Search Results (2,074)

Background/Objectives: Children with neurodevelopmental disorders (NDDs) frequently present with feeding challenges that can lead to inadequate fruit and vegetable consumption, which can increase their risk of nutritional deficiencies and related health issues. The aim of this scoping review was to describe the main interventions focused on promoting fruit and vegetable consumption in children with NDDs. Methods: Two authors carried out a search strategy in PubMed, Scopus, EMBASE, Web of Science, and PsycINFO using the following terms: “autism OR autistic OR asperger OR rett OR pervasive OR disintegrative OR ‘neurodevelopmental disorder’ OR ‘attention deficit disorder with hyperactivity’”; and the outcome (O): “fruit OR vegetable”. We included all randomized or non-randomized studies, published in English or Spanish, which assessed children’s fruit and vegetable consumption. Results: We included seven articles that applied different interventions, such as a mobile health and behavioral modification program (n = 1), repeated food exposure programs (n = 2), a play-based program with parental training (n = 1); the implementation of Dietary Approaches to Stop Hypertension diet (n = 1); an intensive interdisciplinary mealtime behavioral treatment (n = 1); and restrictive diets (n = 1). Conclusions: Parent-led behavior changes supported by multidisciplinary teams using play, positive reinforcement, and food modification strategies were the main interventions used to increase fruit and vegetable consumption in children with NDDs. This review supports designing evidence-based approaches to improve feeding challenges in this population. Full article

Introduction: Major depressive disorder (MDD) is more prevalent in women, but men with MDD may experience higher suicide risk and a different symptom profile. This study investigates the subjective impact of MDD on health-related quality of life (HR-QoL) in males and females. Methods: A cross-sectional analysis was conducted on a representative sample from six Italian regions. MDD diagnoses were determined through semi-structured clinical interviews, and HR-QoL was assessed using the SF-12 questionnaire. Mania, hypomania, and subthreshold hypomanic symptoms were evaluated using the Mood Disorder Questionnaire (MDQ). Results: Women had a higher prevalence of MDD (6.2%) than men (3.5%). However, men with MDD showed significantly lower HR-QoL scores compared to non-depressed males, with a greater difference than that observed in women. No significant sex differences emerged in psychiatric comorbidities, but men showed a trend toward higher MDQ positivity, possibly indicating a different depressive phenotype. Conclusions: Although less frequently diagnosed in men, MDD appears to have a stronger perceived impact on quality of life in males. This finding may reflect under-recognized symptoms such as irritability, hyperactivity, and social rhythm dysregulation. Gender-sensitive screening and intervention strategies are essential to improve early detection and reduce the untreated burden of depression in men, ultimately supporting more equitable mental health outcomes. Full article

Inattention and hyperactivity/impulsivity that feature Attention-Deficit/Hyperactivity Disorder (ADHD) may be challenging in the classroom setting. However, little is known about language teachers’ self-efficacy and the approaches they would employ to deal with context-specific ADHD-like behaviours. Therefore, this mixed-method study used the vignette methodology to investigate the self-reported efficacy and teaching approaches of 62 pre-service English language teachers from Japan, Poland, Turkey, and Ukraine in managing ADHD-like behaviours in six hypothetical classroom scenarios. By comparing diverse educational and cultural contexts, the study aimed to identify convergences and divergences in coping with these behaviours to promote evidence-based approaches in inclusive language teaching. Data were gathered using an online questionnaire with both open- and closed-ended questions on a Likert-type scale. The findings indicate that participants feel moderately confident in managing ADHD-like behaviours; however, some statistically significant country-related differences were observed. A number of similar teaching approaches were identified across the sample, but prominent country-specific differences in approaching specific ADHD-like behaviours were present. The approaches used by participants align with evidence-based recommendations for teaching students with ADHD to some extent. The discussed implications of the study inform pre-service teachers’ education and call for approaches that are more universal in design and language-skill-development-oriented. Full article

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most prevalent neurodevelopmental disorders in childhood and adolescence, characterized by symptoms of inattention, hyperactivity, and impulsivity. These symptoms often interfere with academic, social, and family functioning. In recent years, the use of digital tools and video games has garnered attention as an innovative and engaging approach for neurocognitive rehabilitation. The primary objective of this randomized controlled study was to investigate the comparative effects of two cognitive intervention approaches—one based on new technologies and one using traditional methods—on attention, inhibitory control, and processing speed in children and adolescents diagnosed with ADHD. Thirty-three participants aged 6–17 years were randomly assigned to either an experimental group (n = 17), which received Nintendo Switch-based therapy, or a control group (n = 16), which received traditional board game therapy. Both interventions lasted 8 weeks and included 16 sessions. Outcomes were assessed using the WISC-V, STROOP, and CARAS-R tests. Results showed significant within-group improvements in both groups. The control group exhibited gains in sustained attention and inhibitory control (CARAS-R and STROOP tests, p < 0.05), while the experimental group improved significantly in processing speed, as measured by the WISC-V (p = 0.001). However, no significant differences were found between groups. These findings suggest that both interventions may be effective for enhancing different cognitive processes in children with ADHD. Importantly, the use of familiar digital technologies like the Nintendo Switch may promote greater motivation and adherence to treatment. Further research with larger samples and long-term follow-up is warranted to validate and extend these preliminary findings, as the current sample size was not powered to detect medium or small effects. Full article

Background/Objectives: Developmental coordination disorder (DCD) commonly co-occurs with attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and specific learning disorder (SLD), affecting academics, mental health, and lifestyle. Although screeners such as the Adolescents and Adults Coordination Questionnaire (AAC-Q) are widely used elsewhere, recognition and support for DCD in Japan remain limited. This study examined associations among DCD traits, ADHD/ASD-related difficulties, learning difficulties, mental health difficulties, and lifestyle factors in university students. Methods: We conducted a web-based survey of 16,295 students; responses from 527 were analyzed. The instruments used for the analysis included the AAC-Q, short forms of ADHD and ASD Difficulty Scales, the 7-item Learning Difficulty Scale for Postsecondary Students and 10-item Scale for Childhood Learning Difficulties, and the University Personality Inventory (UPI). Nonparametric and Spearman’s rank correlations were performed. Results: DCD traits were observed at 7.4% (AAC-Q ≥ 32). This is a screen-positive proportion only. AAC-Q scores correlated strongly with ADHD difficulties (r = 0.65), moderately to strongly with ASD difficulties (r = 0.55), and moderately with mental health difficulties measured by the UPI (r = 0.41). Conclusions: These findings suggest that identifying DCD traits at university entry may be associated with greater student self-understanding and improved access to appropriate support. They support targeted DCD screening alongside ADHD/ASD screening at university entry, rather than universal screening. Full article

(1) Introduction: Distal coronary emboli occur in up to 15–30.5% of patients undergoing percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) and are associated with poor myocardial reperfusion in the territory of the infarct-related artery. The objective of this study was to analyze the possible laboratory, clinical and imaging indicators of distal coronary embolism detected with an angiography at the time of PCI with stent implantation for acute coronary syndrome (ACS). (2) Methods: This analysis included 137 patients with ACS. The levels of cardiac enzymes (creatine kinase [CK], muscle–brain fraction of CK, high-sensitivity troponin T [hsTnT]), inflammatory markers (high-sensitivity C-reactive protein, white blood cell counts), sex steroids (total 17β-estradiol, total testosterone, dehydroepiandrosterone sulfate [DHEA-S]), serum lipids and oxidized low-density lipoproteins (oxLDL) were measured and analyzed for their relationship with the incidence of distal coronary embolism at PCI. (3) Results: Slow coronary blood flow was detected in the coronary artery subject to intervention in 9.4% (n = 13) of patients. Triglyceride (TG), high-density lipoprotein (HDL), glucose and serum DHEA-S levels were found to be associated with distal coronary embolization and slow coronary flow at PCI with stenting (DHEA-S: 1.316, OR 1.044–1.659, p = 0.020; TG: 1.130, OR 0.990–1.300, p = 0.072; HDL: 2.326, OR 0.918–5.8977, p = 0.075; glucose: 1.130, OR 0.990–1.300, p = 0.072). In the multivariable model, only DHEA-S after PCI tended to indicate a risk of distal coronary embolism (DHEA-S: p = 0.071; TG: p = 0.339; glucose: p = 0.582; HDL: p = 0.502). (4) Conclusions: Patients with ACS with higher triglyceride levels are at risk of developing slow blood flow after percutaneous intervention with stent implantation. Elevated DHEA-S possibly reflects sympathoadrenal and hypothalamus–pituitary–adrenal hyperactivity associated with ACS and coronary intervention. Full article

Attention deficit hyperactivity disorder (ADHD) is a complex neurodevelopmental disorder that not only affects attention and behavior but is also intricately linked with sleep disturbances and immune system dysregulation. Recent research highlights that individuals with ADHD frequently experience sleep problems, which in turn exacerbate ADHD symptoms and contribute to cognitive and emotional difficulties. Immunological alterations, including elevated proinflammatory cytokines and hypothalamic–pituitary–adrenal axis dysfunction, have been observed among ADHD patients, suggesting a biological interplay between inflammation, sleep, and neurodevelopment. Genetic and environmental factors further modulate these relationships, influencing the onset and progression of the disorder. Thus, there is a need to find a key connecting such topics and the most vulnerable subjects in order to contribute towards a more personalized approach. This review examines the complex relationships between sleep, immunology, and ADHD, and explores the underlying mechanisms that involve circadian rhythm genes, neuroinflammation, and neurotransmitter imbalances. Our review outlines therapeutic strategies, emphasizing the importance of integrated pharmacological, behavioral, and lifestyle interventions to improve sleep quality, regulate immune responses, and ultimately enhance the overall management of ADHD. Full article

Background: Neurodivergent students, including those with Autism Spectrum Disorder (ASD) and Attention Deficit/Hyperactivity Disorder (ADHD), frequently encounter challenges in several areas of foreign language (FL) learning, including vocabulary acquisition. This exploratory study aimed to investigate real-time English as a Foreign Language (EFL) word recognition using eye tracking within the Visual World Paradigm (VWP). Specifically, it examined whether gaze patterns could serve as indicators of successful word recognition, how these patterns varied across three distractor types (semantic, phonological, unrelated), and whether age and vocabulary knowledge influenced visual attention during word processing. Methods: Eye-tracking data were collected from 17 children aged 6–10 years with ADHD or ASD while they completed EFL word recognition tasks. Analyses focused on gaze metrics across target and distractor images to identify percentile-based thresholds as potential data-driven markers of recognition. Group differences (ADHD vs. ASD) and the roles of age and vocabulary knowledge were also examined. Results: Children with ADHD exhibited increased fixations on phonological distractors, indicating higher susceptibility to interference, whereas children with ASD demonstrated more distributed attention, often attracted by semantic cues. Older participants and those with higher vocabulary scores showed more efficient gaze behavior, characterized by increased fixations on target images, greater attention to relevant stimuli, and reduced attention to distractors. Conclusions: Percentile-based thresholds in gaze metrics may provide useful markers of word recognition in neurodivergent learners. Findings underscore the importance of differentiated instructional strategies in EFL education for children with ADHD and ASD. The study further supports the integration of eye tracking with behavioral assessments to advance understanding of language processing in atypical developmental contexts. Full article

Background/Objectives: Attention deficit hyperactivity disorder (ADHD) is a highly prevalent neurodevelopmental disorder. As the retina is an extension of the central nervous system, retinal imaging may provide insights into the ADHD pathophysiology. The objective of this work was to evaluate structural retinal alterations using optical coherence tomography (OCT) in ADHD patients compared to neurotypical controls. Methods: A case–control study involving 200 eyes (100 from 50 patients with ADHD and 100 from 50 controls) was conducted by comparing the thicknesses of the macular region (total retina, inner and outer retinal layers, ganglion cell layer plus inner plexiform layer [GCIPL], and macular retinal nerve fiber layer [mRNFL]), the peripapillary region (pRNFL), and the optic nerve head (ONH) parameters. Areas under the curve (AUCs) were calculated to evaluate diagnostic performance. Right and left eyes were analyzed separately. Results: Patients with ADHD showed a significant reduction in total and outer retinal thickness across several macular sectors in both eyes. No significant differences were observed in mRNFL, GCIPL, inner retina, pRNFL, or ONH parameters between groups. AUC values derived from ROC analysis indicate moderate diagnostic performance for total and outer retinal thickness in the macular region. Conclusions: ADHD is associated with retinal thinning in the macula (total and outer retinal thickness) in both eyes, suggesting the potential of OCT-based biomarkers for this condition. Full article

The etiology of obsessive–compulsive disorder (OCD) remains incompletely understood, but it is widely recognized as the result of a complex interplay among multiple contributing mechanisms, often emerging during childhood. This narrative review synthesizes current evidence on the etiology of childhood-onset OCD, with particular focus on whether GM alterations are involved in the pathophysiological mechanisms underlying the disorder. Specifically, the review first examines both biological and psychosocial determinants of OCD, and then explores the role of the gut microbiome (GM), including the potential of psychobiotics as a novel therapeutic approach. OCD has a strong hereditary component, involving both common polygenic variants and rare mutations. Epigenetic mechanisms such as DNA methylation and microRNA play a role in mediating gene–environment interactions and influencing OCD risk. Dysfunction and hyperactivity within cortico-striato-thalamo-cortical circuits underlie one of the neurobiological bases of OCD. Infections and autoimmune reactions can trigger or exacerbate OCD, particularly in pediatric populations. A range of psychosocial factors have been implicated in the onset of OCD, often in interaction with underlying neurobiological vulnerabilities. Current evidence indicates that GM alterations may also contribute to OCD pathophysiology through immune-mediated neuroinflammation, disrupted gut–brain signaling, and neurotransmitter imbalance. Individuals with OCD present reduced microbial diversity and lower abundance of butyrate-producing taxa, as well as altered IgA levels and increased infection susceptibility. These shifts may affect dopaminergic, glutamatergic, and serotonergic pathways, particularly via tryptophan metabolism and compromised gut integrity. Thus, the GM plays a pivotal role in OCD, constituting a promising approach for understanding its etiology and highlighting the significant clinical potential of microbial-based treatments such as psychobiotics. Nevertheless, despite progress, gaps remain in understanding childhood-onset OCD determinants, including limited longitudinal studies, incomplete characterization of the GM, scarce psychobiotic trials, and a need for integrated multidisciplinary approaches. Moreover, epidemiological evidence is compromised by reliance on lay diagnoses, questionable assessment validity, and insufficient distinction from related disorders. Full article

Background: In recent years, botulinum toxin (BoNT) has been increasingly employed not only as a corrective aesthetic intervention but also as a proactive strategy to delay the visible signs of facial aging. This systematic review aims to evaluate the scientific evidence supporting the preventive role of BoNT in facial aging, focusing on its long-term effects, mechanisms of action, and clinical outcomes when used in younger, pre-symptomatic populations. Methods: A systematic literature search was conducted across PubMed, Scopus, and Web of Science databases. Inclusion criteria encompassed clinical trials and observational studies addressing the use of BoNT for proactive aesthetic strategies. Results: Evidence suggests that early BoNT application may reduce muscle hyperactivity, delay the formation of dynamic wrinkles, and minimize the development of static lines over time. Histological studies indicate a potential remodeling effect on dermal collagen. However, data remain heterogeneous, and long-term safety and efficacy outcomes are not yet fully established. Conclusion: Preventive BoNT injections represent a promising tool in the proactive management of facial aging. Further longitudinal, high-quality studies are needed to substantiate its role within evidence-based aesthetic protocols. Full article

Attention Deficit Hyperactivity Disorder (ADHD) is a lifelong condition; however, traditional treatment focuses on hyperactivity and inattention, which is largely a manifestation of pediatric ADHD. Studies are limited regarding cognitive difficulties, as seen in adult ADHD, as well as treatment strategies for this population. This review of the literature examines multiple recent studies that discuss various novel treatment strategies for cognitive impairment in adults with ADHD. A targeted literature review was conducted using PubMed to identify recent studies on cognitive dysfunction in adults with ADHD, with an emphasis on emerging treatment strategies. Data collected included sample size, intervention strategies, cognitive function, and side effects. Studies on non-invasive brain stimulation revealed significant effects on executive function in adult ADHD patients. Other studies revealed statistically significant improvements in cognitive flexibility and response inhibition in modafinil users. Another study demonstrated significant improvement in working memory with off label use of viloxazine for adults. This review of the literature describes the effectiveness of novel treatment strategies of adult ADHD including non-stimulant medications, behavioral therapies and neurofeedback. This highlights the need for treatment modalities that enhance cognitive outcomes and further research into long-term efficacy and safety of these novel interventions and implementing psychological treatment into medical management of adult ADHD. Full article

Data on the genetic and environmental factors underlying the co-occurrence of Cognitive Disengagement Syndrome (CDS), Attention Deficit Hyperactivity Disorder (ADHD), and Emotional Dysregulation (ED) are limited. This study aimed to explore the nature of the associations between CDS, ADHD with ED, and to assess the role of shared etiological factors in explaining their comorbidity. We analyzed a sample of 400 Italian twin pairs aged 8–18, from Northern Italy and enrolled in the Italian Twin Registry. Bivariate genetic analyses were conducted using parent-rated CBCL scores for CDS, ADHD, and ED. For both CDS–ED and ADHD–ED associations, the best-fitting models were Cholesky AE models (−2LL = −849.167 and −339.030, respectively; p > 0.05), suggesting that the covariation was mainly due to additive genetic factors (CDS–ED—A = 0.81, 95% CI [0.66–0.95]; ADHD–ED—A = 0.86, 95% CI [0.75–0.95]). More than half of the genes were shown to be shared among the phenotypes. Non-shared environmental contributions were smaller (CDS–ED—E = 0.19, 95% CI [0.05–0.34]; ADHD–ED—E = 0.14, 95% CI [0.05–0.25]), indicating interrelated but distinct constructs. Despite some limitations, particularly the exclusive use of the CBCL, findings highlight the importance of monitoring ED symptoms in individuals with CDS or ADHD, and vice versa. Full article

Background: Refractory epilepsy refers to a type of epilepsy in which anti-epileptic medications do not yield results, necessitating alternative medical interventions. The ketogenic diet (KD) is utilized as a non-pharmacologic treatment for refractory epilepsy. This study aims to assess details regarding caregivers’ awareness and practices, challenges faced, and other details regarding the KD as a treatment option for children with refractory epilepsy. Methods: A cross-sectional study included 15 caregivers of children with refractory epilepsy who adhere to the KD. Data were collected using an online, self-administered questionnaire including socio-demographic characteristics and descriptive aspects of KD on 15 caregivers. Results: Caregivers’ awareness scores varied, over half of the caregivers (53.3%) demonstrated low awareness levels, scoring below the midpoint on the awareness scale, while both caregivers’ adherence (t value = 31.5; p < 0.001) and patients’ adherence levels (t value = 26.1; p < 0.001) significantly exceeded the minimum expected thresholds, indicating effective implementation of the diet protocols. Challenges faced by caregivers were categorized as follow: logistical challenges (e.g., issues related to KD availability, cost, and weighing (15.6%)), behavioral challenges (e.g., avoiding prohibited foods (18.8%), feelings of hunger, the social environment, and never eating without caregivers), and medical challenges (e.g., frequent blood glucose monitoring (25%)). The most common side effects of the KD were gastrointestinal symptoms, including constipation (33.3%) and gastroesophageal reflux disease (GERD). Physical symptoms such as dyslipidemia were also reported by 13.3% of participants. In terms of neurological and behavioral improvements, the three most reduced symptoms following KD adoption were hyperactive attention deficit (25%), tremors (20%), and insomnia (20%). Conclusions: This study reveals a significant gap between high adherence and low awareness of the KD among caregivers of children with refractory epilepsy. While adherence is crucial for the success of KD, this discrepancy highlights the need for comprehensive caregiver education that not only focuses on practical implementation but also on the underlying rationale of the diet. This study underscores the importance of multidisciplinary support, by including dietitians, to bridge the knowledge gap. These findings suggest that dietary education programs should aim to improve caregivers’ understanding, ultimately enhancing adherence and long-term outcomes. Future research should explore the psychosocial factors influencing adherence and the role of trust in healthcare professionals in shaping caregiver behaviors. The findings also call for further exploration into the impact of caregiver education on child health outcomes in the long term. The varied knowledge among caregivers indicates a need for further educational interventions or increased visits from dietitians. Strategies need to be framed to overcome the challenges faced and improve adherence. Full article

Background: Chronic illness affects children’s health and disrupts the spatial and temporal aspects of schooling by complicating attendance, interrupting learning routines, and exposing institutional rigidity. While many educational systems treat chronicity as an exception to be managed, this review reconceptualizes it as a pedagogical and symbolic challenge to normative assumptions about inclusion, care, and participation. Objective: To systematically examine how school-based behavioral and psychosocial interventions support children and adolescents with chronic health conditions (CHCs) in inclusive educational settings and to analyze what these interventions reveal about institutional practices of care and recognition. Methods: Following PRISMA 2020 guidelines, we conducted a systematic search across five databases, PubMed, ERIC, PsycINFO, Scopus, and Web of Science, for studies published between January 2010 and April 2025. Of 420 records screened, 28 studies met inclusion criteria. Eligible studies reported on school-based interventions for students aged 5–18 with chronic conditions. Methodological quality was appraised using the Cochrane Risk of Bias 2 tool (for RCTs) and the Joanna Briggs Institute checklist (for quasi-experimental designs). Findings were synthesized narratively and thematically. Results: The included studies addressed asthma, attention-deficit/hyperactivity disorder (ADHD), diabetes, epilepsy, autism, cancer, and food allergies. Interventions ranged from nurse-led management and teacher training to peer education and executive function coaching. Most reported improvements in symptom control, school attendance, academic performance, and psychosocial wellbeing. Several studies also demonstrated how interventions reshaped institutional routines and distributed responsibility for care, challenging rampant assumptions about autonomy, ability, and normativity. Conclusions: School-based interventions for chronic illness operate as health strategies and as symbolic and structural enactments of inclusion. When designed relationally, they modulate schools into responsive institutions where care is integrated in everyday pedagogical and organizational practices. Future research prioritizes longitudinal studies, underrepresented contexts, and the active participation of youth in shaping interventions. Full article