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On May 18, 1918, fourteen thousand high school students from St. Louis, Missouri, public schools, accompanied by fourteen drum corps and seven professional bands, paraded through the city’s Forest Park. Each school marched behind the US flag and its banners. Boys were dressed like soldiers and girls like nurses, in white uniforms bearing a tiny red cross. Battalions of young drummers, followed by legions of adult nurses, closed the parade. As the young people passed by, spectators applauded the inspiring sight. They could feel their hearts burn with new patriotism and new reverence. As the parade ended at Art Hill, eight thousand children in red caps and capes stood at attention on the slope, saluted the onlookers, and began to form a living cross. Below them, the remaining six thousand young people fell into place to form the word Red Cross. For the occasion – the Inaugural Junior Red Cross Parade – the youth had been rallied to demonstrate their patriotism and participation in the war effort. One journalist noted that “the present generation of children are learning that Service means sympathy as well as sacrifice, a desire and willingness to help others as well as a feeling that it is one’s duty and obligation to do so.”
A national conference on Americanization in April 1918 evidenced how social and political concerns mattered in wartime. Many regarded the global war as an unhoped-for opportunity to patch up the American nation and bring together the various ethnic groups living in the United States. Across the United States, ethnic enclaves existed and hyphenated Americans oscillated between pledging allegiance to the Stars and Stripes and being loyal to their homelands. Assimilationists seized the opportunity to foster American ideals in children. They consistently rallied politicians in their crusade against the hyphen and eventually defeated progressive integrationalists.
From August 1914 to April 1917, although the United States remained officially neutral, private individuals engaged American children in the war effort. At the local and state levels, initiatives mushroomed to capture children’s energy. Educationalists feared that explicit talk of war and propaganda in all forms would spoil children’s innocence. This is why they decided to engage children in civic leagues while others sought to mobilize children in the war effort. Although the leaders of these initiatives differed on how best to foster patriotism in the nation’s youth, the consensus was that American children needed to be engaged in civic and patriotic activities and be aware of their responsibilities as future adults.
As the war ended, politicians and educationalists saw the American Junior Red Cross as a means to promote American ideals abroad. Consequently, the American Junior Red Cross shifted its focus on a new form of Americanization, using children as part of a cultural diplomacy that positioned the United States as the global Good Samaritan. Children reached out around the globe, waged war against diseases, dedicated much of their spare time to rescue foreign "brothers" and "sisters," and sponsored children overseas.
Across the nation, children were urged to become “soldiers of the soil,” members of the United States School Garden Army, an initiative created in February 1918 by the US Bureau of Education to promote local gardening. Federal authorities urged local communities to feed themselves while the United States fed the Allies and other nations dependent on the US food supply. The more food civilians grew, the better the United States could feed the world. Children thus became part of a large pool of unpaid labor, serving the interests of both politicians and educationalists: as youth helped to increase food production, they learned skills and habits of self-reliance. Through the United States School Garden Army, children hooverized and learned to change their diet and eat with moderation. Gardening taught them the meaning of sacrifice.
Medical experts and epidemiologists knew the importance of hygiene on the home front. They convinced local, state, and federal authorities that the war on disease had to be fought. Consequently, the Modern Health Crusade, which originated in Detroit, became a nationwide movement in 1915. Federal authorities realized that a high infant mortality rate threatened the fabric of American society in the long run. Additionally, in order to build a strong and healthy army (and nation), bodies had to be physically fit. Children began to matter to the military and the nation writ large. As hygiene became a national concern, between 1914 and 1918, both medical and military authorities promoted hygienic standards to lift the nation.
In organizing a juvenile division of the American Red Cross – the so-called American Junior Red Cross – in September 1917, Woodrow Wilson attempted to mobilize the nation’s twenty-two million schoolchildren. Consequently, the American Junior Red Cross became the first federal youth-focused organization to be specifically dedicated to mobilizing American youth in wartime. In designing this first national youth-focused organization, Wilson impeded radical interventionists and quelled educationalists’ concerns. While directing children’s energy to altruistic humanitarian tasks, the organization opened schools to federal oversight of efforts to instill loyalty and deter dissent. Federal authorities attempted to control teachers and relied upon the educational structures to instill loyalty in the future generations of Americanyouth.
This chapter examines Elizabeth Maconchy’s children’s operas, situating them alongside other works she composed especially for children and young audiences. Much like Benjamin Britten, Maconchy saw the inherent value, intellect, and presence of self in children and youth, and thus did not patronise them in her compositions. Children’s opera can essentially be subdivided into three categories of works: those written about, those written for, and those written with children as the primary audience, subject, or participants. Broadly speaking, children’s operas may coalesce any of the three sets, resulting in an opera that is for an audience of children, about a child- or childhood-focused theme, and performed by a cast or cast members who are children. Justin Vickers examines Maconchy’s children’s operas as an integral facet of her compositional output not to be overlooked, and the milieu proved to be a catalyst for Maconchy’s abundant well of musical creativity. Moreover, these works may be positioned in the broader educational initiatives in music and the arts throughout the British Isles.
Post-mortem imaging is an indispensable tool in the investigation of suspicious childhood deaths, particularly for identifying fractures and intracranial hemorrhages. It offers significant logistical advantages over traditional autopsies, including cost-effectiveness and rapid image acquisition. However, its application requires close collaboration between radiologists, pathologists and forensic experts, and is rarely used as a standalone approach. This chapter delves into the role of post-mortem imaging, with a primary focus on post-mortem CT and some coverage of post-mortem MRI and novel techniques of micro-CT and linear slot scanning.
The chapter discusses key medicolegal considerations, imaging protocols, common findings and interpretation challenges and the importance of maintaining strict chain-of-custody protocols. As post-mortem imaging continues to gain traction, we underscore the need for standardized imaging protocols and enhanced support for multidisciplinary teams to safeguard the well-being of professionals conducting these sensitive examinations.
This paper shows that Elizabeth Anderson’s account of relational egalitarianism offers inadequate resources to combat interactional injustice, that is, the injustices in modes of social interaction that reinforce positions of unequal status and social vulnerability. The paper reviews Anderson’s argument that social integration is key to remedying specific kinds of unjust inequalities before exploring examples of interactional injustice for which integration – as Anderson specifies it – is an inadequate solution because the victims are already highly integrated, such as fat people. The paper argues that a policy-focused account such as Anderson’s misses the fact that interactional injustices are often the cumulative result of many individual people making individually legitimate choices to control their own interactional lives, choices which collectively subordinate, marginalise, or ostracise other people. In order to remedy interactional injustices, we must attend not only to government policies as Anderson does, but also to our personal responsibility for our choices and their collective impact.
To evaluate the prevalence and clinical implications of QT interval prolongation and other electrocardiographic changes in paediatric patients with rheumatic diseases using hydroxychloroquine.
Methods:
This was a retrospective and prospective, observational, and analytical study conducted at a centre of perinatology and paediatrics in Rio de Janeiro, Brazil. A total of 26 evaluations of patients ≤18 years old on hydroxychloroquine were included, all following paediatric rheumatology and cardiology services. Patients were included if they had been receiving hydroxychloroquine for at least six months and had complete clinical records; those with pre-existing cardiac conditions unrelated to hydroxychloroquine were excluded. Clinical, demographic, and electrocardiographic data were collected from medical records using standardised protocols.
Results:
The corrected QT interval was manually measured on 12-lead electrocardiograms and analysed in relation to cumulative drug dose. All electrocardiograms were reviewed independently by two cardiologists to ensure accuracy of corrected QT interval measurements, and discrepancies were resolved by consensus. Most patients were female (76.9%), and systemic lupus erythematosus was the most prevalent diagnosis (88.9%). The cumulative hydroxychloroquine dose ranged from 12 to 447.6 g (mean: 223 g). Corrected QT interval values ranged from 377 to 454 ms (mean: 413 ms). Correlation analysis between cumulative dose and corrected QT interval showed a weak negative association (r = –0.24; p = 0.338), not statistically significant. Simple linear regression confirmed no association between variables (R2 = 5.7%).
Conclusion:
In this cohort of paediatric patients with rheumatic diseases, no significant association was observed between cumulative hydroxychloroquine use and QT interval prolongation.
The double burden of malnutrition (DBM) – the coexistence of undernutrition and overweight/obesity – poses a critical global health challenge, particularly for children and adolescents. School meal programs offer an opportunity to address the DBM by providing nutritious meals that support growth, development, and lifelong health. However, limited school meal quality data hinders effective program design. This study evaluates global school meal quality through nutrient composition analyses and the Global Diet Quality Score (GDQS)-Meal and -Menu metrics.
Design:
Data were collected from the Global Child Nutrition Foundation’s 2024 Global Survey of School Meal Programs, grey literature, and in-country stakeholders. Nutritional content was compared to age-specific Nutrient Reference Values, including Harmonized Average Requirements. The nutritional quality of meals and menus was assessed using GDQS metrics based on 25 food groups.
Setting:
Twenty-nine countries across diverse geographic and socioeconomic contexts.
Participants:
Not applicable.
Results:
Most menus met or exceeded 30% of recommended daily nutrient values. Lunches had the highest nutrient contributions, followed by snacks and breakfasts. GDQS-Meal and -Menu scores revealed variability across age groups, meal types, and countries. Overall, 57% of menus achieved high nutritional quality, 37% medium, and 6% low. Few menus lost points for unhealthy components. Diverse, balanced menus with healthy food groups scored higher, though fortification also proved nutritionally valuable.
Conclusions:
While most menus contribute significantly to daily nutrient needs, variability across countries, age groups, and meal types highlights opportunities for context-specific improvements through diversification and fortification. Learning from high-performing peer programs can help identify feasible improvements.
Despite the urgent need for support interventions for families facing parental life-threatening illness, research is limited – particularly in progressive neurological diseases. This scoping review aimed to systematically map existing interventions to inform the development of tailored support in the neurological context.
Methods
A scoping review was conducted, including articles published between 2013 and 2025, identified through searches in PubMed, CINAHL, PsycINFO, and Web of Science, along with manual screening of reference lists. Extracted data were systematically charted and descriptively summarized.
Results
Of 5172 articles, 15 were included, describing 6 unique interventions aimed at supporting children (0–25 years) and/or parents in families where a parent had a life-threatening illness. While cancer was the predominant diagnosis among ill parents, progressive neurological diseases, such as amyotrophic lateral sclerosis (ALS) and Huntington’s disease, were represented to a limited extent. The interventions targeted children (n = 4), parents in their parenting role (n = 4), or the entire family (n = 7) and were primarily based on psychosocial, psychoeducational, or peer support. Overall, the interventions were positively received by both children and parents and perceived as helpful in navigating their challenging life situations in various ways.
Significance of results
This review confirms a particular lack of knowledge and tailored support for families affected by progressive neurological diseases. While support interventions for other life-threatening illnesses are also limited, those that exist may offer valuable insights to inform the development of support within neurological care contexts. The findings underscore the need for early, proactive, and accessible approaches that address both individual and family needs across the disease trajectory, aligning with core principles of high-quality palliative care.
The differential susceptibility model suggests that the same children who are more susceptible to peer rejection are also more susceptible to peer acceptance. Testing this within-child assumption, we examined whether a subgroup of children exists who are more reactive to both rejection and acceptance, and whether higher levels of sensory processing sensitivity (SPS) characterize this subgroup. We randomly assigned 455 preadolescents (Mage = 10.86, 49.5% boys) to receive either counterbalanced rejection and acceptance feedback (experimental group) or neutral feedback (control group) from online fictitious peers, and assessed their emotional, self-esteem, attributional, and behavioral responses. Results revealed two subgroups of children showing elevated emotional or self-esteem reactivity to both rejection and acceptance, supporting within-child differential susceptibility. However, SPS did not distinguish these subgroups or moderate children’s responses to peer feedback – suggesting limited support for SPS as a differential susceptibility marker to experimentally manipulated peer acceptance and rejection.
Transvenous and epicardial pacing in children carries significant risks of lead failure and infection. Leadless pacing is an alternative with lower risks of infection, lead failure, and longer battery longevity. A retrievable leadless pacemaker was implanted in an 8-year-old, 24 kg patient with heart block. A systematic review evaluated procedural success and the safety of leadless pacemakers in preadolescents weighing less than 30 kg.
Auditory comprehension (AC) develops during the first years of life; however, not all children exhibit typical performance, which may result from the interaction of multiple factors. Therefore, our study aimed to identify the predictive factors of AC in infants with prenatal and perinatal risk factors for atypical brain structure. To test this, a longitudinal study was conducted with 51 participants (28 females; mean age = 36.8 ± 1.4 months). Clinical, demographic, anthropometric, motor, neuropsychological and magnetic resonance imaging (MRI) data were collected from birth to 36 months. A regression model revealed that the age at achievement of fine motor milestones, gestational weeks, corpus callosum volume and maternal age were predictive of AC at 36 months. Moreover, the mental development index (MDI) of the Bayley Scales of Infant Development-2 (BSID-2) assessment at 12 months predicted AC scores at 36 months. We concluded that AC is influenced by caregivers’ interactions and motor development, thereby facilitating new learning opportunities, but is also affected by the neuropathological patterns associated with their risk condition. In addition, early identification of predictor factors may enable targeted interventions during sensitive developmental periods.
We aimed to determine the association between maternal bonding difficulty in the postpartum period and children’s neurodevelopment, considering maternal psychological distress and child sex-specific differences. To evaluate the relationship, the dataset of the Japan Environment and Children’s Study was used, as well as the Mother-to-Infant Bonding Scale (MIBS), the six-item version of the Kessler Psychological Distress Scale (K6) for mothers, and the Ages and Stages Questionnaires Third Edition for children aged 2 to 4 years. Maternal MIBS and K6 were administered at 1 year postpartum. Data from 24,798 boys and 24,025 girls were analyzed. Multivariate logistic regression analyses, with the reference groups being those with maternal MIBS scores ≤4 and K6 scores ≤4, were performed. The Benjamini–Hochberg procedure was employed to account for multiple testing. In boys, maternal bonding difficulty (MIBS score ≥5) without psychological distress (K6 score ≤4) was associated with a screen-positive result for neurodevelopmental delay in all five domains (communication, gross motor, fine motor, problem-solving, and personal-social) at ages 2 to 4 years. In girls, maternal bonding difficulty without psychological distress was associated with a screen-positive result for neurodevelopmental delay in all five domains at 2 years of age. However, at age 4 years, maternal bonding difficulty without psychological distress was no longer associated with a screen-positive result for problem-solving delay in girls. The association of maternal bonding difficulty without psychological distress at 1 year postpartum with screen-positive result for problem-solving delay persisted in boys, but at age 4 years in girls, the association no longer existed.
To examine the prevalence, financial value, and marketing leveraging methods of food sponsorship agreements and food service contracts in Canadian recreation and sport facilities (RSFs).
Design:
Cross-sectional survey using descriptive analysis. RSF managers and directors reported the number, value, and types of marketing leveraging methods used in food-related sponsorship agreements and food service contracts.
Setting:
Publicly funded RSFs in nine Canadian provinces that provide indoor sport programming for children and youth.
Participants:
Eighty-six RSF representatives completed the survey (response rate: 73.9%). Most facilities were municipally owned and located in urban settings; over 70% served children under 13 years.
Results:
Food sponsorship agreements and food service contracts were reported by 36.5% and 65.5% of RSFs, respectively. Financial donations were included in 88.6% of sponsorship agreements and 27.4% of contracts. Sponsors contributed a median of 25.0% (IQR: 13.9%, 83.3%) of total sponsorship income, with a median annual donation per sponsor of $500 (IQR: $288, $1,375). Nearly all agreements and contracts included at least one food marketing leveraging method. Branded signage was the most common in sponsorship agreements (64.6%), while equipment donation was most common in food service contracts (52.2%).
Conclusions and Implications:
Food sponsorship and service agreements are prevalent in Canadian RSFs and include financial and in-kind contributions that may benefit facilities. However, the marketing leveraging methods used—such as branded signage and product provision—may also increase children’s exposure to food marketing. Greater monitoring and evaluation of these marketing practices is needed, especially in the context of proposed national marketing restrictions.
We present a 14-year-old female with a history of ventricular septal defect repair who presented with a striking complaint of a heartbeat sensation in the neck and was subsequently diagnosed with a rare cervical aortic arch, classified as Zhong’s B2 and Haughton’s B type, associated with a Kommerell diverticulum. Comprehensive cross-sectional imaging and conventional angiography excluded true and pseudo-coarctation, highlighting the importance of meticulous anatomical assessment in directing treatment and preventing unnecessary interventions in asymptomatic or non-obstructive cases.
Elizabeth Bowen’s fiction is full of girls; in nearly all her work, she focuses on the act of maturing through adolescence to early adulthood. The experience of girlhood among Bowen’s characters maps onto the generic characteristics of her truncated, ambiguous Bildungsromane, all of which subvert expectations and resist satisfying maturation. Her novels focus on figures experiencing historical and emotional arrest, and her adolescent girls often remain in moments of developmental or social suspension. This essay traces girlhood and adolescence in abeyance in Bowen’s short fiction, and in novels ranging from The Hotel to The Death of the Heart to The Little Girls.