Search Results (14,195)

Background. Children’s health-related quality of life (HRQoL) has been associated with both individual and family-related factors, including internalizing symptoms and parental psychological well-being. Although previous research has highlighted the role of parental mental health, evidence from non-clinical community samples remains limited, particularly when parent-proxy reports are used. Methods. A cross-sectional study was conducted among 242 parents of children aged 8–12 years in Northern Greece. Parents completed proxy measures of children’s HRQoL and internalizing symptoms, as well as self-reported measures of their own HRQoL and anxiety. Nonparametric tests were used for bivariate analyses, and multiple linear regression was applied to identify independent predictors of children’s HRQoL. Results. Higher parental mental HRQoL was positively associated with children’s HRQoL (ρ = 0.213, p = 0.031), while parental anxiety (trait anxiety: ρ = −0.204, p = 0.004; state anxiety: ρ = −0.314, p < 0.001) and parent-reported child internalizing symptoms (depression: ρ = −0.369, p < 0.001; anxiety: ρ = −0.322, p < 0.001) were negatively associated with HRQoL; however, in the multivariable model, only parental mental HRQoL (B = 0.344, p = 0.020) and parental education (B = −2.944, p = 0.044) remained significantly associated with parent-proxy child HRQoL, explaining 29.2% of the variance in children’s HRQoL (R² = 0.292). Conclusions. The findings suggest that parent-proxy child HRQoL is associated with parental psychosocial functioning in this community-based sample. Parental mental HRQoL was the strongest independent correlate of parent-proxy child HRQoL. However, given the exclusive use of parent-proxy reports and the convenience-based sample, these findings should be interpreted cautiously, as shared method variance, rater-related effects, and limited generalizability may have contributed to the observed associations. Further multi-informant and longitudinal studies conducted in more diverse populations are warranted. Full article

Allergic diseases are increasing globally, particularly among children, who are highly vulnerable due to critical windows of immune development. This review examines climate change as a key environmental determinant driving the rising burden of pediatric allergic diseases, including asthma, allergic rhinitis (AR), atopic dermatitis (AD), and food allergy (FA). Climate change influences disease risk through interconnected pathways, such as increased air pollution, altered aeroallergen patterns, and more frequent extreme weather events. Elevated carbon dioxide (CO₂) levels and rising temperatures prolong pollen seasons and enhance allergenicity, while pollutants such as ozone (O₃) and particulate matter (PM) exacerbate airway inflammation and immune dysregulation. Emerging evidence emphasizes the role of early-life exposure, particularly during prenatal and early postnatal periods, when environmental insults can induce long-term effects via epigenetic modifications and immune reprogramming. These mechanisms may increase susceptibility to allergic sensitization and subsequent disease development. Epidemiological studies consistently link exposure to air pollution, including PM_2.5 (PM with aerodynamic diameter < 2.5 μm) and nitrogen dioxide (NO₂), with increased risk of allergic diseases in children. Additionally, climate change-related events such as wildfires, sand and dust storms, and thunderstorms further elevate exposure to allergens and pollutants, contributing to acute exacerbations and disease progression. Climate change may also contribute to allergic diseases through microbiome dysbiosis, as altered environmental microbial exposures, biodiversity loss, air pollution, and antibiotic-associated microbial disruption may impair immune tolerance and promote allergic sensitization in children. Addressing this growing public health challenge requires integrated mitigation strategies to reduce greenhouse gas (GHG) emissions and improve air quality, alongside adaptive interventions to enhance resilience and reduce exposure. Understanding these mechanisms is essential for developing targeted prevention strategies and protecting child health in a changing climate. Full article

This qualitative study incorporates caregiver perspectives to identify their (1) experiences with medical and educational supports for their children with chronic TBI following inpatient rehabilitation and across the recovery trajectory and (2) recommendations to improve service provision for young people with TBI. Nineteen caregivers of children with complicated-mild-to-severe TBI participated in semi-structured virtual interviews. Participants were from a large Midwestern U.S. city. Researchers used reflexive thematic analysis, incorporating an experiential orientation and a deductive approach. Standards for Reporting Qualitative Research guided this process. Children were an average of 5.2 years post-injury, and age at injury ranged from 2.6 to 18.0 years, providing depth of caregiver experiences discussed in interviews. Four primary themes were identified: (1) TBI leads to lasting changes in the child, (2) the healthcare environment is overwhelming, (3) TBI forces a shift in caregiver responsibilities, and (4) school challenges persist over time. Caregivers generated concrete, experience-based recommendations, highlighting the need for increased support, resources, and education in specific areas following pediatric TBI. By centering caregiver voices across recovery, this study underscores their unique expertise in identifying system-level gaps and informing the development of interventions, services, and policies that better support children with TBI and their families over time. Full article

Background/Objectives: Social isolation is a significant risk factor for child maltreatment. However, few studies have examined this relationship across multiple ecological levels, including neighborhood, family, and individual factors. This cross-sectional study operationalized social isolation using social cohesion, social support, and loneliness, and aimed to examine how their inter-relationships influence child maltreatment among Japanese mothers. Methods: Data were collected through an anonymous online survey of 330 Japanese mothers of children aged under six years, conducted April–May 2025. Structural equation modeling was employed in a two-step analytic approach. First, a confirmatory factor analysis was conducted to establish construct validity. Second, the hypothesized structural model was tested to examine the proposed pathways among social cohesion, social support, loneliness, parenting stress, and child maltreatment. Analyses were conducted using weighted least squares with mean and variance adjustment estimation. Results: Higher social cohesion was indirectly associated with reduced child maltreatment via two pathways. First, higher social cohesion was associated with lower loneliness, reduced parenting stress, and decreased child maltreatment (β = −0.063, p < 0.001). Second, higher social cohesion was associated with greater social support, reduced loneliness, lower parenting stress, and decreased child maltreatment (β = −0.043, p < 0.001). Conclusions: These findings highlight that enhancing neighborhood connectedness and alleviating maternal loneliness are key changes that may help to prevent child maltreatment. Full article

Lipomyelomeningocele (LMMC) is one of the most common forms of occult spinal dysraphism, with an estimated incidence of 3–6 per 100,000 live births, and microsurgical untethering remains the cornerstone of management for symptomatic and selected at-risk children. The operation is technically demanding: reported rates of long-term symptomatic re-tethering after partial resection still reach 15–25%, and the surgeon must balance adequate untethering against preservation of the placode and lumbosacral nerve roots. In this technical note, we present a stepwise, illustrated description of our institutional 14-step microsurgical technique for pediatric LMMC. Each step is anchored to a defined anatomical landmark, beginning with a midline skin incision planned away from the anal verge and proceeding through subtotal subcutaneous lipoma resection, identification of the dural penetration site, a limited rostral laminectomy over normal anatomy, dural opening with circumferential dissection of lipoma–dura–cord adhesions, exploitation of the arachnoid–dura plane, electrophysiologically guided debulking of the intradural lipoma, stimulation-controlled division of the fatty filum, pia-to-pia reconstruction of the placode with 8-0 monofilament suture, expansile duraplasty with an artificial dural substitute, and reinforced multilayered watertight closure. Technical pearls aimed at minimizing the risks of cord injury, cerebrospinal fluid leak, and postoperative re-tethering are highlighted at each stage, and the role of multimodal intraoperative neurophysiological monitoring is emphasized. This note is intended as a practical, image-anchored operative reference for pediatric neurosurgeons and trainees managing this challenging closed neural tube defect. Full article

People often prefer similar others. The present study examined children’s use of three distinct similarity cues in their inferences about people’s social preferences. Participants were 144 children aged 4–8 years (49% female; 74% White). In a between-subject design, children observed a target actor demonstrate similar movements (movement condition), show the same liking/disliking of two toys (liking condition), or speak the same non-native language (language condition) as one of two actors (the similar actor) but not the other dissimilar actor. Children were then asked who the target liked to play with between the two actors. The results showed that children chose the similar actor in the movement condition, regardless of whether they explicitly identified the similar actor, whereas in the liking condition, they did so only when they could correctly identify the similar actor. In the language condition, however, the target and the similar actor speaking the same non-native language had no detectable impact on children’s answers. These findings are discussed in terms of how different types of similarity cues may shape children’s understanding of others’ social preferences, while also highlighting the need to consider differences in task demands and cue identifiability across conditions. Full article

Background/Objectives: Spiritual care is a core component of holistic paediatric palliative care, yet nurses often feel insufficiently prepared to address the spiritual and existential needs of seriously ill children and their families. This systematic review aimed to explore nurses’ experiences of providing spiritual care to seriously ill and dying children in paediatric palliative care settings and to identify the factors that facilitate or hinder its provision. Methods: A systematic review was conducted in accordance with PRISMA 2020. CINAHL, PubMed, Web of Science and SAGE were searched for English-language qualitative, quantitative and mixed-methods studies published up to November 2025. Study quality was assessed using JBI critical appraisal checklists, and the findings were synthesised thematically following Thomas and Harden. Results: A total of 228 records were identified, of which ten studies met the predefined inclusion criteria. The thematic synthesis identified one overarching theme—nurses’ engagement with spirituality while caring for seriously ill and dying children—supported by two sub-themes: managing emotional responses and maintaining professional, family-centred support. Conclusions: Nurses recognise spiritual care as essential in paediatric palliative care but often lack the competence and institutional support to provide it consistently. Education should prioritise spiritual assessment, developmentally appropriate communication, ethical boundaries, reflective practice and structured debriefing. Full article

Government-funded teacher education in China links financial support, teacher preparation, employment expectations, and post-graduation service obligations. Understanding how pre-service preschool teachers perceive this policy-based pathway is important for explaining their professional identity development; therefore, this study examined how policy satisfaction and perceived teacher support were associated with the professional identity of government-funded pre-service preschool teachers in Chongqing, Southwest China. Based on paper-based questionnaire data from 620 participants, Latent Profile Analysis identified four profiles: Dissatisfied–Low Support, Moderately Satisfied–Moderate Support, Highly Dissatisfied–Low Support, and Highly Satisfied–High Support. Multinomial logistic regression showed that only-child status and age significantly predicted profile membership, and one-way ANOVA and multiple regression further indicated that professional identity differed significantly across profiles, with lower scores observed in the less satisfied and less supported profiles after controlling for demographic covariates. These findings suggest that strengthening policy communication and accessible teacher support may help promote professional identity development among government-funded pre-service preschool teachers. Full article

Background/Objectives: Although food literacy is extensively studied in schools, the concept is less explored in the context of summer camps, which are also interesting learning environments. This qualitative study aimed to explore the clarity, usefulness and relevance of an adapted food literacy model for summer camps with camp counselors, camp managers and registered dietitians (RDs). Methods: Six semi-structured focus groups with counselors (n = 28) were conducted at summer camps located in the provinces of Quebec and Ontario, Canada. Semi-structured individual interviews were carried out online with camp managers (n = 5) and RDs (n = 6). Through an inductive approach, a thematic content analysis of transcribed verbatim was performed. Using a bottom-up approach, second and third final versions of the adapted food literacy model were developed. Results: Counselors and managers showed their intention to use an easy-to-use food literacy model. To improve their understanding, they proposed clarifying who will use the model and adding pictures. They expressed the need to be supported by incorporating concrete activity ideas and training to enhance the model’s usefulness. RDs highlighted that the model covered essential themes of food literacy. They expressed the need to clarify certain model components to make them easier to understand and more applicable to youth. Conclusions: This study contributed to the co-creation with participants of a clear, useful and relevant food literacy model tailored to the context of summer camps. Such a model will help camp counselors to implement relevant healthy eating actions and multiply opportunities to promote healthy habits among youth. Full article

Annotated text datasets are increasingly reused as classifier targets, annotation candidates, and inputs to aggregate profiles, yet their labels often circulate without enough information about how they were produced. This article presents a reproducible benchmark and validation workflow for the public SASB-Aligned ESG Sentences corpus, a sentence-level sustainability disclosure dataset organized around standards-based categories such as those used in Sustainability Accounting Standards Board (SASB) analytics. Using the downloaded 6460-row version of the corpus, we construct fixed train/validation/test splits, map released child labels to parent categories, and evaluate label reuse through supervised classifiers, prompted GPT-4o classification, blind and candidate-visible Claude annotation, and Monte Carlo aggregation into ESG/Non-ESG category profiles. The reproducibility artifacts provide split metadata, label mappings, prompt templates, model predictions, LLM annotation outputs, profile sensitivity outputs, figure inputs, and scripts for reproducing the reported tables and figures. Results show that label reproduction is strongest at coarser label levels, blind annotation flags 40.3% of held-out sentences as ambiguous, candidate-visible annotation increases agreement while changing the task format, and aggregate profiles remain sensitive to label source. The benchmark supports transparent reuse of sentence-level ESG labels by reporting label source, annotation condition, prompt family, and aggregation level. Full article

This research project aims to explore children’s multilingualism and how children’s preschools build on the language resources which families and children bring to their preschools. Research has shown that children actively create their own knowledge and can express themselves regarding their views on language learning and that each child has a unique bilingual or multilingual experience. This qualitative research study contributes to in-depth research with children on their multilingual experiences as described by their parents, preschool teachers and principals. Data was collected from 2022 to 2025 in semi-structured interviews with six parents, their children’s preschool teachers and principals in three preschools in Iceland. The findings indicate that the parents value their children’s language repertoire and use diverse tools to support their children’s multilingualism. The teachers in the study are all interested in supporting the children’s multilingualism, although some of them claim that they lack knowledge, training, and support in implementing multilingual practices. The children are active agents in developing language policies and practices in their families. They contribute to their families’ language practices with their input, ideas, choices, and language preferences. Although Icelandic is the main language used in the preschools, the children, supported by their teachers and principals, have the opportunity and agency to develop their multilingualism. The research findings provide practitioners, policy makers and parents with suggestions as to how children can and will benefit from support in maintaining their heritage languages. More structured collaboration and policy guidance are likely to strengthen children’s multilingualism. Full article

Burkitt lymphoma (BL) is an aggressive B-cell lymphoma endemic in children in regions of sub-Saharan Africa, where its incidence geographically overlaps holoendemic Plasmodium falciparum malaria and poorly controlled childhood Epstein–Barr virus (EBV) infection. Despite decades of research, the precise mechanistic synergy between these two pathogens remains incompletely defined. This review synthesizes current epidemiological, immunological, and molecular evidence to propose an integrated model for the etiology of endemic BL. We outline a paradoxical, dual-edged relationship wherein EBV infection during infancy may provide a short-term child survival advantage against severe malaria while simultaneously increasing the long-term oncogenic risk in B-cells infected by EBV. P. falciparum infection triggers polyclonal B-cell activation, increasing the probability of an activation-induced cytidine deaminase (AID)-mediated c-MYC translocation in proportion to the recurrent parasite burden. Concurrently, EBV expands within this B-cell pool and modulates the host immune response, potentially through viral interleukin-10 (vIL-10), to prevent lethal malarial inflammation. At the cellular level, EBV provides a critical “second hit” when it establishes latency I infection that rescues c-MYC-translocated B-cells from apoptosis. This framework explains why BL manifests as a “tumor of malaria survivors,” peaking in incidence years after the highest-risk period for malaria mortality. Ultimately, this model underscores that malaria control is a critical form of cancer control and highlights key future directions for validating these pathways in prospective clinical studies. Full article

In the present study, cardiovascular risk indices (Atherogenic Index of Plasma [AIP], Atherogenic Coefficient [AC], Castelli Risk Index-1 [CRI-1], and Castelli Risk Index-2 [CRI-2]) and bone mineral density (BMD SDS) were evaluated in patients with Familial Mediterranean Fever (FMF), and the association of these parameters with disease severity and MEFV gene mutations was investigated. A total of 126 participants (96 FMF patients and 30 healthy controls) were included in the study. FMF patients were classified as mild, moderate, or severe according to the PRAS severity score. Cardiovascular risk indices, biochemical parameters of bone metabolism, and BMD SDS values were compared among the groups. The relationship between BMD SDS and atherogenic indices was assessed by Spearman correlation analysis. The results were also analyzed according to MEFV gene mutations. No significant difference was detected among the groups in terms of sex or age (p > 0.05). FMF patients were found to have substantially higher cardiovascular risk indices than the control group, and these indices increased in parallel with disease severity (p < 0.05). The BMD SDS value of the severe FMF group was significantly lower than that of the other groups (p = 0.025). No difference was detected among the groups with respect to bone metabolism parameters (p > 0.05). No significant correlation was observed between BMD SDS and cardiovascular risk indices (p > 0.05). M694V was the most frequently detected mutation, and the BMD SDS value was lower in patients carrying mutations other than M694V (p = 0.011). The increased cardiovascular risk in FMF patients is associated with disease severity. Severe disease is accompanied by a reduction in bone mineral density. The lack of an association between cardiovascular risk and bone mineral density suggests that these systems may be affected through different mechanisms. It is important that FMF patients are monitored with respect to cardiovascular and bone health. Full article

Children of imprisoned parents, who are often described as ‘orphans of justice’, suffer a multitude of disadvantages when a parent is sent to prison. Whilst their experiences of loss, stigma, and social exclusion are well documented, one area that remains critically under-examined is how court reporting processes may further exacerbate these harms. This study explores the lived experience of children 11–17 yrs (n = 6) who had experienced parental imprisonment, and non-offending adults (parents, caregivers, and adult children of offenders/n = 6) in relation to their experiences of parental crime reported in the press. This study also integrates views from individual interviews conducted with journalists and press regulators (n = 5), as well as data from a content analysis of three regional and two national newspapers across a three-week period. Findings indicate that current court reporting practices can be, for some children and family members, a contributing factor to their difficulties. Participating children and family members assert that publishing partial home addresses and references to family relationships heightens their visibility in the community, which they say contributes to community backlash and negatively affects their physical and mental wellbeing. The content analysis (n = 186 custody related news reports) showed selective disclosure of offenders’ personal and family details. Interviewed journalists strongly defended the principle of open justice and felt legally unable to add the wider context families often wished to share. However, they expressed genuine sympathy for the children, and while resistant to new legal restrictions, were open to developing voluntary guidance to help reduce harm where possible. This study proposes an integrated framework to strengthen ethical journalism and better protect children impacted by parental imprisonment, calling for improved public information, trauma-informed education, participatory research and practitioner tools that centre children’s rights. It argues that open justice must be balanced with relational accountability, ensuring open justice does not come at the expense of children’s wellbeing. Full article

Media representations play a key role in shaping how cyberbullying is understood, problematized, and regulated, particularly in relation to children and young people in the digital environment. While legal scholarship has extensively examined the criminalisation of cyberbullying, less attention has been paid to how these legal developments are reflected in media discourse. This study addresses this gap by analysing the relationship between criminal-law responses and media representations of cyberbullying in Hungary within a broader European context. The research combines a qualitative media discourse analysis of 82 articles from leading Hungarian online news portals (2024–2025) with a comparative legal analysis of criminalisation patterns across EU Member States and a descriptive examination of the Hungarian offence of “online aggression”. The findings identify three dominant media narratives—child protection and social problem framing, criminal justice framing, and regulatory discourse—of which the first is the most prevalent. The results also reveal a limited alignment between legal regulation and media representation, as criminal-law approaches to cyberbullying appear only marginally in media narratives, which instead emphasise prevention, awareness, and institutional responses. These findings suggest that media discourse not only reflects but also shapes societal understandings of cyberbullying, highlighting the importance of considering media narratives in the development and evaluation of legal and policy responses. Full article