Using the Panel Study of Income Dynamics, we document the association between a child’s learning disability (LD) and a broad set of outcomes for both the child and the parents. Young people with an LD report more police contact, drug use, violence, and incarceration, and have lower educational attainment, well-being, and employment. We also provide evidence that mothers are substantially more likely to be out of the labour force when they have a child with an LD, with exits concentrated around the time of diagnosis. Child ADHD shows no association with parental labour supply.
Background Parent-administered massage-based interventions are increasingly used in family-centered care for preterm infants, but their effects across infant and parental outcomes remain uncertain. Objective To systematically evaluate the effects of parent-administered massage-based interventions on growth, feeding, hospitalization, neurodevelopmental, and parental psychological outcomes in preterm infants. Methods We conducted a PRISMA 2020-compliant systematic review and meta-analysis of randomized controlled trials. PubMed/MEDLINE, Scopus, and Web of Science were searched from inception to 26 May 2026. Eligible studies compared parent-administered massage alone or combined with tactile, kinesthetic, oral, or other developmental sensory components against routine care or non-massage controls. Random-effects models with restricted maximum-likelihood estimation were used. Parental psychological outcomes were synthesized narratively because of substantial heterogeneity. Risk of bias was assessed with RoB 2, and certainty of evidence with GRADE. Results Twenty-four randomized controlled trials were included. Moderate-certainty evidence indicated that massage-based interventions were associated with higher odds of breastfeeding or human-milk feeding at discharge (OR 5.42, 95% CI 2.44–11.94), shorter time to full oral feeding (MD −2.04 days, 95% CI −3.95 to −0.13), and shorter hospital length of stay (MD −4.68 days, 95% CI −7.79 to −1.57). Weight-gain velocity was greater in the primary meta-analysis (MD 5.55 g/day, 95% CI 1.71–9.38), but certainty was low, heterogeneity was very high (I 2 = 97.87%), significant small-study effects were detected, and the trim-and-fill adjusted estimate was attenuated and no longer statistically significant (MD 3.45 g/day, 95% CI −1.67 to 8.56). Parent-related psychological findings were generally favorable but were supported by low-certainty evidence. Effects on length growth, head-circumference growth, and motor development were not statistically significant; certainty for length and head-circumference growth was very low. Conclusion Moderate-certainty evidence suggests that parent-administered massage-based interventions may improve selected feeding outcomes and reduce hospital length of stay in preterm or low-birth-weight infants. The effect on weight-gain velocity remains uncertain because of very high heterogeneity, low certainty of evidence, and possible small-study effects. However, many interventions were multimodal and heterogeneity was substantial; therefore, the findings should be interpreted as effects of parent-delivered developmental-care interventions that include massage rather than massage alone, and the independent effect of massage requires confirmation. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420261435482 , identifier CRD420261435482.
The article is devoted to highlighting the historical path, directions, and significance of the educational activities of Ukrainian physicians in the late 19th and 20th centuries. It demonstrates how medical science expanded beyond private consulting rooms, transforming health protection into a public and national initiative through the integration of foundational knowledge with daily prevention, culture, and public health awareness. The synthesized experience of the Shevchenko Scientific Society (NTSh), the Ukrainian Medical Society (ULT), and the network of “Prosvita” reading rooms attests to the development of medical enlightenment across four key directions: sanitary and hygienic education alongside the fight against epidemics; maternal and child healthcare; the development of professional terminology and publishing; and the preservation of medico-historical memory and ethics. The initial stage of mass public health education in Ukrainian lands was associated with overcoming infectious diseases (typhus, cholera, tuberculosis) through the publication of pamphlets and the format of “loud reading” in rural reading rooms. A foundational contribution to the system was made by prominent figures: Yevhen Ozarkevych laid the ground for Ukrainian-language medical terminology, founded the journals Likarskyi Zbirnyk and Zdorovlie, and established the free outpatient clinic “Narodna Lichnytsia”; Academician Ivan Horbachevsky explained the fundamentals of nutritional hygiene and metabolism to the general public; Zenovii Levytskyi and Ovksentii Korchak-Chepurkivskyi advanced preventive medicine, sanitary statistics, and anti-epidemic protection. The work of Feliks Selskyi contributed to reducing child and maternal mortality, overcoming popular superstitions, and introducing hygienic standards during childbirth. An important vector was the preservation of scientific heritage and ethics, realized in the works of diaspora and domestic scholars.
Lesbian, bisexual and queer (LBQ) women are under increasing threat. The combined nature of patriarchal misogyny, femmephobia and queerphobia contributes to high levels of sexual violence and harassment. Current literature focuses on biomedical health – STIs and pregnancy – and interventions targeting youth behaviour. Sociocultural factors are often treated as secondary. Here, we focus on Contextual Safety (CS) – the relationships, discourses, and interpersonal behaviours of others that afford risk, harm, or safety. Through a critical feminist lens, we explored LBQ femme-women’s retrospective accounts of CS. A Reflexive Thematic Analysis of repeated interviews with 10 femme- and LBQ-identified Australians provided insight into experiences and what can be done to protect young people. Pervasive masculine entitlement, with the media’s sexualisation of LBQ femininity, were key contributors to harm. Left with little choice, subject to feminine devaluation, participants often self-sabotaged in response to sexual threats through feigning and fawning. Participants’ experiences displayed stereotype incompatibility and confusion, leading to behaviours which validate either queer identity or a feigned cis-het identity in equally risky ways. Participants urged families and schools to minimise risk through community education. We must continue to push against the status quo to afford more safety in sexual exploration.
Background School-based physical activity (PA) interventions are a population-level strategy for improving children’s health, yet evidence on their combined effects on physical fitness and psychosocial adaptation remains fragmented. This systematic review and meta-analysis synthesized evidence from controlled intervention trials (randomized and non-randomized) examining school-based PA interventions on physical fitness (cardiorespiratory fitness, muscular fitness, body composition) and psychosocial adaptation (self-esteem, psychological well-being, social functioning) in children aged 6–12 years. Methods Following PRISMA 2020 guidelines, we searched PubMed, Web of Science, Embase, SPORTDiscus, Cochrane Library, and PsycINFO from inception to 15 January 2026. Randomized controlled trials (RCTs) and non-randomized controlled trials with a minimum 8-week school-based PA intervention and at least one physical fitness or psychosocial outcome were eligible. Random-effects meta-analyses were performed using Hedges’ g. Heterogeneity was assessed with I2 and Cochran’s Q. Risk of bias was evaluated using the Cochrane Risk of Bias 2 tool for RCTs and ROBINS-I for non-randomized trials. Results Forty studies (39 randomized, 1 non-randomized) involving 21,793 participants met inclusion criteria. School-based PA interventions were associated with significant improvements in cardiorespiratory fitness (g = 0.36, 95% CI [0.25, 0.46], p < 0.001, I2 = 98%) and muscular fitness (g = 0.24, 95% CI [0.17, 0.31], p < 0.001, I2 = 93%); the small reduction in body mass index did not reach statistical significance (g = −0.11, 95% CI [−0.27, 0.04], p = 0.154, I2 = 98%). For psychosocial outcomes, significant small effects were found for self-esteem (g = 0.18, 95% CI [0.10, 0.27], p < 0.001), psychological well-being (g = 0.15, 95% CI [0.09, 0.21], p < 0.001), and social functioning (g = 0.21, 95% CI [0.04, 0.38], p = 0.018). Exploratory subgroup analyses suggested that larger effects were associated with multicomponent interventions, durations of ≥24 weeks, and ≥3 sessions per week. Conclusion School-based PA interventions were associated with small-to-moderate improvements in physical fitness and small improvements in psychosocial adaptation in children. The findings support integrating comprehensive PA programs into school curricula. However, the small effect sizes for psychosocial outcomes and substantial heterogeneity underscore the need for rigorous studies with standardized measurement protocols.
Adolescent health care has been structured around present-focused approaches: rights, holistic health, risk, and gender.These frameworks have led to substantial progress, but they share a limitation: they describe the adolescent's current state without offering a systematic way to project their future trajectory.We present the prospective-dynamic approach, a conceptual framework that integrates these frameworks with an explicit temporal orientation and draws on self-determination theory, motivational interviewing, the future-oriented perspective on adolescent development, the life-course perspective, and positive adolescent development.The prospective-dynamic approach is organized into five operational componentscomprehensive assessment with a temporal perspective, exploration of desires and purpose, construction of trajectories and scenarios, definition of microgoals, and periodic follow-up checkpoints-which can be incorporated into routine consultations without replacing current approaches.This article discusses its rationale, clinical application, and limitations.
Objective To estimate the lifetime and cumulative direct medical burden associated with childhood overweight and obesity in Kazakhstan using a dynamic age-structured modeling approach. Methods A dynamic age-structured Markov cohort model was developed to simulate the progression of children aged 5–9 years through successive age groups and weight states (normal weight, exclusive overweight, and obesity). Transition probabilities were reconstructed using a synthetic cohort approach based on repeated cross-sectional prevalence data and were calibrated to reproduce observed epidemiological patterns. State-specific annual direct medical costs were estimated using a normative costing approach based on national clinical protocols and tariffs. Lifetime burden was calculated as the discounted sum of future medical costs (3% discount rate). Furthermore, cumulative short-term was estimated for the period 2024–2035. Deterministic sensitivity analysis and structural scenario analysis were conducted to assess model robustness. Policy scenarios examined the impact of reducing childhood obesity prevalence by 5 and 10%. Results The average discounted lifetime cost per child was 96,996.26 KZT (USD 206.37), resulting in a total national lifetime financial impact of 194 billion KZT (USD 413 million) for the 2024 cohort of children aged 5–9 years. Over the 2024–2035 horizon, cumulative discounted direct healthcare expenditure reached 128.72 billion KZT (USD 273.9 million), with approximately 71% attributable to obesity. Sensitivity analysis showed that model results were most responsive to parameters related to obesity prevalence and costs. Structural scenarios indicated that the base-case model likely underestimates cost, with age-varying adult costs increasing estimates by up to 13.6%. Policy scenarios demonstrated that a 5 and 10% reduction in childhood obesity prevalence could reduce lifetime burden by 4.8 and 9.4%, respectively. Conclusion Childhood obesity imposes a substantial and persistent economic impact on Kazakhstan's healthcare system. Preventive interventions targeting obesity in early life may yield significant long-term cost savings and should be prioritized in national health policy.
Berik Koichubekov, Khamida Abdikadirova, Nazgul Omarbekova et al.
We present a STEM-based learning trajectory, centered on the phenomenon of earthquakes, that aims to develop spatial reasoning in eight-year-old children. The trajectory has as an end product the design of an evacuation route. Based on a framework integrating spatial reasoning actions, reference frames, and the differentiation of micro-, meso- and macrospaces, the trajectory tasks combine concrete resources (measuring tools, recycled materials) with digital ones (e.g., Google Maps, Google Earth, LightBot) so that students can analyze representations, measure distances, as well as construct and test instruments and artifacts (e.g., a seismograph) not usually included in the primary school curriculum. It is designed to help students articulate and move between different spatial sizes and their representations and use adequate measuring instruments for each. Within a design-based research (DBR) study, the trajectory was implemented with groups of children from a disadvantaged context in Mexico, in two phases and in different modalities: online, during the Covid-19 pandemic, and face-to-face the following year. We describe the pedagogical framework, learning environment, and trajectory design, and report results derived from the analysis of the implementation data –video and audio recordings, photos and student productions. We discuss the practical implications of combining digital and concrete resources, mathematics and the other STEM disciplines; we argue that this can be considered an extended sense of blended learning that helps build a classroom culture of inquiry and gives children agency over their own reasoning. We end by acknowledging the constraints of our work and discuss the accessibility limitations of the online modality in our implementation.
Ana Isabel Sacristán, Andrea Ortiz-Rocha, Ivonne Sandoval
In modern Russia, the family is at a difficult stage of its development Family difficulties manifest themselves in the following trends: the spread of cohabitation, the prevalence of families with one child, the increase in the number of divorces, the decrease in the birth rate, and the increase in the proportion of women who give birth after the age of 25. In this regard, the problem of preparing students for family life and knowing their opinions about modern values and readiness to start a family is very relevant. Purpose: To study the opinion of medical university students about marriage, family, and children. Materials and methods: The study was conducted in 2022 using a voluntary anonymous online questionnaire through a Google form using a random sample method. The sample included 633 students of the Federal State Budgetary Educational Institution of Higher Education "Smolensk State Medical University" of the Ministry of Health of the Russian Federation. Sociological, analytical, and statistical methods were used. Results and discussion: The study revealed that the majority of medical students surveyed plan to start a family at the age of 25–34; 56.4 % of respondents accept the conclusion of one marriage for life; 69.3 % ‒ believe that marriage is one of the main criteria of the well-being of society; 63.3 % ‒ prefer to start a family on love; 84.8 % ‒ positively react to the large family. Among males: 17.3 % did not see the point in getting married, 85.2 % preferred civil marriage, expressed a negative attitude towards marriage (54.9 %) and the birth of a child (94.4 %) during their studies, and 19.8 % perceived unwanted pregnancy as a reason for abortion. Conclusions: In the value system of medical students, marriage and children occupy a dominant position, but there is a preference for civil marriage and a tendency towards later marriages. The adherence to family traditions and scenarios plays a significant role in shaping the students' marriage strategies. Most students approach pregnancy and childbirth planning responsibly.
