Search Results (112)

Breastfeeding education in pre-professional healthcare programs, including dietetics, is often limited and inconsistent. To address this gap, an advanced breastfeeding education and lactation management curriculum was developed that combined evidence-based content with active-learning strategies to support the translation of knowledge into practice. Graduate dietetics students attended four instructional modules, two with hands-on learning activities, and completed pre–post surveys measuring breastfeeding knowledge, attitudes, and counseling self-efficacy. Open-ended questions allowed students to qualitatively evaluate the program. Skills enhancements were evaluated using 11 post-survey items, and thematic analysis of open-ended responses was conducted to identify recurring patterns and areas requiring additional instructional emphasis. Eighty-seven students (mean age = 24.67 ± 4.67 years; 94.3% female) from six cohorts completed the curriculum and evaluation. The skills items demonstrated high internal consistency (Cronbach’s α = 0.92). Across all 11 items, at least 55% (range: 55.17–77.01%) of students reported good to great learning gains (Likert scores of 4 or 5). Qualitative findings indicated increased breastfeeding knowledge, greater appreciation of the complexity of lactation science, and enhanced awareness of challenges faced by breastfeeding mothers. Students reported improvements in learning and confidence in applying lactation education and counseling skills, implying the active-learning curriculum is a promising model for strengthening breastfeeding training in dietetics education and practice. Full article

Nanomaterials are increasingly used in manufacturing, medicine, consumer products, and environmental technologies due to their unique physicochemical properties. Although these materials offer substantial technological and societal benefits, their widespread use has raised concerns about potential health risks. Of particular importance is exposure during pregnancy, as certain nanoparticles can cross the placental barrier and reach the developing embryo. Fetal tissues are highly sensitive to environmental insults, so maternal exposure to nanoparticles may disrupt normal development and increase the risk of abnormal pregnancy outcomes. This review examines the current understanding of nanoparticle-induced developmental toxicity, with a focus on the vulnerability of the maternal–fetal unit. We discuss the structure and function of the placental barrier and the mechanisms that enable nanoparticle transfer from mother to fetus. Particular attention is given to how nanoparticle characteristics, including size, shape, composition, and surface chemistry, influence biodistribution, placental transport, tissue accumulation, and toxicity. We summarize the major molecular and cellular mechanisms implicated in fetotoxicity, highlighting oxidative stress, apoptosis, autophagy, and DNA damage as recurring pathways identified across experimental studies. These interconnected processes contribute to placental dysfunction, impaired fetal growth, developmental abnormalities, and adverse pregnancy outcomes. We also compare findings across different classes of nanoparticles, including metal, metal oxide, carbon-based, and polymeric nanomaterials, identifying both shared toxicological mechanisms and material-specific effects. Evidence from animal models demonstrates that susceptibility varies according to nanoparticle properties, exposure conditions, and species, underscoring the complexity of nanoparticle–biological interactions and the limitations of extrapolating experimental findings directly to humans. Overall, the available evidence indicates that nanoparticle exposure during pregnancy represents a potential risk to fetal health, although important knowledge gaps remain regarding human exposure and long-term developmental outcomes. A better understanding of the mechanisms underlying nanoparticle-induced fetotoxicity is essential for improving human health risk assessment, refining experimental models, informing regulatory policies, and supporting the safe-by-design development of nanomaterials. Such knowledge will help ensure the responsible application of nanotechnology while minimizing potential risks during pregnancy. Finally, this review is distinguished by its integrated analysis of how the chemical characteristics of nanoparticles govern placental transfer and the mechanistic pathways of fetotoxicity across multiple nanomaterial classes, providing a unified framework that connects material properties with their potential for abnormal fetal development and adverse pregnancy outcomes. Full article

At no time in history has social change been as rapid as it is today. Developments in digital technologies have profoundly transformed everyday life, including motherhood experiences. This study examines intergenerational continuity and change in motherhood experiences related to pregnancy, childbirth, and childcare in Mardin, Türkiye, a culturally diverse region where long-standing traditional social relations coexist with rapid social transformation driven by modernization, urbanization, educational expansion, digitalization, and changing gender relations. This socio-cultural context provides a valuable setting for exploring how motherhood has both persisted and changed across generations. The study employed a qualitative phenomenological design based on subjective experiences. Semi-structured interviews were conducted with 60 women from two generations (mother–daughter pairs) using purposive and snowball sampling methods. The interview data were analyzed using MAXQDA 24 through thematic analysis. The findings indicate that motherhood continues to be shaped by enduring patriarchal norms while simultaneously being redefined through medicalization, professional expertise, digitalization, and the ideology of intensive mothering. Important continuities remained, particularly regarding maternal responsibility and gendered divisions of care, whereas substantial changes emerged in digitalization, medicalization, parental roles, family planning, anxiety, child-centeredness, and sources of parenting knowledge. Full article

Background: Intestinal parasitic infection is widespread worldwide and a serious public health problem. It is responsible for enormous morbidity and mortality around the world, particularly in developing countries. Artificial intelligence can create therapeutic suggestions that are individually tailored to each client’s unique traits. This study aimed to develop an intelligent system for mothers to provide future recommendations for more effective interventions to combat intestinal parasitic infections. Methods: A quasi-experimental research design (pre/post-test) was utilized to achieve the aim of the current study. The study was conducted at Dar Al Salam Family Health Center in Cairo Governorate, Egypt. A purposive sample of 200 mothers was included in this study. Two tools were used for data collection: First tool: Structured knowledge questionnaire that has four parts: Part I: Demographic data; Part II: Family history for intestinal parasitic infection; Part III: Home environment; Part IV: Mothers’ knowledge regarding intestinal parasitic infection. Second tool: Mothers’ reported preventive measures checklist. Results: There was a highly significant statistical difference in the mothers’ total knowledge level and total preventive measures regarding intestinal parasitic infection between pre and posttest. Moreover, there was highly significant statistical positive correlation between mothers’ total knowledge and total preventive measures at pre and post-test. The integration of large language model driven insights, quick engineering, and tailored treatments demonstrated favorable outcomes in enhancing mothers’ cleanliness routines. The novelty of this study lies in integrating K-Means clustering, large language models (GPT-4o), and prompt engineering to generate culturally tailored and behavior-specific preventive recommendations for mothers regarding intestinal parasitic infections. Conclusions: Preventive educational programs have a significant positive effect on improving mothers’ knowledge and preventive measures to combat intestinal parasitic infections. This study effectively underscores the significance of artificial intelligence-driven analysis and large language models in producing tailored suggestions to enhance mothers’ hygiene routines. Full article

Objectives: Despite the critical role fathers play in family health decisions, most research on HPV vaccination focuses predominantly on mothers. This study examines gender differences in HPV knowledge and vaccination attitudes among Greek parents, addressing a significant gap in the literature. Methods: A cross-sectional study using convenience sampling was conducted in waiting rooms of public primary healthcare settings in the Larissa prefecture of central Greece, between September and December 2024. Of 250 distributed questionnaires, 208 were returned (response rate: 83%), of which 192 were eligible for analysis. The analysis compares responses from fathers (n = 42) and mothers (n = 150) regarding HPV knowledge, intentions to vaccinate their sons, and general vaccine attitudes; no explicit restriction to one respondent per family was applied. Statistical comparisons employed chi-square tests, Fisher’s exact test, and binary logistic regression. Results: Fathers demonstrated significantly lower HPV awareness compared to mothers (42.9% vs. 64.0%, χ² = 10.907, p = 0.004). Vaccination intentions for sons were similar between groups (fathers: 85.7%, mothers: 85.3%, p = 0.540). No statistically robust association between HPV awareness and vaccination intention was identified in either group, likely reflecting the high overall intention rates and limited outcome variability. Binary logistic regression identified female sex as the only significant independent predictor of HPV awareness (OR = 2.26, 95% CI: 1.12–4.58, p = 0.024). Conclusions: While fathers exhibit significantly lower HPV knowledge than mothers, they demonstrate equal willingness to vaccinate their sons. These findings suggest that knowledge gaps do not necessarily translate to vaccine hesitancy, but highlight the need for targeted, father-inclusive health education interventions. Public health programs should actively engage fathers in HPV vaccination discussions to capitalize on their positive vaccination intentions while addressing their information needs. Full article

Background: Childhood vaccination remains the cornerstone of public health strategies, substantially reducing global morbidity and mortality, yet suboptimal uptake persists in many settings. In South Africa, the challenge is evident, with persistent outbreaks of vaccine-preventable diseases. Addressing localised immunisation shortfalls requires elucidating the complex interplay of factors beyond conventional access barriers. This qualitative study provides context-specific insights into the behavioural and social drivers influencing childhood vaccination uptake among caregivers in Cape Town, South Africa. Methods: Utilising an exploratory qualitative research design, thematic analysis was applied to interview data (n = 25 caregivers) collected via a purposive sampling strategy designed to capture maximum variation in experiences within targeted low-uptake subdistricts. Interpretation of the data was systematically guided by the World Health Organization’s Behavioural and Social Drivers (BeSD) framework. The latter consists of four domains, namely, “Thinking and Feeling”, “Social Processes”, “Motivation”, and “Practical Factors”. Findings: Analysis across BeSD domains reflected a pattern of the intention–behaviour gap, where caregivers are motivated for vaccination but face structural and practical barriers affecting timely uptake. In the Thinking and Feeling domain, widespread conviction regarding the vital benefits of vaccination co-existed with significant anxiety concerning minor side effects (e.g., pain and fever), which sometimes precipitated missed subsequent appointments. Caregivers frequently accept immunisation as a social routine despite having limited knowledge of the diseases it prevents. Social Processes demonstrated that while decision-making authority rested primarily with mothers, compliance relied on the delegation of logistical responsibilities to extended family members. Critically, reports of poor communication, judgment, or negative attitudes among healthcare workers undermined trust and acted as barriers to sustained engagement. Within the Practical Factors domain, structural constraints frequently overshadowed high intent, with pervasive issues such as long waiting times and financial costs cited as the main reasons for missed appointments. Conclusions: Participants generally expressed strong acceptance of vaccination, but attainment of optimal coverage is constrained by systemic failures in patient–provider communication and persistent logistical barriers within the public healthcare delivery system. Strategic public health interventions must therefore move beyond addressing only attitudinal opposition to prioritise targeted efforts that mitigate structural constraints and reinforce personalised, empathetic communication to sustain caregiver confidence and adherence. Full article

PACS1 Syndrome is an ultra-rare neurodevelopmental disorder characterized by intellectual disability, behavioral disturbances, and multisystem involvement. While clinical knowledge is growing, its impact on quality of life (QoL) has not been systematically evaluated, and it is critical to understand the lived experience and psychosocial well-being of these individuals beyond strictly medical outcomes. This study aimed to assess QoL in individuals aged 4–21 years with PACS1 Syndrome using the validated KidsLife scale, proxy-reported by primary caregivers, given the intellectual disabilities and communicative limitations of this population. Twenty-one participants from Spain and other countries were recruited through the Spanish PACS1 Association, and 39 questionnaires from mothers and fathers were analyzed. The KidsLife scale provides standardized scores across eight QoL domains and a global QoL index (QoLI). The mean QoLI was 48.1 ± 28.3, slightly below the median for individuals with intellectual disability, but higher than other neurodevelopmental disorders such as Cornelia de Lange Syndrome. The findings revealed a pattern: while domains related to social inclusion, rights, and physical and material well-being were relatively preserved, reflecting adequate care and access to resources, the most significant compromises were observed in autonomy-related domains, specifically self-determination, interpersonal relationships, and personal development. Most individuals showed a high degree of dependency, and those with greater dependency exhibited lower QoL scores. This situation led more than half of families to reduce their working hours, with caregiving responsibilities disproportionately falling on mothers. Although no statistically significant differences were found between parental ratings, mothers tended to report higher QoL. These findings reflect the substantial functional impact of PACS1 Syndrome and emphasize the need for multidisciplinary support to improve autonomy, social participation, and overall well-being. Full article

Intergenerational trauma significantly affects the health and mental health of African American families, particularly women whose lives are shaped by systemic inequities and historical oppression. This scoping review examines how trauma and resilience are transmitted across generations in African American communities, with a focus on dyads such as mother–child and mother–daughter relationships and a conceptual grandmother–mother–daughter triad. The review aims to identify mechanisms of trauma transmission and resilience and to inform culturally responsive, multigenerational interventions. Peer-reviewed studies published between 2012 and 2025 were identified that included African American caregivers and children and addressed biological, psychological, social, cultural, and resilience dimensions of intergenerational processes. Data were synthesized using a dimensional conceptual analysis approach. Findings indicate that intergenerational trauma is perpetuated through chronic stress and discrimination, maternal mental health challenges, family structure and caregiving strain, and cultural narratives about strength and self-reliance. At the same time, resilience is transmitted through sensitive caregiving, spirituality and faith, social and kin support, racial socialization, and economic survival strategies that draw on cultural and historical knowledge. These results underscore the importance of addressing intergenerational trauma holistically by integrating dyadic evidence within a broader conceptual triadic framework. Culturally responsive, multigenerational interventions that leverage family and community strengths and make space for emotional vulnerability are essential for interrupting cycles of trauma and fostering healing within African American families. Full article

Aim: Traumatic dental injuries (TDI) in children are a common but often underestimated emergency. Parental knowledge and timely response are crucial for successful treatment. This study aimed to evaluate parental knowledge, experiences, and awareness regarding dental trauma management and the use of protective mouthguards. Methods: A cross-sectional study was conducted using a self-administered questionnaire among 333 parents in dental clinics in Split and Zagreb, Croatia. The questionnaire assessed sociodemographic data, parental knowledge of TDIs, and prior experience with dental trauma. Statistical analysis included chi-square test (p < 0.05). Results: The overall level of parental knowledge regarding traumatic dental injuries was generally low (7.6 out of 15 points). Almost all parents correctly identified the age when children have primary or permanent teeth. However, less than half knew that an avulsed primary tooth should not be replanted, while about three-quarters recognized that professional help should be sought within 30 min after trauma. Overall, 43.5% of parents reported that their child had experienced dental trauma, most often affecting primary teeth (60.7%), particularly the maxillary central incisor (76.6%). Mothers demonstrated significantly higher knowledge than fathers (p = 0.025), and prior experience or information about dental trauma significantly improved awareness (p < 0.001). Although 54.3% of respondents were unaware of the purpose of dental shields, 82.3% considered them necessary during contact sports, yet only 12.9% reported that their child actually uses them. Conclusions: Within the limitations of this clinic-based study, the findings indicate gaps in parental knowledge regarding the appropriate management of dental trauma. Strengthening parents’ understanding of emergency response and preventive measures may support timelier and appropriate care and contribute to improved outcomes for children experiencing traumatic dental injuries. Full article

Background/Objectives: Maternal mental health concerns are a leading cause of maternal morbidity and mortality, disproportionately impacting Black mothers in the United States. Structural racism and social determinants of health contribute to increased risks of perinatal mental health issues, limited access to formal services, and adverse health outcomes for Black mothers. While formal mental health services are underutilized, Black mothers employ a variety of culturally relevant and context-specific strategies to support their mental health. This study seeks to understand the barriers, preferences, and experiences that guide their decision-making and inform culturally responsive care. Methods: This qualitative study employed thematic analysis of in-depth interviews conducted with 12 Black mothers aged 20–39 residing in a midwestern metropolitan area. The research explored individual experiences, preferences for support, and perspectives on healthcare to identify pathways for advancing mental health equity. Results: Three major themes emerged: (1) Expanding conceptions of mental health support beyond traditional services, emphasizing preferences for culturally congruent, convenient, and stress-decreasing interventions; (2) The salience of past experiences and identities in shaping support preferences and decisions; (3) What healthcare professionals can do, the knowledge and skills healthcare professionals can gain, and the actions that they can to become more helpful to Black mothers. The importance of healthcare professionals embodying nonjudgmental, patient, and caring attributes, as well as strengths-based, culturally responsive approaches in care. Conclusions: Advancing mental health equity for Black mothers requires increased awareness of existing disparities, barriers to care, and the strengths embedded within their communities. This research provides actionable insights for healthcare providers, policy makers, and researchers to identify, assess, and respond to the unique needs of Black mothers through culturally responsive and participatory approaches. Findings have implications for intervention design, theory development, and policy reform to improve mental health outcomes. Full article

Introduction: Although childhood fever is a common and typically self-limiting clinical presentation, it imposes a substantial emotional and psychological burden on caregivers, especially mothers, primarily due to enduring practices and beliefs that diverge from contemporary evidence-based medical guidelines. Objective: The aim was to investigate how families perceive pediatric fever, identify the factors influencing their caregiving decisions, and examine their experiences across various healthcare settings. Methodology: A qualitative study employing an ethnomethodological approach was conducted at a tertiary care hospital in Spain. The study included ten caregivers (nine mothers and one father) of children presenting with fever. Data were collected through in-depth interviews and field diary observations. Analysis was performed using a combination of inductive and deductive methods, supported by the Atlas.ti 25.0.1 version software. Results: Mothers perceive childhood fever as a disruptive event necessitating rapid decision-making, shaped by emotional responses, prior experiences, culturally transmitted knowledge, and social context. Common caregiving practices included routine administration of antipyretics, application of physical remedies, and early utilization of emergency healthcare services. The caregiver–healthcare professional relationship was characterized by ambivalence, highlighting the need for enhanced health education and greater emotional support for caregivers. Conclusions: Childhood fever represents both a clinical condition and a sociocultural phenomenon. Gaining insight into family practices and beliefs enables the development of more effective, empathetic educational interventions, which can enhance caregiving practices and mitigate parental anxiety. Reporting method: Standards for Reporting Qualitative Research (SRQR) guidelines. Full article

Objective: Our objectives were as follows: (1) to compare cognitive, motor, language, and social performance, parenting skills, and mother–child interactions among preterm children exposed to different feeding practices (exclusive breastfeeding, mixed feeding, and formula feeding) during the first two years of life; and (2) to examine the associations between the feeding type, risks and protective factors, and neurodevelopmental outcomes (cognitive, motor, language, and social domains) in these population in the first two years of life. Method: A total of 116 preterm children (<32 weeks gestational age—GA) and their mothers were recruited from a public hospital in southern Brazil and followed at a neonatal clinic. Children were organized into three groups based on feeding at NICU discharge (exclusive breastfeeding, formula, or mixed feeding). Assessments were conducted at 4, 8, 12, 18, and 24 months of corrected age using the BSITD-III and additional validated instruments measuring environment stimulation, daily activities, maternal knowledge, breastfeeding experience, and mother–child interactions. Results: Clinical and sociodemographic factors were similar across feeding groups. Group comparisons showed that exclusive breastfeeding was associated with higher motor scores at 12 (p = 0.015) and 24 (p = 0.026) months, higher cognitive scores at 12 (p = 0.049) and 18 (p = 0.013) months, and higher language scores at 12 (p < 0.001) and 18 (p = 0.014) months compared to formula feeding. In the social domain, the exclusive breastfeeding group consistently outperformed the formula group across most time points, although a temporary dip was observed at 18 months. Mixed feeding showed intermediate patterns. Children in the exclusive breastfeeding group also demonstrated higher maternal parenting skills and stronger mother–child interactions across time. Longitudinal analyses revealed that the quality of mother–child interactions predicted better motor, cognitive, language, and social outcomes, while clinical vulnerabilities (e.g., prolonged NICU stay, BPD, leukomalacia) negatively influenced trajectories. Conclusions: Exclusive breastfeeding and responsive mother–child interactions emerged as consistent protective factors across developmental domains, buffering the adverse effects of clinical risks. Breastfeeding not only enhances maternal engagement but also contributes to more favorable motor, cognitive, language, and social outcomes in preterm children. Supporting breastfeeding and promoting sensitive caregiving practices are essential strategies for optimizing developmental trajectories and improving the quality of life in this vulnerable population. Full article

The intersection of autism and motherhood/parenthood remains largely underexplored, particularly within the Spanish context. Autistic mothers and birthing parents are often silenced, with limited representation and scarce accessible information, contributing to a broader social and institutional unawareness. This study explores the postpartum experiences of autistic and non-autistic mothers during the first two years following childbirth. Twelve semi-structured interviews were conducted with six autistic and six non-autistic mothers and analyzed using Reflexive Thematic Analysis. Three key themes were constructed, as follows: (1) Ups and Downs: Navigating Emotional and Sensory Experiences, highlighting the intense sensory and emotional load of early motherhood; (2) Lack of Information and Support: The Root of Increased Vulnerability, addressing gaps in institutional support and knowledge; and (3) The Social Dimensions of Early Postpartum: Tensions and Expectations, focusing on family and societal pressures as well as identity struggles. While experiences overlapped in several areas, two tentative distinctions were observed, as follows: autistic mothers appeared to favor self-guided strategies (e.g., books, personal guidelines), whereas non-autistic mothers relied more on professional guidance; additionally, autistic mothers expressed a stronger preference for autonomy, while non-autistic mothers often valued companionship. These findings underscore the urgent need for healthcare professionals to receive training on autistic motherhood/parenthood and for the development of tailored postpartum care guidelines to ensure inclusive, responsive support. Full article

Background/Objectives: Sugar added to pediatric oral medications may increase the risk of dental caries and erosion. Parental awareness and practices play a crucial role in minimizing the oral health risks associated with such medications. Therefore, the aim was to assess parents’ knowledge, attitudes, and practices regarding the cariogenic potential of pediatric oral medications in the Kingdom of Saudi Arabia. Methods: A cross-sectional study was conducted using an online questionnaire. Parents who had at least one child between 2 and 12 years old were included. Participants were categorized into three groups based on the long-term intake of medications and their child’s health status. Group 1: Parents of children with chronic diseases on long-term medications. Group 2: Parents of healthy children on long-term medications. Group 3: Parents of healthy children not on long-term medications. Results: A total of 2195 responses were collected. The majority of parents were aged 31–40 years. More than half of the mothers and fathers had a diploma or a university degree (59% and 54.3%, respectively). Although a high proportion of the parents (78–83%) were aware that medications often contained sugar, only 46–50% were aware of their cariogenic potential, while 27–38% speculated about their erosive potential. In terms of practices, most parents encouraged their children to drink water (70–71%) or rinse their mouths (14–20%) after medication intake. Conclusions: While most parents were aware that pediatric oral medications may contain sugar, there was a lack of proactive measures to mitigate their negative impact on oral health. Further studies are still needed to evaluate and improve public awareness and practices regarding the oral health risks associated with pediatric medications. Full article

With persistent racial inequities, cultural adaptations of health programs can promote equitable maternal mental health. Despite the intersecting identities of Black mothers with preterm birth combined with racial discrimination, previous mental health programs in the neonatal intensive care unit (NICU) are void of the sociocultural context that perpetuates racially motivated care. This study uses a two-round Delphi process to gather knowledge on the cultural appropriateness and content validity of the adapted Mothers and Babies Online Course, a United States Prevention Service Task Force-recommended intervention for managing mental health symptoms in pregnant and new mothers for Black mothers with preterm birth. The Black feminist theory and cultural adaptation strategies were used to conceptualize the adaptation process. Opinions were solicited from Black mothers and professionals based on predetermined criteria. Eleven participants, comprising eight mothers and three professionals, participated in Round One. Of these, only one professional did not participate in Round Two, totaling 10 participants who participated in Round Two. The participants rated the adapted program—eMB 4 Blackmamas, positively, and four themes emerged, substantiating the importance of culturally responsive mental health. The themes also offered additional feedback related to improving the program delivery. Including diverse stakeholders in mental health research offers unique and balanced insights into designing culturally appropriate programs to promote and protect Black maternal mental health in the NICU. Full article