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35 pages, 2146 KB  
Perspective
Rethinking Solitary Living in the True Shrikes (Family Laniidae): Territoriality, Cognitive Innovation, and Vulnerability
by Reuven Yosef
Birds 2026, 7(2), 26; https://doi.org/10.3390/birds7020026 - 21 Apr 2026
Viewed by 1576
Abstract
Solitary living is an evolutionarily widespread yet comparatively under-theorized social system, despite its occurrence across diverse animal taxa. Shrikes (family Laniidae) are small predatory passerines that combine raptorial behavior, strong territoriality, and predominantly solitary space use, making them a powerful model for [...] Read more.
Solitary living is an evolutionarily widespread yet comparatively under-theorized social system, despite its occurrence across diverse animal taxa. Shrikes (family Laniidae) are small predatory passerines that combine raptorial behavior, strong territoriality, and predominantly solitary space use, making them a powerful model for examining the ecology and evolution of solitary living. Here, I synthesize published work on shrike behavioral ecology and explicitly link these traits to the costs and benefits of a solitary lifestyle. I argue that shrikes exemplify how solitary species can offset the absence of social buffering through cognitive innovation, finetuned habitat selection, and flexible yet tightly bounded sociality. I then compare shrike ecology to solitary mammals and reptiles, highlighting convergent patterns in resource dispersion, spatial memory, risk management, and juvenile dispersal. I further examine how anthropogenic pressures, such as habitat fragmentation, climatic instability, and urbanization, interact with solitary life histories and review evidence from management interventions in both European farmland and North American systems that demographic recovery is achievable but remains contingent on addressing broader land-use conflicts and sources of adult mortality. Finally, I outline five interconnected research priorities—spanning cognitive ecology, trophic interactions, movement ecology, genomics, and formal comparative analyses—that would move shrike research from its current observational foundation toward a more experimental, mechanistic, and phylogenetically informed programme. By reframing shrikes as a model taxon for solitary living, this review aims to integrate avian behavioral ecology into broader comparative frameworks of social organization, cognition, and resilience under global change. Full article
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10 pages, 208 KB  
Article
Universal Newborn Screening for Familial Hypercholesterolaemia: Insights from Expectant Parents at a Tertiary Referral Centre in Queensland, Australia
by Caroline Bachmeier, Deborah A. Johnston, Andrew Kassianos, Karam M. Kostner and Helen Tanner
Lipidology 2026, 3(1), 9; https://doi.org/10.3390/lipidology3010009 - 8 Mar 2026
Viewed by 863
Abstract
Background: Familial hypercholesterolaemia (FH) is an inherited condition that substantially increases the risk of premature atherosclerotic cardiovascular disease (ASCVD). Despite effective therapies, many affected individuals remain undiagnosed. Incorporation of FH testing into newborn screening (NBS) is a potential strategy to increase detection. This [...] Read more.
Background: Familial hypercholesterolaemia (FH) is an inherited condition that substantially increases the risk of premature atherosclerotic cardiovascular disease (ASCVD). Despite effective therapies, many affected individuals remain undiagnosed. Incorporation of FH testing into newborn screening (NBS) is a potential strategy to increase detection. This study explores the attitudes of expectant parents toward NBS for FH. Methods: Expectant parents attending Obstetrics and/or Obstetric Medicine clinics at a tertiary referral centre were invited to participate in a semi-structured interview in person or via telephone. The interview explored views on screening children for FH in general, preferred timing of screening, opinions on integrating FH screening into routine NBS, acceptability of genetic testing in children and newborns, willingness to engage in family screening and any potential impact on participation in routine NBS programmes. Participants were also invited to discuss concerns and benefits. Results: All participants (n = 22) supported screening children for FH with the majority (n = 19, 86%) preferring screening during the newborn period, and all but one (n = 21, 95%) supporting adding FH to routine NBS. All participants (n = 22, 100%) considered genetic testing for FH acceptable for children, 21 (95%) considered it acceptable for newborns. All participants would partake in extended family screening and none indicated that including FH genetic testing would reduce their willingness to engage in routine NBS. Concerns raised by participants included administering lipid-lowering therapy to children and potential post-diagnosis stress and anxiety. All participants reported that a diagnosis would not affect parent–child bonding. Key perceived benefits raised by participants included early diagnosis and prevention of heart disease, family screening, and broader health system and community advantages. Conclusions: Expectant parents demonstrated strong support for FH NBS and indicated no negative impact on uptake of routine NBS. Further work is needed to address parental concerns and guide implementation strategies. Full article
20 pages, 461 KB  
Article
Sustainable Intergenerational Contact Patterns and Health Equity: Comparing Migrant and Non-Migrant Older Adults in Europe
by Claudia Vogel, Aviad Tur-Sinai and Harald Künemund
Sustainability 2025, 17(21), 9860; https://doi.org/10.3390/su17219860 - 5 Nov 2025
Viewed by 1014
Abstract
Intergenerational contact is a key component of the informal support systems that contribute to the wellbeing of older adults. As societies age and migration patterns diversify family structures, understanding how contact is sustained across generations becomes increasingly relevant for health equity and the [...] Read more.
Intergenerational contact is a key component of the informal support systems that contribute to the wellbeing of older adults. As societies age and migration patterns diversify family structures, understanding how contact is sustained across generations becomes increasingly relevant for health equity and the sustainability of care systems. In this study, we conceptualise sustainability not in environmental terms but as social and health-system sustainability—that is, the long-term ability of families and care systems to maintain intergenerational ties, ensure equitable access to support, and remain resilient under demographic and social pressures. Drawing on theories of intergenerational solidarity and social capital, this study situates contact as both a resource for individual wellbeing and a pillar of care sustainability in diverse societies. We examine the frequency of contact between parents and adult children among adults aged 50 and above, comparing migrant and non-migrant populations across 25 European countries. Using data from Waves 7, 8, and the COVID-19 wave of the Survey of Health, Ageing and Retirement in Europe (SHARE), we assess both in-person and digital forms of contact before and during the pandemic. Results show that older migrants have less frequent contact with parents but more frequent contact with children than do non-migrants, with similar patterns attested across repeated cross-sections (2017, 2019, 2021). The strong contact observed in each cross-section, facilitated by digital tools, implies resilient family ties under public-health stress. However, resilience is uneven: weaker contact with parents among migrant populations reflects structural barriers such as visa restrictions, caregiving responsibilities, discrimination, language barriers, and unequal digital access. Moreover, differences in access and proficiency with digital tools suggest that digital contact did not compensate equally across groups. These findings underscore the importance of sustainable and inclusive strategies in ageing and health policy. Specifically, targeted digital literacy programmes for older migrants, policies supporting transnational caregiving, affordable internet access, mobility solutions, and anti-discrimination measures in family visitation are crucial to reducing inequities. Full article
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20 pages, 305 KB  
Article
What Are the Experiences of Those Engaged in Professional Youth Work in a Formal Education College in the UK?
by Simon Craig Williams
Youth 2025, 5(3), 90; https://doi.org/10.3390/youth5030090 - 29 Aug 2025
Cited by 1 | Viewed by 3221
Abstract
Further Education in the UK aims to provide strong educational outcomes for young people. However, some young people are facing a range of complex issues that often require extra support or different interventions. A college developed a programme that combined professional youth work, [...] Read more.
Further Education in the UK aims to provide strong educational outcomes for young people. However, some young people are facing a range of complex issues that often require extra support or different interventions. A college developed a programme that combined professional youth work, support services, and formal teaching to see if this approach would improve outcomes. This research took a mixed-method approach to explore if the professional youth work approach has any impact on outcomes for young people. The research showed that professional youth work was considered a unique approach that allowed for more safeguarding concerns to be disclosed, and greater support for additional needs, resulting in improved attendance at college, and better outcomes in Math and English GCSE results. The qualitative data identified five themes that highlighted the effectiveness of this approach: soft skill development, improved familial relationships, unique youth work approaches, effective professional adult relationships, and cohesive professional working. The research concludes that youth work has a positive influence on young people’s formal education experience but must be recognized and supported to be effective. Full article
24 pages, 1131 KB  
Article
Impact of a Brief Family Skills Training Programme “Strong Families” in a Low–Middle-Income-Country: Cambodia
by Aala El-Khani, Dina Idriss-Wheeler, Santana Chea, Shatha Darwish and Wadih Maalouf
Children 2025, 12(6), 728; https://doi.org/10.3390/children12060728 - 31 May 2025
Viewed by 2006
Abstract
Introduction: Children living in low- and middle-income countries (LMICs) are at increased risk of emotional and behavioural challenges, often linked to caregiver stress and harsh parenting practices. Strengthening family functioning through parenting interventions is a critical strategy for improving child mental health in [...] Read more.
Introduction: Children living in low- and middle-income countries (LMICs) are at increased risk of emotional and behavioural challenges, often linked to caregiver stress and harsh parenting practices. Strengthening family functioning through parenting interventions is a critical strategy for improving child mental health in these settings. The Strong Families programme was developed as a light-touch family skills intervention for high-stress, low-resource environments. Methods: A multisite pilot feasibility and acceptability study was conducted in Cambodia with 40 families. Caregivers and children (aged 8–15) participated in a 3-week intervention, with one session per week. Data were collected using the Parenting and Family Adjustment Scales (PAFAS), the Strengths and Difficulties Questionnaire (SDQ), and the Child and Youth Resilience Measure (CYRM-R) at baseline, two weeks, and six weeks post-intervention. Repeated measures ANOVA and Friedman’s ANOVA were used to assess changes over time. Results: Caregivers showed statistically significant improvements across all PAFAS subscales. For example, coercive parenting scores decreased from 8.13 at baseline to 4.00 post-intervention and 2.33 at follow-up (F(2,78) = 59.76, p < 0.001). Positive encouragement improved from 2.60 to 1.00 and 0.33, respectively (F(2,78) = 27.05, p < 0.001). In terms of child outcomes, SDQ total difficulty scores declined from 20.68 to 16.55 over time (F(2,78) = 7.58, p = 0.001). Emotional problems dropped from 5.60 to 2.38 (χ2(2) = 21.17, p < 0.001), and conduct problems from 4.33 to 2.68 (F(2,78) = 11.35, p < 0.001). Prosocial behaviours increased from 5.60 to 9.45 (F(2,78) = 69.93, p < 0.001). Personal resilience scores rose from 32.70 at baseline to 47.48 at follow-up (χ2(2) = 62.42, p < 0.001), while caregiver resilience improved from 23.63 to 33.63 (χ2(2) = 61.83, p < 0.001). Improvements were particularly pronounced among families with the highest baseline challenges. Conclusions: Findings indicate that the Strong Families programme is feasible and effective in improving parenting skills, family adjustment, child mental health, and resilience in a Cambodian LMIC context. These results reinforce the programme’s potential for integration into broader national strategies to improve psychosocial outcomes for families in high-stress, low-resource environments. Full article
(This article belongs to the Special Issue Advances in Child–Parent Attachment and Children's Peer Relations)
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30 pages, 709 KB  
Article
Partnering with Young Parents to Improve Early Hearing Detection and Intervention Programmes
by Genevieve Choi, Holly Teagle, Suzanne C. Purdy and Andrew Wood
Children 2025, 12(5), 629; https://doi.org/10.3390/children12050629 - 13 May 2025
Viewed by 1253
Abstract
Background: Early Hearing Detection and Intervention (EHDI) programmes must partner effectively with families navigating complex circumstances. Adolescent parents (APs) in Teen Parent Units (TPUs) represent a dynamic group demonstrating resilience as they balance childcare, education, and their own developmental journeys. This study explores [...] Read more.
Background: Early Hearing Detection and Intervention (EHDI) programmes must partner effectively with families navigating complex circumstances. Adolescent parents (APs) in Teen Parent Units (TPUs) represent a dynamic group demonstrating resilience as they balance childcare, education, and their own developmental journeys. This study explores their understanding of infant hearing, sources of knowledge, and the development of an effective teaching tool. Methods: A qualitative study was conducted with AP learners at a TPU in Aotearoa, New Zealand. Following a period of relationship-building, three focus groups were held. Data were analysed using content analysis and reflexive thematic analysis. Results: AP learners demonstrated a strong awareness of multisensory interactions. Major sources of knowledge included their relational interactions with people they trusted (midwives and family members), rather than social media. Four key themes emerged in the teaching tool’s development: (1) the effectiveness of multimodal teaching tools, (2) the benefits of peer-supported group learning, (3) the impact of high strain, and (4) the importance of Te Ao Māori (a Māori worldview). Conclusions: This study highlights the importance of culturally grounded health interventions for families navigating complex life circumstances. Group-based learning fostered peer support, hands-on multimodal teaching was effective, and culturally relevant materials and pedagogies enhanced engagement. EHDI programs may more effectively support infants from families navigating complex circumstances by collaborating with trusted support people, integrating with wraparound care networks, utilising safe and familiar settings, and delivering interventions in an engaging and culturally appropriate manner. Full article
(This article belongs to the Section Pediatric Otolaryngology)
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22 pages, 557 KB  
Article
Feasibility of Tiyanjane: A Family–School–Community Intervention Promoting Parental Involvement in the Education of Children with Disabilities in Malawi
by David John Musendo, Sarah Polack, Blessings Chirwa, Ellen S. Nkambule, Claire Mukakagame, Magnolia Chikanya, Thomas A. Nkhonjera and Tracey Smythe
Soc. Sci. 2025, 14(5), 265; https://doi.org/10.3390/socsci14050265 - 25 Apr 2025
Cited by 1 | Viewed by 2292
Abstract
Evidence-based and theory-informed interventions focusing on parents of children with disabilities in low-income countries are scarce. This study examined the feasibility of Tiyanjane, a 12-week pilot intervention developed to promote parental involvement in the education of children with disabilities in Malawi. A mixed-method [...] Read more.
Evidence-based and theory-informed interventions focusing on parents of children with disabilities in low-income countries are scarce. This study examined the feasibility of Tiyanjane, a 12-week pilot intervention developed to promote parental involvement in the education of children with disabilities in Malawi. A mixed-method approach was employed based on five aspects of Bowen’s feasibility framework: acceptability, demand, implementation, practicality, and limited efficacy. Twenty-one participants (13 caregivers, four teachers, and four local leaders) participated in the study. Standardised measures, namely the Parent and Family Adjustment Scale (PAFAS) and the Multidimensional Scale of Perceived Social Support (MSPSS), were employed to evaluate changes in parental practices, adjustments, and perceived social support. Qualitative data were collected using focus groups and in-depth interviews to assess the feasibility of the intervention. Tiyanjane showed promise in promoting parental involvement in the education of children with disabilities. The intervention demonstrated high fidelity, achieving 100% retention and 95% attendance. Local resources, commitment from participants and facilitators, and strong family school–community ties enabled the practicality and execution of the intervention. Significant improvements were observed in the PAFAS and MSPSS scores across the assessed post-intervention outcomes. Minor logistical issues including resource and implementation challenges were reported. Tiyanjane was feasible for the facilitators and participants in the Malawian context. Further studies are needed to assess the programme’s adaptation, integration, and expansion in other contexts before scaling up. Full article
(This article belongs to the Special Issue Nurturing Bridges: Embracing Growth and Connecting Life for Children)
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22 pages, 353 KB  
Article
Exploring Managers’ Insights on Integrating Mental Health into Tuberculosis and HIV Care in the Free State Province, South Africa
by Christo Heunis and Gladys Kigozi-Male
Int. J. Environ. Res. Public Health 2024, 21(11), 1528; https://doi.org/10.3390/ijerph21111528 - 18 Nov 2024
Cited by 1 | Viewed by 2723
Abstract
The integration of mental health (MH) services into tuberculosis (TB) and HIV care remains a significant challenge in South Africa’s Free State province. This study seeks to understand the perspectives of public health programme managers on the barriers to such integration and to [...] Read more.
The integration of mental health (MH) services into tuberculosis (TB) and HIV care remains a significant challenge in South Africa’s Free State province. This study seeks to understand the perspectives of public health programme managers on the barriers to such integration and to identify potential strategies to overcome these challenges. Data were collected between February and October 2021 using qualitative methods including four individual semi-structured interviews and two focus group discussions with a total of 15 managers responsible for the MH, primary healthcare, TB, and HIV programmes. Thematic data analysis was guided by an adapted version of the World Health Organization’s “building blocks” framework encompassing “service delivery”, “workforce”, “health information”, “essential medicines”, “financing”, and “leadership/governance”. Additionally, the analysis underscored the crucial role of “people”, acknowledging their significant contributions as both caregivers and recipients of care. Managers highlighted significant concerns regarding the insufficient integration of MH services, identifying structural barriers such as inadequate MH management structures and staff training, as well as social barriers, notably stigma and a lack of family treatment adherence support. Conversely, they recognised strong management structures, integrated screening, and social interventions, including family involvement, as key facilitators of successful MH integration. The findings emphasise the need for a whole-system approach that addresses all building blocks while prioritising the role of “people” in overcoming challenges with integrating MH services into TB and HIV care. Full article
18 pages, 678 KB  
Systematic Review
Is Resilience a Trait or a Result of Parental Involvement? The Results of a Systematic Literature Review
by Karolina Eszter Kovács, Beáta Dan, Anett Hrabéczy, Katinka Bacskai and Gabriella Pusztai
Educ. Sci. 2022, 12(6), 372; https://doi.org/10.3390/educsci12060372 - 26 May 2022
Cited by 19 | Viewed by 13722
Abstract
Investigating parental involvement has moved to the foreground of research in the past two decades, and research results focusing on family engagement claim its positive impact on children’s academic and non-academic achievement. However, less is known about parental involvement in the case of [...] Read more.
Investigating parental involvement has moved to the foreground of research in the past two decades, and research results focusing on family engagement claim its positive impact on children’s academic and non-academic achievement. However, less is known about parental involvement in the case of families with children with special needs. In our systematic review, we collected studies focusing on parental involvement which emphasised the role of resilience. Using the EBSCO Discovery Service, a total of 467 abstracts from 85 databases were screened, of which 28 papers published between 1984 and 2021 met the research criteria. Papers vary according to methodology (interview, focus group conversation, survey, case study, intervention programme and good practice) and disability group (general or specific). Resilience is interpreted in two ways: as a personality trait or a consequence. Four types of papers could be detected which dealt with the target group, specifically papers focusing on children, parents, teachers and professionals, and intervention programmes with multiple focuses. In conclusion, resilience is an element of parental involvement, either as a personality trait or a result. It is indispensable for the successful development of children in terms of academic and non-academic achievement as well. Programmes providing a wider collaboration with actors involved in the development of children seem to be more effective. In general practice, whether the goal is to build upon resilience as a personality trait or target its development as a consequence, strong collaboration between the parents, teachers and professionals concerned in the process can significantly contribute to the child’s psychological, emotional and academic development. Full article
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7 pages, 297 KB  
Communication
Bridging the Gap between the Pressing Need for Family Skills Programmes in Humanitarian Settings and Implementation
by Aala El-Khani, Rachel Calam, Karin Haar and Wadih Maalouf
Int. J. Environ. Res. Public Health 2022, 19(4), 2181; https://doi.org/10.3390/ijerph19042181 - 15 Feb 2022
Cited by 6 | Viewed by 3713
Abstract
A supportive environment with nurturing caregivers is essential for the healthy development of children. For children who have been exposed to extreme stress, such as humanitarian contexts, the need for strong, healthy, nurturing caregiver relationships may assume even greater importance. Much research has [...] Read more.
A supportive environment with nurturing caregivers is essential for the healthy development of children. For children who have been exposed to extreme stress, such as humanitarian contexts, the need for strong, healthy, nurturing caregiver relationships may assume even greater importance. Much research has been building to position family skills interventions as a key tool in encouraging safe and supporting relationships between caregivers and children, thus preventing many problem behaviours and poor mental health. While there is substantial evidence of the effectiveness of family skills interventions in high-income and stable contexts, evidence of interventions that have been tested in humanitarian and challenging settings, such as contexts of refugee and displacement, are far fewer. Despite the role that family skills interventions can play in protecting children from current and future challenges, there is a significant lack of such interventions being utilised in humanitarian settings. We put forward seven likely reasons for this lack of uptake. Furthermore, the Strong Families programme, a UNODC family skills intervention, is presented as an example of an intervention that aims to bridge this gap of interventions that meet the need for humanitarian and contexts of extreme stress. More research is needed to unpack the content, delivery mechanisms and reach of family skills programmes to further aid programme developers in investing in efforts that might provide significant sustained impact for families in humanitarian contexts. Full article
(This article belongs to the Special Issue Ensure Healthy Lives and Promote Wellbeing for All at All Ages)
38 pages, 2190 KB  
Article
Impact of a Brief Family Skills Training Programme (“Strong Families”) on Parenting Skills, Child Psychosocial Functioning, and Resilience in Iran: A Multisite Controlled Trial
by Karin Haar, Aala El-Khani, Gelareh Mostashari, Mahdokht Hafezi, Atoosa Malek and Wadih Maalouf
Int. J. Environ. Res. Public Health 2021, 18(21), 11137; https://doi.org/10.3390/ijerph182111137 - 23 Oct 2021
Cited by 17 | Viewed by 6852
Abstract
Caregivers have a key role in protecting children’s wellbeing, and, with appropriate skills, can prevent a multitude of negative social outcomes, particularly in challenged or humanitarian settings. Accordingly, the Strong Families programme was designed as a light touch family skills programme, with a [...] Read more.
Caregivers have a key role in protecting children’s wellbeing, and, with appropriate skills, can prevent a multitude of negative social outcomes, particularly in challenged or humanitarian settings. Accordingly, the Strong Families programme was designed as a light touch family skills programme, with a focus of supporting caregiving during stressful situations. To evaluate the short-term impact of the Strong Families programme, we performed a time-convenience, randomized, controlled trial in Iran. A total of 292 families (63% from Iranian decent, 39% from Afghan decent, and 1% other), with children aged eight to twelve years, were recruited through ten centers in Iran and allocated to an intervention (n = 199) or waitlist/control group (n = 93). The two groups did not differ demographically at baseline. We assessed families prospectively, through three scales, PAFAS (parenting and family adjustment scales), SDQ (strengths and difficulties questionnaire), and CYRM-R (child and youth resilience measure). Caregivers in the intervention group improved (highly) statistically significantly on all but one PAFAS subscales (parental consistency, coercive parenting, positive encouragement, parental adjustment, family relationships, and parental teamwork), which was not noted in the waitlist group. On the SDQ, there were (highly) significant positive changes in scores in the intervention group on all sub-scales and the “total difficulty scale“, whereas the waitlist/control group also improved on three (prosocial, conduct problems, and hyperactivity) of the five SDQ subscales. Children originating from Afghanistan improved significantly on the overall resilience scale of the CYRM-R in the intervention group, but not in the waitlist/control group. Overall, all our stratified results of the different scales reflect an accentuated improvement in families with higher levels of problems at baseline. Our comparative results indicated a strong alignment of the strong families programme with its intended short-term impact, per its logical frame on parenting practices and family management skills, children behaviour, caregivers and children mental health, and capacity to cope with stress. We postulate that the potential nudging or diffusion of knowledge (cross-contamination between intervention and waitlist/control group) at the community level could explain improvements in the waitlist/control group on some indicators, however, further research on this is recommend. Full article
(This article belongs to the Special Issue Ensure Healthy Lives and Promote Wellbeing for All at All Ages)
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12 pages, 863 KB  
Article
The Impact of a Preterm Baby Arrival in a Family: A Descriptive Cross-Sectional Pilot Study
by María Jiménez-Palomares, María Fernández-Rejano, Elisa María Garrido-Ardila, Jesús Montanero-Fernández, Petronila Oliva-Ruiz and Juan Rodríguez-Mansilla
J. Clin. Med. 2021, 10(19), 4494; https://doi.org/10.3390/jcm10194494 - 29 Sep 2021
Cited by 17 | Viewed by 4508
Abstract
Background: The rate of premature births is increasing every day, with an estimated 15 million premature babies born worldwide each year. When a child is born prematurely, he or she is transferred to a Neonatal Intensive Care Unit (NICU), requiring special care on [...] Read more.
Background: The rate of premature births is increasing every day, with an estimated 15 million premature babies born worldwide each year. When a child is born prematurely, he or she is transferred to a Neonatal Intensive Care Unit (NICU), requiring special care on an ongoing basis. The admission of the newborn to these units can negatively affect the family routine as it generates changes and requires adaptation to new roles. Objectives: The objective of the present study was to understand the effect of the arrival of a premature baby on the family, based on the parents’ perception. Methods: A cross-sectional descriptive observational study conducted by means of a self-administered online ad-hoc questionnaire which collected information related to the situation of the relatives of premature infants in the region of Extremadura (Spain). The questionnaire consisted of a total of 35 questions, divided into three sections: ‘family environment’, ‘stay in hospital’ and ‘return home’. Results: Among the 53 responses obtained from fathers and mothers, 44 were from mothers. 53.6% of the respondents felt a delay in the acquisition of their parental role and 86.8% were afraid for their baby. During hospital stay, most of the parents had to modify their routines (94.3%), 69.8% suffered from sleep disturbances, 84.9% changed their eating habits and 88.5% referred to loss of time for themselves. Once at home, the time it took to recover their family normality ranged from 4 to 11 months, while 84.9% of respondents neglected their personal appearance and more than half had to give up or reduce their working hours. Conclusion: The arrival of a premature baby has a strong impact on the parents’ family environment, altering their daily routines and occupations both in hospital and at home. If preterm care programmes take into account these possible occupational imbalances, it will not only meet the needs of the parents but also provide family-centred care. Full article
(This article belongs to the Section Obstetrics & Gynecology)
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16 pages, 2950 KB  
Article
Prognostic Impact of PD-L1 Expression in Malignant Salivary Gland Tumors as Assessed by Established Scoring Criteria: Tumor Proportion Score (TPS), Combined Positivity Score (CPS), and Immune Cell (IC) Infiltrate
by Hanno M. Witte, Niklas Gebauer, Daniela Lappöhn, Vincent G. Umathum, Armin Riecke, Annette Arndt and Konrad Steinestel
Cancers 2020, 12(4), 873; https://doi.org/10.3390/cancers12040873 - 3 Apr 2020
Cited by 43 | Viewed by 5749
Abstract
Background: Malignant neoplasms of the salivary glands are rare, and therapeutic options are limited. Results from recently published studies indicate a possible use for checkpoint inhibition in a subset of patients, but there are no established criteria for programme cell death ligand 1 [...] Read more.
Background: Malignant neoplasms of the salivary glands are rare, and therapeutic options are limited. Results from recently published studies indicate a possible use for checkpoint inhibition in a subset of patients, but there are no established criteria for programme cell death ligand 1 (PD-L1) scoring in salivary gland carcinomas (SGCs). Methods: In this retrospective study, we present a cohort of 94 SGC patients with full clinical follow-up. We included 41 adenoid cystic carcinomas (AdCC), 21 mucoepidermoid carcinomas (MEC), 16 acinic cell carcinomas (ACC), 12 adenocarcinomas, not otherwise specified (AC, NOS), 2 epithelial-myoepithelial carcinomas (EMC), one salivary duct carcinoma (SDC), and one carcinoma ex pleomorphic adenoma (CA ex PA). Subsequent histopathological analysis was performed with special emphasis on the composition of the immune cell infiltrate (B-/T-lymphocytes). We assessed PD-L1 (SP263) on full slides by established scoring criteria: tumor proportion score (TPS), combined positivity score (CPS) and immune cell (IC) score. Results: We identified significantly elevated CD3+, TP, CP, and IC scores in AC, NOS compared to AdCC, MEC, and ACC. CPS correlated with node-positive disease. Moreover, AC, NOS displayed IC scores of 2 or 3 in the majority (67%) of cases (p = 0.0031), and was associated with poor prognosis regarding progression-free (PFS) (p < 0.0001) and overall survival (OS) (p < 0.0001). CPS correlated with strong nuclear or null p53 staining in AC, NOS but not in other SGCs. Long-lasting partial remission could be achieved in one AC, NOS patient who received Pembrolizumab as third-line therapy. Conclusions: The current study is the first to investigate the use of established scoring criteria for PD-L1 expression in malignant salivary gland tumors. Our findings identify unique characteristics for AC, NOS among the family of SGCs, as it is associated with poor prognosis and might represent a valuable target for immune checkpoint inhibition. Full article
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20 pages, 241 KB  
Article
Do Children’s Health Resources Differ According to Preschool Physical Activity Programmes and Parental Behaviour? A Mixed Methods Study
by Elena Sterdt, Natalie Pape, Silke Kramer, Sebastian Liersch, Michael Urban, Rolf Werning and Ulla Walter
Int. J. Environ. Res. Public Health 2014, 11(3), 2407-2426; https://doi.org/10.3390/ijerph110302407 - 26 Feb 2014
Cited by 7 | Viewed by 8842
Abstract
Preschool can have positive effects on the development of a healthy lifestyle. The present study analysed to what extent different conditions, structures and behavioural models in preschool and family—children’s central social microsystems—can lead to differences in children’s health resources. Using a cross-sectional mixed [...] Read more.
Preschool can have positive effects on the development of a healthy lifestyle. The present study analysed to what extent different conditions, structures and behavioural models in preschool and family—children’s central social microsystems—can lead to differences in children’s health resources. Using a cross-sectional mixed methods approach, contrast analyses of “preschools with systematic physical activity programmes” versus “preschools without physical activity programmes” were conducted to assess the extent to which children’s physical activity, quality of life and social behaviour differ between preschools with systematic and preschools without physical activity programmes. Differences in children’s physical activity according to parental behaviour were likewise assessed. Data on child-related outcomes and parent-related factors were collected via parent questionnaires and child interviews. A qualitative focused ethnographic study was performed to obtain deeper insight into the quantitative survey data. Two hundred and twenty seven (227) children were interviewed at 21 preschools with systematic physical activity programmes, and 190 at 25 preschools without physical activity programmes. There was no significant difference in children’s physical activity levels between the two preschool types (p = 0.709). However, the qualitative data showed differences in the design and quality of programmes to promote children’s physical activity. Data triangulation revealed a strong influence of parental behaviour. The triangulation of methods provided comprehensive insight into the nature and extent of physical activity programmes in preschools and made it possible to capture the associations between systematic physical activity promotion and children’s health resources in a differential manner. Full article
(This article belongs to the Special Issue Health Behaviors and Public Health)
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