Search Results (1,775)

Background: Physical activity (PA), physical fitness (PF), and motor skills (MS) play crucial roles in overall health and well-being, particularly in early childhood, when habits that affect future health are formed. Methods: This study, involving 299 children (150 boys, 149 girls, mean age 6.9 ± 0.96 years), explored the variance explained by external factors such as socioeconomic status (SES), body composition (BC), sex, and geographical location on motor-related physical fitness (MRPF) and health-related physical fitness (HRPF) in children. Using a variety of assessments, including demographics, anthropometric data, BIA, ActiGraphs, the 20 m shuttle run, 10 and 20 m speed tests, and test items from the Körperkoordinations test für Kinder (KTK) and the TGMD-2, a multiple stepwise regression analysis using SPSS (v 28.0) identified the associated factors. Results: The variables tested show modest explained variance for HRPF, MRPF, and MS, with the largest cumulative explained variance of 26.4%. The explained variances for MRPF and MS were lower (medium to small) than the significant, medium-to-large, explained variances for HRPF. Body fat percentage (BF%), moderate-to-vigorous physical activity (MVPA), parental education and income, and BMI emerged as substantial contributors to HRPF, explaining 12.1% to 26.4% of the variance. Sex, BF%, and quintile status were the most influential associated factors for MRPF, and for MS, BMI and sex emerged as the strongest contributors. Conclusions: These findings underscore the importance of holistic approaches that consider individual factors, such as MVPA, body composition (BC), PA levels, sex, and broader social and economic contexts, to promote children’s well-being. The study emphasises the need for comprehensive strategies to address the multifaceted associations with children’s physical development. Full article

Over recent decades, a substantial body of research has expanded our understanding of how early-life conditions influence long-term health. These observations led to the formulation of the Barker Hypothesis, which postulates that adverse nutritional exposures during fetal life can induce persistent physiological and metabolic adaptations, thereby increasing susceptibility to chronic diseases later in life. This narrative review aims to provide a comprehensive overview of current recommendations for adequate maternal nutrition during pregnancy, with particular emphasis on key nutrients and specific dietary patterns. In addition, the effects of maternal diet on placental function and fetal growth are examined. A literature search was conducted in the following electronic databases: MEDLINE (via PubMed), Scopus, Web of Science, Embase, and the Cochrane Library. Manuscripts published between 2005 and 2025 were considered. The impact of prenatal nutritional exposures on immune development, neurodevelopment, metabolic regulation, and gut microbiota is also discussed, highlighting how these mechanisms may contribute to an increased long-term risk of non-communicable diseases, including obesity, metabolic syndrome, and neuropsychiatric disorders. Maternal nutrition during pregnancy plays a crucial role in shaping infants’ and children’s health, particularly regarding the development of non-communicable diseases. Therefore, ensuring adequate nutritional intake during this critical period—both quantitatively and qualitatively—is essential to optimize health outcomes for the newborn and to promote long-term well-being throughout childhood and beyond. Full article

Background/Objectives: Children with congenital heart disease are exposed to ionizing radiation, which may induce cancer. This study aimed to reassess cancer risk after cardiac catheterization (CC) between 1999 and 2013, with follow-up until 15 years of age, cancer diagnosis, or death. Methods: We studied 2762 children who underwent at least one CC before eight years of age between 1999 and 2013. Cancer diagnoses were obtained from the German Childhood Cancer Registry. For patients with tumors and 60 randomly selected control patients, cumulative effective radiation doses (Deff) were calculated. Results: During 344,80 person-years of follow-up, ten patients developed cancer, whereas 5.3 cases were expected (standardized incidence ratio [SIR] 1.88; 95% CI 0.90–3.46; p = 0.0449). Eight tumors occurred in patients who underwent CC during the first year of life, compared with 3.5 expected (SIR 2.26; 95% CI 0.98–4.46; p = 0.0282). Patients with cancer had a median of 2.0 (1–11) CCs and a median D_eff of 14.6 mSv (2.4–94.3) compared with 1.0 (1–10) CCs and 9.7 mSv (0.7–171.5) in controls. Neither parameter differed significantly. No specific malignancy was predominant. Conclusion: Cardiac catheterization early in life remains associated with an increased cancer risk; however, compared with our previously published 1980–1998 cohort, a reduction in risk was observed. Full article

Hajdu–Cheney syndrome (HCS) is a rare genetic skeletal disorder caused by truncating variants of NOTCH2, characterized by progressive bone resorption and marked phenotypic heterogeneity. Despite advances in understanding Notch signaling in skeletal biology, longitudinal clinical data tracking disease evolution from early childhood through adolescence are lacking. Here, we report a rare longitudinal intrafamilial observation of HCS in a mother and her son carrying the same NOTCH2 pathogenic variant, providing novel insights into disease evolution and therapeutic response. Over extended follow-up, the son exhibited early vertebral fragility despite preserved or supranormal bone mineral density (BMD), whereas the mother developed severe osteoporosis, progressive acro-osteolysis, and multiple vertebral fractures. Longitudinal analysis revealed a dissociation between vertebral fragility and densitometric decline, challenging the paradigm that low BMD is the primary driver of skeletal morbidity in HCS. Treatment responses differed between the two patients, with bisphosphonate therapy in the son associated with stabilized BMD without altering vertebral structural progression, and denosumab in the mother associated with increased BMD, but not preventing progression of acro-osteolysis. Additionally, the emergence of extra-skeletal features during adolescence expands the phenotypic spectrum of HCS and suggests previously unrecognized systemic involvement. These data highlight intrinsic limitations of current therapeutic strategies and emphasize the need for targeted interventions addressing sustained Notch2 activation. Our findings contribute to the understanding of the natural history and therapeutic challenges of HCS, providing the framework for future mechanistic and translational research. Full article

Ototoxicity represents a clinically significant complication of anticancer therapy in pediatric patients. Cytotoxic agents used in oncology, particularly platinum-based chemotherapy, may induce damage to the auditory and vestibular systems, resulting in hearing loss, tinnitus, and balance disturbances. Even mild hearing impairment during childhood may negatively affect speech perception, language development, communication abilities, and subsequent educational and psychosocial functioning. This narrative review aims to synthesize current evidence on treatment-related ototoxicity in children, with particular focus on commonly implicated therapies, clinical consequences, diagnostic approaches, and potential preventive strategies. A focused literature search was conducted in PubMed for publications from 2019 to 2025 addressing ototoxicity associated with pediatric anticancer treatment and audiological monitoring methods. The analysis indicates that platinum-based compounds, especially cisplatin and carboplatin, remain the primary agents associated with ototoxicity, with reported incidence ranging from approximately 20–70% for cisplatin and 10–30% for carboplatin. Additional risk factors include young age, baseline hearing status, renal function, and exposure to other ototoxic agents such as aminoglycoside antibiotics. Early detection relies on comprehensive audiological monitoring combining behavioral and objective methods, including pure-tone audiometry, extended high-frequency audiometry, otoacoustic emissions, and auditory brainstem response testing. Standardized grading systems such as ASHA, Brock, Chang, and SIOP Boston criteria play a key role in identifying and classifying ototoxic changes. Emerging research focuses on improved monitoring protocols, biomarker identification, and the development of otoprotective strategies, including sodium thiosulfate and experimental molecular therapies. Implementing systematic hearing monitoring and preventive strategies is essential to reduce long-term auditory complications and improve quality of life in pediatric cancer survivors. Full article

Background: Globally, rates of children with physical and mental health problems are increasing. Health issues in early childhood often persist into adulthood, highlighting the need to ensure children are supported to flourish from the start of life. Objectives: This protocol describes methods used to test the acceptability and feasibility of a novel digital Flourishing Intervention (designed to empower parents and promote child wellbeing), comprising a Flourishing Check (a newly developed online questionnaire) and a Pathway Tool (an online directory of high-quality, evidence-based programmes and resources). Methods: Using a randomised feasibility trial, participants (N = 600 parents of children aged 0–5 years) will complete the Flourishing Check. The intervention group (n = 400) will access the Flourishing Check and Pathway Tool, whereas a waitlist control group (n = 200) will access the Flourishing Check only. Results: The primary aim is to assess the acceptability and feasibility of the intervention through a mixed-methods design incorporating quantitative data from pre- and post-intervention questionnaires and qualitative data from focus groups. This will be assessed using a traffic light system, which will inform if and how to proceed to a future effectiveness trial. Secondary aims are to assess changes in parent and child outcomes. Primary outcomes will be assessed using descriptive statistics and thematic analysis. Secondary outcomes will be analysed using mixed-effects regression models. Conclusions: We anticipate that the Flourishing Intervention will be feasible and acceptable to parents. This trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12626000187347). Full article

Background/Objectives: Early childhood is a critical period for executive function and broader cognitive development. Physical activity and sleep are modifiable health behaviors that support neurobiological processes underlying learning. While each has been widely examined, research investigating their combined or interactive relationships with learning remains fragmented. This scoping review synthesizes the literature on associations among physical activity, sleep, and cognition in preschool-aged children (3–5 years) and identifies gaps in the integration of these domains. Methods: Electronic databases were searched for peer-reviewed studies published within the past 10 years. Eligible studies included typically developing children aged 3–5 years and examined overlaps between at least two domains: physical activity, sleep, and cognition. Cross-sectional and longitudinal observational studies were included; intervention and review studies, and those conducted during the COVID-19 pandemic, were excluded. Results: Thirty-eight studies met the inclusion criteria. Evidence examining physical activity and sleep was limited and inconsistent. Sleep quality indicators (e.g., sleep efficiency and bedtime regularity) were more often reported to be associated with executive function and broader cognitive outcomes than total sleep duration, which showed variable relationships. Findings linking physical activity and cognition were heterogeneous; however, moderate-intensity and cognitively engaging activities were more often reported in association with executive function than total activity or intensity alone. Conclusions: Findings suggest that sleep quality and characteristics of physical activity may be relevant for preschool cognitive outcomes. Greater integration of these domains is needed, and future research should examine physical activity, sleep, and cognition within a single integrated framework to clarify potential interactive pathways linking these behaviors within this evidence base and to inform physical activity recommendations for early childhood development. Full article

Instructor clarity is a central component of instructional communication and has been consistently associated with positive academic outcomes; however, less evidence exists regarding the mechanisms through which it influences student interest in higher education contexts. From a sustainability perspective, understanding these mechanisms is essential for promoting inclusive, equitable, and high-quality learning environments in line with global educational goals. This study fills a gap in the literature by examining, through multivariate models, the relationship between instructor clarity and student interest as mediated by academic satisfaction and state motivation, within the framework of the Rhetorical/Relational Goals Theory in the Spanish higher education context. A quantitative, cross-sectional, ex post facto research design was employed using a survey method. A non-probabilistic convenience sampling approach was used. A total of 258 undergraduate students from the University of Extremadura enrolled in the Bachelor’s Degree in Early Childhood Education and the Bachelor’s Degree in Primary Education participated in the study. Data were analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM), including an assessment of the model’s predictive capability. The results indicated that instructor clarity was positively associated with academic satisfaction, state motivation, and student interest, with the first two variables acting as complementary mediators in these relationships. Among the predictors, state motivation emerged as the strongest determinant of student interest, whereas the direct effect of instructor clarity was comparatively weaker, highlighting the relevance of indirect pathways. The model demonstrated high predictive power and strong predictive validity with respect to student interest. Overall, the findings indicate that instructor clarity influences student interest primarily through its indirect effects on academic satisfaction and state motivation, emphasizing the importance of fostering motivational processes as key mechanisms linking teaching practices with students’ learning outcomes in higher education. Finally, it should be noted that the findings are directly aligned with Sustainable Development Goal (SDG) 4, contributing to Target 4.3 by enhancing the effectiveness and equity of teaching in higher education, as well as supporting the development of sustainable learning environments that foster long-term student engagement and academic persistence. Full article

Background: Emotional aspects of early dental experiences have long-lasting effects. This study aimed to assess parents’ childhood dental experiences and their impact on current attitudes toward dental treatment and to evaluate the subjectively perceived usefulness of an educational material focused on psychological management of children’s dental visits. Methods: A cross-sectional descriptive pilot study was conducted using an educational booklet developed and distributed to parents, who read it and completed a short questionnaire. Responses received between 27 February–31 March 2025 were analyzed using IBM SPSS Statistics 25. Results: A total of 142 parents (88% mothers) participated. Most participants (83.1%) had a university degree. Negative childhood dental experiences were reported by 44.4% (more frequent among mothers, p < 0.001), and 18.3% had shared these experiences with their children. Emotional discomfort during dental visits was reported by 61.3% of respondents. Dental anxiety was significantly associated with negative childhood experiences (p < 0.001). Parents with higher education were more likely to choose a certified paedodontist for their child than a nearby general dentist (p = 0.002). Most parents (97.9%) found the material provided helpful for managing future dental visits, and 91.6% were willing to share it with others. Conclusions: Childhood dental fear and anxiety may persist into adulthood. Despite the limited generalizability of our results, parents appreciated targeted resources which may support them in promoting positive dental experiences for their children. Full article

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. Full article

Background: Fundamental movement skills (FMS) underpin lifelong physical activity (PA) and health, yet many children are failing to meet age-appropriate standards. Caregivers hold a critical influence over children’s motor development, but little is known about what helps or hinders family participation, including messaging. This study explored the determinants of family FMS engagement in the United Kingdom (UK) during early childhood, addressing unexplored gaps in how guidance reaches families and the role of grandparents in supporting children’s motor development. Methods: Twenty-three semi-structured interviews were conducted with 15 caregivers and 8 educators, including 4 grandparents and 2 family hub practitioners who offered original insights. Eleven children aged 3–5 years completed a flexible draw-and-tell task, enabling inclusion of rarely represented 3-year-olds. Thematic analysis was deployed. Results: Families and outdoor spaces were pivotal to children’s movement opportunities. However, awareness and understanding of FMS and UK PA guidance were poor, even among educators, disrupting dissemination of information to families. Greater emphasis on PA and FMS concepts within professional development, alongside clearer signposting to resources, more visible public-facing campaigns, and digital formats, could improve how families receive these messages. Tensions emerged between parents’ concerns about grandparents’ physical capability and grandparents’ belief that they could adapt to support children’s development. Unexpectedly, no children drew technology despite screen time frequently displacing active play, hinting at its normalisation and regulatory role in children’s lives. Conclusions: To enhance family understanding, value, and participation in FMS, UK policy must evolve to become more visible, relatable, and responsive to diverse family needs. Full article

Childhood obesity is a growing global health problem with significant biomechanical and psychosocial consequences. While many studies have examined these domains separately, few integrate postural abnormalities, psychophysical functioning, and lifestyle factors within a single framework. This narrative review synthesises the literature published between 2005 and 2025 to summarise current evidence and identify research gaps. The findings indicate that overweight and obesity increase the risk of musculoskeletal deviations such as genu valgum, flat feet, and increased lumbar lordosis, as well as altered gait biomechanics and reduced motor competence. Excess body weight is also associated with lower self-esteem, negative body image, depressive symptoms, and reduced health-related quality of life in children and adolescents. These outcomes appear to be influenced by modifiable lifestyle factors, including parental health behaviours, sleep patterns, and screen time, although reported associations remain inconsistent. Notably, few studies address biomechanical, psychological, and environmental factors simultaneously, which limits the understanding of their interactions. To address this gap, a prospective observational study of 250–300 children aged 7–17 years is proposed. The study will combine objective postural assessments, validated psychometric tools, and lifestyle analyses at baseline and after a 12–14-month follow-up. This integrated approach aims to identify postural compensation patterns, psychosocial risk trajectories, and modifiable behavioural predictors associated with childhood obesity, supporting the development of early preventive and interdisciplinary interventions. Full article

Long-chain polyunsaturated fatty acids (LC-PUFAs) of omega-3 family, particularly docosahexaenoic acid and eicosapentaenoic acid, are essential nutrients that play a critical role in children’s growth and health. This review examines the evidence on the effects of omega-3 supplements and omega-3-enhanced foods on children’s development, as well as on neurological and metabolic disorders. Research consistently highlights the importance of DHA in brain and visual development, especially during early childhood, when rapid neural growth occurs. PubMed, Web of Science, Scopus and the Cochrane Library databases were searched for relevant articles published up to January 2026. Adequate omega-3 intake has been associated with improvements in cognitive performance, attention, and learning outcomes. In children with neurodevelopmental conditions such as attention-deficit/hyperactivity disorder and autism spectrum disorder, omega-3 supplementation shows modest but potential benefits in reducing behavioral symptoms and supporting executive function, although results remain mixed. Additionally, omega-3 fatty acids exhibit anti-inflammatory properties that may positively influence metabolic health, including lipid profiles, insulin sensitivity, and obesity-related risk factors in children. Omega-3-enhanced foods provide an alternative to supplements and may improve adherence and overall dietary quality. However, variability in dosage, study design, and baseline nutritional status limits definitive conclusions. Overall, omega-3 fatty acids appear to support healthy development and may aid in managing certain neurological and metabolic disorders in children. Full article

Background: Developing physical literacy in children with developmental disabilities (DDs) is essential to fostering their participation in physical activity. According to the Canadian Framework, physical literacy encompasses multiple interrelated components (behavioral, physical, affective, and cognitive). Such engagement provides numerous benefits, including reduced symptoms of anxiety and depression, as well as improved functional and cognitive health. However, children with DD appear to be less active than those without such conditions. Since individuals who are active during childhood and adolescence are more likely to remain active during adulthood, it becomes crucial to better understand how to support the physical literacy development of children with DD, hence enhancing their participation in physical activity. In addition, children with DD remain underrepresented in the literature, particularly with regard to their opportunities to develop their physical literacy and their varied needs, such as limited physical activity options. Objective: The aim of this scoping review was to identify and analyze the existing literature on the development of physical literacy and physical activity participation in young children (0–6 years) with DD. Methods: Four databases were searched (PsycInfo: n = 722; MEDLINE: n = 997; ERIC: n = 514; CINAHL: n = 771), and 25 articles were retained. Characteristics of these studies were analyzed quantitatively, while their scope was analyzed according to physical literacy components. Results: Most studies (80%) used a quantitative method, and nearly half (44%) concerned young children with autism spectrum disorder. A little more than half of the studies (52%) focused on early intervention programs. In regard to the scope of the studies, none addressed the cognitive component of physical literacy, indicating a lack in the current literature, and more than half provided information on how to support the affective component. Moreover, information regarding parents’ involvement in physical activity of children with DD emerged from six studies analyzed. Conclusions: The results yield interesting insights on how to support the physical literacy development of children with DD and the factors likely to influence their physical activity participation. Early intervention programs promoting physical literacy could be promising avenues to support lifelong physical activity habits for these children. Full article

Background: Most penicillin allergy labels are documented in early childhood and result from events of low risk for allergy. In Germany, evidence-based strategies to evaluate the likelihood of a true penicillin allergy are still lacking. As general practitioner input is indispensable regarding required resources for the implementation of successful delabeling strategies in outpatient care, a mixed-methods study in Baden-Württemberg, Germany explored untapped delabeling potential and conditions for successful initiatives based on their experiences, to support preservation of penicillin as a treatment option and prevent resistance development. Methods: A cross-sectional convergent mixed-methods study was conducted with an online survey and semi-structured interviews. The survey link and invitation to participate in an interview was sent to randomly selected publicly available e-mail addresses. Survey data were analyzed descriptively. Qualitative data were analyzed inductively based on thematic analysis. Results: n = 101 survey questionnaires and n = 15 interviews were analyzed regarding relevance, experiences, framework conditions, and potential approaches to delabeling. All participants with limited recollection of the index reaction. Most participants considered delabeling a highly relevant topic in general practice. Delabeling efforts were discouraged by lack of time, expertise, and remuneration, and uncertainty due to missing guidelines. Taking a sufficient medical history and, if necessary, subsequent testing were seen as one approach to delabeling. For a standardized approach in primary care, patient and care provider education, precise guideline recommendations, and delabeling expert teams were suggested. Conclusions: The findings mirror aspects already identified in international research. A nationwide survey with general practitioners could confirm that addressing necessary resources and systemic adjustments would support effective penicillin allergy delabeling in outpatient care. Full article