Search Results (32)

Background: Child Sexual Exploitation and Abuse is a longstanding global issue, increasingly amplified by digital technologies, mobile devices, and internet access. This shift has intensified Child Online Sexual Exploitation and Abuse (COSEA). WeProtect 2020, a Global Alliance Intelligence brief report, indicated a 200% rise in online abuse forums. Existing studies focus on child protection, grooming, and survey-based analyses and draw inferences regarding grooming tactics and thematic analysis. Social issues such as underreporting, limited threat intelligence sharing, and low cyber awareness persist, leading to vulnerabilities and various exploitations. Further, a lack of social engagement and support persists, posing serious challenges for victims and law enforcement. Multiple studies have used the term Online Child Sexual Exploitation and Abuse (OCSEA) that focus on a technology-centric approach. However, the paper considers Child Online Sexual Exploitation and Abuse (COSEA) child-centric approach as we explore challenges of a child accessing the internet and engaging in online activities. Methods: This study analyses COSEA using the MITRE tactics, techniques, and procedures (TTP) framework to examine perpetrator behavior, motives, and potential attribution, considering the evolving threat landscape. Results: TTP-based analysis enables the identification of adversary intent, methods, and opportunities. The study contributions are threefold: (1) we explore COSEA and its manifestations; (2) we apply the MITRE TTP framework with subjective expert judgment to analyze perpetrator behavior and the victim; for instance, what leads victims to become complicit in wrong acts; and (3) propose mitigation strategies and stakeholder roles. Conclusion: By integrating technical, social, and behavioral perspectives, it highlights the roles of economic, societal, and deterrence factors and recommends policy, education, and collaborative threat-intelligence sharing to enhance child online safety. Full article

Background/Objectives: Children in paediatric palliative care often face school attendance barriers due to complex health needs. This study describes post-training perceptions of a training program by a pediatric hospice team to prepare school care assistants to safely include children with complex conditions, focusing on procedural skills, knowledge of the child, and family partnership. Methods: Care assistants who completed a structured course at the Paediatric Palliative Care Centre, University Hospital of Padua (2023–2024), were surveyed immediately after training. The program combined classroom instruction with hands-on simulation using high-fidelity mannequins and standard devices, including suction, pulse oximetry, ventilation, enteral feeding, and tracheostomy care. It also covered modules on urgent and emergency management, as well as family communication. An anonymous online questionnaire gathered socio-demographic data, prior training, clinical tasks performed, self-efficacy levels, and open-ended feedback. Quantitative results were analyzed descriptively, while qualitative comments were subjected to thematic analysis. Results: Of 130 invited assistants, 105 participated (81%). Participants reported strong perceived confidence: 85% selected the upper end of the 5-point scale (“very” or “extremely”) for routine-management ability, and 60% selected these same response options for emergency-management ability. In the most severe events recalled, 60.5% of incidents were resolved autonomously, 7.6% involved contacting emergency services, and 3.8% involved community or hospice nurses. Seventy-five percent judged the course comprehensive; thematic analysis of 102 comments identified satisfaction, requests for regular refreshers, stronger practical components, and requests for targeted topics. Conclusions: Immediately after the session, participants tended to select the upper end of the self-assurance item for both routine and emergency tasks. Combining core emergency procedures with personalized, child-specific modules and family-partnership training may support safety, trust, and inclusion. Regular refreshers and skills checks are advised. Full article

Background/Objectives: Metabolic syndrome (MetS) and even closely related metabolic and anthropometric alterations require timely intervention to reduce associated risks. Neo-Policaptil^® Gel Retard has shown potential in managing both established MetS and early imbalances. To further characterize its real-world impact, a large post-marketing survey was conducted to assess perceived effectiveness, safety, quality of life (QoL), and patterns of use. Methods: Between December 2021 and May 2025, patients/child caregivers, pharmacists, and physicians completed online questionnaires via a dedicated web platform. Patients reported their direct experience, while healthcare professionals (HCPs) provided observations on patient use. Results: The survey included 2204 patients, 57 child caregivers, 455 physicians, and 387 pharmacists. Overall, 97.7% of patients reported an improvement in their condition. Most physicians (94.3%) and pharmacists (89.1%) rated the overall effectiveness of the product as “good” or “excellent”. The safety profile was judged “good” or “excellent” by 84.4% of patients and by over 93% of HCPs. The product was mainly used as monotherapy or in combination with dietary measures and/or physical exercise. Conclusions: These findings underscore the product’s effectiveness, safety, tolerability, and positive influence on QoL in both adults and children affected by MetS or by related metabolic and anthropometric imbalances. Full article

Foster carers are a hard-to-reach population who carry a vast bureaucratic and emotional load. They need tailored and specialised training, support, and advice regarding the digital lives of the children and young people (CYP) they care for. Looked-after CYP are vulnerable in multiple ways and are particularly at risk in the digital age. Their susceptibility to online risks raises complex challenges. The training programme Fostering in a Digital Age was designed to support foster carers’ understanding of and responses to the digital lives of looked-after CYP, including both positive and negative aspects. It is research-informed and provides relevant knowledge, resources, tools, and skills. This exploratory study sought the opinions of foster carers and social workers regarding the strengths and limitations of the programme and recommendations for improving it. Semi-structured interviews were conducted with ten foster carers who had completed the programme and ten social workers who accessed the programme for evaluation purposes. Participants’ experiences and reflections were analysed using thematic analysis. Resulting themes highlighted the relevance of the training programme, with participants recognising the importance of digital lives for looked-after CYP and the need for tailored guidance. The programme was viewed as flexible, accessible, and user-friendly, with comprehensive coverage of key concepts and reflective activities that enhanced carers’ understanding and confidence. Its child-centred and sustainable design enabled carers to apply learning “as and when” needed and to collaborate with CYP to promote safer digital engagement. However, some participants found the volume of resources overwhelming and reported navigation challenges or digital anxiety. Social workers emphasised professional and structural improvements, while carers focused on the programme’s relational benefits and practical relevance. Both groups recommended wider promotion through local authorities and fostering agencies and adaptations to make the programme suitable for social workers and carers with differing digital skills. Overall, fostering in a digital age effectively provided foster carers with tailored knowledge to support CYP online, prevent harm, and respond to adverse digital experiences, aligning with Self-Determination Theory by supporting carers’ autonomy, competence, and relatedness. This evaluation also revealed gaps in online safety knowledge among both foster carers and social workers, highlighting opportunities for the development of future training programmes. Full article

Background/Objectives: Parents’ vaccine hesitancy constitutes a global challenge, strongly associated with trust in healthcare professionals. This study aimed to identify socio-demographic predictors of parental pro- and anti-vaccination behaviors and investigate the association between these factors and intentions regarding children’s future immunizations. Methods: We conducted a cross-sectional online survey using the Parent Attitudes about Childhood Vaccines (PACV) questionnaire. Participants were recruited purposively and via snowballing through parenting groups and educational institutions. Results: We surveyed 1.046 parents and provided attitudes for 1.701 children; 85.1% of child-specific responses reflected positive attitudes (PACV ≤ 50; median 16.7). In univariate regression, employment (OR = 2.172, 95% CI: 1.530–3.084; p < 0.001) and healthcare employment (OR = 2.907, 95% CI: 1.983–4.262; p < 0.001) increased the odds of positive attitudes, whereas each additional household member (OR = 0.693, 95% CI: 0.597–0.805; p < 0.001) and child (OR = 0.677, 95% CI: 0.579–0.792; p < 0.001) reduced them. Multivariable models confirmed higher odds for suburban/rural residence (OR = 1.614, 95% CI: 1.037–2.513; p = 0.034), employment (OR = 1.869, 95% CI: 1.284–2.721; p = 0.001), and healthcare employment (OR = 2.785, 95% CI: 1.872–4.144; p < 0.001). Among prior non-vaccinators (n = 114), 39.5% planned to vaccinate, 41.2% did not. Those who planned showed greater trust than non-planners in the child’s doctor (mean: 7.49 vs. 3.74) and schedule (mean: 7.89 vs. 1.40), p < 0.001, with lower trust correlating with greater hesitancy and safety concerns. Conclusions: Trust in physicians was strongly associated with both current attitudes and future intentions. Trust-focused, patient-centered communication may be related to more positive vaccination attitudes among parents. However, longitudinal research is needed to determine whether such trust could influence changes in vaccination behavior, especially since parents’ attitudes toward vaccinations can evolve with the arrival of subsequent children. Full article

Hashes are vital in limiting the spread of child sexual abuse material online, yet their use introduces unresolved technical, legal, and ethical challenges. This paper bridges a critical gap by analyzing both cryptographic and perceptual hashing, not only in terms of detection capabilities, but also their vulnerabilities and implications for privacy governance. Unlike prior work, it reframes CSAM detection as a multidimensional issue, at the intersection of cybersecurity, data protection law, and digital ethics. Three key contributions are made: first, a comparative evaluation of hashing techniques, revealing weaknesses, such as susceptibility to media edits, collision attacks, hash inversion, and data leakage; second, a call for standardized benchmarks and interoperable evaluation protocols to assess system robustness; and third, a legal argument that perceptual hashes qualify as personal data under EU law, with implications for transparency and accountability. Ethically, the paper underscores the tension faced by service providers in balancing user privacy with the duty to detect CSAM. It advocates for detection systems that are not only technically sound, but also legally defensible and ethically governed. By integrating technical analysis with legal insight, this paper offers a comprehensive framework for evaluating CSAM detection, within the broader context of digital safety and privacy. Full article

Background: Parents make vital decisions regarding their children’s health and safety. Poor parental self-efficacy is associated with unfavorable health outcomes among their children. This study aims to investigate parental self-efficacy in managing pediatric medications and treatments in Jordan. Methods: This is an online cross-sectional survey study that was conducted in Jordan between 20 April and 4 July 2025. Self-efficacy in managing medications and treatments for children was assessed utilizing a previously validated questionnaire, including healthcare information or decision-making, symptom identification or management, general treatment management, general healthcare navigation, and feeding management. Logistic regression analysis was performed to identify predictors of a higher level of self-efficacy. Results: A total of 597 parents were included in this study. The majority of parents reported high levels of confidence (self-efficacy) in managing various aspects of their child’s care. The highest proportion of parents indicated they were very confident in knowing when their child needs to visit a healthcare provider (35.2%) and in following their child’s diet or nutrition plan (36.9%). Very confident was the most selected response for knowing how to contact healthcare providers (38.4%) and scheduling an appointment (37.0%). Higher income was strongly linked to greater self-efficacy, with parents earning 1001–1500 Jordanian dinars (JOD) showing significantly higher odds (odds ratio (OR) = 4.44, 95% confidence interval (CI): 2.42–8.15, p < 0.001) compared to those earning less than 500 JOD. Parents working in medical fields also had higher odds (OR = 3.30, 95% CI: 1.69–6.45, p < 0.001) compared to those not working. Parents with 2–3 children (OR = 1.73, 95% CI: 1.00–3.00, p = 0.049) or 4–5 children (OR = 1.59, 95% CI: 1.05–3.63, p = 0.03) had greater odds of self-efficacy compared to those with one child. Conclusions: The majority of the parents in this study expressed strong self-efficacy in managing their child’s care, specifically in healthcare-related tasks. Higher self-efficacy was significantly associated with parents’ socioeconomic characteristics such as marital status, medical employment, income, insurance coverage, and number of children. At the same time, lower confidence levels and self-efficacy were observed among divorced parents. More support should be directed towards low-income families and parents who work outside the medical field to enhance their self-efficacy and ultimately the health outcomes of their children. Full article

Background: Understanding the determinants of children’s outdoor play is an important element for child development and broader public health outcomes. There is growing evidence that children’s opportunities for play, particularly outdoor risky play, are diminishing. Parents are concerned with keeping their child safe while affording them independence to play. This study explored parents’ attitudes to risky play and practices around children’s independent mobility in Ireland with the aim of informing public health strategies promoting healthy childhood environments. Methods: An online survey comprising validated scales and standardised questions was completed by a nationally represented sample of 376 parents of children up to 16 years. Data was analysed via descriptive statistics, chi-square tests, and regression analysis. Results: A total of 376 participants accessed the survey, of which 349 completed it. A total of 84% of participants were female. A total of 74% agreed that children need regular exposure to actual risk to develop risk management skills, and 71% trusted their children to play safely. Chi-square tests reveal significant associations between outdoor play in the rain and school travel (p < 0.01), and appropriate age to begin activities at home and in educational settings (p < 0.05). A moderate association was found between the method of school travel and children’s permission to play in the rain (Cramer’s V = 0.51). Respondents considered supervision to be a necessity to ensure their children’s safety. Overall, the results indicate that parents were risk-averse in three of the six categories of risky play, namely, play near dangerous elements, play with adult tools, and out-of-sight play. Conclusions: This study presents a descriptive analysis of findings from the Ireland State of Play Survey. Findings indicate that although parents recognise the benefits of risky play, there is some contradiction between parental attitudes and actual practices, with a lack of willingness or confidence in permitting their children to participate in all such activities. Full article

“Sharenting” appears to have become a common practice among families, who tend to normalise the posting of children’s content on social media, which can raise concerns about the privacy, safety, and mental health of exposed children. This study examines the perceptions and practices of sharenting among families in Asunción (Paraguay). A survey of 73 parents analysed posting habits, knowledge of risks, and possible influencing factors on parental digital behaviour. Data analysis techniques such as descriptive statistics and correlation analysis were used to examine the associations between the key variables. The results reveal that 72.60% of respondents publish content about their children on social networks, while 95.89% recognise that they are concerned about the risks associated with this practice. In addition, 58.90% of the participants indicated that they were unaware of the term sharenting. The analysis suggests that there is no significant association between knowing one’s social media contacts and the decision to post information about one’s children, indicating that perceived privacy may not directly influence the practice of sharenting. This highlights the need to educate families and promote awareness of the risks of children’s exposure to digital platforms. Full article

Background/objectives: Influenza vaccines are recommended and free in Australia for children aged <5 years, but uptake remains low at 25.8% compared to the targets of 40% and 50%. National data on barriers hindering paediatric influenza vaccination can inform strategies to improve uptake. The aim of this study was to measure barriers to influenza vaccination in Australian children aged <5 years. Methods: A national, cross-sectional survey of parents of children aged <5 years was conducted in March/April 2024. Parents were recruited using an online panel and asked about their intention to get an influenza vaccine for their youngest child in the upcoming influenza season. An adapted version of the validated Vaccine Barriers Assessment Tool measured 14 influenza vaccination barriers. Analysis assessed the prevalence of barriers and differences between parents intending to and those unsure or not intending to vaccinate by calculating the prevalence difference and 95% confidence interval. Results: A total of 2000 parents were recruited nationally. The most common barrier was parents feeling distressed when thinking about vaccinating their child against influenza (66.1% of intending parents, 65.6% of unsure/not intending parents). The barrier with the largest difference between intending and not intending/unsure parents was not prioritising their child’s influenza vaccination (47.2% vs. 6.1%, PD = 41.1 ppts, 95% CI: 35.9%, 46.3%). Other barriers with large differences were parents not feeling guilty if their unvaccinated child got influenza (41.5% vs. 7.5%, PD = 34.0 ppts, 95% CI: 28.8%, 39.1%) and parents not believing that influenza vaccines are effective (31.3% vs. 3.0%, PD = 28.2 ppts, 95% CI: 23.6%, 32.9%). Conclusions: Parents should be encouraged and supported to prioritise influenza vaccination alongside routine childhood vaccines in campaigns that emphasise disease risk and the importance, safety and effectiveness of influenza vaccination, and by optimising access to influenza vaccination. We recommend conducting similar surveys regularly to monitor trends in parental barriers to childhood influenza vaccination. Full article

Stakeholders from parents to policy-makers are concerned about youth online safety. Present solutions are frequently punitive and often lack opportunities for youth to make mistakes and try again in a safe environment. This paper proposes a new framework, based on trauma-informed child psychology models and research by computer scientists and human-centered design scholars, entitled Pause, Reflect, and Redirect (PRR). The PRR framework offers three levels of intervention ranging from casual engagement to coached engagement with crisis response. To further develop and validate PRR as a framework, PRR was implemented within a web-filtering software that was installed in a public middle school comprising grades 6 to 8 (i.e., ages 11–14) in an urban charter district. Preliminary results from the deployment of the software suggest that it may help youth make better choices with respect to their online behaviors. Full article

This study focuses on Roblox as a case study to explore the legal and technical challenges of content moderation on child-focused social media platforms. As a leading Metaverse platform with millions of young users, Roblox provides immersive and interactive virtual experiences but also introduces significant risks, including exposure to inappropriate content, cyberbullying, and predatory behavior. The research examines the shortcomings of current automated and human moderation systems, highlighting the difficulties of managing real-time user interactions and the sheer volume of user-generated content. It investigates cases of moderation failures on Roblox, exposing gaps in existing safeguards and raising concerns about user safety. The study also explores the balance between leveraging artificial intelligence (AI) for efficient content moderation and incorporating human oversight to ensure nuanced decision-making. Comparative analysis of moderation practices on platforms like TikTok and YouTube provides additional insights to inform improvements in Roblox’s approach. From a legal standpoint, the study critically assesses regulatory frameworks such as the GDPR, the EU Digital Services Act, and the UK’s Online Safety Act, analyzing their relevance to virtual platforms like Roblox. It emphasizes the pressing need for comprehensive international cooperation to address jurisdictional challenges and establish robust legal standards for the Metaverse. The study concludes with recommendations for improved moderation strategies, including hybrid AI-human models, stricter content verification processes, and tools to empower users. It also calls for legal reforms to redefine virtual harm and enhance regulatory mechanisms. This research aims to advance safe and respectful interactions in digital environments, stressing the shared responsibility of platforms, policymakers, and users in tackling these emerging challenges. Full article

Background/Objectives: Influenza vaccination is the main method for preventing influenza. The objectives of this study are to evaluate the opinions of families on influenza vaccination and to determine the acceptance of influenza vaccination as a routine vaccine in children under 5 years of age. Methods: The method used was a descriptive cross-sectional study based on an ad-hoc survey. Between October 2023 and January 2024, an online survey was conducted among families with children between 6 months and 14 years of age attending paediatric consultations at a health centre. Results: A total of 388 families were surveyed. Out of these, 22.68% reported having ever vaccinated their children against influenza. The main reason for having them vaccinated was having received the recommendation from the paediatrician (68.18%). While 53.61% agreed with routine influenza vaccination, 53.09% did not intend to vaccinate their children against influenza in the 2023/24 period. The reasons for not vaccinating in 2023/24 were unawareness of the disease (29.41%), fear of unwanted effects of vaccination (27.94%) and lack of information about vaccination (19.61%). The reasons for vaccination in 2023/24 were protection of the child (81.87%), recommendation by the paediatrician (43.41%) and protection of the general population and susceptible persons (20.33%). Conclusions: Routine influenza vaccination is accepted by half of the parents. A lack of risk perception of the disease, concern about vaccine safety and lack of information are the main reasons for not vaccinating. It is essential to follow the health professionals’ recommendation to vaccinate. Full article

Diarrhea continues to be a global health problem as acute diarrhea carries the risk of dehydration, while both acute and chronic diarrhea can significantly affect patients’ quality of life and reduce productivity. The innovative medical device Actitan, which consists of a complex of natural molecules, could be an effective option for the treatment of diarrhea from various causes. The aim of this post-market cross-sectional study was to evaluate the perceived efficacy, safety and usage pattern of the two formulations for adults (Actitan-P) and children (Actitan-F) among patients/child caregivers, physicians and pharmacists. Participants completed online questionnaires with closed multiple-choice questions that were rated on a verbal 5-point Likert scale. These surveys were conducted via the online platform Real World Data, which provides digital questionnaires for patients, doctors and pharmacists. Two separate surveys were conducted for the two formulations, with a total of 2630 participants (1488 participants for Actitan-P and 1142 participants for Actitan-F). Overall, the results indicate a high level of efficacy and safety of the product. In the case of Actitan-F, more than 96% of caregivers rated safety as good or excellent, and over 92% rated efficacy as good or excellent. Actitan-P also received positive feedback: nearly 86% of patients reported good/excellent efficacy, and more than 93% rated safety as good or excellent. These positive evaluations were confirmed by physicians and pharmacists, who also did not report adverse effects. In summary, this study confirms the role of Actitan as a safe and effective option for the treatment of diarrhea of different causes and in different patient groups, including young children. Full article

This study introduces Protectbot, an innovative chatbot framework designed to improve safety in children’s online gaming environments. At its core, Protectbot incorporates DialoGPT, a conversational Artificial Intelligence (AI) model rooted in Generative Pre-trained Transformer 2 (GPT-2) technology, engineered to simulate human-like interactions within gaming chat rooms. The framework is distinguished by a robust text classification strategy, rigorously trained on the Publicly Available Natural 2012 (PAN12) dataset, aimed at identifying and mitigating potential sexual predatory behaviors through chat conversation analysis. By utilizing fastText for word embeddings to vectorize sentences, we have refined a support vector machine (SVM) classifier, achieving remarkable performance metrics, with recall, accuracy, and F-scores approaching 0.99. These metrics not only demonstrate the classifier’s effectiveness, but also signify a significant advancement beyond existing methodologies in this field. The efficacy of our framework is additionally validated on a custom dataset, composed of 71 predatory chat logs from the Perverted Justice website, further establishing the reliability and robustness of our classifier. Protectbot represents a crucial innovation in enhancing child safety within online gaming communities, providing a proactive, AI-enhanced solution to detect and address predatory threats promptly. Our findings highlight the immense potential of AI-driven interventions to create safer digital spaces for young users. Full article