INTRODUCTION: A strong mother-infant bond supports healthy development and leads to better long-term outcomes for both mothers and infants. Tools like the Mother-to-Infant Bonding Scale (MIBS) enable objective assessment of this bond. This study examined key psychometric properties of the Dutch MIBS in a Flemish population. METHODS: This study comprised two subsequent parts. First, face and content validity were assessed by an expert panel of healthcare providers (n = 17) and mothers (n = 6). Second, convergent and concurrent validity were assessed based on cross-sectional data collection. Internal consistency was evaluated using Cronbach's alpha. Exploratory factor analysis (EFA) was performed. Evidence based on relationships with demographic and clinical variables was examined to support the validity of the Dutch MIBS. RESULTS: Data were collected from 128 mothers who completed the MIBS and Postpartum Bonding Questionnaire (PBQ) on day 2 postpartum. Experts reached consensus on the face validity of the Dutch version of the MIBS in a Flemish context. Items showed adequate Item Content Validity Index (I-CVI) (≥0.79), except for the "resentful" and "aggressive" items. The scale achieved a Scale Content Validity Index/Average (SCVI/Ave) of 0.89, although internal consistency was moderate (α = 0.66). MIBS and PBQ scores correlated moderately (Kendall's Tau T = 0.27, P < 0.001). Fisher's exact test showed a significant difference in the proportion of mothers classified with disrupted bonding depending on the tool (P = 0.015). Combined feeding was associated with a higher rate of disrupted bonding (P = 0.007). CONCLUSION: This study found that the Flemish MIBS tool had acceptable content validity, except for "resentful" and "aggressive." Reliability was moderate and convergent validity with PBQ was limited, with substantial discordant classification of disrupted bonding. The superiority to the PBQ-tool could not be demonstrated.
Yaël Vanharen, Marie Verstraete, An Van Berendoncks et al.
Although hand transplantation in the adult population is increasingly recognized as an acceptable reconstructive treatment, the ethical trade-offs of performing hand transplants in the pediatric population require closer scrutiny. This analysis applies the concepts of the best interest standard, the Harm Principle, and protections for vulnerable populations to weigh the risks and benefits of immunocompetent pediatric hand transplantation. As only two pediatric hand transplants have been performed to date, much of the outcome data has been extrapolated from the adult population. Such comparisons are problematic given differences in physiology, psychosocial development, adherence, and increased risks of lifelong immunosuppression-including infection, organ failure, and early mortality. Given these uncertainties and our current ethical analysis, immunocompetent pediatric hand transplantation remains ethically impermissible outside of rigorously designed and transparent clinical trials.
Jaclyn T Mauch, Leah M Gudex, Casey J Humbyrd et al.
The adverse effects on parent and child outcomes of poverty and stressors associated with low income are well established. With notable exceptions, however, the potential role of frontline services in improving family financial well-being is underexplored. This article outlines how patient and public involvement (PPI) was initiated early on in research on financial well-being support (FWbS). It illustrates how research can build on and integrate what parents say about services and how to research them. The involvement work was undertaken in one city in part to inform the adaptation of an income maximisation service to be delivered in local children's centres. Parents were involved using two approaches: open events with 'silent conversations', and individual conversations. Parents were invited to comment on four issues: which families should receive FWbS; how to make FWbS accessible; the process of delivering FWbS; and the nature or content of FWbS. The article describes how we approached parents via existing services, how conversations were facilitated and how parents' views informed the immediate service redesign and new research on FWbS to improve parent and child outcomes. It also identifies learning, for instance on engaging people not involved in services, involving people throughout a project and offering training and support for researchers and service providers around how to involve people with lived experience of poverty in respectful and meaningful ways.
Nick Axford, Gisella Hanley, Rebecca Summers et al.
SurvivalDevelopment
Peer-reviewed article·PubMed (US National Library of Medicine)·
IntroductionSexually diverse adolescents report higher suicidality (ideation and attempts) than their heterosexual peers, but information on the onset and course of suicidality from early adolescence to young adulthood among contemporary sexually diverse individuals remains limited. This study traces suicidality trajectories across this critical developmental period, comparing sexually diverse and heterosexual adolescents both overall and by sex assigned at birth.MethodsData was drawn from the Quebec Longitudinal Study of Child Development, an ongoing population-based prospective birth cohort. This study included 1,505 participants who self-reported their sexual attraction at ages 15-17 (2013-2015) and past-year suicidal ideation and attempts using 3-items at ages 13, 15, 17 and 23 (2011-2021) from which a suicidality severity score was derived.Results11.5% of the sample (n = 173, 60.5% female) reported sexually diverse attraction. Growth curve modelling tested the random effect of sexually diverse (vs. heterosexual) attraction on suicidality severity intercept, linear and quadratic latent growth factors. Age-specific contrasts in suicidality severity between sexually diverse and heterosexual adolescents were also examined. Compared to heterosexual adolescents, sexually diverse adolescents showed a steeper increase in suicidality severity from ages 13 to 17, and declining yet persisting disparities from ages 17 to 23. Although developmental trajectories differed across sexually diverse males and females, both experienced greater suicidality severity during adolescence compared with heterosexual peers.DiscussionOur findings point to a developmental trajectory in which sexually diverse adolescents, particularly females assigned at birth, experience elevated suicidality that persists into young adulthood. Targeted and timely interventions during this critical developmental period are essential for suicide prevention.
Peer-reviewed article·PubMed (US National Library of Medicine)·
RATIONALE: Household air pollution is a risk factor for obstructive lung diseases. OBJECTIVES: We estimated the effect of an early-life liquefied petroleum gas cooking intervention on childhood lung function. METHODS: The multi-country Household Air Pollution Intervention Network trial randomized 800 pregnant women (9 to <20 weeks gestation, 18 to <35 years) in Guatemala to receive a gas cookstove and free fuel intervention or continue cooking with biomass until the child is aged 1 year. The present analysis includes only Guatemalan children. At age 3 years, we measured lung function using oscillometry at 7-41 Hz (Tremoflo C-100, Thorasys). Outcomes were resistance and reactance at 7 Hz, area of reactance, resistance at 19 Hz, resistance difference between 7 and 19 Hz, and, as exploration, resistance across frequencies. Upper airway artifacts were removed using Tremoflo software. The effect of the intervention was estimated using linear regression models, unadjusted and adjusted (height, weight, age, sex). Children with respiratory infections during a 7-day recall period were excluded. RESULTS: Valid oscillometry was obtained from 525/750 (70%) 3-year-olds. Among the 225 missed oscillometry tests, 129/225 (57%) were due to the children not being willing to perform the measurements. We did not find evidence of an effect on prespecified oscillometry outcomes. Exploratory analysis suggested that resistance across the frequency spectrum was lower in intervention than control participants (adjusted difference: -0.31 cm H2O*S/L, 95% CI: -0.59, -0.03). CONCLUSIONS: Gas cooking compared to biomass cooking from mid-gestation through infancy was not associated with improved prespecified oscillometry outcomes in 3-year-old children. However, lowered resistance across all frequencies in the intervention arm suggests the intervention may have positively impacted airway caliber. Further studies are warranted, including exposure-response analysis and lung function trajectories. TRIAL REGISTRATION: Clinical trial registered at ClinicalTrials.gov (NCT02944682).
Laura M Grajeda, Keyla Castellanos, Anaité Díaz-Artiga et al.
Peer-reviewed article·PubMed (US National Library of Medicine)·
Excess adiposity is not a recently developed problem but has existed since at least the upper Paleolithic, allowing evolutionary selection pressures to adapt the physiology of the pregnant woman and the feto-placental unit for maternal and fetal protection. Disturbances of the intrauterine environment, in particular metabolic derangements early in pregnancy, such as in women with diabetes and/or obesity, may lead to fetal hyperinsulinaemia. This often results in neonatal adiposity, which may in turn increase the risk for childhood adiposity. In this review, we summarize evidence on possible underlying mechanisms and factors that moderate the association between in utero exposure and childhood adiposity focusing on pregnancies in women with diabetes or obesity. We conclude that in humans causal evidence is missing for fetal programming of adiposity in the deterministic sense as often used and propose a more opportunistic framework. A variety of postnatal exposures and their interaction with the individual's genetic background contribute to the multifactorial problem of excessive adiposity, which may be further compounded by varying sensitivity to environmental perturbations depending on the developmental stage of the individual. We identify research gaps and describe future studies to generate causal evidence necessary.
Gernot Desoye, Ursula Hiden, Evelyn Jantscher-Krenn et al.
BackgroundRecent data highlight problematic rates of mental health symptoms (MHS) among adolescents and young adults following the COVID-19 pandemic, with implications for early identification and clinical service provision. This study estimated the prevalence of MHS and its sociodemographic correlates among Canadian youths.MethodsWe conducted a cross-sectional analysis of 896 iundividuals aged 18-24 years using data from Statistics Canada's Survey on COVID-19 and Mental Health. Symptoms of anxiety, psychological distress, depression, and post-traumatic stress disorder (PTSD) were assessed using validated self-report instruments. Analyses included descriptive statistics, Pearson's chi-square tests, two-way analysis of covariance (ANCOVA), and multivariate linear regression.ResultsParticipants' mean (SD) age was 21.2 (2.0) years; 53% identified as women, and 81% lived in urban areas. Prevalence was highest for psychological distress (57.0%), followed by depression (31.6%), anxiety (23.7%), and PTSD symptoms (12.6%). Women reported higher anxiety and distress than men (p < 0.05). In multivariable analyses, female gender, non-essential worker status, poorer self-rated mental health, weaker community belonging, lower household income, lower life satisfaction, and pre-existing mental health disorder were associated with greater symptom severity (p < 0.05).ConclusionThe rising prevalence of mental health symptoms reflects gendered, socioeconomic, and psychosocial vulnerabilities, requiring trauma-informed clinical screening and equity-focused public health interventions for Canadian youth.
Ogochukwu Kelechi Onyeso, Adebiyi G Boco, Md Kamrul Islam et al.
DevelopmentCA
Peer-reviewed article·PubMed (US National Library of Medicine)·
PURPOSE: To evaluate real-world efficacy of diversified segmental defocus optimization (DSDO) lenses in controlling axial length (AL) growth compared with defocus incorporated multiple segments (DIMS) lenses and no optical correction in children and adolescents with or without myopia. DESIGN: Prospective, multicenter, clinical practice study. PARTICIPANTS: Individuals aged 6 to 16 were recruited from 8 Aier Eye Hospital Group centers in China and wore DSDO lenses, DIMS lenses, or no optical correction. METHODS: Axial length was measured at baseline, 6 months, and 12 months after treatment initiation. Propensity score matching (PSM) was applied to balance baseline characteristics. Axial length changes were compared between DSDO and DIMS lenses in the myopia cohort and between DSDO lenses and untreated control participants in the nonmyopia cohort. MAIN OUTCOME MEASURES: Change in AL over the 6-month and 12-month follow-up periods. RESULTS: A total of 1541 participants were included (myopic group: 654 receiving DSDO lenses and 661 receiving DIMS lenses; nonmyopic group: 85 receiving DSDO lenses and 141 control participants). After PSM, baseline age, sex, spherical equivalent (SE), and AL were well balanced. In the myopic cohort, AL elongation was 0.07 ± 0.12 mm with DSDO lenses and 0.09 ± 0.10 mm with DIMS lenses at 6 months (P = 0.026) and 0.17 ± 0.18 mm versus 0.19 ± 0.16 mm, respectively, at 12 months (P = 0.019). In the nonmyopic cohort, AL growth was 0.18 ± 0.14 mm with DSDO lenses and 0.29 ± 0.14 mm in untreated control participants at 12 months (P = 0.01) and was greater in the hyperopic or emmetropic subgroup (0.00 < SE ≤ 1.50 diopters; P = 0.004). The most pronounced effect was observed within the first 6 months in the nonmyopic control participants. In the myopic cohort, subgroup analyses revealed greater efficacy in children 10 years of age or younger (P = 0.022) and in the low-myopia subgroup (P = 0.001). Age and intervention type independently predicted AL changes, whereas sex did not. Notably, baseline AL was significant determinant of subsequent AL changes in the myopia cohort. CONCLUSIONS: Compared with DIMS lenses, DSDO lenses provide greater control of axial elongation in specific myopic subgroups and effectively suppress physiologic axial growth in nonmyopic children and adolescents. The greatest advantage occurs during the first 6 months and among younger children with low baseline refractive error, highlighting the importance of early, individualized optical intervention for effective myopia prevention and control. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
Peer-reviewed article·PubMed (US National Library of Medicine)·
The 2025 pediatric advanced life support guidelines, developed by the American Heart Association and the American Academy of Pediatrics, are a resource for healthcare professionals caring for infants and children under 18 years of age in peri-arrest and other emergency care situations. The new guidelines address evolving pediatric cardiac arrest patterns, characterized predominantly by respiratory failure or shock, with persistent disparities in out-of-hospital survival and neurological outcomes. Major revisions include setting a blood pressure target above the 10th centile post-cardiac arrest, administering epinephrine after two attempts of defibrillation in a shockable rhythm, and administering early epinephrine in non-shockable cardiac arrest, as well as preventing hyperthermia. It also emphasizes evidence-based strategies such as early high-quality cardiopulmonary resuscitation (CPR), targeted post-arrest care, continuous electroencephalogram for neurological monitoring, and IV sotalol as an option for refractory supraventricular tachycardia. Long-term survivor support and family presence during resuscitation are integrated as vital aspects of care. While core recommendations-such as CPR technique, ventilation strategies, and shock management-are reaffirmed, the update provides a robust framework for multicentric harmonization. The adoption of these updated protocols in promises enhanced resuscitation outcomes, consistent neurological recovery, and the development of context-specific best practices in pediatric emergency care.
BACKGROUND: This study characterizes a pediatric case of fibronectin glomerulopathy (FNG) caused by a novel FN1 variant and investigates the evidence for systemic involvement and genotype-phenotype correlations through a comprehensive literature review. METHODS: We report a female child diagnosed with FNG in February 2017 based on kidney biopsy and genetic testing at our institution. Clinical data and genetic reports were retrospectively analyzed. Fibronectin immunohistochemistry was performed on both kidney and gastric mucosal biopsy specimens. In addition, a literature review of Chinese and English databases was conducted to summarize genetically confirmed FNG cases. RESULTS: The patient was a 9-year-old girl who presented with nephrotic-range proteinuria, microscopic hematuria, hypertension, and progressive kidney decline, culminating in kidney failure ten years after onset. Initial kidney pathology suggested atypical membranoproliferative glomerulonephritis (MPGN). Genetic analysis identified a novel de novo heterozygous deletion in the FN1 gene (NM_212482.5: c.5749_5751delACT; p.Thr1917del). Gastric mucosal immunohistochemistry revealed specific fibronectin deposition within the extracellular matrix, indicating systemic involvement. The comprehensive literature review of 72 patients revealed that the heparin-binding domain is a mutational hotspot, a finding consistent with the variant location in our case. The review also summarized disease management, progression, and post-transplant recurrence risk. CONCLUSION: This study presents the first reported pediatric FNG case internationally associated with the FN1 p.Thr1917del mutation and offers histological evidence suggestive of a possible systemic extracellular matrix proteinopathy. Our findings underscore the value of fibronectin staining and FN1 genetic testing in patients with atypical MPGN and broaden the disease's clinical and genetic profile.
