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24,488 reports · page 268 of 2449

Peer-reviewed articleEurope PMC6 Oct 2026

Quantity and quality of outside of schooltime activities and substance use among Minnesota's LGBTQ+ students.

Objective To examine whether quantity and quality of outside of schooltime (OST) activities are associated with substance use among lesbian, gay, bisexual, transgender, queer, and beyond (LGBTQ+) youth. Methods Data came from the Minnesota Student Survey, administered January-June 2022 in public, tribal, and charter schools in Minnesota, United States. The sample included 24,400 LGBTQ+ students in grades 8, 9, and 11. Logistic regression assessed associations between OST activity quantity and quality and past-30-day e-cigarette, alcohol, and cannabis use. Results Overall, 21% of the LGBTQ+ subsample reported past-30-day substance use. Examined independently, high OST quantity was associated with lower odds of e-cigarette (aOR = 0.73, 95% CI = 0.66, 0.81) and cannabis use (aOR = 0.77, 95% CI = 0.68, 0.87). Analyzed together, higher quality was associated with lower odds of all three substances, and inverse associations for quantity became nonsignificant. Adjusting for quality, high quantity was associated with higher odds of alcohol use (aOR = 1.16, 95% CI = 1.05, 1.28). Conclusions Activity quality was more consistently associated with lower odds of substance use than quantity of participation. Constructing high-quality, supportive OST environments could reduce substance use risk and address behavioral health disparities.

Santos J, Gower AL, Kaja SM et al.

ProtectionDevelopment

Peer-reviewed articleEurope PMC28 Sept 2026

Study protocol for a multi-arm, parallel group randomised controlled trial evaluating the isolated and combined effects of behavioural promotion and hardware provision on handwashing with soap in peri-urban Lusaka, Zambia.

Introduction Diarrhoea and lower respiratory infections remain leading causes of under-five mortality in sub-Saharan Africa. Handwashing with soap (HWWS) is a cost-effective intervention, yet adherence remains low. Effective interventions must address multiple behavioural influences, as knowledge alone is insufficient without supportive environments. Multi-component handwashing interventions target diverse behavioural determinants, yet few studies disentangle the isolated and combined effects of different components. This multi-arm randomised-controlled trial in Lusaka, Zambia, aims to assess the isolated and combined effects of hand hygiene behaviour promotion and handwashing hardware and supply provision on HWWS at handwashing opportunities, strengthening the evidence base for designing sustainable handwashing interventions. Methods and analysis This superiority, multi-arm, parallel group randomised-controlled trial will be conducted in five peri-urban communities in Lusaka, Zambia, with 1800 households randomly assigned to four arms (450 households per arm; 1:1:1:1): (A) handwashing hardware and supply provision only, (B) hand hygiene behavioural promotion only, (AB) hand hygiene behavioural promotion+hardware and supply provision, and (C) control (no intervention). Households receiving the hardware and supply intervention (A, AB) will receive a handwashing facility and supplies to make liquid soap solution with a maintenance check after 3 months. Households receiving the hand hygiene behaviour promotion intervention (B, AB) will receive five bi-weekly visits with a sixth follow-up visit 5 weeks later. HWWS behaviour of one household member will be assessed through structured observations at baseline and endline (6 months after intervention delivery begins). Ethics and dissemination Ethical approval was obtained from London School of Hygiene & Tropical Medicine, Research Ethics Committee, London, UK (Ref: 31387), the University of Zambia Biomedical Research Ethics Committee (Ref: UNZABREC 5834-2024) and the Zambia National Health Research Authority (NHRA -1823/23/12/2024). Results of the main trial will be submitted for publication in a peer-reviewed journal. Trial registration number NCT06865495.

Davies K, Chipungu J, Mwila-Kazimbaya K et al.

SurvivalDevelopmentZMRead at source

Peer-reviewed articleEurope PMC1 Jul 2026

Infant Dietary Patterns and Early Childhood Weight Outcomes: A Secondary Analysis from the Starting Early Program Trial.

Background The Starting Early Program (StEP) promotes healthy nutrition during early life and leads to healthier child weight, but whether dietary patterns contribute to weight or mediate StEP weight outcomes has not been studied. Objectives This secondary analysis identified infant dietary patterns in StEP, determined associations between dietary patterns and child weight outcomes, and examined whether dietary patterns mediated the relationship between StEP and child weight. Methods Data were from 377 mother-infant dyads in a randomized trial testing the efficacy of StEP. Dietary patterns at 10 months were identified using latent class analysis. Child weights were abstracted from medical records at 12, 24, and 36 months. Associations between infant dietary patterns and weight-for-age z-score (WFAz) and likelihood of being classified as overweight (WFA ≥85th percentile) were assessed using linear and logistic multivariable regression models. Mediation was used to assess intervention effects on WFAz via impacts on infant dietary patterns. Results Four classes of infant dietary patterns were identified: Breastfed-High variety, Formula fed-High variety, Formula fed-Low variety, and Mixed fed-Low variety. Compared to the Breastfed-High variety class, infants in the Formula fed-Low variety class had higher WFAz and were more likely to be classified as overweight at 24 and 36 months. Participation in StEP increased membership in Breastfed-High variety, which mediated the association between StEP and lower WFAz at 24 months. Conclusions Infant dietary patterns were identified, and some were associated with child overweight. StEP was associated with a dietary pattern most consistent with guidelines, which mediated intervention effects on child weight.

Berube LT, Kim CN, Deierlein AL et al.

SurvivalDevelopmentExperimentalUSRead at source

Peer-reviewed articleEurope PMC29 Sept 2026

Changes in unintended pregnancy among adolescent girls and young women in Nepal: evidence from the Nepal demographic and health surveys, 2001–2022

Abstract Background Unintended pregnancy remains an important reproductive health concern among adolescent girls and young women, with potential implications for health, education, employment, and socioeconomic opportunities. Evidence on changes in unintended pregnancy over time and its associated factors among married women aged 15–24 years in Nepal remains limited. This study examined changes in unintended pregnancy from 2001 to 2022 and factors associated with unintended pregnancy in the 2022 survey. Methods Data from the Nepal Demographic and Health Surveys (NDHS) conducted in 2001, 2006, 2011, 2016, and 2022 were analyzed among married women aged 15–24 years who had at least one child or were currently pregnant. Weighted frequencies and cross-tabulations were used to examine changes across surveys, and multivariable binary logistic regression was used to identify factors associated with unintended pregnancy in 2022. Results The prevalence of unintended pregnancy increased from 25.7% in 2001 to 27.5% in 2006, declined to 23.2% in 2011 and 20.3% in 2016, and increased again to 26.4% in 2022. In 2022, women with unmet need for spacing (AOR = 5.78, 95% CI: 3.68–9.08) or limiting (AOR = 5.46, 95% CI: 3.17–9.40) had higher odds of unintended pregnancy than those with no unmet need. Higher odds were also observed among women with basic education (AOR = 1.71, 95% CI: 1.07–2.73) and secondary or higher education (AOR = 2.61, 95% CI: 1.57–4.34). Pregnancy-related pressure from husbands or family was associated with higher odds, while mobile-phone ownership was associated with lower odds (AOR = 0.66, 95% CI: 0.46–0.94). Women in the Hill region had higher odds than those in the Mountain region (AOR = 2.05, 95% CI: 1.14–3.69). Conclusion Unintended pregnancy fluctuated between 2001 and 2022, declining through 2016 before increasing again in 2022. In 2022, unmet need for family planning, pregnancy-related pressure, education, and Hill residence were associated with higher odds, while mobile-phone ownership was associated with lower odds. These findings highlight the importance of accessible family planning services and support for women’s participation in decisions regarding pregnancy and childbearing.

Karki RD, Subedi G

SurvivalDevelopmentProtectionNPRead at source

Peer-reviewed articleEurope PMC23 Jul 2026

Policy absence and school meal provision in Türkiye: a structured narrative review and policy analysis.

Introduction School meals are increasingly recognized as instruments for supporting child nutrition, educational participation, and social protection. However, limited attention has been given to how the absence of an institutionalized national program can be distinguished from implementation failure, low policy priority, or fragmented provision. This study examines the institutional organization of school food provision in Türkiye. Methods A structured narrative review was combined with qualitative policy document analysis. Epidemiological studies, national institutional reports, legislative and regulatory documents, international guidelines, and comparative program evidence were reviewed. Policy documents were assessed across five dimensions: legal and institutional commitment, program coverage and entitlement, financing, implementation responsibility and continuity, and monitoring and accountability. Results The reviewed evidence indicates that nutritional vulnerability among children and adolescents in Türkiye includes excess body weight, irregular meal patterns, selected micronutrient-related concerns, and socioeconomic conditions that may constrain access to adequate food. The school food system combines household provision, regulated commercial food services, and publicly financed meals for particular eligible groups. Although these arrangements demonstrate that public intervention exists, the document analysis did not identify a comprehensive national program combining clearly defined entitlement, recurrent financing, designated implementation responsibility, continuity, nutritional standards, and integrated monitoring. The Turkish case is therefore characterized by policy absence at the level of institutionalized national program provision, coexisting with regulatory, targeted, and fragmented interventions. Discussion The study does not establish a causal relationship between this institutional configuration and specific nutritional or educational outcomes. It proposes a state-guaranteed, multi-level governance framework combining national financing and standards with decentralized implementation, professional nutritional oversight, participatory monitoring, and independent evaluation. The study contributes an operational framework for analyzing policy absence as an observable institutional condition rather than as the complete absence of public action.

Yılmaz Yıldız SB

SurvivalDevelopmentTRRead at source

Peer-reviewed articleEurope PMC12 Jun 2026

Parental Acceptability and Experiences of In-Bed Resuscitation at Birth: Findings From a Cross-Sectional Survey.

Objective To assess parental acceptability and experiences of in-bed intact cord resuscitation (ICR) vs standard care during neonatal resuscitation in the Sustained Cord Circulation and Ventilation (SAVE) trial. Study design A national cross-sectional electronic survey was administered 1 month postpartum (2022-2025). A questionnaire initially developed by Katheria et al was used to assess parental acceptability and experiences of ICR. The survey targeted parents of neonates enrolled in the SAVE trial, a randomized controlled trial investigating ICR for ≥180 seconds with standard care. Data were analyzed using descriptive and inferential statistics. Acceptability was compared between groups using χ2 tests, with ORs calculated to quantify effect size. Results The response rate was ∼75% and the final analyses included 333 surveys. Most responses were received from mothers. Parents experiencing in-bed ICR reported greater opportunities to see, touch, and maintain proximity to their neonate (OR, 3.88; 95% CI, 2.32-6.48, for physical contact). The in-bed ICR group also expressed a stronger sense of safety and more positive perceptions of study participation compared with those whose neonates received standard care. No differences between the groups were observed in communication with healthcare professionals. Baseline maternal, perinatal, and neonatal characteristics were comparable between the groups. Conclusions These findings demonstrate the psychosocial benefits of in-bed ICR, enhancing parental proximity, safety perceptions, and physical contact during neonatal resuscitation and stabilization. These results provide a vital parental perspective that complements clinical outcomes and supports future considerations of zero-separation practices for resuscitated neonates.

Wilander M, Thies-Lagergren L, Santesson A et al.

SurvivalDevelopmentRead at source

Peer-reviewed articleEurope PMC22 Mar 2026

Participation, Service Utilization, and Unmet Needs in Patients With a History of Pediatric Disorder of Consciousness.

Objectives To describe participation, health care service utilization, and unmet needs in patients with a history of pediatric disorders of consciousness (DoCs) by level of adaptive functioning (AF). Design Cross-sectional study using telephone-based surveys and interview. Setting Community. Participants Convenience sample of caregivers of patients with pediatric DoC (mean years since injury=5.3, SD=4.2) admitted to Kennedy Krieger Institute or Brooks Rehabilitation. Interventions Not applicable. Main outcome measure(s) Child and Adolescent Scale of Participation (CASP), telephone-based survey of health care utilization and unmet needs designed for this study. Results Forty-one patients were classified into three AF groups: extremely low functioning (n=15), low functioning (n=17), and below/broadly average functioning (n=9). CASP scores significantly differed in all areas of home, community, and school participation by AF group, with mean current level of participation of 56.1 in all groups and scores of 36.1, 58.3, and 85.1 in the extremely low, low, and below/broadly average AF groups (P<.001). Service utilization was notable for medical equipment use in 95% with significantly different needs for assistive technology in the extremely low functioning group including wheelchairs (P=.034), feeding tubes (P=.002), and suctioning needs (P=.001). Physician service use was high (93%) but did not differ by AF for primary or specialty services. Therapy services were also used uniformly between all groups, except for mental health services, which were used more frequently in the below/broadly average AF group. Unmet needs were present in 50% of the cohort and did not differ by AF. Therapy services were the most frequently reported unmet need (70%). Conclusions Patients with a history of pediatric DoC have substantial participation restrictions, health care service utilization, and unmet needs several years after brain injury.

Nelliot A, Suskauer S, Slomine BS et al.

SurvivalDevelopmentProtectionUSRead at source

Peer-reviewed articleEurope PMC20 Jul 2026

Violations of the breast milk substitutes act-2013 and its rules - 2017 in Bangladesh.

Background Inadequate breastfeeding practices increase the risk of mortality and morbidity among infants and young children. Recent global estimates suggest that inadequate breastfeeding is responsible for approximately 16% of child deaths worldwide each year, highlighting the ongoing need to strengthen support systems to improve infant and young child feeding practice in Bangladesh, 55% of infants under six months of age are exclusively breastfed. To improve breastfeeding rates and reduce infant mortality, the Government of Bangladesh enacted the Breast-milk Substitute (BMS) Act, 2013, and its Rules in 2017 to regulate the marketing of breast-milk substitutes. Objectives The study aimed to assess violations of the BMS Act, 2013, and Rules, 2017, focusing on the types, actors, and settings of such violations, while also raising awareness of the Act among key stakeholders and the public. Method We carried out a cross-sectional survey among 818 retail outlets and pharmacies; 969 baby-friendly hospitals; 969 doctors, nurses, and other health professionals; and 315 mothers with children aged 0-24 months across eight divisions of Bangladesh from August 2016 to December 2019. Data were collected through structured interviews, direct observations, and document reviews using a modified International Baby Food Action Network-International Code Documentation Centre (IBFAN-ICDC) protocol and the BFHI Hospital External Assessment Tool. Results All retail outlets surveyed (n = 818) sold unregistered BMS products, and all displayed promotional materials. These retail outlets also sold BMS products labeled with health and nutrition claims. In hospitals, 25.5% of doctors (n = 247) and 21.3% of nurses and other health professionals (n = 206) promoted BMS without medical indication. Additionally, 32.0% of health facilities (n = 300) reported providing financial incentives to health professionals to participate in events sponsored by BMS manufacturers. Furthermore, BMS manufacturers violated the BMS Act, 2013 by establishing breastfeeding corners in 164 hospitals (17.5%). Conclusion This study identified extensive violations of the BMS Act 2013 and its Rules 2017 in Bangladesh, revealing unethical promotion and distribution of BMS. Health professionals in BFHI-trained hospitals played a significant role in these breaches, contributing to the erosion of breastfeeding practices. Urgent monitoring and enforcement are needed to protect infant health and uphold national regulations.

Roy SK, Jahan K, Tasnim S et al.

SurvivalDevelopmentBDRead at source

Every report we find, newest first.

How to use the reports

Quantity and quality of outside of schooltime activities and substance use among Minnesota's LGBTQ+ students.

Parental insights about supports for children with disabilities who are restricted eaters.

Study protocol for a multi-arm, parallel group randomised controlled trial evaluating the isolated and combined effects of behavioural promotion and hardware provision on handwashing with soap in peri-urban Lusaka, Zambia.

Infant Dietary Patterns and Early Childhood Weight Outcomes: A Secondary Analysis from the Starting Early Program Trial.

Trends in California Child and Adult Care Food Program Participation Among Family Child Care Home Providers: The Role of Tiered Meal Reimbursements.

Changes in unintended pregnancy among adolescent girls and young women in Nepal: evidence from the Nepal demographic and health surveys, 2001–2022

Policy absence and school meal provision in Türkiye: a structured narrative review and policy analysis.

Parental Acceptability and Experiences of In-Bed Resuscitation at Birth: Findings From a Cross-Sectional Survey.

Participation, Service Utilization, and Unmet Needs in Patients With a History of Pediatric Disorder of Consciousness.

Violations of the breast milk substitutes act-2013 and its rules - 2017 in Bangladesh.

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