Search Results (51)

Recent years have witnessed a concerning rise in early-onset eating disorders (EDs), prompting a re-evaluation of their etiology, diagnosis, and treatment within pediatric populations. This perspective article synthesizes emerging evidence on the multifactorial origins of EDs in children, emphasizing a biopsychosocial framework that integrates genetic, epigenetic, psychological, and environmental factors. While early manifestations often diverge from adolescent or adult profiles—marked by somatic complaints, selective eating, and ritualistic behaviors—the disorders significantly interfere with developmental milestones. The COVID-19 pandemic has further exacerbated vulnerabilities, acting as a catalyst for disordered eating behaviors through increased familial stress, isolation, and disrupted routines. Central to this framework is the role of parental psychopathology and parent–child feeding interactions, which profoundly shape children’s emotional regulation and attachment patterns. Recent studies also underscore genetic susceptibilities—especially variants in the DRD4 and DAT1 genes—and epigenetic modifications that may mediate the transmission of risk across generations. The article reviews evidence from observational and genomic studies, highlighting how altered gene expression linked to early environmental stress contributes to the heterogeneity of EDs. Finally, it evaluates prevention and intervention strategies, including family-based treatments, digital health tools, and school-based programs. These strategies are essential for timely detection, individualized care, and reducing long-term impairment. Overall, the paper advocates for a nuanced understanding of EDs in children—recognizing their complex origins and developmental implications—to inform clinical practice, public health policy, and future research in pediatric mental health. Full article

In the name of God and profit, Jorge Álvares, the first Portuguese to set foot in China, arrived in 1513 and opened a new chapter for missionary work. One of the most significant forms of “Sino-Portuguese” decorative art, ivory sculpture, is closely linked to the Portuguese mission in the Orient and serves as a witness to encounters between different cultures and religions. This study focuses on representative Sino-Portuguese ivory sculptures of the Virgin and Child from the Late Ming period through a detailed analysis of iconography and a comparative visual critique with European prototypes and Guanyin representations to discuss the significance of missionary visual imagery in cultural interactions. The ivory sculpture of the Virgin and Child is not merely an image; it is a physical object with both material and visual characteristics, acquiring its religious significance during the missionary process. The present study aims to present its artistic hybridity and demonstrate how the Chinese carvers make the Sino-Portuguese “speak” different visual languages, leading to different interpretations. It also reflects the cultural translation that occurs in the complex process of religious contact. In this space of ‘culture in between’, Christianity has been able to transcend cultural and religious boundaries. Full article

Background/Objectives: Peer victimization and aggression can be detrimental to the physical and mental health of adolescents. Adolescents with attention-deficit/hyperactivity disorder (ADHD) are one of the risk groups involved in peer victimization and aggression. The association between multiple types of domestic violence and engagement in peer victimization and aggression warrants more examination in adolescents with ADHD. This study examined the associations of parent-to-child aggression (PCA), witness to domestic violence (WDV), and child-to-parent violence (CPV) with the experiences of peer victimization and aggression among adolescents with a clinical diagnosis of ADHD in Taiwan. Materials and Methods: In total, 247 adolescents with ADHD (206 boys and 41 girls, mean age [SD] = 13.2 [2.0] years) agreed to participate in this study. Adolescents’ peer victimization and aggression, PCA, WDV, and CPV in the previous year were collected. Results: This study found that 28.3% and 12.6% of adolescents with ADHD reported experiences of peer victimization and aggression, respectively. The rates of having PCA, WDV, and CPV ranged from 38.1% to 56.3%. The results of multivariable logistic regression analysis found that child-to-parent financial demand (p = 0.016) and child-to-parent control or domination (p = 0.018) significantly correlated with the experiences of peer victimization. PCA (p = 0.010) and child-to-parent control or domination (p = 0.042) significantly correlated with the experiences of peer aggression. Conclusions: The results of this study show that both CPV and PCA significantly correlate with the experiences of peer victimization and aggression in adolescents with ADHD. CPV and PCA should be included in adolescent prevention programs. Full article

War refugees are more likely to present psychological disorders, such as PTSD. Memory impairments often hinder their ability to recall and integrate traumatic events. This study investigated the memory capacity of 133 Syrian refugee children and adolescents in Lebanon and examined the moderating role of resilience in the relationship between exposure to negative events, post-traumatic stress reactions, and traumatic events recollection. Participants completed the Childhood War Trauma Questionnaire (CWTQ), Post-Traumatic Symptom Reactions Checklist for Children (PTSR-C), and Child and Youth Resilience Measure-28 (CYRM-28). They also performed a timeline exercise, part of Narrative Exposure Therapy, in which they organized and described their positive and negative life memories. Results showed that memories of traumatic events were lower than potentially traumatic events that participants had witnessed. This difference increased as post-traumatic stress increased. Moreover, potentially traumatic events experienced predicted post-traumatic stress reactions, and these predicted negative memories recalled. Participants’ resilience moderated the association between post-traumatic reactions and remembered traumatic memories showing that only for children and adolescents with higher resilience post-traumatic symptoms predicted trauma-related memories. The results highlight meaning making and sharing capacities of natural relational contexts (family, peers, etc.) as potential key processes to be promoted to overcome and process traumatic events. Full article

Background and Purpose: Adverse childhood experiences (ACEs) have been linked with multiple adverse outcomes, including adolescent dating violence (ADV). ADV is a serious public health issue, with the U.S. rates ranging from 6.4% to 73% for victimization across all types and from 11% to 77% for perpetration. Given the high prevalence of ADV and the fact that it has been frequently linked with ACEs earlier in life, it is crucial to thoroughly understand this relation and apply this information to prevention and intervention efforts. However, to date, there are no known reviews synthesizing the link between ACEs and ADV, nor exploring which ACEs have been included across other studies. Methods: To address these gaps, this study included three comprehensive searches to identify the following: (1) the measurement tools used to measure ACEs; (2) the type of ACEs significantly linked with ADV; and (3) the risk and protective factors considered in this relation. Results: A total of 34 studies were included. There were 24 different assessment tools used to measure the ACEs of adolescents, with the number of ACEs included ranging from 1 to 93. All but one study linked at least one ACE to ADV. The types of ACEs linked with ADV consisted of victimization (e.g., child abuse and bullying), witnessing violence (i.e., home and school), and household dysfunction (e.g., caregiver substance abuse). Several risk and protective factors were considered. Conclusions/Implications: This study found the measurement of ACEs in the literature to be inconsistent, making it difficult to synthesize and compare the findings across studies. Despite the measurement inconsistencies, however, most studies linked ACEs with ADV, emphasizing the importance of considering this relation in prevention/intervention programming. Full article

Authorities and civilians can make a report-of-concern to Social Services if they suspect a child is experiencing or witnessing violence. In 2021, Sweden implemented new legislation that considers children as victims of crime not only when abused but also when witnessing family violence, i.e., Barnfridsbrott. This study aimed to describe and analyze reports-of-concern regarding children witnessing family violence. Are there any changes in number of reports over the years? Who is reporting? And what interventions are most frequent? This is a register-based study of reports-of-concern in Gävle municipality in Sweden for the years 2018–2022. This unique register makes it possible to identify and follow up reported cases as long as they are active by Social Services. Results show there was already a major increase in the number of reports-of-concern in 2020. Most reports are made by Social Services and the police. Of all reports related to family violence, an increasing number lead to further investigations. In most of those cases, the children stay with their families, and Social Services offer counselling. Conclusion: there was a distinct increase in reports related to children witnessing family violence already starting in 2020 in the studied municipality, before the new legislation was implemented. Full article

Conflict-related forced displacement, characterized by the experiences of witnessing violent acts, bombing, torture, separation, and the execution of family members, can severely and negatively impact a child’s social determinants of health (SDOH). These experiences are both direct and indirect forms of adverse childhood experiences (ACEs), and urgent attention is needed to understand the impact of forced displacement on children, who are a vulnerable group, and to develop interventions for all systems that influence the child. This phenomenological qualitative study involved in-depth interviews based on the experiences of returnees (n = 20), who are parents of children who experienced forced displacement. This study underscores the direct and indirect impacts of forced displacement on children, with two key themes identified from the data analysis, by concluding that forced displacement: (i) disrupts the positive SDOH of children, and (ii) children’s coping mechanisms are influenced by primary and secondary exposure to trauma. The direct effects are visible through the impact of forced displacement on children’s mental health as a result of exposure to traumatic material. In contrast, the indirect effects of forced displacement on children are influenced by its subsequential effect on their parents and their community. The study also illuminates systemic inequalities, with participants recommending steps that governmental and non-governmental bodies can take to address this phenomenon. Full article

Often in the forensic context, child victims and witnesses are interviewed several times, exposing them to suggestive questions and social pressures. The present study had the main purpose of verifying the effect of coping strategies on the levels of immediate suggestibility and on the Resistant Behavioral Responses (RBRs) of children subjected to repeated suggestive interviews. A sample of 90 children, aged between 11 and 14, were administered the two parallel Gudjonsson Suggestibility Scales (GSS2 and GSS1) a few months apart and the Coping Inventory for Stressful Situations (CISS) to detect their coping strategies. The results showed that the avoidance coping increased suggestive vulnerability and reduced resistant responses. Task-oriented coping favored responses with greater source monitoring, which allow for the rejection of misleading information. Coping strategies did not show direct effects on the management of the socioemotional aspects involved in the suggestive interaction. After the negative feedback that invites children to be more accurate, a smaller effect of the avoidance strategy was recorded, indicating how actively requesting greater source monitoring can lead children to better recognize misleading information. Full article

Congenital syphilis, a preventable and deadly disease, has witnessed an alarming resurgence in the US in recent years, posing a vital public health challenge. Historically, effective prevention and treatment strategies led to a decline in congenital syphilis, and some believed that it could be eradicated. However, inadequate prenatal care, limited access to healthcare services, and gaps in syphilis screening programs have led to a resurgence of congenital syphilis. In this narrative review, we aim to highlight the key factors contributing to the reemergence of congenital syphilis and its implications on maternal and child health. Full article

Child sexual abuse (CSA), the most common type of maltreatment, is any action of a sexual nature by one or more adults towards a minor without the minor’s consent. This abuse represents one of the most damaging forms of trauma, has a severe impact on mental health and psychopathology, and can lead to several disorders, including post-traumatic stress disorder (PTSD). PTSD is characterized as a disorder that encompasses physical symptoms resulting from traumatic experiences that are experienced or witnessed by the victim. This systematic review aims to understand the impact of sexual abuse on post-traumatic stress disorder in children and adolescents. Studies focusing on the relationship between these two variables were obtained through multiple databases. Of the 940 documents collected, 24 were retained for further analysis and the objectives, methodologies, results, and main conclusions were registered. One of the main conclusions was that the earlier the abuse starts and the more severe and long-lasting it is, the symptomatology of PTSD will be aggravated and remain in the long term. Full article

This study aimed to evaluate the awareness, comprehension, and practices concerning forensic odontology among dental students and faculty at a Dental School in Cyprus. An online, cross-sectional, descriptive survey, employing an adapted, self-administered questionnaire, was disseminated to all dental students and faculty at the School of Dentistry, European University Cyprus, in November 2022. The survey assessed participants’ demographic information and explored their awareness with questions alluding to knowledge, attitudes and practices in forensic dentistry. Of those surveyed, 47 faculty members and 304 students responded, yielding response rates of 66.2% and 80%, respectively. Statistical analysis, including Kendall’s tau test and χ² test were employed to examine correlations and associations, with Cramer’s V used to measure the strength of significant associations. The predetermined significance level was α = 0.05. Awareness levels were assessed through participants’ responses to specific questions in the survey. It was revealed that 87% of faculty and 65% of students were familiar with forensic odontology. A noteworthy 94% of faculty and 85% of students recognized teeth as DNA repositories. A high percentage, 98% of faculty and 89% of students, acknowledged the role of forensic odontology in the identification of criminals and deceased individuals. Awareness of age estimation through dental eruption patterns was evident in 85% of faculty and 81.6% of students. A substantial proportion (80% of faculty) maintained dental records, while 78% of students recognized the importance of dental record-keeping in ensuring quality care. Interestingly, 57% of students and 64% of faculty were aware of the possibility of dentists testifying as expert witnesses. The majority, 95.7% of faculty and 85% of students, concurred that physical harm, scars, and behavioral alterations predominantly indicate child abuse. The findings, revealing robust awareness among respondents, underscore the importance of enhancing faculty engagement in relevant seminars to further strengthen their knowledge. Additionally, emphasizing improved record-keeping practices for potential forensic applications emerges as a crucial aspect. These insights have implications for refining dental education in Cyprus and enhancing forensic practices by promoting ongoing professional development and emphasizing meticulous record-keeping within the dental community. Full article

There is limited information regarding caregiver and provider perspectives on uncertainty across the continuum of the neonatal intensive care unit (NICU) experience. Open-ended semi-structured interviews were conducted with providers and English- and Spanish-speaking caregivers of infants with a history of admission to a quaternary safety-net NICU. Major themes were generated using inductive–deductive thematic analysis. Seventy-six individuals participated in the study: 47 caregivers and 29 providers. The median gestational age of the infants was 29 weeks and 85% were classified as having chronic complex disease per the Pediatric Medical Complexity Algorithm. Most providers were neonatologists (37%) and nurses (27%) and more than half had over ten years of experience. A conceptual model of caregiver uncertainty was developed and key domains included drivers of uncertainty and its impact, and factors influencing coping and adaptation. Our analysis found a positive association between caregiver information gathering, clinical continuity, support systems, maternal mental health supports, and witnessing a child’s progress and the development of adjustment to chronic uncertainty. These results suggest key areas for intervention that can promote parental adaptation to the uncertainty inherent in the NICU experience. Full article

In cases of child sexual abuse, interviewing and obtaining trustworthy statements from victims and witnesses is essential because their statements are the only evidence. It is crucial to ascertain objectively the credibility of the victim’s statements, which may vary based on the nature of the questions posed by the forensic interviewer. Therefore, interview skills that eliminate subjective opinions require a high level of training for forensic interviewers. To reduce high-risk subjective interviews, objectively analyzing statements is essential. Understanding the victim’s intent and named entity recognition (NER) in the statements is necessary to give the victim open-ended questions and memory recall. Therefore, the system provides an intent classification and NER method that follows the National Institute of Child Health and Human Development Investigative Interview Protocol, which outlines the collection of objective statements. Large language models such as BERT and KoBERT, along with data augmentation techniques, were proposed using a restricted training dataset of limited size to achieve effective intent classification and NER performance. Additionally, a system that can collect objective statements with the proposed model was developed and it was confirmed that it could assist statement analysts. The verification results showed that the model achieved average F1-scores of 95.5% and 97.8% for intent classification and NER, respectively, which improved the results of the limited data by 3.4% and 3.7%, respectively. Full article

Owing to its strategically advantageous geographical position that connects Asia and Europe, Turkey has consistently experienced a high rate of migration throughout its history. Nevertheless, one of the most remarkable and unparalleled migration events unfolded in 2011, triggered by the internal strife in Syria resulting from the Arab Spring. This tumultuous period witnessed an enormous wave of Syrian refugees seeking refuge within Turkey’s borders. Given its contemporary relevance, this migration carries profound implications for the social sustainability of future generations. This study aims to evaluate the contribution of the Uyum Çocuk (Harmonization Child) platform, initiated by the Turkish Ministry of Interior, to promote social cohesion among both native and immigrant children to the advancement of social sustainability. The platform is assessed across various dimensions of social sustainability, including social equality and justice, cultural diversity and freedom of expression, social participation, sustainable urban development, and eco-consumption. The research findings underscore that the platform primarily focuses on enhancing social equality and justice while other dimensions receive comparatively less attention. Considering Turkey’s role as a host country for millions of migrants, this study recommends that public authorities and civil society organizations prioritize initiatives aimed at instilling the principles of social sustainability across all segments of society, with a particular emphasis on children. Full article

Adverse childhood experiences (ACEs) encompass various adversities, e.g., physical and/or emotional abuse. Understanding the effects of different ACE types on various health outcomes can guide targeted prevention and intervention. We estimated the association between three categories of ACEs in isolation and when they co-occurred. Specifically, the relationship between child maltreatment, witnessing violence, and household dysfunction and the risk of being involved in violence, engaging in health-harming behaviors, and experiencing mental ill-health. Data were from eight cross-sectional surveys conducted in England and Wales between 2012 and 2022. The sample included 21,716 adults aged 18–69 years; 56.6% were female. Exposure to child maltreatment and household dysfunction in isolation were strong predictors of variant outcomes, whereas witnessing violence was not. However, additive models showed that witnessing violence amplified the measured risk beyond expected levels for being a victim or perpetrator of violence. The multiplicative effect of all three ACE categories demonstrated the highest level of risk (RRs from 1.7 to 7.4). Given the increased risk associated with co-occurring ACEs, it is crucial to target individuals exposed to any ACE category to prevent their exposure to additional harm. Implementing universal interventions that safeguard children from physical, emotional, and sexual violence is likely to mitigate a range of subsequent issues, including future involvement in violence. Full article