Search Results (3,417)

Background: Children with disabilities and special educational needs show heterogeneous developmental profiles that may be associated with executive functioning and family factors. This study examined functional developmental profiles in primary education and their associations with executive functions, behavioural indicators, and parental mental health. Methods: Participants were 106 children aged 6–12 years attending mainstream schools, including a subgroup with special educational needs. Parents completed the Developmental Profile-3 (DP-3) and a family mental-health record, while teachers completed the Screening of Emotional and Behavioural Problems in Children (SPECI) and Behaviour Rating Inventory of Executive Function-2 (BRIEF-2) based on structured ratings derived from daily interaction with the child. Correlational and regression analyses were conducted. Results: Executive functions—particularly working memory and planning/organisation—were consistently associated with global, adaptive, and social development. Parental overload showed negative associations with several developmental domains. Associations with behavioural indicators were modest. Conclusions: Developmental functioning in children with and without special educational needs is associated with executive functions and family factors as perceived by parents and teachers. Findings should be interpreted as relational and inform future assessment and inclusive educational planning. Full article

Background/Objectives: Virtual reality (VR) is increasingly used to reduce pain during pediatric needle procedures, but its effectiveness may vary by developmental stage and gender. This study evaluated whether immersive VR reduces venipuncture pain in children and adolescents and examined parent–patient agreement and gender-specific response patterns. Methods: A prospective nonrandomized clinical study was conducted within a hospital-based pediatric venipuncture service using an alternating 1:1 allocation sequence. Participants aged 4–18 years underwent venipuncture with either VR (n = 49) or standard care (n = 29). Procedural pain was measured using the Faces Pain Scale–Revised (FPS-R) with independent parent ratings. Analysis of covariance (ANCOVA) compared post-procedural FPS-R scores while adjusting for baseline pain. Exploratory age and gender-specific analyses were also performed. Results: VR led to a clear reduction in pain for children, even after adjusting for baseline scores (3.55 vs. 4.73; p = 0.003). Adolescents, however, reported similarly low pain in both groups (2.81 vs. 2.79; p = 0.60), and several mentioned that the PEGI 3 content felt too young for them, which likely limited how engaged they were. Among children, girls showed the most noticeable drop in pain, which matches the subgroup’s adjusted significance (p = 0.011). Parent–patient agreement was stronger in children (r ≈ 0.7–0.8) than in adolescents (r ≈ 0.4–0.5), and VR did not change this pattern. Most participants said they would choose VR again for future procedures. Conclusions: Immersive VR helped reduce venipuncture pain in children but had little effect in adolescents, underscoring the need for age-appropriate or more interactive VR content for older patients. Overall, these findings support using VR selectively as a distraction tool that fits the developmental needs of pediatric groups. Full article

With the rise in experience economy and the popularization of digital technology, user-generated content (UGC) has become a core data source for understanding tourist needs and evaluating the service quality of venues. As a landmark venue that combines science education, interactive experience, and landscape viewing, the service quality of the Macau Science Center directly affects tourists’ travel experience and word-of-mouth dissemination. However, existing studies mostly rely on traditional questionnaire surveys and lack multi-technology collaborative analysis. In order to accurately identify the factors affecting satisfaction, this study uses 788 valid UGC data from five major platforms, namely Google Maps reviews, TripAdvisor, Sina Weibo, Xiaohongshu (Rednote), and Ctrip, from January 2023 to November 2025. It integrates word frequency analysis, semantic network analysis, latent Dirichlet allocation (LDA) topic modeling, and Valence Aware Dictionary and sEntiment Reasoner (VADER) sentiment computing to construct a systematic research framework. The study found that (1) the core attention dimensions of users cover the needs of parent–child and family visits, exhibitions and interactive experiences, ticketing and consumption services, surrounding environment and landscape, emotional evaluation, and recommendation intention. (2) The keyword association network has gradually developed from a loose network in the early stage to a comprehensive experience-dense network. (3) LDA analysis identified five main potential demand themes: comprehensive visiting experience and scenario integration, parent–child interaction and characteristic scenario experience, core venue facilities and ticketing services, visiting value and emotional evaluation, and transportation and surrounding landscapes. (4) User emotions were predominantly positive, accounting for 82.7%, while negative emotions were concentrated in local service details, and the emotional scores showed a fluctuating upward trend. This study provides targeted suggestions for the service optimization of the Macau Science Center and also provides a methodological reference for UGC-driven research in similar cultural venues. Full article

Background/Objectives: Asthma, type 1 diabetes mellitus (T1DM), and epilepsy are prevalent chronic diseases among school-aged children, affecting safety, attendance, and academic performance. This systematic review evaluated school teachers’ knowledge, attitudes, and preparedness regarding these conditions and identified gaps that hinder effective management and inclusion. Methods: Following PRISMA guidelines, PubMed, Cochrane Library, Scopus, and Google Scholar were searched between 20 September and 9 October 2025. Forty-nine quantitative cross-sectional studies assessing teachers’ knowledge, attitudes, or preparedness toward asthma, T1DM, or epilepsy were included. The AXIS tool assessed methodological quality, focusing on clarity of objectives, sample justification, ethical transparency, and instrument validation. Results: Teachers’ knowledge was generally moderate and varied by region. Studies on epilepsy (n = 21) highlighted misconceptions and limited understanding of seizure first aid. Diabetes studies (n = 9) indicated moderate awareness but insufficient preparedness for hypoglycemia and insulin management. Asthma studies (n = 19) revealed inconsistent knowledge, particularly regarding symptom recognition and emergency response. AXIS assessment identified recurring limitations, including unjustified sample sizes, limited instrument validation, and poor reporting of non-responders. Conclusions: These findings emphasize the need to enhance school preparedness through targeted, evidence-based teacher training, clear health policies and emergency protocols, awareness and inclusion initiatives, improved collaboration among teachers, parents, and healthcare providers, and strengthened school health infrastructure. Addressing these areas is critical to ensure safe, inclusive, and supportive learning environments for children with chronic illnesses. Full article

The aim of the evaluation was to gather information on parents’ experiences and attitudes towards the Irish National Newborn Bloodspot Screening Programme (NNBSP). An interviewer-administered survey was completed by 151 parents whose babies underwent newborn bloodspot screening (NBS) between 2023 and 2025 and for whom the screening result was normal. Results suggest that NBS is highly acceptable to parents, with 100% glad their baby underwent screening. The majority (95%) felt they were provided the information needed to understand the importance of NBS for their baby, and 93% are in favour of screening for more conditions. Positive aspects of NBS reported by parents included the following: blood sampling being undertaken in the home, the sample-taker being very nice and being advised in advance to keep the baby’s heel warm to ease the sampling process. Negative aspects of NBS reported included the following: having to return to the hospital for sampling, the baby becoming distressed, not receiving adequate information and not receiving the screening results. Parents were more likely to report negative experiences if the sample was not taken at home and if the sample was taken by a healthcare professional other than a public health nurse. Parents offered recommendations for improvements to the programme. This study provides important insights into parents’ experiences and attitudes towards NBS in Ireland. Full article

This comparative study, the first to date, examines how representative samples of citizens across 40 OECD countries (N = 41,232) balance religion and child welfare when deciding whether to move a five-year-old thriving in foster care to match parental religion. Using a vignette experiment and six hypotheses, the analysis links religiosity, perceived religious rights, authoritarian values, institutional context, and confidence in child protection to placement preferences. A large majority (88%) would not move the child, prioritising stability and well-being. The results show a trust “paradox” in which higher confidence in child protection correlates with support for moving the child. Justifications show broad appeal to the best interest principle across opposing choices. Deference to professional assessment varies markedly across countries, indicating divergent authority of social work expertise. Findings underscore the need to operationalise the best interests standard and to account for institutional context, while policymakers should recognise stable placements as the public default. Full article

Background: Although parenting interventions are effective in improving parenting practices and child development, most are developed within Western cultural frameworks that may not align with South Asian collectivist values and family structures. The extent to which cultural adaptation influences the effectiveness of parenting interventions in South Asian populations remains unclear. Aim: To systematically review the effectiveness of parenting interventions on child developmental outcomes, parenting outcomes, and parental health among South Asian families, and to examine whether the depth of cultural adaptation, assessed using Bernal’s Ecological Validity Model (EVM), is associated with intervention effectiveness. Methods: A systematic review and meta-analysis were conducted. We systematically searched CINAHL, MEDLINE, Science Direct, PsychINFO, PubMed, and Cochrane library. Data were extracted from six electronic databases up to August 2023. Quality and risk of bias were appraised using the Revised Cochrane Risk of Bias Tool for Randomized Trials for the quantitative studies and the Critical Appraisal Skill Program (CASP) checklist for the qualitative studies. Results: Seventeen studies (fifteen quantitative, two qualitative) involving 8088 participants were included; ten studies contributed data to meta-analysis. Parenting interventions were associated with moderate improvements in parenting knowledge (SMD = 0.51, 95% CI 0.25 to 0.76) and small improvements in parental involvement (SMD = 0.36, 95% CI 0.00 to 0.72). Significant reductions in parental depression (SMD = −0.77, 95% CI −1.20 to −0.34) and disability symptoms (SMD = 0.82, 95% CI 0.68 to 0.96) were observed, though effects on post-natal depression (SMD = 0.15, 95% CI −1.00 to 1.30) and physical quality of life (SMD = −0.27, 95% CI −1.22 to 1.75) were non-significant. For children, large improvements were found in cognitive (SMD = 0.84–1.48), language (SMD = 0.79, 95% CI 0.25 to 1.33), and social development (SMD = 0.54, 95% CI 0.16 to 0.91), but not in emotional or motor development. Sensitivity analyses indicated larger effects for studies demonstrating deeper cultural adaptation. Qualitative findings highlighted maternal empowerment, improved mental wellbeing, and the importance of family support and culturally congruent facilitators for engagement. Overall certainty of evidence was rated as low due to high heterogeneity, risk of bias, and imprecision. Discussion: Culturally adapted parenting interventions show promising benefits for parenting practices, parental mental health, and child developmental outcomes among South Asian families, particularly when adaptations extend beyond surface-level changes. However, evidence quality is low and inconsistent, highlighting the need for more rigorous trials and clearer reporting of cultural adaptation to optimize effectiveness. Full article

Background/Objectives: Vaccination programs are highly effective public health interventions, yet parental hesitancy toward combination vaccines has led to growing demand for alternative vaccination schedules, defined in this study as parental requests to split or replace recommended combination vaccines with single-antigen vaccines for non-clinical reasons. While parental attitudes have been widely studied, little empirical evidence exists on the real-world use of single-antigen vaccines and their public health implications in countries with otherwise high coverage. This study examined the prevalence patterns and parental motivations for requesting such alternative vaccination schedules in Israel, where national guidelines recommend specific combination vaccines, including measles-mumps-rubella-varicella (MMRV) and the pentavalent diphtheria-tetanus-pertussis–inactivated polio–Haemophilus influenzae type b (DTaP+IPV+Hib) vaccines, but informal accommodations exist. Methods: A mixed-methods design was employed: a retrospective cohort analysis of vaccination data from 2018 to 2021 (before and during the COVID-19 pandemic) focused on measles (first dose at 12 months) and pertussis (four-dose primary series), followed by semi-structured interviews with Maternal and Child Health clinic providers, policymakers, and parents. Results: Alternative vaccination schedules involving single-antigen measles or pertussis vaccines are occasionally used despite official policy, accounting for less than 1% of vaccinations overall. Outcomes include delayed administration, lower uptake of combination vaccines, and incomplete protection in certain groups. Parents cited safety concerns, fear of immune overload, and mistrust of authorities. These concerns were often amplified by misinformation, while providers described balancing parental preferences with the need for adequate coverage. Conclusions: This study provides new evidence on how vaccine hesitancy translates into service utilization, highlights the tension between individualized parental decision-making and contribution to collective health, and underscores the need for communication, policy strategies and service designs that sustain high coverage while addressing community-specific concerns. Full article

Background: Parental burnout is a state of extreme exhaustion that is detrimental to family life. There is some evidence, albeit limited, that children of exhausted parents are at risk of neglect or abuse. The children’s lived experience remains an underinvestigated issue. This qualitative and participatory study aimed to explore children’s and adolescents’ perceptions and experience of parental burnout, as well as the resources they identify as available to assist them. Methods: We interviewed 24 children of exhausted parents, including children typically developing (n = 17), children with illness/disability (n = 3), and children with learning/behavioral difficulties (n = 4). We used interactive data collection tools, adapted to the participants’ age. The interviews were followed by a participatory validation seminar. Results: We evidenced a high emotional burden experienced by children exposed to parental burden. The children conveyed feeling insecure about what happens, perceiving a mismatch between their own needs and those of their parents, and being afraid both of and for their parents. Conclusions: Our results call for an increased recognition of parental burnout as not only a personal or family problem, but a possibly important societal and public health concern, with implications for child prevention and health promotion. Full article

Whilst there has been substantial attention to care-experienced parents’ needs and experiences in the academic literature internationally, understandings of nascent services, their characteristics and implementation processes are more limited. With an overarching socioecological resilience systems framing and drawing on an innovation perspective, we aim to develop understanding of how to design and develop innovations to enable care-experienced parents’ successing. We conducted a narrative literature review that included 33 sources published internationally between 2017 and 2025. We conducted thematic analysis to identify adversities experienced by and innovations developed for care-experienced parents. We authenticated the themes in a workshop with members of the practice community and developed frameworks to represent the themes. Findings are represented in three sections. First, we consider parental needs, with an overview of adversities experienced by care-experienced parents together with individual protective factors and required service responses, framed by psychological, social and structural domains. Second, drawing upon such understanding, we consider intervention design, with a focus on exemplar innovations and the characteristics that are represented by five service delivery models: therapeutic; social; partnership; advocacy; and co-production. Third, with a need to ensure that service intervention is effective, we examine the process of developing service innovations and consider five dynamic ingredients that enable implementation success: shared leadership; receptivity of context; co-production; learning and adaption; and outcome measurement. Our review contributes new understanding to inform processes of designing and implementing innovations to enable care-experienced parents’ successing. We offer a framework that represents a starting point towards enabling care-experienced parents’ successing that can be applied in policy and practice, although more research is needed. Full article

University students worldwide experience considerable health challenges. We examined health inequalities in a nationwide, gender-balanced sample of 1105 German students, considering negative (stress, depression, burnout) and positive health outcomes (self-rated health [SRH], well-being) alongside vertical (subjective social status [SSS], parental academic background) and horizontal (gender) determinants. Analyses used bivariate statistics, multivariate regressions, and interaction terms. Higher SSS was associated with better SRH (β = 0.322) and well-being (β = 0.355), and lower stress (β = −0.154), depression (β = −0.127), and burnout (β = −0.219). First-generation students reported highly significant poorer SRH and well-being than students with one (β = 0.114; β = 0.112) or two academic parents (β = 0.162; β = 0.192). Students with two academic parents showed lower stress (β = −0.087, p = 0.007) and burnout (β = −0.099, p = 0.002). Interactions suggest a protective effect of higher SSS on depression (β = −0.219, p = 0.026) and burnout (β = −0.264, p = 0.006), more pronounced among male students, who additionally benefited more from an academic household regarding SRH (β = 0.100, p = 0.044). These findings underscore intersectional and multifaceted inequalities among German students and the need for interventions. Full article

Introduction: Parents of children presenting global developmental delay (GDD) need to be involved in their therapy to intensify treatment. Vojta therapy (VT) is an intensive physiotherapeutic treatment that can be administered at home. Whilst parental experience of Home-Based Program (HBP) for preterm or cerebral palsy is well documented, there is a lack of understanding about parents of GDD children on HBP with VT. Objectives: The aim of this work was to describe parents’ perspectives concerning their participation in, concerns with, and perception of the results of an HBP with VT. Methods: A qualitative case design based on an interpretative approach was presented. A purposeful sampling was used. Data was collected in two stages: firstly, semi-structured interviews, and secondly, photo-elicitation. An inductive thematic analysis was used. Results: Seventeen parents were included. Three themes emerged from parents’ perspectives. Firstly, parents’ active participation in VT, which includes their desire to become an active agent to contribute to their child’s improvement, their implication of compromise, learning process, time required, effort, and factors that influence their adherence and continuity. Secondly, parents’ perception of the results achieved: motor improvement and better resting, feeding, and breathing; and time and commitment required to achieve them. Thirdly, parents’ initial concerns about suitability, daily implementation, therapy functioning, or evidence, as well as concerns about emotional bonds. Conclusions: Parents universally perceive that their commitment and efforts were rewarded. They recognized that the emotional bond with their child was strengthened by the therapy. The results regarding the beneficial effects perceived by the parents should be treated with caution, as no instruments for assessing the effect or efficacy were used in this study. Full article

Toxoplasmosis is a parasitic disease associated with significant morbidity and mortality. This cross-sectional study aimed to determine the prevalence, associated risk factors, and ocular health outcomes related to Toxoplasma gondii seropositivity in 161 residents from four Quilombolas communities in the northern region of Tocantins, Brazilian Legal Amazon. Peripheral blood samples were collected and tested by Enzyme-Linked Immunosorbent Assay (ELISA) for Immunoglobulin G (IgG) and/or Immunoglobulin M (IgM) and Polymerase Chain Reaction (PCR), while a standardized form was used to collect sociodemographic, health, and behavioral data. Statistical analysis, conducted using Epi-Info 3.3.2, considered T. gondii seropositivity as the primary outcome, with a significance level less than 5% (p ≤ 0.05). An overall seroprevalence of 62.11% (100/161) was observed. Key risk factors significantly, as measured by the Odds Ratio (OR), associated with T. gondii seropositivity included being elderly (OR: 4.07, CI: 2.05–8.06, p < 0.01), having cats (OR: 5.56, CI: 2.74–22.27, p < 0.01), a low parental education level (OR: 2.97, CI: 1.46–6.02, p < 0.01), children playing on the ground (OR: 2.50, CI: 1.30–4.82, p < 0.01), and having a home vegetable garden (OR: 3.80, CI: 1.94–7.47, p < 0.01). Regarding ocular health, no conclusive direct association was established between T. gondii seropositivity and specific ocular manifestations when analyzed for children and the elderly separately. Observed ocular problems in the grouped population were primarily linked to age-related comorbidities rather than parasitic infection. High rates of T. gondii seropositivity, driven by specific environmental and socioeconomic factors, highlight the vulnerability of these communities, emphasizing the need for targeted preventive strategies. Full article

My article criticizes the view held by many ecologists that species have evolved essentially equivalent levels of fitness, thus permitting their coexistence. I show that a recently proposed version of this view called the “equal fitness paradigm” (EFP) has multiple problems, empirically and conceptually. Some of these problems are (1) an energetic fitness measure (OPG = lifetime production of surviving offspring per parental body mass) that ignores the critical effect of the timing of reproduction; (2) flawed methods and data used to calculate and interpret the body-size scaling invariance of OPG upon which the EFP is based; (3) omission of the profound effects of population size and geographical range size on species-level fitness; and (4) lack of recognition that if the EFP were true, species-level selection would not be able to operate. By contrast, the “variable fitness paradigm” (VFP), which is a mainstay of modern evolutionary biology, is supported by numerous lines of evidence at multiple levels of biological organization. Extensive fitness variation allows natural selection to operate at all these levels. Distinguishing fitness and adaptiveness as reproductive power and efficiency of resource acquisition, respectively, helps explain species coexistence within the conceptual framework of the VFP. No EFP is needed. Full article

The current study explores the social experiences of adolescent and transition-age youths with intellectual disabilities (IDs) and the support mechanisms available to these groups in Saudi Arabia. This study adopts a qualitative methodology with a semi-structured interview constituting the data collection method involving 13 parents with children aged between 11 and 19 years, a critical adolescent period and transition to early adulthood. The results suggest that family, caregivers, community, friendships, and healthcare providers play important roles that impact the quality of life for these groups. The main challenges identified include health-related issues, employment challenges, educational barriers, insufficient services, inadequate community participation, and limited social relationships, with special emphasis on obstacles linked to transition during the 18 to 19-year period when youths must navigate transfers from pediatric to adult services and changes associated with legal rights. This study highlights several reasons it is important to increase awareness and education, while also continuing to improve support systems aimed at dealing with both transition challenges and adolescent needs. The results further illustrate that although support from family provides the foundation for care, systemic changes are needed to promote social inclusion and reduce stigma during critical development periods. The current study contributes to the limited research related to IDs in the context of the Middle East, with special reference to Saudi Arabia. Finally, the discussion highlights several insights that are culturally specific for the development of policy and provision of services associated with the transition from adolescence to early adulthood. Full article