Search Results (946)

Background: The Adverse Childhood Experiences (ACE) Pyramid has been widely used for more than two decades to illustrate pathways linking childhood adversity to health outcomes across the lifespan. Since its development, substantial advances in the science of toxic stress have expanded understanding of the biological mechanisms through which adversity influences lifelong health. Objective: To describe the development and scientific rationale for a revised ACE Pyramid that reflects contemporary evidence on toxic stress, the biological pathways linking childhood adversity to health, and opportunities for prevention and healing. Methods: A multidisciplinary revision process was conducted in collaboration with subject matter experts from government, academia, healthcare, professional associations, and community-based organizations. Iterative review and refinement were used to align the framework with current scientific evidence and practice. Results: A revised ACE Pyramid was developed that preserves the familiar structure of the existing framework while incorporating advances in the science of toxic stress, prevention, and healing. Compared with the ACE Pyramid featured on the CDC website during development of the revised framework, the revised framework more explicitly emphasizes prolonged or excessive activation of the stress response as a central mechanistic pathway linking childhood adversity to lifelong health, expands the biological layer to encompass multiple interacting biological systems beyond neurodevelopment alone, and integrates prevention and healing opportunities throughout the framework. Conclusions: The revised ACE Pyramid synthesizes more than two decades of advances in the science of toxic stress into an accessible conceptual framework. It explains how childhood adversity becomes biologically embedded to shape lifelong health while emphasizing that prevention is possible and healing can occur throughout the life course. By providing a shared framework for understanding toxic stress biology, it may help inform trauma-informed clinical care, public health action, research, and policy aimed at advancing health equity and improve outcomes for children and families. Full article

Early exposure to scientific learning establishes a critical foundation for nurturing how natural phenomena are explored and our innate curiosities are pursued, as well as our potential to elevate the complexity of our understanding. Through the lens of Vygotsky’s social constructivist theory, this study investigates how 124 first- through fifth-grade students participated in an unstructured free play lab across two 12-week cohorts and how this influenced students’ exposure to the crosscutting concepts (CCCs) outlined in the Next Generation Science Standards (NGSS). An observational protocol was followed to gather images, which were subsequently analyzed to identify instances in which students interacted with the CCCs. The findings indicate that students engaged with all CCCs, most frequently through observations, modeling, and problem solving. The type of play influenced the extent to which students gained exposure to certain CCCs. Social interactions and moments when play caused cognitive disequilibrium further supported engagement. The results suggest that free play serves as a meaningful vehicle for increased exposure to scientific ideas in developmentally appropriate and socially mediated contexts. Leveraging play as a pedagogical tool offers opportunities to increase exposure to numerous foundational scientific skills and ideas in formal and informal settings. Full article

Background: Contemporary data on macronutrient intake and carbohydrate composition in Indian adults are limited. The Indian Study to Assess Real-World Carbohydrate Consumption (I-STARCH-1) characterised these patterns among adults with and without type 2 diabetes mellitus (T2DM). Methods: This multicentre cross-sectional study included 1104 adults (690 with T2DM and 414 without) recruited by convenience sampling from 29 diabetes-focused centres across 14 Indian states. Dietary intake was assessed using a structured three-day dietary recall. Between-group differences were estimated using linear mixed-effects models adjusted for age and sex, with the centre as a random intercept. Results: Carbohydrates contributed 62.1% of the energy, fat 25.1%, and protein 12.8%. Mono- and disaccharides accounted for 20.1% of the total carbohydrate intake, and fibre intake averaged 15.4 g/day. Participants with T2DM had lower carbohydrate %E and a lower simple-carbohydrate proportion of total carbohydrate, but higher protein and fat %E; these differences persisted after adjustment. Absolute fibre intake did not differ between the groups. The composition varied modestly across the four geographic zones. Descriptively, the carbohydrate contribution was lower and the fat contribution was higher than that in the Study To Assess the dietaRy CarboHydrate content of the Indian type 2 diabetes population (STARCH) 2014 cohort, but the cohorts were non-harmonised. Conclusions: Carbohydrates remained the predominant energy source, with low fibre intake. The overall macronutrient profile closely resembled the contemporary national population estimates. The findings support attention to carbohydrate composition and fibre adequacy alongside quantity but describe healthcare-seeking adults rather than the general Indian population. Full article

The theoretical underpinnings and empirical data supporting oxytocin as a context-dependent biomarker of prosocial affiliation, bonding, attachment, emotional regulation, cognitive development, and the modulation of stress responses are summarized. We propose an interdisciplinary consensus against a backdrop of inconsistencies concerning behavioral and experimental findings for the oxytocinergic system. Current knowledge gaps demonstrating the inability to establish a hierarchy of findings are related to the following: (a) the theory and practice of oxytocinergic therapeutic interventions; (b) identification, characterization, and quantification of functional, mechanistic, and molecular biomarkers and matrices; (c) context- and time-dependent resilience factors associated with mind–brain–body development, (d) measures of intergenerational transmission, and (e) summative indicators of psychopathological co-morbidities. We analyze prospective objective measures of oxytocin against subjective caregiver reports of positive childhood experiences (PCEs, resulting from secure nurturing, established daily routines, pleasurable social interactions, opportunistic and spontaneous play, secure environments), which favor healthy developmental outcomes in preschool children. Few studies prospectively use the painless, noninvasive sampling of risk and resilience biomarker levels to index the health status, emotional regulation, and cognitive development in preschool children. We present the methodology for novel measures of risk (cortisol) and resilience (oxytocin) in human scalp hair. Future studies validating the therapeutic efficacy of oxytocin or the stress-mediating effects of oxytocin on socioemotional regulation and health status should systematically address these gaps. Full article

Creativity is recognized as a multifaceted competence that can be nurtured within educational contexts, yet traditional pedagogies often fail to foster its potential. Concurrently, the rapid evolution of generative artificial intelligence (genAI) is reshaping conceptions of creative agency, positioning AI as a collaborative partner rather than a mere tool. This systematic review examines 27 empirical and theoretical studies on generative AI tools and closely related AI-mediated creative-support systems in their early adoption phase (January 2022–March 2024) aimed at enhancing creativity in educational and professional settings, with a focus on art and design educational contexts. Findings indicate that while AI tools show promise in boosting short-term creativity dimensions like fluency and originality, the field remains methodologically fragmented. The empirical studies mostly rely on short-term interventions, small samples, and individual-centric measures, missing the dialogic complexity of human–AI collaboration. Based on these gaps, this study proposes a theoretically grounded research agenda. The agenda consists of three theoretically informed propositions for future investigation: Interaction as a transversal unit of analysis across the 4P framework; creative agency as a dynamic continuum regulating initiative, control, and responsibility; and process-oriented assessment capable of supporting metacognitive reflection during human–AI co-creation. Finally, this work presents a reflection on post-2024 AI developments, underlining how such developments increase the relevance of the proposed research agenda. Full article

A set of six themes and their categories was identified through thematic analysis of narrative portraits based on in-depth interviews with 27 highly curious individuals who varied in age, gender, ethnicity, and profession. Each theme and its components (categories) are depicted, along with typical quotes from individuals assigned to the category. Curiosity was conceptualized using the five-dimensional model (5-DC) comprising Joyous Exploration; Deprivation Sensitivity; Stress/Uncertainty Tolerance; Social Curiosity (overt and covert); and Thrill Seeking. Additionally, the study addressed personality traits subsumed under the Big Five model (specifically, traits related to Openness to Experience, Conscientiousness, and Agreeableness). It also included agency, self-regulation, self-efficacy, quest for freedom, resilience, grit, flexibility, and creativity. The findings are discussed in relation to the validity of the interview data in general and the identified themes in particular. The authors address implications for nurturing curious minds. Full article

Canonical vascular diagrams do not capture patient-specific differences in vessel identity, course, depth, calibre, branching, adjacency, dynamic behaviour, or post-procedural route. This targeted narrative review with purposive publication selection had two objectives: to synthesise vascular anatomical evidence relevant to nursing and health professions practice and education, and to use that synthesis to propose an action-oriented conceptual framework. PubMed/MEDLINE and the Web of Science Core Collection were searched from inception to 2 August 2026. After exact DOI and normalised-title deduplication, 1683 unique records underwent title/abstract inspection and keyword-assisted prioritisation; 56 information-rich human anatomical, ultrasonographic, clinical, educational, and sentinel case publications were purposively retained for full-text evidence charting and narrative synthesis. The synthesis identified six interpretive anatomy-to-risk mechanisms: possible vessel misidentification, unsafe neurovascular adjacency, device–vessel mismatch, dynamic positional change, misinterpretation of anomalous central routes, and loss of patient-specific anatomical knowledge between encounters. These categories are qualitative synthesis outputs, not frequency estimates or causal effects. The literature informed VASC-N—Verify; Assess; Scan and distinguish; Choose, adapt, and confirm; and Note, notify, and nurture learning—as an author-developed conceptual framework of proposed observable behaviours. A preliminary Nursing Actionability Test and minimum reporting checklist were also developed. Patient-specific vascular anatomy becomes educationally and clinically relevant when recognition may change a decision, support proportionate verification or escalation, preserve future access, or strengthen assessment. VASC-N and the accompanying tools have not been validated; prospective content-validity, feasibility, reliability, educational-transfer, and clinical-outcome studies are required. Full article

The proliferation of Artificial General Intelligence (AGI) presents a systemic paradox within complex socio-technical systems: while enhancing efficiency, AGI may subvert human autonomy through comfort-based alignment rather than overt coercion. Although algorithmic management research has theorized surveillance-based control—the “Iron Cage”—it has largely overlooked the voluntary erosion of autonomy driven by algorithmic nurturing and its recursive feedback loops. This study proposes the Algorithmic Nurturing Perspective (ANP) by synthesizing five foundational behavioral theories—bounded rationality, expectancy theory, prospect theory, goal-setting theory, and social information processing theory—reinterpreted within the AGI context. ANP elucidates how AGI systemically reconfigures socio-technical systems through three self-reinforcing causal feedback loops: the automation of choice, the externalization of emotional regulation, and isolation from social reality. We derive eight propositions illustrating how these mechanisms trigger individual-level cognitive dependence and systemic regression, which subsequently emerge as organizational-level pathologies, including learning myopia, leadership degeneration, and declining strategic decision quality. By introducing the “Golden Cage” as a novel conceptual lens, the ANP shifts the AI governance discourse from an “efficiency-vs-coercion” framework to an “autonomy-vs-compliance” paradigm. We further propose Cognitive Friction Design as a multilevel balancing intervention to mitigate these risks. As a self-contained theoretical contribution, this framework stands independently of any single empirical test while remaining falsifiable: a mechanism-differentiated system dynamics simulation demonstrates the internal coherence of the proposed feedback structure, and proposition-by-proposition falsification conditions specify the empirical pathway for causal verification in future research. We further identify balancing-dominant conditions under which algorithmic assistance may enhance, rather than erode, human autonomy. Full article

Background: Adolescent boys often lack adequate menstrual education, leaving them susceptible to harmful sociocultural influences and reinforcing discriminatory attitudes. The purpose for this study was to explore adolescent boys’ knowledge, sociocultural beliefs, and attitudes toward menstruation. Methods: A descriptive-phenomenological qualitative study was conducted, involving 25 in-depth interviews with adolescent boys enrolled in senior high school (eligibility age range 14–19 years; achieved sample aged 15–19 years) from five districts in Ghana’s Volta Region. Participants were purposively sampled to ensure diverse perspectives. Semi-structured interviews explored knowledge sources, sociocultural influences, and attitudes toward menstruation. Data were analyzed thematically using Braun and Clarke’s six-phase framework with the aid of MAXQDA software. Results: Adolescent boys’ knowledge of menstruation was fragmented, stemming from family, school, and internet sources. Mothers were frequently cited as key informants, but misconceptions about menstruation persisted. Sociocultural and religious beliefs reinforced menstruation-related taboos, such as restrictions on cooking and entering sacred spaces, shaping discriminatory attitudes. Reactions to menstrual leaks varied from empathy to teasing. Conclusions: The findings highlight the need for inclusive menstrual education targeting boys and their families. Educational programs should include biological, emotional, and social aspects of menstruation to help reduce myths and nurture empathy. Full article

Critical thinking (CT) is a distinctive form of reasoning focused on examining the truthfulness of arguments, making evidence-based judgments, making informed decisions, and participating actively in socio-environmental issues. It also includes emancipatory and argumentative dimensions that enable questioning authority. Despite the benefits of science for human well-being and development, scientific claims are increasingly challenged by personal, political, and institutional positions on issues such as climate change, vaccination, and nutrition. These challenges often promote pseudoscientific and denialist attitudes that spread rapidly through mobile devices, the Internet, and social media. Science education should therefore aim to build a scientifically literate citizenry able to respond critically to scientific and technological advances, including those promoted through STEM education. Inquiry-based science education is especially valuable because it encourages the search for and use of evidence, fostering science-based CT for democratic societies. In addition, socio-scientific issues, due to their controversial nature, provide ideal contexts for developing critical competencies such as evaluating arguments, identifying reasoning errors, assessing sources, solving problems, and making responsible decisions in public debates on socially relevant issues. Full article

Background: Maternal depressive symptoms have been associated with adverse child and family outcomes, including child behavioural problems, suboptimal parenting quality, and increased child screen time. However, the developmental pathways linking these factors remain poorly understood. The first model of this study examined whether children’s behavioural problems mediated associations between maternal depressive symptoms and later parenting quality (i.e., nurturant, hostile, consistent). The second model then investigated whether these pathways extended to preschool children’s screen time during the pre-bedtime period. Methods: Longitudinal data from the APrON Study (N = 373 dyads) were analyzed. A mean score for maternal depressive symptoms (EPDS) was derived using data collected across pregnancy and 3, 6, and 12 months postpartum. At age 3 years, child behaviour was assessed using the Child Behavior Checklist. At 5 years, parenting quality was measured using the Parenting Scale, and children’s screen time (frequency of use before bedtime) was assessed using a single maternal-reported item developed by the APrON team. Parallel and parallel serial mediation models were estimated using structural equation modeling. Findings: Maternal depressive symptoms were indirectly associated with more hostile parenting through children’s externalizing problems (p < 0.01, 95% CI [0.02, 0.11]) and directly associated with less nurturant parenting (p = 0.02, 95% CI [−0.19, −0.02]). Results from the parallel serial mediation model indicated that maternal depressive symptoms were indirectly associated with greater child screen time via children’s externalizing problems (p = 0.02, 95% CI [0.01, 0.06]). Significance: These findings suggest that children’s externalizing problems may represent a plausible pathway linking maternal depressive symptoms with later maternal hostile parenting and preschool children’s screen time. Full article

Background: Healthcare access in Vietnam confronts regional disparities and rising demand, requiring collaborative policies and strong workforce performance to guarantee effective and affordable services. This study scrutinises how organisational culture shapes healthcare workforce performance within Vietnam’s public healthcare organisations, with particular emphasis on organisational commitment, knowledge-sharing behaviour, and digital health transformation. Methods: This study employed a quantitative, cross-sectional survey design. Data were collected from 450 healthcare professionals in public healthcare facilities in southern Vietnam through convenience and snowball sampling, using a structured questionnaire measuring organisational culture (Denison model), organisational commitment, knowledge-sharing behaviour, digital health transformation and job performance on a six-point Likert scale. Data were analysed using partial least squares structural equation modelling (PLS-SEM) in SmartPLS 3.0. Results: The findings indicate that organisational culture is directly and substantively associated with healthcare workforce performance. In addition, knowledge sharing and digital health transformation operate as mediating mechanisms, with knowledge sharing showing a notably stronger indirect association. Notably, the relationship between organisational commitment and healthcare workforce performance was indicated to be not statistically significant. Conclusions: This study offers important practical and healthcare policy implications for healthcare administrators, human resource practitioners, public-sector leaders, and health policy stakeholders, predominantly in designing and employing targeted, culture-driven interventions aimed at improving healthcare workforce performance. Specifically, fostering a culture that encourages knowledge exchange and supports digital health transformation emerges as a critical pathway for organisational advancement. Such initiatives are instrumental in nurturing a motivated, engaged, and high-performing workforce, thereby underlining the sustainable development of public healthcare organisations. Full article

Drawing on panel data from firms listed on the SME Board and Growth Enterprise Market (GEM) between 2010 and 2024, this study examines how patient capital influences SME innovation. It considers both the quantity and quality of innovation and investigates the underlying mechanisms. Using the China Industrial Enterprises Database (2000–2014), it further explores the innovation effects of patient capital on unlisted SMEs. The empirical findings are as follows. First, patient capital, measured by the proportion of relationship-based debt and stable equity, exhibits a significant and robust positive association with the output and quality of SME innovation, and this association gradually strengthens over time. Second, heterogeneity analyses show that relationship-based debt is more strongly associated with innovation in state-owned enterprises and national-level “Little Giant” firms (specialized, refined, distinctive, innovative SMEs), whereas stable equity is significantly associated with innovation only in private and ordinary enterprises. The association between stable equity and innovation is more pronounced in non-regulated industries, while the association for relationship-based debt remains consistent across industries. Third, mechanism tests reveal that patient capital is linked to SME innovation through four channels: alleviating financing constraints, fostering university–industry–research collaboration, improving knowledge conversion efficiency, and strengthening market power. Fourth, an extended analysis confirms that patient capital is also significantly associated with innovation among unlisted SMEs, indicating strong external validity of the study’s conclusions. Based on these findings, this paper advocates for establishing a long-term financing mechanism oriented toward patient capital, with differentiated allocation and optimization of institutional environments across industries. Such an approach should facilitate three transmission channels—university–industry–research collaboration, knowledge transfer, and market power—while extending policy coverage to unlisted SMEs, thereby nurturing a virtuous cycle ecosystem of “long-term capital → sustained R&D → high-quality innovation.” Full article

Self-managed leisure is a key determinant of volitional development and the transition to adulthood in young people. This article examines the relationship between perceived family and social support environments and levels of self-management and motivation among young people aged 18 to 29. A quantitative descriptive-correlational design was used to administer the Self-managed Leisure Scale (SLS) [Escala de Autogestión del Ocio (SLS)] and the Environment Scale (ES) [Escala de Entornos (EE)] to a sample of 468 young people living in Spain. The results reveal medium-to-high levels of self-management, highlighting that women have greater perceived competencies and relational connections than men, although they also perceive greater social barriers. It was confirmed that greater family and social support correlates significantly with higher levels of autonomy, competence and social relationships in leisure time. In the area of motivation, multiple orientations are observed to coexist, with slightly higher average scores for the identified regulation. It was concluded that self-management is an essential psychosocial mechanism for integral human development, which enables young people to be the authors of their own experience. Fostering environments that nurture basic psychosocial needs is critical for promoting active, healthy and engaged citizens and transforming leisure into a space of participation and well-being. Full article

The digital age marks the 4th Industrial Revolution (4IR), which has changed every aspect of our lives, including youth ministry globally and Southern Africa in particular. However, it is worth noting that the digital revolution has significantly transformed the lives of young people, bringing opportunities and challenges for youth ministry. This shift raises important questions about the nature of youth ministry as the church seeks to embrace digitalization and social media in conjunction with face-to-face pastoral care ministry among the youth. This article explores the challenges and opportunities presented by the digital era for youth ministry in Southern Africa. It argues that the digital era poses significant challenges that cause the risk of losing contact and the erosion of meaningful relationships in pastoral ministry, but at the same time provides opportunities for digital convenience in communication and collaboration to advance learning, sharing, and the participation of young people in the church. This article employs textual analysis for data collection and qualitative inductive critical data and content analysis. The church’s understanding of the challenges and opportunities of the digital era helps in designing and adapting new methods and strategies for nurturing young people for ministry in the church and society. The article contributes to the discourse on the integration of social media in youth pastoral ministry. Full article