Search Results (276)

Background/Objectives: Parents report unmet information needs relating to childhood brain tumors. Existing research shows that providing information to families supports self-efficacy and well-being. The project therefore aimed to co-design resources tailored to the informational needs of families navigating childhood brain tumors in Australia. Methods: Mixed methods were used across multiple phases. A landscape analysis in Phase 1 confirmed the gap in Australian resources as well as the identification of international resources suitable to inform local solutions. Following the Double Diamond Design Framework, subsequent phases of the project aimed to discover and define the problems faced by families before developing and delivering the solution. Parents of children with brain tumors participated in a journey mapping workshop, content adaptation through feedback, and an online survey to determine the preferred delivery mode of information. Clinicians provided iterative feedback as the resource was developed and refined. Results: Nine mothers participated in journey mapping and iterative adaptation of the resource along with twelve clinicians. There were 46 respondents to the survey, which identified a preference for multi-modal delivery of information, and 23 clinical and consumer reviewers in the final revision phase. The process of adaptation is presented, providing transparency on the development of this national resource. Conclusions: The use of self-efficacy theory and co-design was pivotal in this project. Integration of concepts from self-efficacy moves beyond simply presenting information to empowering the audience to feel capable of the task ahead of them. Co-design ensured the content and tone of the resulting resource are fit-for-purpose from the perspective of both clinicians and consumers. The resource is available as a physical book, digital resource, and audiobook and disseminated through children’s hospitals, professional networks, and brain tumor support groups. Full article

Background/Objectives: Oral health plays a crucial role in the physical, emotional, and social well-being of children. Data from 2019 indicate that oral diseases remain a major concern in the Italian paediatric population, affecting not only children’s health but also caregivers’ well-being. This study aimed to assess the importance attributed by Italian families to their children’s oral health and correlate parents’ perceptions with children’s actual oral health status. Methods: A total of 131 children aged 0–12 years, admitted to the IRCCS Giannina Gaslini Children’s Hospital (Genoa, Italy) for reasons other than dental problems, were enroled between 1 January and 31 December 2024. Parents completed validated questionnaires (ECOHIS or PCPQ + FIS) based on their child’s age, along with supplementary questions on socio-demographic background and dental history. Oral examination was performed to assess dmft/DMFT scores, the Index of Orthodontic Treatment Need (IOTN), and the Modified Gingival Index (MGI). Results: In younger children (0–5 years), oral health was generally good, but the presence of caries negatively impacted the family’s quality of life. Older children (6–12 years) showed higher rates of caries and gingival inflammation, affecting their daily functioning and emotional well-being. Poor oral health was more common among children of non-European backgrounds and those with lower parental education. Early dental visits, within the recommended 24 months of age, were rare. Conclusions: Despite clear international recommendations, early dental visits remain uncommon, and many children experience preventable oral health issues. These findings highlight the urgent need to improve caregiver education and public health strategies to promote early preventive dental care. Full article

Background: Hansen’s disease or leprosy is one of the 21 neglected tropical diseases (NTDs). In Ecuador, leprosy is considered eliminated as a public health problem; however, new cases are reported annually. Additionally, Mycobacterium leprae infection was detected in nine-banded armadillos across the country, suggesting a potential zoonotic reservoir. This literature review aims to provide an updated overview of the epidemiological situation of leprosy in Ecuador, identify knowledge gaps, and outline research priorities to support the development of a comprehensive national strategy for achieving zero autochthonous cases. Methods: This article analyses the current situation of leprosy in Ecuador based on international and national publications. A retrospective literature search using five international, regional, and national publications on leprosy published between 1954 and 2024 (70 years) with no restriction on language or publication date, was performed. Findings: Our review identified 28 publications with the earliest article dating back to 1954. Of these, 14 were published in international journals, 15 (53.6%) were in Spanish. Four nationwide studies documented leprosy cases across Ecuador’s three continental regions (Coast, Andes, and Amazon) with a predominance in the tropical coast. No cases have been reported from the Galápagos Islands. From 1983, Ecuador started multi-drug therapy. Data from the Ministry of Public Health (MoH) system identified 1539 incident cases, showing a significant decline in new cases from 2000 to 2024, with no cases in children. New cases detection rate by 100,000 inhabitants was 0.51 in 2019 according to the World Health Organization (WHO). No study has genotyped the Mycobacterium spp. in human cases, other animal species, or environment. According to the MoH, multibacillary leprosy accounts for 78.95% of diagnosed cases, with confirmation based on Ziehl–Neelsen staining and histopathology. No survey has assessed disabilities, knowledge, attitudes, and practices (KAP) or stigma related to leprosy. Research is needed on transmission routes, Mycobacterium genotyping, genetic susceptibility, and antibiotic resistance. BCG vaccination coverage fell to 75.3% in 2021. Cases are currently diagnosed and treated on an outpatient basis in large hospitals. Conclusions: This comprehensive review highlights persistent gaps in leprosy research and critical information, despite seven decades of documented cases in Ecuador. The disease is still endemic across the country, particularly at subnational level in the subtropics and tropics of the Pacific coast and the Amazon. There is a need for nationwide epidemiological research on reservoirs and the environment applying the One Health concept. Increased laboratory facilities and readily available official data are required to improve our understanding of leprosy in Ecuador. Strengthening community-level efforts is essential for Ecuador to meet the targets of the “WHO’s Towards Zero Leprosy: Strategy 2021–2030.” Full article

Background: Examining medico-legal cases within hospitals aids in identifying care-related problems, facilitating necessary corrections and emphasizing successful preventive measures. The case of Meyer Children’s Hospital is particularly noteworthy as it offers insights into the evolution of litigation in regard to a tertiary pediatric hospital. Methods: The study sample comprised 158 malpractice claims received by Meyer Children’s Hospital from 1 January 2010 to 31 December 2023, which were managed by the Claims Management Committee (CMC) responsible for civil liability within the hospital. In this observational retrospective study, the following variables were analyzed: (1) The characteristics of the patients (age–sex) and the manner in which they interacted with the hospital, ultimately resulting in the compensation claim (method of access, area of specialty, outcomes based on the International Classification of Patient Safety (ICPS)). (2) Medico-legal factors: the details of the compensation claim, the significant issues noted in various cases, and the findings of the medico-legal inquiry conducted by the CMC. In cases of ADR (Alternative Dispute Resolution), we evaluated the nature of the procedure, the results, and the amount of compensation awarded. Results: We conducted a descriptive statistical analysis to delineate the trend of claims and identify specific deficiencies within structures or departments over time. Invasive procedures and surgical operations were identified as the leading causes of accidents, resulting in heightened mortality rates and serious injuries. The most common errors observed were diagnostic and therapeutic. Conclusions: The data that emerged highlighted a low rate of claims (11.28/year) and a low claim/service ratio (0.0002%), suggesting a high level of safety of patient care at the hospital. The acceptance rate (32%), the percentage of rejected cases (48/158~30% of total, or 48/99~49% of resolved claims), the average compensation (EUR 68,312), and the percentage of cases (92%) with judicial opinions consistent with those of the CMC indicate a tendency to pursue exploratory compensation requests and the effectiveness of CMC’s activity. Meanwhile, the predominant error types (surgical and diagnostic) are in accordance with national and international data. Finally, the scarcity of disputes concerning informed consent reflects the impressive effectiveness of the communication strategies utilized by the pediatricians at this center. Full article

Background/Objective: Pediatric feeding problems are becoming more widespread. They represent a synthesis of social, behavioral, and biological issues. Inevitably, the multifaceted nature of these problems has to be evaluated through one multidimensional tool. The Pediatric Assessment Scale for Severe Feeding Problems is designed to assess these complex issues and represents the first attempt to associate these factors into a single multidimensional measure. The aim of this study is to translate and culturally adapt the Pediatric Assessment Scale for Severe Feeding Problems into Greek and to assess its psychometric properties for use among a Greek Cypriot pediatric sample. Methods: This study involved 142 parents of children with symptoms of feeding problems. It included parents of children who were oral-fed (n = 65), partially oral-fed with supplementation (n = 62), and tube-fed (n = 15). The sample of parents was recruited from mainstream and special education schools in Cyprus and were asked to complete a Greek-translated version of the PASS-FP. Results: The PASS-FP-Gr demonstrated excellent psychometric properties. Internal consistency was good, and test–retest reliability showed a perfect Spearman’s rank correlation with high significance. The tool exhibited strong discriminatory ability, with statistically significant differences in median scores across the three feeding groups. Conclusions: The PASS-FP appears sensitive to the Greek Cypriot population and presents satisfactory psychometric features. It demonstrated excellent discriminatory ability, as evidenced by the participants’ consistent response patterns. Full article

Background/Objectives: Autism Spectrum Disorder (ASD) includes significant feeding difficulties, behavioral issues, and communication deficits that are linked to serious medical complications and developmental challenges. The Brief Autism Mealtime Behavior Inventory (BAMBI) is a commonly used tool to screen for mealtime behavior problems in children with ASD; however, it lacks validation for use within the Greek-Cypriot population. The current study sought to present the translation, cultural adaptation, and validation of the BAMBI for Greek-Cypriot parents of children with ASD. Methods: Three bilingual experts translated the inventory into Greek, following the translation guidelines by the World Health Organization. The inventory was then administered to 117 parents: 42 children with ASD and 75 typically developing children. Principal Component Analysis was used to obtain the tool’s statistical reliability and validity. Results: BAMBI-Gr demonstrated strong internal consistency, as indicated by a Cronbach’s alpha of 0.755, and showed excellent test–retest reliability, with an intraclass correlation coefficient of 0.999. PCA identified three key factors: General Refusals, Refusing Food, and Autism-Related Features. Significant differences in BAMBI-Gr scores of the comparative group of parents of children with ASD and parents of typically developing children highlighted the tool’s sensitivity in detecting mealtime behavior problems. Receiver Operating Characteristics analysis set the cut-off points for optimum distinguishing of feeding problems at 46.00 (sensitivity 0.738, 1-specificity 0.000). Conclusions: The Greek-translated version of the BAMBI demonstrates validity and effectiveness as a parent-reported assessment tool for identifying feeding and mealtime difficulties in children with ASD. Full article

Background/Objectives: Internalizing disorders are highly prevalent during adolescence. Previous research has shown that psychological inflexibility (PI) in both adolescents and their parents contributes to internalizing problems. However, how parental and adolescent PI relate to one another in explaining these difficulties remains unclear. The present exploratory study examined whether adolescent PI mediates the relationship between maternal PI and internalizing problems in adolescents. Methods: The study sample included 81 mother–adolescent dyads (80% female adolescents). Mothers completed a general self-report measure of PI, while adolescents completed self-report measures assessing both PI and internalizing problems. Results: The results showed that adolescent PI partially mediated the relationship between maternal PI and internalizing difficulties in female adolescents, whereas the mediation model was not significant for male adolescents. Conclusions: Findings suggest that mothers with high levels of psychological inflexibility may foster similar patterns in their children, particularly in daughters, thereby increasing adolescents’ vulnerability to increased psychological distress. Full article

Background: Developmental dyslexia (DD) affects reading ability and exacerbates mental health challenges among children. This study examines the relationships between reading ability, depressive symptoms, and internalizing and externalizing behavior problems in Chinese school-age children, focusing on potential mediating effects. Methods: A case–control study was conducted with 44 dyslexic children and 81 controls from Shantou, China. Assessments included phonological processing tasks for reading ability, the Depression Self-Rating Scale for Children (DSRS) for depressive symptoms, and the Child Behavior Checklist/6–18 (CBCL/6–18) for behavior problems. Mediation analyses were performed using the PROCESS macro 4.1 for SPSS. Results: Dyslexic children showed significantly poorer reading ability (all phonological tasks, p < 0.001), higher prevalence of depressive symptoms (40.9% vs. 17.3%, p < 0.01), and greater behavior problems (internalizing and externalizing, both p < 0.001) compared to controls. Both depressive symptoms and behavior problems significantly mediated the effects of reading ability on each other, forming a feedback loop that further impairs reading skills. Externalizing behavior problems showed the strongest mediation effect, explaining up to 33.53% of the relationship between depressive symptoms and reading ability. Conclusions: The study reveals a complex interaction between reading ability, depressive symptoms, and internalizing and externalizing behavior problems in Chinese school-age children, suggesting the need for integrated interventions targeting educational and psychological aspects. Further longitudinal research is needed to clarify causal relationships and refine intervention strategies. Full article

This study focuses on the current service/care difficulties and challenges that social institutions in Hungary are facing during their daily operations; how they can react to them utilizing their internal resources, mechanisms, and capacities; and what concrete, tangible needs and demands are emerging in terms of methodological professional support, potential forms, interventions, and direction for professional development. A total of 24 general and 55 specific service and operational problems were identified and assessed in eight different service areas (family and child welfare services, family and child welfare centers, respite care for children, care for the homeless, addiction intervention, care for people with disabilities, care for psychiatric patients, specialized care for the elderly, and basic services for the elderly). The empirical base of the study uses a database of 201 online questionnaires completed by a professional target group working for social service providers in two counties (Győr-Moson-Sopron and Veszprém), representing 166 social service providers. The questionnaires were completed between November and December of 2022. The findings will be used to develop a professional support and development problem map. Social institutions face complex and serious service/care difficulties and challenges in their daily operations. Three distinctive basic problems clearly stand out in both severity and significance from the complex set of factors assessed. The biggest problem in the social care system is clearly the complex challenge of low wages, followed by the administrative burdens in the ranking of operational difficulties, and the third key factor was the psycho-mental workload of staff. Full article

Background/Objectives: Social worry may appear in preadolescence, causing it to persist in the future, such that adolescents become more avoidant of situations in which they are evaluated by others. Many previous studies have shown that approximately 4% of preadolescent children suffer from high levels of social worry, which may lead to other problems in the future. It is important to take necessary precautions to explore this worry and take the necessary measures to address it. This study aimed to do so by extracting the psychometric properties of the Social Worries Questionnaire (SWQ) for preadolescence in Arab countries. Methods: The sample consisted of 269 children aged 8–12 years. The SWQ, Spence Child Anxiety Scale (SCAS), Child Abuse Self-Reporting Scale (CASRS-12), and Arabic version of the Children’s Depression Inventory (AVCDI) were administered via various social media. Results: Confirmatory factor analysis was used, and the one-factor model showed that the scale consists of 14 items. The results also indicated evidence of discriminant validity, and that the internal consistency was acceptable. For reliability, the test–retest results showed that the value was appropriate. Conclusions: This scale could be valuable in detecting worry in preadolescent children and providing them with therapeutic and psychological services. Full article

Background/Objective: A growing body of international research continues to show evidence of worsening youth mental health since the beginning of the COVID-19 global pandemic, yet very little research in this area has included young children under 6 years. Given the potential impact of early life stress during this critical period of development, it is crucial to better understand the effects on this age group. The objective of this study was to better understand the impact of the COVID-19 pandemic on the emotional health of very young children. Methods: This study utilized retrospective chart review of primary care records to compare the prevalence of markers of stress in two cohorts of children under the age of 6 years, comparing children presenting for care prior to the pandemic (1 April 2019–31 March 2020; control period) with those presenting for care during the first year of the pandemic (1 April 2020–31 March 2021; study period) in a large pediatric primary care clinic in Washington, DC, USA. Based on power calculations, charts of 200 patients from each cohort were reviewed and prevalence of stress markers were summarized using counts and percentages and compared between groups using chi-squared tests. Multivariable logistic regression models were also conducted for each domain adjusting for age, gender, and insurance type. Results: Overall, sleep difficulties were significantly more prevalent during the pandemic period compared to the control period (14% vs. 6.5%, p = 0.013). In addition, signs of stress presented differently across age groups. For example, during the pandemic period toddlers (13–35 months) were 13 times more likely (OR = 13, 95% CI [2.82, 60.4], p < 0.001) and preschool-aged children (36–71 months) were 18.5 times more likely (OR = 18.5, 95% CI [4.0, 86], p < 0.001) than infants to present with behavior problems, indicating substantially higher risk of externalizing symptoms in older children compared to infants. Toddlers were less likely than infants to present with mood changes (e.g., fussiness or crying) (OR = 0.15, 95% CI [0.03, 0.65], p = 0.011). In addition, toddlers (OR = 0.55, 95% CI [0.31, 0.97], p = 0.038) and preschool-aged children (OR = 0.15, 95% CI [0.06, 0.4], p < 0.001) were also less likely to present with feeding difficulties compared to infants. Conclusions: One of the very few studies of young children under 6 years (including infants) during the COVID-19 pandemic, this study found that even very young children experienced stress during the pandemic. Signs of emotional stress were identified in a primary care office during routine care, highlighting an important opportunity for early intervention and/or prevention, such as counseling and resources for caregivers, in settings where young children are already presenting for routine care. Full article

Background/Objectives: Parenting stress, the emotional strain resulting from the demands of child-rearing, can profoundly affect both parental well-being and children’s emotional and behavioral development. This study examined the impact of maternal parenting stress during early childhood on the longitudinal progression of children’s internalizing, externalizing, and attention deficit hyperactivity disorder (ADHD) symptoms, from early childhood through adolescence. Methods: The study included 406 mother–child pairs from the Rhea mother–child cohort in Crete, Greece. Maternal parenting stress was assessed at age 4 using the Parental Stress Scale (PSS). Children’s symptoms were evaluated at ages 4 (Strengths and Difficulties Questionnaire, ADHD Test), 6, 11, and 15 years (Child Behavior Checklist, Conners’ Parent Rating Scale) through maternal reports. Multivariate mixed regression models, incorporating a random intercept for each child and a random slope for age at follow-up, were used to analyze the trajectories of symptoms from ages 4 to 15. Group-based trajectory modeling was applied to identify trajectory groups from 4 to 15 years, and multinomial logistic regression models were implemented to examine the associations between parental stress and group trajectories. Results: The results revealed that higher parental stress at age 4 was significantly associated with increased internalizing (b = 0.94, 95% CI: 0.68, 1.21), externalizing (b = 1.03, 95% CI: 0.75, 1.30), and ADHD symptoms (b = 0.86, 95% CI: 0.58, 1.14) over the study period. Notably, the impact of parenting stress on behavioral problems decreased with age (interaction with age, p = 0.032). Additionally, higher parenting stress at age 4 was linked to a greater likelihood of belonging to adverse symptom trajectories, including high decreasing, low increasing, and stable high trajectories for both internalizing and externalizing problems. Conclusions: These findings underscore the importance of early maternal parenting stress as a predictor of long-term emotional and behavioral difficulties in children, emphasizing the need for early intervention programs that support maternal mental health and children’s emotional development. Full article

Background: This longitudinal study aims to explore the stability and changes in child temperament dimensions between the ages of three and six, analyzing their relationship with emotional and behavioral problems, differentiated by gender. Method: This study involved 24 boys and 25 girls from various early childhood education centers in Málaga, Spain. To assess temperament, the Spanish adaptation of the Children’s Behavior Questionnaire was used, while emotional and behavioral problems were evaluated using the SPECI Screening for Emotional and Behavioral Problems in Children. Results: Findings indicate that 9 out of the 15 temperament dimensions remained stable, while 4—anger/frustration, attentional focusing, perceptual sensitivity, and sadness—showed significant changes in the total sample. The gender-specific analysis revealed different developmental patterns for boys and girls. Girls exhibited changes in attentional focusing, fear, and perceptual sensitivity, while boys showed changes in anger/frustration and attentional focusing. In addition, girls scored higher in discomfort and fear, whereas boys stood out in activity levels. Regarding behavioral problems, girls’ externalizing symptoms were significantly associated with attentional focusing and smiling/laughter, while internalizing symptoms were linked to low-intensity pleasure and perceptual sensitivity. Conclusions: These findings highlight the importance of addressing temperament from a gender-differentiated perspective when designing educational and family interventions aimed at promoting socioemotional development. Full article

Malaria is still one of the biggest global health problems, especially in parts of the world, such as sub-Saharan Africa, which remains most heavily affected. Despite significant advancements in testing, treatment, and prevention, malaria continues to seriously impact millions, primarily young children and populations in rural and impoverished areas. This paper looks at how the malaria parasite works inside the body, how it avoids the immune system, and how it becomes resistant to current drugs. Thanks to new advances in genetic and biochemical research, scientists are discovering new weak points in the parasite that could lead to better treatments. New vaccines, like RTS, S and R21, along with antibody-based therapies, offer renewed hope; however, extending the duration of the immunity they induce and ensuring effectiveness across diverse parasite strains remain significant challenges. Solving the malaria crisis will require more than science—it also necessitates equitable and timely access to treatments, robust health systems, and international collaboration. Continued research and global cooperation bring the world closer to ending malaria for good. Full article

Background/Objectives: Children with above-average cognitive functioning often present complex developmental profiles, combining high cognitive potential with heterogeneous socio-emotional and learning trajectories. Although the cognitive and behavioral characteristics of giftedness have been widely studied in Anglophone countries, evidence remains limited in Southern Europe. This study aimed to investigate the cognitive, academic, and emotional–behavioral profiles of Italian children and adolescents with above-average cognitive functioning, using an inclusive, dimensional approach (IQ > 114). Methods: We analyzed a cross-sectional sample of 331 children and adolescents (ages 2.11–16.5 years), referred for clinical cognitive or behavioral evaluations. Participants were assessed using the WPPSI-III or WISC-IV for cognitive functioning, the MT battery for academic achievement, and the Child Behavior Checklist (CBCL) for emotional and behavioral symptoms. Comparative and correlational analyses were performed across age, gender, and functional domains. A correction for multiple testing was applied using the Benjamini–Hochberg procedure. Results: Gifted participants showed strong verbal comprehension (mean VCI: preschoolers = 118; school-aged = 121) and relative weaknesses in working memory (WM = 106) and processing speed (PS = 109). Males outperformed females in perceptual reasoning (PR = 121 vs. 118; p = 0.032), while females scored higher in processing speed (112 vs. 106; p = 0.021). Difficulties in writing and arithmetic were observed in 47.3% and 41.8% of school-aged participants, respectively. Subclinical internalizing problems were common in preschool and school-aged groups (mean CBCL T = 56.2–56.7). Working memory negatively correlated with total behavioral problems (r = −0.13, p = 0.046). Conclusions: These findings confirm the heterogeneity of gifted profiles and underscore the need for personalized educational and psychological interventions to support both strengths and vulnerabilities in gifted children. Caution is warranted when interpreting these associations, given their modest effect sizes and the exploratory nature of the study. Full article