Search Results (221)

This paper proposes a structured design framework and system architecture for a non-intrusive spatial system aimed at supporting child behavior in everyday domestic environments. Rooted in ethical considerations, our approach defines four core behavior-guided design strategies: routine recovery, emotion-responsive adjustment, behavioral transition induction, and external linkage. Each strategy is meticulously translated into a detailed system logic that outlines input conditions, trigger thresholds, and feedback outputs, designed for implementability with ambient sensing technologies. Through a comparative conceptual analysis of three sensing configurations—low-resolution LiDARs, mmWave radars, and environmental sensors—we evaluate their suitability based on technical feasibility, spatial integration, operationalized privacy metrics, and ethical alignment. Supported by preliminary technical observations from lab-based sensor tests, low-resolution LiDAR emerges as the most balanced option for its ability to offer sufficient behavioral insight while enabling edge-based local processing, robustly protecting privacy, and maintaining compatibility with compact residential settings. Based on this, we present a working three-layered system architecture emphasizing edge processing and minimal-intrusion feedback mechanisms. While this paper primarily focuses on the framework and design aspects, we also outline a concrete pilot implementation plan tailored for small-scale home environments, detailing future empirical validation steps for system effectiveness and user acceptance. This structured design logic and pilot framework lays a crucial foundation for future applications in diverse residential and care contexts, facilitating longitudinal observation of behavioral patterns and iterative refinement through lived feedback. Ultimately, this work contributes to the broader discourse on how technology can ethically and developmentally support children’s autonomy and well-being, moving beyond surveillance to enable subtle, ambient, and socially responsible spatial interactions attuned to children’s everyday lives. Full article

Background/Objectives: Parents of individuals with substance use disorders (SUDs) often carry significant emotional and relational burdens, yet their voices remain underrepresented in addiction research. This study explores how Greek parents navigate the long-term challenges of caring for adult children with SUDs, with a focus on emotional strain, caregiving identity, and culturally embedded coping strategies within a collectivist context. Methods: Eight Greek parents (six mothers and two fathers, aged 47–60) participated in in-depth, semi-structured interviews. Conversations were conducted either in person or via video call, depending on participant preference and geographical constraints. Data were analyzed using Interpretative Phenomenological Analysis (IPA) to explore lived experience and the meaning-making processes shaping parental coping over time. Results: Four overarching themes were identified as follows: (1) Living in Vigilance, reflecting constant hyper-alertness, emotional exhaustion, and social withdrawal rooted in trauma; (2) Shifting Parental Identity, capturing the evolution of parents into caregivers, advocates, and informal caseworkers amid systemic neglect; (3) Struggling Within Systems, highlighting exclusion, blame, and fragmentation in institutional care—with moments of empathy holding outsized emotional weight; and (4) Coping as Cultural Duty, showing how caregiving was sustained through values of sacrifice, loyalty, and protective silence, even at great personal cost. Conclusions: Greek parents supporting adult children with SUDs face a complex interplay of trauma, cultural obligation, and institutional strain. Their coping is shaped by deeply held familial values rather than access to effective support. The findings call for culturally attuned, family-inclusive interventions and further research into long-term caregiving across diverse contexts. Full article

Background: Moral harassment (mobbing) in healthcare, particularly among nurses, remains a persistent issue with detrimental effects on mental health, resilience, and quality of life. Aim: We examine the relationship between the resilience of nurses working in Emergency Departments (EDs) and how these factors influence experiences of workplace mobbing. Methods: This cross-sectional study included 90 nurses from four public hospitals in Greece’s 5th Health District. Data were collected between October 2023 and March 2024 using the WHOQOL-BREF, Workplace Psychologically Violent Behaviors (WPVB) scale and the Connor–Davidson Resilience Scale (CD-RISC). The sample consisted primarily of full-time nurses (84.3% female; mean age = 43.1 years), with 21.1% reporting chronic conditions. Most participants were married (80.0%) and had children (74.4%), typically two (56.1%). Statistical analyses—conducted using SPSS version 27.0—included descriptive statistics, Pearson and Spearman correlations, multiple linear regression, and mediation analysis, with significance set at p < 0.05. Results: Resilience was moderate (mean = 66.38%; Cronbach’s α = 0.93) and positively correlated with all WHOQOL-BREF domains—physical, psychological, social, and environmental (r = 0.30–0.40)—but not with the overall WHOQOL-BREF. The mean overall WHOQOL-BREF score was 68.4%, with the lowest scores observed in the environmental domain (mean = 53.76%). Workplace mobbing levels were low to moderate (mean WPVB score = 17.87), with subscale reliabilities ranging from α = 0.78 to 0.95. Mobbing was negatively associated with social relationships and the environmental WHOQOL-BREF (ρ = –0.23 to –0.33). Regression analysis showed that cohabitation and higher resilience significantly predicted better WHOQOL-BREF outcomes, whereas mobbing was not a significant predictor. Mediation analysis (bootstrap N = 5000) indicated no significant indirect effect of resilience in the relationship between mobbing and WHOQOL-BREF. Conclusions: Resilience was identified as a key protective factor for nurses’ quality of life in emergency care settings. Although workplace mobbing was present at low-to-moderate levels, it was negatively associated with specific WHOQOL-BREF domains. Enhancing mental resilience among nurses may serve as a valuable strategy to mitigate the psychological effects of moral harassment in healthcare environments. Full article

There has been a widely held view for some time that school teachers and principals need to possess a level of knowledge and understanding of the legal regulation of schools and that of their workers. This study explores the level of understanding of legal matters pertaining to the school environment that independent school teachers hold in Queensland. This level of ‘legal literacy’ is investigated in a qualitative research study that explains the various areas of education law that are known and those that are less understood by such educators. Data was analysed using content analysis methodology, using a coding scale that was created specifically for the purposes of coding the participants’ scenario responses. Overall, it was discovered that the level of legal literacy held by Queensland independent school teachers was alarmingly low. This varied across the myriad topics, but essentially, the educators surveyed did not demonstrate an adequate legal understanding to successfully complete their roles. More education in this area should be made available for educators to better equip them with such an understanding to ensure they know when and how to more capably protect themselves and the children entrusted to their care. Full article

Bring them home, keep them home is research based in New South Wales (NSW) Australia, that aims to understand successful and sustainable reunification for Aboriginal families who have children in out-of-home care (OOHC). This research is led by Aboriginal researchers, and partners with Aboriginal organisations. It is informed by the experiences of 20 Aboriginal parents and family members, and more than 200 practitioners and professionals working in child protection and reunification. This paper traces the evolution of Bring them home, keep them home which is now at the forefront of influence for NSW child protection reforms. Using specific examples, it highlights the role of research advocacy and resistance in challenging and disrupting systems in ways that amplify the voices of Aboriginal families and communities and embeds these voices as the foundation for radical innovation for child reunification approaches. The paper shares lessons being learned and insights for Aboriginal-led research with communities in the pursuit of restorative justice, system change, and self-determination. Providing a framework for liberating Aboriginal families from child abduction systems, this paper seeks to offer a truth-telling and practical contribution to the international efforts of Indigenous resistance to child abduction systems. Full article

Introduction: It is widely acknowledged that good quality relationships between social workers and children are essential to children’s non-formal inclusion in child protection processes. However, research exploring the perspective of children has shown this relationship to be highly complex, particularly when children are taken into care. Methods: This paper combines insights from two qualitative participatory studies conducted in Italy, both developed out of a collaboration between university, professional social work associations, and the Italian association of care leavers. The two projects explored, respectively, the perspectives of social workers on the one hand and of children in care and care leavers on the other regarding their relationship. Outcomes: The data reveal the complexity of the relationship between children and social workers, showing how both share a mirrored perception of it. Social workers recognise children’s negative feelings toward them and see them as inevitable, especially in cases of tense family dynamics. A relationship marked by hostile attitudes, anger, and distrust not only fuels social workers’ emotional struggles but also makes it harder to engage children effectively. While hostile attitudes and mistrust are often seen as obstacles to positive engagement, we advocate for recognising them not as barriers to be overcome but as realities to be acknowledged and addressed openly. This approach can create space for both children and practitioners to explore alternative forms of agency, fostering more meaningful participation. Full article

Background and Objectives: Estimating the need for palliative care for children is a crucial step in addressing the needs of children facing life-threatening conditions, while providing a powerful argument to combat unacceptably wide disparities in access to care. The need for palliative care for children in Romania remains insufficiently quantified. More accurate estimates are indispensable to assess the true extent of need and to support adequate policy responses. Materials and Methods: This retrospective cross-sectional study aimed to estimate the need for pediatric palliative care in Romania for 2022–2023. We analyzed secondary data obtained from the General Directorates of Social Assistance and Child Protection (DGASPC) in 41 counties and the six sectors of Bucharest. The analysis focused on life-limiting conditions as defined by the WHO Annex 3, Order no. 253/2018. Results: The study identified 14,499 pediatric cases with palliative care needs, showing a highly uneven national distribution, especially across diagnostic groups and age categories. We observed a higher number of cases in rural areas (7553) compared with urban areas (6946). Our own data do not include resource estimates; however, prior reports indicate only 50 palliative care beds for children in Romania. Conclusions: This study reveals a substantial and unevenly distributed need for pediatric palliative care in Romania, with notable disparities across age groups, diagnostic categories, and urban-rural areas. The identification of 14,499 eligible cases underscores the urgency of developing targeted policies and allocating adequate resources to ensure equitable access to specialized palliative services for all children in need. Full article

Background: Adolescents with a chronological age of less than 15 years or a gynecological age of less than 2 years may have a higher probability of complications because they are more likely to conceive within 1 to 2 years of menarche and, therefore, are still growing and maturing. This could impair their ability to adapt to the physiological demands of pregnancy. Objective: To evaluate the relationship between chronological age and gynecological age with low birth weight and small for gestational age among adolescent mothers in Mexico City. Methods: A retrospective cohort design of adolescent mother–child dyads was conducted. The study followed 1242 adolescents under 19 years of age and their children, collecting data on physical, socioeconomic, and clinical characteristics, including hemoglobin levels. Low birth weight was assessed using the Intergrowth-21st project standards and categorized as above or below 2500 g. The mothers were grouped by chronological age (<15 years and ≥15 years) and gynecological age (<3 years and ≥3 years). Adjusted odds ratios were calculated using binary logistic regression models. The outcome variables were low birth weight and small for gestational age. The independent variables included gynecological age, chronological age, age at menarche, hemoglobin concentration, and gestational weight gain, among others. All independent variables were converted to dummy variables for analysis. Calculations were adjusted for the following variables: marital status, maternal education, occupation, educational lag, family structure, socioeconomic level, pre-pregnancy body mass index, and initiation of prenatal care. Results: The average age of the participants was 15.7 ± 1 years. The frequency of small for gestational age and low birth weight was 20% and 15.3%, respectively. Factors associated with small for gestational age included gynecological age < 3 years [aOR = 2.462, CI 95%; 1.081–5.605 (p = 0.032)], hemoglobin < 11.5 g/dL [aOR = 2.164, CI 95%; 1.08–605 (p = 0.019)], insufficient gestational weight gain [aOR = 1.858, CI 95%; 1.059–3.260 (p = 0.031)], preterm birth [aOR = 1.689, CI 95%; 1.133–2.519 p = 0.01], and living more than 50 km from the care center [aOR = 2.256, CI 95%; 1.263–4.031 (p = 0.006)]. An early age of menarche [aOR = 0.367, CI 95%; 0.182–0.744 (p = 0.005)] showed a protective effect against small for gestational age. Factors associated with low birth weight included gynecological age < 3 years [aOR = 3.799, CI 95%; 1.458–9.725 (p = 0.006)], maternal age < 15 years [aOR = 5.740, CI 95%; 1.343–26.369 (p = 0.019)], preterm birth [aOR = 54.401, CI 95%; 33.887–87.335, p = 0.001], living more than 50 km from the care center [aOR = 1.930, CI 95%; 1.053–3.536 (p = 0.033)], and early age of menarche [aOR = 0.382, CI 95%; 0.173–0.841 (p = 0.017), which demonstrated a protective effect, respectively. Conclusions: The study concludes that biological immaturity, particularly early gynecological age, significantly contributes to adverse birth outcomes during adolescent pregnancies. Interestingly, early menarche appeared to have a protective effect, whereas chronological age was not a significant predictor of small for gestational age. Chronological age has an even greater impact: women younger than 15 years are 5.7 times more likely to have low birth weight infants. However, chronological age did not increase the likelihood of having an SGA newborn. Full article

Background: Postoperative sepsis (POS) is a serious pediatric safety event tracked by the Agency for Healthcare Research and Quality’s Pediatric Quality Indicator 10 (PDI 10). Purpose: This study examined POS in United States inpatient care. Methods: Using the 2019 Kids’ Inpatient Database (KID), a nationally representative sample of U.S. pediatric discharges, we performed multivariable logistic regression to examine patient- and hospital-level predictors of POS. Results: Among approximately 5.24 million weighted discharges, 577,625 (12.65%) were flagged with POS. Key independent risk factors included undergoing major surgery, being treated in large urban teaching hospitals, and admission for surgical or injury-related care. Hospital characteristics such as Western region location, for-profit ownership, and large bed size were associated with increased POS odds, while rural and small hospitals showed protective effects. Race/ethnicity showed mixed findings; Native American and “Other” race patients had elevated POS risk, while Hispanic children had slightly reduced odds compared to White peers. Conclusions: Contrary to prior assumptions, neither age nor sex was a significant independent predictor. This study expands upon prior pediatric adverse event research by delineating the distinct risk profile of POS. The findings underscore the need for targeted infection control strategies in high-risk environments and support ongoing quality improvement efforts to reduce the surgical sepsis burden in children. Full article

Aboriginal communities in Australia have long advocated for self-determination in child protection. This includes appeals for greater structural authority in systems of care and protection, with Aboriginal children in the care of Aboriginal agencies. Advocacy from agencies, including the Victorian Aboriginal Child and Community Agency (VACCA), has resulted in legislative and funding reforms in Victoria that place Victorian Aboriginal community-controlled organisations (ACCOs) at the forefront of responses supporting Aboriginal children and families. This article provides an overview of that advocacy, the context in which the reform arose. Then, it details how VACCA has implemented the reforms by developing a model for Aboriginal child protection centred on culture, self-determination and human rights. Importantly, it discusses the process and negotiation of transferring authority exercised by the government to ACCOs and offers insights for the system and practice transformation. This article outlines how ACCOs like VACCA are shifting the language, culture and practice of child protection. Full article

Background: The provision of education, health, and social care for children with special educational needs and disabilities (SEND) in England has long been criticised for its inequities and chronic underfunding. These systemic issues were further exacerbated by the onset of the COVID-19 pandemic and the accompanying restrictions, which disrupted essential services and resulted in widespread unmet needs and infringements on the rights of many children with SEND. This study aimed to use a three-phase consensus-building approach with 1353 participants across five stakeholder groups to collaboratively develop evidence-informed priorities for policy and practice. The priorities sought to help address the longstanding disparities and respond to the intensified challenges brought about by the pandemic. Methods: A total of 55 children with SEND (aged 5–16), 893 parents/carers, and 307 professionals working in SEND-related services participated in the first phase through online surveys. This was followed by semi-structured interviews with four children and young people, ten parents/carers, and 15 professionals, allowing for deeper exploration of lived experiences and priorities. The data were analysed, synthesised, and structured into five overarching areas of priority. These were subsequently discussed and refined in a series of activity-based group workshops involving 20 children with SEND, 11 parents/carers, and 38 professionals. Results and Conclusions: The consensus-building process led to the identification of key priorities for both pandemic response and longer-term recovery, highlighting the responsibilities of central Government and statutory services to consider and meet the needs of children with SEND. These priorities are framed within a children’s rights context and considered against the rights and duties set out in the United Nations Convention on the Rights of the Child (1989). Priorities include protecting and promoting children with SEND’s rights to (1) play, socialise, and be part of a community, (2) receive support for their social and emotional wellbeing and mental health, (3) feel safe, belong, and learn in school, (4) “access health and social care services and therapies”, and (5) receive support for their parents/carers and families. Together, they highlight the urgent need for structural reform to ensure that children with SEND receive the support they are entitled to—not only in times of crisis but as a matter of routine practice and policy. Full article

Background/Objectives: Early care and education programs promote children’s social–emotional development, predicting later school success. The COVID-19 pandemic worsened an existing youth mental health crisis and increased teacher stress. Therefore, we applied an infant and early childhood mental health consultation model, Jump Start Plus COVID Support (JS+CS), aiming to decrease behavioral problems in children post-pandemic. Methods: A cluster randomized controlled trial compared JS+CS to an active control, Healthy Caregivers–Healthy Children (HC2), at 30 ECE centers in low-income areas in South Florida. Participants were not blinded to group assignment. Teachers reported on children’s social–emotional development at baseline and post-intervention using the Devereux Early Childhood Assessment and Strengths and Difficulties Questionnaire. We assessed whether teacher stress, classroom practices, and self-efficacy mediated the relationship between JS+CS and child outcomes. We also explored whether baseline behavior problems moderated JS+CS effects on child protective factors, relative to HC2. Results: Direct group-by-time differences between JS+CS and HC2 were limited. However, JS+CS demonstrated significant within-group improvements in teacher-reported child protective factors, behavior support practices, and classroom safety practices. Classroom safety practices consistently mediated positive changes in child behaviors, including the DECA total protective factor score and subdomains of initiative and self-regulation. Additionally, teacher perceptions of behavior support mediated gains in child attachment. Conclusions: JS+CS shows promise in building protective systems around children through intentional support for teachers, underscoring the value of whole-child, whole-environment approaches in early intervention. Full article

Background/Objectives: Preschool children from low-income, ethnically diverse communities face disproportionate rates of behavioral challenges and early expulsion from early care and education (ECE) programs. This study evaluated the efficacy, feasibility, and utility of Jump Start on the Go (JS Go), a bilingual, AI-enabled mobile application. JS Go is designed to deliver a 14-week early childhood mental health consultation model in under-resourced ECE settings. Methods: This mixed-methods study compared JS Go to the standard in-person Jump Start (JS) program. Participants included 28 teachers and 114 children from six centers (three JS Go, three JS). Quantitative measures assessed teacher classroom practices and child psychosocial outcomes at baseline and post-intervention. App usability and acceptability were only evaluated post-intervention. Seven semi-structured interviews were conducted post-intervention with JS Go directors/teachers to assess the app’s feasibility for implementing the four program pillars: safety, behavior support, self-care, and communication. Results: JS Go was more effective than JS in promoting teacher classroom practices related to behavior support and resiliency. Both programs were similar in improving children’s protective factors and reducing internalizing behaviors, with consistent effects across English and Spanish-speaking children. Teachers rated the JS Go app with high acceptability, though predicted future usage showed greater variability. Rapid qualitative analysis showed that participants found the app easy to use, frequently accessed its resources, and considered it helpful for reinforcing key strategies across the four program pillars. Conclusions: JS Go is a novel approach to providing mental health consultation. It represents a promising mobile adaptation of the established JS consultation model, with important implications for future practice and research. Full article

Background/Objectives: Increased burdens on caregivers of infants and toddlers significantly affect caregivers’ quality of life and health. Although adequate care during infancy contributes to child development and special health care needs affect caregiver burden, the risk factors for and protective factors against increased caregiver burden remain unclear. We aimed to evaluate children’s health care needs and required caregiving time and identify factors associated with increased caregiver burden. Methods: We conducted an online survey of 287 Japanese caregivers who were randomly selected from a web panel and were raising children aged <4 years. The survey comprised a sociodemographic data form, Children with Special Health Care Needs (CSHCN) Screener, caregiving time survey form, and questions on increased burden. Needs and caregiving time were evaluated by dividing the participants into CSHCN and non-CSHCN groups. Related factors were analyzed using increased burden as the dependent variable. The chi-square test, Mann–Whitney U test, and modified Poisson regression were used for data analysis. Results: Among the children of the 287 participating caregivers, 16.4% were identified as CSHCN, while 96.9% had no specific diagnosis. Overall, 38.3% of the CSHCN group met only one of the five CSHCN Screener items. The CSHCN group spent significantly more time providing and arranging/coordinating health care. The non-CSHCN group spent significantly more time providing daily care. After adjusting for covariates, increased caregiver burden was significantly associated with a younger age of the child, more caregiving time required 6 months prior to the survey, and providing care for CSHCN. Conclusions: To help reduce the burden of childcare on caregivers of infants and young children, children’s needs should be identified and generous childcare provided from an early age. Early identification of CSHCN and appropriate support for families may help reduce caregiver burden during early childhood. Full article

Background: Mothers of children with Type 1 Diabetes Mellitus (T1DM) frequently face high levels of psychological stress. While the impact of this stress on caregiving is well documented, the potential role of spirituality as a protective factor has received limited attention. Objective: This cross-sectional study aimed to assess the relationships among psychological symptoms, spirituality, and coping in mothers caring for children with T1DM, with a particular focus on the potential protective role of spirituality in caregiver resilience. Methods: A total of 134 mothers completed validated Greek versions of the Symptom Checklist-90 (SCL-90) and the Spiritual and Religious Attitudes in Dealing with Illness (SpREUK) questionnaire. Descriptive statistics, Pearson correlations, and multiple linear regression analyses were used to explore associations and predictive relationships. Results: Participants reported elevated psychological symptoms, particularly somatization, anxiety, and depression. Regression analysis revealed that trust in higher guidance was a significant negative predictor of somatization (b = −0.775, p < 0.001), indicating a potential buffering effect. In contrast, the search for support was positively associated with somatization (b = 0.704, p < 0.001), suggesting a more reactive coping pattern. Other spiritual variables, including the total spirituality score and reflection, were not statistically significant in the multivariate model. Conclusions: These findings highlight the relevance of spirituality—particularly spiritual trust—in understanding psychological distress among caregiving mothers. Incorporating existential and spiritual elements into psychosocial interventions may enhance maternal well-being. Longitudinal studies are needed to clarify spirituality’s role as a protective or mediating factor in chronic caregiving contexts. Full article