Search Results (138)

Background/Objectives: Physical inactivity is associated with increased cardiometabolic disease risk and poor cognition in children and their parents. Family-based physical activity offers an opportunity for children and their parents to engage in physical activity concurrently. The present study examined the effect of an acute bout of family-based tag rugby on risk factors for cardiometabolic disease and cognition in families. Additionally, this study qualitatively explored families’ perceptions of enjoyment and factors affecting implementation with considerations for socioeconomic status. Methods: Sixteen families (27 children, 20 parents) participated in an exercise (45 min family-based tag rugby) and resting control trial (45 min seated rest), separated by seven days. Postprandial gylcaemia, insulinaemia, lipaemia and cognitive function were measured following exercise/rest. Families also participated in whole-family focus groups and separate parent and child interviews. Results: In parents, postprandial plasma insulin concentrations were lower on the exercise trial than the rested control trial at 30 min (p = 0.004) and 120 min following the consumption of a standardised lunch (p = 0.011). In children, a significant trial*time interaction for inverse efficiency scores on the Sternberg paradigm (three-item) was exhibited (p = 0.016). In parents, a significant trial*time interaction for inverse efficiency score on the Stroop congruent test was exhibited (trial*time interaction; p = 0.012), whereby inverse efficiency scores improved immediately post-exercise, compared with the rested control trial (p = 0.016). Qualitatively, families from all socioeconomic backgrounds agreed that tag rugby is an inclusive, enjoyable mode of physical activity that families want to participate in together, which can be adapted to overcome the barriers associated with the cost of and access to local facilities. Conclusions: An acute bout of tag rugby improved postprandial insulin concentrations in parents and cognitive function in children and their parents. Tag rugby was deemed an appropriate exercise modality for families from a range of socioeconomic backgrounds. Full article

Background/Objectives: This study presents a brief report on the preliminary psychometric properties of a first Polish version of the Parental Assistance with Child Emotion Regulation (PACER) Questionnaire. The PACER measures ten emotion regulation (ER) strategies parents use to assist their children in their ER. We aimed to examine PACER’s internal consistency reliability, convergent, divergent and discriminant validity. Methods: The sample included 74 Polish-speaking parents aged from 27 to 50, recruited in 2025. Along with the PACER, we used a robust set of psychometric tools for measuring parental burnout, anxiety and depression symptoms, somatic complaints, well-being, and beliefs about emotions. Results: All PACER subscale scores demonstrated good-to-excellent internal consistency reliability (i.e., Cronbach’s alpha of ≥0.83). Encouraging adaptive strategies (e.g., reappraisal) in one’s children was associated with better outcomes (e.g., lower parental burnout and psychopathology symptoms), whereas maladaptive strategies (e.g., avoidance) were associated with worse outcomes. We also demonstrated that PACER strategy scores were statistically separable from maladaptive beliefs about emotions, indicating good discriminant validity. Conclusions: Overall, the Polish PACER demonstrated promising psychometric properties and strong clinical relevance. These findings can help to inform interventions targeted at improving parents’ capacity to help their children regulate emotions, which in turn may help to prevent parental burnout. Full article

Background/Objectives: Orthopaedic surgery is often recommended for children with cerebral palsy (CP) across all Gross Motor Function Classification System (GMFCS) levels. Despite this, little is known about the experience of parents during their child’s surgery and recovery. Methods: This topic was explored using a mixed-methods research design. Using an interpretive description methodology, in-depth interviews with parents of children with CP who had undergone orthopaedic surgery were completed by a physical therapist within an interdisciplinary clinical context in an acute care orthopaedic surgery clinic. Transcripts were reviewed by inductive thematic analysis. Resulting themes were used to inform the development of a self-administered survey, which was distributed to a separate cluster sample of parents. Results: From interviews with six parents, four themes were identified: (1) preparing and being prepared, (2) feeling known and recognized, (3) knowing and advocating for your child, and (4) feeling stressed and coping. The results of surveys completed by 25 parents were analyzed using descriptive statistics. When asked whether their child’s surgery was a stressful experience, 80% (20/25) agreed. However, 60% (15/25) indicated that the surgery was not a negative experience. Forty-four percent (11/25) felt their child’s recovery was longer than expected. Survey responses to questions related to the qualitative themes were similar across GMFCS levels and surgical procedures. Conclusions: The findings identify the importance of recognizing the needs of parents and suggest opportunities for collaboration between the healthcare team and families in caring for children across the spectrum of functional mobility and orthopaedic procedures. Full article

Background/Objectives: Maternal vitamin supplementation (including folic acid, vitamin D, and multivitamin supplements) during pregnancy may lower the likelihood of neurodevelopmental disorders in offspring. This study examines the associations between maternal vitamin suppletion during pregnancy and morphological patterns in offsprings’ brain structure and traits of Autism Spectrum Disorder (ASD) and Attention-Deficit Hyperactivity Disorder (ADHD) in a large population-based study of child development. Methods: The study cohort included a total of 3937 children (aged 9–11) participating in the Generation R cohort in Rotterdam, the Netherlands. Maternal vitamin D and folateserum levels, multivitamin supplement use, and overall dietary quality (as assessed by the Food Frequency Questionnaire, FFQ) during pregnancy were used as predictors. T1 structural MRI scans were acquired and segmented using Freesurfer to assess brain morphometry. Cortical and subcortical brain volumes of children were separated into four independent components and used as mediators. ADHD and ASD traits, as measured by parent-completed questionnaires (Child Behavior CheckList and Social Responsiveness Scale, respectively) were used as outcome variables. Results: Results show that (1) maternal vitamin D, multivitamin supplementation, and better diet quality were associated with fewer ADHD or ASD traits in the offspring; (2) vitamin D and diet quality were associated with larger-volume childhood brain components; (3) larger-volume brain components were associated with fewer ADHD and ASD traits; (4) part of the association between dietary factors in pregnancy and offspring ADHD and ASD traits was mediated through the brain volumes of the children. Conclusions: Though all observed effect sizes were small, further population-based research should be performed to further delineate the effects of gestational multivitamin and vitamin D exposure and investigate whether this may be an avenue for preventive interventions. Full article

The absence of parental presence has a direct impact on the emotional stability and social routines of children, especially during extended periods of separation from their family environment, as in the case of daycare centers, hospitals, or when they remain alone at home. At the same time, the technology currently available to provide emotional support in these contexts remains limited. In response to the growing need for emotional support and companionship in child care, this project proposes the development of a multi-platform software architecture based on artificial intelligence (AI), designed to be integrated into humanoid robots that assist children between the ages of 6 and 14. The system enables daily verbal and non-verbal interactions intended to foster a sense of presence and personalized connection through conversations, games, and empathetic gestures. Built on the Robot Operating System (ROS), the software incorporates modular components for voice command processing, real-time facial expression generation, and joint movement control. These modules allow the robot to hold natural conversations, display dynamic facial expressions on its LCD (Liquid Crystal Display) screen, and synchronize gestures with spoken responses. Additionally, a graphical interface enhances the coherence between dialogue and movement, thereby improving the quality of human–robot interaction. Initial evaluations conducted in controlled environments assessed the system’s fluency, responsiveness, and expressive behavior. Subsequently, it was implemented in a pediatric hospital in Guayaquil, Ecuador, where it accompanied children during their recovery. It was observed that this type of artificial intelligence-based software, can significantly enhance the experience of children, opening promising opportunities for its application in clinical, educational, recreational, and other child-centered settings. Full article

Background/Objectives: Depression and anxiety in children pose a significant public health concern, with long-term implications for well-being. Over 10% of children and adolescents are affected by emotional disorders such as depression and anxiety. African American youth face disproportionate exposure to mental health risk factors, including poverty, adverse childhood events, community violence, and racial discrimination, which elevate their vulnerability to these disorders. A particularly at-risk subgroup includes African American children in kinship care arrangements (e.g., grandparents raising grandchildren), who may face additional factors such as family disruption and separation from birth parents. Methods: This mixed-methods sequential study examined how caregiver stress and birth mother–child relationship quality relate to depression and anxiety symptoms in African American children in kinship care. Phase I included survey data from 58 caregivers of children aged 5 to 12; Phase II involved interviews with 16 of these caregivers. Results: Results indicated that lower caregiver stress was associated with reduced child depression and anxiety symptoms. Furthermore, findings suggest that a high quality of the birth mother–child relationship serves as a promotive factor, particularly for depressive symptoms. Qualitative findings highlighted two themes: (1) the weight of kinship care, marked by factors such as ongoing grief and financial strain; and (2) birth parent relationships, defined by a mix of connection, conflict, and loss that affects children’s mental health. Conclusions: These findings underscore the need for greater understanding of the strengths and resources within kinship families that support positive mental health outcomes and highlight the importance of targeted interventions to reduce caregiver stress and foster supportive parent–child relationships. Full article

Background/Objectives: Bronchopulmonary dysplasia (BPD) is a chronic lung disease affecting preterm infants, often resulting in prolonged neonatal intensive care unit (NICU) stays and significant parental stress. The experiences of parents navigating their preterm infant’s early NICU journey are important to support clinical trials to improve infant outcomes. Aim: The aim of this study was to explore parental perceptions of their infant’s health progression during the first 10 days of life through personal diary entries and their correlation with the echo scans assessments, as part of the Exploring Right vEntricular function applicability in a Prediction mOdel to identify pReterm infanTs with early BronchoPulmonary Dysplasia (REPORT-BPD) feasibility study. Methods: An embedded qualitative design was employed, utilising thematic analysis of 17 parent diaries. Parents of preterm infants (<32 weeks of gestation) admitted to a NICU documented their daily experiences. Thematic analysis was applied to ensure a rigorous, inductive examination of emerging themes. Findings: Four main themes were identified: (1) developing parent–infant relationships, highlighting the emotional impact of separation and the significance of bonding; (2) health and well-being of premature infants and family, reflecting parental vigilance, cautious optimism, and emotional distress; (3) parents navigating support and the NICU environment, describing challenges related to medical procedures, communication with staff, and adapting to a highly technical setting; and (4) emotions and protective gestures, illustrating parental resilience, coping mechanisms, and the innate drive to protect their child. Conclusions: Parental experiences in the NICU were shaped by emotional turmoil, uncertainty, and the need for support in navigating their infant’s care. Diaries provided an effective means for parents to express their experiences; they could serve as a communication tool in clinical trials to provide a deeper understanding of the development of the recruited preterm infants. Full article

Background/Objectives: School bullying is a significant issue that negatively impacts children’s well-being, emphasizing the need to identify family-related factors contributing to bullying victimization. This study explored the potential link between parental marital quality and school bullying victimization by employing a moderated mediation model. Methods: Parent–child attachment, measured separately as father–child and mother–child attachment, was tested as a mediator, with child gender included as a moderator. Data were collected from both children and their mothers, comprising 358 mother–child pairs recruited from three primary schools in suburban Beijing, China. Results: Results revealed that greater parental marital quality was associated with a lower risk of bullying victimization, with father–child attachment mediating this relationship. Furthermore, child gender moderated the mediating effect of father–child attachment, such that the indirect pathway from parental marital quality to bullying victimization through father–child attachment was statistically significant for girls but not for boys. Conclusions: These findings highlight the importance of father–child attachment in preventing bullying victimization and suggest that gender-sensitive implications may be necessary. Full article

This study aims to illustrate the impact of accumulated traumatic experiences in adolescence and to evaluate the potential of brief focal psychotherapy (BFP) as a treatment approach for complex trauma. We present the case of a 14-year-old boy who experienced vicarious gender-based violence, child abuse, early maternal separation without alternative secure attachment figures, and forced sudden migration. The patient exhibited symptoms consistent with post-traumatic stress disorder (PTSD) and complex trauma. The culturally sensitive intervention, delivered at a public child and adolescent mental health center, consisted of twenty weekly individual sessions of 45 min each, complemented by three 45 min psychoeducation sessions with the caregiver. The assessment was conducted using a multitrait and multi-informant approach, systematically gathering information across multiple domains of functioning (emotional–behavioral, physical, cognitive, self-perception, and relational) and from different sources (the adolescent, his mother, and the clinician) through clinical interviews, projective techniques, and parental feedback. The primary therapeutic focus was the establishment of a secure therapeutic alliance to facilitate emotional exploration and trauma processing. Following treatment, the patient demonstrated significant improvements in emotional regulation, family relationships, and school performance, as measured by both self-report and parental observations. This case highlights the potential of BFP in addressing complex trauma in adolescents, particularly during a developmental stage marked by increased vulnerability to the effects of chronic trauma exposure. The findings suggest that BFP can effectively reduce both acute symptomatology and broader psychosocial consequences associated with prolonged and cumulative trauma. Further research, particularly controlled studies and longitudinal follow-ups, is needed to refine and optimize the use of BFP by mental health professionals working with adolescents affected by complex trauma. Full article

Background: The majority of Australian children exceed the World Health Organization’s recommended dietary intake of free sugar, particularly through the consumption of sugar-sweetened beverages. Front-of-pack nutrition labels increase perceived risk and deter the consumption of sugar-sweetened beverages. However, past studies of young children have focused almost exclusively on a parent’s choice of beverage for children. This study investigated the influence of four label designs (text-based warning, tooth decay pictorial, teaspoons of sugar, and Health Star Rating) on the beverage choices of N = 1229 Australian children (aged 4–11 years) and their parents. Methods: In an online vending machine scenario, parent–child dyads were separately asked to select which beverage they would choose for themselves before and after being randomised to one label condition. The beverages displayed included 100% fruit juice, soft drink, soft drink with a non-nutritive sweetener, flavoured milk, plain milk and bottled water. Beverage healthiness was determined by a 1–10 rating based on a review by a panel of experts (10 dietitians and nutritionists). Results: Mixed-model ANOVAs showed that for parents, each label design performed comparably; however, for children, small but significant differences were seen in the effectiveness of different label designs, with the teaspoons of sugar label, text-based warning, and tooth decay pictorial found to be more impactful in promoting healthier drink choices than the Health Star Rating. Conclusions: These findings can inform public health advocacy efforts to improve food labelling and could be incorporated into educational resources to help children understand the nutritional profiles of different sugary drinks. Full article

This study discusses how cultural interpretations of the foster parent role might shape perceptions and practices related to the temporariness of care and reunification with biological families. Employing a contrastive-comparative approach, the study compares interviews with seven Japanese foster parents, with prevailing discourses surrounding the foster parent role in Norway. The findings suggest that the Japanese foster parents implicitly recognize the temporariness of their role. In contrast, the Norwegian foster parent role has typically been associated with an emphasis on the risks associated with separation from new attachment figures, which may be perceived as detrimental to children’s well-being. We argue that this conceptualization, which frames children as inherently vulnerable, may shape the foster parent’s role as one of protection, with a primary focus on shielding the child from disruption and fostering a secure attachment. This perspective, we suggest, could have implications for the temporariness of children’s care placements and the process of reunification. The study calls for a critical examination of the values underlying current child protection practices and encourages openness to alternative perspectives, including those informed by different cultural contexts. Full article

Objective: This study aimed to explore the association between adolescents’ health risk behaviours (excessive use of alcohol, (e)cigarette smoking, cannabis use) and familial factors. A special objective of this study was to compare findings between Bulgarian and Lithuanian adolescents aged 15 years. Material and Methods: National samples from the WHO Health Behaviour in School-aged Children (HBSC) survey in 2021/2022 were analysed. The focus was on adolescents aged 15 (n = 64,349), including those from Bulgaria (n = 793) and Lithuania (n = 1137). The set of outcome variables included drunkenness, smoked cigarettes, e-cigarettes, and used cannabis (all variables were measured during the last 30 days); their indicators were child’s talking separately to their father and separately to their mother, as well as the four-item family support scale. All variables were dichotomised and their associations were analysed using Structural Equation Modelling with a WLSMV estimator. Results: In the total sample, the prevalence of drunkenness was 14.9%, cigarette smoking at 12.6%, e-cigarette smoking at 18.4%, and cannabis use at 5.9%; while in Bulgaria, in contrast to Lithuania, these behaviours were much more prevalent, at 27.0%, 29.9%, 29.8%, and 11.1%, respectively. The use of substances was significantly associated with selected familial factors, which were more pronounced among girls than boys in most subsamples. Low family support showed the strongest association with increased substance use (in the total sample, regression weight B varied from 0.231 to 0.382). Adolescents’ difficulty in talking to mother was more pronounced (B = 0.123 to 0.204) than difficulty in talking to their father (B = 0.058 to 0.140). Comparison of data samples from Bulgaria and Lithuania showed stronger relationships in Bulgarian adolescents compared to other countries, which are more pronounced among boys. In addition, among Bulgarian adolescents, easy communication with their father had an inverse association (increasing prevalence) with cannabis use. Conclusions: Adolescent health risk behaviours, such as use of substances, are associated with familial factors, including parent–teen communication and family support. Generally, these associations are more pronounced among girls than boys, and more evident among Bulgarian adolescents than their Lithuanian counterparts. Identifying environmental factors in families helps to plan interventions to prevent development of multiple health risk behaviours in adolescents. Full article

Background: Antimicrobial resistance is a growing global health threat, with antibiotic misuse in pediatric populations being a significant contributing factor. In Romania, antibiotic consumption and resistance rates are among the highest in Europe. Objective: To assess Romanian parents’ knowledge, attitudes, and practices regarding antibiotic use in children, and to identify key misconceptions and behavioral risks contributing to inappropriate antibiotic use. Methods: A cross-sectional survey was conducted among 400 parents of hospitalized children in a pediatric department in Romania. Participants completed a 15 item structured questionnaire. Data were analyzed using descriptive statistics, chi-square tests, and binary logistic regression to examine associations and control for potential confounding effects between education level, residential environment, and parental misconceptions regarding antibiotic use. Results: Among the 400 surveyed caregivers, 86% (n = 344) held at least one misconception regarding antibiotic use. Additionally, 42.5% (n = 170) of participants reported that they had never heard of the concept of antibiotic resistance. Misconceptions were significantly more prevalent among individuals with lower levels of education and those residing in rural areas (p < 0.001). While 89.8% (n = 359) stated that they had never administered antibiotics to their children without a physician’s recommendation, a separate subset of 28% (n = 112) acknowledged that they had asked a doctor to prescribe antibiotics for their child. Moreover, 23.3% (n = 93) reported seeking a second medical opinion when antibiotics were not initially prescribed. Conclusions: Despite high adherence to medical advice, widespread misconceptions persist. These findings highlight the need for targeted, population-specific educational interventions to promote rational antibiotic use and address AMR in high-burden settings like Romania. Full article

Background: Despite the widespread use of precautionary allergen labelling (PAL) by manufacturers, PAL is not always used consistently and can be a source of misinterpretation by consumers and allergists. Although its use is not specifically regulated in Canada, some voluntary guidelines exist. The aims of this study were to investigate allergic consumers’ and clinicians’ understanding of PAL, to describe consumers’ attitudes towards products with PAL, and to examine recommendations given by clinicians to their patients about these products. We also compared two groups of consumers enrolled in this study, since the majority of them (72%) were registered in the Food Allergy Canada database and the others (28%) came from representative consumers of the general population. Methods: An online survey was sent from 2 to 28 December 2021 to allergic consumers registered with Food Allergy Canada’s database and to a group of allergic consumers extracted from a panel representative of the general population and not registered with Food Allergy Canada (third-party panel). All consumer participants had a food allergy or were a parent/caregiver of a child with food allergy and had to be diagnosed by a medical professional. Considering that consumers registered via the Food Allergy Canada database could be more informed about labelling than the third-party consumer panel, we conducted a multivariate analysis (logistic regression) on the key variables related to PAL allowing to compare these two groups of participants. In addition, a separate online survey was sent to allergist members of the Canadian Society of Allergy and Clinical Immunology and provincial associations to investigate their understanding of PAL from 12 November 2021 to 16 January 2022. Results: A total of 1080 consumers and 63 allergists (29% of allergists in Canada) responded to the surveys. Fifty percent of consumers were adults with food allergy, and 50% were a parent/caregiver of a child with food allergy. Food allergy was diagnosed most commonly by an allergist in 76% of the cases. Fifty-four percent of consumers purchased products with a PAL statement at least occasionally, and more than half of consumers (53%) considered PAL a very useful tool. Most surveyed individuals (59%) had not heard of the term “individual allergen threshold” or had heard the term but did not know what it meant. The same allergic consumers were reluctant to buy food products with even a small amount of their allergen (i.e., a dose that would not trigger an allergic reaction in the vast majority of them). Half of allergists reported PAL was not useful in its current form, and 83% supported the consumption of foods with PAL to their patients in some circumstances. Conclusion: While most consumers are somewhat confident in the accuracy of ingredient information on pre-packaged foods, interpretation of PAL remains confusing by many allergic consumers. If changes are to be made based on allergen thresholds, a multi-stakeholder approach will be required with greater consumer and allergist education on risk assessment concepts to facilitate the implementation of allergen population thresholds into the application of PAL. Full article

Background: Parents supporting AYAs with blood cancer juggle dual, competing roles as cancer caregiver and parent, which may heighten distress as they feel pulled simultaneously in two opposing directions. Likewise, AYAs encounter paradoxical needs as they revert to being more dependent on their parents to prioritize their survival while their developmental trajectory toward independence is disrupted. Parents need help understanding the underlying tensions they face in caregiving to reduce their distress and promote their connectedness with their AYA. Using a dialectical lens, we identified tensions parents encountered while caregiving in three contexts (clinical, family, and online communication) to inform a targeted psychosocial intervention. Methods: In partnership with The Leukemia & Lymphoma Society, we recruited 20 parents for in-depth interviews. Parents cared for adolescents aged 15–18 (n = 10) or emerging adults aged 19–29 (n = 10) diagnosed >3 months prior and in active treatment or within 2 years since treatment ended. Transcripts were thematically analyzed. Results: Parents described four ongoing tensions they needed to negotiate as they cared for their AYA: (1) being the driver versus passenger in their child’s care; (2) coping with cancer together as a family versus separately; (3) deciding to reveal versus conceal information; and (4) expecting normative developmental and disease trajectories versus disrupted trajectories. These tensions characterize the complex caregiving “dance” parents navigate in all three care contexts. Conclusions: Psychosocial education can normalize these tensions for parents to promote healthier coping and reduce distress while enhancing connectedness with their AYA. As caregiver–patient outcomes are interrelated, it may improve AYAs’ well-being. Full article