Search Results (2,137)

Population ageing, social isolation, and limited opportunities for meaningful contact between generations pose important challenges to healthy ageing and community well-being. This mixed-methods pilot study examined the feasibility, acceptability, co-creation process, and preliminary outcomes of the P-IN Programme, a community-based intergenerational intervention involving preschool children and older adults living in residential care. The programme was developed and implemented in partnership with a preschool and a residential care facility in Portugal and comprised ten intergenerational sessions shaped through an iterative co-creation process involving participants, professionals, and researchers. Twenty-three children, eighteen older adults, and five professionals contributed to the study. Quantitative pre–post assessment explored fluency in both generations and cognitive functioning, quality of life, subjective well-being, and social participation in older adults. Qualitative data examined intergenerational beliefs, participants’ experiences, relationships, and reciprocal learning, while also informing the co-creation process. Most quantitative outcomes remained stable, although cognitive functioning showed a moderate, non-significant effect. Perceived quality of life changed significantly in an unfavourable direction. In contrast, qualitative findings revealed broader and more relational representations of the other generation, alongside shared experiences and clearer recognition of reciprocal learning. The integration of both components showed that positive relational and experiential changes were not necessarily accompanied by changes in broader standardised outcomes. Overall, the P-IN Programme was feasible to implement and generally well received within the two participating community settings. These findings support further evaluation of co-created intergenerational programmes using larger samples, controlled designs, and longer-term follow-up. Full article

Background: Mothers of children with autism spectrum disorder (ASD) play a central role in coordinating multidisciplinary interventions. This study examined quality of life (QoL) among Saudi mothers of children with ASD and its associations with caregiver burden, psychological distress, financial experiences, and perceived clarity of post-diagnosis service pathways. Methods: This cross-sectional quantitative survey included an exploratory free-text component. Of 109 survey submissions, 106 contained completed core survey data. Two brief open-ended questions were presented to 60 participants; 53 provided a post-diagnosis challenge response and 46 provided a general additional comment. These responses were reviewed descriptively as supplementary contextual observations. QoL was assessed using an adapted 22-item Arabic questionnaire derived from the Arabic WHOQOL-BREF source instrument and was analysed as an adapted QoL composite rather than as standard WHOQOL-BREF domain scores. Hierarchical linear regression used a fixed complete-case sample, and regression diagnostics and sensitivity analyses were conducted. Results: Ninety-nine mothers had sufficient valid responses to calculate the adapted QoL composite (mean = 50.65, SD = 17.32, on a 0–100 metric). The hierarchical regression included 82 participants and explained 59.3% of the variance in adapted QoL (R² = 0.593; adjusted R² = 0.536). Higher caregiver burden was associated with lower adapted QoL (B = −12.94, p < 0.001), whereas higher household income (B = 3.19, p = 0.040) and greater pathway clarity (B = 6.92, p = 0.005) were associated with higher adapted QoL. Psychological distress and perceived financial burden were associated with QoL in bivariate analyses but did not show statistically significant unique associations in the multivariable model. The free-text observations referred to caregiving demands, emotional adjustment, service-navigation uncertainty, and therapy affordability; they were not treated as formal qualitative findings. Conclusions: In this cross-sectional Saudi sample, caregiver burden emerged as the factor most strongly associated with lower adapted maternal QoL, whereas higher household income and clearer post-diagnosis service pathways were associated with better QoL. These findings highlight the importance of family-centred approaches that attend to caregiving demands, affordability, and access to clear post-diagnosis guidance. Prospective research using validated or fully documented measures should examine how caregiver and service-related factors can be addressed to strengthen maternal wellbeing over time. Full article

Background: Physical activity is relevant for physical and psychosocial development in children and adolescents with Down syndrome. However, evidence regarding the effects of structured physical activity interventions across different motor and psychosocial domains remains limited and heterogeneous. This systematic review aimed to examine the effects of structured physical activity interventions on motor and psychosocial outcomes in this population. Methods: The review was conducted according to PRISMA guidelines and registered in PROSPERO (CRD42025114068). Scopus, PubMed, and Web of Science databases were searched, with the final search conducted on 15 December 2025. Eligible studies were peer-reviewed articles published in English within the previous 10 years that investigated structured physical activity interventions in children and adolescents with Down syndrome and reported motor or psychosocial outcomes. Methodological quality was assessed using a modified Downs and Black Checklist. Due to substantial clinical and methodological heterogeneity across interventions, comparators, and outcome measures, findings were synthesized narratively. The certainty of evidence was assessed using the GRADE approach. Results: Five studies, including 186 participants, were included, of whom 166 had Down syndrome and 20 were typically developing children. The included studies reported improvements in motor skills, balance, coordination, and psychosocial outcomes. Interventions included Pilates, core stability and treadmill training, fundamental movement skills training, adapted football, and traditional Indian dance. Motor outcomes were generally associated with improvements in balance, postural control, coordination, and motor competence. Psychosocial outcomes were assessed in only two studies and showed preliminary improvements, including reductions in aggression, attention problems, anxiety/depression, and social problems. Overall, the certainty of evidence was rated as low across the assessed outcome domains. Conclusions: Structured physical activity interventions may be associated with improvements in motor development, while their effects on psychosocial outcomes appear encouraging but require further investigation. The findings should be interpreted cautiously because of the small number of studies, methodological limitations, and heterogeneity of interventions and outcome measures. Further high-quality randomized controlled trials with larger samples and standardized outcome measures are needed. Full article

Background/Objectives: Nursing research on children with disabilities spans diverse disability groups, care settings, and areas of practice; however, its development and structure have not been comprehensively examined. This study aimed to examine publication trends, major research themes, temporal development, and collaboration patterns. Methods: The Web of Science Core Collection was searched on 29 June 2026 without publication-year restrictions. English-language articles and reviews indexed in Science Citation Index Expanded (SCI-EXPANDED) and Social Sciences Citation Index (SSCI) were included, yielding 1915 publications from 1977 to 2026. VOSviewer and Biblioshiny were used to analyze publication trends, keyword co-occurrence, thematic structure and evolution, trend topics, and country and institutional collaboration. Results: Research output increased substantially, particularly during the last decade. Across the study period, the United States had the highest publication output and co-authorship connectivity, followed by England, Canada, and Australia. Nursing, children, autism spectrum disorder, intellectual disability, and cerebral palsy were among the largest nodes in the keyword network. The thematic map positioned the autism–pediatrics–developmental disability cluster slightly within the motor themes quadrant, while the disability–children with disabilities–qualitative research, adolescents–communication–transition, and children–nursing–intellectual disability clusters were positioned among the basic themes. Thematic evolution showed both continuity and diversification, with autism, nursing, children, and intellectual disability represented across multiple periods, while quality of life, education, and mental health were represented in the most recent period. Trend topic analysis further showed that well-being, implementation, pediatric nursing, anxiety, and mental health were among the topics with more recent median publication years. Conclusions: Nursing research on children with disabilities has expanded and diversified, with recurring disability-specific topics alongside more recent topics related to psychosocial issues, pediatric nursing, and implementation. Future research could build on the thematic patterns identified in this study through systematic reviews and primary nursing research, while bibliometric studies incorporating additional databases could provide a more comprehensive view of the field. Full article

The COVID-19 pandemic lockdowns heavily impacted the stress levels of families worldwide. We examined parental stress levels regarding a variety of subtopics (including finances, schooling, and seeing extended family) in North Bay, Ontario, Canada. A mixed-method survey approach was used with a volunteer sample of 101 parents from the North Bay community. Included in the survey were 25 potential parental stressors, which parents were asked to rate in terms of their stressfulness, both during the COVID-19 lockdowns and post-pandemic. To accomplish this, participants were administered only one questionnaire, after the height of the pandemic was over, and asked to reflect on both the current time and on the time during the lockdown phase of the pandemic. General stress levels were higher after the lockdowns ended compared to during the lockdowns, indicated by 20 out of the 25 surveyed parental stressors. Four themes were identified in the qualitative data obtained from open-ended questions: ability to parent; requiring additional support; mental and physical well-being; and child-rearing. Specifically, in terms of the first theme, some parents felt that parenting had become more difficult, while others did not. With respect to theme two, many parents felt a need for support in a variety of areas, which relates to theme three, as supports were often desired to improve mental or physical well-being. The fourth theme highlighted the opportunity to spend more time at home with family and raise children according to parents’ own principles. Parents were also asked about changes in their behaviours, like gambling and alcohol use; gambling, in particular, increased during and after the pandemic compared to before. However, parents reported that the difficulty associated with continuing to parent as they did before the lockdowns was minimal, and that it did not change during or after the lockdowns. Finally, parents were asked about changes to their own mental and physical health; results were mixed, but approximately half of participants perceived positive changes in their well-being. Thus, compared to existing research, the current study provides a more comprehensive overview of stressors experienced by families in the wake of COVID-19 lockdowns. It also brings to light suggestions and recommendations from survey respondents to improve parents’ quality of life in post-COVID-19 North Bay, Ontario. Full article

Background: Caring for dependent children with chronic illnesses or disabilities constitutes a major public health challenge, subjecting family caregivers to prolonged physical and emotional stressors. Objectives: To quantitatively synthesize the relationship between depressive symptomatology and quality of life (QoL) in this population. Methods: A systematic review methodology with meta-analysis was conducted following PRISMA guidelines and Cochrane handbook recommendations. Databases such as PubMed, CINAHL, PsycInfo and Scopus were consulted up to February 2026. Results: Thirty-three original studies evaluating family caregivers of children under 18 years of age and reporting statistical data of association were included. The meta-analysis revealed a statistically significant moderate-to-strong negative association between depressive symptoms and overall QoL (r = −0.532; I² = 9.51%), maintaining similar values across all analyzed domains (physical, mental, social and environmental) as well as the summary components of the SF-36 questionnaire. According to the GRADE criteria, the overall certainty of evidence was rated as low to very low across all QoL domains and SF-36 components. Conclusions: This study demonstrates that heightened depressive symptomatology is substantially associated with compromised well-being among family caregivers. Full article

Autism spectrum disorder is a neurodevelopmental condition that may be associated with challenges affecting children and their families. This cross-sectional comparative study examined family quality of life (FQoL) among families of children with autism spectrum disorder and families of typically developing children in Croatia. The study included 185 families of children with autism spectrum disorder and 188 families of typically developing children. Families of children with autism spectrum disorder reported significantly lower FQoL across all domains compared with typically developing children (4.00 ± 0.66 vs. 4.51 ± 0.38, t = −9.14, p < 0.001, d = −0.95), with the largest differences observed in emotional wellbeing and disability-related support. Mean differences were substantial relative to the five-point response scale; however, their clinical or practical significance cannot be formally determined because no minimal clinically important difference has been established for the instrument. Internal consistency was satisfactory in both groups (Cronbach’s α = 0.72–0.95 and 0.70–0.83, respectively). FQoL domains showed moderate to strong positive intercorrelations in both groups. The observed group differences were unadjusted for potential confounders, and the cross-sectional design does not establish causality. Disability-related support findings should be interpreted cautiously because this domain addresses disability-specific needs. Direct measures of service accessibility and quality were not included. Future research should incorporate longitudinal designs, comprehensive sociodemographic and clinical data, and direct measures of service experiences. Full article

Pediatric health research must translate evidence into decisions that affect children’s development, safety, function, and long-term well-being. Scientific progress can still fail in two opposing ways: claims may exceed their evidentiary support, or research programs may remain productive while repeatedly refining an established signal without resolving decision-relevant uncertainty. These risks are amplified by developmental heterogeneity, ethical constraints, surrogate or short-term outcomes, long follow-up, and caregiver-mediated implementation. This concept paper formalizes these failures as Evidence Drift (ED) and Causal Maturation Drift (CMD). ED is a claim-level failure in which a finding moves into a stronger or different inferential domain without an adequate bridge. CMD is a trajectory-level failure in which research continues to accumulate within an established domain after a signal is sufficiently characterized, without proportionate progression toward temporal, causal, comparative, long-term, or implementation evidence. Inferential Fidelity is proposed as the governing principle linking claim calibration to purposeful uncertainty reduction. Applications are illustrated through early childhood caries microbiome research, vitamin D and childhood caries, silver diamine fluoride, pediatric biomarker and omics pipelines, and artificial intelligence prediction studies. Two preliminary eight-item appraisal frameworks are introduced: the Evidence Drift Assessment Scale (EDAS) for claims and the Causal Maturation Drift Assessment Scale (CMDAS) for literature trajectories. These formative frameworks prioritize item-level profiles; any standardized index is secondary and non-diagnostic. A phased validation program includes content validation, cognitive testing, multi-assessor reliability, hypothesis-based construct testing, bibliometric trajectory mapping, and evaluation of practical utility. The framework offers investigators, reviewers, funders, guideline panels, and policymakers a structured approach to determining whether conclusions remain within evidentiary boundaries and whether research activity reduces the uncertainties that matter most to children and families. Transferability beyond pediatric research requires empirical testing. Full article

Maintaining thermally comfortable environments in educational buildings is important for supporting students’ cognitive function, well-being, and learning performance. However, current thermal comfort standards for building environmental design have largely been based on adults and do not adequately account for the physiological differences of children. This paper develops and validates a comfort model for school-age children. The model extends the capability of the recently-developed MPMV model for adults, by incorporating age-dependent metabolic rates, thermoregulation, and heat physiological adaptation. The proposed model is validated using thermal sensation votes (TSV) collected from seven independent experiments in climatic chambers and ten field studies in air-conditioned and free-running schools under various climate conditions worldwide. The model performance is evaluated against the observed TSV using the RMSE index. For reference purposes, the adults’ PMV model is also included in the benchmark. The results demonstrate that the proposed model consistently produces good results with RMSE between 0.17 and 0.44 for urban and rural schools. In contrast, the adults’ PMV model produces inconsistent results with large discrepancies in most cases with RMSE between 0.27 and 1.04. The improvement is particularly pronounced in naturally-ventilated urban and rural schools, where adult-based comfort models systematically mis-predict children’s thermal sensation. These findings support the need for child-specific thermal comfort criteria and offer a robust analytical basis for improving classroom’s environmental design and operation, and future development of thermal comfort standards that explicitly consider children’s needs. Full article

Background: Children with Down syndrome often have co-occurring physical conditions affecting well-being, and respiratory issues remain a leading cause of hospitalization and death among people with Down syndrome. Parents of children with Down syndrome experience stressors associated with respiratory illness and challenges navigating healthcare access. No prior qualitative study has examined parental perspectives on respiratory health specifically among children with Down syndrome. Identifying parental concerns can help in the development of strategies to mitigate respiratory ailments in children with Down syndrome. Methods: One-hour, semi-structured interviews were conducted among 24 families of children with Down syndrome to understand respiratory concerns. Findings were identified through codebook thematic analysis. Results: The themes identified included persistent concerns about respiratory health, repeated impact from acute and chronic respiratory issues, a rapid and unexpected decline in health during respiratory illness, insurance coverage concerns, and a lack of confidence in assessing air quality which could impact respiratory health. Conclusions: Insights gained from interviews of parents of children with Down syndrome can help policy makers identify opportunities to prevent and mitigate respiratory health problems. Findings underscore the importance of clinician responsiveness to parental concern about rapid deterioration and suggest that insurance coverage policies for this high-risk population warrant further research and policy consideration. Full article

Background/Objectives: Family-Centered Care (FCC) is an established standard in pediatric rehabilitation, but it has been studied almost entirely inside health services; whether its principles survive the move into community settings is largely unknown. This paper describes how caregivers perceive the family-centeredness of a community-based adapted sport program and characterizes child quality of life and caregiver well-being. Methods: Cross-sectional study within the “Skill-In” program (University of Messina). Nineteen caregivers of children with neurodevelopmental disabilities completed the MPOC-20, the KIDSCREEN-52 proxy version and the CarerQoL, analyzed with Spearman correlations and bootstrap confidence intervals. Results: The overall MPOC-20 mean item score was 5.43/7 (SD 0.83), concealing a wide spread from Respectful and Supportive Care (6.25) to Providing General Information (3.78). “Not applicable” responses (14.2%) clustered in items presupposing a clinical provider. KIDSCREEN-52 raw sums were converted to Rasch-based T-values (norm: mean 50, SD 10). Eight of ten dimensions fell within half a standard deviation of the norm, including Social Acceptance (47.65); two did not, Social Support and Peers (34.58) and Autonomy (39.42), each over one standard deviation below. Caregivers reported favorable well-being (CarerQoL-VAS 7.32/10), though six of nineteen reported no support. Associations between care processes and family outcomes were weak. Conclusions: A sport organization with no clinical mandate delivered the relational core of family-centered care comparably to rehabilitation services, while falling short on structured information. The children’s quality-of-life profile was normal on most dimensions but selectively low on peer support and autonomy. Acceptance, on this evidence, is not connection: social participation must be designed for, not assumed. Full article

In today’s world, where people are exposed to ever-increasing flows of information, children may find it difficult to regulate their emotions, attention, thoughts and behaviour. Self-regulation is widely recognised as a key factor in children’s learning, emotional well-being and social functioning, yet there remains a lack of research analysing how processes related to self-regulation can be conceptually explored in museum, experiential and sensory educational settings. To address this gap, this study examines the conceptual links between the exhibits and educational activities at the Museum of Feelings, established in Lithuania in 2025, and children’s emotional, cognitive and behavioural self-regulation. The study employed qualitative deductive content analysis. The museum’s exhibits and the associated educational activities were analysed using a coding system derived from the academic literature. The analysis identified three main categories of self-regulation: emotional, cognitive and behavioural. The results of this study reveal that the museum’s exhibits and activities were conceptually linked to all three categories. The activities analysed were linked to the development of emotional vocabulary, the recognition and naming of emotions and bodily sensations, reflection on the interrelationships between thoughts, feelings, bodily sensations and behaviour, attention regulation, impulse control, and the exploration of constructive ways of responding to complex emotions and social situations. By revealing how these aspects of self-regulation are given meaning within the experiential museum environment, this study offers a new theoretical perspective on the educational potential of museum activities. However, the identified links are conceptual and theoretical in nature and should therefore not be interpreted as empirical evidence of the museum’s impact on children’s self-regulation. Full article

Background/Objectives: Children now spend a substantial part of daily life in digital environments, and their digital, media, and information literacies shape their online safety, social-emotional development, and mental health, making these competencies a concern for child public health and preventive paediatric care. This study applies a Synthetic Knowledge Synthesis (SKS) to map how digital, media, and information literacies (hereafter digital literacies) among children have evolved, comparing neurotypical and neurodivergent children. SKS is a semi-automated approach that combines descriptive bibliometrics, keyword co-occurrence mapping, and qualitative content analysis to map an entire research field or topic. Methods: We treat digital literacies as relevant to children’s health, well-being, and safe online participation, and we analyse Scopus-indexed literature from 1996 to 2025 using descriptive bibliometrics, keyword co-occurrence mapping, and qualitative content analysis. Results: The mapping shows strong growth in general digital-literacy scholarship alongside a small but persistent body of work on a “double digital divide” affecting children with autism spectrum disorder (ASD), ADHD, and dyslexia. The two bodies of work differ in emphasis: the general literature foregrounds social integration and critical agency, while research on neurodivergent children foregrounds inclusive pedagogy, implicit learning, and multimodal expression. It also shifts from general digital-safety awareness toward protective mediations for vulnerabilities such as social-emotional decoding differences and impulsivity, which bear on children’s online safety and mental health. Because bibliometric mapping reveals where research is concentrated rather than what works in practice, the synthesis points to evidence gaps rather than proven methods. Conclusions: On this basis, we argue for an integrated public-health and socio-educational framework that complements universal literacy standards with adaptive, assistive safety nets, so that all children can take part in digital life safely and on equal terms. Full article

Early childhood education and care (ECEC) systems in equitable welfare states are designed to provide comparatively standardised institutional inputs, yet substantial developmental gaps among children persist. This study examined this configuration—descriptively labelled the “Flemish Paradox”—using data from the OECD’s International Early Learning and Child Well-being Study (IELS 2025) for the Flemish Community of Belgium (2363 five year olds in 200 ECEC centres; parent-questionnaire data were available for a subset of the sample, and missing parent-report data were addressed through multiple imputation). Children’s cognitive and executive skills were measured with standardised direct tablet-based assessments, while home environments were reported by parents, separating measurement sources. Two-level hierarchical linear models with design-based weighting (child weight and 92 BRR replicate weights), pooled across five plausible values and 20 multiply imputed datasets, showed comparatively limited between-centre outcome variation (ICC ≈ 23% for foundational learning, ≈11% for executive function). Within centres, family socioeconomic status (B = 25.11, p < 0.001) and a print-focused home literacy index (PHLI; B = 16.60, p < 0.001) were positively associated with foundational learning, and centre-mean PHLI showed an independent contextual association (B = 24.11, p < 0.001). A positive within-centre indirect association through children’s executive function skills was estimated (3.60, 95% Monte Carlo CI [1.83, 5.40]); a secondary exploratory analysis indicated a parallel between-centre pattern (8.40, 95% CI [1.16, 15.65]). Centre socioeconomic composition was strongly associated with outcomes (B = 36.38, p < 0.001); the analysis did not provide evidence that it modified the within-centre PHLI–learning association (p = 0.219). The findings are consistent with cultural-capital perspectives and indicate that family resources, print-focused home literacy, and EFs are jointly associated with early learning within a multilevel ECEC context. However, the cross-sectional design does not establish temporal or causal mediation, and the results should not be interpreted as evidence regarding the effectiveness of particular family- or centre-based interventions. Full article

Background/Objectives: Positive psychological constructs such as psychological well-being, resilience, subjective vitality, and mental toughness are fundamental to students’ emotional adjustment and overall development. Physical activity (PA) is a modifiable factor known to enhance these variables; however, the influence of its timing throughout the day remains underexplored. This systematic review aimed to examine the effects of PA on psychological well-being, resilience, subjective vitality, and mental toughness in children and adolescents, considering the timing of implementation—before, during, or after school hours—and the specific characteristics of the activities performed. Methods: Following the PRISMA guidelines, a comprehensive search was conducted in Scopus, PubMed, ERIC, and Web of Science, identifying 29 studies published between 2014 and 2026, comprising 12 cross-sectional and 17 longitudinal studies. Results: Overall, PA was positively associated with all four psychological variables across different times of the day. PA before school, such as active commuting and active starts, was primarily associated with higher in well-being and vitality. During-school interventions, particularly structured programs such as active breaks and cooperative games, were associated with better resilience, emotional self-regulation, and prosocial behavior. After-school PA, especially organized and voluntary activities, was associated with higher resilience and mental toughness. The effects varied according to the intensity, structure, social context, and student role, with moderate-to-vigorous intensities and cooperative formats producing the most consistent benefits. Conclusions: In conclusion, PA appears to exert a beneficial influence on positive psychological development, with variations depending on the time and mode of practice. Schools, particularly through Physical Education programs, constitute a key context for promoting students’ emotional, motivational, and behavioral health. Full article