Search Results (5,291)

The quality of the grandparent–grandchild relationship has been associated with positive developmental outcomes, including emotional regulation, also during adolescent years. However, available measures often lack psychometric evidence supporting their use with adolescent populations, including the Grandchildren’s Received Affection Scale, which is one of the most widely used measures of grandchildren’s perception of affection received from their grandparents. This study examined the psychometric properties of the Grandchildren’s Received Affection Scale for Adolescents (GRAS-A), including its internal structure, internal consistency, sex-based measurement invariance, and construct validity. A sample of 220 adolescents (Mage = 16.45; 53.2% girls) reported on residing with grandparents, the grandparent they were closest to, and the frequency of contact with their grandparents, and completed the GRAS-A and a measure of emotion regulation. Confirmatory factor analyses supported a 15-item four-factor model, and all subscales demonstrated at least acceptable internal consistency. The measurement model was invariant across boys and girls, who reported comparable levels of affection received from grandparents. GRAS-A scores were positively associated with cognitive reappraisal and frequency of contact with grandparents, and did not differ according to whether adolescents identified their maternal or paternal grandparents as the closest. These findings provide evidence for the reliability and validity of the GRAS-A as a measure of adolescents’ perceptions of affection received from grandparents, supporting its use in research on grandparent–grandchild relationships during adolescence. Full article

Violence against women (VAW) is highly prevalent in Kenya and is especially concentrated in informal settlements, where poverty, inadequate infrastructure, and limited protection systems heighten exposure to harm and constrain help-seeking and exit. Although research has increasingly examined violence prevention and response in these settings, less is known about how women with lived experience of VAW understand the conditions needed to prevent violence, interrupt ongoing harm, and sustain safety. This study examined survivor-defined priorities across Kibera and Mathare, two informal settlements in Nairobi. We conducted in-depth, semi-structured interviews with 36 women and analyzed the transcripts using inductive thematic analysis. Analysis identified three interconnected themes: material conditions of safety and autonomy; accessibility and trust in systems of support; and social and relational conditions sustaining violence. Across these themes, participants emphasized economic autonomy; safe and reliable infrastructure; knowledge of rights and referral pathways; responsive and accountable institutions; accessible, confidential, and continuous formal support; social connection and informal support; and transformation of gender norms, including engagement with men and boys. These priorities did not map neatly onto a single stage of prevention but operated across preventing violence, interrupting ongoing harm, and supporting longer-term safety and recovery. The findings underscore the need for VAW strategies in informal settlements that address the interconnected material, institutional, and relational conditions shaping women’s capacity for safety. Full article

Background: Concentric knee and trunk strength may contribute differently to maximal force and stretch-shortening cycle performance in youth sailors. This study evaluated the predictive value of concentric knee and trunk isokinetic strength for these outcomes in highly trained youth Optimist sailors. Methods: Forty highly trained Optimist sailors (20 boys and 20 girls; age, 13.03 ± 1.40 years) completed knee and trunk isokinetic testing at 60°·s⁻¹ and 180°·s⁻¹, isometric mid-thigh pull, squat jump, and countermovement jump tests. Velocity-specific multiple linear regression models included a composite of dominant and nondominant knee extensor and flexor strength, trunk extensor strength, trunk flexor strength, and sex. Results: The models explained 60.7% and 49.4% of the variance in isometric mid-thigh pull peak force at 60°·s⁻¹ and 180°·s⁻¹, respectively. The knee strength composite was independently associated with peak force at both velocities (β = 0.51, p = 0.003; β = 0.56, p = 0.006). The models explained 1.3–3.5% of dynamic strength index variance and 17.8% and 4.5% of eccentric utilization ratio and elastic index variance at 60°·s⁻¹ and 180°·s⁻¹, respectively. Trunk flexor strength was associated with eccentric utilization ratio and elastic index at 60°·s⁻¹ (β = 0.52, p = 0.029), although these outcomes are mathematically dependent. Sex was not associated with any outcome. Conclusions: Concentric isokinetic strength showed greater predictive value for maximal force than for stretch-shortening cycle performance. Combined knee extensor and flexor strength was consistently associated with maximal force, whereas limited variance was explained in stretch-shortening cycle outcomes. Full article

In urban slums, adolescent sexual and reproductive health and rights (ASRHR) are shaped by societal structures which contribute to vulnerabilities, health inequities, and adverse ASRHR outcomes. There have been increasing calls for meaningful youth engagement to foster positive change. The Together Project is a youth-led research project implemented in Kallyanpur slum in Dhaka (Bangladesh) aiming to answer the question: How are societal structures shaping ASRHR structural vulnerabilities and agency? Working with 10 adolescent community co-researchers (8 girls, 2 boys), we recruited 22 participants (16 girls, 6 boys) for a photovoice study exploring ASRHR experiences. We collected 58 photos analyzed through Visualizing DEPICT, a participatory method, and co-developed three themes. First, “Navigating limited ASRHR awareness through a broken system” demonstrates how perspectives of ASRHR are structured within a restrictive system. Second, “Facing gender-based inequities from girlhood to womanhood” highlights gendered inequities that influence structural vulnerabilities affecting adolescent girls. Third, “Shaping ASRHR through community and social pressure” summarizes how social structures shape ASRHR. By centering adolescents’ understandings of ASRHR in an urban slum of Dhaka, we present a discussion of how ASRHR are shaped through oppressive structures. Our findings underscore the urgent need for structurally informed ASRHR interventions to support transformative societal changes. Full article

Background: Duchenne muscular dystrophy (DMD) is the most common X-linked progressive neuromuscular disorder of childhood. The classic course of DMD is characterized by onset after a period of normal motor development. However, in recent years, evidence has been accumulating of prodromal features of the disease, including speech delays and neurocognitive impairments. Methods: This study investigates whether congenital bilateral clubfoot may represent the first clinical manifestation of DMD. Results: We present two cases of male patients with congenital bilateral clubfoot who were subsequently diagnosed with DMD. We demonstrate the high efficacy and safety of the Ponseti method for correcting foot deformities in these patients. We discuss a possible pathogenic link between dystrophin deficiency and impaired intrauterine myogenesis. Conclusions: This is the first report of an association between congenital clubfoot and DMD, highlighting the need for expanded early diagnostic protocols for boys presenting with idiopathic clubfoot. Full article

Background: Building on Duda’s hierarchical approach, this study examined gender differences in students’ perceptions of (dis-)empowering motivational climates, self-esteem and social physique anxiety in the physical education context. Furthermore, it analysed the associations of (dis-)empowering climates with these self-presentation-related outcomes among boys and girls. Methods: A total of 2438 Spanish Physical Education students (Mage = 16.15 ± 2.01; 50.74% girls) participated in this cross-sectional research. A multi-group structural equation modeling approach was used to answer the research objectives. Results: Girls scored significantly higher than boys in negative self-esteem and social physique anxiety. The multi-group structural equation modeling showed slightly higher coefficients among boys for the associations between empowering climate and positive self-esteem and between disempowering climate and negative self-esteem. The negative self-esteem–SPA coefficient was higher among boys, whereas the inverse positive self-esteem–SPA coefficient was higher among girls. Conclusions: The main findings underscore the relevance of PE teachers creating empowering climates and avoiding disempowering climates, given their associations with positive self-esteem and social physique anxiety among boys and girls. Full article

Philip Roth’s The Plot Against America represents his exploration of the psychological influence of prejudice—in this case anti-Semitism—upon a young boy. Roth varies his narrative approach, sometimes allowing the older Philip Roth to comment on events but for the most part working through indirect discourse to allow the reader to see into the mind of Young Philip as he tries to absorb the impact of anti-Semitism on his family. Roth reveals the emotional response of his characters as they experience individual events involving anti-Semitism, with Young Philip experiencing mostly fear and humiliation, his father overwhelmed by indignation. Full article

Background/Objectives: Juvenile systemic sclerosis (jSSc) is a rare, chronic autoimmune disease with limited pediatric data. We aimed to characterize the demographic, clinical, immunological, and microvascular features of a Russian cohort of children with jSSc, and to evaluate treatment outcomes and predictors of escalation to biologic therapy. Methods: A retrospective single-center study of 40 children with jSSc (36 girls, 4 boys) followed over a 20-year period (2004–2024) was conducted. Clinical assessment included the modified Rodnan Skin Score (mRSS) and the Juvenile Systemic Sclerosis Severity Score (J4S). Nailfold capillaroscopy (NFC) was performed in 12 patients. Autoantibody profiling was available for 30 patients. Two first-line regimens were compared: glucocorticosteroids with penicillamine (PA, n = 19) versus glucocorticosteroids with DMARDs (methotrexate, mycophenolate mofetil, or cyclophosphamide; n = 21). Predictors of switching to biologic therapy were identified using binary logistic regression. Results: Median age at onset was 9.0 years (IQR 6.0–10.0), and diagnostic delay was 12.0 months (IQR 4.0–24.0). Diffuse cutaneous jSSc predominated (82.5%). Gastrointestinal involvement was detected in 82.5%, Raynaud’s phenomenon in 87.5%, and ILD in 37.5%. NFC revealed reduced capillary density (5.26 ± 1.33/mm). Giant capillaries were observed exclusively in males (4/4 vs. 0/8, p = 0.002). DMARD-based regimens were associated with better outcomes than PA, particularly for joint involvement. Eleven patients (27.5%) were switched to biologic therapy, primarily rituximab. ILD and J4S > 15 were the strongest predictors of switching (probability 60–61% vs. 8–15%, p < 0.001). The 5-year survival was 100%; the estimated 10-year survival was 71.4%, although the latter estimate should be interpreted cautiously because of the small number of events and loss to follow-up. Conclusions: In our cohort, children with jSSc present predominantly with diffuse cutaneous involvement. Male patients may be at risk for more severe microvascular changes, possibly related to diagnostic delay. ILD and J4S > 15 were associated with escalation to biologic therapy, and earlier switching to rituximab may be beneficial in refractory patients. Future prospective multicenter studies are needed to validate these findings. Full article

Background/Objectives: Chronic non-cancer pain often requires approaches beyond pharmacological treatment. This protocol describes a mixed-methods study evaluating the effectiveness of a multicomponent intervention based on non-pharmacological therapies (NPhTs) and exploring participants’ post-intervention experience. Methods: The design includes a randomized, controlled, two-arm parallel-group clinical trial with 1:1 allocation, embedded within a mixed-methods approach that includes a qualitative phenomenological strand. This study will be conducted at Hospital San Juan de Dios del Aljarafe, Spain. A total of 160 adults with chronic non-cancer pain will be randomly assigned to the intervention or control group. The intervention group will receive five weekly 3.5 h face-to-face sessions combining pain education, emotional regulation, cognitive-motivational and mind–body techniques, lifestyle recommendations, peer support, and home practice, supported by a mobile application. The control group will continue usual care, without the workshop or intervention-related app content. The primary outcome will be change in the EuroQol-5D (EQ-5D) index from baseline to 1 month. Secondary outcomes will include the EQ-5D visual analogue scale (VAS) score, pain intensity, well-being, self-esteem, resilience, anxiety and depression, pain catastrophizing, medication use, and healthcare resource use. Outcomes will also be assessed at 4 months and, in the intervention group, at 7 months. Semi-structured interviews will explore the participants’ experiences, perceived usefulness of the techniques, and barriers and facilitators to maintaining the strategies learned. Conclusions: This protocol will evaluate the effectiveness and acceptability of a structured group-based NPhT intervention for chronic non-cancer pain. The findings may inform its applicability to person-centered and self-care-oriented models of care. Trial registration: ClinicalTrials.gov NCT06440668. Full article

This study sought to document the psychometric properties of scores on the French Version of the Physical Literacy Self-Description questionnaire. A sample of 191 French-speaking Canadian and French children, aged 5–12 years, participated in this study. Results from an exploratory factor analytic solution supported a two-factor solution encompassing (a) perceived confidence and value; and (b) perceived skills competence. Subsequent analyses supported the weak, strong and strict invariance of this solution as a function of sex, and its weak, strong, and partial strict invariance (one item was less reliable in France) across countries. The results also revealed meaningful differences in terms of latent variances (showing more inter-individual variability in Canada and among boys) and covariances (showing stronger correlations in France and among boys) across grouping variables. Results further revealed a lack of differential item functioning as a function of age and time spent in moderate to vigorous physical activities, but minimal evidence of differential item functioning as a function of body mass index (on two items). Moreover, Canadian children scored higher on perceived confidence and value and lower on perceived skills competence, while younger children scored higher on perceived skills competence. Likewise, children spending more time in moderate physical activity scored higher in the perceived confidence and value factor, while those spending more time in vigorous physical activity scored higher on the perceived skills competence factor. Finally, results supported the convergent validity of scores obtained on the French Physical Literacy Self-Description questionnaire in relation to parental ratings of children’s overall, cognitive, and motor physical literacy. Full article

Background/Objectives: The retina is a highly metabolically active tissue that depends on precise vascular regulation. Childhood represents a critical period of ocular growth, and retinal vascular characteristics may provide insights into the relationship between microvascular development, ocular biometry, and refractive development. However, retinal vascular parameters in children living at high altitude remain poorly characterized. Our goal was to characterize retinal vascular caliber and evaluate its associations with ocular biometric parameters, refractive status, and peripheral oxygen saturation among children living at high altitude. Methods: This cross-sectional baseline analysis included 1410 children from the Lhasa Childhood Eye Study. Retinal vascular parameters, including central retinal arteriolar equivalent (CRAE), central retinal venular equivalent (CRVE), and arteriolar-to-venular ratio (AVR), were measured from fundus photographs using computer-assisted IVAN software. Ocular biometric parameters, cycloplegic refraction, and SpO₂ were assessed. Multivariable linear regression and sensitivity analyses accounting for school clustering and ocular magnification were performed. Results: The mean age was 7.90 ± 0.49 years, and 47.6% were female. Girls had shorter axial length (AL) and larger CRAE and CRVE than boys. Longer AL was associated with smaller CRAE (B = −5.64, p < 0.001) and CRVE (B = −11.24, p < 0.001), while AVR was positively associated with AL (p = 0.03). Lower SpO₂ was independently associated with larger CRAE (B = −0.35, p = 0.042), but not CRVE. After AL-based relative ocular magnification correction, the associations between AL and CRAE or CRVE were no longer significant. Myopic children had smaller CRAE and CRVE and higher AVR than non-myopic children. Conclusions: Retinal vascular caliber was associated with ocular biometric characteristics, SpO₂, and refractive status in children living at high altitude. The attenuation of AL-related associations after magnification correction highlights the importance of accounting for ocular magnification in retinal vascular measurements. Full article

Central nervous system (CNS) relapse remains a major cause of treatment failure in pediatric acute lymphoblastic leukemia (ALL). Repeated isolated CNS relapse is particularly rare and associated with poor prognosis, while optimal therapeutic strategies remain insufficiently defined. Intensified CNS-directed therapy may improve disease control but is also associated with substantial long-term neurotoxicity and survivorship burden. We present the case of a boy with favorable-risk B-cell ALL who developed two isolated CNS relapses despite a good initial response to frontline therapy and absence of classical CNS relapse risk factors. The second relapse was associated with extensive meningeal involvement and optic nerve infiltration. The patient underwent intensive multimodal CNS-directed therapy, including repeated intrathecal chemotherapy, liposomal cytarabine administered according to the IntReALL 2010 protocol, cranial irradiation, and allogeneic hematopoietic stem cell transplantation (alloHSCT) from a matched sibling donor. Durable long-term remission was achieved despite the extremely unfavorable prognosis that is associated with a second isolated CNS relapse. A twenty-year follow-up extending into early adulthood revealed substantial late complications, including epilepsy, transient ischemic attack, optic nerve injury, endocrinopathies, obesity, secondary thyroid malignancy, neurocognitive difficulties, and depression requiring long-term psychiatric and psychological support. The present case illustrates the complex balance between effective CNS disease control and cumulative treatment-related neurotoxicity in pediatric ALL survivors. It also highlights the cumulative CNS injury and long-term survivorship burden that is associated with repeated CNS relapse and multimodal CNS-directed therapy. Full article

Background/Objectives: The primary objective of the present study was to assess motor competence and identify motor difficulties among Greek adolescents using the Movement Assessment Battery for Children—2nd Edition (MABC-2). The secondary aim was to evaluate associations and differences across gender, school grade (age), BMI, hand dominance, extracurricular organized PA participation, and school type in relation to motor competence. Methods: The MABC-2 was utilized primarily as an exploratory screening instrument to identify potential motor difficulties within the sampled adolescent cohort (N = 742; M_age = 13.98 yrs.), rather than as a definitive clinical diagnostic tool for Developmental Coordination Disorder. Results: This study identified a low prevalence of motor difficulties among the sampled adolescents (1.5% definite, 3.6% at risk). Preliminary trends suggested a 1.5:1 boy-to-girl motor difficulty ratio. Within exploratory analyses, “at-risk” boys scored lower in balance and manual dexterity, while girls showed potential challenges in ball skills. Tentative subgroup analyses indicated that physical activity participants within these cohorts scored higher in balance and ball skills, though small sample sizes warrant caution. Other demographic or school environmental factors—specifically academic grades, body mass index, handedness, and school types—showed no clear associations with motor competence. Conclusions: This study identified a low prevalence of motor difficulties among Greek adolescents, with preliminary trends suggesting that structured extracurricular activity may support motor development. The findings indicate potential gender variations in specific motor domains and highlight the need for longitudinal research to confirm these observations. Full article

PLA2G6-associated neurodegeneration (PLAN) is an autosomal recessive neurodegenerative spectrum encompassing infantile, juvenile/atypical and adult-onset phenotypes. Juvenile PLAN may initially resemble autism spectrum disorder or nonspecific developmental regression, delaying diagnosis. We describe a 14-year-old boy and his 9-year-old sister, both with initially normal early development, followed by progressive gait impairment, speech and cognitive regression, epilepsy or paroxysmal events, contractures and loss of independent ambulation. Brain MRI in both siblings demonstrated marked symmetric cerebellar atrophy, susceptibility-weighted hypointensity of the globus pallidus and substantia nigra compatible with iron accumulation and bilateral optic nerve thinning. Electroneurography showed selective motor axonal involvement. Molecular testing identified the same two heterozygous PLA2G6 findings in both children: c.1934G>A (p.Arg645Gln), classified as likely pathogenic by the diagnostic laboratory, and a copy-number gain encompassing exons 4–7. Parental testing was unavailable; therefore, the phase of the findings could not be established, and it remains unknown whether they are in trans or in cis. The shared phenotype is highly suggestive of juvenile PLAN. However, unresolved phase and incomplete structural characterization of the copy-number gain preclude confirmation of biallelic PLA2G6 involvement and definitive molecular attribution. These related cases provide a descriptive account of a juvenile PLAN-like phenotype, without independently attributing the phenotype to p.Arg645Gln, establishing variant pathogenicity or a specific genotype–phenotype correlation. Full article

The COVID-19 pandemic affected adolescent mental health. However, the concurrent associations among adolescents’ preventive practices, parent–child conflict, and depressive symptoms during the initial lockdown remain unclear. This cross-sectional study included 2558 adolescents (48.75% girls; M age = 13.06 years) from Zhengzhou, China, of whom 2543 were included in the analytic sample after cases missing age or class identifiers were excluded. All focal constructs were assessed once by adolescent self-report. Latent moderated mediation analyses showed that preventive practices were directly and negatively associated with depressive symptoms. A significant indirect association was observed through parent–child conflict such that greater engagement in preventive practices co-occurred with less parent–child conflict and fewer depressive symptoms. The negative direct association between preventive practices and depressive symptoms was stronger for boys, whereas the positive association between parent–child conflict and depressive symptoms was stronger for girls. However, these interaction terms added only ΔR² = 0.003 and 0.004 in observed-score sensitivity models and were not statistically significant in the subsample sensitivity analysis. These findings identify parent–child conflict as a concurrent correlate of the association between preventive practices and depressive symptoms during the pandemic. Full article