Future

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. Full article

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. Full article

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. Full article

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. Full article

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. Full article

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. Full article

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. Full article

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. Full article

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. Full article

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. Full article

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. Full article

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. Full article

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. Full article

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. Full article

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. Full article

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. Full article

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. Full article

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. Full article

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. Full article