The Latest Children’s Mental Health Journal Articles
Keep up to date with the latest in children’s mental health. Check out the latest children’s mental health articles from leading medical journals in a single view, helping you discover relevant articles quickly and easily
- Telephone-guided self-help for mental health difficulties in neurological conditions: a randomised pilot trial.This study aimed to conduct a randomised pilot trial to assess the feasibility of a randomised controlled trial (RCT) to investigate the effect of telephone-guided self-help for the treatment of mental health difficulties in children with neurological conditions.Preliminary RCT. The primary outcome measure was the Strengths and Difficulties Questionnaire.Neurology clinics in a national tertiary paediatric […]
- Mental Health Disorders in Children With Congenital Heart Disease.Data on anxiety, depression, and attention-deficit/hyperactivity disorder (ADHD) are lacking for youth with congenital heart disease (CHD), particularly those with simple CHD. This study aims to characterize these disorders in youth with CHD compared to those without CHD.A comparative cross-sectional study was conducted by using the electronic medical records of a large tertiary care hospital […]
- Principles of Care for Young Adults With Co-Occurring Psychiatric and Substance Use Disorders.Over 50% of young adults (defined as individuals aged 18-25 years) with substance use disorders (SUDs) have at least 1 co-occurring psychiatric disorder, and the presence of co-occurring disorders worsens SUD outcomes. Treatment of both co-occurring psychiatric disorders and SUDs in young adults is imperative for optimal treatment, yet many barriers exist to achieving this […]
- Identification of Prenatal Opioid Exposure Within Health Administrative Databases.Health administrative data offer a vital source of data on maternal prenatal opioid exposure (POE). The impact of different methods to estimate POE, especially combining maternal and newborn records, is not known.This population-based cross-sectional study included 454 746 hospital births with linked administrative data in Ontario, Canada, in 2014-2017. POE ascertainment included 3 sources: (1) prenatal […]
- Three-Year Outcomes After Brief Treatment of Substance Use and Mood Symptoms.Screening, brief intervention, and referral to treatment (SBIRT) for adolescents exhibiting co-occurring substance use and mental health problems may improve outcomes and have long-lasting effects. This study examined the relationship between access to SBIRT and substance use, depression and medical diagnoses, and health services use at 1 and 3 years postscreening for such adolescents.The study […]
- A Pilot Study of Transdiagnostic Group Cognitive-behavior Therapy for Anxiety: An Intensive Weekend Intervention.Anxiety disorders are highly prevalent and can cause serious functional impairment. Cognitive-behavioral treatments are effective but they are not always readily available. One factor contributing to this problem is the large number of disorder-specific treatments that require a high level of clinician training and resources, despite the similarity in the mechanisms underlying the various anxiety […]
- International consensus on a standard set of outcome measures for child and youth anxiety, depression, obsessive-compulsive disorder, and post-traumatic stress disorder.A major barrier to improving care effectiveness for mental health is a lack of consensus on outcomes measurement. The International Consortium for Health Outcomes Measurement (ICHOM) has already developed a consensus-based standard set of outcomes for anxiety and depression in adults (including the Patient Health Questionnaire-9, the Generalised Anxiety Disorder 7-item Scale, and the WHO […]
- Effectiveness of hospital clowns for symptom management in paediatrics: systematic review of randomised and non-randomised controlled trials.To evaluate evidence from randomised controlled trials and non-randomised controlled trials on the effectiveness of hospital clowns for a range of symptom clusters in children and adolescents admitted to hospital with acute and chronic conditions.Systematic review of randomised and non-randomised controlled trials.Medline, ISI of Knowledge, Cochrane Central Register of Controlled Trials, Science Direct, Scopus, American […]
- Size at birth and cognitive function among rural adolescents: a life course epidemiology study protocol of the Kisalaya cohort in Mysuru, South India.It is proven that adverse intrauterine environment results in ‘early life programming,’ alterations in metabolism and physiological development of the fetus, often termed as ‘Developmental Origins of Health and Disease’ (DOHaD) resulting in a smaller size at birth, greater non-communicable diseases (NCD) risk factors during childhood and adolescence, and cardiometabolic disorders in adulthood. Nevertheless, very […]
- Early Physical Abuse and Adult Outcomes.Because most physical abuse goes unreported and researchers largely rely on retrospective reports of childhood abuse or prospective samples with substantiated maltreatment, long-term outcomes of physical abuse in US community samples are unknown. We hypothesized that early childhood physical abuse would prospectively predict adult outcomes in education and economic stability, physical health, mental health, substance […]
- Trajectories of anxiety and depressive symptoms during enforced isolation due to COVID-19 in England: a longitudinal observational study.There is major concern about the impact of the global COVID-19 outbreak on mental health. Several studies suggest that mental health deteriorated in many countries before and during enforced isolation (ie, lockdown), but it remains unknown how mental health has changed week by week over the course of the COVID-19 pandemic. This study aimed to […]
- Reducing Adolescent Psychopathology in Socioeconomically Disadvantaged Children With a Preschool Intervention: A Randomized Controlled Trial.Living in poverty increases exposure to adversities that undermine healthy development, impeding growth in the social-emotional and language skills that support adaptive coping and promote mental health. Evidence-based programs have the potential to improve current preschool practice and strengthen these early skills, potentially reducing risk for later psychopathology. The authors tested the hypothesis that an […]
- Effects of Peer Victimization on Child and Adolescent Physical Health.Peer victimization is recognized as a pressing public health issue, affecting ∼1 in 5 youth. Although extensive research demonstrates the negative effects of peer victimization on youth mental health, considerably less is known about if and how peer victimization adversely impacts physical health. Focusing on studies published in the past 5 years, this state-of-the-art review […]
- Provider Specialty and Receipt of Metabolic Monitoring for Children Taking Antipsychotics.Metabolic monitoring is important for children taking antipsychotic medication, given the risk for increased BMI, impaired glucose metabolism, and hyperlipidemia. The purpose was to examine the influence of provider specialty on the receipt of metabolic monitoring. Specifically, differences in the receipt of recommended care when a child receives outpatient care from a primary care provider […]
- The neurodevelopmental nature of attention-deficit hyperactivity disorder in adults.Population studies have suggested that most adults with attention-deficit hyperactivity disorder (ADHD) did not have the disorder in childhood, challenging the neurodevelopmental conceptualisation of ADHD. Arbitrary definitions of age at onset and lack of defined trajectories were accounted for the findings.The objective of this study was to assess the proportion of individuals presenting with either […]
- Use of virtual reality in the supportive care management of paediatric patients with cancer.Paediatric patients with cancer undergo multiple treatments and procedures that can be invasive and painful. Virtual reality technologies could support the management of paediatric cancer. This Review focuses on the physiological and psychological efficacy of virtual reality in supportive care management. Virtual reality has shown potential in reducing pain scores, pulse rates, and distress scores, […]
- Association of Inflammatory Activity With Larger Neural Responses to Threat and Reward Among Children Living in Poverty.Children exposed to severe, chronic stress are vulnerable to mental and physical health problems across the lifespan. To explain how these problems develop, the neuroimmune network hypothesis suggests that early-life stress initiates a positive feedback loop between peripheral inflammatory cells and networked brain regions involved in threat and reward processing. The authors sought to test […]
- Association of Childhood Lead Exposure With MRI Measurements of Structural Brain Integrity in Midlife.Childhood lead exposure has been linked to disrupted brain development, but long-term consequences for structural brain integrity are unknown.To test the hypothesis that childhood lead exposure is associated with magnetic resonance imaging (MRI) measurements of lower structural integrity of the brain in midlife.The Dunedin Study followed a population-representative 1972-1973 birth cohort in New Zealand (N = 564 […]
- Psychological interventions for depression in children and young people with an intellectual disability and/or autism: systematic review.Children and young people with intellectual disability and/or Autism Spectrum Disorder (autism) experience higher rates of mental health problems, including depression, than their typically developing peers. Although international guidelines suggest psychological therapies as first-line intervention for children and young people, there is limited evidence for psychological therapy for depression in children and young people with […]
- Clinical utility of the parent-reported Strengths and Difficulties Questionnaire as a screen for emotional and behavioural difficulties in children and adolescents with intellectual disability.We assessed the clinical utility of the parent-reported Strengths and Difficulties Questionnaire (SDQ) as a screen for emotional and behavioural difficulties in 626 children and young people with intellectual disability. Using the Developmental Behavior Checklist (DBC2-P) to determine clinical caseness, the area under the curve for the SDQ total difficulties score was 0.876 (95% CI […]
- Bullying victimization among Lebanese adolescents: The role of child abuse, Internet addiction, social phobia and depression and validation of the Illinois Bully Scale.Both bullying victimization and perpetration were associated with depression, social phobia, physical and psychological child abuse and Internet addiction in Lebanon. The prevalence of bullying in Lebanon is alarming, with 50% of school-aged children and adolescents reporting being bullied at some point. The high rate of both bullying victimization can be reflective of the inefficacy […]
- ‘The mean mummy way’ – experiences of parents instilling eye drops to their young children as described in online forums and blogs.Adults often have difficulty instilling eye drops in their own eyes, but little has been documented about the difficulties experienced by parents when administering eye drops to their young children, where the challenges of instillation are accentuated by their inability to cooperate. This qualitative study explores parents’ experiences of administering eye drops to their children […]
- Umbrella systematic review of systematic reviews and meta-analyses on comorbid physical conditions in people with autism spectrum disorder.Comorbid physical conditions may be more common in people with autism spectrum disorder (ASD) than other people.To identify what is and what is not known about comorbid physical conditions in people with ASD.We undertook an umbrella systematic review of systematic reviews and meta-analyses on comorbid physical conditions in people with ASD. Five databases were searched. […]
- Kindergarten Readiness, Later Health, and Social Costs.To estimate associations between kindergarten readiness and academic, psychological, and health risks by end of high school.This study is based on 966 Canadian children. At age 5, trained examiners assessed child number knowledge and receptive vocabulary. Teachers reported kindergarten classroom engagement. At age 17, participants reported academic grades, school connectedness, anxiety sensitivity, substance abuse, physical […]
- Trajectories of Maternal Postpartum Depressive Symptoms.To identify homogenous depressive symptom trajectories over the postpartum period and the demographic and perinatal factors linked to different trajectories.Mothers (N = 4866) were recruited for Upstate KIDS, a population-based birth cohort study, and provided assessments of depressive symptoms at 4, 12, 24, and 36 months postpartum. Maternal demographic and perinatal conditions were obtained from […]
- Prebirth Household Challenges To Predict Adverse Childhood Experiences Score by Age 3.With this study, we seek to understand the relationship between prebirth household challenges and the child’s adverse childhood experiences (ACEs) score by age 3 in a statewide-representative birth cohort to inform primary prevention strategies.We used a longitudinally linked data set from the Alaska 2009-2011 Pregnancy Risk Assessment Monitoring System, its 3-year follow-up survey, and multiple […]
- A large-scale genome-wide association study meta-analysis of cannabis use disorder.Variation in liability to cannabis use disorder has a strong genetic component (estimated twin and family heritability about 50-70%) and is associated with negative outcomes, including increased risk of psychopathology. The aim of the study was to conduct a large genome-wide association study (GWAS) to identify novel genetic variants associated with cannabis use disorder.To conduct […]
- Parental experience of prophylactic antibiotics.Long-term prophylactic antibiotics are often used to prevent bacterial infections. However, supporting evidence for this is not always robust. Including parents in decisions relating to medication is key to medicines optimisation. Parental concern regarding medication is a major determinant of poor adherence. This study explores parental experiences of having a child prescribed prophylactic antibiotics and […]
- Environmental risk factors, protective factors, and peripheral biomarkers for ADHD: an umbrella review.Many potential environmental risk factors, environmental protective factors, and peripheral biomarkers for ADHD have been investigated, but the consistency and magnitude of their effects are unclear. We aimed to systematically appraise the published evidence of association between potential risk factors, protective factors, or peripheral biomarkers, and ADHD.In this umbrella review of meta-analyses, we searched PubMed […]
- Oral health behavior among school children aged 11-13 years in Saveh, Iran: an evaluation of a theory-driven intervention.Good oral health (OH) is essential for physical, social, mental health, and overall quality of life. This study assessed the usefulness of the theory of planned behavior (TPB) in changing oral health-related behaviors among school children aged 11-13 years in Saveh, Iran.In this descriptive before and after study, participants were sixth-grade students at single sex primary […]
- Designing a paediatric hospital information tool with children, parents, and healthcare staff: a UX study.The hospital patient pathway for having treatment procedures can be daunting for younger patients and their family members, especially when they are about to undergo a complex intervention. Opportunities to mentally prepare young patients for their hospital treatments, e.g. for surgical procedures, include tools such as therapeutic clowns, medical dolls, or books and board games. […]
- Educational attainment trajectories among children and adolescents with depression, and the role of sociodemographic characteristics: longitudinal data-linkage study.Depression is associated with lower educational attainment, but there has been little investigation of long-term educational trajectories in large cohorts with diagnosed depression.To describe the educational attainment trajectories of children with a depression diagnosis in secondary care, and to investigate whether these trajectories vary by sociodemographic characteristics.We identified new referrals to South London and Maudsley’s […]
- Epidemiological surveillance study of female genital mutilation in the UK.Describe cases of female genital mutilation (FGM) presenting to consultant paediatricians and sexual assault referral centres (SARCs), including demographics, medical symptoms, examination findings and outcome.The well-established epidemiological surveillance study performed through the British Paediatric Surveillance Unit included FGM on the monthly returns.All consultant paediatricians and relevant SARC leads across the UK and Ireland.Under 16 years […]
- Innovations in Cardiorespiratory Monitoring to Improve Resuscitation With Helping Babies Breathe.Ninety percent of intrapartum-related neonatal deaths are attributable to respiratory depression, with the vast majority of these deaths occurring in low- and lower-middle-income countries. Neonatal resuscitation training with Helping Babies Breathe (HBB) decreases mortality from respiratory depression. Cardiorespiratory monitoring in conjunction with HBB can provide valuable resuscitation feedback for both training and bedside purposes. In […]
- Study of Natural products Adverse Reactions (SONAR) in children seen in mental health clinics: a cross-sectional study.Paediatric mental health patients frequently use natural health products (NHP) in addition to prescription medications, but very little is known about adverse events and possible NHP-drug interactions.To determine: (1) the prevalence of paediatric mental health patients taking prescription medications only, NHP only, both NHP and prescription medications concurrently or neither; (2) which prescription medications and […]
- Association of Prenatal Alcohol Exposure With Psychological, Behavioral, and Neurodevelopmental Outcomes in Children From the Adolescent Brain Cognitive Development Study.Data on the neurodevelopmental and associated behavioral effects of light to moderate in utero alcohol exposure are limited. This retrospective investigation tested for associations between reported maternal prenatal alcohol use and psychological, behavioral, and neurodevelopmental outcomes in substance-naive youths.Participants were 9,719 youths (ages 9.0 to 10.9 years) from the Adolescent Brain Cognitive Development Study. Based […]
- Large-Scale Functional Brain Network Architecture Changes Associated With Trauma-Related Dissociation.Dissociative experiences commonly occur in response to trauma, and while their presence strongly affects treatment approaches in posttraumatic spectrum disorders, their etiology remains poorly understood and their phenomenology incompletely characterized. Methods to reliably assess the severity of dissociation symptoms, without relying solely on self-report, would have tremendous clinical utility. Brain-based measures have the potential to […]
- Pediatric Mental Health Boarding.The growing prevalence of pediatric mental and behavioral health disorders, coupled with scarce psychiatric resources, has resulted in a substantial increase in the number of youth waiting in emergency departments (EDs) and medical units for inpatient psychiatric care.To characterize the prevalence of pediatric mental health boarding and identify associated patient and hospital factors.Medline and PsycINFO.All […]
- Mental Health and Timing of Gender-Affirming Care.Gender-incongruent (GI) youth have high rates of mental health problems. Although gender-affirming medical care (GAMC) provides psychological benefit, some GI youth present to care at older ages. Whether a relationship exists between age of presentation to GAMC and mental health difficulties warrants study.A cross-sectional chart review of patients presenting to GAMC. Subjects were classified a […]
- Long-term Cognitive, Psychological, and Health Outcomes Associated With Child Abuse and Neglect.Potential long-lasting adverse effects of child maltreatment have been widely reported, although little is known about the distinctive long-term impact of differing types of maltreatment. Our objective for this special article is to integrate findings from the Mater-University of Queensland Study of Pregnancy, a longitudinal prenatal cohort study spanning 2 decades. We compare and contrast […]
- Maternal Psychological Resilience During Pregnancy and Newborn Telomere Length: A Prospective Study.In the context of the importance of elucidating the determinants of the initial, newborn setting of telomere length (TL), it is increasingly evident that maternal stress and stress-related processes during pregnancy play a major role. Although psychological resilience may function as a buffer, research in this area has not yet examined its potential role vis-à-vis […]
- Alcohol, Tobacco, and Comorbid Psychiatric Disorders and Associations With Sexual Identity and Stress-Related Correlates.The authors examined psychiatric comorbidities associated with alcohol use disorders and tobacco use disorders among heterosexual, bisexual, and gay and lesbian men and women in the United States and whether stress-related factors were predictive of comorbidities.The authors used data from the National Epidemiologic Survey on Alcohol and Related Conditions-III (2012-2013, N=36,309) to examine the co-occurrence […]
- Imagery rescripting and eye movement desensitisation and reprocessing as treatment for adults with post-traumatic stress disorder from childhood trauma: randomised clinical trial.Investigation of treatments that effectively treat adults with post-traumatic stress disorder from childhood experiences (Ch-PTSD) and are well tolerated by patients is needed to improve outcomes for this population.The purpose of this study was to compare the effectiveness of two trauma-focused treatments, imagery rescripting (ImRs) and eye movement desensitisation and reprocessing (EMDR), for treating Ch-PTSD.We […]
- Emotional abuse and neglect: time to focus on prevention and mental health consequences.Emotional abuse and emotional neglect are among the most prevalent of childhood maltreatment types and associated with a range of poor mental health outcomes. We need to move beyond correlational research and shift our focus to sophisticated multimodal studies to fully understand the psychobiological mechanisms underlying these associations and to intervention studies. Get PDF with […]
- Imagery rescripting and eye movement desensitisation and reprocessing as treatment for adults with post-traumatic stress disorder from childhood trauma: randomised clinical trial.Investigation of treatments that effectively treat adults with post-traumatic stress disorder from childhood experiences (Ch-PTSD) and are well tolerated by patients is needed to improve outcomes for this population.The purpose of this study was to compare the effectiveness of two trauma-focused treatments, imagery rescripting (ImRs) and eye movement desensitisation and reprocessing (EMDR), for treating Ch-PTSD.We […]
- Emotional abuse and neglect: time to focus on prevention and mental health consequences.Emotional abuse and emotional neglect are among the most prevalent of childhood maltreatment types and associated with a range of poor mental health outcomes. We need to move beyond correlational research and shift our focus to sophisticated multimodal studies to fully understand the psychobiological mechanisms underlying these associations and to intervention studies. Get PDF with […]
- The Relationship Between Air Pollution and Cognitive Functions in Children and Adolescents: A Systematic Review.Air pollution has a negative impact on one’s health and on the central nervous system. We decided to assess studies that evaluated the relationship between air pollution and cognitive functions in children and adolescents by reviewing studies that had been published between January 2009 and May 2019. We searched three major databases for original works […]
- Intrapersonal predictors of weight bias internalization among elementary school children: a prospective analysis.Weight-related stigmatization is a widespread problem. Particularly the internalization of weight-related stereotypes and prejudices (weight bias internalization, WBI) is related to mental and physical health impairments. To date, little is known about the risk factors of WBI. Previous studies are mainly cross-sectional and based on adult samples. As childhood is a sensitive period for the […]
- Assessment of parental nurturing and associated social, economic, and political factors among children in the West Bank of the occupied Palestinian territory (WB/oPt).Parental nurturing expressed through love and affection is a broad concept that entails caring for children and their activities, encouraging them and praising their achievements. Lack of love and affection makes children more susceptible to psychological problems such as stress, anxiety and depression across their life time. This study aims to evaluate parental nurturing and […]
- The Sources of Parent-Child Transmission of Risk for Suicide Attempt and Deaths by Suicide in Swedish National Samples.The authors aimed to clarify the sources of parent-child transmission for suicide attempt and death by suicide.Three sources of parent-child resemblance (genes plus rearing, genes only, and rearing only) were examined in parents and offspring from four family types from Swedish national samples: intact nuclear families, families with a not-lived-with biological father, families with a […]
- Treatment-Specific Associations Between Brain Activation and Symptom Reduction in OCD Following CBT: A Randomized fMRI Trial.The authors sought to examine whether brain activity is associated with treatment response to cognitive-behavioral therapy (CBT) in adolescents and adults with obsessive-compulsive disorder (OCD), and whether any associations are treatment specific relative to an active control psychotherapy (stress management therapy; SMT).Eighty-seven patients with OCD (age range 12-45 years; 57 female, 39 medicated) were randomly […]
- The Sources of Parent-Child Transmission of Risk for Suicide Attempt and Deaths by Suicide in Swedish National Samples.The authors aimed to clarify the sources of parent-child transmission for suicide attempt and death by suicide.Three sources of parent-child resemblance (genes plus rearing, genes only, and rearing only) were examined in parents and offspring from four family types from Swedish national samples: intact nuclear families, families with a not-lived-with biological father, families with a […]
- Treatment-Specific Associations Between Brain Activation and Symptom Reduction in OCD Following CBT: A Randomized fMRI Trial.The authors sought to examine whether brain activity is associated with treatment response to cognitive-behavioral therapy (CBT) in adolescents and adults with obsessive-compulsive disorder (OCD), and whether any associations are treatment specific relative to an active control psychotherapy (stress management therapy; SMT).Eighty-seven patients with OCD (age range 12-45 years; 57 female, 39 medicated) were randomly […]
- Effectiveness of a peer-delivered, psychosocial intervention on maternal depression and child development at 3 years postnatal: a cluster randomised trial in Pakistan.Maternal depression has a recurring course that can influence offspring outcomes. Evidence on how to treat maternal depression to improve longer-term maternal outcomes and reduce intergenerational transmission of psychopathology is scarce, particularly for task-shifted, low-intensity, and scalable psychosocial interventions. We evaluated the effects of a peer-delivered, psychosocial intervention on maternal depression and child development at […]
- Maternal Depression in Early Childhood and Developmental Vulnerability at School Entry.To assess the relation between exposure to maternal depression before age 5 and 5 domains of developmental vulnerability at school entry, overall, and by age at exposure.This cohort study included all children born in Manitoba, Canada, who completed the Early Development Instrument between 2005 and 2016 (N = 52 103). Maternal depression was defined by using […]
- Self-management interventions to reduce healthcare use and improve quality of life among patients with asthma: systematic review and network meta-analysis.To compare the different self-management models (multidisciplinary case management, regularly supported self-management, and minimally supported self-management) and self-monitoring models against usual care and education to determine which are most effective at reducing healthcare use and improving quality of life in asthma.Systematic review and network meta-analysis.Medline, the Cochrane Library, CINAHL, EconLit, Embase, Health Economics Evaluations Database, […]
- Protocol for a pilot randomised, double-blind, placebo-controlled trial for assessing the feasibility and efficacy of faecal microbiota transplantation in adolescents with refractory irritable bowel syndrome: FAIS Trial.Irritable bowel syndrome (IBS) is a common chronic medical condition, in both children and adults. Despite the availability of effective (non)pharmacological treatments, symptoms persist in a significant amount of patients with IBS. Faecal microbiota transplantation (FMT) may be an effective alternative treatment in adolescents with refractory IBS through manipulation of the intestinal microbiota.This randomised, placebo-controlled […]
- Threat, hostility and violence in childhood and later psychotic disorder: population-based case-control study.A growing body of research suggests that childhood adversities are associated with later psychosis, broadly defined. However, there remain several gaps and unanswered questions. Most studies are of low-level psychotic experiences and findings cannot necessarily be extrapolated to psychotic disorders. Further, few studies have examined the effects of more fine-grained dimensions of adversity such as […]
- Increasing Early Childhood Screening in Primary Care Through a Quality Improvement Collaborative.Multiple early childhood screenings are recommended, but gaps persist in implementation. Our aim for this project was to improve screening, discussion, referral, and follow-up of development, autism spectrum disorder (ASD), maternal depression, and social determinants of health (SDoH) to 90% by July 2018.This 1-year national quality improvement collaborative involved 19 pediatric primary care practices. Supported […]
- Venipuncture activates the cerebral cortex in children with intellectual disability.To evaluate the pattern of cortical activation during a painful procedure, such as a venipuncture, in children with intellectual disability and compare it with that of cognitively healthy children.A cohort study was conducted and cortical activation was assessed by multichannel cerebral near-infrared spectroscopy to monitor variations in oxyhaemoglobin and deoxyhaemoglobin (Hbb) in children with and […]