Future doi: 10.3390/future4020016

Authors: Yi Xu Fei Gao Yong Zhou Yuying Zhang Jingjing Li Bo Peng Xueke Yao Xinran Yu Xiaoyan Zhang Keqing Shi Huiying Zhang Mingjia Bao Jia Wang

Background: Bullying victimization among adolescents is common and has been consistently associated with higher risks of anxiety and depressive symptoms among adolescents exposed to bullying. Breakfast consumption may function as a daily regulatory resource that supports emotional regulation and coping; however, whether breakfast consumption patterns moderate the associations between bullying victimization and mental health outcomes among adolescents remains unclear. This study examined the associations among bullying victimization, breakfast consumption, and anxiety and depressive symptoms among adolescents and tested the moderating role of breakfast consumption. Methods: Using a multistage stratified cluster sampling design, 67,683 adolescents were recruited from 234 schools across 13 cities in Heilongjiang Province, China. Standardized anonymous questionnaires assessed adolescents’ experiences of bullying victimization, breakfast consumption, anxiety and depressive symptoms, and relevant covariates. Multivariable mixed-effects logistic regression models were applied to estimate the associations between bullying victimization and mental health outcomes among adolescents. Linear trend tests and interaction terms between breakfast frequency and bullying frequency were used to examine moderating effects. Results: Except for verbal victimization (items 1 and 6), among adolescents exposed to most forms of bullying victimization, those reporting higher breakfast frequency had lower risks of anxiety and depressive symptoms (all trend p < 0.05). Among adolescents exposed to relational, physical, and cyber victimization, breakfast frequency moderated the associations between bullying frequency and anxiety and depressive symptoms (all p for interaction < 0.05), with sex-stratified sensitivity analyses yielding consistent results. Among adolescents who consumed breakfast daily, greater breakfast diversity (≥3 vs. 1–2 food groups) was associated with lower risks of anxiety and depressive symptoms. Specifically, among adolescents who experienced physical victimization “sometimes,” those consuming breakfast with ≥3 food groups had a 29% lower risk of anxiety symptoms (ROR = 0.71, 95% CI: 0.48–0.98) and a 30% lower risk of depressive symptoms (ROR = 0.70, 95% CI: 0.46–0.97) than those consuming 1–2 food groups. Among adolescents exposed to cyber victimization, those consuming breakfast with ≥3 food groups had a 32% lower risk of depressive symptoms at the “sometimes” frequency (ROR = 0.68, 95% CI: 0.45–0.98) and had a 32% lower risk of anxiety symptoms (ROR = 0.68, 95% CI: 0.42–0.96) and a 35% lower risk of depressive symptoms (ROR = 0.65, 95% CI: 0.40–0.95) at the “often” frequency than those consuming 1–2 food groups. Conclusions: Among adolescents exposed to bullying victimization—particularly relational, physical, and cyber victimization—those reporting higher breakfast frequency had lower risks of anxiety and depressive symptoms than those who skipped breakfast. Greater breakfast diversity was also associated with lower risks, particularly among adolescents exposed to physical and cyber victimization.

Future doi: 10.3390/future4020015

Authors: Yu-Min Kang An-Na Yeo Su-Young Lee

Early childhood caries risk is dynamic and can change over relatively short periods, even in the presence of preventive interventions. This study aimed to predict caries risk transitions in preschoolers using longitudinal data from the CAMBRA-kids mobile application. Using machine learning, we identified children whose risk progressed to high or extreme categories over 12 months and clarified the key contributing factors. A Random Forest model was developed using a multidimensional dataset that integrated parent-reported behavioral data and clinical assessments. Model performance was evaluated through ROC and precision–recall (PR) analyses, while SHAP was employed to ensure model interpretability and identify influential variables. Despite improvements in disease indicators and risk factors overall following the intervention, a subset of children transitioned to high or extreme risk. The model demonstrated acceptable discriminative performance with high precision in an imbalanced dataset. Changes in quantitative light-induced fluorescence loss, restored teeth, and red-fluorescent plaque area were identified as key predictors. These findings suggest that caries risk escalation reflects cumulative biological and clinical changes rather than short-term behavioral fluctuations and support the use of longitudinal, explainable machine learning for early risk identification and targeted prevention.

Future doi: 10.3390/future4020014

Authors: Cailin McLaughlin Abbi Marrs Barbara L. MkNelly Angie J. Keihner Noah Cooke Katherine E. Soule

Farm-to-school initiatives, including school gardens, are an increasingly popular strategy to increase student access to healthy produce and nutrition education opportunities. While studies show school garden programs and garden-enhanced nutrition education can positively impact student consumption of fruits and vegetables, there is a gap in evaluation tools that can be used by practitioners across varied school sites, grades, and communities, to assess outcomes of their garden programs. This effort piloted the Student Garden Retrospective Survey (SGR) for grades 4+ in four classrooms in two counties in California. The instrument included items to measure program exposure, garden skill experiences, changes in students’ behaviors, preferences, and attitudes, as well as their perceptions of the program. Student and teacher feedback on the evaluation tool was gathered to determine if students understood the questions being asked, were able to complete the survey, and whether the evaluation questions were pertinent to their school gardening experiences. The results demonstrate that the SGR is suitable for evaluating school garden and garden-enhanced nutrition education programming. In the future, the evaluation tool can be used by practitioners to iteratively improve garden-based education to enhance students’ nutrition and health outcomes.

Future doi: 10.3390/future4020013

Authors: Shan Cai Ning Ma Yunfei Liu Jiajia Dang Panliang Zhong Di Shi Peijin Hu Guangrong Zhu Jun Ma Yanhui Dong Yi Song Patrick W. C. Lau

Objectives: This study aimed to explore whether the association of lifestyle behaviors with mental well-being differed by sports app use among college students, while also examining differences by sex. Methods: A total of 38,738 Chinese college students aged 19–22 years from a nationally cross-sectional survey in 2019 were included in this study. The Warwick Edinburgh Mental Wellbeing Scale was applied to evaluate mental well-being. Clustered lifestyle behaviors were defined as unfavorable (zero to two healthy factors), intermediate (three healthy factors), or favorable (four to five healthy factors). The use of sports apps was classified as dichotomized frequently (sometimes and often) and infrequently (never, rarely, and occasionally). Log-binomial regression was used to investigate the associations. Results: Intermediate (PR = 1.14, 95% CI: 1.11–1.18) and unfavorable (PR = 1.29, 95% CI: 1.26–1.33) lifestyles were positively associated with low mental well-being. Infrequently using sports apps was associated with low mental well-being (PR = 1.08, 95% CI: 1.06–1.10). The magnitude of the association between an unfavorable lifestyle and low mental well-being was smaller among girls who frequently used sports apps (PR = 1.22, 95% CI: 1.16–1.27) than among those who used them infrequently (PR = 1.31, 95% CI: 1.24–1.38). Conclusion: These findings suggest that integrating engagement with digital sports apps into campus health promotion strategies might help support mental well-being, especially for college students with multiple unhealthy lifestyle behaviors.

Future doi: 10.3390/future4020012

Authors: Ebele Okoye Jerome Bronson Mary Shaw Robyn Breland Angela Omondi

Background: Individuals with intellectual and developmental disabilities (IDD) experience persistent health disparities that result in poorer health outcomes, reduced quality of life, and inequitable access to healthcare. Objective: This narrative review synthesized existing literature to identify key barriers to health equity and contributors to health disparities among individuals with IDD. Method: This study was a narrative (non-systematic) review that adopted a qualitative synthesis approach. A literature review was conducted across PubMed, CINAHL, PsycINFO, Medline, and Google Scholar to identify peer-reviewed articles published between 2010 and 2025 that address health disparities, health inequities, healthcare barriers, and social determinants of health among individuals with IDD. Thematic analysis was employed to synthesize the included studies and identify recurring patterns and themes. Results: A total of 88 articles were included. Two overarching domains shaping health disparities were identified: barriers to health equity and contributing factors. Seven barrier categories emerged: attitudinal, communication, policy, programmatic, social, physical, and transportation. Five key contributors were also identified: limited access to healthcare, comorbid conditions, low health literacy, adverse social determinants of health, and caregiver burden. Conclusions: Health disparities among individuals with IDD are driven by intersecting social, structural, and healthcare system barriers rather than individual limitations alone. This review informs policymakers, public health professionals, and interventionists on how to advance health equity for individuals with IDD through targeted, person-centered interventions.

Future doi: 10.3390/future4010011

Authors: Luke Hanna Con Burns Cian O’Neill Edward Coughlan

The Daily Move (TDMo) is a modified version of The Daily Mile, a primary school-based physical activity initiative, that provides children greater choice in activities during participation. This study evaluated a teacher-led implementation of TDMo, aiming to assess its sustainability within primary schools. Teachers (N = 60) implemented TDMo with their classes for two 5-week blocks across two school semesters. Data were collected via questionnaires administered at the start and end of each block (Time 1 to Time 4), aligned with the RE-AIM framework’s effectiveness, adoption, implementation, and maintenance elements. Two teacher focus groups (n = 6) and one child focus group (aged 8–9 years; n = 6) were conducted at Time 4. The findings presented in this paper are based only on participants who provided complete questionnaire data at all four timepoints (n = 28). TDMo was perceived to positively impact multiple health metrics across timepoints, including physical fitness (agreement decreased from 92 to 84%), movement proficiency (agreement increased from 84.6 to 96.2%), and attention and concentration (agreement decreased from 96.2 to 92.3%). Teachers reported all children responded positively to its adoption (100%). Children’s involvement in game selection increased significantly from Block One to Block Two (p = 0.01). The main implementation barriers were curriculum demands (agreement decreased from 80 to 72%) and inclement weather (agreement increased from 50% to 53.8%). Most teachers intended to sustain their implementation of TDMo (96.2%). The diverse and novel design of TDMo offers potential holistic health benefits and supports long-term sustainability. The variety of physical activity appears to enhance children’s enjoyment and encourage teachers’ sustained implementation. Recognition of these benefits by teachers and school staff, and their commitment to incorporating movement breaks within a typical school day, may further support sustainability.

Future doi: 10.3390/future4010010

Authors: Jun Tang Jiao Zhang Xufang Wu Tianchun Wang Xi Liang Zhen Xiang Lifeng Yang Ranran Song

Background: Children with Attention Deficit Hyperactivity Disorder (ADHD) often face behavioral challenges, which may be exacerbated through bidirectional parent–child interactions. Sex differences and cultural context may further shape this pathway. This study aims to examine these relationships among children’s ADHD symptoms, behavioral problems, and parental emotions (anxiety and depression) within China, testing whether parental emotions serve as a mediator and exploring potential differences across child sex. Methods: A path analysis was conducted among children’s ADHD symptoms, children’s behavioral problems, and parental emotional symptoms. Children’s ADHD symptoms were measured using the Swanson, Nolan, and Pelham version IV scale-parent form (SNAP-IV), while the Strengths and Difficulties Questionnaire (SDQ) assessed behavioral problems. Parental emotional symptoms were measured with the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) scales. All questionnaires are in Chinese. Results: The direct, indirect, and total associations of children’s ADHD symptoms on behavioral problems were significant in all models. In the full model, the indirect association, defined through parental emotional symptoms, was estimated at 0.206 (95% CI: 0.157–0.262). The indirect pathway constituted 27.3% of the total association. Conclusions: Parental emotional symptoms are associated with both children’s ADHD symptoms and their behavioral problems, indicating a potential pathway warranting further investigation. Child sex does not play a significant moderating role in the path, but an indirect association from ADHD symptoms to peer problems is observed in boys, not girls.

Future doi: 10.3390/future4010009

Authors: Damian Roland Virginia Ashman Anuj Patel Katherine Blake-Smith Laura Hiams Samantha Keating Annie Traynor Zain Islam Nasima Miah Qadeer Arshad Gianina-Ioana Postavaru

The development of health literacy skills yields numerous benefits, including reduced premature mortality, better engagement with preventative health services (e.g., immunisations and screening) and medication compliance. Schools are an ideal setting to promote health education. The Personal, Social, Health, and Economic curriculum is essential in equipping children for adulthood, addressing health, relationships, and well-being. In recent years, commendable emphasis has been placed on mental health, healthy relationships, substance use, healthy weight, and physical activity. However, education concerning physical health, including immunisation, within the context of health literacy has not been prioritised. This Viewpoint piece examines several contemporary issues within the realm of health education, including contributions from those with lived experience, and proposes recommendations to complement broader health improvement models.

Future doi: 10.3390/future4010008

Authors: Basilici Maria Chiara Stefanelli Federica Nocentini Annalaura Menesini Ersilia

Recent collective stressful events have influenced adolescents’ perceptions of the future; however, their impact on future-thinking and the coping strategies used to manage these challenges remain unclear. This study examines adolescents’ future-related concerns in response to collective stressful events and the strategies they adopt to cope with them. In spring 2024, 12 focus groups were conducted with 97 high school students (46.4% females; Mage = 15.34; SDage = 1.06) in Italy. Participants discussed experienced collective stressful events, their main concerns about the future, and related coping strategies. Data were analyzed using thematic analysis. Students identified four major events: war, climate change, economic crisis, and the COVID-19 pandemic. These events triggered concerns such as ‘uncertainty about future plans and goals,’ ‘limitations on personal freedom,’ ‘deteriorating survival conditions,’ ‘the outbreak of sudden events and natural disasters,’ and ‘job loss and increase in prices.’ Five coping strategies emerged: ‘taking action,’ ‘staying informed,’ ‘avoiding overthinking,’ ‘seeking social support (from family, friends, and teachers),’ and ‘seeking support from institutions.’ Findings highlight adolescents’ future-related concerns and underscore the need for interventions promoting adaptive future-oriented thinking.

Future doi: 10.3390/future4010007

Authors: Sadaf Ashraf César Bento Bebiana Sabino Hélio Antunes Cíntia França Helder Lopes Ana Rodrigues

Schoolbags represent a common source of physical strain for school-aged children and may influence posture during critical years of growth. This systematic review synthesizes evidence published since the previous review (1995–2014), which mainly focused on load thresholds and did not consider postural health as a multidimensional outcome. The review protocol was prospectively registered in PROSPERO (CRD420251080328). PubMed, Web of Science, and Google Scholar were systematically searched up to 11 June 2024. Of 1013 screened articles, 12 studies met the inclusion criteria. Schoolbag weight was the most frequently investigated factor, followed by postural and spinal alterations, particularly scoliosis. Excessive loads were consistently associated with trunk inclination, postural asymmetry, lumbar strain, and musculoskeletal discomfort. Several studies reported demographic differences, with girls showing greater susceptibility to postural deviations and boys carrying heavier loads. Compared with earlier evidence, more recent studies employed improved postural assessment methods and broader outcome frameworks incorporating ergonomic and behavioral factors. Despite methodological heterogeneity, findings support limiting schoolbag weight to 10–15% of body weight. This review highlights the importance of integrating ergonomic design, carrying behaviors, and demographic modifiers into school health guidelines and provides practical recommendations for clinicians, educators, and policymakers.

Future doi: 10.3390/future4010006

Authors: Miranda Badolato David Diehl Alicia Papanek Jeneé Duncan Karla Shelnutt Anne Mathews

Families with low income are faced with various intertwined public health issues, including low literacy levels and nutrition insecurity. Although numerous studies have detailed effective methodologies for delivering literacy or nutrition education in silos, there is no protocol for developing, implementing, and evaluating a brief, interdisciplinary literacy and nutrition education program for parent–child dyads. Books & Cooks, a seven-week literacy and nutrition education program aimed at improving families’ literacy and nutrition capacities by providing parents with strategies to assist their child, facilitating interactive education lessons, and providing take-home reflection activities, was piloted during the 2023–2024 school year. Results informed the protocol for current and future cohorts in efforts to further enhance outcomes. Family literacy capacity is addressed using evidence-based, grade-appropriate literacy techniques and evaluated using validated and internally developed instruments. Family nutrition capacity is addressed through education and cooking lessons based on the 2020–2025 Dietary Guidelines and MyPlate and evaluated using validated instruments. Results will be analyzed by assessing change from baseline to post-program completion, addressing potential confounding factors, and utilizing randomization. By detailing the development, implementation, and evaluation of this study, we anticipate that this protocol will provide guidance for cross-functional collaborators who seek to address various public health concerns in at-risk populations.

Future doi: 10.3390/future4010005

Authors: Gabrielly Santos Pereira Marcelo Lourenço da Silva Ana Beatriz Oliveira Luciano Maia Alves Ferreira

Pain in children and adolescents remains an underestimated and undertreated condition, with long-term physical and psychosocial consequences. Non-invasive neuromodulation has emerged as a promising, low-risk approach for managing acute and chronic pain by modulating central and peripheral neural pathways. This systematic review followed PRISMA 2020 guidelines to evaluate the efficacy, safety, and clinical applicability of non-invasive neuromodulation techniques in pediatric pain. Searches were conducted in PubMed, Embase, Scopus, Web of Science, Cochrane CENTRAL, and ScienceDirect for randomized controlled trials (RCTs) published between 2015 and 2025. Six RCTs met the inclusion criteria, encompassing percutaneous electrical nerve field stimulation (PENFS), transcutaneous auricular vagus nerve stimulation (taVNS), transcutaneous electrical acupoint stimulation (TEAS), and transcutaneous electrical nerve stimulation (TENS). Four trials reported significant reductions in pain intensity alongside improvements in functional outcomes and quality of life, particularly in functional abdominal pain and postoperative contexts. Most studies showed low or moderate risk across domains, with appropriate randomization and blinded assessment. No serious adverse events were reported, confirming an excellent safety profile. These findings support non-invasive neuromodulation as a feasible and well-tolerated adjunct to conventional pediatric pain management. Further high-quality trials are warranted to standardize protocols and explore mechanisms of neuroplasticity in the developing nervous system. PROSPERO (CRD420251170866).

Future doi: 10.3390/future4010004

Authors: Fernanda Pombal Lia Sousa Alexandra Pereira Marta Catarino Constança Festas

Children with special health care needs require health and related services beyond those required by children in general, which may affect their participation and inclusion in school. School nurses play a key role in supporting these children through a range of health-related interventions within the school setting. However, evidence on school nurse–led interventions for this population remains fragmented. This scoping review will follow the JBI methodology and aims to map the nature and extent of interventions developed by school nurses for children with special health care needs in school settings worldwide. The review will provide an overview of current practices and may inform the development of school health policies and evidence-informed nursing interventions. This research is registered on the Open Science Framework platform since 10 June 2024, with data updated on 26 August 2025.

Future doi: 10.3390/future4010003

Authors: Bettina F. Piko

Adolescence is a critical life period connected with the initiation of substance use. Exploring the prevalence of and contributors to adolescents’ smoking, drinking, and drug use is essential for developing effective health education programs. This study aims to detect prevalence rates of adolescent substance use and their association with sociodemographics and a set of psychological, social, and school-related variables. Participants were high school students (9th graders, N = 1590; 694 males, 896 females) in Békés county, Hungary. The lifetime prevalence rates were the following: smoking (47.2%), alternative smoking (49.2%), drinking (85.7%), cannabis use (7.6%), sedative use (7.0%), and designer drug (herbal) use (3.7%), with gender differences (a surplus of girls) found only in smoking and sedative use. Using bivariate logistic regression analyses, depressive and psychosomatic symptoms and internet addiction increased the odds of all types of substance use, life satisfaction, future orientation, and social support from the family, while school achievement and school satisfaction showed odds-reducing effects. In multivariate analyses, the various types of substance use were predicted by different variables, while psychosomatic symptoms, social support from the family, and school achievement seemed to be the most relevant contributors. Health education programs should also incorporate fostering mental health to prevent adolescent substance use.

Future doi: 10.3390/future4010002

Authors: Katerina Antonopoulou Nikolaos Anastasopoulos Dimitrios A. Alexopoulos Sofia Kouvava

While perfectionism is recognized as a complex personality trait with both adaptive and maladaptive facets in adults, the specific developmental and contextual factors that influence its emergence in children are poorly understood. This study addresses this critical gap by examining associations between children’s perceptions of family climate and emotion regulation strategies. A sample of 191 children (94 boys, Mage = 11.27 years, SD = 0.97) completed standardized measures of perfectionism, family environment, and emotion regulation. Results indicated that both family climate and emotion regulation significantly predict perfectionism in children (R2 = 0.36). Specifically, children’s perceptions of high parental control, a strong achievement family orientation, and reliance on expressive suppression (hiding emotions) emerged as moderate, significant predictors. These findings clarify the developmental factors underlying perfectionism, providing actionable targets—particularly around adaptive parenting and emotion coping—for child and family support programs and preventative interventions focused on promoting long-term well-being.

Future doi: 10.3390/future4010001

Authors: Alexandra Ribeiro Sara Diogo Gonçalves Maria Monteiro Ana Caramelo

Food allergies in school-aged children are a growing public health concern, requiring coordinated strategies to ensure safety in educational settings. This study aimed to evaluate the safety conditions for children and young people with food allergies in public schools of the municipality of Matosinhos, Portugal. A descriptive, cross-sectional, quantitative study was conducted during the 2022/2023 academic year, targeting coordinating teachers from all public schools. Data were collected using a structured questionnaire based on national guidelines for managing food allergies in schools. Results revealed significant gaps in preparedness: 35.99% of respondents reported the absence of a formal document on food allergies, 66.01% indicated no school training plan on the topic, and bar and canteen staff were often excluded from training (50.00% and 42.00%, respectively). Furthermore, 83.02% stated that preventive measures were not consistently adopted, and 49.99% felt insufficiently trained to act in emergencies. Based on these findings, an intervention project with tailored training sessions for coordinating teachers was proposed to improve safety and inclusion for students with food allergies. The study highlights the urgent need for standardized protocols, inclusive training, and preventive measures in schools to mitigate risks and foster a safe learning environment for children with food allergies.

Future doi: 10.3390/future3040025

Authors: Hayley D. Seely Luke Still Emily Weinberger Eileen Chen Kalyn Holmes Ryan Loh Christian Thurstone

Background: Adolescent mental health and substance misuse is a growing issue, disproportionately affecting diverse youth and those in low-resourced, high-stress environments. Yet, despite recent advances in evidence-based practices for adolescent substance use, perpetuating factors remain under-explored and marginalized, and underserved groups continue to be underrepresented. The current study aimed to investigate sociocultural factors impacting substance misuse and treatment outcomes. Methods: Data from adolescents receiving combined mental health and substance misuse treatment at a regional safety-net hospital were analyzed. Using Latent Class Analysis (LCA), demographic variables including insurance coverage, area deprivation, race, ethnicity, age, gender, court involvement, and primary mental health diagnoses were used to identify unique adolescent subgroups based on these different sociocultural risk factors. Identified classes were tested as predictors of treatment engagement, length of treatment, future service utilization, substance misuse, and urine drug screen results. Results: Five unique subgroups were identified, differentially impacting substance misuse, future service utilization, and treatment outcomes. Conclusions: These results highlight the need for improved access to resources for adolescents who have been marginalized and traditionally underserved. Furthermore, the identified subgroups can inform future research and practice.

Future doi: 10.3390/future3040024

Authors: Laetitia Gomes Frederica Simplício Anna Litvinchuck Amélia Rica Elisabete Cioga

Objective: This study aimed to analyze parents’ perceptions regarding adolescents’ screen use, signs of screen dependency, and its impact on sleep among 10- to 16-year-olds in the district of Leiria, Portugal. A descriptive–correlational, cross–sectional study was conducted in April 2024 using an online questionnaire completed by a non-probabilistic accidental sample of 616 parents or legal guardians. Nearly half of the respondents (48.2%) perceived adolescents as dependent on screens, while 68.7% believed that their screen time was excessive. Several behavioural signs consistent with digital dependence were reported. Increased screen use was significantly associated with shorter sleep duration, daytime sleepiness, and difficulties initiating sleep. Although many adolescents still achieved the recommended number of hours of sleep, those perceived as screen-dependent were more likely to experience compromised sleep quality and quantity. These findings reinforce the growing concern about adolescents’ digital habits and underscore the importance of implementing targeted health promotion strategies focused on responsible screen use and sleep hygiene among school-aged youth.

Future doi: 10.3390/future3040023

Authors: Daniel Gaffiero Amelia Dytham Rebecca Cotton Rahim Hussein Michaela E. Christodoulaki Stephanie A. Davey

Human papillomavirus (HPV) vaccination is a cornerstone of cancer prevention across genders. In the United Kingdom (UK), the programme now includes boys, yet uptake remains below target, with persistent disparities by gender and region. This commentary examines the drivers of these gaps, including the historical framing of the HPV vaccine as a vaccine for girls, limited public awareness of boys’ eligibility, and challenges in school-based delivery. Gendered misconceptions, cultural norms, and inadequate communication continue to limit uptake in boys, while healthcare professionals, including general practitioners, dentists, and pharmacists, remain underused in supporting vaccine access and tackling parental hesitancy. Schools are central to equitable delivery, but teachers often lack training and possess low-to-moderate knowledge of HPV-related topics, including HPV vaccination availability for boys and HPV-related cancers affecting men. Drawing on health behaviour theory, we propose evidence-informed, multi-level recommendations to improve uptake, from gender-inclusive messaging and more efficient consent processes to digital engagement tools that support parents. We also highlight our ongoing research into parental attitudes toward HPV vaccination for boys aged 9–12 in England, which will inform future targeted interventions and policy development.

Future doi: 10.3390/future3040022

Authors: Alejandro Borrego-Ruiz Juan J. Borrego

Schools constitute strategic settings for shaping eating behaviors among youth. Given the profound environmental, health, and social challenges associated with current food systems, there is an urgent need to explore dietary patterns that simultaneously support human well-being, ecological sustainability, and ethical principles. This comprehensive review provides a contemporary overview of the role of plant-based diets as an instrumental pathway to a healthier and more sustainable future by examining (i) environmental and social impacts of current food systems; (ii) the effects of plant-based diets on health; (iii) determinants of plant-based diet implementation in schools, including barriers and facilitators to their adoption; and (iv) the development of future-oriented dietary guidelines. Transitioning to plant-based diets, combined with sustainable agricultural practices, can reduce resource use and promote ecological sustainability. Promoting plant-based diets can also encourage the development of a more responsible and equitable social culture. Plant-based diets consistently provide metabolic, cardiovascular, and anti-inflammatory benefits across diverse populations, contributing to healthy weight and glycemic regulation. Well-planned plant-based diets may also improve cognitive function and promote psychological well-being. The integration of plant-based diets in schools is limited by barriers such as children’s food preferences, habitual eating patterns, peer influence, time and resource constraints, limited knowledge, cultural attachment to meat, and low family involvement. Conversely, facilitators including experiential learning, nutrition education, teacher and family engagement, social norms, ethical or environmental motivations, and institutional support promote acceptance and implementation. Ongoing research is required to refine dietary recommendations, assess long-term health outcomes, and ensure nutritional adequacy across pediatric populations. Continued evaluation of school-based interventions and policy frameworks will be essential to optimize the integration of plant-based diets and to monitor their health, ethical, and environmental impacts.

Future doi: 10.3390/future3040021

Authors: Emily Lockhart Jennie Bickmore-Brand Phil Doecke

Objective: Health education is critical in imparting health literacy to children and developing community health and wellbeing. The effectiveness of the teaching–learning interaction in health education classes depends on the teacher employing effective teaching methods, facilitating students’ deep understanding, critical thinking, and the development of skills, beliefs and attitudes that will be needed for them to cultivate healthy behaviours throughout their lives. Health education teaching differs from other learning areas as it addresses controversial and sensitive topics in class. Little research has been conducted regarding the preferred teaching methods of health educators and their ability to employ these teaching methods effectively in the classroom. Methods: In this paper, we present findings from a doctoral grounded theory study to explain the preferred teaching methods of teachers as they work with young people in the important learning area of health education. The study was conducted using a Chamazian constructivist grounded theory approach with the data being analysed using an inductive process, beginning with open codes and progressing to high-level categories. Main Results: This study determined that the preferred teaching method of the teachers delivering health education in Western Australia was discussion-based teaching. We examine the literature regarding discussion-based teaching methods, particularly in health education. Our findings evidence that teachers report preferring a discussion-based teaching approach, even though the health curriculum advises a critical inquiry approach and many schools in Australia currently promote an explicit teaching method. Conclusions: Teachers have expressed uncertainty as to how to effectively employ a discussion-based approach in class and have sought further clarification as they lead class discussions. Effective teaching practices need to be interrogated to support teachers, so how do we do this in a way that provides clarity for teachers and ultimately produces the best outcomes for young people?

Future doi: 10.3390/future3040020

Authors: Shu-Wen Liu Ka Long Hoi

This study examined the effects of perceived parenting styles and restrictive parental internet intervention on adolescents’ cyberbullying behaviors in Macau. A survey conducted in 2023 gathered responses from 708 secondary school students aged 12 to 18. The findings indicated that fathers’ authoritative and permissive parenting styles were positively associated with adolescents’ experiences of cyberbullying, both as perpetrators and victims. Mothers’ authoritative style was significantly associated with increased cyber-victimization. Notably, when mothers used an authoritative style and also applied restrictive internet intervention strategies—such as time or content controls—adolescents reported higher levels of cyber-victimization. These results suggest that rigid control, if not combined with open communication, may heighten risk. This study highlights the importance of involving both parents—particularly fathers—in adolescent media education and calls for increased awareness in social work, education, and family policy to prevent and mitigate cyberbullying in the digital age.

Future doi: 10.3390/future3040019

Authors: Béatrice Necsa Kianoush Harandian Caroline Fitzpatrick Eric F. Dubow Linda S. Pagani

Background: Preschool bedroom television placement represents an established risk factor for negative psychological and behavioral outcomes in adolescence. Girls and boys have different risk factors for developmental psychopathology. It is unclear if childhood sport participation can act as a protective factor for the potential maladaptive behaviors associated with having a bedroom television in early childhood. Methods: This study aims to evaluate the impact of having a bedroom television in early childhood on later externalizing behaviors while examining the potential beneficial role of extracurricular sport participation in middle childhood using the Quebec Longitudinal Study of Child Development (Canada). We examine subsequent teacher-reported psycho-social outcomes by the end of sixth grade. Linear regression is used to examine the interaction between child-reported bedroom television placement (age 4 years) and parent-reported childhood sport participation trajectories (ages 6 to 10 years) in predicting behavioral outcomes at age 12 years. Results: For boys, extracurricular sport amplified the relationship between having a preschool bedroom television and subsequent physical aggression (b = 0.95, SE = 0.32, p < 0.001) and ADHD symptoms (b = 0.59, SE = 0.30, p ≤ 0.05), beyond individual and family characteristics. No interaction results were found for girls; however, consistent sport participation between ages 6 and 10 years resulted in a decrease in ADHD symptoms in girls (b = −0.329, SE = 0.102, p ≤ 0.001). Conclusion: Unexpectedly, for boys exposed to early bedroom television, consistently participating in extracurricular sport in childhood exacerbated long-term behavioral risks. Social unpreparedness from bedroom television placement countered the intended benefits of sport. This private access to screens might influence sedentary, unsupervised, isolated activity that increases the chances of viewing violence and reduces opportunities for social interaction.

Future doi: 10.3390/future3040018

Authors: Farzana Sharmin Anika Tasneem Chowdhury Mosharop Hossian Shaima Rafiquzzaman Dhiraj C. Biswas Fatema Hashem Rupa Suraiya Begum

Background: Childhood obesity is becoming an increasingly pressing issue on a global scale. This study aimed to explore the relationship between thyroid hormone levels and body mass index (BMI) in obese children and adolescents, an area with limited research, particularly in Bangladesh. Methods: This cross-sectional study was undertaken in Bangabandhu Sheikh Mujib Medical University, Bangladesh, from August 2018 to January 2020. We included 105 participants aged 10–18 years, divided into obese (n = 69) and normal-weight (n = 36) groups based on the CDC BMI percentiles. We conducted chi-square tests, Pearson correlation, and linear regression analyses. Results: Obese participants exhibited significantly higher mean levels of TSH (4.40 ± 3.20 µIU/mL vs. 2.26 ± 0.97 µIU/mL, p-value 0.0002) and FT3 (3.52 ± 0.71 pg/mL vs. 3.02 ± 0.48 pg/mL, p-value < 0.001) and lower FT4 levels (1.23 ± 0.21 ng/dL vs. 1.38 ± 0.30 ng/dL, p-value 0.0002) compared to normal-weight participants. We observed a positive correlation between BMI and TSH (p-value 0.002) and FT3 (p-value < 0.001), and a negative correlation between BMI and FT4 (p-value 0.003). Most of the obese children were euthyroid (71.01%), with 27.54% showing subclinical hypothyroidism and 1.45% showing overt hypothyroidism. Multivariable linear regression analysis revealed that with a one unit increase in BMI, FT3 increased by 0.032 ± 0.011 pg/mL (p-value 0.004), FT4 decreased by 0.010 ± 0.004 (p-value 0.017 ng/dL, and TSH increased by 0.104 ± 0.044 µIU/mL (p-value 0.020). Conclusions: The significant association between BMI and thyroid hormone levels underscores the necessity for routine thyroid function monitoring in obese paediatric populations. The early detection and management of thyroid dysfunction may enhance health and well-being outcomes in obese children and adolescents.

Future doi: 10.3390/future3030017

Authors: Maria V. Lopes Andreas Ihle Élvio Rúbio Gouveia Adilson Marques Fahri Safa Cinarli Cíntia França

Parental involvement in youth sports is an increasingly relevant topic because of its key implications for children’s development in youth sports. This study’s aims are threefold: (1) to investigate parental involvement practices based on parents’ previous sports experiences, (2) to examine athletes’ and parents’ perceptions on parental involvement practices across different age categories, and (3) to compare the athletes’ and parents’ overall perceptions on parental involvement practices. In total, 423 participants (151 youth players and 272 parents) completed the Parental Behaviors in Sports (PBSP) questionnaire. The PBSP includes separate versions for parents and athletes, each assessing five key dimensions: (1) sports support, (2) competition attendance, (3) technical influence, (4) performance pressure, and (5) sports expectations. In the parents’ group, 154 participants (56.6%) reported previous sports experience. No statistically significant differences were observed in the PBSP dimensions between parents with and without previous sports experience. Parents’ years of sports experience negatively correlated with performance pressure (r = −0.155, p = 0.013) and expectations (r = −0.149, p = 0.017). Age group analysis showed lower competition attendance in the U18 group and higher expectations in the U12 group. When comparing parents’ and athletes’ responses, statistically significant differences emerged in all PBSP dimensions except for performance pressure. These findings underscore the importance of aligning parental involvement with children’s experiences to foster enjoyment, reduce pressure, and support sustained engagement in youth sports.

Future doi: 10.3390/future3030016

Authors: Anna Papadimitriou Eirini Karakasidou

The purpose of this study is to explore the extent to which self-esteem, depression, anxiety, and stress experienced during childhood may contribute to the development of disordered eating behaviors in adulthood. The existing literature indicates that disordered eating habits are positively associated with symptoms of anxiety, stress, depression, and low self-esteem. However, most research focuses on the concurrent relationships among these variables rather than examining whether low self-esteem and poor mental health in childhood can influence the emergence of disordered eating behaviors later in life. An online quantitative survey was conducted using questionnaires completed by 135 participants aged between 30 and 70 years. The results revealed that low self-esteem and high levels of depression, anxiety, and stress during childhood were associated with increased disordered eating behaviors in adulthood. These findings suggest that negative self-perceptions and poor mental health in childhood have lasting effects that extend into adulthood. This knowledge can be valuable for psychologists, mental health professionals, parents, and schools in designing intervention programs aimed at enhancing children’s and adolescents’ self-esteem, promoting good mental health, and fostering healthy eating habits.

Future doi: 10.3390/future3030015

Authors: Judit Rogés Katherine Pérez Xavier Continente Juan Miguel Guerras Brenda Robles Inmaculada Mateo Carmen Vives-Cases Marina Bosque-Prous Helena Gonzalez-Casals Cinta Folch Montse Bartroli María José López Esteve Fernández Albert Espelt

This study analyzes the impact of the COVID-19 pandemic on alcohol, cannabis, and tobacco use among adolescents aged 14–19 in Central Catalonia across three periods. Data were obtained from two waves of the DESKcohort project. The first wave (n = 4641) was pre-COVID-19 and the second wave was divided into two phases: post-COVID-19 with restrictions (n = 3478) and post-COVID-19 without restrictions (n = 2900). The prevalence of monthly binge drinking, cannabis use in the last 30 days, and daily tobacco use was calculated. Poisson regression models estimated adjusted prevalence ratios (aPR) comparing two post-pandemic phases to the pre-pandemic baseline. Binge drinking increased during the restrictions among girls [aPR = 1.5 (95%CI: 1.1–2.1)] and boys [aPR = 1.7 (95%CI: 1.3–2.3)]. Cannabis use decreased during restrictions and remained low post-pandemic, especially among girls [aPR = 0.6 (95%CI: 0.5–0.8)] and boys in the 4th Compulsory Secondary Education (CSE) [aPR = 0.4 (95%CI: 0.3–0.6)], and girls in the 2nd Post-Compulsory Secondary Education/Intermediate-Level Training Cycles (PCSE/ILTC) [aPR = 0.7 (95%CI: 0.6–0.9)]. Daily tobacco use also dropped among boys in the 4th year of CSE [aPR = 0.5 (95%CI: 0.3–0.7)] and girls in the 2nd year of PCSE/ILTC [aPR = 0.7 (95%CI: 0.6–0.9)]. The COVID-19 pandemic has created a unique opportunity to reassess patterns of adolescent substance use in a context of sudden social disruption. The findings highlight the need to denormalize alcohol and tobacco use and promote healthier adolescent behavior through education.

Future doi: 10.3390/future3030014

Authors: Keisha McCoy Chana S. Max

Paraprofessionals play a crucial role in supporting both teachers and students within a classroom, even though the specifics of their duties vary. While their responsibilities involve supporting student achievement, research has shed light that many paraprofessionals feel unprepared for their responsibilities in the classroom. This study aimed to address a gap in the existing literature by exploring how a professional development program that mirrors the trainings special education teachers receive would impact paraprofessionals and help them feel more prepared for their responsibilities in the classroom. Employing a generic qualitative methodology, this study sought to capture the experiences of 43 paraprofessionals. Data collection involved an online open-ended questionnaire at the start and conclusion of the school year. The study’s outcomes revealed five patterns in the data: (a) paraprofessionals struggled with collaborating with classroom teams at the start of the school year, (b) paraprofessionals struggled with managing student behavior at the start of the school year, (c) professional development was helpful to most of the paraprofessionals, (d) professional development led to better preparedness to address challenging behavior, and (e) professional development led to better preparedness to address the instructional needs of students with disabilities. Following a thorough analysis and synthesis, these patterns were condensed into two general themes: the importance of professional development for paraprofessionals and the importance of presenting the professional development that teachers receive on a continuous basis to paraprofessionals as well. These findings are significant for school leaders and educators, as they highlight the importance of providing professional development to paraprofessionals while supporting students with disabilities.

Future doi: 10.3390/future3030013

Authors: Afeez A. Hazzan Lauren J. Lieberman Pamela Beach Jonathan Ferrer

Individuals with CHARGE syndrome often experience motor delays impacting their balance, flexibility, and hand–eye coordination. Due to the medical complications associated with CHARGE syndrome, 40% of children will not develop functional communication skills and many more will have difficulty with speech and oral communication. Family caregivers play a critical role in the care of children and youths with disabilities, especially CHARGE syndrome. However, there is minimal research on the parental experiences of children and youth with CHARGE syndrome. The purpose of this study was to understand the family caregiver experiences and needs of parents of children and youth with CHARGE syndrome and related disabilities. Six family caregivers of children and youth living with CHARGE syndrome in the United States were interviewed to understand their current quality of life, factors influencing their quality of life, and the coping strategies they use. The interviews were transcribed verbatim and then analyzed using qualitative content analysis. The themes generated from the qualitative analyses of interviews showed that family caregivers experienced significant challenges in their quality of life and faced barriers as they navigated a complex system of care. However, family caregivers described robust approaches such as social support for coping with some of the stresses.

Future doi: 10.3390/future3020012

Authors: Yi Xing Qi Ma Mengjie Cui La Mang Peijin Hu Bin Dong Yanhui Dong Li Chen Jun Ma Yi Song

Child and adolescent health plays a critical role in shaping future public health and intergenerational outcomes. In China, rising rates of myopia, obesity, mental health issues, and other common conditions highlight the need for continuous monitoring. Since 2016, the Chinese National Surveillance on Students’ Common Diseases and Risk Factors (CNSSCDRF) has provided comprehensive, nationwide data on student health. By 2022, the system had expanded to nearly all counties, tracking key indicators such as vision problems, overweight/obesity, dental caries, and health-risk behaviors across multiple administrative levels. This review outlines the surveillance methodology, including sampling, data collection, and analysis. Findings have directly informed school health policies and technical guidelines, supporting national goals such as those in the Healthy China 2030 Plan.

Future doi: 10.3390/future3020011

Authors: Yumna Ali Yasuhiro Kotera Matthew Cotterill Ann-Marie Edwards Stephen Palmer

(1) Background: Adolescent health and well-being are associated with sports and physical education activities. Novel therapies for athletics training, sporting formations, and physical culture are important. In areas where sports facilities are scarce and not cost-effective, they can lead to poorer physical and mental well-being in adolescents. Emotions related to sports, somatic anxiety, worry, and concentration disruption aligned with task and ego orientation have been under-researched in Pakistan. (2) Methods: A sample of 830 adolescents between the ages of 14 and 19 years were recruited from Pakistan’s sports training center through purposive sampling. Sport-specific emotions, anxiety, task and ego orientation, and coaching athlete purpose (CAP) were measured. (3) Results: Regression analysis showed that different dimensions of sports anxiety (somatic trait anxiety, worry, and concentration disruption) have a significant effect on the task and ego orientation of sports education students. The Hayes process macro analysis shows that CAP significantly mediates between sports emotions and orientation. (4) Conclusions: It is important to introduce Rational Emotive Behavior Coaching and integrate ontological health and well-being for coaching in the sports field.

Future doi: 10.3390/future3020010

Authors: Jianhui Guo Feifei Si Huan Wang Yaqi Wang Xinyao Lian Shaodong Xie Zhiyong Zou Jing Li

Despite growing concern, there is limited comprehensive and up-to-date research on the burden, disparities, and inequalities of depressive disorders in the Western Pacific region. We obtained data from the Global Burden of Disease Study (GBD; 2021) for the Western Pacific region. We reported the prevalence and disability-adjusted life years (DALYs) rates of depressive disorders from 1990 to 2021. Our results showed that the prevalence of depressive disorders in the Western Pacific region was 1723.1 per 100,000 people (95% UI: 1359.2–2164.9), contributing to 1057.3 DALYs per 100,000 (95% UI: 683.0–1551.8). From 1990 to 2021, the burden of depressive disorders initially decreased but then increased, with Japan, Malaysia, and South Korea seeing the most significant rise. The burden grew with age, especially in the 10–14 age group, and exhibited significant sex disparities, especially in this age group. Among 31 countries, those with higher UHC scored had higher prevalence rates, but the gap between high- and low-UHC countries has decreased over time, indicating that countries with lower UHC might face greater challenges in the future. Our results highlight the differences in burden by sex and age call for targeted policies and interventions to promote youth mental health. Accelerating universal health coverage could be a key strategy to further reduce this high burden.

Future doi: 10.3390/future3020009

Authors: Elisabetta Fenizia Jacopo Postiglione Lucia Irene Porzio Grazia De Angelis Dario Bacchini Santa Parrello

This study investigates the dropout risk among first- and second-year high school students in the peripheral areas of Southern Italy, where the dropout rates are extremely high. It focuses on individual and relational factors associated with dropout, analyzing data from 645 students (Mage = 14.64) who completed a self-report questionnaire. The examined variables include self-efficacy, amotivation, future orientation, peer relationships, and students’ trust in teachers. Hierarchical regressions assessed the influence of grade levels on these dimensions. Our findings show a positive developmental trend in second-year students, including higher self-efficacy, better peer relationships, and reduced intentions to drop out. However, trust in teachers declines during this transition. Moreover, relationships with teachers show no significant improvement across grades. Therefore, this study underscores the importance of fostering trust between students and teachers as a protective factor against dropout. It also reveals the need for interventions targeting both students and the educational environment to improve teacher–student relationships and support students’ educational aspirations. By addressing these relational aspects, stakeholders can better mitigate dropout risks and promote school engagement during critical transitions in adolescence.

Future doi: 10.3390/future3020008

Authors: Alison C. McLeish Kandi L. Walker Lindsey A. Wood Osayande Agbonlahor Kolbie Vincent Savanna Kerstiens Madeline M. Tomlinson Joy L. Hart

Youth use of electronic cigarettes (e-cigarettes or vaping) has skyrocketed in recent years, resulting in a youth vaping epidemic. To combat this epidemic, a coalition of U.S.-based researchers created the Rapidly Advancing Discovery to Arrest the Outbreak of Youth Vaping (VapeRace) Center to stop youth e-cigarette use through integration of research across basic, clinical, behavioral, and population-based domains. Because most research on youth vaping is researcher-driven, the VapeRace Community Engagement and Research Translation (CERT) Core was created to facilitate stakeholder input and engagement with Center activities to develop partnerships between VapeRace researchers, youth, and the community. To help achieve these goals, a VapeRace Youth Advisory Council (YAC) was formed. This article describes the development and implementation of the VapeRace YAC, details its outcomes, and offers lessons learned and future recommendations for similar youth advisory groups.

Future doi: 10.3390/future3020007

Authors: Jing Li Yaqi Wang Yihang Zhang Jieyu Liu Yanhui Dong Yi Xing Yi Song

The concurrent rise in multiple health conditions among students, including myopia, obesity, spinal curvature abnormalities, and mental health disorders, represents a critical public health challenge. These interconnected health issues necessitate comprehensive prevention strategies that simultaneously address multiple conditions through synchronized behavioral and environmental interventions. In response to this need, the National Disease Control and Prevention Administration issued the Technical Guidelines for Co-Prevention of Common Diseases in Students on 30 April 2024, marking a significant advancement in China’s student health protection initiatives. The guidelines establish three core strategic priorities: enhancing surveillance of shared risk factors, implementing a systematic tiered approach to public health interventions, and developing an integrated, multisector prevention framework. This evidence-based, comprehensive initiative provides practical solutions for preventing comorbidities and enhancing overall student health outcomes. Further research is warranted to assess long-term effectiveness, explore regional implementation challenges, and support the development of standardized monitoring and evaluation systems.

Future doi: 10.3390/future3020006

Authors: Ning Pan Jing-Xian Zhao Xin-Tong Su Kai-Ze Yang Lei Shi Xin Wang Jin Jing Xiu-Hong Li Li-Zi Lin

Background: It remains unclear whether adherence to the 24-hour movement guidelines is beneficial for children with mental, behavioral, and developmental disorders (MBDDs). Methods: The results of the 2016–2020 National Survey of Children’s Health (NSCH) in the U.S. were used in this study. All types of MBDDs, adherence to the different movement guidelines (physical activity [PA], screen time [ST], and sleep), and various health indicators (general physical health, emotional regulation, cognitive and social functioning) were parent-reported. Weighted logistic regression models were used to assess the associations between adherence to the 24-hour movement guidelines and health indicators in children with and without MBDDs. Results: The majority of children with MBDDs had a lower weighted proportion of meeting the PA, ST, and sleep guidelines compared to those without MBDDs (all p values < 0.05). Less than half of the associations between adherence to the 24-hour movement guidelines and the different health indicators were significant among children with MBDDs, while the associations were all significant among children without MBDDs (ORs ranged 1.22–2.10, all p values < 0.05). When there were no between-group differences in the statistically significant associations between guideline adherence and health indicators (e.g., sleep guideline and general physical health), children with specific MBDDs can achieve comparable health benefits through adherence to the 24-hour movement guidelines (e.g., children with emotional disorders or developmental disorders experience better general physical health through adherence to the sleep guideline). Conclusion: We highlight the prioritization of the 24-hour guidelines for different health indicators among children with various MBDDs, and children with certain MBDDs could attain similar health benefits as those without these conditions by adhering to the 24-hour movement guidelines.

Future doi: 10.3390/future3020005

Authors: Sara Arenas-Carranza Eva Olmedo-Moreno Jorge Expósito-López

The migration experience of unaccompanied foreign minors (UFMs) has significant emotional and cognitive implications. The present research explores the way in which migration trauma influences the cognitive and emotional development of UFMs, contextualizing the current situation of this population in relation to migration trauma and neuroeducation. This study aimed to understand these impacts by examining the lived experiences of UFMs. An interpretative paradigm was adopted alongside a qualitative methodological approach, employing a collective case study technique to explore individual narratives in depth. The present findings highlight links between migratory trauma and cognitive and emotional development through a neuroeducational lens. Emphasis was placed on the importance of understanding the unique experience of each child and the critical role of professional support in mitigating the adverse effects of migration trauma.

Future doi: 10.3390/future3010004

Authors: Andrew P. Hills Sara Hills Sisitha Jayasinghe Nuala M. Byrne

Chronic health conditions including obesity, cardiovascular diseases, type 2 diabetes, and depression are rising in Australia, and are often addressed reactively in adulthood rather than proactively during childhood. Evidence highlights the first 2000 days (from conception to five years of age) as a critical window for prevention, where movement, active play, proper nutrition, and adequate sleep are key to reducing chronic disease risk. Despite this, limited longitudinal data on children’s growth and development hinders effective intervention. Up to one in four Australian children are living with overweight or obesity, with poor movement behaviours, sedentary lifestyles, unhealthy diets, and inadequate sleep as primary contributors. Active play fosters motor skill development and lifelong health but faces barriers like overprotective caregiving and sedentary environments. Actionable strategies to enhance activity levels in this age group include providing educator training, developing online resources, fostering communities of practice, improving infrastructure, and advocating for policy changes. A coordinated effort by parents, caregivers, educators, and health professionals is essential to prioritise movement in early childhood, laying the foundation for healthier growth and reducing the burden of chronic diseases.

Future doi: 10.3390/future3010003

Authors: Amy Lee Lara Phillips Viet Tran

Background: Child physical abuse is a significant contributor to overall pediatric mortality and morbidity and is associated with both short- and long-term effects on the physical, social and mental wellbeing of the child involved. Fractures are the second most common physical injury in children suffering from physical abuse and are present in up to 55% of cases of physically abused children. Specific fracture patterns may prompt suspicion for abuse, although none are specific. We aim to identify the incidence of fracture types associated with abuse in children under three years old presenting to the ED. Methods: This study was a retrospective descriptive study. The inclusion criteria consisted of (a) children less than three years of age, (b) presenting to the ED, (c) between 1 January 2020, and 31 December 2022, inclusive and (d) with a diagnosis consistent with a fracture type associated with abuse. Results: There were 214 patients diagnosed with fractures who were under 3 years of age. Of these, twenty-one patients fit the criteria for fracture suspcious for non-accidental injury (a rate of one per month if following a normal distribution). The diagnosis of NAI was considered in eight (38%) patients. NAI was not considered in 13 (62%) patients. A medical record review of these patients up to 12 months after initial ED presentation showed that five did not re-present to the ED, one was referred to CSS from outpatients and two re-presented within this period with minor head injuries. Conclusions: Presentations of fractures concerning NAI are rare but important not to miss. Automated systems and targeted education and action are critical to ensure that concerns for NAI are managed appropriately.

Future doi: 10.3390/future3010002

Authors: Giorgio Maria Regnoli Massimiliano Sommantico Gioia Tiano Jacopo Postiglione Barbara De Rosa

The COVID-19 pandemic and the confinement experience have significantly affected the relationship between young adults and their parents. The present study focuses on the design and validation of the Perceived Young Adult Lockdown Parental Relationship Scale (PYALPRS), a measure assessing two dimensions of the child–parent relationship associated with the COVID-19 lockdown period: Oppression-Conflict and Closeness-Support. After a phase of construct definition and item design and purification, 100 Italian young adults (M = 24; SD = 3.9) were recruited to explore the factor structure of the scale. Then, a sample of 259 Italian young adults (aged 18–35; M = 24; SD = 3.8) was used to demonstrate the psychometric validity of the scale. The results of our confirmatory factor analysis, which resulted in high goodness of fit scores, support two identifiable factors reflecting the theory-based constructs of the PYALPRS. Moreover, internal consistency and convergent and divergent validity analyses show that the PYALPRS can be considered a reliable and valid instrument. ANOVA demonstrated that there were significant differences between being a cohabitant or single as well as between different perceptions of the home space during lockdown on the Oppression-Conflict dimension, while a larger home space perception was associated with the Closeness-Support dimension.

Future doi: 10.3390/future3010001

Authors: Tyler Prochnow Megan S. Patterson Sara A. Flores Jeong-Hui Park Laurel Curran Emily Howell Deja Jackson Stewart G. Trost

Physical activity (PA) decreases during summer months, potentially leading to accelerated weight gain and increased depressive symptoms in adolescents. Summer care programs offer opportunities for PA promotion but understanding how different groups (based on initial perceived and objectively measured PA) respond to these programs is crucial for developing focused interventions. Adolescents (n = 47; mean age = 11.0 years; 51.1% female) who participated in an 8-week summer program wore ActiGraph GT9X accelerometers to measure moderate-to-vigorous physical activity (MVPA) at the beginning and end of the program. Self-reported PA was assessed using the Health Behavior in School-Aged Children survey. Both measures were then transformed into respective z-scores. K-means cluster analysis was performed to identify distinct groups based on device-measured and perceived PA at the beginning of summer. Changes in MVPA were compared across clusters using one-way ANOVA and post hoc Tukey’s HSD tests. Three clusters were identified: “High Accuracy Actives” (n = 17), “Underestimators” (n = 22), and “Overestimators” (n = 8). “Overestimators” showed the largest mean increase in MVPA (30.63 min/day), followed by “Underestimators” (17.76 min/day). “High Accuracy Actives” experienced a mean decrease in MVPA (−7.69 min/day). ANOVA revealed significant differences in MVPA change between clusters (F(2,44) = 4.93, p = 0.01). Summer care programs can positively impact adolescent PA, particularly for those who initially underestimate or overestimate their activity levels. However, strategies are needed to prevent declines among initially highly active participants. For example, adolescents who underestimate their activity levels may benefit from interventions focused on building self-efficacy and providing positive feedback, while those who overestimate might require educational components about PA guidelines and self-monitoring techniques.

Future doi: 10.3390/future2040017

Authors: Bryan R. Christ Lucie Adams Benjamin Ertman Sofia Catalina Arango-Lasprilla Natalia Albaladejo-Blázquez Paul B. Perrin Rosario Ferrer-Cascales

The COVID-19 pandemic severely affected teaching and student outcomes throughout the world, yet the long-term impacts of the pandemic on teachers and students in Latin America and Spain remain largely underexamined. This study examined the experiences of 5416 teachers from 20 Spanish-speaking countries during and after the pandemic, with an emphasis on teachers’ health, teaching experiences, and school-based support; perceptions of their students’ experiences and struggles; and relationships with students, families, and colleagues. The study used an online survey design with recruitment primarily based on snowball sampling, with most variables being collected using Likert-style responses. Descriptive statistics as well as bivariate correlations between variables were calculated. The results suggested that teachers were mostly healthy and reported moderate fear of COVID-19, though there was much variability. While, on average, teachers did not believe the pandemic had had a negative impact on their relationships with parents, colleagues, and students, they believed that the pandemic had a meaningful negative impact on their students by increasing problems in five key domains: educational, behavioral, social, emotional, and familial. Teachers had received very little training regarding online teaching, although they were moderately satisfied with the resources they had received to teach online and the safety measures their schools had implemented. Schools should provide additional support to teachers, students, and families during times of prolonged stress such as pandemics to help mitigate their lasting effects on students’ academic and psychosocial functioning.

Future doi: 10.3390/future2040016

Authors: Carolina Lunetti Laura Di Giunta Clementina Comitale Ainzara Favini

Empirical findings support the important role played by prosocial behavior and scholastic performance in significantly affecting adolescents’ long-term psychosocial adjustment. Furthermore, several studies showed the positive impact of academic self-efficacy in affecting adolescents’ social and academic functioning; however, no studies have investigated the effect of other important personality structures, such as students’ feedback sensitivity. The present study aims to investigate the effects of adolescents’ feedback sensitivity (reward sensitivity/punishment sensitivity) on their prosocial behavior and scholastic performance, also examining the potential indirect effect of academic self-efficacy on the association between reward/punishment sensitivity and prosocial behavior/scholastic performance. The participants were 132 adolescents from Rome (Italy). A structural equation model showed a positive and significant effect of academic self-efficacy on scholastic performance and prosocial behavior, a positive significant effect of punishment sensitivity on prosocial behavior, a positive significant effect of reward sensitivity on academic self-efficacy and a significant indirect effect of academic self-efficacy on the association between reward sensitivity and scholastic performance. The results of this study are useful in terms of practical implications to promote students’ adjustment.

Future doi: 10.3390/future2040015

Authors: Tingting Liu Yixi Sun Ruiyuan Zhang Changwei Li

The impact of childhood exposure to parental smoking on epigenetic age acceleration (EAA) in later life has not been thoroughly investigated. This study investigates the relationship while considering genetic susceptibility to smoking. We analyzed data from 3102 participants in the Health and Retirement Study (HRS) who also participated in the 2016 Venous Blood Study and the 2015–2017 Life History Mail Survey. Self-reported measures included childhood parental smoking exposure and smoking status in late adulthood. We utilized five epigenetic clocks—HorvathAA, HannumAA, GrimAA, PhenoAA, and DunedinAA—and assessed genetic susceptibility with a polygenic risk score (PRS) for smoking initiation, categorized into tertiles. We regressed the clocks against chronological age to derive EAA residuals. Associations between childhood exposure and EAA were examined in the overall sample and by PRS tertiles, stratified by race. The model controlled for age, sex, education, smoking, alcohol consumption, body mass index, and CESD scores. Significant associations were found between childhood exposure to parental smoking and the EAA measured by GrimAA (β = 0.98; p < 0.001) and DunedinAA (β = 0.01; p = 0.002) among White participants, with stronger effects in those with a high PRS. Similar patterns were observed in Black participants, highlighting the importance of preventing secondhand smoke exposure in children.

Future doi: 10.3390/future2040014

Authors: Maryanne L. Campbell Juhi Aggarwal Kimberly T. Nguyen Midhat Rehman Derek G. Shendell

During the COVID-19 pandemic, the New Jersey Safe Schools Program (NJSS) surveyed a subset of newer NJ high school (HS) teachers who completed NJSS work-based learning supervisory trainings from October 2021 to June 2023. The purpose of this study was to gain insight on NJ HS teacher perceptions of school provided mental health services, and well-being supports received during the COVID-19 pandemic. Via online surveys, teachers anonymously identified who should be responsible for supporting mental well-being in schools, satisfaction with existing mental health services, and self-care practices implemented during the COVID-19 pandemic. Of the 114 HS teachers surveyed, nearly 70% would recommend existing school mental health services to colleagues, 53% would like an increase in mental health and counseling services available at their school, and 44% would like their schools to improve mental health literacy. This study presents insight into the needs teachers expressed for appropriate school mental health support and services. Data will inform guidance for how to better address identified needs, including employee wellness, and creating positive social and emotional school environments. School districts should prioritize the implementation of suitable and equitable school-based mental health services to teachers and students alike to promote healthy and productive school environments.

Future doi: 10.3390/future2040013

Authors: Ziqi Liu Lili Yang Min Zhao Yongfu Yu Bo Xi

Background: While both high birth weight and childhood overweight/obesity have been associated with a heightened risk of high blood pressure (BP) during childhood, the association between weight status change from birth to childhood and the risk of high BP has not been fully explored. This study aimed to investigate how changes in weight status from birth to childhood influence the development of high BP in childhood. Methods: The data for this study were obtained from the baseline survey of the Huantai Childhood Cardiovascular Health Cohort Study, which included 1237 children aged 6 to 11. Children with a birth weight under 2500 g or a body mass index (BMI) below the fifth percentile for their age and sex during childhood were excluded. Based on birth weight (high birth weight [>4000 g] vs. healthy [≤4000 g]) and childhood weight status (overweight [including obesity] vs. healthy weight), participants were categorized into four groups: consistently healthy weight, weight decrease, weight increase, and consistently excess weight. Results: Compared to children who maintained a healthy weight from birth to childhood, higher odds of childhood high BP was observed among those with consistently excess weight (odds ratio [OR] = 2.73, 95% confidence interval [CI] = 1.46–5.12) and those with a weight increase (OR = 2.77, 95% CI = 1.91–4.02). In contrast, children with a weight decrease did not exhibit significantly higher odds of childhood high BP (OR = 0.94, 95% CI = 0.36–2.45). Conclusion: Children who become overweight in childhood or who consistently had excess weight from birth were at higher risk of childhood high BP. However, the risk of high BP in childhood may be mitigated or eliminated in individuals with high birth weight who achieve a healthy weight by childhood.

Future doi: 10.3390/future2040012

Authors: Hui Xue Xin Wang Linyuan Lai Ying Li Feng Huang Xiaoyan Ni Yong Tian Meng Li Lijun Fan Jie Yang Wei Du

Background: Previous studies reported screen time in association with unhealthy dietary behaviors, such as excessive intake of sugar-sweetened beverages leading to dental caries. Thus, we aimed to explore the association between screen time on mobile devices and dental caries experience in adolescents, as well as whether sugar-sweetened beverages would mediate the association. Methods: We analyzed 24,374 junior and senior high school students of age 12 to 17 years from the 2021 “Surveillance for common diseases and health risk factors among students” Project in Jiangsu Province of China. Dental caries experience was determined by the designated dentists. Screen time and consumption of sugar-sweetened beverages were self-reported and treated as a priori risk. We employed an instrumental variable (IV) approach for the current cross-sectional setting. We used the lasso technique to shortlist covariates from a range of confounding factors. Binary logistic regression or ordered logistic regression was performed where appropriate to explore the associations of screen time on mobile devices with dental caries and sugar-sweetened beverages. Results: The prevalence rate of dental caries was 38.4% in the study population. In comparison with <2 h/d screen time on mobile devices, extended screen time (≥2 h/d) was associated with higher dental caries risk (coefficient: 1.27, 95%; confidence interval: 0.80–1.75). Mediation analysis suggested that sugar-sweetened beverage intake might be an independent risk factor for dental caries, instead of the mediator between screen time on mobile devices and dental caries. None of the interaction terms under investigation was statistically significant. Conclusions: Exposure to mobile device screens and sugar-sweetened beverages was associated with dental caries in adolescents. These findings highlighted the importance of increasing awareness of potential risks owing to mobile device usage and sugar-sweetened beverages and the necessity to develop appropriate intervention strategies for school-aged adolescents.

Future doi: 10.3390/future2030011

Authors: Ane Olabarria Harkaitz Zubiri-Esnaola Sara Carbonell Josep María Canal-Barbany

Research demonstrates that overcoming school violence is crucial for ensuring a safe environment and quality education for all students. The scientific literature shows that educators can significantly impact school violence, but their effectiveness hinges on the quality of their training. Therefore, identifying the most effective training types is essential. This literature review aims to identify and synthesize the characteristics of teacher-training programs that have effectively reduced school violence. Inclusion criteria were studies focusing on interventions to reduce school violence, with either quantitative or qualitative outcomes. Exclusion criteria were studies not specifically addressing school violence or lacking evaluative measures. Data sources included Web of Science, EBSCO Host, Medline, Scielo, and Scopus, with searches conducted in December 2023. From an initial pool of 2128 articles, 13 studies were included. The results, synthesized through narrative analysis, reveal the key features of teacher-training programs that effectively address school violence, including the nature of the training, the content covered, and the social impact achieved.

Future doi: 10.3390/future2030010

Authors: Pedro Cabrera Vega Gara Castellano Caballero Desiderio Reyes Suárez Lourdes Urquía Martí Marta Siguero Onrubia Moreyba Borges Luján Octavio Ramírez García Fermín García-Muñoz Rodrigo

Obstetric trauma refers to injuries that occur to the newborn during the birth process and can occur despite proper perinatal care. Limiting risk factors could reduce its incidence and avoid significant morbidity and mortality to the infant. The aim of our study was to determine the incidence of birth injury in our setting and to discover its associated risks factors. For this case–control study, all births that took place in our center during the year 2021 were systematically reviewed. A total of 231 full-term newborns, with 77 cases and 154 controls, were included. For each case, two controls of similar sex and gestational age, born during the same shift before and after the case were selected. Preterm infants, outborn patients, twins, and infants with major congenital anomalies were excluded. The incidence of birth injury was 22.8‰ of singleton births. The most frequent injuries were cephalohematoma, peripheral facial paralysis, and clavicle fracture. After the adjusted logistic regression analysis, the variables that were independently associated with obstetric trauma were (aOR; 95% CI) breech presentation: 10.6 (1.2, 92.6), p = 0.032; dystocia: 7.8 (3.8, 16.2), p < 0.001; forceps instrumentation: 3.1 (1.0, 9.1), p = 0.043; induced labor: 3.0 (1.6, 5.5), p < 0.001; and newborn birthweight (per each 100 g): 1.1 (1.0, 1.2), p = 0.004. In conclusion, the incidence of birth trauma in our setting was 22.8‰ of singletons. The most frequent injuries were cephalohematoma, peripheral facial paralysis, and clavicle fracture. There was an independent association between birth trauma and breech presentation, dystocia, forceps instrumentation, labor induction, and infant birthweight.

Future doi: 10.3390/future2030009

Authors: Di Wu Jie Luo Qin Zhang Shudan Liu Xuan Xi Wenyi Wu Yuanke Zhou Yu Tian Yujie Wang Zongwei He Jie Zhang Hong Wang Qin Liu

Background: Puberty is a life milestone that marks the transition from childhood to adulthood. An ambispective Chongqing Pubertal Timing (CQPT) cohort was started in 2014 to understand pubertal timing and identify environmental risk factors. Methods: A total of 1429 children and adolescents were recruited and have been followed up once every 6 months for 8 years in a district of Chongqing, China. Data were collected via questionnaires for social and family environment, health conditions, gestational and maternal information, and in-person physical examinations by trained medical school graduate students in follow-ups. Environmental exposures of polycyclic aromatic hydrocarbons (PAHs), neonicotinoids, and heavy metals in urine samples were measured at different time points. Results: The mean ages at pubertal onset were 10.20 for thelarche, 11.62 for pubic hair development, and 11.84 for menarche in girls, and 11.16 for genital development, 11.66 for testicular enlargement, and 12.71 for first spermatorrhea in boys. Four OH-PAHs were associated with delayed timing of menarche, thelarche, pubic hair, and axillary hair development in girls, and thiacloprid was found to potentially impact genital stages in boys and axillary hair development in girls. Conclusions: We built a cohort to provide evidence of regional pubertal timing of boys and girls and the significant environmental factors. Further health outcomes, especially mental health and women’s health and its long-term health implications, will be followed.

Future doi: 10.3390/future2020008

Authors: Ana Cerqueira Fábio Botelho Guedes Tania Gaspar Emmanuelle Godeau Celeste Simões Margarida Gaspar de Matos

The characteristics of the school environment can influence students’ participation. Therefore, exploring the existing barriers to school participation and academic success of students with chronic conditions (CCs) is essential since they are a population at an increased risk for impairments and difficulties in these areas. This specific study aimed to explore the personal and school-environment variables associated with the school participation of students with CCs. Additionally, it aimed to analyze the differences between (1) male and female adolescents concerning the impact of CCs on school participation and the personal and school-environment variables; and (2) adolescents with and without school participation affected by the existing CCs regarding personal and school-environment variables. This work included 1442 adolescents with CCs, 56.3% female (n = 769), with a mean age of 15.17 years (SD = 2.33), participating in the Health Behavior in School-Aged Children (HBSC) 2022 study. The results showed that girls and students with school participation affected by CCs are at greater risk regarding the personal and school-environment variables under study. In the multivariable logistic regression analysis of the association between these variables and the school participation of students with CCs, a greater weight of personal variables was observed, followed by those of the school environment related to interpersonal relationships and, finally, the physical environment and safety-at-school variables. The study highlights the relevance of considering the existing barriers to school participation and academic success of students with CCs. The results also underline the importance of aligning the intervention of health and education professionals and policymakers. All of these professionals must make a joint effort to overcome existing barriers in the school context and move towards an increasingly balanced environment that promotes and protects the equal participation of all students.

Future doi: 10.3390/future2020007

Authors: Gina Tomé Nuno Rodrigues Margarida Gaspar de Matos

Background: In Portugal, teachers have constantly sought better working conditions in order to improve their mental health, which can result in demotivation and personal and professional exhaustion. Methods: A total of 1454 national public school teachers participated in this study, 17.4% (n = 253) male, aged between 22 and 66 years old (M = 51.4, SD = 7.5). The instrument used included questions concerning sociodemographic data (gender, years of teaching experience, age, length of service), a life satisfaction scale, WHO-5/quality of life perception, the physical and psychological symptoms scale-HBSC, depression, stress, and the anxiety scale-DASS-21. It also included questions about the school environment: relationship with the principal, and school atmosphere. Results: Four groups of teachers were created for the statistical analyses: No Life Satisfied/No Symptoms; Life Satisfied/No Symptoms; No Life Satisfied/With Symptoms; and Life Satisfied/With Symptoms. The results revealed that male teachers showed higher percentages for the following groups: No Life Satisfied/No Symptoms (χ2 = 17.223(3), p ≤ 0.001, 20.2%), Life Satisfied/No Symptoms (χ2 = 17.223(3), p ≤ 0.001, 43.3%) and No Life Satisfied/With Symptoms (χ2 = 17.223(3), p ≤ 0.001, 23.9%). Conclusions: The results made it possible to identify a profile of teachers who are more likely to develop mental health problems and psychological distress: those who have lower perceived life satisfaction and more psychological symptoms, which are associated with a low perception of quality of life, a worse relationship with principals and a worse perception of the quality of the school environment; this situation seems to be even worse among female teachers.

Future doi: 10.3390/future2020006

Authors: Alba González Moreno María del Mar Molero Jurado

School violence is a social problem that has an impact on the psychological well-being of adolescents. One of the least identified roles within school violence is that of bystander, which refers to students who witness acts of violence perpetrated by their peers in the school environment. Current scientific evidence determines that young people with high self-esteem and resilience tend to have better mental health. The aim of this research is to identify the role of being a bystander of school violence on self-esteem and resilience in this crucial developmental stage of adolescence. The sample is composed of a total of 730 adolescents aged between 14 and 19 years. The results obtained indicate that young people who perceive themselves as non-bystanders of school violence show higher levels of self-esteem. As for the differences according to sex, it was found that non-bystander boys have greater resilience and self-esteem compared to girls. There are negative correlations between a healthy lifestyle and stress, but positive correlations between healthy lifestyle and self-esteem. In addition, we wanted to investigate the likelihood that observant adolescents intervene to help their peers. The results show that resilience acts as a protective factor that encourages such intervention, while self-esteem would be a risk factor. These findings highlight the importance of promoting resilience and self-esteem in school settings to improve peer relationships and foster healthy youth development.

Future doi: 10.3390/future2020005

Authors: Ziyun Liang Guohua He Liyuan Tao Xuhui Zhong Tianxin Lin Xiaoyun Jiang Jie Ding

Clinical trials of chronic kidney disease (CKD) in children have important implications for the early identification and management of CKD. The selection of clinical trial outcomes is critical for assessing the effectiveness of interventions in pediatric CKD clinical trials. This review systematically examines the spectrum of outcome measures deployed in pediatric CKD clinical trials, which includes clinical and alternative outcomes, patient-reported outcome measures (PROMs), and safety indicators. Alternative outcome measures were stratified into four levels of evidence strength: convincing, probable, suggestive, and inconclusive. Consequently, the selection of outcome measures for pediatric CKD clinical trials mandates careful consideration of both their methodological feasibility and the robustness of their evidence base. Moreover, the burgeoning field of PROMs warrants integration into the design of future pediatric clinical trials to enrich the relevance and impact of research findings.

Future doi: 10.3390/future2020004

Authors: Stephanie Taylor Iona Novak Michelle Jackman

Children with spinal muscular atrophy (SMA) are now living longer as a result of advancements in pharmaceutical and medical interventions. There is a paucity of research regarding therapeutic interventions to support this population to be independent and participate in life activities that are most important to them. The aim of this case report is to explore the use of the Cognitive Orientation to daily Occupational Performance (CO-OP) approach to support a child with SMA type 1 to achieve their functional and participation goals. This is a retrospective case study. A 7-year-old girl with SMA type 1 received ten 1 h sessions of CO-OP, weekly in the home and community settings with a physiotherapist. Clinically meaningful improvements were found in goal performance and satisfaction on the Canadian Occupational Performance Measure (COPM) and Performance Quality Rating Scale (PQRS). Despite the progressive nature of SMA, the CO-OP approach was able to support goal attainment. Given medical advances are leading to a longer life span for children with neuromuscular conditions, further research is needed to investigate the efficacy of functional and participation-based interventions, including impact on quality of life and self-efficacy.

Future doi: 10.3390/future2010003

Authors: Jelle Fostier Elena Leemans Lien Meeussen Alix Wulleman Shauni Van Doren David De Coninck Jaan Toelen

This study explores the feasibility of large language models (LLMs) like ChatGPT and Bard as virtual participants in health-related research interviews. The goal is to assess whether these models can function as a “collective knowledge platform” by processing extensive datasets. Framed as a “proof of concept”, the research involved 20 interviews with both ChatGPT and Bard, portraying personas based on parents of adolescents. The interviews focused on physician–patient–parent confidentiality issues across fictional cases covering alcohol intoxication, STDs, ultrasound without parental knowledge, and mental health. Conducted in Dutch, the interviews underwent independent coding and comparison with human responses. The analysis identified four primary themes—privacy, trust, responsibility, and etiology—from both AI models and human-based interviews. While the main concepts aligned, nuanced differences in emphasis and interpretation were observed. Bard exhibited less interpersonal variation compared to ChatGPT and human respondents. Notably, AI personas prioritized privacy and age more than human parents. Recognizing disparities between AI and human interviews, researchers must adapt methodologies and refine AI models for improved accuracy and consistency. This research initiates discussions on the evolving role of generative AI in research, opening avenues for further exploration.

Future doi: 10.3390/future2010002

Authors: Sadaf Ashraf Roberto Viveiros Cíntia França Rui Trindade Ornelas Ana Rodrigues

Knee and foot deformities refer to structural abnormalities in the knee and foot bones, joints, ligaments, or muscles. Various factors, including genetics, injury, disease, or excessive use, can cause these deformities. These musculoskeletal conditions can significantly impact individuals’ quality of life. This study examined foot and knee deformities in 231 young healthy adults (165 men, 66 women) aged 22.6 ± 4.9 years and their association with physical activity and body composition. The postural assessment was performed by two Physiotherapists, with the subject standing in three views: side, anterior, and posterior. Physical activity (Baecke’s Habitual Physical Activity Questionnaire) and body composition (InBody 770) were assessed. Results showed that the most common foot deformity was pes planus, while the genu recurvatum was the most common knee deformity among the individuals. Physical activity level was negatively associated with knee and foot deformities. Conversely, body composition differed with the presence of genu recurvatum. These findings present a starting point to understand the occurrence of knee and foot postural alterations according to the individuals’ body composition and physical activity profiles, which could support the deployment of tailored interventions among healthy adults. In addition, early detection of postural changes is crucial in mitigating their negative long-term impact on physical well-being.

Future doi: 10.3390/future2010001

Authors: Feng Huang Yan Wang Hui Xue Xiyan Zhang Yong Tian Wei Du Lijun Fan Jie Yang

Background: School bullying is a global problem. Although previous studies showed rural adolescents were at higher risk of being bullied compared to their urban counterparts, the rural–urban differences in the risk of bullying or poly-bullying victimization in relation with different characteristics and the joint association of internet addiction and depressive symptoms with the observed urban–rural disparities are unclear. Objective: We aim to investigate the rural–urban differences in bullying or poly-bullying victimization among adolescents and whether the observed rural–urban differences are associated specifically with internet addiction or depression. Methods: This cross-sectional study considered a total of 25,377 Grade 7 to 12 adolescents from the ‘Surveillance for Common Disease and Health Risk Factors among Students’ project implemented in Jiangsu Province in 2019. Rurality of residence was ascertained via the Regulation of Statistical Classification. We used Poisson regression to estimate the age–sex adjusted rate ratios (RRs) and 95% confidence interval (CI) for bullying and poly-bullying victimization. Results: Approximately 20.26% (95%CI: 16.11–25.47%) and 7.67% (5.48–10.74%) rural adolescents experienced bullying and poly-bullying, in comparison with 16.50% (12.65–21.52%) and 5.81% (4.34–7.78%) urban adolescents, respectively. Rural adolescents had 14% and 23% higher rates of bullying victimization (RR: 1.14, 95%CI: 1.03–1.26) and poly-victimization (RR: 1.23, 95%CI: 1.05–1.44) than their urban counterparts. When further controlled for internet addiction, the observed rural–urban disparities increased among adolescents with depressive symptoms, whereas diminished among those without depressive symptoms.

Future doi: 10.3390/future1030009

Authors: Shuangshuang Guo Ting Jiao Ying Ma Stephen P. Lewis Brooke A. Ammerman Ruoling Chen Erica Thomas Yizhen Yu Jie Tang

Many studies have identified that adverse childhood experiences (ACEs) are associated with non-suicidal self-injury (NSSI) and suicidality. However, most studies have been restricted to a few types of ACEs. This study aims to investigate the association of 13 common types of ACEs with NSSI, suicidal ideation (SI), and suicide attempts (SA), as well as the mediation of depressive and anxiety symptoms therein. A total of 1771 (994 male, 777 female) students aged 11–16 (12.9 ± 0.6) years who participated in the baseline survey of the Chinese Adolescent Health Growth Cohort study were included in the analysis. ACEs, including childhood maltreatment, other common forms of ACEs, and smoking, were measured via the Chinese version of the Child Trauma Questionnaire (CTQ) and a series of valid questionnaires that were derived from previous studies. NSSI was measured using the Chinese version of the Functional Assessment of Self-mutilation. SI and SA were measured using questions derived from the Global School Based Student Health Survey. Depressive symptoms were measured via the Chinese version of the Center for Epidemiologic Studies Depression Scale, and anxiety symptoms were measured via the General Anxiety Disorder-7. Of the included participants, 92.0% reported one or more category of ACEs. Smoking, parent–child separation, emotional abuse, physical abuse, and being bullied were positively associated with NSSI; smoking, parent–child separation, emotional abuse, physical abuse, emotional neglect, and being bullied were positively associated with SI; smoking, emotional abuse, and being bullied were positively associated with SA. The associations of ACEs with NSSI, SI, and SA were each partially or completely mediated through depressive and anxiety symptoms. Children and adolescents who had experiences of smoking, physical abuse, and being bullied during childhood are consistently and independently associated with NSSI and suicidality, and these associations may be largely mediated through depressive and anxiety symptoms. In conclusion, not all the types of ACEs are independently associated with NSSI, and suicidality and other associations may mediate through depressive and anxiety symptoms. Target interventions for adolescents’ NSSI and suicidality should focus on those who have a history of ACEs and depressive and anxiety symptoms.

Future doi: 10.3390/future1030008

Authors: Yunfei Liu Panliang Zhong Jiajia Dang Di Shi Shan Cai Ziyue Chen Yihang Zhang Jun Ma Yi Song

Objective: To describe the secular trends of cause-specific mortality among adolescents aged 10 to 24 years from 2004 to 2019 and explore the association between mortality and economic status, education level as well as health investment. Methods: Mortality data of adolescents aged 10 to 24 years were obtained from the national disease surveillance points system. The age-standardized mortality rate (ASMR) was calculated by using the population data from the sixth national population census in 2010. GDP per capita, urbanization rate, illiteracy rate of the population over 15 years old, government education expenditure per capita, number of health service providers per 1000 people, and number of health beds per 1000 people were collected from China’s Economic and Social Big Data Research Platform. Age-period-cohort analysis was used to analyse the net age, period, and cohort effects of mortality among adolescents, while panel data regression was used to explore the association between mortality and economic status, education level as well as health investment. Results: Overall, the ASMR was 28.84 per 100,000 and the top five causes of mortality were road injuries, drowning, intentional self-harm and sequelae, leukaemia, and falls among adolescents aged 10 to 24 years in China in 2019. All-cause mortality declined with an annual percentage change of 4.02% (95% Confidence interval: 3.74% to 4.30%) from 2004 to 2019 yet with persistent differences across different demographic (gender and age) and geographical (urban-rural, and regional) subgroups. Notably, the ASMR for HIV/AIDS in males, lower respiratory infections in urban adolescents, and iron deficiency anaemia as well as cervical cancer in adolescents aged 20 to 24 years showed an increase over time. The multivariate panel data regression showed that the ASMR decreased by 5.18 (3.27, 7.08) per 100,000 for every increase in the number of health beds per 1000 population, but with insignificant association with GDP per capita and illiteracy rate in the total sample. Health beds investment was positively associated with ASMR at almost all subgroups except for adolescents aged 10 to 14 years; GDP per capita increase was helpful to males and rural adolescents while an increasing literacy rate was beneficial for females and adolescents aged 15 to 19 years. Conclusion: Given the persistent differences between subgroups, further investments including improving health services, especially increasing health bed investment, GDP per capita, and reducing the illiteracy rate and concern for adolescents in males, rural areas, the western regions, and aged 15 to 24 years are needed. Additionally, the increased burden of some diseases, such as HIV/AIDS, must be of further concern.

Future doi: 10.3390/future1020007

Authors: Maiheliyakezi Tuersunniyazi Min Tong Li Wang Shumin Zhang Yan Lu Huijing Shi

(1) Background: Previous studies have shown that stress increases the risk of bullying (including perpetration and victimization) in adolescents, and depressive symptoms are associated with both stress and bullying. However, the relationship between stress, depressive symptoms, and bullying has not been fully elucidated. In addition, previous studies have focused only on stressors but have ignored the role of resilience in evaluating individual’s stress. This study aimed to incorporate resilience into the assessment of an individual’s stress, which we named comprehensive stress; to examine the relationship between comprehensive stress and bullying; and then to investigate the potential role of depressive symptoms in this relationship. (2) Methods: We recruited 6353 middle and high school students from the 2021 Shanghai CDC Youth Risk Behavior Surveillance Project. After signing informed consent, participants provided demographic information and completed effective measures of stressors, resilience, depressive symptoms, and bullying. (3) Results: Latent profile analysis revealed four profiles of comprehensive stress, labeled as Low stressor–High resilience (37.57%, n = 2216), Moderate high stressor–Average resilience (14.38%, n = 848), Average stressor–Moderate low resilience (33.33%, n = 1966), and High stressor–Low resilience (14.72%, n = 868). In comparison to students in the Low stressor–High resilience profile, students in other profiles demonstrated higher likelihoods of engaging in bullying victimization and perpetration, as well as higher levels of depressive symptoms. Specifically, students in the High stressor–Low resilience profile had the highest odds of bullying victimization (OR = 6.74, 95% CI: 4.92–9.22) and perpetration (OR = 5.15, 95% CI: 3.56–7.46), along with the highest level of depressive symptoms (β = 11.35, Se(β) = 0.17). Students in the Average stressor–Moderate low resilience profile had a moderate increase in the odds of bullying victimization (OR = 2.21, 95% CI: 1.63–3.00) and perpetration (OR = 2.69, 95% CI: 1.91–3.80), as well as a moderate level of depressive symptoms (β = 5.03, Se(β) = 0.13). Students in the Moderate high stressor–Average resilience profile also showed increased odds of bullying victimization (OR = 2.99, 95% CI: 2.12–4.20) and perpetration (OR = 2.80, 95% CI: 1.88–4.20), as well as a moderate level of depressive symptoms (β = 4.44, Se(β) = 0.16). Depressive symptoms were positively correlated with both perpetration and victimization. Furthermore, the mediating role of depressive symptoms between comprehensive stress and bullying was observed. (4) Conclusions: Combining stressors and resilience is crucial when evaluating an individual’s stress. Comprehensive stress is associated with bullying, and depressive symptoms may partially mediate this relationship.

Future doi: 10.3390/future1020006

Authors: Nilanga Aki Bandara Dhruv Lalkiya Abdullah Alhamam Kourosh Afshar

The sexual health of young people during the youth age period is of utmost importance, as it sets the stage for sexual well-being over the life course. In addition to the existing challenges that youth face concerning their sexual health, electronic cigarettes may also negatively impact their sexual well-being. Specifically, through issues such as stuttering priapism, reduced sperm quality and quantity, and erectile dysfunction. Electronic cigarette use among youth is prevalent. Therefore, given the negative sexual health impacts associated with electronic cigarette use, coupled with the prevalent use of electronic cigarettes, it is necessary for youth to receive adequate support and guidance, so they understand the potential impacts that electronic cigarette use can have on their sexual well-being. Urologists are uniquely situated to play an important role in supporting the sexual health of youth, given their medical and surgical knowledge, however, it appears that they do not receive adequate training to carry out discussions about sexual health with youth. This paper aims to support urologists to have discussions with youth patients on the impact that electronic cigarettes have on their sexual health through a proposed four-step framework. This four-step framework involves: (i) establishing the relationship, (ii) assessing current electronic cigarette use, (iii) sharing research examining the impact of electronic cigarettes on sexual health, and (iv) discussing strategies to prevent/reduce or stop electronic cigarette use. It is necessary to acknowledge that this framework is only a small component of efforts to educate youth on the impacts that electronic cigarettes have on their sexual health. Moving forward, implementation and evaluation of this framework is needed.

Future doi: 10.3390/future1010005

Authors: Baozhuo Ai Shiyu Zhang Jiaying Fu Xiaona Yin Guomin Wen Dengli Sun Danxia Xian Yafen Zhao Hualiang Lin Weiqing Chen Weikang Yang Zilong Zhang

Background: Attention deficit hyperactivity disorder (ADHD) affects approximately 2–7% of children worldwide and has become a global public health concern. The health effects of green space on ADHD in young children are unclear. We investigated associations between school-surrounding greenness and hyperactivity behaviors in preschool children. Methods: We performed a cross-sectional analysis using data of 66,678 preschool children (mean age: 3.53 years) from an on-going cohort in Shenzhen, China. The greenness surrounding kindergartens was measured using satellite-derived Normalized Difference Vegetation Index (NDVI) values at buffers of 250 m, 500 m, and 1000 m. Children’s hyperactivity behaviors were measured using the validated Conners’ Parent Rating Scale-Revised. We used generalized linear mixed models to assess the associations of greenness exposure with hyperactivity behaviors with adjustment for a variety of covariates. Results: Exposure to higher school-surrounding greenness was associated with lower prevalence of hyperactivity behaviors. In fully adjusted models, the odds ratio of hyperactivity behaviors in relation to an IQR (0.1) increase in NDVI at the 250 m buffer was 0.91 [confidence interval (CI): 0.84,0.98]. Consistent results were observed for greenness at the 500 m and 1000 m buffers. The negative association between greenness and hyperactivity behaviors was more pronounced in boys than in girls. Conclusions: Our findings suggest that higher levels of school-surrounding green spaces are associated with a lower risk of hyperactivity behaviors in preschool children.

Future doi: 10.3390/future1010004

Authors: Tashi Dendup I Gusti Ngurah Edi Putra Tandin Dorji Sonam Zangmo Karma Doma Tshering Sonam Phuntsho Dorji Khandu

Data on factors influencing multiple sexual partners that can inform cost-effective interventions are limited in Bhutan. This study examined factors associated with multiple sexual partners among adolescents. We analyzed the data of 7437 school-going adolescents from the 2016 Bhutan Global School-based Student Health Survey. Multivariable logistic regression stratified by sex was conducted. The prevalence of sex with multiple partners was 7.39%, with a much higher prevalence among males than females. In the overall sample, males, those >15 years of age, who smoked, consumed alcohol, used drugs, exhibited truancy, and were unmonitored by parents, had higher odds of having sex with multiple partners. In both males and females, being >15 years old, smoking, and drug use were associated with having multiple sexual partners. Alcohol use and truancy were significant only among males, whereas a lack of parental monitoring was significant only among females. The findings suggest that reducing substance use and enhancing parental support, and targeting males and older adolescents may yield larger gains.

Future doi: 10.3390/future1010003

Authors: Xijie Wang Yanhui Li Di Gao Zhaogeng Yang Bin Dong Yanhui Dong Zhiyong Zou Jun Ma

This cohort was set up to capture pubertal onset among children in China and to analyze how timing of pubertal onset would influence cardiovascular disease risk in later life. Pubertal onset was defined as secondary sexual characteristics (SSC) attained Tanner II stage, which was breast development for girls and testis of 4 mL for boys. Meanwhile, height growth spurt, defined as age of take-off and age of peak height velocity, were also involved to observe the consistency between the three indicators in discriminating pubertal onset. The study was conducted in Xiamen, China from November 2017 to November 2020 with 6-month gaps. One thousand, four hundred and sixteen children from four project schools who had not yet started puberty were involved at baseline. By November 2020, 1272 children were still under follow-up, with 945 (74.3%) of them reaching Tanner II stage. We would continue to follow the pubertal development, as well as change in crucial risk factors for cardiovascular disease in these participants. Evidence from the present cohort study would help to reveal the influence of pubertal growth on long-term cardiovascular health and would be one of the very first studies to provide such evidence from Asian countries.

Future doi: 10.3390/future1010002

Authors: Giulia Stefenelli

New generations are key players at present, but they are also our future, those who will lead any future changes and innovation [...]

Future doi: 10.3390/future1010001

Authors: Jun Ma

The recent consensus regarding children’s and adolescents’ health and development is that focus should not only be devoted to what sounds serious now but that our perspective should extend to considering the roots, where a healthy childhood and adolescence is essential to achieving full potential as an adult—i [...]