Child Outcomes Research Articles

Treatment outcome of post-streptococcal acute glomerulonephritis and its associated factors among children less than 15 years at the referral hospital of East Amhara, Ethiopia

ObjectivesAimed to assess the treatment outcome of post-streptococcal acute glomerulonephritis and its associated factor among children of less than 15 years at a referral hospital in Amhara Northeast Ethiopia, 2022.ResultsIn this study, 322 Post- post-streptococcal acute glomerulonephritis children with a response rate of 97% were included. Of these, 33.54% of them had a poor treatment outcome. Age less than or equal to 5 years (AOR = 3.2, 95% CI (1.5–7.3), Creatinine level > 1.3 mg/dl (AOR = 5.5,95% CI (2.5–11.7), blood urea nitrogen leve ≥ 119 mg/dl (AOR = 4.9,95% CI (1.1–19) and length of stay > 10 days(AOR = 2.6,95% CI (1.18–5.9) were statistically significant with poor outcome of children with post-streptococcal acute glomerulonephritis and management during admission to reduce poor treatment outcomes.

Association between socioeconomic deprivation, ethnicity and health outcomes in preschool children with recurrent wheeze in England: a retrospective cohort study

BackgroundPreschool-aged children have among the highest burden of acute wheeze. We investigated differences in healthcare use, treatment and outcomes for recurrent wheeze/asthma in preschoolers from different ethno-socioeconomic backgrounds.MethodsRetrospective cohort study...

Mitochondrial DNA copy number and neurocognitive outcomes in children.

Low mitochondria DNA copy number (mtDNAcn) has been linked to cognitive decline. However, the role of mtDNAcn in healthy cognitive development is unclear. We hypothesized early-life mtDNAcn would be associated with children's learning and memory. We quantified mtDNAcn in umbilical cord blood and child blood at ages 5-7 from participants in a prospective birth cohort. We administered the Children's Memory Scale (CMS) at ages 9-14 (N = 342) and the Wechsler Intelligence Scale for Children (WISC-IV) at ages 7 and 9 (N = 457). Associations between mtDNAcn tertiles and CMS and WISC were evaluated with linear regression and linear mixed-effects models, respectively. We examined non-linear associations using generalized additive mixed models. Relative to the middle tertile of mtDNAcn, lower childhood mtDNAcn was associated with lower WISC Working Memory (β = -2.65, 95% CI [-5.24, -0.06]) and Full-Scale IQ (β = -3.71 [-6.42, -1.00]), and higher CMS Visual Memory (β = 4.70 [0.47, 8.93]). Higher childhood mtDNAcn was linked to higher CMS Verbal Memory (β = 7.75 [2.50, 13.01]). In non-linear models, higher childhood mtDNAcn was associated with lower WISC Verbal Comprehension. Our study provides novel evidence that mtDNAcn measured in childhood is associated with children's neurocognitive performance. mtDNAcn may be a marker of healthy child development. Mitochondrial DNA copy number (mtDNAcn) may serve as a biomarker for early-life neurocognitive performances in the children's population. Both low and high mtDNAcn may contribute to poorer neurocognition, reflected through learning and memory abilities. This research elucidated the importance of investigating mitochondrial biomarkers in healthy populations and facilitated advancements of future studies to better understand the associations between mitochondrial markers and adverse children's health outcomes.

Cognitive and academic outcomes in children with myelin oligodendrocyte glycoprotein antibody-associated disease.

To describe the impact of paediatric myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) on academic and cognitive outcomes. This was an observational, retrospective, and descriptive single-centre study, carried out on a paediatric case series of children with MOGAD. A total of 51 patients were included (22 females); their median age was 8 years and the median follow-up duration was 31.1 months (interquartile range 23.5). The most frequent clinical presentation was acute disseminated encephalomyelitis (54.9%), followed by optic neuritis (35.5%). At the last follow-up, regardless of the clinical phenotype at disease onset, 39.5% of patients with MOGAD received academic and educational interventions (p < 0.05 compared to before disease onset), including academic accommodations (p < 0.05) or the need for a learning support assistant (p < 0.05). Ten patients were evaluated with the Wechsler Intelligence Scale for Children, Fifth Edition (WISC-V). The overall IQ was calculated for six patients (mean = 92); two of these patients had an IQ lower than 85. No difference was found regarding prenatal and neonatal neurodevelopmental characteristics between this cohort and the general population. MOGAD was associated with a need for academic support; lower scores were found on the WISC-V. Patients with MOGAD should receive cognitive and academic assessments to inform educational planning and support academic success.

Esophagitis, treatment outcomes, and long-term follow-up in children with esophageal atresia.

Survival rates in children born with esophageal atresia (EA) with or without tracheoesophageal fistula (TEF) have improved; however, morbidity associated with the disease remains high. This study aimed to assess the prevalence of gastroesophageal reflux disease (GERD), eosinophilic esophagitis (EoE), fungal esophagitis, esophageal strictures, and long-term outcomes in children with EA/TEF. We conducted a retrospective chart review on patients with EA/TEF who were seen at Children's Wisconsin from January 2003 to January 2023. Patients born with EA/TEF were included if they underwent at least one endoscopy after 1 year of age. GERD was diagnosed based on abnormal findings on endoscopy, pH-metry, and/or history of fundoplication. EoE and fungal esophagitis were diagnosed based on abnormal endoscopy. Esophageal stricture diagnosis was based on findings on endoscopy and/or esophagram, and clinical symptoms necessitating esophageal dilation. Eighty-five patients (64.7% males, mean age 7.5 years) were included, the majority had type C EA/TEF (90.6%). GERD was diagnosed in 61.1% (n = 52), 49.4% (n = 42) by macro and/or microscopic endoscopic findings, 22.3% (n = 19) by abnormal pH-metry, and 21.1% (n = 18) by the need for fundoplication for refractory reflux and/or esophageal stricture. Risk of GERD increased with lower gestational age (p = 0.0030), lower birth weight (p = 0.023), and long-gap EA (p = 0.034). In children diagnosed with GERD, only 13.4% of patients (n = 7/52) were able to be weaned off proton pump inhibitor (PPI) without disease recurrence. However, overall, at the completion of the study, 44.7% (n = 38) of patients were successfully weaned off PPI without evidence of GERD. EoE was diagnosed in 20% of the patients (n = 17). All patients diagnosed with EoE required escalation of therapy from PPI alone to swallowed corticosteroids in 52.9% (n = 9), dupilumab in 23.5% (n = 4), elemental formula in 17.6% (n = 3), and elemental formula and swallowed steroids in 5.8% (n = 1). Fungal esophagitis was diagnosed in 15.3% of patients (n = 13). An esophageal stricture requiring dilation was diagnosed in 77.6% (n = 66) of patients at a mean age of 28.5 months, with over 60% diagnosed by 24 months of age. Children born with EA/TEF continue to be at high risk of developing GERD, EoE, fungal esophagitis, and esophageal stenosis. Diagnostic and therapeutic endoscopy remains a high-yield test to identify and treat these comorbidities.

Effects of Mozart–Orff parent–child music therapy among mothers and their preschool children with autism spectrum disorder: A mixed-methods randomised controlled trial

BackgroundAutism spectrum disorder (ASD) negatively impacts mental health, particularly in mothers of autistic children who experience heightened stress. Applied behaviour analysis (ABA) and music therapy are recognised interventions for improving ASD symptoms. However, the specific benefits of parent–child music therapy and ABA for autistic children and their mothers remain uncertain. This study evaluated the effects of parent–child music therapy on preschool autistic children and their mothers.MethodA randomised controlled trial was conducted with 100 mother–child pairs assigned to either the control group receiving ABA or the intervention group receiving both music therapy and ABA. Qualitative interviews were conducted post-intervention for 12 mothers.ResultsChildren in the intervention group exhibited lower scores for ASD symptoms than those in the control group. Moreover, mothers in the intervention group demonstrated reduced dysfunctional parent–child interaction, lower overall parental stress, significantly improved family functioning, and increased levels of hope compared with those in the control group. Mothers held positive views regarding music therapy.ConclusionsCombining ABA with parent–child music therapy can alleviate ASD symptoms in children and reduce stress in mothers. Improved parent–child interaction and enhanced family functioning further support the benefits of this combined approach. Parent–child music therapy, combined with ABA demonstrated positive outcomes for autistic children, including reduced ASD symptoms, improved parent–child interaction, decreased parental stress, enhanced family functioning, and increased hope. These findings highlight the potential of incorporating music therapy as a valuable component in the comprehensive treatment of ASD.Trial registrationThis study was registered in the Chinese Clinical Trial registry (05/07/2021, ChiCTR2100048261, https://www.chictr.org.cn/showproj.html?proj=128957). Ethical approval was obtained from the Research Ethics Committee of Fujian Medical University and the study hospital (Fujian Provincial Maternity and Child Health Hospital; 2017 − 105), and informed consent was obtained from all subjects and/or their legal guardian(s).

Health Promotion and Physical Wellness in Pediatric Physical Therapy.

A health promotion and physical wellness (HPPW) life course approach for pediatric physical therapy (PT) is recommended to improve children's health outcomes across the lifespan. A life course approach describes how a child's individual responses to environmental factors influence health outcomes. Using HPPW strategies, pediatric physical therapists can identify health risks and promote positive outcomes. Outcome measures and intervention recommendations are outlined to assist therapists in integrating HPPW strategies to ensure a longitudinal plan of care and optimal health outcomes for children. A child's health trajectory begins in the prenatal period and is influenced by individual and environmental factors. Pediatric PT uses child- and family-centered approaches and environmental assessments to design plans of care that address child and family HPPW goals. Incorporating HPPW strategies into pediatric PT facilitates positive health and physical wellness across a child's lifespan.See the video abstract for insights from the authors. Supplemental digital content available at https://www.dropbox.com/scl/fi/3g468hj1rpxrrivbeses0/HPPW-Video-Abstract_1080.mp4?rlkey=4p1i8z1gynroz064zpx3alijz&st=8u0gqemz&dl=0.

Exploring past research to move forward: a scoping review of aims, outcomes, and recommendations in parental mental illness qualitative research.

As parental mental illness is a global public health concern, rigorous qualitative research is central to understanding families' experiences, needs and outcomes to inform optimal service provision in adult mental health and children's social services. The current review identified, appraised and synthesized international qualitative research exploring Families and Parent Mental Illness (FaPMI) research to determine the focus, findings and outcomes and to summarize the recommendations made about the direction of future research. Findings are classified according to outcomes for children, parents, and families. While some children experienced positive outcomes from a parent's illness, most faced impacts on their social-emotional wellbeing, school performance, increased caregiving responsibilities, strained parent relationships, and lack of understanding about parental mental illness. Some family members endured abuse and struggled to adapt to an ill parent's unpredictable needs, with reluctance to discuss the situation. Parents found parenting challenging yet viewed having children as a protective factor. Future research should gather diverse perspectives, explore within-family factors and social environments, develop and test interventions, and address methodological issues like sampling. This review highlights the centrality of qualitative data in comprehensively understanding and evaluating outcomes of parental mental illness on families and provides clear recommendations regarding future research.

Geographical disparities in temporal trends of low birth weight in Saskatchewan from 2002/2003 to 2021/2022: insights from a joinpoint regression analysis.

Low birth weight (LBW) is an important public health indicator that is associated with various negative health outcomes in infants. To effectively implement interventions that would improve health outcomes in children, it is important to understand both the historical trends and current levels of LBW rates. In this study, trends and regional differences in LBW rates in Saskatchewan from 2002/2003 to 2021/2022 were assessed. A joinpoint regression analysis was conducted using historical LBW rates, obtained from the Canadian Institute for Health Information database. Data were analysed using average percent change and average annual percent change. Spatial patterns and trends were identified using a choropleth map. From a provincial and national rate of 5.2% in 2002/2003, the LBW rate in Saskatchewan increased to 6.5% in 2021/2022, approaching the national rate of 6.8%. Over the 20-year period, average annual changes for Canada were 1.4% and 1.0% for Saskatchewan. There was a turning point in the study: 2004/2005 for Canada and 2011/2012 for Saskatchewan. Initially, Saskatchewan had stable LBW rates, increasing yearly by 0.1%, while the national rate was 5.7%. However, in recent years, Saskatchewan's rate increased to 1.8% annually, surpassing the national rate of 0.9%. Geographical differences were also observed within Saskatchewan, with the Far North region having the highest LBW rate (9.2%), and the Central West region having the lowest rate (4.3%) in 2021/2022. The Central East, Regina Qu'Appelle, and southern Saskatchewan saw significant upwards trends in LBW rates between 2015/2016 and 2021/2022. There is an increasing trend in LBW rates in Canada and Saskatchewan, as well as geographical disparities within the province. The geographical disparities in LBW rates underscore the need for tailored interventions in high-risk regions in the province.

Parenting and outcomes for children with cerebral palsy

Parenting and outcomes for children with cerebral palsy

Impact of autologous mitochondrial transfer on obstetric and neonatal health of offspring: A small single-center case series

IntroductionA pilot study was carried out to test the efficacy of the autologous mitochondrial transfer therapy (AUGMENT) technique. No improvements in pregnancy rate, development, or embryo quality were observed in the AUGMENT-treated group versus the Control group in this study. The main objective of this research is to analyze whether AUGMENT technology did have any impact on the obstetric and perinatal outcomes of pregnancies and children resulting from treated oocytes. MethodsFollow up study of women with a livebirth who participated in a pilot randomized controlled trial in which sibling MII oocytes were randomly allocated to AUGMENT + intracytoplasmic sperm injection (ICSI) (AUGMENT group) or ICSI alone (control group). Preimplantation genetic testing for aneuploidy was performed in both groups. Pregnancy and neonatal outcomes of 14 women (15 pregnancies) and their 18 children were analyzed. The information was retrieved by reviewing the medical records or through questionnaires sent to the patients. ResultsNo differences were found in this small case series between the AUGMENT and control groups regarding the rate of gestational complications, birth defects, gestational age at delivery (271.4 ± 12.56 vs 278 ± 10.4 days), birthweight (3.1 ± 0.6 kg vs. 3.1 ± 0.4 kg) and neonatal outcome. DiscussionThe few pregnancies achieved using AUGMENT oocyte therapy had similar outcomes than controls in this very small series. Our very preliminary data need to be confirmed in larger samples. The long term follow up of these children also needs to be analyzed.

PENDEKATAN BERDIFERENSIASI DALAM MODEL INQUIRY LEARNING TERHADAP PENINGKATAN HASIL BELAJAR PAI MATERI ANAK SALEH SISWA KELAS IV SD NEGERI 2 DONOTIRTO BANTUL

The purpose of this class action research is to determine the improvement of PAI learning outcomes for pious children through a differentiated approach in the inquiry learning model for grade IV students of SD Negeri 2 Donotirto Bantul. Through a differentiated approach, it seeks to find out the learning needs of students to the maximum, combined with an inquiry learning model that involves students to the maximum so that students are more actively involved. This class action research was carried out in two cycles. The subject of this study is a fourth grade student of SD Negeri 2 Donotirto Kretek totaling 20 children. Data collection techniques are carried out through tests, observations, and documentation. The data analysis technique uses quantitative descriptive analysis. The results of this study show that a differentiated approach in the inquiry learning model to improve the learning outcomes of PAI material for pious children in grade IV students of SD Negeri 2 Donotirto Bantul can improve the learning outcomes of grade IV students of SD Negeri 2 Donotirto. The improvement of learning outcomes can be seen based on the value of student learning outcomes from pre-cycle, cycle I, and cycle II. This can be seen from the completeness of the first cycle which shows 65% while in the second cycle it shows a completeness of 100%, from this there is an increase in completeness of 35%.

Hemophagocytic Lymphohistiocytosis/Macrophage Activation Syndrome in pediatric Inflammatory Bowel Disease: clinical characteristics and outcomes.

Hemophagocytic Lymphohistiocytosis (HLH)/Macrophage Activation Syndrome (MAS) in children with inflammatory bowel disease (IBD) has been reported only anecdotally. This study aimed at describing the clinical features and outcomes of children diagnosed with both IBD and HLH/MAS. Data on IBD and HLH/MAS characteristics, biochemical, microbiological and genetic assessments, treatments, and outcomes were collected from the Italian Pediatric IBD Registry and presented using descriptive statistics. Out of 4643 patients with IBD, 18 (0.4%) were diagnosed with HLH/MAS, including 12 with ulcerative colitis and 6 with Crohn disease. Among the 18 patients, 7 (39%) had early-onset IBD, but the median age at HLH/MAS diagnosis was 14.0years (IQR 11.9-16.0). Half of the patients had active IBD at HLH/MAS diagnosis, 11 (61%) patients were on thiopurines, and 6 (33%) were on anti-TNF biologics. An infectious trigger was identified in 15 (83%) patients. One (5%) patients was diagnosed with XIAP deficiency. All patients discontinued thiopurines and 5 (83.3%)discontinued anti-TNF biologics; 16 (80%) patients received steroids for HLH/MAS. Three (17%)patients had a relapse of HLH/MAS. No patient developed lymphoma or died during a median follow-up of 2.7years (IQR 0.8-4.4). Conclusions: HLH/MAS mainly affects children with early-onset IBD but primarily develops during adolescence, following an infection while on immunosuppressant treatment. Although the prognosis is generally favorable, it is crucial to investigate an underlying immune deficiency.

Participation of fathers and siblings in home rehabilitation programmes for children with neuro-developmental delay: a scoping review

BackgroundThe role of, and impact on, mothers caring for children with neuro-developmental delay (NDD) is well documented. However, the role of fathers and siblings in families of children with NDD remains significantly understudied, particularly in low- and middle-income countries (LMICs). There has been an increased call for holistic rehabilitation of children with NDD at the family level. This study aimed to explore the involvement of fathers and siblings in the home rehabilitation programmes of children with NDD.MethodsA scoping review was conducted using the Joanna Briggs Institute (JBI) Peters et al.'s methodology and reported according to Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Articles were retrieved from PUBMED, ScienceDirect, PsycINFO, SCOPUS, PEDro, and Google Scholar. Reference lists of relevant studies were also manually searched.ResultsThirty research articles were identified. Father and sibling participation in home-based rehabilitation and caregiving is low in LMICs compared to high-income countries due to economic factors and cultural beliefs. Reduced participation stresses mothers and reduces developmental outcomes in children with NDD.ConclusionsThis review highlights the need for rehabilitation professionals to encourage father and sibling participation in caregiving for children with NDD in home rehabilitation programmes.

‘It's something that people don't have the knowledge of’: Perceived participation of pupils with Prader‐Willi syndrome in specialist schools and staff preparedness

AbstractThere is an abundance of literature on health‐related outcomes for children and young people with Prader‐Willi syndrome and on their lived experiences as well as on their caregivers'. However, little is known about the experiences of education practitioners when providing for them. This study gathered in‐depth evidence of the lived experience of school staff in two secondary specialist schools, on (1) perceptions of functioning and participation of young people with Prader‐Willi syndrome in the setting and (2) how prepared they felt to support them in achieving full participation, including challenges faced. Semi‐structured interviews were conducted with six school staff and transcripts were analysed both deductively (using the ICF classification system) and inductively. School staff perceive the needs of these pupils as mostly related to their body functions, in alignment with a medicalised understanding of disability. However, they recognise the key role of environmental modifications to address these. Staff feel mostly unprepared and perceive their training as limited. Despite wide recognition of the need to conceive disability holistically, medicalised understandings are still present. Training from a biopsychosocial perspective is needed. Future research should address the development of core sets of ICF codes for people with Prader‐Willi syndrome.

Effects of Trauma-Informed Training on Teacher Perceptions of Child Outcomes: Student-Teacher Relationships, Behavior, and Expulsion Risk

Effects of Trauma-Informed Training on Teacher Perceptions of Child Outcomes: Student-Teacher Relationships, Behavior, and Expulsion Risk

The mediating role of marital quality in parenting intervention: Effects on preschoolers' conduct problems and effortful control.

This study explores whether marital quality mediates the effects of a parenting intervention on preschoolers' conduct problems and effortful control. Using data from 209 children in a two-wave randomized controlled trial of the Hitkashrut program, participants were assigned to either a 14-session co-parent training group or a minimal intervention control group. Intent-to-treat analysis revealed that improvements in marital quality significantly mediated the intervention's impact on both conduct problems and effortful control. An alternative model, which hypothesized that changes in child behavior would lead to improvements in marital quality, was not supported, reinforcing the importance of targeting marital dynamics to achieve better child outcomes. These findings highlight the potential of marital-focused strategies within parenting interventions to foster healthier family environments and improve long-term developmental trajectories in children.

Latino Family Engagement and Student Outcomes in Early Elementary School: Evidence from Two National Datasets

ABSTRACT Family engagement in children’s schooling is important. Research indicates that Latino families often utilize home-based practices (e.g. reading, telling stories, singing, counting) over school-based involvement (e.g. participating in school events and committees, volunteering in the classroom). Using an assets-based approach, the present study considers both school- and home-based forms of engagement for Latino families. Drawing upon data from two large, nationally representative datasets, the Early Childhood Longitudinal Study, Kindergarten Class of 2010–11 (ECLS-K:2011; N = 4,590) and the Head Start Impact Study (HSIS; N = 1,670), this study seeks to examine national patterns of Latino family school- and home-based engagement in kindergarten, and how such engagement relates to child academic, cognitive, and behavioral outcomes in early elementary school. Descriptive findings show high levels of Latino family participation in a variety of both home-based academic activities and school-based activities. Regression analyses indicate an association between Latino family engagement and child outcomes, most evident in school-based engagement. Implications for educators, schools, and research are discussed.

Protective and Promotive Factors in Migrant and Refugee Children Facing Violence: A Systematic Review.

Migrant and refugee children are at risk of experiencing various forms of violence before, during, or after migration. This study systematically identifies, reviews, and synthesizes evidence on protective and promotive factors that contribute to the resilience of migrant and refugee children facing violence. Of the 3,663 articles identified through search in five electronic databases and snowball technique, 31 quantitative or qualitative research studies met the inclusion criteria. To be included in the review, studies had to (1) have been published after 2013; (2) have been published in English; (3) include migrant or refugee children and/or adolescents aged 18 or below at the time of interview or migration; (4) mention some types of maltreatment, peer violence, or community violence faced by the children or adolescents; (5) examine the association between the hypothesized protective or promotive factors and indicators of adaptive functioning; and (6) include outcome measures that assessed adaptive functioning such as well-being or absence or low-levels of internalizing and externalizing problems. Quality assessment did not lead to the exclusion of any studies. Five levels of protective and promotive factors were identified: individual, family, school and peers, community, and spatial dimension, which converged to highlight the importance of regulatory, interpersonal, and meaning-making strengths for these children. Understanding and addressing these protective and promotive factors is crucial for promoting well-being and improving mental health outcomes in migrant and refugee children facing violence. The findings of this review have significant implications for designing intervention programs and public policies that support these children effectively.

A Systematic Review and Meta-Analysis of the Efficacy of Antimicrobial Chemoprophylaxis for Recurrent Acute Otitis Media in Children.

Acute otitis media (AOM) is a common childhood infection. Recurrent AOM affects a subset of children, resulting in an adverse impact on quality of life, socioeconomic disadvantage, and risk of long-term sequelae. Antimicrobial chemoprophylaxis is used in some settings but is increasingly controversial due to an awareness of adverse long-term effects and contribution to global antibiotic resistance. A comprehensive literature search was undertaken using Medline (1946-October 2023) and Embase (1974-October 2023). The primary aim was to assess the efficacy of antimicrobial chemoprophylaxis on AOM episodes in children < 18 years of age. Bias and quality assessment was performed. Dichotomous data were analysed using risk ratio with 95% confidence intervals. Meta-analysis was carried out using random-effects models for pooled analysis, independent of heterogeneity. Heterogeneity was assessed using the I2 statistic. The effect of antimicrobial chemoprophylaxis in children with rAOM on the number of individual AOM episodes. assessment of antimicrobial agents and outcomes in children with risk factors. Assessment of qualitative data was performed on 20 studies (n = 2210). No controlled trials were identified post-multivalent pneumococcal conjugate vaccine (PCV) introduction, restricting current generalisability. Quantitative meta-analysis on nine pre-PCV studies (n = 1087) demonstrated antimicrobial chemoprophylaxis reduced any episode of AOM with a risk ratio 0.59 (95% CI 0.45-0.77). Families and clinicians must balance marginal short-medium term benefit (based on pre-PCV data), and the potential for adverse effects to that individual, and the societal risk of antimicrobial resistance with prolonged antibiotic use.