Global pediatrics最新文献

{"title":"Infant EEG power predicts early childhood language and motor skills in a rural South African cohort","authors":"Shaina P. Brady ,&nbsp;Peter C. Rockers ,&nbsp;Denise Evans ,&nbsp;Lezanie Coetzee ,&nbsp;Diana C. Lopera-Perez ,&nbsp;Günther Fink ,&nbsp;Davidson H. Hamer ,&nbsp;Aisha K. Yousafzai ,&nbsp;Amanda R. Tarullo","doi":"10.1016/j.gpeds.2025.100298","DOIUrl":"10.1016/j.gpeds.2025.100298","url":null,"abstract":"<div><div>Early neural development underlies fundamental behavioral outcomes. In low- and middle-income countries (LMICs), healthy development is often perturbed by compounded adversities, yet little is known about the neural mechanisms driving these trajectories. The current study explores the relationship between infant EEG power and early childhood developmental outcomes at two timepoints in the Greater Tzaneen subdistrict, Mopani district, Limpopo Province, South Africa. In a sample of 242 children, we assessed how EEG relative power at seven months related to development at 17 and 36 months. Increased left hemisphere theta band activity (4–6 Hz) predicted lower caregiver-reported language and motor skills, and increased left hemisphere beta activity (13–30 Hz) predicted reported motor skills at 17 months. Increased infant gamma power (30–48 Hz) in the left hemisphere was associated with higher observed language and gross motor skills at 36 months. Results suggest that early neural oscillations have small but consistent associations with later language and motor skills in a LMIC context.</div></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"14 ","pages":"Article 100298"},"PeriodicalIF":0.0,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145266369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of pain and pain management practices in hospitalized children in Ayder, Tigray, Ethiopia","authors":"Hansa Haftu Lemma,&nbsp;Afewerk Salih,&nbsp;Amanuel Hadgu,&nbsp;Dawit Seyum,&nbsp;Goitom Gebrekidan","doi":"10.1016/j.gpeds.2025.100296","DOIUrl":"10.1016/j.gpeds.2025.100296","url":null,"abstract":"<div><h3>Background</h3><div>Pain in children is a commonly unaddressed, neglected, and undertreated issue. This study aims to assess pain, the clinical profile associated with pain, and pain management practices in children.</div></div><div><h3>Methodology</h3><div>A hospital-based cross-sectional study was conducted in the Pediatric ward from March 20 to June 30, 2020. A total of 238 children were selected using a stratified sampling method. Pain was assessed through history (guardian/patient report), the FLACC scale (for infants and young children), and a numerical pain scale for older children. Data were analyzed using SPSS, with statistical significance considered at p-value &lt; 0.05.</div></div><div><h3>Results</h3><div>All 238 patients were enrolled in the study. The mean age of the study subjects was 6.6 ± 5.5 years. The severity of pain was assessed at the time of admission, during the hospital stay, and at discharge. The overall pain prevalence, as reported by caregivers and patients, was 67.6 %. Based on different pain assessment tools for various age groups, the magnitude of pain was 64.3 % at admission, 55.9 % during the hospital stay, and 26.5 % at discharge. Multivariable regression showed that age, area of residency, and diagnosis were significantly associated with pain. Eighty-four children (39.3 %, 84/214) who were in pain did not receive any pain relief. Paracetamol was used as an analgesic in 31.8 % of patients, and &gt;50 % of paracetamol doses were administered as needed.</div></div><div><h3>Conclusion</h3><div>Pain remains a prevalent problem at admission and during the hospital stay. A significant number of patients were not properly assessed or treated for pain.</div></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"14 ","pages":"Article 100296"},"PeriodicalIF":0.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145157890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infuence of prebiotics on childhood autism: Evidences and implications","authors":"Mariagiovanna Di Chiano ,&nbsp;Emanuela Calò","doi":"10.1016/j.gpeds.2025.100295","DOIUrl":"10.1016/j.gpeds.2025.100295","url":null,"abstract":"<div><div>Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by persistent deficits in social communication and social interaction across multiple contexts, as well as restricted, repetitive, and stereotyped patterns of behaviour, interests, or activities. In this context, individuals often exhibit behavioural alterations and frequent gastrointestinal disturbances, which are often associated with gut dysbiosis.</div><div>In recent years, interest in prebiotics as modulators of the gut microbiota has grown significantly, as these compounds promote the growth of beneficial bacteria and the production of metabolites with potential neuroprotective effects.</div><div>This review summarizes the main preclinical and clinical evidence on the use of prebiotics in the context of ASD, describing the biological mechanisms underlying their potential therapeutic effects.</div><div>Several studies suggest that supplementation with prebiotics, such as galacto-oligosaccharides and fructo-oligosaccharides, may improve both gastrointestinal symptoms and certain behavioral aspects in individuals with ASD. These effects are thought to be mediated through modulation of the microbiota, reduction of inflammation, and regulation of the gut–brain–microbiota axis.</div><div>However, the literature highlights significant methodological heterogeneity and inconsistent findings, underscoring the need for more rigorous and standardized studies.</div><div>In conclusion, prebiotics represent a promising complementary therapeutic strategy in ASD, but further research is needed to precisely determine their efficacy, safety, and optimal use.</div></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"14 ","pages":"Article 100295"},"PeriodicalIF":0.0,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145095633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perinatal oxidative stress and bone development in the first year of life: A preliminary study using REMS","authors":"Serafina Perrone ,&nbsp;Silvia Carloni ,&nbsp;Virginia Beretta ,&nbsp;Serena Benedetti ,&nbsp;Elena Scarpa ,&nbsp;Laura Cannavò ,&nbsp;Chiara Petrolini ,&nbsp;Federica Grassi ,&nbsp;Vincenzo Raitano ,&nbsp;Maria Cristina Albertini ,&nbsp;Domenico Corica ,&nbsp;Tommaso Aversa ,&nbsp;Elvira Di Pasquo ,&nbsp;Maria Elisabeth Street ,&nbsp;Malgorzata Wasniewska ,&nbsp;Andrea Dall’Asta ,&nbsp;Tullio Ghi","doi":"10.1016/j.gpeds.2025.100294","DOIUrl":"10.1016/j.gpeds.2025.100294","url":null,"abstract":"<div><h3>Background</h3><div>Oxidative stress has been implicated in impairing tissue development, but its impact on early postnatal skeletal growth in humans remains poorly understood. This study investigates the relationship between perinatal redox status and bone development during infancy, using Radiofrequency Echographic Multi Spectrometry (REMS), a non-invasive, radiation-free technology for bone quality assessment.</div></div><div><h3>Methods</h3><div>A longitudinal observational study on a cohort of healthy, full-term neonates (<em>n</em> = 65, 29 females and 36 males) was conducted. Total antioxidant capacity (TAC) and markers of protein and DNA oxidation (advanced oxidation protein products (AOPP); 8-hydroxy-2′-deoxyguanosine (8OH-dG)) were measured in arterial cord blood at birth. Auxological parameters were collected at birth and during follow-up visits at 1, 3, 6, and 12 months. Bone quality was assessed using REMS at 3, 6, and 12 months, and results were expressed as age-adjusted Z-scores.</div></div><div><h3>Results</h3><div>Cord blood TAC levels showed a significant positive correlation with birth weight (<em>r</em> = 0.51, <em>p</em> &lt; 0001), length (<em>r</em> = 0.40, <em>p</em> = 0.0013), and birth head circumference (<em>r</em> = 0,42, <em>p</em> = 0,0017). Statistical positive correlations were also found between cord blood TAC and length and weight a 1 month of age (<em>r</em> = 0.51, <em>p</em> &lt; 0.001; <em>r</em> = 0.36, <em>p</em> = 0.0067). In contrast, higher levels of oxidative damage were inversely associated with REMS-derived Z-scores at both 6 and 12 months of life (8OH-dG vs REMS-derived Z-scores at 6 months (<em>r</em>=-0.23, <em>p</em> = 0.02), and AOPP vs REMS-derived Z-scores at 12 months (<em>r</em>=-0.33 <em>p</em> = 0.022; <em>r</em>=-0.64, <em>p</em> &lt; 0.001, respectively). REMS Z-scores also showed strong internal consistency across timepoints (3 vs 6 months, <em>r</em> = 0.53, <em>p</em> &lt; 0.001,; 6 vs 12 months, <em>r</em> = 0.29, <em>p</em> = 0.046). A significant correlation was observed between REMS Z-score and head circumference at 3 months (<em>r</em> = 0.48, <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Our findings suggest that perinatal oxidative balance plays a critical role in early longitudinal growth. REMS appears to be a reliable tool for tracking bone quality in infancy, with potential for future applications in pediatric bone health monitoring. Although limited to healthy infants born from physiological pregnancies, this study provides foundational data in a largely unexplored area and supports the hypothesis that fetal redox status may influence lifelong skeletal outcomes.</div></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"14 ","pages":"Article 100294"},"PeriodicalIF":0.0,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145095630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug‑related problems and associated factors among hospitalized pediatric patients in a general hospital, Tigrai, northern Ethiopia: a cross-sectional study","authors":"Gebretekle Gebremichael Hailesilase,&nbsp;Haylay Araya Gebrezgabiher,&nbsp;Abrahaley Mulu Kidane","doi":"10.1016/j.gpeds.2025.100293","DOIUrl":"10.1016/j.gpeds.2025.100293","url":null,"abstract":"<div><h3>Background</h3><div>Drug-related problems (DRPs) are associated with increased risks of morbidities and mortalities. However, there are limited studies on DRPs among hospitalized pediatric patients in Ethiopia. This study aimed to evaluate DRPs and associated factors among hospitalized pediatric patients in Adigrat general hospital, Tigrai, northern Ethiopia.</div></div><div><h3>Methods</h3><div>A retrospective cross-sectional study was conducted among hospitalized pediatric patients in Adigrat general hospital. Data was collected from the patients’ medical charts between 01 July 2024 and 31 August 2024. Potential drug-drug interactions were screened using Micromedex 2.0 software. Logistic regression was used to analyze association of variables with DRPs. Data was analyzed using statistical package for social science version 21 and statistical significance was set at P value &lt; 0.05 in the multivariate analysis.</div></div><div><h3>Results</h3><div>A total of 114 (77.6 %) patients had at least one DRP. A total of 325 DRPs were identified in those 114 patients, averaging 2.85 (1<span><math><mo>−</mo></math></span>13) DRPs per patient. Moreover, 15.0 % of the patients experienced <span><math><mo>≥</mo></math></span>5 DRPs. Regarding the proportion of DRPs, unnecessary drug therapy, ADRs and dosage too low accounted for 22.8, 18.5 and 18.1 % of the DRPs, respectively. Substantial proportions (<em>n</em> = 47; 14.5 %) of the ADRs were due to potential drug-drug interactions. Anti-infectives for systemic use (68.8 %) and drugs of the alimentary tract and metabolism (10.2 %) were the most commonly implicated drug classes in DRPs. The number of diseases per patient was significantly associated with the occurrence of DRPs (Adjusted Odds ratio = 5.875, 95 % CI: 1.735–19.895).</div></div><div><h3>Conclusions</h3><div>The DRPs were prevalent among hospitalized pediatric patients. Unnecessary drug therapy, ADRs and dosage too low were the most widespread categories of DRPs. Clinicians should follow pediatrics guidelines and use drug interaction screening databases when prescribing drugs to pediatric patients.</div></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"14 ","pages":"Article 100293"},"PeriodicalIF":0.0,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145095631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early bone health: exploring relationship between oxidative stress and skeletal development in newborn infants","authors":"Serafina Perrone ,&nbsp;Laura Cannavò ,&nbsp;Virginia Beretta ,&nbsp;Elena Scarpa ,&nbsp;Serena Benedetti ,&nbsp;Chiara Petrolini ,&nbsp;Vincenzo Raitano ,&nbsp;Domenico Corica ,&nbsp;Tommaso Aversa ,&nbsp;Maria Cristina Albertini ,&nbsp;Andrea Dall’Asta ,&nbsp;Maria Elisabeth Street ,&nbsp;Tullio Ghi ,&nbsp;Silvia Carloni ,&nbsp;Malgorzata Wasniewska","doi":"10.1016/j.gpeds.2025.100292","DOIUrl":"10.1016/j.gpeds.2025.100292","url":null,"abstract":"<div><div>Bone health during childhood is critical for proper skeletal development and long-term quality of life. The process of bone formation relies on a balance of mineralization and cellular activity, which is regulated by oxidative stress (OS). While physiological levels of reactive oxygen species (ROS) are important for normal bone cell function and homeostasis, excessive OS can contribute to the development of bone diseases, such as osteoarthritis and osteoporosis. Enzymes like xanthine oxidoreductase are involved in amplifying ROS production, which can lead to cartilage degradation and disrupted bone remodeling. Despite increasing recognition of OS as a risk factor in adult skeletal health, its impact on fetal and neonatal bone development remains underexplored. In vitro and animal model studies, including those using free radicals exposure, have been performed to understand how OS impairs osteogenesis.</div><div>This review examines the role of OS in perinatal bone development analyzing key environmental risk factors and the potential long-term consequences of early-life redox imbalance on skeletal health.</div><div>The sensitivity of the fetal bone to OS suggests that oxidative damage during this critical period can result in impaired bone growth, low birth weight, and long-term skeletal disorders. Oxidative stress interferes with osteoblast differentiation, enhances adipocyte formation from mesenchymal stem cells, and stimulates osteoclast activity, leading to bone resorption. Clinical studies on the impact of OS on neonatal bone metabolism remain limited. Identifying key risk factors for early-life redox imbalance could be crucial in developing potential antioxidant therapies to support skeletal health during childhood</div></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"14 ","pages":"Article 100292"},"PeriodicalIF":0.0,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coping strategies, anxiety and self-efficacy among participants in neonatal resuscitation courses for instructors","authors":"Francesca Saretta ,&nbsp;Laura Polloni ,&nbsp;Francesco Cavallin ,&nbsp;Giuseppe De Bernardo ,&nbsp;Paolo Ernesto Villani ,&nbsp;Rossana Schiavo ,&nbsp;Daniele Trevisanuto","doi":"10.1016/j.gpeds.2025.100291","DOIUrl":"10.1016/j.gpeds.2025.100291","url":null,"abstract":"<div><h3>Aim</h3><div>To investigate coping strategies, anxiety and self-efficacy among participants in Neonatal Resuscitation Courses for instructors.</div></div><div><h3>Methods</h3><div>Cross-sectional study. Sixty-four participants in two Neonatal Resuscitation Courses for Instructors were assessed by using validated questionnaires.</div></div><div><h3>Results</h3><div>Overall, self-efficacy and functional coping strategies were moderate/high, while levels of anxiety were quite low. Self- efficacy was positively correlated with positive attitude (<em>r</em> = 0.29; <em>p</em> = 0.02) and problem solving (<em>r</em> = 0.44; <em>p</em> &lt; 0.01) and inversely correlated with avoidance strategies (<em>r</em>=-0.30; <em>p</em> = 0.01) and anxiety (trait <em>r</em>=-0.47; <em>p</em> &lt; 0.01; state <em>r</em>=-0.35; <em>p</em> = 0.01). Emotional maturity was positively correlated with positive attitude (<em>r</em> = 0.42; <em>p</em> &lt; 0.01) and problem solving (<em>r</em> = 0.45; <em>p</em> &lt; 0.01) and inversely correlated with anxiety (trait -0.51; <em>p</em> &lt; 0.01; state <em>r</em>=-0.34; <em>p</em> = 0.01). Finalization of action was positively correlated with problem solving (<em>r</em> = 0.40; <em>p</em> &lt; 0.01) and inversely correlated with avoidance strategies (<em>r</em>=-0.34; <em>p</em> = 0.01) and trait anxiety (<em>r</em>=-0.32; <em>p</em> = 0.01). Relational fluidity was positively correlated with turning to religion (<em>r</em> = 0.28; <em>p</em> = 0.03) and inversely correlated with avoidance strategies (<em>r</em>=-0.31; <em>p</em> = 0.01), and trait anxiety (<em>r</em>=-0.42; <em>p</em> &lt; 0.01). Context analysis was positively correlated with problem solving (<em>r</em> = 0.34; <em>p</em> = 0.01) and inversely correlated with state anxiety (<em>r</em>=-0.36; <em>p</em> &lt; 0.01). Problem solving was significantly higher in doctors compared to nurses (<em>p</em> = 0.01).</div></div><div><h3>Conclusions</h3><div>Neonatal resuscitation instructor candidates displayed high self-efficacy and functional coping strategies, with low anxiety levels. This may help professionals to better deal with stressful and demanding situations and reinforce adaptive work management.</div></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"14 ","pages":"Article 100291"},"PeriodicalIF":0.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145019389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The unseen burden: Challenges by children and adolescents in witness protection programs in western countries","authors":"Pietro Ferrara ,&nbsp;Margherita Zona ,&nbsp;Ignazio Cammisa ,&nbsp;Ida Giardino ,&nbsp;Maria Pastore ,&nbsp;Mehmet Vural ,&nbsp;Massimo Pettoello-Mantovani ,&nbsp;Francesca Scaltrito ,&nbsp;Clara Pettoello-Mantovani","doi":"10.1016/j.gpeds.2025.100288","DOIUrl":"10.1016/j.gpeds.2025.100288","url":null,"abstract":"<div><div>Witness Protection Programs are indispensable tools in the fight against organized crime, designed to safeguard individuals whose testimonies are crucial for justice. While these programs have demonstrated remarkable success in ensuring the physical safety of adult witnesses, the profound and often unaddressed challenges faced by accompanying children and adolescents represent a critical oversight. This article examines the multifaceted psychosocial, familial, educational, and societal hurdles encountered by children and adolescents relocated within western witness protection programs, focusing in particular on Europe and the US. Drawing upon existing literature, this report elucidates the cumulative trauma, identity disruption, social isolation, and educational instability inherent in their experiences. The analysis reveals a historical underestimation of children's unique vulnerabilities and rights within these programs. Recommendations emphasize the urgent need for a paradigm shift towards child-centric and family-focused western witness protection programs, advocating for holistic assessment, integrated mental health services, prioritized educational continuity, proactive social integration strategies, community engagement, enhanced professional training, and robust long-term research to ensure the comprehensive well-being of this exceptionally vulnerable population.</div></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"14 ","pages":"Article 100288"},"PeriodicalIF":0.0,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144926030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The silent wounds of war: Psycho-physical impacts and international legal implications for children in conflict zones","authors":"Pietro Ferrara ,&nbsp;Margherita Zona ,&nbsp;Ida Giardino ,&nbsp;Francesca Scaltrito ,&nbsp;Clara Pettoello-Mantovani ,&nbsp;Ignazio Cammisa","doi":"10.1016/j.gpeds.2025.100287","DOIUrl":"10.1016/j.gpeds.2025.100287","url":null,"abstract":"<div><div>Children exposed to war confront a distinct array of adversities that extend far beyond the immediate threats of violence and displacement. While the direct consequences—such as physical harm, the loss of loved ones, and the destruction of homes—are profoundly distressing, the more insidious and enduring damage often stems from the disruption of critical developmental processes. Armed conflict undermines the foundational elements required for healthy childhood development, including emotional security, consistent caregiving, education, accessible healthcare, stable social networks, and physical safety. The psychological impact of living in, or fleeing from, conflict zones infiltrates all aspects of a child's life. The breakdown of community infrastructure, forced displacement, and prolonged uncertainty severely limit opportunities for peer interaction, structured play, and social learning—experiences that are vital for shaping self-concept, empathy, and emotional regulation. In environments where fear, mistrust, and violence become normalized, children may struggle to form secure attachments or to envision a hopeful future. It is widely recognized that environmental and contextual factors exert a profound influence on children's developmental trajectories, encompassing cognitive, emotional, and physical domains. Research consistently highlights the role of neighborhood safety, access to healthcare and education, and socioeconomic stability in shaping developmental outcomes. At the neurobiological level, chronic exposure to stress activates regulatory systems such as the hypothalamic–pituitary–adrenal (HPA) axis, which, when persistently engaged, can interfere with brain maturation. This dysregulation is often associated with impairments in memory, attention, language acquisition, and executive functioning, and with increased susceptibility to internalizing disorders such as post-traumatic stress disorder (PTSD), anxiety, depression, and attachment-related difficulties.</div><div>Physiologically, prolonged stress can weaken immune function, disturb sleep patterns, hinder somatic growth, and elevate the risk of both acute health problems and chronic diseases. The pervasive and multi-dimensional impact of war on children calls not only for academic inquiry but also for immediate ethical and policy responses. This article emphasizes that a nuanced understanding of trauma's effects across developmental systems is critical to inform targeted, trauma-responsive interventions.</div><div>The aim is to raise attention on the importance of establishing effective strategies, which must prioritize not only the treatment of individual symptoms but also broader efforts aimed at prevention and systemic recovery, thereby fostering resilience and contributing to the long-term rehabilitation of communities affected by conflict.</div></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"14 ","pages":"Article 100287"},"PeriodicalIF":0.0,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145004422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Montenegro Charter for the protection and recovery of children in disasters","authors":"Neboija Kavaric ,&nbsp;Joseph Haddad ,&nbsp;Massimo Pettoello-Mantovani","doi":"10.1016/j.gpeds.2025.100286","DOIUrl":"10.1016/j.gpeds.2025.100286","url":null,"abstract":"<div><div>The Charter was jointly developed by EPA-UNEPSA and the International Pediatric Association (IPA) through the contributions of ideas and recommendations from presidents and delegates of European National Pediatric Societies who participated in the 2nd EPA-UNEPSA Hot Topics International Meeting held in Budva, Montenegro, on June 12, 2025 in collaboration with the Association for Preventive Pediatrics of Montenegro,: Giuseppe Buonocore, former President, Italian Academy of Pediatrics; Robert Cohen, President, Conseil National Professionnel de Pédiatrie, Association Française de Pédiatrie Ambulatoire; Pietro Ferrara vice-President, Italian Society of Pediatrics; Hilary Hoey, former President, Faculty of Paediatrics, Royal College Physicians Ireland; Esin Koc, President, Turkish Neonatal Society &amp; the Union of European Neonatal and Perinatal Societies (UENPS); Georgios Konstantinidis, President, Serbian Pediatric Association; Georgina Kuli Lito, President, Albanian Society of Pediatrics; Hajrija Maksić, President, BIH Pediatric Association; Aida Mujkić, President, Pediatric Society of Croatia; Leyla Namazova, President UPR; Tudor Pop, President, Romanian Society of Preventive Pediatrics; Beiqi Ramus, President, Kosovo Pediatric Association; Aspazija Sofijanova, President, N.Macedonia Pediatric Association; Eli Somekh, former President, Israeli Pediatric Association; Tarana Taghi-zada, President, Azerbaijan Pediatric Association &amp; Vice president, Eurasian Federation Children's Doctors; Stephen Turner, President, Royal College of Paediatrics and Child Health, UK; Mehmet Vural, former President, Turkish Pediatric Association. The International Pediatric Association (IPA) and EPA-UNEPSA gratefully acknowledge their invaluable contributions.</div></div>","PeriodicalId":73173,"journal":{"name":"Global pediatrics","volume":"14 ","pages":"Article 100286"},"PeriodicalIF":0.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144890729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}