Objective: The Certainty About Mental States Questionnaire (CAMSQ) is a self-report measure of individuals' perceived certainty about their own and others' mental states. This study examined the psychometric properties of the Turkish version of the CAMSQ in adolescents aged 14-18 years (CAMSQ-Y-TR). Method: A non-clinical sample of 576 adolescents (M = 15.49, SD = 1.31) completed the CAMSQ, the EPOCH Measure of Adolescent Well-Being (EPOCH), and the Strengths and Difficulties Questionnaire (SDQ). Construct validity was tested with exploratory (EFA) and confirmatory factor analysis (CFA); reliability, criterion validity, and measurement invariance across gender and grade level were also examined. Results: The EFA supported a two-dimensional structure (Self-Certainty and Other-Certainty) explaining 42.01% of the total variance, and the CFA showed acceptable fit (χ²/df = 2.69, CFI = 0.90, GFI = 0.98, RMSEA = 0.054, SRMR = 0.055). Cronbach's alpha was .85 for the total scale, .80 for Other-Certainty, and .82 for Self-Certainty. Self-Certainty was positively related to well-being and negatively related to internalizing symptoms, whereas the Other-Self discrepancy (hypermentalizing) was negatively related to well-being and positively related to internalizing and externalizing symptoms. Full scalar invariance was supported across gender and grade level. Conclusion: The CAMSQ-Y-TR showed sufficient psychometric properties for use with Turkish-speaking adolescents aged 14-18 years.
Emotion regulation is widely assumed to support adolescents’ prosocial behavior, yet evidence from Indonesian senior high schools remains inconsistent, particularly in rural settings. This study described emotion regulation and prosocial behavior among eleventh-grade students at SMA Negeri 1 Talamau, West Pasaman, Indonesia, and examined the relationship between these variables. A quantitative correlational design involved 65 students selected from a population of 187 through proportionate random sampling. Data were collected using Likert-type emotion regulation and prosocial behavior scales comprising 37 items (α = .918) and 38 items (α = .937), respectively. Descriptive percentage analysis and Pearson product-moment correlation were conducted following normality and linearity testing. Most students exhibited high emotion regulation (61.54%), while nearly half demonstrated very high prosocial behavior (49.23%). No students were classified in the low or very low categories. The correlation was positive but very weak and statistically nonsignificant (r = .185, p = .141). These findings provide no evidence of a statistically significant linear association within this sample and caution against assuming that higher emotion regulation necessarily corresponds to greater prosocial behavior in this school context. The study contributes contextual evidence to research on adolescent socioemotional development and recommends combining emotion regulation training with peer-based prosocial programs in school counseling. Future research should involve larger samples and examine empathy and school climate alongside emotion regulation.
The protection of children as victims of sexual violence is a state constitutional obligation requiring comprehensive legal protection. The Witness and Victim Protection Institution (LPSK), established under Law Number 31 of 2014, is mandated to restore victims' rights, yet its assistance is not always available from the outset, as shown by a 2024 child rape case in the Jambi Regional Police jurisdiction handled without LPSK assistance, the problem this study addresses. This study analyzes LPSK's role in protecting children as victims of sexual violence, examines the forms of protection provided, and compares its regulation under positive law and Islamic law. This study uses a normative juridical method with a conceptual approach, statute approach, and case approach, analyzed qualitatively-descriptively. Results show LPSK carries out preventive and repressive protection through eight programs; Jambi Regional Police data recorded 144 protection applications from 2022 to 2025, a declining trend not necessarily reflecting fewer actual cases, while effectiveness remains constrained by limited access to reproductive health services and weak restitution execution. Positive law regulates protection in stages through Law Number 12 of 2022 and Law Number 35 of 2014, while Islamic law situates child protection within maqasid al-sharia, especially hifz al-nafs and hifz al-nasl. Both legal systems, despite differing normative approaches, place children as subjects who must be fully protected.
Background: Universal childhood immunization is among the most cost-effective public health interventions, yet full-immunization coverage in India continues to fall short of the 85% target envisaged under the Universal Immunization Programme (UIP), with substantial dropout and missed opportunities contributing to preventable morbidity and mortality. Objectives: To assess the immunization status of children aged 0–5 years admitted to the paediatric department of a tertiary care hospital in Ahmedabad and its association with socio-demographic determinants, and to identify the reasons for failure of immunization. Methods: A hospital-based, cross-sectional, purposive-sampling study was conducted in the Department of Paediatrics of a tertiary care hospital, Ahmedabad, over 24 months (December 2016–November 2018). Five hundred children aged 0–60 months were enrolled. Immunization status was ascertained by structured maternal/paternal interview, cross-verified against immunization (Mamta) cards, and classified as completely, partially, or non-immunized as per the National Immunization Schedule. Data were analysed on Microsoft Excel using Pearson's chi-square test; p<0.05 was considered significant. Results: Of 500 children (266 male, 234 female), 66.6% were completely immunized, 27.2% partially immunized, and 6.2% non-immunized. Coverage was highest for the birth dose (BCG+OPV+HepB, 85.8%) and lowest for measles-2/booster-1 (57.7%). The BCG-to-measles-1 dropout rate was 16.2% and the Pentavalent-1-to-3 dropout was 11.4%. Complete immunization was significantly associated with joint family structure, institutional delivery, delivery attended by a doctor, higher parental education, and higher family income (all p<0.05); gender, birth order, and possession of an immunization card were not significantly associated. Among the 167 partially/non-immunized children, the leading parent-reported reasons for failure were unawareness of the need for subsequent vaccination (26.3%), child sickness at the scheduled time (14.4%), and lack of faith in immunization (11.9%). Conclusion: Immunization coverage among hospitalised children in Ahmedabad remains below the UIP target and is driven largely by modifiable knowledge, attitude and health-system barriers rather than vaccine unavailability. Structured parental counselling from the antenatal period, reminder and tracking systems, and strengthened interpersonal communication by frontline health workers could substantially narrow the coverage gap.
Maternal and child health service utilisation and pregnancy risk-prevention behaviour remain challenging in geographically isolated and border areas. These outcomes are interrelated because knowledge and attitudes may shape health decisions, while financial, geographical, and social resources determine the ability to translate decisions into action. Purpose: This study aimed to analyse the association of predisposing, enabling, and reinforcing factors with maternal and child health (MCH) service utilisation and pregnancy risk-prevention behaviour among pregnant women in the Melonguane Community Health Centre catchment area, Talaud Islands Regency. Method: An analytical cross-sectional study was conducted among 152 pregnant women from February to May 2026 using total sampling. Data were collected through interviewer-administered questionnaires. Associations were analysed using Chi-square or Fisher’s Exact tests at p<0.05. Multivariable regression was not performed. Results: Knowledge and positive attitudes were significantly associated with both outcomes (p<0.001). JKN coverage, distance to the health centre, transport access, spousal support, and health education were also significantly associated with both outcomes, while household income and community health worker involvement were associated with MCH utilisation. Implications: Maternal health interventions should integrate health education, financial protection, improved geographical and transport access, and family- and community-based support. Conclusion: MCH service utilisation and pregnancy risk-prevention behaviour are associated with interacting individual, enabling, and reinforcing factors. Because the cross-sectional design cannot establish causality and bivariate analysis cannot identify dominant determinants, future studies should use multivariable and longitudinal or intervention designs.
BACKGROUND: Maternal and child malnutrition is a serious public health problem in low and middle-income countries (LMICs) and can cause cycles of poverty, disease, and developmental delays. OBJECTIVE: This comparative narrative review explores maternal and child nutrition indicators, determinants, interventions and policies in India and Palestine and identifies common lessons and transferable recommendations for LMICs. METHODS: A structured, non-exhaustive search of the PubMed, Scopus, Web of Science, and WHO/UNICEF data repositories and some relevant grey literature published from 2010 to 2024 was used to obtain these narratives. Records were reviewed with background eligibility criteria and the evidence included was then thematically synthesised in a narrative format rather than systematically. KEY FINDINGS: India has achieved significant improvement in addressing child stunting and maternal anaemia through key initiatives like POSHAN Abhiyaan, ICDS, and Anaemia Mukt Bharat. However, there are still significant geographic and socioeconomic gaps, and the double burden of malnutrition (undernutrition and overweight) is growing. Palestine is experiencing a unique but significant nutrition crisis, due to prolonged conflict, occupation, and economic turmoil: Around 19.6% of Palestinian children are stunted and IDA is common among pregnant women. Both countries face issues of micronutrient deficiencies, poor infant and young child feeding practices, and gender inequities which negatively impact maternal nutrition. POLICY IMPLICATIONS: The two successful interventions have complementary lessons for each other: the convergence model in India, which is community based, and the integration of nutrition into primary healthcare in Palestine, which benefits from international partnerships. Multi-sectoral responses involving collaboration between the health, agriculture, education, and social protection sectors are needed, with a strong governmental commitment and monitoring systems. CONCLUSIONS: This review highlights that nutrition-specific clinical interventions are essential but that sustainable nutrition improvements need to be implemented through policies that address the underlying structural, socioeconomic, and, in Palestine, the political determinants of malnutrition. The lessons learned from India and Palestine are broadly relevant to other LMICs in a similar context of nutrition transitions.
Abstract Objectives To estimate age trajectories of infant mortality among Palestinian refugees using electronic health records, addressing the scarcity of reliable mortality data in forced displacement settings. Setting Palestinian refugees living in Gaza, West Bank, Jordan, Syria and Lebanon. Design We fitted a Bayesian Negative Binomial model to observed death counts, using a flexible parametric function (a shifting power function) to capture the shape of the infant mortality curve, across strata to infer age trajectories of infant mortality. Participants Palestinian refugees born in 2010–2020 and registered with UNRWA health services in Gaza, West Bank, Jordan, Syria and Lebanon. The sample was stratified by sex, field, gestational age and birth cohort. Main outcome measures Survival rate to age 1. Results Overall, the survival rate to age 1 was 98.64%, with slightly lower rates for males (98.57%) than females (98.68%). Across settings, West Bank refugees had the lowest infant mortality (99.08% survival rate), and Jordan refugees had the highest (98.22% survival rate). Results by gestational age showed a 98.85% survival rate at age 1 among term births compared to a 73.32% survival rate among very preterm births. Survival rates by cohort (births up to 2015 or after) were 98.78% and 98.42%, respectively. Conclusion Our findings highlight the potential of electronic health records for mortality monitoring in forced displacement settings as they reveal consistent mortality trajectories by sex and gestational age, while identifying meaningful variation across refugee settings and subgroups. Summary boxes What is already known in this topic We searched PubMed and Google Scholar for articles published between Jan 1, 2000, and Feb 20, 2026, in English, using the terms “Palestinian refugees,” “infant mortality,” “neonatal mortality,” and “UNRWA.” We found a handful of studies estimating infant mortality among Palestinian refugees, mostly based on household surveys (eg, MICS, national statistical office surveys) or UNRWA surveys using preceding birth techniques. The preceding birth technique has notable limitations, including recall bias, small sample sizes, and selection bias. The majority of these studies focus exclusively on Palestinian refugees residing in Gaza. Estimates for Gaza suggest a sustained decline, from around 127 deaths per 1,000 births in 1960 to 20.2 per 1,000 births in 2006, with a slowdown thereafter and an increase in more recent years. A combined estimate (excluding Syria) across four settings where Palestinian refugees reside measures infant mortality at 18 per 1,000 births in 2011. What this study adds This study uses a unique data linkage bringing together UNRWA’s obstetric and child health records, providing more extensive information and a larger sample size than previous studies. This is also the first study to assess the data quality of these electronic records and to estimate age trajectories of infant mortality among Palestinian refugees. We developed a statistical strategy that estimated infant mortality trajectories covering all five UNRWA fields (Gaza, Jordan, Lebanon, Syria, and the West Bank) for children born in 2010-2020, and examined differences across subpopulations by sex, field, gestational age and cohort.
Introduction: Breastfeeding is a double-duty action proposed to protect simultaneously against undernutrition and overnutrition, yet the shape of the duration–response relationship between breastfeeding and nutritional status in early childhood remains contested, particularly in settings experiencing the double burden of malnutrition. This review aimed to synthesise primary evidence published in the last five years on the association between breastfeeding duration (≤1, 3–5, 6, 6–11 and ≥12 months) and the full spectrum of nutritional status (stunting, underweight, normal weight, overweight and obesity) in children aged 2–6 years. Methods: The study strictly adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020 guidelines. Randomised controlled trials (RCT), prospective and retrospective cohort, case-control and cross-sectional studies were eligible; systematic reviews and meta-analyses were excluded from the evidence tables but used in the discussion. Risk of bias was appraised with a ROBINS-E-adapted domain tool and the Newcastle–Ottawa Scale (NOS) for observational studies and RoB 2 for randomised evidence. Where estimates were comparable, ratio measures were oriented as longer/any versus shorter/no breastfeeding and pooled using DerSimonian–Laird random-effects models, with subgroup, leave-one-out, cumulative, meta-regression and small-study analyses. Certainty was graded with GRADE. Results: 41 studies from 25 countries met eligibility (40 observational, one secondary analysis of a cluster-RCT), comprising more than 161,000 children in the 37 studies that reported sample size. Twenty-seven studies addressed over-nutrition and 13 under-nutrition. Longer or any breastfeeding was associated with lower odds of overweight/obesity (10 estimates from 9 studies; pooled ratio 0.71, 95% CI 0.63–0.80; I² = 60.8%; 95% prediction interval 0.50–1.01), robust to leave-one-out and trim-and-fill adjustment (0.73, 0.64–0.83). The association was stronger for exclusive breastfeeding (0.61, 0.53–0.71) than any/full breastfeeding (0.76, 0.66–0.86; P-between = 0.036) and for obesity (0.55, 0.43–0.71). All seven continuous estimates showed lower BMI z-scores with longer breastfeeding (−0.02 to −0.50). For stunting, pooling was dominated by extreme heterogeneity (0.49, 0.08–3.17; I² = 98.4%) driven by a national survey showing higher stunting with breastfeeding into the third year; after its exclusion the association was protective and homogeneous (0.27, 0.19–0.38; I² = 0%). Most observational studies had some concerns (65.0%) or high (35.0%) overall risk of bias, principally from confounding and recall-based exposure measurement. Discussion: The evidence is compatible with a protective, approximately monotonic association between longer (particularly exclusive) breastfeeding and overweight/obesity at 2–6 years, with benefit already apparent after 3–5 months and extending beyond 12 months. For linear growth, exclusive breastfeeding to 6 months and continued breastfeeding into the second year are associated with less stunting, whereas the apparent harm of breastfeeding beyond 24 months in food-insecure settings is most plausibly explained by reverse causation and inadequate complementary feeding rather than by breast milk itself. Conclusion: Longer breastfeeding is associated with a more favourable nutritional status in early childhood, particularly lower overweight and obesity, with low-certainty evidence; the association with stunting depends on complementary-feeding context and is of very low certainty. Programmes should protect exclusive breastfeeding for six months and continued breastfeeding with adequate complementary feeding, while future cohorts should use prospectively recorded duration categories and causal designs.
Stunting is a disorder of child growth that is caused by a mother’s nutritional status during pregnancy, suboptimal breastfeeding practices, and dietary patterns that do not meet nutritional needs. One of the regions implementing the stunting reduction policy is Sidoarjo Regency under its Health Department. However, less research specifically analyzing how the Health Department integrates organizational, program, resource support, and institutional strategies as the leading sector for accelerating stunting reduction. Therefore, this study aims to analyze the strategies of the Sidoarjo Regency Health Department to hasten the reduction of stunting and explain how integrating these four strategic dimensions contributes to achieving this goal. This study employed a qualitative method, and the research informants included officials from the Sidoarjo District Health Department, health workers, Posyandu cadres, and other stakeholders involved in the program’s implementation. The results show that accelerating the reduction of stunting requires integrating Corporate Strategy, Program Strategy, Resource Support Strategy, and Institutional Strategy into a mutually supportive governance system. Corporate Strategy provides direction for policy and organizational governance; Program Strategy translates policy into integrated interventions; Resource Support Strategy ensures the availability of resources; and Institutional Strategy strengthens cross-sectoral collaboration. Therefore, the effectiveness of implementation is determined by the integration of all four dimensions through mechanisms of coordination, monitoring and evaluation, organizational learning, and continuous feedback. The proposed conceptual model expands on Kooten’s strategic perspective by positioning strategic integration as the foundation of adaptive governance in accelerating the reduction of stunting.
Fajar Muharram, Fauzan Romadlon, Dian Alviana et al.
Professional development for Early Childhood Education (ECE) teachers requires a growth mindset to address instructional challenges and limited access to training, particularly in rural areas. This study aims to examine the association between growth mindset and professional development orientation among ECE teachers in Manggarai Regency, East Nusa Tenggara, Indonesia. Using a descriptive quantitative survey approach, data were collected through a closed-ended Likert-scale questionnaire completed by 29 teachers. Data were analyzed using descriptive statistics (means, standard deviations, and score ranges) across four categories: growth mindset, professional engagement, reflective teaching, and perceived impacts on children’s behavior. The results indicate a strong growth mindset (M = 3.98) and high professional engagement (M = 4.03), although participation in learning communities varied; reflective teaching was also high (M = 3.94), and teachers reported increased children’s independence and learning enthusiasm (M = 3.98). These findings imply the need for context-specific training and strengthened teacher collaboration/learning communities to enhance reflective practice and improve the quality of ECE provision.
