Food literacy is a multidimensional concept capturing interrelated factors driving individuals’ food behaviors. Conceptualization to date has focused on adults without considering developmental limitations of childhood. This scoping review clarifies conceptualization and measurement of food literacy in late childhood and adolescence.

We searched the literature in 7 electronic databases, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews for article screening and selection. We conducted an inductive content analysis to identify the primary dimensions and indicators of food literacy for children and adolescents and examined assessment of these dimensions in existing measurement tools.

Articles covering late childhood and adolescent populations.

Older children and adolescents (9-18 years).

The initial search in November 2023 yielded 1319 articles with 13 meeting inclusion criteria, and a search update in February 2026 yielded 4 additional recently published articles for inclusion. We identified 4 dimensions and 23 formative indicators of child and adolescent food literacy. Conceptualization and measurement of food literacy in children to date have heavily emphasized dimensions pertaining to food systems and nutrition knowledge and confidence in everyday food skills relative to valuing shared food experiences and purposeful engagement with food.

Valuing shared food experiences and purposeful engagement with food are understudied dimensions of food literacy, despite evidence that they are important determinants of food behaviors. Future research should focus on further conceptual development and validation of age-appropriate indicators for these dimensions.

Emotion dysregulation is a transdiagnostic construct associated with multiple mental health conditions and shown to be an amenable target for treatment. The original Emotion Dysregulation Inventory (EDI) was created as a proxy-report measure validated in autistic and nonautistic youth. The goal of the current study was to develop a self-report version, the EDI-Self-Report (EDI-SR), that captures a first-person perspective and creates the option of multi-reporter measurement from adolescence through adulthood.

Using methods developed by the Patient-Reported Outcomes Measurement Information System (PROMIS), potential items and response options were written and tested in cognitive interviews. Two samples (996 participants who are autistic or have other intellectual and developmental disabilities and 1,000 participants selected to be representative of the US census as a nonclinical comparison group) completed the initial item pool. Items were assessed using exploratory and confirmatory factor analyses, item response theory analyses, concurrent calibrations, convergent correlations with comparable legacy measures, internal consistency reliability, and test–retest reliability.

Exploratory factor analyses suggested splitting Reactivity and Dysphoria items for confirmatory factor analyses and subsequent analyses. Following analyses, a 25-item Reactivity scale, a 7-item Dysphoria scale, and a 6-item Reactivity short-form scale were finalized. EDI-SR subscales showed convergent validity and superior total information when compared with similar measures, strong internal consistency reliability, and good test–retest reliability.

The EDI-SR provides an efficient, precise measure of ED in autistic individuals, individuals with other intellectual and developmental disabilities, and a US census-matched representative sample, and allows for multi-reporter assessment in clinical and research contexts.

To examine whether the number of parents using high levels of structure or coercive control food parenting practices is associated with children’s dietary intake.

Cross-sectional analysis of father-mother dyads from the Fathers & Families cohort study. Fathers and mothers independently reported their food parenting practices and child’s dietary intake. Multivariate logistic regression models estimated associations between the number of parents (0, 1, or 2) using high structure or coercive control practices and children’s intake of fruit, vegetables, fast food, and sugar-sweetened beverages (SSBs), adjusting for demographics and recruitment site.

United States

474 father-mother dyads with a child aged 2-6 years

Structure, but not coercive control, was positively associated with vegetable intake. Compared with none, having one parent report high structure increased the odds of children consuming vegetables >once/day (aOR=2.09; 95%CI:[1.06, 4.54]); associations were stronger when both parents reported high structure. Structure was also associated with lower fast food and SSB intake frequency. Compared with none, having one parent report high structure increased the odds of children consuming fast food <once/week (aOR=1.79; 95%CI:[1.23, 2.62]) and limiting SSBs to <once/week (aOR=1.52; 95%CI:[1.03, 2.23]); associations were stronger when both parents reported high structure. Compared with none, high coercive control by one (aOR=0.69; 95%CI:[0.49, 0.96]) or both parents (aOR=0.57; 95%CI:[0.33, 1.00]) was associated with lower odds of limiting SSB to <once/week.

Children’s dietary patterns were healthiest when both parents used structure-based food parenting practices. Coercive control from one or both parents was associated with greater SSB intake frequency.

Expanded multiplex PCR gastrointestinal panels (GIPs) are routinely ordered to diagnose infectious diarrhea. However, recommendations for repeat GIP testing are limited, resulting in variable testing practices. We evaluated the diagnostic yield of repeat GIP testing within 14 days.

We conducted a retrospective cohort study of adults (age ≥ 18 years) tested with GIPs across 12 hospitals and outpatient centers (2019–2024). We analyzed the first diarrheal episode per patient, excluding cases with invalid/missing results and C. difficile results. Repeat testing was defined as a GIP completed within 14 days of an index GIP, excluding confirmatory testing using the same stool sample. The primary outcome was diagnostic yield (new pathogen detection), and the secondary outcome was pathogen persistence (same pathogen detection).

Among 16,502 patients, 507 (3.1%) underwent repeat GIP testing within 14 days (median interval: 6.3 days; IQR: 2.7–9.8). Only 4.6% [19/415] index-negative patients and 2.2% [2/92] index-positive patients detected new pathogens on repeat testing, with 51% [47/92] index-positive patients demonstrating persistence of at least one pathogen from their initial test. The number needed to test (NNT) to identify one new pathogen was 24 (95% CI: 16–39) tests overall, and 127 (95% CI: 50–455) tests to identify one new pathogen warranting antimicrobial treatment. Most repeat testing (86% [436/507]) was ordered by a different clinician.

Repeat GIP testing within 14 days rarely provided new diagnostic information, highlighting the limited utility of early repeat testing. Institutional policies discouraging repeat GIPs within 14 days may improve diagnostic stewardship.

We aimed to translate and cross-culturally adapt the Supportive and Palliative Care Indicators Tool-4ALL (SPICT-4ALL) for use in the Tamil healthcare context.

The translation and cross-cultural adaptation of the SPICT-4ALL (2023 version) were conducted using the TRAPD model (Translation, Review, Adjudication, Pretesting, and Documentation). Cross-cultural adaptation used a modified Delphi-technique. Twelve participants, including mid-level healthcare workers from primary care and palliative care settings and lay people from India and Sri Lanka, scored the items on the tool. Agreement on scores was assessed, and focus group discussion (FGD) was used to reach consensus.

Delphi panel agreement was 34% initially but reached 100% with minor changes to items in the translated version after the FGD. Thematic analysis found SPICT-4ALL in Tamil is user-friendly and accessible for proactive identification of palliative care needs, facilitates person-centered care planning, and enhances interdisciplinary coordination.

SPICT-4ALL-Tamil 2023 is the translated and cross-culturally adapted version for use in the Tamil healthcare context. This will enable and empower mid-level health workers within the primary and secondary care settings and people not in the healthcare field to identify individuals with palliative care needs. Further research to validate and study acceptability of the tool and its impact on patient outcomes is warranted.

Various fluid removal strategies are utilized to mitigate the deleterious effects of fluid accumulation in neonates following cardiac surgery. We aim to describe practice patterns and identify associations of fluid management strategies with outcomes in neonates undergoing cardiac surgery using the Neonatal and Pediatric Heart and Renal Outcomes Network dataset.

Multicentre retrospective study including neonates who underwent cardiac surgery between 2015 and 2018. Primary outcomes were duration of mechanical ventilation, delay in first negative daily fluid balance, peak cumulative fluid balance, and severe persistent acute kidney injury. Multivariable logistic and ordinal regression models assessed associations between fluid removal strategies and clinical outcomes.

Of 2,240 neonates, 25% (n = 560) received furosemide in the operating room. Peritoneal catheters were placed in 24% (n = 527), and 8.6% (n = 193) underwent prophylactic peritoneal dialysis. Diuretic use on postoperative day 0 ranged 6–95% across institutions. Diuretics on postoperative day 0 were associated with shorter time to negative daily fluid balance (odds ratio 0.55; 95% confidence interval 0.30–0.995) and shorter duration of mechanical ventilation (odds ratio 0.58; 95% confidence interval 0.39–0.86). Intraoperative diuretics were also associated with shorter duration of mechanical ventilation (odds ratio 0.60; 95% confidence interval 0.42–0.86). Receipt of continuous diuretic infusion on postoperative day 0 or 1 was associated with longer duration of mechanical ventilation (odds ratio 3.02; 95% confidence interval 1.98–4.58). No association of diuretic use with severe persistent acute kidney injury was found.

Early use of diuretics in neonatal cardiac surgery is highly variable and has a differential association with outcomes. Future studies that standardize the dose, timing, and mode of administration (intermittent vs continuous) of diuretics are warranted to identify potential associations with outcomes.

Early prediction of depressive and anxiety disorders is challenging due to substantial heterogeneity in risk pathways. Conventional machine-learning models trained on aggregated populations may obscure subgroup-specific mechanisms and limit interpretability for prevention. We evaluated whether a hybrid unsupervised–supervised framework can identify meaningful subgroups and yield more interpretable risk prediction.

We analyzed cohort data of 15,897 Japanese adults who completed baseline (August–September 2020) and 6-month follow-up (February–March 2021) surveys and did not screen positive for depressive and anxiety disorders at baseline (K6 score < 13). Using 169 baseline demographic, psychosocial, lifestyle, and behavioral variables, we performed hierarchical clustering to derive data-driven subgroups. Within each cluster, we trained Random Forest models to predict incident screened depressive and anxiety disorders at follow-up (K6 ≥ 13) and interpreted predictors using SHapley Additive exPlanations (SHAP).

The overall 6-month incidence was 6.23%. A five-cluster solution revealed two high-risk subgroups: an older-adult profile with poor quality of life (12.9%) and a working-parent profile characterized by work–family overload (29.8%). Compared with a global model trained on the full sample, the cluster-then-predict framework showed broadly similar overall performance but performed better in the highest-risk subgroup and revealed more differentiated predictor profiles. Loneliness, health-related quality of life, happiness, and personality traits predominated in clusters with moderate adversity, whereas lifestyle disruption (sleep, diet, and irregular routines) characterized the high-risk late-life subgroup and alcohol dependence and work–family burden characterized the high-risk working-parent subgroup.

Addressing risk-factor heterogeneity before prediction may enable more interpretable, context-tailored prevention strategies.

Social cognitive deficits are common across many psychiatric conditions and contribute to broader social dysfunction. One hypothesized mechanism involves altered basic visual processing, which may disrupt the perception of low-level social cues and, in turn, compromise broader social cognitive processes. Here, we examined relations between basic visual processing and different levels of social cognition in a transdiagnostic youth sample.

A sample of 148 youth, ranging from healthy individuals to individuals with neuropsychiatric diagnoses and significant social dysfunction, completed two measures of basic visual processing (contrast sensitivity and visual integration) and a battery of social cognition tasks spanning lower-level (gaze perception) to mid-level (emotion recognition) to higher-level (theory of mind) social cognition. We used a four-level path model to test whether basic visual processing predicts gaze perception, which in turn predicts emotion recognition, which predicts theory of mind.

Poorer contrast sensitivity and visual integration were associated with less precise gaze perception, which was, in turn, associated with worse emotion recognition, which was associated with worse theory of mind. This four-level path model demonstrated good fit and showed superior fit compared to alternative models.

These findings suggest that basic visual processing influences the perception of basic social cues (e.g. gaze direction), which subsequently impairs more complex social perception and inference. Notably, this study extends prior observations from individuals with chronic schizophrenia to a transdiagnostic youth sample, indicating that altered basic visual processing may be a shared mechanism contributing to social cognitive deficits across psychiatric disorders and illness stages.