搜索结果：Style

Art style classification is a fundamental task for digital art analysis and intelligent cultural heritage management. However, existing methods often fail to deliver stable and interpretable results due to dispersed style cues, complex local textures, strong interference from background and subject content, and the difficulty of identifying regions that are causally relevant to style recognition. To address these issues, we propose a Multi Source Collaborative Style Network, termed MCS-Net, which jointly models global composition and local brushstroke textures within a unified framework. MCS-Net consists of four modules, namely a basic style feature encoding module, an attention generation module, a style contrastive learning module, and a counterfactual attention module. The attention generation module discovers multiple complementary discriminative regions. The contrastive learning module constructs a more discriminative embedding space to improve the separability of fine-grained styles. The counterfactual attention module builds counterfactual attention samples to explicitly estimate the true contribution of regions to predictions, thereby suppressing spurious activations, improving robustness, and providing counterfactual-supported evidence for model interpretation. Experiments on three public datasets, WikiArt, MultitaskPainting100k, and Pandora18k, demonstrate that MCS-Net outperforms representative baselines across standard evaluation metrics.

Parents of children with autism spectrum disorder (ASD) face persistent emotional, psychological, and social challenges. Cultural stigma and limited resources in India may add to this burden. This study examined the association between parental stress, parenting styles, and ASD severity in Indian families. We recruited 63 parents of children aged 3-12&#xa0;years with a clinically confirmed diagnosis of ASD (DSM-5 criteria) between November 2023 and January 2024 through Autism Community Support Groups. Of these, 60 were included in the final analysis after excluding three cases with missing data. Data were collected using a socio-demographic proforma, the Parental Stress Scale, and the Parenting Styles and Dimensions Questionnaire-Short Version. Statistical analyses were performed using SPSS Statistics version 23.0. Given violations of the normality assumption, non-parametric analyses were employed: the Kruskal-Wallis H test with Mann-Whitney U pairwise comparisons assessed differences in parental stress across severity levels, and Spearman's rank-order correlation examined associations between stress and parenting styles. Parental stress differed significantly across ASD severity levels, H (2)&#x2009;=&#x2009;21.397, p&#x2009;<&#x2009;.001. Parents of children with mild ASD reported the lowest stress (M&#x2009;=&#x2009;57.24, SD&#x2009;=&#x2009;4.72), followed by moderate ASD (M&#x2009;=&#x2009;62.73, SD&#x2009;=&#x2009;5.46) and severe ASD (M&#x2009;=&#x2009;68.00, SD&#x2009;=&#x2009;4.58). Pairwise comparisons indicated that parents of children with mild ASD reported significantly lower stress than those with moderate ASD (U&#x2009;=&#x2009;129.00, p&#x2009;=&#x2009;.002) and severe ASD (U&#x2009;=&#x2009;10.00, p&#x2009;<&#x2009;.001). Parental stress was positively correlated with authoritarian parenting style (rs&#x2009;=&#x2009;.314, p&#x2009;=&#x2009;.014), while no significant associations were found with authoritative or permissive styles. ASD severity is significantly associated with higher parental stress among Indian families. Parental stress was positively associated with an authoritarian parenting style. These findings highlight the need for culturally responsive, family-centered interventions that address both child symptom severity and parental well-being.

To assess whether personality styles vary across student and professional cohorts in dentistry, using psychology controls. A total of 249 dental students and 162 practicing dentists were compared with 160 psychology students and 430 psychotherapists. All participants completed the Personality-Styles-and-Disorders-Inventory (PSDI). Fourteen personality styles were analyzed across disciplines and career stages. MANOVA with post-hoc-tests showed significant differences among the four groups (dental and psychology students and professionals). Both student groups showed strong fluctuations around the normative mean, indicating higher emotional levels and peaks in stress-dependent styles. Dental students showed signs of severe stress and burnout tendencies. Their depression scores were highest, while optimism was lowest. Professionals generally showed lower values than students, often below the norm, indicating "functional adaptation" and professional stability. Psychotherapists showed the most balanced profile with the lowest values. Dentists remained moderately higher than psychotherapists, indicating higher stress. Their most distinctive characteristic was "compulsiveness", reflecting precision and perfectionism, already elevated during training and increasing in practice. While psychotherapists developed from higher stress levels during their studies to a balanced profile, dentists maintained higher stress and increased their perfectionism. Dentists demonstrate stronger tendencies towards precision and perfectionism than psychologists, who show greater flexibility and openness. Professionalization appears associated with adaptive personality style, although compulsive tendencies in dentistry remain elevated and may increase with clinical experience. These findings suggest an interplay between pre-existing dispositions and occupational socialization. Longitudinal studies are needed to clarify whether these differences are present before training or arise during professional practice. Insights into the differences in personality styles between dental students and dentists may inform dental education and prompt further research on dentist-patient relationships and treatment outcomes.

This study aimed to assess nursing students' perceptions of concept mapping, explore their learning preferences, and examine its relationship with learning styles. A cross-sectional study was conducted. A total of 174 female nursing students were recruited using a convenience sampling method. Data collection tools included the Scale for the Effectiveness of Concept Maps in Nursing Education, a 30-item Likert-Scale Questionnaire assessing perceptions of concept mapping effectiveness; the visual, auditory, reading/writing, and kinesthetic questionnaire, measuring learning style preferences; and a single Likert-scale question assessing the perceived difficulty of creating concept maps. The average participant age was 21 years, with a grade point average of 4.25. Students reported high mean scores on the Scale for the Effectiveness of Concept Maps in Nursing Education (M = 85.09), indicating strong endorsement of concept mapping for integrating care plans and processing information. Significant positive correlations were found between concept map effectiveness and care planning, information processing, and perceived difficulty. Visual, auditory, reading/writing, and kinesthetic results showed high preferences across all learning styles, with a significant correlation (p = .002) between concept mapping and the visual learning style. Concept mapping is an effective strategy for enhancing nursing education, especially for visual learners. Cite this article as: Ibraheem, A., Hussein, A. S. E., & Hussein, E. S. E. (2026). The relationship between the perception of undergraduate nursing students of the nursing concept map and their learning styles. Florence Nightingale Journal of Nursing, 34, 0335, doi: 10.5152/FNJN.2026.25335.

Background/Objectives: Age-related functional decline is increasingly linked to chronic low-grade inflammation (inflammaging) and sarcopenia, two interconnected processes contributing to frailty, metabolic dysregulation, and impaired physical function. These conditions share several underlying mechanisms, including immune dysregulation, mitochondrial dysfunction, oxidative stress, and impaired anabolic signaling. This narrative review critically evaluated the mechanistic and translational interactions between natural bioactive compounds and lifestyle interventions in modulating inflammaging and sarcopenia. Methods: Evidence from molecular, experimental, epidemiological, and clinical studies was synthesized to examine the effects of bioactive compounds-including polyphenols, flavonoids, carotenoids, and omega-3 fatty acids-as well as physical activity and dietary patterns. Particular emphasis was placed on inflammatory regulation, redox homeostasis, mitochondrial adaptation, and muscle metabolism, including NF-&#x3ba;B, AMPK-mTOR, and Nrf2 signaling pathways. Results: Observational studies and randomized controlled trials generally indicate that anti-inflammatory dietary patterns and regular physical activity are associated with improved muscle strength, physical performance, and inflammatory status in older adults. Mechanistically, nutritional bioactives and exercise appear to converge on several pathways involved in mitochondrial function, oxidative stress, anabolic signaling, and immune activation. Emerging evidence suggests potential convergence and interaction of biological pathways affected by nutritional and lifestyle interventions; however, formal evidence demonstrating true synergistic effects in humans remains limited. Nevertheless, substantial heterogeneity persists regarding intervention protocols, dosage strategies, bioavailability, and long-term clinical outcomes. Conclusions: Natural bioactive compounds and lifestyle-based interventions represent promising approaches for targeting biological processes implicated in inflammaging and sarcopenia. By integrating current evidence within a hormesis-oriented geroscience framework, this review highlights the importance of adaptive redox regulation, metabolic resilience, and evidence-based lifestyle strategies in healthy aging. Future well-designed longitudinal and intervention studies are needed to clarify the clinical relevance of these interactions and optimize translational implementation.

Sex differences and lifestyle factors such as physical activity play an important role in cardiovascular autonomic regulation. Heart rate variability (HRV) is a widely used marker of cardiac autonomic modulation and cardiovascular health. However, the combined influence of sex and physical activity levels on HRV in young, healthy adults has not been sufficiently explored. Therefore, this study investigated the effects of sex and a physically active lifestyle on HRV in men and women. A cross-sectional study was conducted on a cohort of young, healthy adults aged 18-30 and categorized into four groups based on: physically active men (AM; n = 37), sedentary men (SM; n = 44), and physically active women (AW; n = 31) and sedentary women (SW; n = 40). Regarding the impact of lifestyle, the AM group exhibited 41% higher total variance (VAR-RR) and 34% higher RMSSD (a parasympathetic index) than the SM group. The AW exhibited 74% and 78% higher VAR-RR and RMSSD, respectively, compared to the SW. Furthermore, the physically active groups (AM and AW) displayed a 75% and 50% lower LF/HF ratio, respectively, compared to their sedentary counterparts. Interestingly, the LF/HF ratio was 66% higher, and the RMSSD was 20% lower in the AM group than in the AW group. HRV indices demonstrated large to very large effect sizes. In conclusion, these findings demonstrate significantly advantage in cardiac autonomic modulation among physically active individuals and women. Together, these results reinforce the roles of female sex and an active lifestyle as important protective factors for cardiovascular health.

Background and Objectives: Numerous risk factors for both female and male fertility have been established including age, ovarian reserve, infertility cause, occupational and lifestyle factors. The objective of our study was to determine the influence of occupational and lifestyle factors on assisted reproduction (ART) outcomes at a Serbian referral tertiary center. Materials and Methods: The study included all consecutive infertile couples undergoing ART at the Clinic for Ob/Gyn University Clinical Center Belgrade, from January 2019 to January 2022. Inclusion criteria comprised primary and unexplained infertility, age &#x2264; 45 years, body mass index &#x2264; 30 kg/m2 and undergoing fresh autologous ART cycles. All patients filled in the socio-epidemiological questionnaire that analyzed their lifestyle and habits. Medical history data and data regarding the current ART cycle were taken from patient records. The primary outcome was clinical pregnancy. Results: Our study included 501 couples (women and men) with infertility undergoing ART. Clinical pregnancy was achieved in 22.2% of examined patients. Achieving clinical pregnancy in the ART cycle for women was associated with younger age and use of vitamins, minerals, and trace elements, whereas younger age and absence of chronic illnesses were the most important factors for male partners. When women and men were assessed together as couples, achieving clinical pregnancy correlated only with the use of vitamins, minerals and trace-elements by both partners. Conclusions: This study confirmed that some occupational and lifestyle factors were associated with clinical pregnancy after ART in patients with unexplained primary infertility and normal BMI.

Small object detection under adverse weather remains challenging due to weather-induced domain shifts and sparse visual cues of small targets. In contrast to R-YOLO/QTNet and conventional UDA methods, which mainly rely on weather-specific restoration/enhancement or global feature/magnitude alignment, SABDR explicitly targets cross-weather small object adaptation through bidirectional domain translation, degradation-aware receptive-field modeling, feature-statistics modulation, and style-direction alignment. Specifically, the Bidirectional Dynamic Domain Adaptation Network, termed BiDDC-Net, translates between source and target domains and dynamically adjusts receptive fields according to weather severity. The Style-Aware Domain Adaptation Module, termed AIFI-DA, enhances discriminative small-object channels using feature statistics. SDA is further used as a complementary training-time regularizer to encourage style-direction consistency without directly matching feature magnitudes. Experiments are conducted on Cityscapes&#x2192;Foggy Cityscapes and MOT-Fly&#x2192;Foggy/Rainy/Snowy MOT-Fly, including newly added rainy and snowy MOT-Fly settings, with both YOLOv5s and YOLO26 evaluated on all MOT-Fly weather conditions. SABDR achieves 47.7 mAP50 on Cityscapes&#x2192;Foggy Cityscapes, and obtains 96.0%/96.8%, 66.7%/77.1%, and 95.0%/95.6% mAP50 on Foggy, Rainy, and Snowy MOT-Fly with YOLOv5s/YOLO26, respectively. The improvements on MOT-Fly are reported under a fixed single-seed setting and should therefore be interpreted as single-run empirical gains rather than statistically validated improvements. These results demonstrate its effectiveness under the evaluated fog/rain/snow cross-weather small object detection settings.

This exploratory analysis of a randomized controlled trial aimed to identify baseline predictors of dropout in overweight women with polycystic ovary syndrome (PCOS) participating in a lifestyle intervention program. An exploratory analysis was conducted using data from a randomized controlled trial involving overweight or insulin-resistant women with PCOS aged 18-45. All participants received cyclic progestin, metformin, and a structured lifestyle intervention. Dropout was defined as proactive withdrawal, missing two consecutive visits, or loss of contact for more than six months. Univariate and adjusted multivariable logistic regression models were used to identify factors associated with dropout. Among the participants, 61.06% (n&#x2009;=&#x2009;69) dropped out within one year. No significant differences were observed in baseline demographic, clinical, biochemical, psychological, or dietary characteristics between completers and dropouts. However, baseline physical activity level (PAL), objectively measured using an accelerometer, was identified as the strongest predictor of dropout. Each 0.3-unit increase in PAL was associated with a 29.6% reduction in the likelihood of dropout. Baseline PAL is strongly associated with the risk of dropout. Screening for PAL in women with PCOS is recommended, and those with lower PAL should receive personalized support in addition to lifestyle interventions to improve adherence and promote weight loss.

Aim: To summarize current evidence on lifestyle interventions, metabolic stabilization and screening strategies relevant to diabetic retinopathy during pregnancy. Materials and Methods: A narrative review of clinical studies, systematic reviews, meta-analyses and guideline documents was performed using PubMed/MEDLINE, Scopus and Google Scholar. Baseline retinal status in early pregnancy is the strongest predictor of progression. Additional risk is associated with longer diabetes duration, elevated glycated hemoglobin, glycemic variability, nephropathy and hypertensive disorders, including preeclampsia. Women without retinopathy in early pregnancy generally have a low risk of sight-threatening disease during the same gestation, whereas women with pre-existing retinopathy require close surveillance. Lifestyle interventions do not directly treat retinal lesions, but they improve glycemic control, support appropriate gestational weight gain and reduce vascular burden. Evidence also suggests that continuous glucose monitoring and automated insulin delivery may indirectly support retinal protection by improving metabolic stability. Conclusions: In pregnant women with diabetes, ophthalmic screening remains the main clinical priority. However, lifestyle-based metabolic support is a meaningful complementary strategy and should be integrated into antenatal care alongside risk-stratified retinal follow-up.

Background/Objectives: Previous literature has linked nutrition with both psychological distress and well-being. However, less is known about how psychological and spiritual resources cluster within individuals or whether distinct psychospiritual profiles are associated with dietary and lifestyle behaviors. This study examined these associations using a person-centered approach. Methods: A community sample of 522 adults from the United States completed measures of perceived stress, depressive symptoms, coping self-efficacy, gratitude, forgiveness, religiousness/spirituality, daily spiritual experiences, religious/spiritual meaning and beliefs, and dietary and lifestyle behaviors. Latent profile analysis was conducted to identify psychospiritual profiles. Results: Four profiles were identified: Moderate (n = 195), Flourishing (n = 199), Vulnerable (n = 70), and Maladaptive (n = 58). The Flourishing profile demonstrated the most adaptive psychological functioning and was associated with healthier dietary behaviors, including lower breakfast skipping and fast-food consumption, greater whole-grain and vegetable intake, lower salt use, and lower sweets and dessert intake. The Vulnerable profile demonstrated the highest levels of perceived stress and depressive symptoms together with relatively elevated religiousness/spirituality, whereas the Maladaptive profile was characterized by elevated distress and consistently low levels of psychological and spiritual resources. Overall, the Vulnerable and Maladaptive profiles demonstrated less favorable dietary patterns relative to the Flourishing and Moderate profiles. However, the observed effects were generally modest and selective. Conclusions: Dietary and lifestyle behaviors may be associated with broader psychospiritual configurations rather than isolated psychological characteristics alone. The findings additionally highlight the heterogeneous nature of religiousness and spirituality within psychological functioning.

Background/Objectives: Adolescence is a critical period for the adoption of health-risk behaviors and the development of non-communicable diseases (NCDs). Schools represent a strategic setting for health promotion interventions; however, Italian studies simultaneously assessing NCD-prevention knowledge and lifestyle behaviors in the same adolescent population remain scarce. The study aimed to evaluate improvements in knowledge regarding nutrition and other lifestyle-related behaviors among Italian adolescents following a school-based educational intervention. Secondary objectives included describing lifestyle behaviors within the study population and exploring participants' evaluation of the intervention. Methods: A quasi-experimental pre-post study was conducted between March and May 2025 in five lower secondary schools. A total of 410 adolescents aged 11-16 years were enrolled through a two-stage cluster sampling procedure. The intervention, lasting approximately two hours, was delivered by a trained nurse-researcher and addressed four health domains: nutrition, physical activity, screen exposure, and substance use. Results: Following the intervention, a measurable increase in overall knowledge scores (mean increase: +3.9 points) was observed, with 88.9% of participants showing improvement. The largest improvements were observed in nutrition-related knowledge and awareness of passive smoking harms. Despite these gains, unhealthy behaviors remained prevalent, including low adherence to physical activity recommendations (36.1%), suboptimal dietary quality (39.9%), and high screen exposure. A linear regression model identified five independent determinants of higher knowledge improvement: older age, female gender, higher screen exposure, having at least one employed parent, and lower pre-intervention test scores. The intervention was positively evaluated, with high levels of satisfaction, clarity, and perceived usefulness. Conclusions: Nevertheless, the persistent gap between knowledge and behavior underscores the need to integrate motivational and environmental components, gender-sensitive approaches, and longitudinal evaluations to foster sustainable, healthy choices and contribute to NCD prevention.

Background: Population ageing increases the burden of chronic diseases, multimorbidity, and functional limitations, making nutrition and lifestyle important modifiable determinants of healthy ageing. Universities of the Third Age (U3A) provide an educational and social environment for older adults, but multidimensional relationships between nutrition knowledge, diet quality, lifestyle, and health status in this population remain insufficiently characterized. This study aimed to assess these associations among older adults attending U3A in Poland. Methodology: A cross-sectional online survey was conducted between January and April 2026 among community-dwelling older adults participating in U3A programs. Of 700 distributed invitations and 520 returned questionnaires, 450 complete and eligible responses were included. The questionnaire was based on the KomPAN&#xae; framework and expanded with items on health, lifestyle, psychosocial resources, barriers to healthy eating, and sources of health information. Diet quality was assessed using the pro-Healthy Diet Index, non-Healthy Diet Index, and overall Diet Quality Index (DQI). Nutrition knowledge was measured using a 24-item scale. Analyses included distributional diagnostics, non-parametric group comparisons, FDR-corrected Spearman correlations, psychometric assessment, principal component analysis, multivariable regression with model diagnostics, and profile segmentation. Results: The mean age was 73.63 &#xb1; 5.73 years, and most participants were women. The median DQI was 15.59 [3.93-24.86], with a predominance of neutral diet quality. Nutrition knowledge was moderate, with a median score of 12.00 [9.00-15.00], and the scale showed very good internal consistency. PCA identified three dietary patterns: convenience/ultra-processed, prudent/health-promoting, and traditional meat-and-fat. Higher DQI was associated with better nutrition knowledge, greater physical activity, a more favorable sleep profile, regular meal timing, and lower disease burden. Participants with multimorbidity had significantly lower DQI. Segmentation distinguished a health-engaged/higher-resource profile and a lower-resource/nutritionally vulnerable profile. Conclusions: U3A participants in Poland are educationally and socially active but nutritionally heterogeneous. The predominance of neutral diet quality, moderate nutrition knowledge, and identifiable knowledge gaps indicates the need for targeted, practical, and behavior-oriented nutrition education supporting healthy ageing.

In healthcare organizations, ethical conduct is strongly influenced by nursing leadership. Although prior research has emphasized the role of leadership in shaping professional behavior, limited attention has been given to how different leadership styles affect nurses' moral courage through ethical decision-making processes. This study examines the effects of three leadership styles-ethical, empowering, and authoritarian-on nurses' moral courage, with ethical dilemma identification as a mediator and perceived ethical climate and compassion fatigue as moderators. A cross-sectional survey was conducted among registered nurses in a Chinese tertiary hospital (N&#x2009;=&#x2009;314). A moderated mediation model was tested using structural equation modeling. The results show that ethical and empowering leadership are positively associated with moral courage, whereas authoritarian leadership is negatively associated. These relationships are mediated by ethical dilemma identification, suggesting that leadership shapes moral courage by influencing nurses' recognition of ethical issues. Moreover, a supportive ethical climate strengthens the positive effects of ethical and empowering leadership, while compassion fatigue weakens these relationships. These findings highlight the critical role of leadership in promoting ethical practice in nursing. Practically, healthcare organizations should foster ethical and empowering leadership, strengthen ethical climates, and address compassion fatigue to enhance nurses' moral courage in clinical settings.

Background/Objectives: Lifestyle Modification Programs (LMPs) based on exercise and nutrition aim to prevent/manage chronic diseases and foster well-being. However, moving LMPs from research to medical practice can be challenging, as programs must be both effective and feasible. The primary goal of this study was to assess cardiorespiratory fitness (CRF) changes according to an LMP, measured through VO2max, as a key indicator of health outcomes and intervention efficacy. Methods: In this single-arm intervention study, 100 subjects were enrolled; per-protocol analysis of main parameters was performed on 85 participants (15 were excluded due to medical/technical reasons). A feasible intervention program (of low resource intensity with only two physician/patient encounters) provided personalized exercise prescription, optimized nutritional habits based on the Mediterranean diet and Healthy Eating Plate principles, and supported behaviour change. We assessed CRF through VO2max, a key indicator of health outcomes and intervention efficacy. We also analyzed, using regression analysis, the relationship between VO2max (the gold-standard measure of CRF) and METSpeak, a simpler, feasible parameter of CRF derived from Exercise Stress Testing. Body composition (BC) and AHA diet score were also measured at baseline and post-6-month intervention. Statistical analyses included paired comparisons and multivariable regression to explore factors influencing CRF changes. Results: Analysis on the primary outcome, VO2max, was performed according to the intention-to-treat principle and per-protocol. This feasible protocol resulted in a significant increase in VO2max, improvements in fat-free mass, and a reduction in fat mass. Overall, 42.4% of participants achieved an improvement of &#x2265;1 MET, a change previously associated with reduced mortality risk. Older participants tend to experience smaller improvements in VO2max. Conclusions: Although observing an improvement in CRF and BC following an LMP is not surprising, the strength of the study is to show the feasibility of implementing an effective, feasible LMP into clinical routine, supporting the integration of such programs into clinical practice.

Smart home automation (SHA) is an advanced service that automates household tasks with minimal human intervention, enhancing efficiency, convenience, and personalization. SHA serves as the critical bridge that transforms home environments into intelligent spaces that respond adaptively to user needs. Despite these benefits, SHA penetration remains limited due to various challenges, making it essential to understand SHA acceptance. This study examines two user-centered constructs influencing SHA acceptance: users' lifestyles (UL) and perceived difficulty of use (PDU). Through a systematic process, the dimensions of both constructs were defined and measurement items were developed. A research model extending the Technology Acceptance Model was proposed, in which UL and PDU influence the perceived usefulness (PU) and intention to use (IU) of SHA. The model was tested using data collected from 167 non-users of SHA in South Korea. Results reveal that UL characterized by energy-saving negatively affects IU, whereas UL characterized by lack of time for household tasks positively affects IU. Additionally, PDU from automation configuration negatively affects both PU and IU. Based on these findings, practical strategies to enhance SHA acceptance are proposed. This study contributes by extending the acceptance framework for SHA through conceptualizing UL and PDU and by revealing how these user-centered constructs shape PU and IU, thereby clarifying their role in SHA acceptance and informing managerial strategies that promote broader penetration.

Childhood obesity is a complex public health issue in which parental perceptions and family dietary behaviors are pivotal. This study assessed the feasibility of the Smart Family lifestyle counseling intervention in Greek primary care. It explored changes in children's dietary behaviors relative to parental weight perception and Mediterranean diet adherence. A single-arm pretest-posttest pilot study was conducted in Patras, Greece, from Health4EUKids Joint Action. The intervention consisted of four monthly face-to-face counseling sessions using the Smart Family methodology. In total, 49 parent-child dyads (aged 2-12 years) completed the program. Data collection included child anthropometric measurements, validated food frequency questionnaires, parental perception of child weight status, and parental Mediterranean diet adherence. Parents who underestimated their child's weight status had significantly higher Mediterranean diet scores than those who overestimated (p = 0.032); those with low adherence tended to overestimate and those with moderate adherence to underestimate. The largest reduction was observed for sweets and desserts (median -2.35 servings/week), with significant reductions in sugar-sweetened beverages, grains and cereals, whole wheat products, and dairy. Fish and vegetable intake increased significantly, but fruit intake did not change. Changes in fast food and red meat differed significantly across Mediterranean diet score tertiles, with larger decreases in the lower tertiles. Smart Family counseling was feasible to deliver through trained healthcare professionals in Greek primary care over four months, with reductions in selected discretionary foods observed alongside the intervention. Parental weight perception and Mediterranean diet adherence emerged as potential barriers to change although the findings are exploratory and require confirmation in a future controlled trial.

Parental emotional expressivity toward their child is an integral component of creating a family emotional climate, which is the primary context in which children develop social-emotional skills. The current study sought to empirically test Darling and Steinberg's model that parent attitudes that make up parenting style effect parental emotional expressivity during parent-child interaction. Using longitudinal data from the NICHD Study of Early Child Care and Youth Development (SECCYD), the authors examined the compounding effects of maternal authoritarian attitudes measured soon after birth on maternal emotional expressivity toward their infant across three time points (child at 6, 15, and 24 months old). Hierarchical linear modeling analyses (HLMs) demonstrated that a mother's (n = 1165, Mage = 28.2 years) authoritarian attitudes were associated with both decreased positive expressivity and increased negative expressivity toward their child at 6 months of age. Mothers who held more authoritarian attitudes at baseline demonstrated an increased rate of growth in negative expressivity toward their child over time. Maternal race and income were also significantly associated with the linear rate of growth of negative expressivity over time but not in positive expressivity. This suggests that authoritarian attitudes measured when the child is 1 month old continue to impact parent behavior up to 23 months later. This pattern suggests a potential window for effective universal prevention efforts in promoting nurturing parent behavior and promoting positive parent-child relationships. A possible target of prevention intervention could be providing parents with components of a modularized emotion regulation curriculum. The content could help parents to regulate their negative expressivity toward the child and focus on the message they want to convey to the child related to the child's specific behavior.