Search Results (3,225)

Background: The paediatric dentistry domain requires effective management of pain in children during invasive procedures such as the inferior alveolar nerve block (IANB). This study aimed to evaluate the effectiveness of Buzzy BEE^TM in reducing pain perception during IANB in children. Methods: This crossover study recruited 38 children aged 6–10 years scheduled for bilateral dental procedures requiring IANB. The washout period was 7 days, and two visits were scheduled for procedures on either side. Two randomly allocated groups received the study intervention, with each group receiving it alternately at each visit. Outcomes measured were pulse rate; subjective pain assessment using the Wong–Baker FACES Rating Scale (WBS); objective pain assessment using the Sound, Eyes and Motor (SEM) scale; and parental rating of observed pain on a scale of 1–10. Results: A statistically significant reduction in pulse rate after IANB was observed in the Buzzy BEE group at the first (p = 0.02) and second (p = 0.002) visits. At the second visit, the WBS scores (p < 0.001) and ‘eye’ (p = 0.004) and ‘motor’ (p = 0.002) scores on the SEM scale were significantly reduced in the Buzzy BEE group. The crossover analysis identified a significant treatment effect on pulse rate (p < 0.001) and significant carryover effects on WBS and SEM scores (p < 0.001). Conclusions: The use of Buzzy BEE reduced pulse rates during IANB, suggesting a positive impact on children’s anxiety. The carryover effects in the current study limit the consistency of improvements in subjective and objective pain perceptions. Further studies with a larger sample size and an extended washout period are recommended to evaluate the effectiveness of Buzzy BEE in reducing pain perception during IANB. Full article

Background/Objectives: Incorporating parent training into cognitive-behavioral therapy for anxious youth has not been shown to significantly improve outcomes perhaps because these interventions have not addressed potential interfering psychological barriers to implementing parenting changes and rarely offer between-session support. There is growing evidence that Acceptance and Commitment Therapy (ACT) can target these psychological barriers and generate more flexible and adaptive behavioral repertoires in parents of children with a variety of presenting challenges. Methods: Following a pilot trial of “Acceptance and Commitment Therapy for Parents of Anxious Children (ACT-PAC)” a six-week group-based intervention focused on targeting psychological barriers to parenting change using mindfulness and acceptance approaches, we collected qualitative feedback from participants in two post-treatment phases by conducting individual interviews and a focus group with participants that completed the intervention. Results: Analysis of interview responses revealed that parents found ACT principles and processes to be helpful, and many also appreciated the ACT-PAC group setting that allowed parents to recognize their experiences were shared by others and to self-disclose in a non-judgmental space. Feedback from the focus group further provides preliminary evidence that ACT-PAC is acceptable to and feasible for parent participants and suggests modifications such as involving additional caregivers, making resources more readily available, and creative structural changes that may facilitate between-session practice. Conclusions: Results suggest that the group-based intervention can be both maintained and improved for future participants. Limitations to generalizability in light of possible selection bias and the small focus group sample size are addressed. Full article

Background/Objectives: Promoting postural health in children requires not only adequate knowledge but also the implementation of health-promoting behaviors in the school environment. Teachers play a key role in this process; however, the extent to which their knowledge is reflected in everyday practice remains unclear. The study aimed to analyze and compare the levels of knowledge among preschool, early school, and physical education teachers regarding postural health in children and adolescents, including postural abnormalities, ergonomics, the selection of corrective exercises, and behaviors that promote correct body posture. Methods: A cross-sectional study was conducted on a sample of 153 teachers in Poland: 24 preschool (P), 53 early school education (EE), and 76 physical education (PE) teachers. The self-report Teachers’ Body Posture Literacy Questionnaire (TBPLQ) was used to assess knowledge regarding postural abnormalities. Results: PE achieved the highest TBPLQ scores, with significant differences observed mainly in comparison with EE (r = 0.30–0.50, p < 0.001). Across all groups, teachers performed best in recognizing postural abnormalities and worst in selecting appropriate corrective exercises. Although knowledge levels were relatively high, only weak correlations were found between knowledge and postural hygiene-promoting behaviors. The largest behavioral differences concerned the use of appropriate sportswear during physical education classes (η² > 0.14). Conclusions: Teachers demonstrated relatively high levels of knowledge regarding posture health. However, a clear knowledge–behavior gap was identified. Knowledge was only partially translated into proactive health-promoting actions, particularly regarding corrective interventions and communication with parents. The results suggest the need for educational initiatives for teachers focusing on proactive health-promoting and postural hygiene behaviors. Full article

Food waste in school canteens is widely recognized as a significant issue because of its economic consequences, environmental impact, and implications for children’s health. Previous studies have used robust methods to quantify this problem and assess mitigation strategies. This case study of primary school children (6–11 years) used a child-driven approach to measure plate waste and explore reasons for uneaten food and concern about waste. The results indicated that a group of volunteer children (n = 104) directly involved in the assessment were able to evaluate their peers’ food waste, obtaining estimates comparable to those reported in previous studies (mean: 108.4 g per child). The students for whom food waste was measured (n = 443) took part in interviews and proved to be active participants capable of evaluating their own context, although their level of engagement could be further strengthened. Among children who reported leaving food uneaten, a substantial proportion provided specific reasons; nevertheless, generic explanations accounted for 26% of responses for the first course and 35% for the second. Approximately 78.5% of the children demonstrated a high level of sensitivity to food waste, recognizing its direct effects (wasting their parents’ money), indirect effects (waste in a broader sense), and social effects (world hunger/poverty). Establishing a baseline for children’s sensitivity to their own food waste is therefore needed, as it could serve as an indicator of both the urgency and the effectiveness of educational interventions. Full article

Eating behavior and eating habits are shaped from the earliest stages of life through interactions among biological, familial, social, and environmental factors. The aim of this narrative review is to integrate evidence on the early-life determinants of eating behavior and their influence on dietary intake from infancy to adolescence. A narrative review was conducted with a structured search approach prioritized on longitudinal studies, intervention trials, and policy evaluations when available, and using cross-sectional evidence mainly to describe patterns and sociodemographic factors. Synthesizing the current evidence, our framework proposes that breastfeeding, responsive complementary feeding, and self-regulatory parenting are associated with higher responsiveness to internal hunger, satiety cues, and preference for nutrient-dense foods. Conversely, coercive practices, early exposure to highly palatable foods, and the influence of food marketing are linked to dominant hedonic responses and impulsive consumption patterns. Furthermore, family environments characterized by stress or food insecurity, together with high access to low-nutrient foods, may increase vulnerability to poor eating habits and emotional eating during adolescence. Overall, the evidence highlights the need for preventive interventions that integrate parenting support, school food education, digital marketing regulation policies, and the promotion of healthy food environments across multiple sectors. Understanding the biological, psychological, and social factors linking early determinants to dietary intake and eating behaviors across development is essential for promoting a balanced relationship with food and preventing chronic diseases from an early age. Full article

Children in residential care constitute a particularly vulnerable group at high risk of developing emotional and behavioral difficulties as a consequence of adverse experiences and dysfunctional family environments. Identifying risk and protective factors is essential for designing interventions tailored to their needs; however, the available research remains limited and does not always provide the evidence required to guide effective programs within the child protection system. The aim of this study was to examine the prevalence of emotional and behavioral problems among children in residential care and to analyze the role of family factors, sex, and age in these difficulties. The sample consisted of 210 children aged 6 to 18 years institutionalized in residential care centers and supervised apartments. A cross-sectional design was employed, administering the Strengths and Difficulties Questionnaire (SDQ) along with an ad hoc questionnaire to collect socio-family variables. The results reveal a high prevalence of emotional and behavioral difficulties. The multivariable models explained between 8.1% and 29.4% of the variance in emotional and behavioral functioning and showed that age, sex, exposure to gender-based violence, parental substance use, and parental intellectual disability were associated with specific emotional and behavioral dimensions. The study highlights the need to develop and implement educational and therapeutic programs aimed at strengthening children’s emotional regulation, addressing behavioral difficulties, and considering family-related adversity in intervention planning. Full article

Objective: Based on the Person-Centered Approach, this study targeted parents of very preterm (VPT) infants in Neonatal Intensive Care Units (NICUs) from Italy and Portugal. The primary aim was to classify parents by identifying latent classes of perceived risks (NICU stressors) and resources (sources of social support). Potential specificities in class membership according to Country of Belonging and sociodemographic factors were also investigated. Methods: Overall, 303 parents (92 Italian; 211 Portuguese) completed a survey including sociodemographic factors, Parental-Stressor-Scale-NICU, and Multidimensional-Scale-of-Perceived-Social-Support. Data were analyzed by multigroup latent class analysis and multinomial logistic regression. Results: Three statistically valid and cross-country classes were identified and labelled as Class 1, Adjusted/Beneficial-and-Supported-System, Class 2, Stressed-and-Supported-System, and Class 3, Parental-Role-Alteration-with-Family-Supported-System. Portuguese parents were mainly grouped in Classes 1 and 2, while Italian parents were in Class 3. Men were less likely to belong to Classes 2 and 3, while older parents having another child were more likely to belong to Class 3. Conclusions: The experience of parents of VPT infants in NICUs is inherently challenging, yet identifying specific risk profiles featured by the unique nuances of stressors and sources of support while accounting for further factors (Country of Belonging, Gender, Age, Having another child) can foster the customization of interventions aimed at providing parents with the necessary resources for adjusting to this extremely demanding experience. Full article

Background/Objectives: Childhood vaccine refusal may negatively affect immunization programs in Türkiye, where regional clusters of hesitancy have emerged despite high national coverage. This study aimed to identify sociodemographic, behavioral, and vaccine confidence-related factors independently associated with childhood vaccine refusal in Konya, Türkiye. Methods: An unmatched case–control study was conducted between July and October 2025 in family health centers across Konya. Cases were parents who had refused at least one routine childhood vaccine (n = 406); controls were parents whose children had completed all routine vaccinations (n = 412). Data were collected through face-to-face interviews using a 47-item structured questionnaire and the Turkish version of the Vaccine Hesitancy Scale (VHS). Independent associations were assessed using multivariable logistic regression, with multicollinearity evaluated by variance inflation factors. Results: Maternal employment (aOR = 0.371, 95% CI: 0.218–0.633), parental COVID-19 vaccination (aOR = 0.131, 95% CI: 0.086–0.200), mother’s complete childhood immunization (aOR = 0.418, 95% CI: 0.262–0.667), tetanus vaccination during pregnancy (aOR = 0.259, 95% CI: 0.159–0.421), and neonatal vitamin K administration (aOR = 0.256, 95% CI: 0.132–0.497) were independently associated with lower refusal odds. Higher number of children (aOR = 1.281) and perceived vaccine-related adverse events in the social environment (aOR = 16.982, 95% CI: 9.914–29.089) increased refusal odds. VHS scores were significantly lower in the refusal group (22.2 ± 6.4 vs. 39.8 ± 6.5; p < 0.001), indicating greater hesitancy. Notably, 21.9% of refusing parents reported being advised by a healthcare professional not to vaccinate. Conclusions: Childhood vaccine refusal in Konya was associated with sociodemographic, behavioral, preventive health-related, and vaccine confidence-related factors. The findings suggest relatively reduced engagement with selected preventive health practices, greater reliance on non-professional information sources, and lower vaccine confidence among refusing parents. Interventions should focus on strengthening healthcare-professional communication, trust-building, transparent risk communication, and evidence-based social media strategies. Full article

Adolescent depression and anxiety are prevalent, yet brief and scalable parent–child digital interventions remain understudied. This study evaluated the effects of a digital parent–child single-session growth mindset intervention targeting beliefs about intelligence, failure, and emotion on adolescent internalizing of symptoms. In a three-arm waitlist cluster randomized controlled trial, 390 parent–child dyads from seven secondary schools in Hong Kong were assigned to a parent–child intervention group, a child-only intervention group, or a waitlist control group. Students were assessed at baseline, 2 weeks, and 3 months, and parents at baseline and 3 months. Cluster-adjusted generalized estimating equations were used for intention-to-treat analyses. A significant time-by-group interaction was observed for child-reported depression, whereas the interaction effects for other outcomes were non-significant. However, cluster-adjusted baseline differences across groups limited attribution of changes in depression to intervention effects. Relative to controls, the parent–child intervention descriptively showed short-term improvement in hopelessness and sustained gains in child-reported parent–child relationships over 3 months. Moderation analyses suggested clearer short-term benefits among adolescents with higher baseline symptoms and among girls. Overall, the PC-SMILE intervention in this study did not show statistically significant effect on reducing internalizing symptoms. Improvement on intervention design and implementation would benefit further refinement of brief, scalable parent–child digital interventions. Trial registration: ClinicalTrials.gov NCT05493865. Full article

Background: Parenting stress is a known risk factor for children’s social anxiety, yet the mediating and moderating mechanisms underlying this relationship remain underexplored, particularly regarding gene–environment interactions. This quantitative, cross-sectional study, grounded in diathesis-stress and family process theories, examined whether maladaptive parenting mediates the link between parenting stress and children’s social anxiety, and whether FKBP5 gene variation moderates this mediation. Methods: A sample of 1774 fourth- to sixth-grade students (aged 10–14 years) and their parents participated. Parenting stress and maladaptive parenting were parent-reported, children’s social anxiety was self-reported, and children’s FKBP5-related cumulative genetic score was derived from four SNPs (rs4713916, rs1360780, rs3800373, rs9296158). Moderated mediation analyses were conducted. Results: Parenting stress was significantly and positively associated with children’s social anxiety. Maladaptive parenting partially mediated this relationship. The FKBP5 showed a marginally significant moderating effect, with simple slope analysis suggesting parenting stress was more strongly associated with child social anxiety among children with higher genetic risk. No moderating effect was found for the path from maladaptive parenting to social anxiety. Conclusions: Parenting stress is associated with children’s social anxiety both directly and indirectly through maladaptive parenting, with FKBP5-related cumulative genetic risk potentially moderating the direct effect. These findings offer preliminary evidence that may inform preventive interventions targeting parenting stress, although replication is needed. Full article

Background/Objectives: Cochlear implantation (CI) represents a well-established intervention for the management of severe to profound sensorineural hearing loss. The co-occurrence of severe hearing loss and Autism Spectrum Disorder (ASD) presents unique diagnostic and therapeutic challenges that significantly impact post-implantation outcomes. This review aims to synthesize the current literature on cochlear implantation in children with Autism Spectrum Disorder (ASD), including diagnostic, audiological, rehabilitative, and functional outcome considerations. Methods: A structured search of PubMed and Scopus was performed for English-language articles published between January 2000 and January 2026, focusing on audiological assessment, rehabilitation challenges, multidisciplinary management, and post-implant functional outcomes in this population. Results: The findings synthesized in this review suggest that cochlear implantation in children with Autism Spectrum Disorder must be interpreted within a broader communicative-ecological framework rather than through auditory metrics alone. These findings highlight a multidimensional model of post-implant outcomes, shaped by the dynamic interplay between auditory access, social engagement, family context, and language-learning environments. Conclusions: Most children with ASD and severe-to-profound hearing loss show improvements in speech perception and production after cochlear implantation, although outcomes are highly variable. A multidisciplinary approach, through coordinated collaboration among specialists, enhances family engagement, optimizes compliance with care plans, and ultimately contributes to improved clinical and developmental outcomes. ASD should not be considered a contraindication for CI; however, careful individual assessment, realistic parental counseling, and a multidisciplinary approach availability to evaluation and rehabilitation are essential. Full article

Background/Objectives: The family constitutes a primary ecological system shaping infant emotional and mental health. Parent responsiveness in particular shapes early regulatory capacities in the developing child. Added contextual stress such as that associated with natural disasters may strain caregiving relationships. Brief, universally accessible parenting interventions offer scalable support for strengthening early relational health and may be useful in contexts of natural disaster-related stress as well as in the general population. This qualitative study examined the perceived impact and contextual relevance of MERTIL (My Early Relational Trust-Informed Learning) for Parents, a brief digital psychoeducational parenting program targeting early relational health, among families raising young children in disaster-affected communities. Methods: Fourteen parents residing in the Hunter New England and Central Coast region of New South Wales, Australia, with young children aged 0–5 years, participated in semi-structured interviews conducted approximately 6 months after completing MERTIL for Parents. Interviews explored lived experiences of parenting in the context of natural disaster (analysed via applied phenomenological methods) and parents’ perceptions of program components that supported everyday caregiving (analysed via reflexive thematic analysis and content analysis). Results: Parents described interconnected personal, relational, and environmental stressors that influenced aspects of the parent–infant relationship. Key retained knowledge from the program included a normalisation of parenting challenges, a strengthened understanding of attachment, trust, safety and repair, and attuned, emotion-focused parenting practices. Conclusions: This pilot study illuminates the lived experience of parenting in disaster prone regions and highlights the potential for this brief, universal digital parenting program to provide support for early relational health in such contexts. Full article

Deaf people experience significant barriers to education, healthcare, employment, and information access, resulting in inequities across a myriad of contexts. To better understand these disparities, our all-deaf research team conducted semi-structured interviews with deaf and hearing (parents, caregivers, and educators) adults across Ecuador, exploring how structural, institutional, and social factors influence daily life and well-being. Participants (n = 36) described systemic exclusion from education and employment, limited access to interpreters and assistive technologies, and constrained autonomy due to insufficient family support and institutional resources. These barriers compound health risks by restricting access to care, information, and social participation. Participants’ narratives highlighted how political and economic instability, institutional neglect, and discrimination create structural vulnerabilities that extend beyond individual-level factors. Findings underscore the importance of public health interventions that address structural and communicative inequities, including inclusive education, accessible health services, and community-based support, to improve health equity and quality of life for deaf populations in Ecuador. Full article

Background: Childhood obesity remains a major public health challenge worldwide, with increasing prevalence across Europe. Schools represent an important setting for promoting healthy lifestyles through physical activity and nutrition-related interventions. This systematic review aimed to evaluate the effectiveness of school-based interventions promoting physical activity and healthy eating behaviours among children and adolescents aged 6–18 years in European countries. Methods: A systematic literature review was conducted using PubMed and Scopus. Studies were eligible if they were conducted in school settings, targeted children and adolescents aged 6–18 years, were implemented in European countries, had a minimum duration of nine months, and assessed anthropometric and/or behavioural outcomes related to obesity prevention. Methodological quality was assessed using the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool. Results: Sixteen studies conducted across nine European countries met the inclusion criteria. Intervention duration ranged from nine months to five years, and most studies employed multicomponent approaches combining physical activity promotion, nutrition education, environmental modifications, and parental involvement. Seven studies were rated as strong quality, six as moderate quality, and three as weak quality. Among the fourteen studies assessing BMI or other anthropometric outcomes, eleven (78.6%) reported statistically significant improvements in at least one obesity-related measure, including BMI, BMI z-score, waist circumference, waist-to-height ratio, body fat percentage, or overweight/obesity prevalence. Evidence regarding physical activity and nutrition-related outcomes was more heterogeneous, although several studies reported improvements in dietary behaviours, nutrition knowledge, sedentary behaviour, and physical activity levels. Positive anthropometric effects were more commonly observed in interventions lasting at least one academic year and in multicomponent programmes. Some studies also reported differential effects according to sex and parental educational background. Conclusions: The findings of this review suggest that long-term, multicomponent school-based interventions can contribute to improving obesity-related anthropometric outcomes among children and adolescents in European countries. However, evidence regarding sustained changes in physical activity and dietary behaviours remains less consistent. Future research should focus on identifying the most effective intervention components and strategies for achieving long-term behavioural change across diverse populations and educational contexts. Full article