Search Results (1,910)

Childhood obesity increases chronic disease risk, but no comprehensive synthesis has evaluated the impact of school-based combined nutrition education and physical activity interventions on cardiometabolic biomarkers in children aged 3 to 12 years. This systematic review was conducted in accordance with PRISMA guidelines and registered in PROSPERO (CRD420251085194). Five databases were systematically searched through June 2025. Twelve randomized controlled trials involving 18,231 children were included and assessed using the PEDro scale. Ten trials demonstrated significant improvements in at least one cardiometabolic biomarker. Blood pressure (8 studies) outcomes showed systolic reductions of 1.41–6.0 mmHg in six studies. Glucose metabolism (5 studies) improved in two studies with reductions of 0.20–0.22 mmol/L. Lipid profiles (7 studies) improved in three studies, including total cholesterol (−0.32 mmol/L). Insulin levels (5 studies) decreased significantly in two investigations. Anthropometric improvements included BMI and body fat. Physical activity increased by >45 min/week and dietary habits improved significantly. Programs with daily implementation (90-min sessions 4x/week), longer duration (≥12 months), family involvement (parent education), and curriculum integration (classroom lessons) showed superior effectiveness. Interventions targeting children with overweight/obesity demonstrated higher changes compared to the general population. However, methodological limitations included a lack of assessor blinding, absence of subject/therapist blinding, and inadequate retention rates. School-based interventions combining nutrition and physical activity can produce significant improvements in cardiometabolic biomarkers, supporting comprehensive, sustained multicomponent programs for early chronic disease prevention. Full article

Background: The diagnosis of a disability in a child may significantly impact the entire family system. While existing literature has primarily focused on parental reaction to the diagnosis, little is known about how typically developing siblings process this event. Methods: This exploratory study presented the preliminary psychometric properties of the Reaction to Diagnosis Questionnaire—Sibling Version, adapted from an instrument originally designed to assess parental reaction to the child’s diagnosis. Following a back-translation and adaptation process, a cross-sectional study was conducted on 623 typically developing siblings (M = 24.6 years, SD = 5.76) of individuals with neurodevelopmental disorders or physical disabilities. Results: Exploratory factor analyses supported a refined 32-item questionnaire with two factors—lack of resolution versus resolution, both showing excellent internal reliability. No significant differences were found based on typically developing sibling sex, age, or type of disability of the brother/sister, while correlational analyses indicated that greater disability severity was associated with lower resolution and higher lack of resolution. Conclusions: Results suggested that the Reaction to Diagnosis Questionnaire—Sibling Version is a promising tool for assessing the reaction to the brother/sister diagnosis on behalf of the typically developing siblings. Further research is needed to confirm these results and inform intervention programs promoting well-being and adaptive family functioning. Full article

The primary objective of any conservation breeding program is to preserve the genetic diversity of populations. This objective is a persistent challenge, especially in small populations which are prone to loss of heterozygosity. In this study, we proposed a novel parent-selection strategy aimed at the long-term maintenance of high levels of genetic diversity. Our approach is based on estimating the Probability of Offspring Heterozygosity (POH)—the likelihood that a mating will produce heterozygous offspring—using SNP genotype data. This strategy was evaluated through computer simulations, where parental pairs with the highest POH values were preferentially selected to produce the next generation. Simulations explored the effects of varying the number of breeding pairs, and the number of unlinked SNP markers. Selection based on POH resulted in observed heterozygosity (H_OBS) consistently exceeding expected heterozygosity (H_EXP), a trend that was sustained for up to 1000 generations. While further evaluation is needed within more complex population genetic frameworks—accounting for linkage disequilibrium, recombination, optimal contribution, and phenotypic selection—our findings highlight the potential of POH as a valuable tool for enhancing genetic diversity in conservation breeding programs. Full article

Cowpea (Vigna unguiculata [L.] Walp) is a vital food security crop in sub-Saharan Africa, including Eswatini. The productivity of the crop is low (<600 kg/ha) in the country due to a lack of improved, locally adapted, and farmer-preferred varieties with biotic and abiotic stress tolerance. The objective of the study was to assess the agronomic performance of newly developed elite cowpea mutants to select best-yielding and adapted pure lines for production and genetic improvement in Eswatini. A total of 30 cowpea genotypes, including 24 newly developed advanced mutant lines, their 3 founder parents and 3 local checks, were profiled for major agronomic traits in two selected sites (Lowveld Experiment and Malkerns Research Stations) using a 6 × 5 alpha lattice design with three replications. A combined analysis of variance revealed that the genotype x location interaction effects were significant (p < 0.05) for germination percentage (DG %), days to flowering (DTF), days to maturity (DMT), number of pods per plant (NPP), pod length (PDL), number of seeds per pod (NSP), hundred seed weight (HSW), and grain yield (GYD). Elite mutant genotypes, including NKL9P7, BRR4P11, SHR9P5, and NKL9P7-2 exhibited higher grain yields at 3158.8 kg/ha, 2651.6 kg/ha, 2627.5 kg/ha, and 2255.8 kg/ha in that order. The highest-yielding mutant, NKL9P7, produced 70%, 61%, and 54% more grain yield than the check varieties Mtilane, Black Eye, and Accession 792, respectively. Furthermore, the selected genotypes displayed promising yield components such as better PDL (varying from 13.1 to 26.3 cm), NPP (15.9 to 26.8), and NSP (9.8 to 16.2). Grain yield had significant positive correlations (p < 0.05) with DG %, NSP, and NPP. The principal component analysis (PCA) revealed that 81.5% of the total genotypic variation was attributable to the assessed quantitative traits. Principal component (PC) 1 accounted for 48.6%, while PC 2 and PC 3 contributed 18.9% and 14% of the overall variation, respectively. Key traits correlated with PC1 were NPP with a loading score of 0.91, NSP (0.83), PDL (0.73), GYD (0.68), HSW (0.58), DMT (−0.60), and DTF (−0.43) in a desirable direction. In conclusion, genotypes NKL9P7, BRR4P11, SHR9P5, NKL9P7-2, Bira, SHR3P4, and SHR2P7 were identified as complementary parents with relatively best yields and local adaptation, making them ideal selections for direct production or breeding. The following traits, NPP, NSP, PDL, GYD, and HSW, offered unique opportunities for genotype selection in the cowpea breeding program in Eswatini. Full article

This paper examines the importance of ‘education outside the classroom’ (EOtC) in an Australian secondary school. The primary aim was to develop a sense of belonging, build resilience, and enhance wellbeing in female students. This study investigated two cohorts of Year 9 students (aged 14–15 yrs) who participated in a four-week residential EOtC pilot program. The first cohort (Wave 1; N = 58) undertook the program alongside (N = 39) boys. The second cohort was single-sex girls (Wave 2; N = 28). A mixed-methods research design was implemented to inform experiences of students, parents, and staff and to triangulate inferences drawn from the data. Quantitative data was gained from pre- and post-program surveys with students and parents, whilst qualitative data was gathered from student focus groups, staff, and parents through semi-structured interviews to assess more nuanced impacts. School belonging was measured using the PISA six-item scale. Academic buoyancy was quantified using the four-item Academic Buoyancy Scale. Self-efficacy, peer relations, and resilience were evaluated by employing the 34-item Adolescent Girls’ Resilience Scale. The findings revealed significant improvements in students’ sense of belonging, including higher levels of school belonging than reported Australia-wide averages for 15-year-olds. Despite students’ mean academic buoyancy scores being more than a point lower than reported baseline scores for Australian high school students, it was promising to see a modest increase following the EOtC program. In conclusion, EOtC is a potent vehicle for developing a sense of belonging, enhancing resilience, and equipping students to deal with academic challenges. Full article

Maternal mental illness significantly impacts caregiving, influencing both mothers and their children. This narrative review examines the challenges faced by mothers with conditions such as depression, anxiety, bipolar disorder, and schizophrenia, which often disrupt caregiving routines, emotional stability, and social integration. These difficulties can hinder secure attachments and contribute to adverse developmental outcomes in children, including heightened risks of anxiety, depression, behavioral issues, and cognitive impairments. Children of mothers with mental illnesses are 1.8 times more likely to develop emotional or behavioral problems and face a 2.7 times higher risk of suicidal ideation during adolescence. Intergenerational transmission of mental illness is also prevalent, with affected children showing a 2.5 times greater likelihood of developing mental illnesses in adulthood. Effective interventions include cognitive behavioral therapy (CBT), family-based approaches, and community programs integrating parenting education and mental health resources. These strategies have demonstrated improvements in maternal well-being and child resilience. The review highlights the need for comprehensive policies addressing maternal mental health, early intervention for children, and culturally sensitive support systems to break cycles of intergenerational mental illness. Future research should prioritize evaluating long-term intervention effectiveness and exploring innovative tools like digital mental illnesses solutions to support affected families. Full article

Much U.S. research supports the effectiveness of parenting education delivered via the home visiting method. Home visitors are essential to reaching fathers in this context, but not all have favorable attitudes toward father engagement or feel confident working with fathers. Given that father involvement is important for a wide range of child and adolescent outcomes and that fathers benefit from parenting education, it is important to better understand the forces that shape home visitors’ attitudes toward fathers, and thus their subsequent efforts to include them in publicly funded programming. Using survey data from 95 home visitors in Tennessee, this study explores whether home visitors’ beliefs about fathers and attitudes toward father engagement vary as a function of home visitor or agency characteristics. Results suggest training in social work, reporting father-friendly organizational attitudes and behaviors at one’s agency, and reporting supervisor support specifically for father engagement relate to various favorable fathering attitudes. Home visitors’ strategies to engage fathers in home visiting are presented, including strategies for before, during, and after the home visit. Overall, family service agency administrators are in key positions to make decisions that can improve agency father-friendliness, home visitor attitudes toward fathers, and subsequent outcomes for fathers, mothers, and children. Full article

Background: Medical education is considered one of the most academically and emotionally demanding training programs. Throughout their education, medical students are exposed to various factors that can lead to psychological distress, depression, and anxiety. The aim of this longitudinal study was to examine the changes in psychological distress, depression, anxiety levels and internet addiction among medical students throughout their six-year education and to identify the contributing factors. Methods: The study cohort consisted of 282 students who enrolled in the medical faculty in the 2017–2018 academic year. A questionnaire including sociodemographic characteristics, the General Health Questionnaire-12 (GHQ-12), Beck Depression Inventory (BDI), State–Trait Anxiety Inventory (STAI), and Young Internet Addiction Test (IAT) was administered to the students during the first week of their education. The same questionnaire was readministered at the end of the third and sixth years. Friedman’s variance analysis was used to compare measurement data across the three time points, while Cochran’s Q Test was employed for categorical variables. Results: The median scores of the GHQ-12, BDI, S-Anxiety, and IAT significantly increased from the first to the sixth year (p < 0.05). The prevalence of depressive symptoms, S-Anxiety, and risky internet use significantly increased from the first to the final year, particularly between the third and sixth years. According to logistic regression analysis based on sixth-year data, students whose fathers were university graduates, who had been diagnosed with COVID-19, and who were dissatisfied with their social lives were found to be at increased risk for psychological distress and depression. Students with high parental expectations were found to be at risk of depression and S-anxiety. Those dissatisfied with their occupational choice were at risk for both psychological distress and S-anxiety. Conclusions: It was found that the mental health of medical students deteriorated during their education, especially during the clinical years. Given that these students will be responsible for protecting and improving public health in the future, it is essential to prioritize their own mental well-being. Interventions aimed at preserving the mental health of medical students should be planned. Full article

This study investigates the complex relationship between levels of religiosity and attitudes toward secularization among individuals receiving higher religious education in Türkiye. Secularization is defined as the diminishing influence of religion in public life and the rise of critical attitudes toward religious norms, a process that accelerated particularly during the modernization period following the establishment of the Republic. The primary aim of the research is to analyze whether there is a significant relationship between secular attitudes and the perceived influence of Islam among theology faculty students. The study employs a quantitative, descriptive survey design and includes a sample of 380 undergraduate, graduate, and doctoral students from the faculties of theology at Kocaeli, Sakarya, Marmara, and Istanbul universities. Data were collected using the “Perceived Influence of Religion Scale” and the “Secular Attitude Scale,” both of which demonstrated acceptable reliability (Cronbach’s Alpha = 0.70). Demographic variables such as age, gender, marital status, parental education level, type of education (formal or distance), and economic status were also incorporated into the analysis. The findings revealed statistically significant differences based on marital status, parental education level, type of education program, and previous educational background. For instance, single students reported perceiving a higher influence of religion compared to their married counterparts, while students with fathers who held university degrees perceived a lower influence of religion. These results offer valuable insights into how modern social transformations influence religious attitudes and practices. Full article

Background/Objectives: Parenting stress, the emotional strain resulting from the demands of child-rearing, can profoundly affect both parental well-being and children’s emotional and behavioral development. This study examined the impact of maternal parenting stress during early childhood on the longitudinal progression of children’s internalizing, externalizing, and attention deficit hyperactivity disorder (ADHD) symptoms, from early childhood through adolescence. Methods: The study included 406 mother–child pairs from the Rhea mother–child cohort in Crete, Greece. Maternal parenting stress was assessed at age 4 using the Parental Stress Scale (PSS). Children’s symptoms were evaluated at ages 4 (Strengths and Difficulties Questionnaire, ADHD Test), 6, 11, and 15 years (Child Behavior Checklist, Conners’ Parent Rating Scale) through maternal reports. Multivariate mixed regression models, incorporating a random intercept for each child and a random slope for age at follow-up, were used to analyze the trajectories of symptoms from ages 4 to 15. Group-based trajectory modeling was applied to identify trajectory groups from 4 to 15 years, and multinomial logistic regression models were implemented to examine the associations between parental stress and group trajectories. Results: The results revealed that higher parental stress at age 4 was significantly associated with increased internalizing (b = 0.94, 95% CI: 0.68, 1.21), externalizing (b = 1.03, 95% CI: 0.75, 1.30), and ADHD symptoms (b = 0.86, 95% CI: 0.58, 1.14) over the study period. Notably, the impact of parenting stress on behavioral problems decreased with age (interaction with age, p = 0.032). Additionally, higher parenting stress at age 4 was linked to a greater likelihood of belonging to adverse symptom trajectories, including high decreasing, low increasing, and stable high trajectories for both internalizing and externalizing problems. Conclusions: These findings underscore the importance of early maternal parenting stress as a predictor of long-term emotional and behavioral difficulties in children, emphasizing the need for early intervention programs that support maternal mental health and children’s emotional development. Full article

Background/Objectives: Sexual health research involving young adolescents remains scarce despite rising rates of early sexual debut, pregnancies, and sexually transmitted infections (STIs) in this population. We explored community stakeholders’ perspectives on engaging young adolescents in sexual health research in Western New York to inform strategies for engaging young adolescents in sexual health research. Methods: This qualitative descriptive study was conducted from April 2022 to June 2023. Seventeen community stakeholders, including health education teachers, youth counselors, and adolescent health providers, participated in semi-structured in-depth interviews. Data were analyzed using conventional content analysis, managed by MAXQDA 2020. The rigor and trustworthiness of the data were ensured through triangulation with observations, peer debriefing, team analysis, and respondent validation. Results: Participants were predominantly female (94.1%), 52.9% Black/African American, 41.2% White, and 5.9% Caucasian–Indian American, and aged 23–59 years. Four themes emerged: perspectives on conducting sexual health research with young adolescents, recruitment strategies, sexual health questions appropriate for young adolescents, and building readiness for participation in sexual health research. Participants reported the need for sexual health research with young adolescents and recommended building a trusting relationship and involving schools, parents, and trusted community organizations in the research process. Suggested research questions included those related to awareness of sex, STIs, available resources, experiences with sexual education, and desired support. The findings also revealed the need to initiate sexual health conversations early when children start asking questions, as a foundation for meaningful participation in sexual health research. Conclusions: The findings suggest that sexual health research with young adolescents is feasible and necessary, with implications for the design of developmentally appropriate sexual health research and interventions grounded in trust and community collaboration. Future research should explore the perspectives of caregivers and young adolescents to inform studies and programs that are attuned to young adolescents’ developmental needs. Full article

Background: Childhood hearing loss is a public health problem of critical importance associated with speech development, academic achievement, and quality of life. Parents’ awareness and knowledge about risk factors contribute to early detection and timely intervention.  Objective: This study aims to examine Jordanian mothers’ knowledge of childhood hearing loss risk factors and investigate the impact of education level and socioeconomic status (SES) on the accuracy and comprehensiveness of this knowledge with the moderating effect of health literacy. Material and Methods: The approach employed an embedded mixed-methods design with a dominant quantitative strand supported by qualitative data, utilizing quantitative surveys (n = 250), analyzed using structural equation modeling (SEM) in SmartPLS, and qualitative interviews (n = 10), analyzed thematically to expand upon the quantitative findings by exploring barriers to awareness and healthcare-seeking behaviors. Results: The accuracy and comprehensiveness of knowledge of hearing loss risk factors were also positively influenced by maternal knowledge of hearing loss risk factors. Maternal knowledge was significantly associated with both education level and socioeconomic status (SES). Furthermore, maternal knowledge and accuracy were significantly moderated by health literacy, such that mothers with higher health literacy exhibited a stronger relationship between knowledge and accuracy. Qualitative findings revealed that individuals encountered barriers to accessing reliable information and comprehending medical advice and faced financial difficulties due to limited options for healthcare services. Conclusions: These results underscore the need for maternal education programs that address specific issues, provide simplified healthcare communication, and enhance access to pediatric audiology services. Future research should explore longitudinal assessments and intervention-based strategies to enhance mothers’ awareness and detect early childhood hearing loss. Full article

School readiness during early childhood is crucial for future academic success. Existing guidelines recommend a comprehensive approach. This concurrent validation study developed a School Readiness Index (SRI) with five readiness domains: early learning skills, approach to learning, cognitive skills, socioemotional development, and physical health. Through a cross-sectional comparative design, the school readiness skills of 119 Puerto Rican children (63 males, 56 females) aged 54–65 months were assessed using standardized tests (e.g., Batería IV Woodcock-Muñoz and NIH Toolbox Cognition Battery), parental questionnaires (e.g., Ages and Stages Questionnaire-3), and physical health assessments. Each measure was scored and classified using a binary coding system (0 and 1) based on participant abilities (e.g., 1 for expected performance, 0 if below expectations). A composite SRI score was calculated using 25 indicators. Discriminant validity was assessed by comparing children’s registration status in the special education program (SEP). Sex, household income, and maternal education are key determinants of school readiness. Children registered in the SEP had significantly lower composite scores than those not registered, supporting the SRI’s discriminant validity. The SRI is a reliable tool for identifying Hispanic children from Puerto Rico who may benefit from additional support. Inclusive and multidisciplinary assessment strategies are essential. Full article

Background/Objectives: Participation in sports activities is one of the risk factors for traumatic dental injuries. Nevertheless, little data are available in the literature on such problems in persons with disabilities. This study aims to evaluate the prevalence and severity of traumatic dental injuries in athletes with intellectual disabilities and other coexisting chronic diseases, as well as the use of mouthguards and the level of treatment of injuries in this population. Methods: The research was carried out in seven special needs schools. Two calibrated dentists performed dental examinations in 100 subjects practicing sports, aged 8–30 years (study group), and in 128 individuals, aged 8–25 years, who do not perform systematic physical activity (control group). Statistica Software v.10 was used for statistical analysis, with the level of statistical significance at p ≤ 0.05. Results: The majority of individuals had one tooth affected by traumatic injury in the study and control individuals, with the results amounting to 14% and 5%, respectively; the difference between both groups was statistically significant (p = 0.02). Only one athlete used a mouthguard during training and competitions. Restorative treatment of traumatically damaged teeth was performed in six athletes (37%) out of the total sixteen subjects affected by dental injuries from the study group and in two (15%) out of thirteen participants from the controls. Conclusions: This study reveals that dentists should be professionally prepared to meet the special needs of the population with disabilities and chronic disorders to minimize the burden of dental trauma. There is an urgent need for preventive programs for special needs athletes, their parents/caregivers, and trainers concerning the use of mouthguards. Full article

Juvenile substance use continues to be well researched. Prior research suggests that youth substance use can have far-reaching impacts. While several causes of substance use have been explored, including parental supervision and family structure, it is unclear if caregiver type can impact a juvenile’s substance-using behavior. The current study uses school-level data to examine self-reported substance use among youth who reside with both biological parents, a single parent, custodial grandparent(s), or other caregiver types. The results identify significant differences in self-reported substance use across primary caregiver types. These findings have implications for specific substance use prevention programs to target youth who reside in custodial grandparent-headed households. Full article