Introduction The Missing Piece Surveillance study was a school-based surveillance study documenting group A Streptococcus (Strep A) infection in children in two towns of the Kimberley region of Western Australia (Broome and Derby). The Kimberley experiences higher rates of the serious immune-mediated conditions acute rheumatic fever (ARF) and rheumatic heart disease (RHD), which can result from Strep A infection. The clinical epidemiological study aimed to document the prevalence and features of superficial Strep A infections, particularly impetigo (skin sores) and pharyngitis (sore throat) in children aged 5-15. Surveillance required several years of collaboration with participants, their families, their teachers and their schools to support primary data collection. Methods Following the completion of surveillance, the research team aimed to find a way to share their findings with the communities they worked with, particularly with the children who has provided their time and biological samples. In this study, we describe the use and value of participatory action research methods to co-create two storybooks telling the stories of the Missing Piece study. Results Through consultation, focus groups and reflection, we explored how the design, content and use of storybooks could create meaning for participants. Discussion Resultingly, children's voices and preferences were incorporated into the communication tool, producing an outcome that reflected participatory action methodology and co-creation.
Kassandra Fernando, Ann Grand, Heather J. Bray et al.
Background Fungal infections in children infected with human immunodeficiency virus (HIV) are a significant cause of morbidity and mortality. However, there are no reports on this subject in Nigerian children. Objective This study aimed to document the spectrum of fungal infections and their outcomes in Nigerian children infected with HIV. Methodology The case records of all children infected with HIV in three South West Nigerian tertiary hospitals were studied. Data on the identified fungal infection, clinical presentation, and outcomes were obtained and analyzed. Results A total of 175 children infected with HIV, comprising 89 (50.9%) boys and 86 (49.1%) girls, with ages ranging from 2 months to 16 years, were studied. Of the population studied, 83 (47.4%) had dermatophytosis and 24 (13.7%) had invasive fungal infections (IFIs). Tinea capitis, thrush (pityriasis versicolor), and tinea corporis constituted more than 75% of the dermatophytosis. Invasive candidiasis, Pneumocystis pneumonia, cryptococcal disease, and aspergillosis accounted for more than 95% of the IFIs. Among the 175 children, 61 (34.9%) admissions and 12 (6.9%) deaths were recorded. Nine of the 12 deaths were due to IFIs. Infants and children not on Highly Active Anti-Retroviral Therapy had higher rates of IFIs ( p < 0.01). Admission and death rates were higher among those with IFIs ( p < 0.01). Higher rates of IFIs and dermatophytosis were found among those with a low socioeconomic status ( p < 0.05). Appropriate diagnostics were lacking for Pneumocystis pneumonia and cryptococcal disease diagnosis. Fluconazole was the only antifungal available and accessible for cryptococcal meningitis management. Conclusion Fungal infections cause significant morbidity and mortality in children infected with HIV. Appropriate diagnostics and medications must be made accessible to reverse IFI treatment outcomes.
Olusola Adetunji Oyedeji, Joseph Babafunso Ayinde, Odunayo Afolayan et al.
Stepfamily structure frequently divides parents and stepparents around discipline. This may be rooted in the fact that stepparents lack the attachment history and shared understanding that buffer irritation. Both warm, strong parent-child relationships and positive, caring stepparent-stepchild relationships are firmly linked to children’s well-being. However, effective parenting and positive stepparenting are often different. We have increasingly overwhelming evidence that parents, not stepparents, need to retain discipline and limit-setting, especially early on. Successful stepparents focus on building trusting, caring relationships with their stepchildren. Research is also clearly establishing that most positive stepparent roles are actually not parental. Despite this fact, the quality of stepparent-stepchild relationships is robustly linked to children’s well-being: When stepparents lead with warmth rather than control, a wide range of roles are associated with significantly better emotional and physical health outcomes for children. Conversely, distant, conflicted and coercive stepparent-stepchild relationships are linked to poorer emotional and physical well-being for children. With flexibility, patience, and respect for children’s pacing, stepparent-stepchild relationships can become warm enduring bonds.
Importance Family-centered care is an approach to pediatric health care that recognizes the essential role of the family in ensuring child health and well-being, seeks to establish collaborative partnerships among the child, family, and health care team, and provides a framework for implementing trauma-informed care. However, the association between receiving family-centered care and key measures of child and family well-being, including among families with a history of trauma and adversity, is unknown. Objectives To examine associations between family-centered care and child flourishing and family resilience and connection among US children and to assess whether associations differ by the child’s history of adverse childhood experiences (ACEs). Design, Setting, and Participants This cross-sectional study used 2021 to 2024 National Survey of Children’s Health data from children aged 6 to 17 years. Analyses were conducted in September to December 2025. Exposure Caregiver report of receipt of family-centered care by the child’s physician or other health care practitioners in the past 12 months. Main Outcomes and Measures Child flourishing and family resilience and connection based on caregiver response to established measures. Results This study assessed 110 984 children (mean [SD] age, 11.5 [0.02], years; 57 302 [51.0%] male and 53 682 [49.0%] female) who had a health care visit in the past 12 months. Adjusted for potential confounders, the prevalence of child flourishing was 8.6 percentage points higher (prevalence difference [PD], 0.086; 95% CI, 0.072-0.101), and the prevalence of family resilience and connection was 8.2 percentage points higher (PD, 0.082; 95% CI, 0.069-0.096) for those who received family-centered care compared with those who did not. Among children with and without ACEs, the prevalence of child flourishing (with ACES: PD, 0.112; 95% CI, 0.089-0.132; without ACEs: PD, 0.068; 95% CI, 0.049-0.087) and family resilience and connection (with ACEs: PD, 0.105; 95% CI, 0.085-0.125; without ACEs: PD, 0.0563; 95% CI, 0.043-0.081) was higher for those who received family-centered care compared with those who did not, with larger estimates among children with ACEs than children without ACEs. Conclusions and Relevance Results from this cross-sectional study found that family-centered care was associated with a higher prevalence of child flourishing and family resilience and connection, particularly among those with a history of adversity. These results suggest that family-centered care offers a practical and measurable way for health care professionals to promote well-being for all children and families but particularly for children with a history of ACEs.
Anna E. Austin, Christine Katie Thang, Sasha S. Svendsen
This cross-sectional study examined how language mindset beliefs are associated with psychological well-being and English achievement among Chinese higher vocational students, an underrepresented population in educational psychology. A total of 1,030 students from a private vocational and technical university completed the PERMA-Profiler and Language Mindset Inventory and reported their latest College English Test Band 4 (CET-4) score. Spearman rank-order correlations, regression-based moderation analysis with heteroscedasticity-robust standard errors, Mann–Whitney U tests, and Kruskal–Wallis H tests were used. Growth language mindset (GLM) was strongly associated with overall psychological well-being ( r s = 0.589), with its strongest observed PERMA subscale associations involving meaning ( r s = 0.583), accomplishment ( r s = 0.568), and engagement ( r s = 0.542). Fixed language mindset (FLM) showed weaker associations with positive PERMA subscale scores and its strongest association was with negative emotion ( r s = 0.408). CET-4 scores were only weakly associated with well-being ( r s = 0.110), GLM ( r s = 0.127), and FLM ( r s = −0.080). Neither the well-being × GLM nor the well-being × FLM interaction was significant, indicating no evidence that either language mindset factor moderated the association between well-being and CET-4 achievement. Demographic differences in CET-4 achievement by gender, only-child status, and hometown locale were statistically significant but small; male students also reported slightly higher FLM scores than female students. These findings suggest that the two theory-grounded LMI composite scores are more closely related to learners’ psychological functioning than to standardized English achievement, although their current-sample structural distinctiveness should be interpreted cautiously.
: Parental divorce is a multifaceted family change that may affect children’s emotional security, behavior, educational functioning, social relationships, and long-term psychological well-being. However, contemporary scientific evidence does not support the deterministic view that divorce in itself inevitably leads to impaired psychological adjustment in the child. Rather, a child’s condition is shaped by the interaction of the family climate before the divorce, interparental conflict, the quality of parenting, economic resources, living conditions, the child’s developmental stage, and the quality of relationships after the divorce.
This study applies the Cognitive Grammar framework to Alice Munro’s short story My Mother’s Dream, which centres on a young woman’s struggle to reconcile motherhood with her identity as a violinist in a post-war provincial Canadian community. The narrative intricately plays with the theme of infant death, presented initially as part of the young mother’s dream and revisited as a possibility in the post-climactic scene. Both scenes are analysed through the Cognitive Grammar concept of construal and its dimensions of specificity, prominence, and perspective (Langacker, 2008), complemented by the reference point model and the notion of action chains to explore how narrative meaning emerges through conceptual patterns. These tools enable a scientifically justified explanation of foreboding in the early scene and panic in the later one. Employing a qualitative, interpretive methodology based on close reading and the manual application of the Cognitive Grammar toolkit (Stockwell, 2014; Harrison, 2017a; Giovanelli, et al., 2021), this study demonstrates the framework’s potential to illuminate the processes of meaning encoding and decoding in fictional texts.
Adolescents are increasingly screened for suicide risk in primary care (PC), leading to increased suicide risk identification. Research highlights the importance of parents in promoting adolescent safety and well-being. However, parents and adolescents are not always aligned in how to engage parents in adolescent care. Furthermore, little is known about what support parents need when caring for a child with suicidal thoughts and behaviors (STB) in PC. In this study, 16 pediatric PC professionals, 20 adolescents with histories of STB, and 18 parents of adolescents with histories of STB completed interviews regarding their perspectives on adolescent suicide care in PC. Interviews asked about barriers, facilitators, needs, and if and how parents should be involved in PC-based adolescent suicide care. Interviews were audio recorded, transcribed, and analyzed using inductive and deductive thematic analysis. Results demonstrated that adolescents, parents, and PC professionals believe parents play an important role in adolescent suicide care in PC. However, all groups reported key challenges that impede effective parent involvement, including the following: (a) concerns about mental health and suicide stigma, (b) poor parent-child relationships, (c) parent-child difficulty communicating about mental health and safety, and (d) concerns about patient confidentiality and privacy. Additionally, parents reported needs, including (a) help navigating youth mental health services, (b) emotional support, and (c) education/resources about adolescent STB. Results highlight a tension between adolescent hesitancy toward parent involvement, parents' desire to be more included and informed in their child's care, and PC staff concerns regarding how to navigate this discrepancy. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Abstract This study aimed to ascertain whether paternal involvement in childrearing at 18 months was associated with developmental and caregiving outcomes at the age of 3 years. We used the health examination records of 52,921 children born in Kitakyushu City, Japan, between 2013 and 2019, whose caregivers were designated to answer a question about paternal involvement at the 18‐month examination. Valid responses were given by 33,619 caregivers, of whom 21,956 (65.3%) reported consistent involvement. To adjust for confounding by child and family characteristics, 1:1 propensity score matching was applied, yielding 11,175 matched pairs of children with consistent versus inconsistent involvement. The primary outcome, physician‐flagged developmental issues, was slightly less prevalent among children with consistent paternal involvement (11.1% vs. 12.3%; relative risk .91, 95% CI .83–.99). Fewer children in this group were unable to say their own name (11.8% vs. 13.4%) or had difficulty dressing (5.5% vs. 7.0%). A lower proportion of caregivers reported concerns about childcare (19.6% vs. 23.5%) and frustration with childcare (16.3% vs. 20.3%). These findings suggest that consistent paternal engagement during toddlerhood is associated with slightly better child development and caregiver well‐being, highlighting its potential relevance to early childhood health promotion strategies.
Abstract Genomic medicine has profoundly transformed Nephrology—a specialty uniquely positioned to take advantage of the mechanistic insights provided by genomics that can guide precision care. Genetic kidney diseases account for a substantial proportion of chronic kidney disease in both children and adults, and the integration of genomic testing has redefined diagnosis, management, and even the conceptual architecture of kidney disorders. Contemporary Nephrology is increasingly guided by genomic understandings that clarify pathogenesis, refine clinical classification, and enable precision interventions. As genomic sequencing becomes embedded in clinical workflows, the focus is shifting from single-timepoint analysis to iterative genomic reanalysis. The reinterpretation of genomic data in light of new knowledge, improved annotation, and evolving classification criteria substantially increases diagnostic yield and optimises patient care. Reanalysis represents not only a technical evolution but also a philosophical shift- viewing genomic data as a living, longitudinal resource that requires continual stewardship. This review explores the foundational role of genomics and genetic kidney disease in Nephrology, the state of genomic integration in clinical practice, and the transformative potential of genomic reanalysis. It also considers imminent frontiers, including multi-omics, artificial intelligence, and the foundational importance of equity in genomic care. Together, these advances signal a reimagining of Nephrology—from a phenotype-based discipline to one rooted in molecular precision and iterative discovery.
Jacqueline Soraru, Erik Biroš, Aron Chakera et al.
