Search Results (13,573)

Background: Worldwide, around 400,000 children are diagnosed with cancer every year. Understanding survivors’ social and stigma-related experiences may help address their needs and improve their outcomes. Objectives: To explore the social and stigma-related experiences, coping strategies, and support needs of pediatric cancer survivors in Newfoundland and Labrador, a province of Canada. Methods: This is a qualitative, cross-sectional study focusing on retrospective participant experiences. Eligibility criteria included being diagnosed with cancer before the age of 18 and being diagnosed or treated in the province. Extensive recruitment activities were employed. Data collection occurred through semi-structured virtual interviews and completion of a sociodemographic survey. Participant interviews were transcribed verbatim, and themes were identified iteratively through inductive thematic analysis. Descriptive statistics were used to define the participants’ sociodemographic characteristics. Results: Seven participants were recruited. Thematic analysis identified five major themes: (i) isolation and being treated differently; (ii) support received, coping mechanisms, and support needs; (iii) resilience and interest to give back; (iv) workplace and disability related experiences; and (v) additional impacts of cancer. Our results showed that participants received substantial social support in various ways but inadequate professional mental health support. School was a significant setting for cancer-related stigmatization. Discrimination in the workplace was rare and was disability-related rather than cancer-related. Conclusions: Our results show that there are significant issues to address, such as stigma and isolation experienced by pediatric cancer survivors as well as the need to improve the psychosocial support programs offered to them. Our results also show that the participants had distinct lived experiences compared to adult-onset cancer populations. Overall, the findings presented are expected to inform further studies and healthcare-education policies to help address these issues and improve the experiences of pediatric cancer survivors. Full article

Background/Objectives: Recent pediatric sleep research has increasingly adopted an integrated lifestyle perspective, examining sleep together with diet, physical activity, sedentary behavior, and family environments. However, bowel habits remain comparatively underrepresented despite their potential importance for child health. This conceptual narrative review revisits the Four Kai framework, which brings together sleep, eating, bowel habits, and physical activity as four fundamental daily physiological behaviors and explores their potential relationships with adaptive pleasure, self-regulation, and daytime functioning. Methods: This conceptual narrative review incorporated a descriptive PubMed literature-mapping exercise conducted on 16 July 2026. The search covered publications from January through June of each year from 2022 to 2026 and focused on studies in which sleep was a principal research topic together with terms related to diet, bowel function, physical activity, and lifestyle. Publications clearly outside pediatric or adolescent populations were excluded. Titles and abstracts were reviewed, with full texts consulted when necessary, and eligible studies were classified thematically according to their principal research objective. This exercise was intended to provide descriptive context for the conceptual review and was not conducted as a systematic or scoping review. Results: The descriptive mapping and narrative synthesis indicate that pediatric sleep research frequently examines sleep in relation to diet, physical activity, sedentary behavior, family environments, and other lifestyle factors, whereas everyday bowel habits remain comparatively underrepresented. The reviewed literature supports multiple individual and pairwise associations among sleep, eating, physical activity, bowel function, and daytime functioning but does not establish that these four behaviors operate as a single integrated physiological system. Direct empirical evidence for a pathway linking the Four Kai through adaptive pleasure and positive self-regulation to daytime functioning is currently lacking. Conclusions: The Four Kai framework is best regarded as a hypothesis-generating conceptual framework rather than an established biological or causal model. Its potential value lies in bringing sleep, eating, bowel habits, and physical activity into a common perspective and generating testable questions about their possible functional integration. Future longitudinal and intervention studies should evaluate these behaviors together with adaptive pleasure, self-regulation, and daytime functioning to determine which proposed relationships can be empirically supported. 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

Background: Food insecurity continues to pose a significant public health challenge in urban low-income communities, where limited resources and unstable food systems may negatively relate to children’s nutrition. Although prior studies have linked food insecurity with inadequate dietary intake, the role of coping strategies in this relationship remains insufficiently understood. This study investigated the associations between household food insecurity, coping strategies, and children’s dietary intake in densely populated urban areas of Surabaya, Indonesia. Methods: A cross-sectional study was conducted among 55 mother–child pairs in Simolawang and Bulak Banteng from September 2025 to February 2026. We used the Household Food Insecurity Access Scale (HFIAS) and the Short Food Literacy Questionnaire (SFLQ), and coping behaviors were assessed using the Reduced Coping Strategy Index (r-CSI). Children’s dietary intake was obtained through a Semi-Quantitative Food Frequency Questionnaire (SQ-FFQ). Pearson correlation and multivariate regression analyses were applied to examine relationships among variables. Results: Most households were classified as food secure (61.82%), although varying degrees of food insecurity were observed. Household food insecurity was not significantly associated with children’s energy or macronutrient intake. In contrast, coping strategy scores were positively associated with household food insecurity (β = 0.26–0.27), indicating greater use of coping strategies among households experiencing greater food insecurity. Conclusions: Food insecurity was linked to increased coping behaviors but not directly to children’s macronutrient intake. Coping mechanisms may help sustain short-term intake but do not guarantee adequate nutrition. Interventions should address both food access and dietary quality in urban poor settings. Full article

Background: The global prevalence of oral disease including dental caries varies significantly across different regions, and South Africa is no exception. Although dental caries is a major public health concern, it is largely preventable through the promotion of proper oral hygiene practices and screening. The study aimed to assess the oral health status of school children within selected primary schools in the Tshwane District, South Africa. Methods: The study used a quasi-experimental design employing a quantitative research approach, structured into three phases: a pre-test assessment, the implementation of the intervention, and a post-test evaluation. A total of 390 primary school learners from five selected schools underwent dental screening and were included in the study on a voluntary basis. Data analysis was conducted using IBM SPSS version 30, incorporating both descriptive and inferential statistical tools. Results: Prior to screening, 75.9% of participants exhibited dental caries, while only 24.1% showed no signs of tooth decay. Following the intervention, improvements in oral hygiene status were observed among participants. The proportion of children presenting with high plaque scores decreased markedly from 19.0% at baseline to 1.8% post-intervention. Similarly, the prevalence of poor oral hygiene declined from 30.1% pre-intervention to 16.2% after the intervention, indicating an overall enhancement in hygiene practices. The proportion of dmft in primary teeth recorded 37.3% pre intervention, higher than post intervention (23.2%). Additionally, the record of DMFT in permanent teeth (49.2%) pre-intervention compared to the post intervention (40.8%). The study reported a similar percentage on the treatment during pre and post intervention (75.9%). Conclusions: Dental screening intervention yielded promising short-term results, particularly in plaque reduction and caries detection. However, its long-term success hinges on integrating school efforts with parental support and improving access to follow-up dental care. A comprehensive, multi-stakeholder approach remains essential to ensure lasting oral health benefits for children. Full article

Meningitis is a significant public health problem despite the availability of effective vaccination programs, especially in children and young people. The memory-dependent features of disease transmission, immunity and vaccination dynamics are not often represented in classical integer-order epidemic models. This study proposes a fractional-order model of meningitis transmission with memory using the Atangana–Baleanu–Caputo fractional derivative. The model features susceptible, vaccinated, exposed, infectious, treated, and recovered populations to assess the impact of vaccination coverage, vaccine effectiveness, loss of vaccine immunity, and treatment on the spread of meningitis. The basic mathematical characteristics of the model, such as positivity, existence, uniqueness, and stability of solution are proven. The Laplace–Adomian Decomposition Method (LADM) is used to obtain the approximate analytical solutions, and a numerical simulation is used to analyze the influence of the fractional-order memory and epidemiological parameters on the epidemic process. The most important parameters that influence the basic reproduction number are found in sensitivity analysis to be the transmission rate and the vaccination-related parameters. The results show that simply increasing the vaccination coverage and vaccine effectiveness can substantially decrease the number of disease transmissions, and vaccine coverage can produce memory effects to change the timing and duration of outbreaks. The suggested fractional-order computational framework is a framework that is vital for studying the dynamics of meningitis and can be used for the design of long-term vaccination and disease-control strategies. Full article

Background/Objectives: Undernutrition remains a public health concern among preschool children in Malaysia. Although oral nutritional supplementation (ONS) globally has been recommended to improve nutritional status, evidence from community-based randomised controlled trials among underweight Malaysian preschool children remains limited. This study evaluated the effectiveness of ONS on growth, dietary intake, appetite, and common illnesses among underweight preschool children in Kuala Lumpur, the capital city of Malaysia. Methods: A multi-centre, community-based, cluster-randomised controlled trial was conducted among underweight preschool children aged 4–6 years from 16 government-subsidised preschools. Participants were assigned to receive ONS plus nutrition education (ONS + NE) or nutrition education alone (NE only) for 90 days. Anthropometric measurements, dietary intake, appetite, attainment of catch-up growth, and parent-reported common illnesses were assessed. Between-group differences were analysed using analysis of covariance adjusted for baseline values. Results: Ninety-six underweight preschool children were randomised to ONS plus nutrition education (ONS + NE, n = 56) or nutrition education alone (NE only, n = 40). Compared with the NE group, children receiving ONS + NE demonstrated significantly greater improvements in weight-for-age z-scores at day 60 and day 90 (p < 0.05). The ONS + NE group also achieved significantly higher catch-up growth attainment at day 60 (116.6 ± 38.5% vs. 99.1 ± 17.4%; p = 0.029) and day 90 (114.6 ± 37.2% vs. 95.5 ± 23.8%; p = 0.021). In addition, significantly higher energy, macronutrients, selected micronutrient intakes, and appetite scores were observed in the ONS + NE group (all p < 0.05). Conclusions: ONS combined with nutrition education improved weight-related growth, dietary adequacy, catch-up growth energy achievement, and appetite among underweight preschool children. ONS may serve as an effective community-based strategy for nutritional rehabilitation in this population. Trial registration: ISRCTN15093638. Full article

Heavy metal deposition along high-traffic roadsides poses a persistent threat to agricultural safety, yet the partition barrier efficiency across rhizosphere–root–shoot interfaces in perennial nut crops remains poorly understood, representing a significant research gap. This study determined the concentrations of potentially toxic elements in the rhizosphere soils and distinct organs (leaves, pericarp, and edible seeds) of Siirt pistachio trees along a distance gradient (0, 50, and 100 m, plus a control site) in the Siirt and Tillo districts. To filter analytical baseline noise, all raw datasets were subjected to strict solid-matrix limit of detection (LOD) screening using a standardized dilution factor of 30 mL/g (DF = 15 mL final volume/0.5 g sample mass). Soil analysis revealed that the alkaline pH (6.90–7.27) and highly calcareous nature (21.97–65.75%) of the rhizosphere acted as a powerful edaphic barrier, immobilizing metals in the soil and limiting their translocation to aboveground tissues. Plant accumulation followed a leaf > pericarp > seed hierarchy, proving the canopy’s role as an effective vegetative filter. Crucially for food safety, highly toxic Cd (<1.74 µg/kg) and Bi remained entirely below detection limits in edible seeds. Cr peaked in leaves (730.42–795.00 µg/kg) but was highly restricted in seeds. Detected kernel concentrations of As, Co, Ni, Pb, and Sb were strictly below international toxic thresholds, while essential Cu physiologically concentrated in seeds and leaves. Consequently, the cumulative Hazard Index (HI) remained exceptionally below the 1.0 critical safety limit for both adults (<0.18) and children (<0.32). This confirms that roadside pistachios pose zero non-carcinogenic health hazards and are completely safe for human consumption. 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

Background/Objectives: Problematic internet use (PIU) is a growing behavioral health concern among school-aged children. Whether health literacy and health-promoting lifestyle beliefs are associated with PIU among gifted children—a developmentally distinct population—has, to the best of our knowledge, not been investigated. Methods: A cross-sectional correlational design was used with 118 gifted students (M = 13.80, SD = 2.06) attending a Science and Art Center (BİLSEM) in İzmir, Türkiye. Data were collected using the Problematic Internet Use Scale–Adolescent Form (PIUS-A; α = 0.92), the Health Literacy for School-Aged Children Scale (HLSAC; α = 0.87), and the Adolescent Health-Promoting Lifestyle Beliefs Scale (AHPLBS; α = 0.91) in a classroom setting under researcher supervision. A three-step hierarchical multiple linear regression was performed, with age, sex, daily sleep duration, daily screen time, and weekly physical activity entered as covariates in the first step. Results: Covariates explained 24.8% of the variance in PIU (p < 0.001), with daily screen time as the strongest predictor (β = 0.36). Health-promoting lifestyle beliefs added significant incremental variance (ΔR² = 0.063, p = 0.023); health beliefs were the only statistically significant belief predictor (β = −0.24, p = 0.036), with lower health belief scores associated with higher PIU. Health literacy domains did not add statistically significant incremental variance (ΔR² = 0.028, p = 0.495), and no individual domain was a statistically significant predictor. Conclusions: Within the constraints of a cross-sectional design, health beliefs appear to play a more prominent role than health literacy in the covariate-adjusted explanation of PIU among gifted school-aged children. School health nurses may prioritize interventions that strengthen internalized health beliefs alongside information-based education, contributing to more equitable, tailored school health services for this population. Full article

Background/Objectives: Drowning among children younger than five years remains a major public health problem in Thailand, particularly in residential water environments. Caregivers’ supervision and home safety practices play an important role in preventing childhood drowning. This study evaluated the association between participation in the Be SAFE Program, a community-based educational intervention developed using the Health Belief Model (HBM), and changes in caregivers’ health beliefs and self-reported drowning prevention behaviors. Methods: A quasi-experimental pretest–posttest control group study was conducted among 60 caregivers of children younger than five years recruited from two community settings in Ubon Ratchathani Province, Thailand. Participants were assigned to either an intervention group (n = 30) or a control group (n = 30). The intervention group participated in the HBM-based Be SAFE Program, whereas the control group received routine care. Outcomes included HBM constructs and self-reported drowning prevention behaviors. Baseline-adjusted analyses of covariance (ANCOVA) were performed to compare post-intervention outcomes between groups. Holm adjustment was applied to account for multiple comparisons. Results: After adjustment for baseline scores, caregivers in the intervention group demonstrated significantly greater improvements than those in the control group in perceived susceptibility, perceived severity, perceived benefits, cues to action, self-efficacy, and self-reported drowning prevention behaviors, together with significantly lower perceived barriers (all Holm-adjusted p < 0.05). Large effect sizes were observed across all measured outcomes. Conclusions: The findings suggest that the HBM-based Be SAFE Program was associated with greater short-term improvements in caregivers’ health beliefs and self-reported drowning prevention behaviors than routine care. These findings support the potential value of theory-based community educational programs for childhood drowning prevention while highlighting the need for larger multi-site studies with longer follow-up to confirm the program’s effectiveness and broader applicability. Full article

Children living in agricultural communities are particularly vulnerable to pesticide exposure through multiple environmental pathways, yet community-level public policies specifically designed to protect children remain limited in many low- and middle-income countries. This study aimed to develop a community-based public policy for preventing pesticide exposure among young children in rural Thailand through a participatory action research (PAR) approach. Guided by the Kemmis and McTaggart PAR framework, one complete PAR cycle was conducted between February 2022 and January 2023 in Ban Nangoi Village, Sakon Nakhon Province, Thailand. Purposive sampling recruited 62 stakeholders representing parents, farmers, healthcare personnel, local government representatives, academics, and community members. Data were collected through semi-structured interviews, focus group discussions, participant observations, and community meetings and analyzed using thematic analysis. The PAR process enabled stakeholders to jointly identify local priorities and co-develop a context-specific public policy summarized as the “3 Cs for Farmers, 2 Ps for People, and 1 S for Community” framework. Participants reported greater awareness of pesticide-related health risks, stronger multisectoral collaboration, improved stakeholder communication, and wider adoption of preventive practices. These findings suggest that PAR is a feasible approach for co-creating context-specific public policies while strengthening local environmental health governance. Rather than demonstrating the effectiveness of the policy in reducing pesticide exposure, this study highlights the value of stakeholder participation and policy co-creation in supporting sustainable community action. Future research should incorporate objective pesticide exposure measures, quantitative outcome indicators, and longer-term follow-up to evaluate policy effectiveness across diverse agricultural settings. Full article

Background/Objectives: Dental caries remains one of the most prevalent and preventable childhood diseases worldwide. Despite universal access to free dental care in Saudi Arabia, preventable oral diseases remain common, highlighting persistent gaps in oral health literacy and preventive behaviours among children. Male students consistently demonstrate poorer oral health knowledge and practices than their female counterparts, yet they remain understudied. This study aimed to assess oral health knowledge, attitudes, and practices (KAP) among male primary school students in Al Lith city, Saudi Arabia, and to identify their associated sociodemographic determinants. Methods: A school-based analytical cross-sectional study was conducted during the 2023–2024 academic year in Al Lith city, Makkah Province, Saudi Arabia. A total of 430 male students aged 10–13 years from grades five and six were recruited via multistage cluster sampling from 8 randomly selected schools. A validated, interviewer-administered, Arabic-language questionnaire assessed knowledge (18 items), attitudes (12 Likert-scale items), and practices (12 items) related to oral health, alongside sociodemographic data. The study was designed and reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. Data were analysed using IBM SPSS Statistics version 27. Descriptive statistics and multivariable logistic regression were performed. Results: Of the 430 participants, 83.3% were aged 11–12 years, 89.8% were Saudi nationals, and 89.1% resided in intact, two-parent households. Knowledge deficits were widespread: only 8.4% correctly identified the recommended timing of sweet consumption, 20.2% understood dental plaque, and 28.6% recognised the protective role of fluoride. Attitudes were generally positive, with 80.1% agreeing that teeth should be brushed twice daily and 71.6% endorsing regular dental visits; however, 60.3% held that dental attendance was necessary only when pain was present. Substantial practice gaps were also evident: only 33.3% brushed for the recommended two minutes, and 12.6% had never visited a dentist. In multivariable analysis, low household income was independently associated with better oral health knowledge (adjusted odds ratio [AOR] = 2.22; 95% confidence interval [CI]: 1.04–4.74; p = 0.039), divorced parental status was independently associated with positive oral health attitudes (AOR = 5.40; 95% CI: 1.28–22.79; p = 0.022), and older age was independently associated with poorer oral health practices (AOR = 0.72; 95% CI: 0.55–0.93; p = 0.014). Conclusions: Male primary school students in Al Lith demonstrated generally positive oral health attitudes but significant deficits in knowledge and preventive practices. Comprehensive, school-based oral health promotion programmes that address key misconceptions, actively engage parents, and integrate culturally accepted practices—such as miswak use—with evidence-based preventive guidance are needed. Full article

Background: Child sexual abuse is a major public health concern, particularly for children from socioeconomically disadvantaged families. This study examined the effect of a body safety training (BST) program on the self-protection skills of preschool children from low-income families. Methods: This one-group pretest–posttest quasi-experimental study was conducted with 32 children aged 4–6 years attending a public kindergarten located in a low-income neighborhood in Türkiye. The children participated in a seven-session BST program. Data were collected via the What If Situations Test (WIST), with assessments conducted before and after the intervention. Differences between the pretest and posttest scores were analyzed via the Wilcoxon signed-rank test, and effect sizes (r) were calculated. Results: Statistically significant improvements were observed in the WIST subscales of appropriate touching recognition, inappropriate touching recognition, Saying skill, Doing skill, Telling skill, and Reporting skill, as well as in the Personal Safety Questionnaire scores (all p < 0.05). A significant increase with a large effect size was observed in the WIST total skill scores following the intervention (Z = −4.756, p < 0.001, r = 0.84; mean change = 6.34, 95% CI: 4.63–8.13). Conclusions: Participation in the BST Program was associated with significant improvements in the self-protection skills of preschool children from low-income families. These findings suggest that structured body safety education may be a promising approach for supporting personal safety skills among socioeconomically disadvantaged preschool children. Full article

Mite-induced allergic respiratory diseases are a major global health concern, and evidence on allergen immunotherapy (AIT) combining allergens from different mite families remains limited, particularly for Lepidoglyphus destructor. This study evaluated the effectiveness and safety of subcutaneous allergen immunotherapy containing glutaraldehydempolymerized extracts of Dermatophagoides pteronyssinus, Dermatophagoides farinae, and L. destructor in mite-allergic patients in Spain. This retrospective multicenter study included 199 patients with allergic rhinoconjunctivitis, with or without asthma. Effectiveness outcomes included combined symptom and medication scores (CSMS), symptom scores, and medication use. Safety outcomes included adverse reactions. Mixed models for repeated measures showed significant improvements in rhinoconjunctivitis and asthma outcomes (all p < 0.001). Adjusted LS-mean rhinoconjunctivitis CSMS decreased by 50.7% at T1 and 76.1% at T4; symptom and medication scores decreased by 85.3% and 69.3%, respectively, at T4. Asthma CSMS decreased by 43.1% at T1 and 89.0% at T5, while symptom and medication scores decreased by 93.4% and 88.5%, respectively. Similar patterns were observed in children. No systemic reactions occurred. Twenty mild local reactions were recorded in 17 patients (8.5%), corresponding to an estimated rate of 0.32% across 6169 injections. This AIT was associated with sustained clinical improvement and a favorable safety profile in adults and children. Full article