Background This study aimed to explore young people's knowledge and attitudes around illicit drug use, its prevention, and the barriers and facilitators to accessing support, with the aim of informing the development of preventative interventions that resonate with young people and address their specific needs and concerns. By drawing on these insights, interventions can be tailored to be more engaging, relevant and impactful for young people. Methods A qualitative approach was used to analyse data collected from focus groups and interviews with young people ( N = 97) in the United Kingdom, living in areas of socioeconomic disadvantage. Questions focused on the knowledge of young people around substances, the sort of substance use prevention education, or interventions, they would see as beneficial, and the obstacles and facilitators to accessing support for issues around substance use. Findings The findings suggest that prevention strategies which are likely to appeal to young people should provide non-stigmatizing, harm-reduction approaches to prevention education, which are provided as early as possible. Interventions should provide the skills to enable autonomous decision making, consider including parents/families in education and include trusted sources of support such as those with experience and knowledge of substance use. Conclusions This study informs the development of preventative interventions for young people by providing insight around the knowledge and views of young people in the United Kingdom. It highlights the importance of taking a multifaceted approach to prevention that considers individual, social, and systemic factors.
Abstract Background Outcome measurement in paediatric rheumatology extends beyond inflammatory disease activity to assess fatigue, pain, physical function, psychosocial well-being, and quality of life. Despite the available multiple assessment instruments, their clinical use remains inconsistent across health professions and care settings, limiting comparability. This exploratory international survey aimed to describe current outcome measurement practices among Health Professionals (HPs) working in paediatric rheumatology, identify commonly used and prioritised measures, and explore implementation challenges. It was conducted as part of the Core Outcome Measures work in Paediatric Rheumatology, Shaped by Health Professionals (ComPaS-HP) Initiative. Methods An anonymous international online survey was circulated to the Pediatric Rheumatology European Society (PReS) HPs community, existing paediatric rheumatology HP contacts, HP WhatsApp groups, and congress-related communication channels. HPs working with children and adolescents with rheumatic diseases reported upon current outcome measurement practices, perceived priorities, and implementation challenges. The survey was intended as an exploratory, practice-informed consultation rather than as a representative international survey. Results The survey was completed by 47 respondents from 12 countries across Europe and North America. Respondents were mainly physiotherapists ( n = 31, 66%) and nurses ( n = 11, 23.4%), with psychology, physiology, dietetics, occupational therapy, and epidemiology each represented by one respondent. Across domains, respondents favoured brief, familiar, and clinically practical tools. In routine practice, the strongest preferences were observed for pain scales, the Childhood Health Assessment Questionnaire / Multidimensional Childhood Health Assessment Questionnaire (CHAQ/MD-CHAQ), active joint count, morning stiffness duration, and school participation indicators. The 11-point Numeric Rating Scale was reported as used always or often by 66.0% of respondents, CHAQ/MD-CHAQ by 61.7%, active joint count by 55.3%, and school attendance/participation records by 55.3%. The most frequently reported barriers were time constraints (72.3%) and patient burden (46.8%), whereas the strongest facilitators were short and child-friendly tools (76.6%) and clear guidance or standardised protocols (51.1%). Conclusions These exploratory findings suggest a pragmatic, layered approach to outcome measurement in paediatric rheumatology. Rather than proposing a core set, this exploratory phase identifies practice-informed priorities and implementation-relevant signals that may inform future, more representative consensus-building work within the ComPaS-HP Initiative.
Background The use of electroencephalography (EEG) in automated screening of Attention-Deficit/Hyperactivity Disorder (ADHD) has created a large body of literature that suggests promising outcomes, with reported classification accuracies often above 90%. A major methodological issue suggests that a substantial part of these results are actually due to data leakage, whereby EEG epochs pertaining to the same subject end up in both training and testing sets, allowing classifiers to capitalize on features specific to the individual rather than on genuine disorder-related biomarkers. Methods We assessed the performance of three classical machine learning algorithms, namely, Logistic Regression (LR), Random Forest (RF), and Support Vector Machine (SVM), as well as three deep learning models: Long Short-Term Memory (LSTM), Convolutional Neural Network (CNN), and CNN-BiLSTM, on a standard pediatric EEG dataset containing 121 children and 4,173 epochs. The performance of each model was compared in terms of both segment-wise cross-validation (Protocol A) and subject-wise cross-validation (without any data leakage, Protocol B).To evaluate neurotopographic plausibility without making unsupported causal assertions, we applied Deep SHapley Additive exPlanations (SHAP) to the best-generalizing architecture. Results The performance discrepancy was substantial. Under segment-wise evaluation, the SVM operating on power spectral density (PSD) features reached 90.0% accuracy (95% CI: [89.1%, 90.9%], AUC = 0.96). However, the same model dropped to 65.6% (95% CI: [62.1%, 69.1%], AUC = 0.72) under subject-wise evaluation—a statistically significant 24.4 percentage point collapse ( p < 0.001, Wilcoxon signed-rank). In contrast, deep architectures learning directly from raw EEG were resilient: the stand-alone CNN lost only 2.5 percentage points, achieving 72.7% accuracy (95% CI: [66.0%, 79.4%], AUC = 0.72, recall = 88.0%) on completely unseen participants. Post-hoc SHAP attribution identified the highest relative contributions in frontal (F3, Fz, F4) and central (Cz) electrodes, aligning with established ADHD neurophysiology. Conclusion Hand-engineered spectral features are highly vulnerable to identity leakage, whereas end-to-end convolutional models generalize across subjects with realistic, uninflated performance. Strict subject-wise validation is strongly recommended as standard practice for translational EEG research.
OBJECTIVE: Parents of children with mental health problems often experience judgment about their parenting. Such stigma is associated with lower parental well-being and greater child symptom severity. Theory-driven descriptions of and interventions for parental stigma are limited. The authors aimed to investigate how parents experience and cope with stigma via the What Matters Most framework. METHODS: Interviews were conducted with 24 parents (50% women, mean±SD age=39.8±8.6 years) of children ages 6-17 with depression (N=9), attention-deficit hyperactivity disorder (N=7), or substance use problems (N=8). Interviews explored what parents view as central to being respected as a "good parent," how a child's mental health problems threaten these qualities and shape stigma toward parents, and how parents cope with stigma and restore a positive moral identity. RESULTS: Parents reported being respected for support, open communication, boundaries, role modeling, and their child's well-being. When children have mental health problems, stigma reflects perceived parental failure to meet ideals, leading to emotional distress and self-doubt. With support from peers and clinicians, parents found new ways to fulfill or redefine these ideals, reducing self-stigma. CONCLUSIONS: Parental stigma centers on threats to identity as good parents. Mental health services can mitigate stigma by helping parents reinterpret and reasonably fulfill parenting ideals.
Background Motor skill development is a central objective of school physical education, yet the comparative effectiveness of teaching models remains unclear. Objective This systematic review and network meta-analysis compared physical education teaching models for motor skill development in school-aged children and adolescents. Methods Records were identified from Scopus ( n = 300), Web of Science ( n = 41), OpenAlex ( n = 63), and PubMed ( n = 33). After removal of 42 duplicates, 395 records were screened, 65 full texts were assessed, and 21 studies were retained in the systematic review. Thirteen studies contributed to the under-18 primary network restricted to school-based physical motor execution or sport-specific performance outcomes; 19 contributed to a broader sensitivity network. The protocol was registered in PROSPERO (CRD420261417609). Random-effects models estimated standardized mean differences (SMD) relative to Control and P -score rankings. Results The primary network contained nine treatment nodes. Hybrid Teaching Games for Understanding–Sport Education (TGfU-SE), Nonlinear pedagogy, and Functional games showed the most favorable relative effect estimates in the primary network. However, the treatment ordering was sensitive to outcome definition, participant age, and individual studies, while substantial heterogeneity, network inconsistency, sparse comparisons, and risk of bias remained. In the broad sensitivity network, Cooperative had the highest P -score and estimated effect only while the single Akil visual-motor integration study was included; the node disappeared when that study was removed. Conclusion Restricting the primary network to participants younger than 18 years improved population and outcome comparability and reduced heterogeneity, but significant inconsistency, sparse comparisons, and risk of bias preclude a definitive hierarchy. The P -score ordering should therefore be interpreted as a set of conditional effect estimates rather than proof that one teaching model is universally superior. In practice, physical education teachers should select and implement structured teaching models according to student age, learning objectives, sport content, and teaching context. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420261417609 , identifier PROSPERO (CRD420261417609).
Abstract Therapeutic advances and the rapid, cost-effective development of next-generation sequencing (NGS) have increased interest in expanding newborn screening (NBS) through genomics. The SeDeN-p2 study assessed the acceptability among healthcare professionals in France, of expanding NBS, particularly with genetics as a first-line test, by examining areas of convergence and divergence in their expectations. A national cross-sectional survey was conducted between June and December 2021 via professional networks and learned societies involved in NBS and genetics, in partnership with the French Society of Newborn Screening. The questionnaire comprised 101 closed-ended and 14 open-ended questions. After data cleaning, 1077 responses were analysed. Respondents were mainly paediatricians (43%), gynaecologists or midwives (36%), and medical geneticists or genetic counsellors (17%). Support for the inclusion of treatable childhood-onset conditions was very high, with over 95% endorsing their integration into NBS, although 29% still considered the current NBS programme sufficient. Views varied substantially by specialty, particularly regarding the scope of conditions and the use of NGS. Genetics professionals were more conservative, especially concerning variants with limited actionability, organisational constraints, and interpretive uncertainty, while midwives and gynaecologists were generally more favourable. Convergence was strongest for treatable paediatric conditions and shared ethical concerns, notably data misuse, psychosocial burden, and the child’s future autonomy. The need for improved communication with families was widely emphasised. The SeDeN-p2 study shows strong but conditional support among French healthcare professionals for integrating genetics into NBS, providing key insights to inform future policy and practice.
Camille Level, Frédéric Huet, Dominique Salvi et al.
An estimated one billion children live at extremely high risk of adverse effects from climate change. Even when children are not exposed to direct physical impacts, the existential threat of climate change can have a psychological impact by creating a stressor that exacerbates underlying mental health disorders or contributes to the development of new disorders. Children and adolescents worldwide are experiencing high rates of fear and worry related to climate change, particularly in low- and middle-income countries. Despite this disparate impact, most studies on this topic have been conducted in the Global North. The Galápagos Islands are part of a medium-income nation and will face stark impacts of climate change in the coming decades. Currently, it is unknown how the threat of climate change is affecting the mental health of the children living in the islands. To address this gap, we conducted semi-structured, qualitative interviews with children and adolescents on the island of San Cristóbal to determine their thoughts, perspectives, and understanding of climate change ( N = 30). These interviews also required participants to draw what they expect the island to look like in 100 years. We identified major themes from the interview transcripts and drawings, including the children’s personal identification with nature, feelings of anger and frustration, and feelings of sadness and loss regarding climate change. The findings from this study will inform interventions to promote emotional resilience among the children in San Cristóbal, as well as educational initiatives to address knowledge gaps.
Victoria Moffitt, Kelly Penelope Kennedy, Ayla Malefakis et al.
Background: Antepartum depression (APD) is a significant public health concern affecting maternal well-being, pregnancy outcomes, and child development. In India, APD remains under-recognized despite its high prevalence. Identifying its burden and determinants is essential for strengthening maternal mental health services. Methods: A hospital-based cross-sectional study was conducted among 210 antenatal mothers attending outpatient and inpatient departments from February to May 2025. Sample size was calculated using prevalence from a South Indian study. Data were collected using a pretested semi-structured questionnaire. APD was assessed using the Edinburgh Postpartum Depression Scale (EPDS) with a cut-off score ≥13. Statistical analysis was performed using SPSS version 25. Bivariate analysis employed Chi-square and Fisher’s exact tests, followed by logistic regression for variables with p<0.20. Results: Among the 210 participants, 84 (40.0%) were screened positive for Antepartum depressive symptoms. Maternal education, husband’s occupation, gestational age, social support, and consanguinity showed significant associations. Multivariable analysis identified low/moderate social support (AOR=2.63), gestational age <32 weeks (AOR=3.21), husband’s non-professional occupation (AOR=4.48), and consanguinity (AOR=2.91) factors independently associated with screening-positive antepartum depressive symptoms. Conclusions: APD is highly prevalent, driven largely by psychosocial and socioeconomic factors. Routine EPDS screening and integration of mental health services into antenatal care are strongly recommended. Clinical Significance: Routine screening for antepartum depression using EPDS and identification of high-risk groups such as women with poor social support and socioeconomic stress can improve early detection and management, thereby enhancing maternal and fetal outcomes.
ABSTRACT Early and prolonged parent–child separation (EPPCS) may affect the health and well‐being of affected families. This phenomenon is common but understudied among Chinese immigrant families, especially those living in low‐income communities. Whereas some research has been conducted to understand the mental health and development of separated–reunited children, no research has examined the mental health condition of affected parents. The present study collected interviews ( N = 24) and daily diary survey data (50% of the interview sample) to explore parental mental health and emotions and related factors among Chinese immigrant parents who have reunited with their children after EPPCS. Results integrating qualitative and quantitative analysis showed relatively low challenging mental health conditions in general, yet moderate positive to minor negative emotions (i.e., without extreme emotional reactions) among parents. Factors related to parental mental health included financial stress, children's educational attainment, family relationships, acculturation and homesickness. Parenting stress and a lack of communication with children could affect their negative emotions. Engagement in leisure activities, healthy parent–child bonding, quality family time and the child's advancement in academics were found to be beneficial to parental mental health conditions and positive emotions. The study provides insights for policies and community‐based services to support parents' parenting skills and relationships with their separated children during separation and after reunification.
Abstract Internalizing problems are prevalent in childhood and are associated with exposure to adverse childhood experiences (ACEs); however, their co-development across childhood remains understudied. Prior research documents sociodemographic disparities (i.e., race/ethnicity, sex, income) in ACE exposure and internalizing problems. The current study examined individual and co-developing trajectories of ACEs and internalizing problems and sociodemographic disparities among 4,655 diverse at-risk youth at ages 3, 5, and 9. Participants were 52.2% boys and racially and ethnically diverse, with 44.7% Black, 22.5% Hispanic, 16.7% Other, and 16.2% White youth. Results showed various trajectories with stable levels of cumulative ACE exposure over time and internalizing problems trajectories that decreased or increased over time. Findings provide some evidence for a dose–response relationship between ACEs and internalizing problems. Youth of Color (φ = 0.26, 0.11, 0.19) and from low-income backgrounds ( ϵ 2 = 0.07–0.09, 0.02, 0.06–0.08) were more likely to be in worse trajectories of ACEs, internalizing problems, and joint trajectories across ages 3, 5, and 9, respectively. Findings underscore the need for culturally responsive trauma-informed interventions and policy-level efforts that target the root cause of inequities.
Cynthia M. Navarro Flores, Melanie M. Domenech Rodríguez, Brenna Gomer et al.
