax-type appliances and a nontreated control group. OHRQOL was assessed by using the Child Perceptions Questionnaire for 8-10-year-olds at 4 times: before RPE, during RPE (T1), at the end of RPE (T2), and 1month after the appliance removal (T3). Generalized mixed models were used for data analysis (α=0.05). Both groups exhibited similar demographic characteristics and OHRQOL scores at baseline. All participants completed the study. RPE had a time-dependent effect on OHRQOL. At T1 and T2, this therapy is expected to increase the overall OHRQOL scores by 1.17 times (ie, ∼17% increase; T1 95% confidence interval [CI], 1.08-1.26; T2 95% CI, 1.09-1.27; P=0.001). In contrast, the overall OHRQOL scores at T3 are expected to be 0.28 times the baseline scores (ie, ∼72% reduction; T3 95% CI, 0.26-0.31; P=0.001). All individual domains of the OHRQOL evidenced a positive impact of treatment at T3 (P=0.001). Only the oral symptoms and social well-being domains showed a significantly negative impact of the treatment at T1 and T2. Correction of the transverse maxillary deficiency by RPE in children aged 8-10years improves OHRQOL. There is a temporary worsening of OHRQOL during the treatment of this condition using RPE. This trial was not registered. The protocol was not published before trial commencement. This study was financed by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brazil, Financing Code001.