Search Results (456)

Background: Increasing evidence suggests that breast milk and its bioactive components, including short-chain fatty acids and the milk microbiome, are influenced by maternal nutrition and body mass index (BMI). Bioactive components transferred to the infant through breast milk play a pivotal role in infant growth and development and have indications in the child’s future short- and long-term health outcomes. This study aimed to assess the impact of maternal pre-pregnancy BMI (PP-BMI) on human breast milk macronutrient composition, short- and long-chain fatty acid profiles, and breast milk microbiome profiles. Approach: This was an exploratory cohort study of forty-four lactating Caucasian women, two to fourteen weeks postpartum, divided into groups based on pre-pregnancy body mass index (BMI). Study participants signed informed consent, completed health and nutritional surveys, and provided a breast milk sample. Breast milk samples were subjected to proximate analysis, microbiome identification and short- and long-chain fatty acid extraction and analysis. Results: Maternal age, maternal physical activity, infant birth weight, and time of lactation at sample collection were not significantly different between the maternal PP-BMI groups. PP-BMI was significantly different between the two maternal groups. No significant differences were found between the maternal BMI groups concerning nutritional intake. No differences in breast milk microbiomes were observed in alpha diversity and beta diversity between the maternal PP-BMI groups. For long-chain fatty analysis in breast milk samples, myristic acid was significantly higher in the PP-BMI overweight/obese group while stearic acid was significantly higher in the PP-BMI normal-weight group. Butyric, valeric, and isocaproic acid concentrations in HBM were significantly higher in the PP-BMI normal-weight group and lower or undetectable in the PP-BMI overweight/obese group. Conclusions: Data from this exploratory cohort study indicate that maternal diet and pre-pregnancy BMI may be associated with differences in selected HBM fatty acids. There were no significant differences in microbiomes for alpha and beta diversity in breast milk between maternal PP-BMI groups; however, lower relative abundance was observed in the breast milk of the PP-BMI overweight/obese group. These findings should be interpreted in the context of the study’s limitations, including convenience recruitment from a Facebook group, the modest sample size, and restriction to Caucasian women from a single geographic region. Full article

Temporal psychological well-being (subjective well-being, future confidence and life satisfaction) is an important indicator of the level of mental health and well-being. During adolescence, the dynamic development of their psychological well-being is more susceptible to multiple factors. However, the trends and multidimensional influences on adolescents’ temporal psychological well-being, as well as their co-development with the relationship between interpersonal relationships and temporal psychological well-being, are not known. Therefore, 568 adolescents (M_age ± SD = 17.41 ± 1.14) aged 16 to 19 years were selected for this study using longitudinal data from the 2018, 2020, and 2022 China Family Panel Studies (CFPS). Analyses were conducted using the latent growth curve model (LGCM). It was found that adolescents’ subjective well-being, future confidence, and life satisfaction showed a significant linear decline. Health status, academic pressure, and parent–child relationships were significantly associated with the initial level and developmental trajectory of temporal psychological well-being. In addition, we observed co-development patterns between interpersonal relationships and adolescents’ temporal psychological well-being, such that parallel changes in interpersonal relationships coincided with changes in well-being over time, and vice versa. This study reveals the dynamic patterns of changes in adolescents’ temporal psychological well-being and their co-development with relationships, providing empirical evidence for targeted interventions. Full article

Parental emotional expressivity toward their child is an integral component of creating a family emotional climate, which is the primary context in which children develop social–emotional skills. The current study sought to empirically test Darling and Steinberg’s model that parent attitudes that make up parenting style effect parental emotional expressivity during parent–child interaction. Using longitudinal data from the NICHD Study of Early Child Care and Youth Development (SECCYD), the authors examined the compounding effects of maternal authoritarian attitudes measured soon after birth on maternal emotional expressivity toward their infant across three time points (child at 6, 15, and 24 months old). Hierarchical linear modeling analyses (HLMs) demonstrated that a mother’s (n = 1165, M_age = 28.2 years) authoritarian attitudes were associated with both decreased positive expressivity and increased negative expressivity toward their child at 6 months of age. Mothers who held more authoritarian attitudes at baseline demonstrated an increased rate of growth in negative expressivity toward their child over time. Maternal race and income were also significantly associated with the linear rate of growth of negative expressivity over time but not in positive expressivity. This suggests that authoritarian attitudes measured when the child is 1 month old continue to impact parent behavior up to 23 months later. This pattern suggests a potential window for effective universal prevention efforts in promoting nurturing parent behavior and promoting positive parent–child relationships. A possible target of prevention intervention could be providing parents with components of a modularized emotion regulation curriculum. The content could help parents to regulate their negative expressivity toward the child and focus on the message they want to convey to the child related to the child’s specific behavior. Full article

This study revisits the debate surrounding the impact of Official Development Assistance (ODA), also known as foreign aid, on two macro-indicators: economic growth and child mortality. Unlike previous studies, which assessed the interaction of aid with composite indicators of recipient countries, this study examines the impacts of individual recipient factors, such as corruption, democracy, income, wars and exports. To overcome the issue of an inverse causal relationship potentially existing between the amount of aid received and macro-performance, a model of donor aid allocation is specified within an instrumental variables framework. The results show that ODA is more likely to be positively associated with economic growth in countries with lower levels of corruption. This positive association is evident when the level of corruption is at least one standard deviation lower than the recipient’s average. The interaction of ODA with recipients’ levels of democracy, income, wars or exports does not show a significant association with growth. The association between ODA and child mortality appears to be generally more significant, with a positive sign, than that obtained for economic growth, although the magnitude is relatively modest. Full article

Background/Objectives: Distal femoral physeal fractures are rare and particularly uncommon in very young patients, as they typically require a significant amount of kinetic energy. They carry a high risk of premature physeal closure and later growth disturbance. We aimed to describe the management and long-term outcome of an open distal femoral physeal fracture in a 6-year-old child. Methods: We report a previously healthy 6-year-old child sustained an open distal femoral physeal fracture in an electric scooter–motor vehicle collision. Emergency treatment included trauma assessment, resuscitation, intravenous cefazolin, urgent irrigation and debridement, open reduction, crossed smooth Kirschner-wire fixation, and immobilization. Long-term follow-up included growth prediction using the multiplier method. Results: The injury was classified intraoperatively as a Salter–Harris type I distal femoral physeal fracture. Despite timely surgical treatment, progressive limb-length discrepancy developed, increasing from 1.3 cm at 10 months to 6.5 cm over 5 years. Growth prediction estimated a final discrepancy of 7.32 cm at skeletal maturity, and contralateral distal femoral epiphysiodesis was performed. The literature confirms that displaced high-energy distal femoral physeal injuries in younger children carry a substantial risk of premature physeal closure and later corrective surgery. Conclusions: Open high-energy distal femoral physeal fractures in young children are limb-growth-threatening injuries. This case demonstrates that satisfactory initial fracture management does not eliminate the risk of later premature physeal closure, and that clinically important discrepancy evolves gradually over several years. Long-term follow-up and growth prediction are essential to guide timely corrective treatment to minimize the leg-length discrepancy in bone maturity. Full article

Social and emotional learning (SEL) has become increasingly central to educational policy and lifelong development, while advances in robotics have opened new possibilities for supporting socio-emotional competencies through human–robot interaction. Despite the rapid growth of robot-assisted SEL research, this field remains fragmented, with limited understanding of its intellectual structure, thematic foci, and evolution. To address this gap, this study conducted a scientometric analysis of 241 publications indexed in Web of Science using bibliometric methods. Results indicate a steady growth trajectory, with research concentrated in a small number of core countries driving international collaboration. Influential publications and co-citation patterns reveal a strong foundation in autism-related interventions and child-centered social skill development. Thematic mapping shows that motor themes are dominated by soft skills, autism, and interaction design, while emotion recognition and affective computing form technically mature but specialized streams. Foundational concepts such as human–robot interaction and artificial intelligence remain central yet theoretically evolving. Emerging links between robotics, STEM, and project-based learning suggest ongoing pedagogical expansion. This study maps the intellectual and thematic structure of robot-assisted SEL, showing how robots are emerging as mediational agents in hybrid learning systems while revealing uneven integration and misalignments between technological capabilities and pedagogical foundations. Full article

Retinopathy of Prematurity (ROP) affects preterm infants worldwide, involving abnormal development of retinal blood vessels associated with supplemental oxygen use in neonatal care. Although there have been strides in identifying at-risk infants, implementing early screening, updating disease criteria through the International Classification of Retinopathy of Prematurity (ICROP), and developing new therapies, ROP remains a leading cause of preventable blindness. As preterm birth survival rates rise, the incidence of ROP continues to increase and is projected to rise even in countries with abundant resources and well-established care programs. Improving ROP care requires global standardization of screening, diagnosis, and management to prevent missed diagnoses and minimize outcome variability. Intravitreal anti-vascular endothelial growth factor (VEGF) injections are changing the landscape of ROP management, but longitudinal research is needed to determine their long-term safety in preterm infants. Effective ROP management relies on teamwork across disciplines and open communication with parents. Given that parents are lifelong caregivers of a child who may be affected by ROP-related vision impairment, including them in the care team and encouraging psychosocial support is vital. Socioeconomic disparities and limited access to ROP-trained ophthalmologists exacerbate disease burden, underscoring the need for innovative solutions to improve access to care. This perspective emphasizes the importance of globally standardizing ROP prevention and care, noting that efforts are still incomplete, equitable access has not been realized, and the long-term role of anti-VEGF agents in ROP treatment remains unclear. Full article

Despite growing emphasis on democratic citizenship education in South Korea, limited research has examined the social and psychological factors influencing children’s democratic citizenship—defined here as awareness of and willingness to engage in societal issues as responsible community members. This study examines the relationship between parent–child communication and democratic citizenship, focusing on the mediating roles of growth mindset and peer relationships among South Korean elementary school students. A total of 212 students in grades four to six completed a cross-sectional survey assessing parental communication, democratic citizenship (operationalized as civic awareness and community engagement), growth mindset, and peer relationships. Serial-multiple-mediation analysis was conducted to evaluate the mediating effects of growth mindset and peer relationships. The results indicated that positive parent–child communication was associated with higher levels of democratic citizenship and that growth mindset and peer relationships jointly mediated this relationship in a serial manner. These findings highlight the importance of fostering open parent–child communication, encouraging a growth mindset, and promoting positive peer relationships to enhance democratic citizenship development in children. Given the cross-sectional design, causal inferences should be interpreted with caution, and longitudinal studies are needed to confirm these relationships. Full article

Background/Objectives: Child malnutrition is a global health challenge linked to poor growth, impaired development, weakened immunity, and adverse outcomes. Early risk detection is essential, but current screening tools differ in accuracy and feasibility. This study aimed to develop and validate new bedside pediatric malnutrition screening models based on machine learning and evolutionary computation methods that can capture complex patterns in non-invasive clinical indicators while remaining practical for routine ward use. Methods: We conducted a cross-sectional study including 180 hospitalized children (1 month–18 years) recruited consecutively from six pediatric wards. The required sample size (minimum 138 participants) was calculated a priori using national prevalence estimates of pediatric undernutrition (4–9.5%) to ensure adequate precision at a 95% confidence level. Data collection included a questionnaire, anthropometry, subjective malnutrition risk assessment, and the Subjective Global Nutritional Assessment (SGNA) tool. Screening models were developed using decision trees, random forests, XGBoost, lasso regression, artificial neural networks, ANFIS, and genetic programming. Their performance was evaluated against the SGNA tool and physician-based subjective malnutrition risk assessment using sensitivity, specificity, AUC, and Cohen’s κ. Results: Machine learning and intelligent evolutionary models (GP, ANN, and ANFIS) showed the best performance in this sample, with substantial to high agreement (κ = 0.81–1.00) and high diagnostic accuracy (AUC = 0.92–1.00) with the subjective malnutrition risk assessment. The GP model demonstrated the highest apparent accuracy in this dataset, but also higher complexity, whereas simpler models such as decision trees showed lower accuracy but greater interpretability and feasibility for routine clinical use. However, validation was performed on a relatively small independent sample, and no external validation was conducted, which may limit the generalizability of the findings. Conclusions: While complex models may serve as digital assessment instruments, simpler models are rapid and more suitable for bedside screening. All developed models are non-invasive and cost-effective and show potential for supportive approaches for early detection of malnutrition risk at hospital admission. However, given the limited validation sample and the absence of external validation, these findings should be interpreted with caution, and further large-scale, multicenter studies are required to confirm generalizability and clinical applicability. Full article

Background: Maternal dietary avoidance during breastfeeding of infants with food allergies (FA) is common, but its impact on growth and development is unclear. Methods: This prospective cohort study enrolled infants aged 4–6 months who were mainly breastfed from the child health care clinic of Children’s Hospital of Chongqing Medical University, Chongqing, China. The participants were classified into a group with clinically diagnosed FA and a non-food allergies (NFA) group. To analyze avoidance extent, the FA group was stratified into high (≥5 types) and low (<5 types) avoidance subgroups based on the median number of avoided food categories. Outcomes included anthropometric Z-scores and ASQ:SE-2 social–emotional scores at 12 months, analyzed using Generalized Estimating Equations. Results: High avoidance mothers comprised 50% of the FA group. Compared to the high avoidance group, the non-FA group showed significantly better linear growth (β = 0.84, 95% CI 0.38–1.30, p < 0.001). Weight and head circumference showed no differences. High avoidance was associated with higher ASQ:SE-2 scores versus both the low avoidance and non-FA groups (p < 0.001), indicating greater social–emotional concerns. Conclusions: Extensive maternal dietary avoidance was associated with suboptimal linear growth and higher social–emotional risk scores in infants with FA, underscoring the need for integrated nutritional and developmental monitoring. These findings warrant cautious interpretation given the exploratory nature of this single-center study. Full article

Background/Objectives: Following prior in vitro and in vivo investigations on the bone health benefits of green onions and oats, we aimed to assess the effects of WCO31, Allium fistulosum L. (green onion) root and Avena sativa L. (oat) mixtures, on height growth and safety. Methods: This multi-center, randomized, double-blind, placebo-controlled study included 150 children aged 6–8 years (75 males and 75 females) who fell between the 3rd and 50th percentiles of the Korean National Growth Charts but had not yet developed secondary sexual characteristics. They were randomly assigned to receive daily oral administration of WCO31 (1.2 g/day) or a placebo for 24 weeks. For efficacy analysis, height, growth rate, growth rate standard deviation score (SDS), height SDS, and growth-related parameters were measured. To evaluate the safety of the intervention, several safety parameters (including the incidence of adverse events, laboratory tests, and vital signs) were monitored. Results: The WCO31 group demonstrated significantly superior outcomes, including height, growth rate, growth rate SDS, height SDS, and height-for-age Z-score, than the placebo group (all p < 0.001). Moreover, no safety-related concerns were identified. Conclusions: WCO31 positively influences height growth and demonstrates a favorable safety profile, with no observable adverse effects. This study provides the first clinical evidence supporting growth enhancement using natural extracts, suggesting that WCO31 could serve as a cost-effective, safe, and accessible complementary strategy for promoting child growth. Full article

Background/Objectives: Sleep disturbances have an impact on children’s physical and psychological development, yet little is known about the changes and factors influencing sleep after PICU discharge. To explore the trajectory of changes in sleep quality of critically ill children and to identify factors affecting sleep quality three months after Pediatric Intensive Care Unit (PICU) discharge. Methods: A longitudinal observation study was conducted between November 2022 and November 2023 at a tertiary children’s hospital. The Children’s Sleep Habits Questionnaire (CSHQ) was used at six time points: PICU-admission (T0), 1 week (T1), 2 weeks (T2), 1 month (T3), 2 months (T4), and 3 months (T5) after PICU discharge. The CSHQ is a 33-item parent-report outcome measure evaluating sleep problems. Total scores range between 33 and 99 points. A score of ≤41 indicates normal sleep; a score of >41 indicates sleep disturbance. Data were analyzed using the latent category growth model, univariate analysis, and multifactorial logistic regression. Results: Parents of 237 children completed all follow-up surveys. Prevalence of sleep disorders at T0-T5 of children with a score >41 were 46.5%, 83.5%, 69.7%, 54.3%, 50.2%, and 51.7%, respectively. General linear modeling revealed significant changes in CSHQ scores over time (F = 63.77, p < 0.05). The trajectories of identifying sleep changes were divided into three latent categories: High Sleep Disorder Group (n = 15, 6.33%), Moderate Sleep Disorder Group (n = 110, 45.2%), and No Sleep Disorder Group (n = 115, 48.52%). The trajectories were significantly different among preschool age, baseline sleep habit scores, surgery, and length-of-stay in pediatric wards (p < 0.05). The child’s age and surgical history were independent factors of sleep disturbance. Conclusions: The observed peak in sleep disturbances at 1-month post-PICU suggests that this period may be a critical window to develop and implement targeted interventions to improve sleep. The persistent sleep disorders highlight the need for long-term monitoring. Full article

Sleep is critical for physical growth and healthy child development. Traditionally, interventions targeting sleep improvement in children have focused on the parents. This scoping review aimed to identify and summarize the available evidence on child-focused interventions designed to promote healthy sleep habits among children aged 3–12 in healthcare settings. The review was conducted in accordance with JBI guidelines. A comprehensive search strategy was employed, encompassing databases such as PubMed, CINAHL, Psychology & Behavioral Sciences Collection, Education Source, Scopus, Web of Science, the Public Health Database, and Portugal’s Open Access Scientific Repository. Following identification and screening, 15 articles were included. Three types of interventions were identified: isolated, combined, and structured programs. Overall, the studies suggest that, while sleep-related knowledge tends to improve, achieving sustained, long-term behavioral change remains challenging in this age group. Active child participation appears essential for promoting lasting results and developing more tailored, child-friendly interventions. Full article

Background: Alzheimer’s disease (AD) is a progressive neurodegenerative disorder that severely affects cognitive, behavioral, and functional abilities, creating a substantial burden for family members who provide continuous care. Caregivers often experience role changes, occupational imbalance, emotional distress, and reduced quality of life, although some report personal growth. These experiences extend beyond active caregiving and include anticipatory grief during disease progression and grief after the relative’s death. Despite this continuum, few studies have examined caregiving, loss, and bereavement from an integrative perspective. This protocol describes a mixed-methods study aimed at exploring the lived experiences of family caregivers of individuals with AD, focusing on how evolving relational, occupational, and identity-related losses influence their well-being and adaptation. Methods: A parallel convergent mixed-methods design will be used. The quantitative component consists of a cross-sectional observational study including 66 caregivers recruited through purposive sampling across kinship categories (spouse/partner, adult child, grandchild) and care settings (home care with day-center attendance vs. institutionalized care). Data will be collected using the Zarit Burden Interview, Role Checklist, Short Form-36 Health Survey, and Occupational Balance Questionnaire. Descriptive and subgroup analyses will be conducted using SPSS (version 27). The qualitative component comprises a multiple-case study with approximately 36 participants across three groups: caregivers living with individuals with AD, caregivers of institutionalized relatives, and bereaved family members. Semi-structured interviews (45–80 min) will be conducted online or in person, transcribed verbatim, and analyzed thematically using MAXQDA (version 26). Integration will follow a concurrent approach, combining quantitative and qualitative results through joint narratives and displays to produce a comprehensive interpretation. Discussion: This study aims to deepen understanding of the caregiving–grief continuum in families affected by AD by integrating quantitative indicators of burden, health status, and occupational balance with qualitative accounts of adaptation and meaning-making. Findings are expected to support the development of holistic, evidence-based interventions that promote caregiver well-being throughout the care trajectory and during bereavement. Ethics and Dissemination: Ethical approval was granted by the Research Ethics Committee of Universidad Rey Juan Carlos (Code: 041220246522024; 15 October 2025). ClinicalTrials.gov Identifier: NCT07251738. Registered November 2025. Protocol version: Version 2. Full article

Objectives: The transition to complementary feeding represents an important interval in child nutrition and development. Nutrient demands for growth are high, yet less is known regarding how caregivers make decisions regarding the introduction of solid foods to their infants and what influences their choices and feeding practices. Methods: Semi-structured interviews were conducted via Zoom with caregivers (N = 46, 83% mothers) of typically developing children (6–24 months of age) residing in the United States. A content analytic approach, with consensus coding performed by team members, was undertaken. The Developmental Niche framework guided thematic analysis. Results: Four major themes and four subthemes were identified: (1) Caregivers’ Approach Introducing Solid Foods with Anticipation and Concern, including subthemes of the (a) timing and order of complementary foods (CF) offered to children and (b) foods caregivers avoid offering; (2) Caregivers’ and Children’s Learning, including subthemes of (a) children’s rapid learning and skill development, and (b) the concurrent rapid demands for changes in food parenting; (3) Drivers of Caregivers’ Decisions Related to Offering Solid Foods to their Children; and (4) The Goal of CF: Integration of the Child into Family Mealtimes. Conclusions: Caregivers seek to provide adequate nutrition while balancing children’s health needs with the challenge of encouraging acceptance of family foods and respecting individual preferences. Juggling myriad demands (e.g., time, convenience, other family members, cultural traditions, and expectations), caregivers seek to help their children develop a healthy relationship with food. Full article