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Although women's autonomy is key to patient care, the extent to which patients exercise autonomy during clinical consultations in resource-limited contexts such as Zambia remains unknown. This study aimed to examine women's experiences of autonomy in decision-making and respectful treatment in Zambian maternal healthcare. The study was conducted in Lusaka and used a cross-sectional survey design. The sample consisted of 305 women who were conveniently recruited. Data was collected using a questionnaire consisting of sociodemographic data and two validated instruments: the 7-item Mothers Autonomy and Decision-Making Scale (MADM), and the 14-item Measure of Respect (MOR) index. Higher levels of decision-making autonomy, according to MADM, are significantly associated with higher levels of perceived respect in maternal healthcare settings, according to MOR (p&#x2009;<&#x2009;.001). Furthermore, higher education was found to correlate significantly with higher autonomy and respect (p&#x2009;<&#x2009;.001). Both instruments showed an excellent (MADM) and good (MOR) internal consistency among this sample (Cronbach's alpha&#x2009;=&#x2009;0.959 and 0.851, respectively). Overall, while there's significant variation in responses, there is a slight tendency towards positive experiences in both autonomy and respect in maternal healthcare settings. Health authorities should promote the implementation of autonomous and respectful care for all women, regardless of socioeconomic or educational background, and provide a supportive environment that fosters user participation in decision-making.

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Chronic Pelvic Pain (CPP) is a complex and often debilitating condition that significantly impacts quality of life. Its diverse symptoms and intricate biological and psychological mechanisms highlight why multimodal and multidisciplinary approaches are widely recommended for CPP management. Hypnotherapy is an underutilized treatment for patients with CPP, despite widespread dissatisfaction with pharmacological options. Though research on psychological approaches has had mixed results, there's emerging evidence that hypnosis may be effective. A few case studies and controlled trials have shown its potential to not only modulate pelvic pain but also help restore a patient's overall quality of life, including hedonic functions like sexual pleasure. This review explores the available research on hypnotherapy for various urogenital pain syndromes. While preliminary findings are promising, they are limited by the lack of standardized interventions and the heterogeneity of the studies. More research is needed, specifically in the form of well-designed randomized controlled trials using validated measures for pain, sexual satisfaction, and quality of life.

Research on telemedicine adoption often exhibits a fragmented approach, analyzing patients and healthcare professionals separately. This study addresses that gap by jointly assessing the acceptance of telemedicine in Spain, a country characterized by a low conversion rate from intention to use to actual adoption. An extended UTAUT2 model was applied, incorporating contextual variables such as Trust, Personal Innovativeness, Word of Mouth, and Novelty. Based on a cross-sectional quantitative design with 684 participants (203 professionals and 481 patients), the model demonstrated a high explanatory power for usage intention (adjusted R2 = 0.800). The findings confirm that Performance Expectancy, Hedonic Motivation, and Habit are significant predictors for both groups. Likewise, the contextual variables Trust, Personal Innovativeness, and Novelty had a positive and significant impact. In contrast, Effort Expectancy, Social Influence, and Facilitating Conditions were not significant, while Perceived Price Value showed a negative effect. A multi-group analysis revealed that Performance Expectancy and Trust exert a significantly greater influence on usage intention among healthcare professionals. These findings validate the extended model in healthcare contexts with dual user profiles, challenge the universal applicability of certain UTAUT2 constructs in digitally mature environments, and underscore the need for differentiated implementation strategies based on user profile.

The "experience of embodiment" is a psychological construct that captures how individuals inhabit and relate to their bodies within specific socio-cultural contexts and is closely tied to mental health and well-being. The construct was originally developed to explain the body-related experiences of cisgender girls and women and has not yet been investigated in trans*feminine individuals. Grounded in social constructivism and informed by tenets of gender minority stress, this study investigated trans*feminine experiences of embodiment. Trans*feminine individuals (N&#x202f;=&#x202f;28) engaged in focus groups, a photo-elicitation task, and one-on-one semi-structured interviews. Reflexive thematic analysis, incorporating both inductive and deductive approaches, was used to construct five interrelated themes: (1) challenging vs. embracing cisnormativity, (2) desire: incoming and outgoing, (3) radical self-care vs harm, (4) journeys to alignment, and (5) corseting euphoria. These themes captured both the internal processes and structural forces shaping embodied experiences, and identified notable distinctions, alongside similarities, to the "experience of embodiment" construct. This novel research advances a broader and more inclusive conceptualization of the experience of embodiment by centering the lived body-related experiences of trans*feminine individuals.

To investigate how experienced allied health practitioners (AHPs) enhance participation outcomes for community-dwelling adults with high disability support needs and challenging behaviour following extremely severe acquired brain injury (ABI). Participants were 23 AHPs experienced in adult ABI rehabilitation who participated in semi-structured interviews. Responses were illustrated with a single de-identified case example. Qualitative data analysis was conducted using NVivo and followed the six steps of Reflexive Thematic Analysis. Eight themes to enhance participation outcomes were identified: (1) "building a good relationship," (2) "it takes a team", (3) "I just need to find something he can do", (4) "behaviour, activity and participation are inseparable", (5) "behaviour is everybody's business", (6) "environments that match the person's needs", (7) "work with the disability support workers, team leader, and the person above them", and (8) "there's a direct correlation between behaviour and participation". This study supports a bidirectional relationship between behaviour and participation that can be harnessed to shape successful AHP interventions. Implications for future clinical research include the importance of integrating behaviour support plans into structured routines focused on meaningful activity and role participation following ABI, and concurrently measuring behaviour and participation outcomes. Interventions developed by AHPs and implemented by disability support workers can assist people with ABI who have high daily support needs and challenging behaviour to achieve meaningful participation goals.Disability workers require training and ongoing support from AHPs to manage complex disability support needs and challenging behaviour.Challenging behaviour and participation are related bidirectionally, and need to be measured and addressed together.

In ageing societies, understanding the lived experiences of dependent older adults is essential for designing care policies that support health, dignity, and well-being. While ageing in place is widely promoted, less is known about how dependent older adults themselves define its limits. This study examines how dependent older adults describe the conditions under which ageing in place supports-or undermines- their dignity and quality of life. We conducted 30 in-depth interviews with individuals aged 65 and older in Barcelona, Spain, all officially recognized as having some degree of dependency. Interviews were analysed using a thematic approach, according to environmental gerontology and person-environment fit frameworks. Ageing in place emerged not as a fixed preference but as a fragile and continuously negotiated process of the person-place relationship. Remaining at home is sustained by symbolic autonomy and attachment to familiar environments, supporting control over daily routines and a sense of dignity. At the same time, participants described a state of care liminality, continuously reassessing their ability to remain at home in light of anticipated health decline. Three interconnected boundaries emerged: deteriorating health, perceived burden on family members, and loneliness. Ageing in place among dependent older adults should be understood as a conditional and relational process rather than a universal ideal. Recognising older adults' own definitions of its limits is essential for designing responsive care policies.

Approximately 500,000 people are diagnosed with cancer in Germany each year. It is estimated that 37% of these cases are preventable. However, public awareness of cancer prevention, particularly of the European Code Against Cancer (ECAC), remains low. The mobile exhibition Step by Step through Cancer Prevention by the Comprehensive Cancer Center Munich (CCC Munich) was developed to provide accessible, actionable knowledge aimed to promote healthier lifestyle choices. The mobile exhibition was evaluated in a cross-sectional study using the RE-AIM framework (Reach, Effectiveness, Adoption, Implementation, and Maintenance) during the period between September 2024 and March 2025. Data were collected via an online questionnaire which was accessible through QR codes embedded in the exhibition. The survey included demographic items and questions assessing knowledge gain, behavioral intentions, and visitor feedback. Descriptive statistics were calculated in SPSS. A total of 123 participants completed the survey. Most respondents (87.8%) reported learning something new, 83.7% intended to implement at least one preventive recommendation, and 96.7% planned to share the information with others. By March 2025, the exhibition had been hosted by two companies and attracted interest from 18 institutions, with eight planning to host it in 2026. The mobile exhibition enhanced visitors&#x2019; knowledge and motivation toward healthier behaviors while demonstrating strong organizational uptake. Its interactive design and flexibility make it a scalable, cost-effective tool for cancer prevention education. Further research should evaluate long-term behavioral outcomes and strategies to reach populations with lower health literacy.

Despite the advancements in federated learning (FL) for privacy-preserving AI, its implementation in medical diagnostics faces persistent challenges. Some of these are intolerable computational loads, communication delays, and inefficiencies in dynamic healthcare environments. Since X-ray models are likely to be imbalanced/heterogeneous, and be prone to adversarial attacks, the likelihood of slow convergence, high complexity, and the negative effects of these with FL models are high. As is highly likely, this will result in performance loss under constraints of such level &#x2014;most likely with noisy or imbalanced data. Nevertheless, to have a stable FL platform for the actual healthcare utilization, it is essential to overcome these challenges. These challenge are responded to by proposing a new integration of ResNet-50 and privacy preserving techniques for federated medical diagnosis. The latter is a data privacy and security, which is achieved with stochastic noise and homomorphic encryption on top of the superior classification performance of ResNet-50 in processing high dimensional X-ray images. Through effective imbalanced datasets reduction and reduced computational complexity, our method reduces convergence during training with adaptive learning rates and advanced data balancing methods. The model is applied on Python with the use of the TensorFlow and PyTorch libraries, integrating the real-time data using improved communication formula. It is also compared with other approaches and achieve a considerable improvement in accuracy of 99.6%, Precision is 98.8%, Recall is 99.2%, and F1 Score is 99% compared to the 5% improvement of conventional FL models. The model is equally stable and scalable in the dynamic case of a healthcare setting, with guarantees on effective diagnostics and data privacy. The system is a new standard for privacy friendly AI in healthcare diagnosis and gives an effective and scalable solution in X-ray classification task. Now that it&#x2019;s an open door for future research, there&#x2019;s further expansion of more complex privacy mechanisms and integration with other AI systems.

Microsurgery is an essential skill in plastic surgery, particularly for oncological reconstructions. The traditional training pathway in India spans approximately 12 years, encompassing medical school, general surgery residency and plastic surgery specialization. Given the projected 12.8% rise in cancer incidence by 2025 in India, there's an urgent need to expedite microsurgical training without compromising patient care quality. At a tertiary cancer institute, a structured four-phase microsurgical training program was implemented from April 2022 to December 2023 for second-year plastic surgery residents. The program incorporated Peyton's four-step teaching approach-demonstration, deconstruction, comprehension, and performance-and utilized simulation-based training with latex gloves, silicon tubes, and live rat models. Progression to subsequent phases required achieving a minimum score of 8/10 on the Microsurgical Anastomosis Rating Scale (MARS10). Residents advanced from assisting in flap harvests to independently performing complete microsurgical procedures. Over the study period, 1,520 free flap surgeries were performed in our institute. Residents individually conducted between 73 and 79 flap harvests and 18 to 22 microvascular anastomosis. The flap survival rate among resident-performed surgeries was 94.73%, close to the institute's overall rate of 95.53%. According to statistical analysis, there was no significant difference (p&#x2009;=&#x2009;0.812), indicating the training model's effectiveness. The structured training model effectively reduced the microsurgical learning curve, maintaining high standards of patient care. By integrating simulation-based practice and objective assessment, the program offers a replicable framework for accelerating microsurgical competency among plastic surgery residents.

Switzerland faces challenges in long-term care due to its high life expectancy and the resulting increased prevalence of non-communicable diseases and functional dependence among older adults. Nursing homes are addressing increasingly complex acute care needs amid healthcare professional shortages. The nurse practitioner role has emerged globally as a key strategy to enhance the accessibility, quality, and coordination of care in these settings. While the role was recently legislated in the canton of Vaud, there's a scarcity of solid scientific data on nurse practitioner implementation and impact in Switzerland. The aim of this study is to assess the implementation of the nurse practitioner role in nursing homes in order to develop a toolkit that supports the sustainability of this new role's deployment in Switzerland. This two-phase study will evaluate the implementation of the nurse practitioner role in two distinct nursing homes in the canton of Vaud, using the PEPPA Plus model (based on Donabedian's framework) as a guide. Phase 1 employs an embedded mixed-method case study design across three work packages (WPs). WP1 uses Rapid Ethnography (observations, interviews, document analysis) to assess structural elements influencing implementation before and one year after nurse practitioner deployment. WP2 uses a prospective descriptive quantitative design where NPs log their activities per act daily or five consecutive days each month over the course of one year. WP3 uses a longitudinal multi-method approach, combining a pre-post quasi-experimental quantitative component to measure resident, staff, and institutional outcomes (e.g., hospitalizations, pressure sores) at 3, 6, and 12 months, with qualitative interviews. Phase 2 (WP4) will use Thoele's three-step methodology-data preparation, focus group evaluation, and toolkit design-to develop a best practices toolkit to support the nurse practitioner role's sustainability based on Phase 1 results. For Phase 1 analysis, data from each nursing home will be analyzed separately (intra-case analysis) and then compared (inter-case analysis). Qualitative data (interviews) will be analyzed using thematic content analysis and triangulated with quantitative data for a comprehensive understanding. Quantitative outcomes will be analyzed using descriptive statistics and generalized linear models (e.g., Poisson regression) for pre-post comparisons over two six-month periods. All procedures will comply with the ethical principles outlined in the Declaration of Helsinki. Given the nature of the study, ethical approval from the Ethics Commission of the Canton of Vaud was not required, according to the latter. Data and material will be available on request from the authors. 10.17605/OSF.IO/7FX8M.

Collaboration with parents is essential in speech and language therapy to achieve therapeutic goals for children. However, linguistic and cultural differences can complicate communication and collaboration with multilingual parents. This study offers insight into the perspectives, experiences, and needs of multilingual parents who share little or no common language with the Speech and Language Therapist (SLT)&#xa0;supporting their child. This study aims to provide an in-depth understanding of the perspectives of multilingual parents on the perceived communication and collaboration with SLTs. Individual in-depth interviews were conducted with 12 multilingual parents whose children were involved in SLT. The oral interviews were supported by a visual and tactile method, the Yucel method, which had not previously been applied in this context. The data were analysed using reflexive thematic analysis. Reflexive thematic analysis revealed six key themes: 1) Language barriers affect the equity within parent-SLT partnerships, 2) Inclusive communication in speech and language therapy is not self-evident, 3) Child-centred communication simplifies the complexity of the message, 4) There is a discrepancy between the desire and the possibilities for collaboration in therapy, 5) Contextual factors influence the interaction between parents and SLTs and 6) Empowerment of multilingual children and their parents enhances through speech and language therapy CONCLUSION: This study provides a unique view into the perspectives of multilingual parents regarding communication and collaboration with SLTs. The identified themes underscore the importance of increasing awareness of the complex multilingual interactions between SLTs, parents, and children. The findings highlight the vulnerable position of parents and advocate for the conscious and appropriate use of inclusive communication strategies in SLT practice. Furthermore, the study emphasizes that the impact of SLT extends beyond child empowerment, contributing to the broader support and inclusion of multilingual families. What is already known on this subject Speech and language therapists (SLTs) often face challenges when collaborating with multilingual parents due to linguistic and cultural differences. While some previous studies have explored parental perspectives on partnership with SLTs, little research has focused specifically on multilingual parents and their views on communication and partnership in speech and language therapy. What this study adds to existing knowledge This study offers a unique perspective of parents who share little or no common language with the SLTs supporting their children. It provides insight into the experiences, needs, and viewpoints of multilingual parents, a group often underrepresented in research. The findings emphasise the importance of raising awareness among SLTs of inclusive communication and collaboration with multilingual parents. What are the clinical implications of this study? This study underscores the importance of increasing awareness of the complex multilingual interactions between SLTs, parents, and children. It highlights the vulnerable position of parents and advocates for the adequate and conscious use of inclusive communication strategies when language barriers are significant. Moreover, speech and language therapy hold substantial value for multilingual families, contributing to their communicative self-efficacy. There is a discrepancy between parents' willingness to act as partners and the actual opportunities to collaborate in an equitable way in the absence of a shared language. Despite language differences, parents report increased empowerment in their family's communicative participation through speech and language therapy, underscoring its broader value. The use of complementary visual and tactile methods, such as Yucel, enables a more inclusive approach in both research and practice by facilitating access to parental perspectives that might otherwise remain underexplored.

To identify clinicians' perceived challenges and barriers in the management of low anterior resection syndrome (LARS) through exploration of attitudes and decision-making practices around screening, diagnosis and management. Exploratory interpretive qualitative design. Semi-structured interviews were undertaken and a reflexive thematic qualitative analysis was conducted using an iterative-inductive approach. Eleven colorectal surgeons, six physiotherapists and three specialist nurses were interviewed. Data were grouped into four major themes and 13 sub-themes. Variation in clinician engagement with LARS was identified, with clinicians' knowledge, training and personal interest in managing patients raised by participants as contributing factors. An absence of standardized management pathways presented challenges in clinical practice with the lack of structured multidisciplinary approaches and referral pathways combined with a perceived lack of established treatment guidelines impacting on clinical decision-making. Inequities in access to specialist pelvic services and treatment were identified as systemic limitations which influence clinical decision-making in relation to clinical practice and implementation of patient care. The interpretation of the patient experience with LARS and perceptions of treatment acceptability were identified to influence clinical decision-making and demonstrated divergent perceptions of patient experience. This study identified several challenges in LARS management from a clinician's perspective. A lack of standardized treatment guidelines and pathways, limited treatment access, and inconsistent clinician engagement present challenges. Divergent perceptions of patient experience and treatment acceptability further complicate care. These findings highlight the urgent need to address these systemic limitations through enhanced surgeon education, standardized treatment/referral guidelines, improved patient resources and expanded access to multidisciplinary care.

Our knowledge of the immune system continues to expand at a rapid pace, and this coupled with technological advances now enables us to interrogate both the breadth and the depth of the immune response at levels without precedent. This has also facilitated rapidly integrating some of this carefully vetted knowledge into clinical practice. Notable examples of these advances include successfully harnessing the therapeutic potential of the immune system (immunotherapy), as well as an expanding menu of clinical flow-cytometry laboratory tests to assess the phenotype and function of the cellular immune response. This has also given rise to an emerging sub-discipline called "Immune-Health", with its premise undergirded by the notion that the surveillance capacity and sentinel nature of the immune response might enable the immune system to serve as a reliable barometer of overall health of the individual. At its core, immune-health entails defining baseline immune characteristics for each individual so that perturbations in this baseline signature can serve as clinically actionable biomarkers that might predict the onset, help monitor the progression and potentially mitigate the effects of the underlying disease process. Defining appropriate reference-ranges (RR) for key cellular immune parameters constitutes one of the essential building-blocks of the concept of immune-health. Establishing pediatric RR for cellular correlates of immune-health and disease is a time-consuming and labor-intensive process, and consequently only a select few specialty laboratories at some children's hospitals (with a well-established immunodeficiency/immunedysregulation clinical service) and a couple of large national reference laboratories in the United States (US) have invested their time and effort into this endeavor. Furthermore, the lack of standardization in the definition of immune subsets has also complicated this effort. In 2012, the Human Immunophenotyping Consortium (HIPC) established by the National Institute of Allergy and Infectious Diseases (NIAID)-Division of Allergy, Immunology and Transplantation, published a benchmark study that attempted to standardize the definitions for several cellular immune parameters. In general, Europe has led the charge in advancing these standardization efforts, while similar efforts in the US have been rather sparse, and currently there's a marked paucity of US based studies describing the establishment of pediatric reference ranges (RR) for T and B cell subsets based on the HIPC standardization initiative. In this report, we describe the results of the endeavor, at a large, free-standing children's hospital in the US with a busy clinical immunology service, to establish pediatric reference ranges for na&#xef;ve and memory T and B cell subsets largely adapted from the subset definitions outlined by the HIPC.

Anaplastic thyroid carcinoma (ATC) is a highly lethal malignant tumor, and there's still no effective treatment for it. Isobavachalcone (IBC) is a chalcone derivative and comes from the traditional Chinese herb Psoralea corylifolia. IBC exhibits potent anti-cancer activity against various cancers. However, its efficacy and mechanism of action in ATC remain unclear. This research used in vitro and in vivo models to evaluate the anti-cancer effects of IBC on ATC. The results showed that IBC has significant anti-cancer effects with extremely low toxicity. Mechanically, IBC inhibits ATC cell growth by inducing cell cycle arrest in the G2/M and S phases. IBC induces apoptosis and pyroptosis, with caspase-dependent Poly ADP-ribose Polymerase (PARP) and Gasdermin E (GSDME) cleavage simultaneously. This study reveals a novel function of IBC in inducing pyroptosis in tumor cells, expands its known pharmacological spectrum and highlights its value as a therapeutic agent for ATC.

BACKGROUND: While Canadian First Nations communities actively participate in sport, cultural, and land-based activities, they face various barriers to physical activity. Despite calls for increased support at all government levels, access to suitable programs for those with chronic conditions in particular remains limited. As part of an ongoing partnership between the University of British Columbia and Carrier Sekani Family Services (CSFS), this qualitative study aimed to explore current values, perceived barriers, and potential facilitators of physical activity among people living with chronic health conditions in rural and remote First Nations communities in northern British Columbia. METHODS: This qualitative study is part of a larger mixed-methods, community-based participatory action project with CSFS titled Niwh Yizt&#x2019;iyh Hilht&#x2019;iz Nets&#x2019;eelh&#x2019;iyh &#x2013; &#x201c;Strengthening our Bodies&#x201d;. Semi-structured interviews, with optional Photovoice, were conducted with participants aged 12&#xa0;years and older who had at least one chronic condition and belonged to First Nations communities served by CSFS. Participants were recruited from a prior community-based physical activity survey study that captured brief information on current physical activity experiences in their community. Data were analyzed using reflexive thematic analysis, guided by Indigenous Wholistic Theory (a framework emphasizing the interconnected and cyclical physical, mental, emotional, and spiritual dimensions of health and wellness) to ensure cultural relevance. Coding progressed from semantic to latent themes, supported by NVivo and reflexive journaling. RESULTS: Interviews were conducted with 29 participants from three communities (69% female, mean age: 55&#xa0;years old), all managing various chronic conditions such as diabetes, arthritis, and cardiovascular disease. The identified themes were: 1) Integrating cultural values with physical activity to manage chronic disease, 2) Cultural disconnection: A barrier to health and physical activity, and 3) Community approaches to facilitate physical activity in chronic disease. Together, these themes highlight the role of culture, supportive community structures, and tailored approaches in physical activity engagement. CONCLUSION: To strengthen physical activity programming, service providers should ensure initiatives are aligned with community values, address identified barriers, and encourage locally recognized facilitators. These insights will empower health care organizations and communities to develop targeted, inclusive strategies for physical activity programming tailored to individuals with chronic conditions.

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Urinary stone disease (USD, or urolithiasis) is common and poses a substantial healthcare and economic burden on the working-age population. This study aimed to provide epidemiological insights into the prevalence, incidence, trends, and risk factors of USD among the Chinese population. We conducted a prospective cohort study involving 966,481 participants from the CHinese Electronic health Records Research during 2009-2022 in Yinzhou, China (CHERRY). Temporal trends were estimated using annual percentage changes (APC) via Joinpoint regression analyses. Stratified Cox proportional hazards regression and propensity score analyses were employed to evaluate potential risk factors, population attribution factor (PAF) and number needed to prevent (NNTP). From 2014/2015 to 2021, there was an annualized increase in USD incidence by 5.3-6.8% (P&#x2009;<&#x2009;0.05). Identified risk factors for USD included tobacco smoking, alcohol drinking, high body mass index, diabetes, hyperlipidemia, hypertension, and cardiovasculardisease while regular exercising served as a protective factor of USD. The PAF ranged from 1.3% for non-drinking behavior to 22.5% for regular exercising (weekly). Correspondingly, the NNTP ranged from 182 for non-smoking behavior to 21 for weekly exercising. USD is a common disease affecting approximately 1 in 10 Chinese, with the incidence rate increasing by 5-6% annually over the past 6-7 years. Lifestyle factors and metabolic syndromes are potential risk factors for the development of USD.

To provide pediatric clinicians with a list of mobile applications to recommend to patients to promote independence, healthy habits, and self-management skills in children or individuals who may benefit from extra support. Technology has become deeply embedded in healthcare delivery. With 95% of 13-17-year-old teenagers having access to smartphones, mobile applications represent a natural extension of care that can be integrated into treatment plans. Structured routines and healthy habits are positively associated with life satisfaction and negatively associated with anxiety and depression, emphasizing the value of interventions that support self-management. Mobile applications span diverse functions to support adolescent development: health-tracking apps enable chronic disease management and mental health monitoring; habit-tracking tools reinforce positive routines; study platforms provide personalized learning; and focus apps strengthen attention and time management. Mobile applications are low-cost, accessible tools that represent valuable adjuncts to traditional pediatric care. Apps spanning health tracking, habit formation, academic support, and focus enhancement provide frameworks for youth to develop autonomy. When integrated into care plans, these apps can reinforce positive behaviors, support chronic disease management, and promote lifelong healthy habits. Clinicians and caregivers should collaboratively explore which applications best meet each child's needs.