Search Results (332)

Background: Early childhood caregivers are exposed to intensive caregiving demands and have a high risk of depression. Guided by the family stress process model and Acceptance and Commitment Therapy (ACT), this cross-sectional study examined whether psychological flexibility mediates the association between parenting stress and depression. Methods: A cross-sectional survey was conducted among 1140 Chinese primary caregivers of infants aged 0–36 months in Ya’an, Sichuan, China, from 9 October 2022 to 8 October 2025 using convenience sampling. Validated scales included the Parenting Stress Index-Short Form (PSI-SF), Acceptance and Action Questionnaire-II (AAQ-II) (Higher AAQ-II scores reflected lower psychological flexibility), and Patient Health Questionnaire-8 (PHQ-8). Hayes’ PROCESS Model 4, with 5000 bootstrap resamples, was adopted for the mediation analysis. Results: Parenting stress was positively associated with depressive symptoms (r = 0.335, p < 0.01) (weak-to-moderate effect size). Psychological flexibility exerted a partial mediating effect between the two variables, and the indirect effect accounted for 45% of the total effect. Caregivers with lower household income, lower educational level, and those caring for children aged 0–12 months reported significantly higher depression (all p < 0.05). Conclusions: Parenting stress is an important risk factor for depression, and psychological flexibility plays a significant partial mediating role in this relationship. ACT-based interventions targeting psychological flexibility may hold implications for depression among early childhood caregivers. Full article

Background/Objectives: Early childhood caries (ECC) is a common, preventable, and socially patterned disease, yet the literature on ECC is vulnerable not only to limitations in evidence generation but also to errors in evidence translation. This conceptual framework paper focuses on evidence translation rather than estimating a new treatment effect. Methods: Literature and framework development were informed by targeted narrative searches of PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar, with an emphasis on ECC literature from 2010 onward and foundational methodological sources. Sources were purposively retained if they clarified an evidentiary domain, a cross-domain bridge, or a competing interpretation; priority was given to systematic reviews, trials, longitudinal and causal studies, natural experiments, clinical guidance, and implementation evaluations. No pooled effect estimates were produced. Results: Evidence drift is the movement of a finding into a stronger or different claim without adequate bridging evidence. The proposed framework comprises association, mechanism, causation, consequence, disease control, and policy implementation, with commercial and structural determinants operating as a cross-cutting upstream layer. It classifies the inference advanced rather than study design alone and permits primary and secondary domain tags. A four-question test asks whether the research question and conclusion occupy the same domain, what bridge supports the movement, and whether uncertainty is retained. Five trajectories illustrate the framework: vitamin D, dental rehabilitation under general anesthesia, oral microbiome research, silver diamine fluoride (SDF), and sugar taxation. In the SDF case, lesion-arrest evidence is explicitly separated from the still-unproven implementation hypothesis that endpoint-only pathways may create differential standards of care. Conclusions: The original contribution is an integrated vocabulary, decision procedure, and validation agenda for ECC evidence appraisal. The framework generates three prespecified, testable hypotheses: (1) trained raters will classify claims with reproducible inter-rater agreement (kappa ≥ 0.70); (2) claims judged to contain evidence drift will be significantly less likely than domain-concordant claims to include an explicit bridge; and (3) using the structured framework will improve the transparency and proportionality of reviews compared with usual appraisal. Prospective testing of content and construct validity, as well as practical utility, in peer review, guideline development, education, and policy evaluation is required before standardized implementation. Full article

This article addresses the need to rethink educational innovation as a transformative driver for sustainability within the framework of the Sustainable Development Goals (SDGs), particularly SDG4. Its aim is to analyze the role of arts education as a catalyst for this innovation, with creativity as its primary strategy. To this end, a Scoping Review methodology following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. A review of Open Access (OA) publications indexed in Web of Science (WoS) and Scopus between 2000 and 2025 is conducted. The results of this analysis show that most studies (n = 19) are developed in higher education contexts, with a strong emphasis on publications labeled as innovative and grounded in creativity, as well as a frequent association between innovation and the use of new technologies or digital tools. These publications also explicitly link their proposals to the SDGs, highlighting the central role of arts education in sustainability. However, there is a limited presence of studies at earlier or compulsory educational levels—such as early childhood, primary, or secondary education—as well as in museum contexts, which are closely connected to the arts. The article concludes that arts education holds significant transformative potential to foster engagement with sustainability in the pursuit of critical and creative generations for a more sustainable world. Full article

Background/Objectives: Authentic assessment—the systematic observation of naturally occurring social–emotional behavior by familiar caregivers—is increasingly mandated by international early childhood frameworks, yet the field lacks a comprehensive tool inventory, conceptual clarity on “authenticity,” and synthesized evidence on contextual coverage. This scoping review maps authentic social–emotional development (SED) assessment tools for children aged 0–8, examines how authenticity is conceptualized, and identifies gaps in cultural adaptation, disability inclusion, and age-range coverage. Methods: Following the Arksey and O’Malley framework enhanced by Levac et al. and JBI methodology, six databases (PsycINFO, ERIC, Education Source, MEDLINE, Scopus, Web of Science) were searched for English-language peer-reviewed publications (2006–2026), supplemented by hand-searching and forward citation tracking. Inclusion criteria targeted children aged 0–8 assessed via authentic modalities (naturalistic observation, play-based assessment, portfolio, performance-based tasks, curriculum-embedded measurement) in any global setting. Data charting used an integrated sociocultural and interpretive assessment framework. Reporting followed PRISMA-ScR. Results: Thirty-three studies yielded 43 instruments, 29 meeting authentic assessment criteria. Naturalistic observation predominated (23 studies; 69.7%), followed by play-based assessment (10; 30.3%); portfolio and curriculum-embedded approaches were under-represented. Most studies originated from the United States (57.6%) and targeted preschoolers (3–5 years; 75.8%), with thin coverage of infants/toddlers and primary-grade children. “Authenticity” was operationalized across ecological, participatory, and cultural dimensions rarely integrated theoretically. Conclusions: This review provides the first systematic landscape map of authentic SED assessment for children aged 0–8, confirming feasibility and diversity while revealing gaps in age coverage, geographic reach, and cultural adaptation. The integrated framework offers a potentially transferable analytic model, and findings can inform equitable, contextually responsive assessment practice and policy. Full article

Caregivers’ knowledge of language milestones and active engagement in responsive interactions are critical predictors of children’s long-term literacy and communication outcomes. Qualitative inquiry that captures caregivers’ personal perspectives and systemic barriers is essential in order to fully understand how these language-rich environments are created. This study examines caregivers’ perceptions of their natural everyday interactions with children under five, exploring their knowledge of resources and barriers to accessing speech–language support services. Eight primary caregivers of at least one child aged under five participated. After completing a brief demographic questionnaire each participant engaged in a semi-structured interview focused on their perceptions and knowledge of supporting children’s language development through everyday verbal interactions and navigating barriers to services. Data were analyzed using reflexive thematic analysis. Findings highlight the new insights that emerge when caregivers are asked to reflect on how they create language-rich environments. Participants valued Early Childhood Education (ECE) networks as a key source of information but reported a lack of reliable, accessible guidelines on language developmental milestones. Caregivers also expressed a need for practical strategies to enhance everyday interactions. Despite sample size limitations, these findings highlight challenges faced by caregivers and the critical need for further qualitative inquiry into how caregivers’ perceptions shape communication-supportive practices. Full article

This study utilized an experimental single-case design to evaluate a professional development package to support educators’ implementation of an augmentative and alternative communication (AAC)-supported, play-based naturalistic developmental behavioral intervention (NDBI), which we called naturalistic AAC intervention (N-AAC). Participants were three minimally speaking students with autism (4–8 years of age), each paired with one of their educators (i.e., speech-language pathologist, pre-service special education teacher, early childhood assistant teacher). The primary aim was to examine the effects of professional development on educator implementation of N-AAC. We also descriptively examined changes in students’ communication and language use during educator–child play and generalization to peer interactions. The findings showed that professional development was effective at teaching educators to implement N-AAC with fidelity. Student communication outcomes showed descriptive improvements following educator training and coaching and N-AAC implementation. However, as expected, gains did not generalize to peer interactions. The findings suggest that professional development improves educator implementation of AAC-supported NDBI strategies during play and that their increased implementation fidelity is accompanied by promising descriptive changes in student communication. Future research is needed to further examine the impact on student communication, promote generalization to peer interactions, and evaluate the potential for larger-scale implementation. Full article

Background/Objectives: Health-related quality of life is a key indicator of well-being during childhood and adolescence. This study analysed its association with lifestyle-related factors, body composition, physical fitness, academic performance, and sociodemographic variables. Methods: A cross-sectional study was conducted with 949 schoolchildren from the Canary Islands, Spain, with a mean age of 11.8 ± 1.78 years. Health-related quality of life, moderate-to-vigorous physical activity, and sleep problems were assessed using questionnaires, while physical fitness and body composition were measured using field-based tests and anthropometric assessments. Results: Schoolchildren in the highest health-related quality of life tertile showed higher moderate-to-vigorous physical activity, fewer sleep problems, lower body mass index and waist circumference, better lower-body explosive strength, higher cardiorespiratory fitness, and better academic indicators. The multivariable model explained 27.7% of the variance in health-related quality of life. Sleep problems showed the strongest inverse association (β = −0.352; p < 0.001), whereas Primary Education (β = 0.256; p < 0.001), perceived academic performance (β = 0.124; p < 0.001), moderate-to-vigorous physical activity (β = 0.104; p = 0.001), lower-body explosive strength (β = 0.090; p = 0.045), and male gender (β = 0.094; p = 0.003) were positively associated with health-related quality of life. Conclusions: Schoolchildren’s health-related quality of life is closely related to sleep-related difficulties and, to a lesser extent, to movement behaviour, lower-body fitness, perceived academic competence, and sociodemographic factors. These results may inform integrated school-based strategies that combine sleep education, opportunities for daily movement, fitness development, and support for students’ perceived academic competence. Full article

Background/Objectives: School-based programmes may play an important role in promoting healthier and more sustainable dietary habits from early childhood. This study described and evaluated a community-based intervention aimed at promoting Mediterranean diet (MD) principles, improving food literacy, and raising awareness of sustainable food practices among primary school children in the Tagus Lezíria region, Portugal. Methods: The intervention was implemented in 23 schools across 11 municipalities and included two seasonal rounds of participatory educational activities focused on healthy eating, local and seasonal foods, sensory exploration, balanced meals, composting, food storage, sustainable food production, and food waste prevention. A total of 872 children participated in the intervention activities, and 370 provided paired baseline and follow-up KIDMED assessments. Results: The mean KIDMED score decreased significantly from 8.0 ± 2.2 at baseline to 7.5 ± 2.4 after the intervention. Overall, 31.6% of participants improved their score, 18.9% showed no change, and 49.5% showed a decrease. The proportion of children who did not skip breakfast increased from 79.8% to 88.6%, and avoidance of fast-food restaurants more than once weekly increased from 85.4% to 89.6%. Smaller favourable changes were observed for pastry, sweet, and fish consumption, and olive oil use, whereas fruit, vegetable, pulse, and nut consumption did not improve. Conclusions: The intervention produced heterogeneous outcomes. Although overall MD adherence decreased, almost one-third of participants improved individually, with favourable changes in breakfast and selection of less healthy behaviours. Longer programmes with stronger family involvement may be required to reinforce core MD foods and achieve broader, sustained improvements. Full article

Early childhood education (ECE) in Vietnam remains a heavily feminized profession, deeply influenced by traditional gender stereotypes. This study employs an explanatory sequential mixed-methods design, involving a survey of 256 male teachers and 12 in-depth interviews, to examine their career motivations and professional commitment. Regression analysis reveals that gender stereotypes (β = 0.585, p < 0.001) and professional experiences (β = 0.249, p < 0.001) are the primary predictors of commitment. Findings highlight a significant paradox: despite high intrinsic motivation and positive perceptions of institutional equity, long-term commitment remains low due to persistent societal prejudice and “hyper-visibility” pressure. The study concludes that while schools provide a supportive institutional environment, sustainable workforce diversification requires both institutional and societal efforts to address persistent gender stereotypes. The findings suggest that strengthening the recruitment and retention of male preschool teachers depends on promoting inclusive professional cultures, reducing gender-based stigma, and ensuring that professional recognition and career development opportunities are grounded in demonstrated competencies rather than gendered assumptions. These findings contribute to contemporary debates on gender, professional identity, and workforce diversity in early childhood education. Full article

Anxiety toward experimental sciences may hinder learning, confidence in teaching science, and the professional development of pre-service teachers. Science teaching self-efficacy and familiarity with the STEAM approach have been identified as protective factors, although evidence examining these variables together remains limited. The purpose of this study was to analyze the validity and reliability of a brief measure of science teaching self-efficacy among pre-service teachers through its relationships with anxiety toward experimental sciences, familiarity with the STEAM approach, and academic achievement in science. A quantitative, cross-sectional study was conducted with 325 students enrolled in Early Childhood and Primary Education programs at the University of Jaén, with a mean age of 21.05 years (SD = 2.79). Results indicated that factor analyses supported the unidimensional structure of the Brief Science Teaching Self-Efficacy Scale for Pre-Service Teachers (BSTSES-PST) and showed satisfactory internal consistency. Science teaching self-efficacy was negatively associated with anxiety toward experimental sciences and positively associated with STEAM familiarity and academic achievement. In conclusion, the BSTSES-PST is a valid and reliable instrument for assessing science teaching self-efficacy among pre-service teachers. Greater self-efficacy was associated with lower anxiety, greater STEAM familiarity, and higher academic achievement. Full article

Objective: To systematically evaluate the impact of a school-based sodium reduction education program using mobile health (mHealth), known as EduSaltS, on salt-related knowledge, attitudes, practices (KAP) and sodium intake among adults and children during its real-world scaling-up and to examine geographic and population heterogeneity in its effects. Methods: A multi-center pragmatic pre–post study design was used. The EduSaltS program was implemented in three cities (Ganzhou in southern China, Zhenjiang in eastern China, and Qinhuangdao in northern China) between April 2022 and July 2024. Ten primary schools were selected from each city. Baseline and follow-up surveys were conducted approximately 12 months apart, aligned with the school calendar. Electronic questionnaires were used to collect baseline and post-intervention data on the primary outcome—salt-related KAP—from adults and children. In Ganzhou and Zhenjiang, 24 h urine collections were conducted to measure urinary sodium excretion. Results: A total of 721 adults and 770 children were included in the final analysis. After the intervention, the total KAP scores significantly increased in both adults and children across the three sites: by 8.7–10.0 points in adults and by 11.4–16.7 points in children (all p < 0.001). The changes in sodium intake showed significant heterogeneity. A significant decrease in urinary sodium was observed among adults in Ganzhou (−14.0 mmol/24 h, 95% CI: −26.1, −2.0, p = 0.022), corresponding to a reduction of 0.82 g in daily salt intake. No significant change was found among adults in Zhenjiang (adjusted difference: −0.7 mmol/24 h, 95% CI: −13.4 to 12.0, p = 0.912). In children, after the one-year intervention, urinary sodium excretion showed a significant increase from baseline to follow-up in both cities (Ganzhou: +12.9 mmol/24 h, p = 0.018; Zhenjiang: +14.0 mmol/24 h, p = 0.0002). Conclusions: The pre–post evaluation showed that the EduSaltS program was associated with significant improvements in salt-related knowledge across regions. Its effectiveness in reducing sodium intake, however, varied substantially by population and geographic location. The observed increase in children’s urinary sodium excretion may partly reflect normal childhood growth and the limitations of a pre–post design without a control group. Pragmatic randomized controlled trials are warranted to verify the effectiveness of such interventions in reducing sodium intake and blood pressure across diverse populations and settings. Full article

Background: Sagittal spinal alignment is an important indicator of musculoskeletal health during childhood. Although sports gymnastics has been suggested as a potentially beneficial form of physical activity for postural development, evidence from short-term school-based interventions remains limited. Therefore, the aim of this study was to examine the effects of an additional sports gymnastics training program on sagittal spinal alignment in fifth-grade primary school students. Methods: A total of 139 fifth-grade students (11.0 ± 0.5 years) participated in this quasi-experimental longitudinal study and were allocated to an experimental group (n = 74) and a control group (n = 65). The intervention lasted six weeks and consisted of one additional sports gymnastics session per week (60 min) in addition to regular physical education classes. Sagittal spinal alignment was assessed using the Spinal Mouse device by measuring thoracic kyphosis and lumbar lordosis. Baseline-adjusted between-group differences were evaluated using analysis of covariance (ANCOVA). Results: Small descriptive reductions in thoracic kyphosis and lumbar lordosis were observed in the experimental group; however, these within-group changes did not reach statistical significance. After adjustment for baseline values, ANCOVA demonstrated a statistically significant between-group difference for thoracic kyphosis (F = 5.05, p = 0.026, partial η² = 0.038). Nevertheless, because the adjusted mean value was lower in the control group than in the experimental group, this finding should be interpreted with caution. No significant between-group difference was observed for lumbar lordosis (F = 2.24, p = 0.137, partial η² = 0.017). An increase in the proportion of participants classified as having physiological sagittal spinal alignment was observed in both groups, with a descriptively greater increase in the experimental group (14.9% to 45.9%) than in the control group (7.7% to 35.4%). Conclusions: The findings provide preliminary evidence that a short-term additional sports gymnastics program may be associated with changes in sagittal spinal alignment among school-aged children. However, because of the quasi-experimental design, the low intervention dose, and the short duration of the program, the results should be considered exploratory. Further randomized controlled studies with longer intervention periods are needed to clarify the effects of sports gymnastics on sagittal spinal alignment in children. Full article

Mental health during childhood is a major public health concern, and physical activity has been proposed as a modifiable behaviour associated with psychological well-being and emotional health. This study examined the associations between physical activity and mental health indicators, including psychological well-being, anxiety symptoms, and everyday stress, in primary school children. A cross-sectional study was conducted with 207 children from two schools in Jaén (Spain). Physical activity, psychological well-being, anxiety, and stress were assessed using validated questionnaires. Pearson correlations and multiple linear regression analyses adjusted for age, sex, and socioeconomic status were performed. Physical activity was positively associated with all dimensions of psychological well-being and with total psychological well-being (r = 0.182, p = 0.009). Significant inverse correlations were observed between physical activity and all anxiety dimensions, as well as total anxiety (r = −0.145, p = 0.037), although the association with total anxiety was not significant after adjustment (β = −0.149, p = 0.112). Physical activity was also negatively associated with all stress dimensions and remained significantly associated with lower total stress after adjustment (β = −0.253, p = 0.007). These findings indicate that higher levels of physical activity are associated with greater psychological well-being and lower everyday stress in primary school children. However, given the cross-sectional design, these associations should not be interpreted as causal relationships. Longitudinal studies are needed to clarify the directionality of these associations. Full article

Introduction: In recent years, electronic cigarettes, including disposable e-cigarettes and tobacco heating devices, have grown in popularity, especially among young people and young adults. Although e-cigarettes are touted as a “safer” alternative to traditional cigarettes, a growing body of evidence indicates that vaping can cause serious health problems, especially in the respiratory and cardiovascular systems. Aim of the Study: The aim of the study was to assess the prevalence of disposable e-cigarettes and other nicotine products among adolescents and young adults, as well as to examine the factors associated with regular smoking and nicotine dependence across individual nicotine-containing products. Material and Methods: The survey was conducted among residents of southern Poland. A total of 625 (100%) people were examined. Among them were: 350 women and 275 men. The subjects were aged between 14 and 29 years (Median and 25th–75th percentile: 19; 16–23). The study used an original questionnaire, the completion of which was anonymous and voluntary. The questions included in the survey concerned the smoking status of the respondents, the main sources of nicotine intake and general information such as age, gender, place of residence, employment or education, and financial stability of the family. The survey used the Fagerström test to examine the degree of nicotine dependence among the subjects. Results: A total of 34% (212; 33.92%) of the surveyed group of adolescents and young adults were smokers, most of whom used disposable e-cigarettes (69; 32.55%). In addition, 60% (368; 58.88%) of respondents reported having tried disposable e-cigarettes. Smokers, of both traditional cigarettes and e-cigarettes, accounted for 14% (88; 14.08%) of the study group. The results of the study showed a statistically significant effect of the age of the participants on the method of nicotine intake (p = 0.013). In the younger group, e-cigarettes were more often used, while in the older group, the use of heated tobacco products and traditional cigarettes dominated. Respondents’ median age at the first use of nicotine products was 16 years. Factors such as living in the city, lower financial stability, and having a parent who smoked during childhood were significantly associated with a higher likelihood of regular nicotine product use. Among the regular users, a high level of nicotine dependence was observed in 28.64% (n = 61) of individuals, with the largest proportion occurring among those using electronic cigarettes (39.37%; n = 50). Conclusions: 1. In the study group of adolescents and young adults, disposable e-cigarettes were the most used nicotine-containing product. 2. Parental smoking and male gender were positively associated with the likelihood of smoking, whereas primary education and financial stability were inversely associated with tobacco use. 3. Electronic cigarette users exhibited the highest average nicotine dependence scores. Multivariate analysis confirmed that male gender, the type of nicotine product used, and place of residence were independently associated with higher Fagerström test scores. Full article

This qualitative content analysis investigates how preservice teachers (PSTs) curate primary sources in early childhood and elementary social studies contexts, revealing the ideological implications of their instructional choices. Drawing on 347 selections submitted by 103 PSTs in a scaffolded, inquiry-based assignment, the study analyzes whether selections perpetuate dominant cultural narratives or reflect counternarratives and culturally sustaining practices. Findings indicate that while nearly half of all sources aligned with White, male, Eurocentric perspectives, a significant subset engaged historically marginalized voices, suggesting emergent but uneven commitments to inclusive representation. Selections varied in depth of reflection, often shaped by archival access, curricular constraints, and unexamined pedagogical habits. Grounded in Critical Educational Theory, Reflective Teaching Practices, and Culturally Sustaining Pedagogy, the study highlights the ideological weight of source selection and the need for teacher preparation programs to scaffold reflective, justice-oriented engagement with historical materials. These findings contribute to ongoing conversations about equity, civic responsibility, and culturally responsive teaching in early social studies education. Full article