Search Results (10,511)

Companion animals have increasingly become central to human emotional life, yet the literature linking living with companion animals, human–animal interaction, and mental health remains fragmented. This study mapped global research trends on companion animals and mental health from 2000 to 2024 using bibliographic records retrieved from the Web of Science Core Collection (WoSCC). A final dataset of 930 peer-reviewed articles was analyzed with Bibliometrix (RStudio), CiteSpace, and VOSviewer to characterize publication growth, national and institutional collaboration, influential authors and journals, co-cited references, keyword clusters, and citation bursts. Results show a strong nonlinear increase in output after 2015, with the United States as the dominant contributor and Australia and the WoSCC country node labelled England (distinct from Scotland) as important international bridges. Core knowledge clusters center on human–animal interaction, animal-assisted intervention, older adults, child/adolescent development, loneliness, attachment, and post-traumatic stress. Recent burst terms and references indicate a shift from general companion-animal caregiving and physiological stress buffering toward intervention design, vulnerable populations, and pandemic-era mental health. Overall, the field has matured into an interdisciplinary research area with growing methodological sophistication, but future work should strengthen cross-cultural evidence, longitudinal designs, standardized outcome measures, and explicit assessment of animal welfare. Full article

Maternal wellbeing during pregnancy is an important component of maternal mental health and has implications for both maternal and child outcomes. Although psychological resources such as self-control and social support are generally assumed to promote wellbeing, maternal wellbeing may also be influenced by psychological vulnerabilities, including perceived stress and ADHD (Attention Deficit Hyperactivity Disorder) symptoms. Recent theoretical perspectives further suggest that some beneficial characteristics may exhibit diminishing returns at higher levels. This study examined linear and nonlinear associations among perceived stress, ADHD symptoms, self-control, perceived social support, and maternal wellbeing during the second trimester of pregnancy. A sample of 149 first-time pregnant women from Romania completed measures of maternal wellbeing, perceived stress, ADHD symptoms, self-control, and perceived support from partners, family members, and friends. Hierarchical regression analyses were conducted, including quadratic terms derived from the Too-Much-of-a-Good-Thing framework. Perceived stress emerged as the strongest predictor of lower maternal wellbeing, whereas family support was positively associated with wellbeing. ADHD symptoms were negatively associated with wellbeing at the bivariate level but did not uniquely predict wellbeing after controlling for the remaining study variables. Most importantly, self-control demonstrated a significant nonlinear association characterized by diminishing returns, such that increases in self-control were associated with progressively smaller improvements in wellbeing at higher levels. No comparable nonlinear effects were observed for perceived stress or social support. Overall, the findings suggest that maternal wellbeing is shaped by both psychological vulnerabilities and psychological resources, and that the benefits of some psychological strengths may not increase uniformly across their entire range. Full article

National health surveys generate reusable population-based evidence, but repeated use may produce thematic concentration, heterogeneous methodological reporting, and analytical overlap. This revised bibliometric and meta-research study audited 328 Scopus records retrieved for Peru’s Demographic and Family Health Survey (ENDES), excluded 14 records without eligible analytical ENDES use, and analyzed 314 publications. Matched full texts were available for 284 articles. Publications spanned 2001–2026 and increased mainly from 2019 onward. The most frequent thematic domains were Cardiometabolic health/adiposity (n = 93), Maternal/reproductive health (n = 77), and Child nutrition and growth (n = 39). The most reused ENDES years after validation were 2019 (n = 110), 2018 (n = 81), 2017 (n = 76), 2021 (n = 68), and 2022 (n = 66). Initial ENDES-year extraction showed a 25.4% false-positive rate, a 45.8% false-negative rate, and 28.3% complete article-level agreement. At a pairwise similarity threshold of 0.80, 32 analytical-overlap clusters were identified. The findings characterize the Scopus-indexed and Scopus-retrieved ENDES corpus and emphasize the need for explicit corpus auditing, transparent coding rules, validated survey-year extraction, and reproducible scripts. Full article

Background/Objectives: Ultra-processed foods (UPFs) are linked to cardiometabolic disease, but cross-sectional surveys often underestimate or invert these associations due to age structure, diagnosis-related dietary changes, and reporting bias. This study explores the potential influence of these biases and examines cross-sectional associations between dietary proxies and prevalent cardiometabolic conditions using the most recent national data from Spain. Methods: We analyzed the 2023 Spanish Health Survey (n = 21,032). Body Mass Index (BMI) was derived from self-reported weight and height. Hypertension and diabetes were defined as self-reported medical diagnoses. Dietary items were mapped as UPF-rich proxies, processed-meat exposure, protective dietary markers, and beverage comparators. Weighted logistic models were adjusted for sociodemographic and lifestyle factors. Bias-probing analyses included stratification by self-rated health, exclusion of severe chronic comorbidities (n = 4107), and model-based beverage contrasts. Results: Prevalence reached 53.6% for excess weight, 23.9% for prevalent hypertension, and 7.4% for prevalent diabetes. Weekly fast-food consumption was consistently associated with excess weight (OR 1.20, 95% CI 1.07–1.35), obesity (OR 1.28, 95% CI 1.09–1.50), prevalent hypertension (OR 1.18, 95% CI 1.02–1.37), and prevalent diabetes (OR 1.33, 95% CI 1.10–1.61). Excluding participants with severe chronic comorbidities strengthened the fast-food association with prevalent diabetes (OR 1.46, 95% CI 1.17–1.81). Conclusions: Fast food emerged as the most consistent adverse dietary marker co-occurring across all prevalent outcomes, whereas processed meat was specifically associated with prevalent excess weight and obesity rather than prevalent cardiometabolic diagnoses. Stratified and sensitivity analyses provided empirical patterns consistent with age confounding and possible post-diagnosis dietary changes influencing cross-sectional associations, highlighting the need for cautious interpretation in public health surveillance. Full article

Informed consent is fundamental to Australian newborn bloodspot screening (NBS), but emerging genomic screening technologies pose new challenges to clinical care and research. Optimizing consent processes is necessary to support ethical practice and maintain public trust as NBS evolves. This study aimed to identify gaps and opportunities to improve NBS consent processes in Queensland, Australia, while also exploring preliminary insights into the evolving complexity of consent in the context of genomic NBS (gNBS) and NBS-related research. A qualitative study design was used, with two facilitated interest-holder workshops (a total of 12 h) involving 86 participants (healthcare professionals, policy-makers, researchers, genomics experts, and consumer representatives). Workshop 1 (n = 25) was held virtually, and Workshop 2 (n = 61) was held in person. Thematic analysis was used to identify practical recommendations and ethical considerations. Participants identified three priority domains for improving consent in Queensland’s NBS program: (1) revision of the Guthrie Card and consent statement, (2) development of consistent, antenatal information resources across healthcare providers, and (3) standardized consent delivery training for healthcare staff. Discussions also highlighted tensions around information requirements for informed consent, revealing growing complexities regarding layered consent models. While recommendations on research consent were not fully developed at the workshop, insights highlighted the growing complexity and divergence of views on layered consent models. Findings suggest that improving NBS consent requires both operational reform and reassessment of ethical standards, alongside broader interest-holder engagement and feasible, scalable models also suited to genomic technologies. A nationally consistent framework is needed. Full article

Background/Objectives: Long-term recovery following adolescent anorexia nervosa (AN) remains incompletely understood because restoration of nutritional status does not necessarily coincide with psychological remission. Comprehensive evaluation of recovery requires consideration of psychological, behavioural, and patient-reported outcomes in addition to anthropometric measures. To evaluate long-term recovery following adolescent anorexia nervosa by integrating clinical outcomes, patient- and caregiver-reported experiences, orthorexic tendencies, and eating-disorder psychopathology, and to identify factors associated with persistent psychological impairment. Methods: This retrospective follow-up study employed a cross-sectional survey design. Families of 100 former patients previously hospitalized for adolescent anorexia nervosa in a child and adolescent psychiatric inpatient unit were invited to participate 5–10 years after discharge. Follow-up questionnaires were returned by 23 former patients and 17 caregivers. Former patients completed the SCOFF questionnaire and questions assessing orthorexic tendencies, whereas caregivers and the patients as well provided information regarding their child’s long-term recovery, treatment experiences, current functioning, and selected demographic characteristics. Responses from former patients and caregivers were analysed according to respondent group and the variables available for each group, while information from both groups was used to obtain a comprehensive assessment of long-term recovery. Descriptive and inferential statistical analyses were performed. Results: Mean BMI increased from 13.4 kg/m² during the acute phase of illness to 18.8 kg/m² at follow-up, indicating substantial nutritional improvement. Nevertheless, approximately 60% of former patients screened positive on the SCOFF questionnaire, suggesting persistent eating-disorder symptoms despite nutritional rehabilitation. Orthorexic tendencies were strongly associated with positive SCOFF screening results (Cramér’s V = 0.828; p < 0.001). Psychiatric comorbidity and poorer subjective health perception were also associated with less favourable long-term outcomes. Qualitative findings further demonstrated that recovery was perceived as extending beyond symptom reduction to include psychological wellbeing, restoration of autonomy, interpersonal functioning, and social reintegration. Full article

Background/Objectives: Childhood-onset systemic lupus erythematosus (cSLE) is a chronic, multisystem autoimmune disease that is associated with more severe organ involvement, more intensive drug therapy, and increased long-term organ damage compared with adult-onset disease. The objectives of this study were to evaluate the performance of widely used small area-level multidimensional indicators of neighborhood disadvantage in a mixed urban–rural cSLE cohort against disease outcomes. Methods: This retrospective cohort study utilized electronic health records to identify and evaluate pediatric patients with cSLE across a single center in South Carolina between 1 January 2020 and 31 December 2024. Primary outcomes included disease activity at diagnosis, measured by Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K); the achievement of a low lupus disease activity state (LLDAS) by the last visit; the development of major organ involvement; and the rates of unplanned hospitalizations and emergency department visits. The associations of the census tract-level Area Deprivation Index (ADI), Social Vulnerability Index (SVI), and Childhood Opportunity Index (COI) with clinical presentation and outcomes were estimated using generalized linear models and logistic regression. Results: A total of 85 patients with cSLE were included, of which 76% reported being of Black race, and 28% lived in rural areas. Lupus disease severity was inconsistent across the metrics of area-level social vulnerability, neighborhood deprivation, child opportunity, and rurality. Patients who lived in more socially vulnerable communities were more likely to attain LLDAS during follow-up, while those who lived in lower-opportunity areas were more likely to develop CNS lupus. Baseline disease activity, renal involvement, and healthcare use were not significantly associated with area-level social disadvantages or rurality. Conclusions: In this single-center, mixed urban–rural cohort of children with cSLE, indicators of neighborhood-level disadvantage and rurality alone explained little variation in disease severity and disease control overall. The utility of available small area-level metrics is likely context-dependent and influenced by regional features, population characteristics, and the outcomes being studied. Future work should integrate individual- and area-level factors across diverse settings to better understand the drivers of health disparities. Full article

Kindergarten environments combine high microbial exposure with increased immunological vulnerability, yet antibiotic resistance genes (ARGs) in kindergarten dust remain poorly characterized. This systematic review synthesized evidence on the occurrence and potential health relevance of ARGs in kindergarten dust. Following PRISMA 2020 guidelines, PubMed, Scopus, and Web of Science were searched. Four studies from China, Hong Kong, and Norway (2018–2024) met the inclusion criteria. ARGs were detected in all kindergarten dust samples, indicating that dust is a consistent reservoir of antibiotic resistance determinants. A consensus resistome (classes detected in ≥2 studies) encompassed sulfonamide, macrolide–lincosamide–streptogramin B (MLSB), tetracycline, beta-lactam, aminoglycoside, and multidrug resistance genes; beta-lactam resistance genes were the only class reported in all four studies. Clinically important ARGs associated with last-resort antibiotics, including mecA, vanA, bla_NDM, and mcr-5, were reported in three studies. Class 1 integron-integrase genes (intI1) frequently co-occurred with ARGs, suggesting potential horizontal gene transfer. Limited evidence indicated higher ARG abundance in urban and winter samples. One study reported antibiotic-resistant bacteria carrying resistance markers concordant with those in kindergarten dust in the urine of children attending the same facilities; however, this cross-sectional, single-site evidence is consistent with, but not sufficient to establish, a dust-to-child exposure pathway. The available evidence supports the plausibility that kindergarten dust may contribute to children’s exposure to ARGs and ARG-carrying bacteria, but current studies do not establish causal transmission from dust to child colonization or infection. Standardized monitoring and longitudinal studies are needed to assess health risks and guide mitigation strategies in early childhood educational settings. Full article

Background: Expanded Newborn Screening (NBS) allows screening for more than 50 inborn errors of metabolism (IEMs), thanks to the use of tandem mass spectrometry (MS/MS). Beyond its primary diagnostic function, NBS offers a valuable opportunity to obtain comprehensive information regarding the nutritional status of each newborn. This aspect is particularly significant in very-low-birth-weight (VLBW) preterm infants, who are at increased risk of multiple perinatal complications. The objective of the present study was to leverage the extensive dataset generated from NBS samples of VLBW infants to explore potential correlations with longitudinal extrauterine growth restriction (EUGR). Methods: We retrospectively analyzed 155 VLBW newborns hospitalized in the neonatal intensive care unit (NICU) and screened at IRCCS Giannina Gaslini Children’s Hospital between May 2021 and December 2023. Forty-six NBS metabolites were evaluated at 48–72 h of life (T0), 30 days of life (T1), and at a body weight of 1800 g (T2). Results: Several metabolites showed significant differences between infants with and without longitudinal EUGR in the univariate analyses across the three sampling time points. However, after adjustment for multiple comparisons using the Benjamini–Hochberg procedure, no metabolite remained significantly associated with longitudinal EUGR. Conclusions: Although several metabolites initially appeared to be promising candidates, no independent metabolic signature of longitudinal EUGR was identified after adjustment for multiple testing. Nevertheless, the biological plausibility of several metabolic pathways potentially implicated in postnatal growth provides a rationale for future prospective studies with larger cohorts and more targeted metabolic panels to better elucidate the biological mechanisms underlying longitudinal EUGR. Full article

Background: Timely hepatitis B vaccine birth-dose (HepBV-BD) vaccination is a cornerstone strategy for preventing mother-to-child transmission of hepatitis B virus (HBV). Although hepatitis B vaccination coverage in China has improved substantially, evidence regarding long-term district-level spatiotemporal inequalities in timely birth-dose vaccination remains limited, particularly in western China. This study assessed spatiotemporal disparities in hepatitis B vaccination coverage across Chongqing, China, from 2016 to 2025. Methods: This ecological descriptive study used district- and county-level vaccination surveillance data from the Chongqing Immunization Information Management System. Temporal trends in HepBV-BD, timely birth-dose (TBD), HepBV2, and HepBV3 coverage were analyzed. Regional disparities, interregional inequalities, and spatial clustering were assessed using Global Moran’s I and Local Indicators of Spatial Association (LISA). Results: All vaccination indicators improved substantially during the study period. TBD coverage increased from 81.9% to 95.4%, whereas HepBV3 coverage increased from 83.7% to 98.7%. TBD coverage was strongly positively associated with HepBV3 coverage(r = 0.95, p < 0.001). Mountainous ethnic minority regions consistently exhibited the lowest TBD coverage despite marked improvement over time. Absolute interregional inequality decreased from 30.8 to 8.4 percentage points. Although Global Moran’s I was not statistically significant, LISA analysis identified persistent localized low-coverage clusters in southeastern mountainous regions and emerging high–high clusters in northern Chongqing. Conclusions: Hepatitis B vaccination coverage in Chongqing improved markedly between 2016 and 2025, accompanied by declining geographic inequality. Nevertheless, persistent spatial inequities in timely birth-dose vaccination remained in mountainous ethnic minority areas. Continued monitoring of spatial inequalities, together with strengthened primary healthcare capacity, culturally tailored health education, and equitable resource allocation, may help support geographically targeted immunization strategies and accelerate progress toward the WHO goal of eliminating viral hepatitis as a public health threat by 2030. Full article

Background/Objectives: Maternal vitamin D deficiency has been associated with preeclampsia, but evidence regarding preconception partner-specific vitamin D biomarkers is limited. We evaluated associations between preconception maternal and paternal vitamin D biomarkers and the odds of preeclampsia. Methods: This secondary prospective cohort analysis used data from the Folic Acid and Zinc Supplementation Trial (FAZST), a multicenter study conducted in the United States between 2013 and 2017. Of the 2370 enrolled couples who were seeking infertility treatment, 1054 couples achieved a documented pregnancy. Because preeclampsia can only be ascertained among pregnancies progressing beyond 20 weeks of gestation, the primary analytic population was restricted to 826 pregnancies that reached ≥20 weeks, including 98 with preeclampsia and 728 without preeclampsia. Preconception serum total 25-hydroxyvitamin D (25(OH)D), vitamin D-binding globulin (VDBG), albumin, free 25(OH)D, and bioavailable 25(OH)D were assessed in both partners. Multivariable logistic regression models estimated adjusted odds ratios (aORs) and 95% confidence intervals (CIs). Results: In categorical analyses, maternal total 25(OH)D findings were consistent with a possible U-shaped pattern. Compared with concentrations of 30–< 50 ng/mL, concentrations ≤20 ng/mL were associated with higher odds of preeclampsia (aOR = 2.58, 95% CI: 1.13–5.88), as were concentrations ≥50 ng/mL (aOR = 5.45, 95% CI: 1.71–17.41). Similar categorical patterns were observed for maternal free 25(OH)D, with higher odds at concentrations ≤8.25 pg/mL (aOR = 2.23, 95% CI: 1.13–4.43) and ≥12.5 pg/mL (aOR = 4.71, 95% CI: 1.97–11.29), and for maternal bioavailable 25(OH)D concentrations ≤3.5 ng/mL (aOR = 2.61, 95% CI: 1.19–5.72) and ≥5.0 ng/mL (aOR = 5.38, 95% CI: 2.15–13.46). Lower paternal bioavailable 25(OH)D was associated with lower odds of preeclampsia in the fully adjusted model (aOR = 0.50, 95% CI: 0.28–0.89); however, this finding should be considered exploratory. Conclusions: Among pregnancies progressing to ≥20 weeks, lower and higher categories of maternal total, free, and bioavailable 25(OH)D were associated with the odds of preeclampsia relative to intermediate categories. These categorical findings are consistent with a possible U-shaped pattern but do not establish a nonlinear dose–response relationship. Paternal findings were limited and should be considered exploratory. Full article

Background/objective: Postpartum depression (PPD) is a significant public health issue affecting about 19% of mothers globally. It has well-documented impacts on maternal well-being, mother–infant relationships, and child developmental outcomes. At the same time, the level of vitamin D deficiency in women of reproductive age is very high (affecting 60–87 percent of pregnant women globally). The review aims to synthesize current evidence and highlight priority research areas to improve maternal mental health outcomes. Methods: A systematic literature search of PubMed, Scopus, and Google Scholar (2015–2026) was conducted, followed by narrative synthesis of mechanistic, observational, and interventional evidence. Results: Adequate vitamin D status may contribute to a reduced risk of postpartum depression through multiple interacting pathways, including serotonin synthesis and metabolism (via tryptophan hydroxylase 2 (TPH2) and monoamine oxidase-A (MAO-A) regulation), neuroplasticity via brain-derived neurotrophic factor (BDNF) signaling, and suppression of the pro-inflammatory cytokine cascade. Dose–response meta-analyses and large prospective cohort studies indicate consistent negative relationships between maternal vitamin D levels and postpartum depressive and anxiety symptoms with optimal serum 25-hydroxyvitamin D (25(OH)D) levels of 90–110 nmol/L. Conclusions: There is still limited evidence on the intervention; it is still methodologically diverse, and only a few randomized controlled trials have been carried out on specifically postpartum populations. Full article

The coexistence of undernutrition and excess weight is an important child public health challenge. This study described temporal trends and departmental spatial configurations of wasting, stunting, overweight, and obesity among children under five years of age in Peru during 2014–2024. Analyses used anthropometric assessment records from the Nutritional Status Information System (SIEN), collected in public healthcare facilities and aggregated by department and year. Annual Percentage Change summarized average temporal trends, while observed prevalence maps, Global Moran’s I, Local Indicators of Spatial Association (LISA), and a median-based bivariate classification were applied independently to 2014, 2019, and 2024. Queen contiguity was the primary spatial specification, along with KNN-4 sensitivity analysis. Wasting and obesity increased on average, stunting decreased, and overweight showed no significant long-term trend. Global autocorrelation was most consistent for wasting, whereas findings for excess-weight indicators were sensitive to the weights matrix. LISA identified local spatial classifications at nominal p < 0.05; however, these findings were exploratory because no multiple-testing correction was applied. The bivariate classification identified two, four, and three departments with concurrent high relative undernutrition and excess-weight scores in 2014, 2019, and 2024, respectively. These record-based findings show territorial heterogeneity within SIEN but do not represent population prevalence, causal geographic effects, or an integrated spatiotemporal process. Full article

Black children and youth remain disproportionately represented within child welfare systems across Canada, yet limited research has examined how Black girls experience trauma within out-of-home placements and how these experiences shape mental health and suicidality. This qualitative study examines the experiences of Black young women who aged out of care in Ontario, Canada, and explores how cumulative and intersecting forms of trauma, affected their emotional well-being and mental health. Drawing on critical race theory, Black girlhood studies, and critical suicidology, the study conceptualizes trauma as relational, structural, and cumulative rather than as a singular event. Findings drawn from six out of 10 participants reveal five key themes: dysfunctional foster families and complex traumas; trauma of multiple placement; lack of mental health support for the initial and ongoing traumas they experienced while in care; and mental health impacts of out-of-home placements and exposure to traumas and suicide-related behaviours of other youth in care. The participants highlighted the links between their experiences in foster care and the increased risk of suicide-related thoughts and behaviours. The findings highlight the need for models of care that are racially affirming, trauma-informed, and culturally responsive for child welfare and mental health interventions for Black girls in out-of-home placements. The key limitation of the study is the small sample size. Full article

Background/Objectives: Women who exclusively pump (EP) expend more time and effort on pumping and feeding infants their expressed breast milk (EBM) than those who directly breastfeed. However, little is known about their 24 h milk production (MP) or pumping and feeding dynamics. Methods: An online survey of 195 EP women explored the experiences, characteristics, MP and pumping and feeding dynamics of EP women. Quantitative data were compared by prematurity/neonatal unit admission, milk supply and parity, and self-reported MP was compared with MP in a predominantly breastfeeding reference group. Results: The 24 h pumping frequency was 6.0 [5.0, 8.0] with a pumping session duration of 25 [20, 30] min and a total pumping time of 2.3 [1.8, 3.0] h/24 h. The self-reported MP was 900 [600, 1100] mL/24 h, which was higher than that of the reference group (p = 0.012). Infant cues (58%), as well as advice from the child health nurse (39%), lactation consultant (34%) and pediatrician (34%) informed EBM feed volumes. Fifty-six percent of the infants were fed on demand, with 37% using a feeding schedule. Infants were fed 7.0 [6.0, 8.0] times/24 h; the average individual EBM feed and total 24 h volume were 120 [100, 150] and 750 [600, 900] mL, respectively. Conclusions: This study confirms it is possible to sustain lactation with EP and provide sufficient EBM volumes for the infant. However, the time commitment of EP and infant feeding represents a serious burden. These families would benefit from enhanced professional support and accessible evidence-based pumping and feeding guidelines. Full article