Minerva Pediatrics最新文献

Background: Caregivers of children with complex chronic diseases (CCD) or life-limiting conditions (LLC) experience heightened strain. Understanding their concerns is essential for effective support, particularly in pediatric palliative care (PPC) where compassionate support is crucial. Amid substantial growth in PPC services in Portugal, assessing the effectiveness of care in addressing these concerns and adapting to the evolving needs of parents is imperative. The aim of this study was to perceive the impact of PPC from the caregivers' perspective.

Methods: Participants consisted of children with CDD or LLC and their caregivers followed by the PPC team. Institutionalized children were excluded. Our mixed-methods study involved analyzing sociodemographic characteristics and assessing caregiver and child well-being using quantitative data and explored caregiver concerns and the impact of PPC through qualitative data obtained from semi-structured interviews.

Results: We included 43 children and caregivers. Caregivers (90.6% mothers; mean age 40) often experience fatigue (90.7%) although they rarely feel exhausted (67.4%). Sleep disturbances (58.1%) are the children's most frequent perceived symptom. Seven categories emerge from caregivers' concerns. Among the five categories arising from caregivers' perceived impact of PPC integration, 95.3% prioritize enhanced contact with healthcare professionals. Increased support to facilitate caregiver rest and early referral emerges as primary suggestions for improving PPC.

Conclusions: The PPC appears to be effective in alleviating parents' primary concerns, highlighting the crucial importance of early referral. Implementing strategies to provide respite for caregivers and closer monitoring of these children becomes a priority to improve the quality of life for this inherently intertwined dyad, the child-family unit.

Introduction: The overall contribution of physical exercise on the management of disabling consequences of leukemia and lymphoma in children is missing. The aim of this scoping review (ScoR) was to systematically collect, map and present the current research evidence concerning studies reporting data on physical exercise among children with leukemia and lymphoma.

Evidence acquisition: This ScoR was performed by adopting recommendations of the 2020 version of the "Joanna Briggs Institute Methodological Guidance", along with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews. PubMed, Scopus, and the Central (Cochrane) were searched up to December 2023. Original studies were included, and results were presented numerically and thematically.

Evidence synthesis: One hundred twelve articles were identified through the search; 14 studies met the inclusion criteria. Publications have increased over the years. Most of the studies were conducted in Western countries. 11 articles (79%) owned to primary research (seven RCTs, and four observational studies), and 3 studies (21%) were systematic reviews. The overall sample size was of 293 individuals. 1 study included a mixed population of leukemias and lymphomas, while the others included only children with leukemia. The features of physical exercise were well described, including details on duration of treatment, frequency of exercises sessions, and duration of sittings.

Conclusions: The studies indicated physical exercise as a contributor to the improvement of motor abilities and quality of life. More studies including outcome measures that assess disability are recommended. More evidence on the impact of physical exercise in children with lymphoma is needed.

Background: Term and preterm infants are frequently exposed to painful procedures and stimuli during hospitalization in the Neonatal Intensive Care Unit (NICU). Pain is widely recognized to cause short- and long-term effects in the newborn. In recent years there has been a growing medical interest and a strong demand from parents for phytotherapeutic drugs, but literature data are limited, and excellent methodological studies are necessary to evaluate the importance of phytotherapy in the neonatal period.

Methods: We evaluated the use of an oral phytotherapeutic gel based on chamomile, angelica and oats in the management of full term and preterm infant pain caused by minor diagnostic or therapeutic procedures. We enrolled full term infants (>37 weeks gestational age [GA]) and preterm infants with higher GA than 28 weeks, weighing more than 1000 grams. Assessed painful procedures were minor diagnostic or therapeutic ones. Newborns were double-blind randomized into two groups (A and B) to orally receive the phytotherapeutic gel (solution A) and a gel of the same consistency and aroma (solution B) before the painful procedure.

Results: The group of newborns to whom solution A had been administered showed significantly lower scores in the Pain Scale (P<0.01) during painful procedure. This figure indicates that the herbal medicine has been effective in reducing pain experience in the population of examined newborns.

Conclusions: To the best of our literature research, our work is the first scientific study highlighting the possibility of preventive beneficial effects of phytotherapeutic drugs on pain control.

Adolescent suicide is a major public health problem, as suicide is one of the leading causes of death for adolescents. Predicting and preventing suicide represent very difficult challenges for clinicians. Youth suicide might be prevented by identifying risk factors for adolescent suicidal behavior. Diagnostic assessment involves identification of multiple factors including gender differences, psychopathology, comorbidity, interpersonal problems, family discord, family psychopathology, accessibility of lethal suicide methods, exposure to suicide, previous attempt, social support, life stressors, and protective factors. The literature clearly indicates a need for suicide awareness and prevention programs and for early identification of adolescents at risk for suicidal behaviors. However, many health care professionals who have frequent contact with adolescents are not sufficiently trained in suicide evaluation techniques and approaches to adolescents with suicidal behavior. Pediatricians and other health professionals involved in adolescents' care need more in-depth information about the characteristics and the warning signs for suicide.

Background: Previous pandemics around the world have shown that negative emotions are intensified in individuals when restrictions are imposed on human daily life activities. This study aims to draw attention to the pandemic-specific factors that might be associated with the severity of depression, anxiety, and COVID-19 phobia of high school students.

Methods: A total of 1431 high school students aged 14 to 18 years were invited to participate in this study using online survey forms. They were asked to fill out a questionnaire about themselves and the changes in their lives during the pandemic. They completed the COVID-19 Phobia Scale (C19P-S) and the Revised Children's Anxiety and Depression Scale (RCADS).

Results: Findings showed that being a girl is an increased risk factor for anxiety, depression, and COVID-19 phobia. In addition, following the official daily COVID-19 data and having a healthcare professional in the building of residence are significant risk factors for COVID-19 phobia. Having a psychiatric disorder, having a chronic disease, losing anyone due to COVID-19 infection, undergoing a COVID-19 diagnostic test, and meeting friends in person are increased risk factors for anxiety or depression during the pandemic.

Conclusions: Changes in adolescents' lives caused by the COVID-19 pandemic are negatively affecting their mental health. Studies are needed to maintain the mental well-being of adolescents under the conditions of this pandemic.

Introduction: In recent years, the rehabilitation of children with neurological disorders has taken into account the possibility of using videogaming consoles and virtual reality systems to make children's therapy more enjoyable, motivating, participated and effective. This study aims at conducting a systematic review about the use and the efficacy of digital games in pediatric neurorehabilitation.

Evidence acquisition: In accordance with the PRISMA approach, a rather wide-ranging search was conducted on PubMed, Scopus, and Web of Science databases by using different combinations of keywords based on MeSH terms.

Evidence synthesis: Fifty-five papers have been included into this review, namely, 38 original studies and 17 reviews. The total number of children and adolescents is 573, with 58% of them being affected by cerebral palsy. Despite a wide variability in the adopted protocols, devices, assessment tools, and a more frequent focus on motor aspects than on cognitive ones, the results of the majority of the analyzed studies support the safety (i.e., absence of severe adverse effects) and efficacy of the videogame-based therapy.

Conclusions: Videogames, when administered by means of commercial consoles or ad-hoc digital systems, seem to be a valid support for physical therapy. Further researchers are needed to deeply investigate the role of this approach in cognitive therapy and cognitive outcomes.