Search Results (319)

This paper examines the social and political consequences of parenting with a conviction for a sexual offence in contemporary Britain. We argue that the systems governing people labelled “sex offenders” operate in ways that exceed what Michel Foucault described as biopolitical governance. While biopolitical frameworks have often been interpreted as oriented toward the optimisation and management of life, including through practices of rehabilitation and reintegration, contemporary punishment bureaucracies frequently foreclose these possibilities in practice. For many parents, redemption is not simply delayed but structurally denied, leaving their citizenship permanently uncertain. Drawing on collaborative, reflexive phenomenology, we develop the concept of cleft identity to describe this condition. Parenting is typically understood as a key site of responsible citizenship, centred on the care and protection of life. Yet parents with sexual offence convictions remain subject to ongoing surveillance, disclosure and stigma, marking them as permanently suspect. They are therefore required to perform the responsibilities of “good” parenting while simultaneously treated as moral outsiders. We argue that this tension produces a form of suspended citizenship in which stigma operates not simply as social reaction but as a mechanism of governance. The paper develops this argument through a theoretically driven, collaborative phenomenological case study intended for analytic illumination rather than empirical generalisation. Full article

Background/Objectives: Rare diseases have a substantial impact not only on affected individuals but also on their families, particularly parents who assume primary caregiving roles. Despite increasing attention to rare conditions, parents’ experiences remain fragmented across the literature. This integrative review aimed to synthesise existing evidence on the experiences and multidimensional impact of caring for a child with a rare disease on parents. Methods: An integrative review was conducted following Whittemore and Knafl’s methodology and reported according to PRISMA 2020 guidelines. A systematic search was performed across MEDLINE, CINAHL, PsycINFO, PsycARTICLES, and Scopus from 1 November 2025 to 31 January 2026. Twenty-two studies (qualitative, quantitative, mixed-methods, and reviews) were included. Data were analysed using thematic synthesis. Results: Three interrelated themes were identified: (1) the diagnostic journey, characterised by prolonged uncertainty, fragmented care, and the pivotal role of communication; (2) multidimensional caregiving burden, encompassing emotional, social, economic, and physical impacts, with notable gender differences; and (3) adaptive trajectories, involving dynamic coping processes, parental upskilling, and meaning-making. Across studies, caregiving burden emerged as a cumulative and system-influenced phenomenon, while adaptation was found to coexist with ongoing uncertainty rather than representing a linear resolution. Conclusions: Caring for a child with a rare disease profoundly affects parents across multiple domains. The findings highlight the need for integrated, family-centred care models, improved diagnostic communication, and sustained psychosocial support. Implications for nursing practice: Nurses play a key role in recognising caregiver burden, supporting adaptive processes, and promoting effective communication throughout the diagnostic and care trajectory. Full article

Background: Infants discharged home from a neonatal intensive care unit (NICU) often have multiple ongoing medical needs. The Coached, Coordinated, Enhanced Neonatal Transition (CCENT) program provides nurse navigator-led support for caregivers of high-risk infants through their first year after transitioning from the NICU to home. The objective was to compare health care resource use and costs between CCENT and standard care control groups post-discharge. Methods: Resource use and costs were collected at 4 months and 12 months post-discharge from families enrolled in the CCENT randomized controlled trial across Canada. Infant healthcare utilization and parent mental health service use and costs were analyzed from public health care system and family payer perspectives and were compared statistically between groups and within groups over time. Results: A total of 97 and 105 infants were randomized to the intervention and control groups, respectively. Significant reductions in use of medications and equipment were observed over time in both groups while use of allied health professionals decreased and emergency department (ED) visits increased for CCENT. Annual total healthcare costs per child to the public payer were $4135 (95% CI $2825, $5709) for the CCENT group and $4578 (95% CI $2246, $8356) for controls. The cost of delivering CCENT was $669 per family (SD $362). The average annual out-of-pocket cost per family was $724 (95% CI $467, $1024) for CCENT and $728 (95% CI $479, $1007) for controls. Conclusions: This study indicates the importance of considering patterns of healthcare utilization, program costs and costs to families when implementing NICU to home care interventions. Excluding the cost of a nurse navigator, costs to the healthcare system were not increased in the intervention group. Such a program may help families access appropriate care. Full article

Background/Objectives: Within a family-centered care framework, families of children with cerebral palsy (CP) rely on both informal and formal support systems to manage caregiving demands, yet the adequacy and perceived helpfulness of this support vary. This study aimed to examine the availability of different support sources for families of children with CP in Saudi Arabia, explore their perceived helpfulness, and evaluate the influence of child-, parent-, geographical-, and household-related characteristics on the level of family support helpfulness. Methods: A cross-sectional study was conducted among 223 caregivers of children diagnosed with CP across Saudi Arabia. The participants completed the Child and Family Questionnaire and the Family Support Scale (FSS), and the children were classified on the Gross Motor Function Classification System (GMFCS). Kruskal–Wallis H and Mann–Whitney U tests examined the differences in perceived support helpfulness across family, child, and household characteristics. Results: Spousal and kinship support were perceived as the most helpful sources, with families of children with bilateral spastic CP and more severe GMFCS perceiving less support. Overall, informal social support was significantly perceived as more helpful than formal support. Conclusions: Families of children with CP rely mainly on spouses and relatives for support, with lower perceived helpfulness among those facing greater caregiving demands, highlighting the need to improve the accessibility, coordination, and quality of support services. Full article

Biological family contact is critical to child wellbeing in non-relative substitute care. Drawing on the Capability Approach, this study sought to learn how and in what ways policy supporting family contact is carried out in practice and the impact on children. This qualitative study was conducted in the Czech Republic which has been transitioning from child institutional care to a foster care system. Sixty-six Czech stakeholders were interviewed across a spectrum of positions and perspectives, including care leavers, and child welfare professionals in NGO’s, children’s institutions, and government officials. Despite policies mandating parental involvement, care leavers often navigated family connections alone or were deliberately kept apart. Professionals often found it challenging and frustrating to engage parents, doubting it was in the best interests of the child. Some NGOs focused on effective parent engagement and saw success in reconnecting young people with their families. Practice recommendations include a shift toward prevention and family preservation, education of professionals about the importance of family connections, and empathy training to understand parent behaviors, needs, and motivations. The Capability Approach highlights the importance of child participation in decisions that affect their lives, including their right to know their own families. Full article

Australia’s ban on social media for under-16s, introduced in December 2025, made it the first country worldwide to implement a nationwide prohibition on major platforms for adolescents. This narrative literature review compares Australia’s age-based restriction with international approaches to protecting young people from online risks. The review synthesized 26 academic studies and 15 grey literature sources (policy documents, legislation, and official reports published between 2015 and 2025). It employed Bronfenbrenner’s bioecological systems theory to examine effects across family, platform, institutional, and broader socio-legal contexts. Three key themes emerged: (A) Empirical findings on age-threshold policies remain inconclusive and context-dependent. While unregulated use relates to psychological vulnerabilities, structured and intentional engagement can promote social connection, identity exploration, and support access, especially for marginalized youth. (B) Global responses vary, favoring alternatives like parental consent, platform duty-of-care obligations, and screen-time control measures. (C) Balanced, sustainable harm reduction depends on combining parental involvement, platform accountability, and digital literacy education. Overall, while Australia’s precautionary approach addresses legitimate developmental and public health concerns, its effectiveness seems limited by enforcement challenges, risks of digital exclusion, and potential human rights issues. Bronfenbrenner’s framework underscores the need for coordinated governance across interconnected systems to lessen online harm. Full article

Introduction/Objectives: Intersectoral collaboration between education and mental health services is central to the care of autistic children and adolescents. However, recent literature indicates that evidence remains limited regarding how these collaborative arrangements are implemented in routine public services, particularly in low- and middle-income countries (LMICs). This study aimed to assess the intersectoral collaboration between Brazilian educational and mental health services for autistic children and adolescents and to examine the frequency and type of intersectoral contact. Methods: An exploratory cross-sectional study was conducted in the municipal public education system of Niterói, a city in the Southeast region of Brazil. Participants included parents of 123 autistic children and adolescents, 49 teachers from mainstream education and specialized educational services (SES), and 24 health professionals. Data were collected using structured questionnaires with multi-informant reports. The instruments were specifically developed for the study and submitted to expert content-validation procedures. Analyses included descriptive statistics and, in a subsample of 51 matched cases with paired responses from teachers and health professionals, Cohen’s kappa to assess agreement between reports. Results: Low levels of intersectoral collaboration were observed, characterized by infrequent contact, limited information exchange, and slight agreement between reports from teachers and health professionals (κ = 0.25; p = 0.01). Teachers were more likely to know where care was provided than to know which specialists were involved, while more than half of health professionals did not know which school the child attended. Conclusions: In the investigated municipal network, care appeared fragmented, highlighting difficulties in translating intersectoral recommendations from public policies into routine collaborative practices. Full article

Background/Objectives: Prior research suggests that it is possible to improve health outcomes in children with adverse childhood experiences (ACEs) through multi-component interventions that promote protective factors. We designed the Families Implementing Resilient Systems Together (FIRST) study to address the gaps in research on the potential effectiveness of screening for specific ACEs through pediatric practice. Methods: As part of our clinical quality improvement efforts to improve patient care for children impacted by ACEs, we trained a random sample of pediatricians on strategies to promote protective factors and encouraged them to make referrals to community health workers (CHWs) and parenting education resources. This manuscript describes our clinic data on practice changes associated with the FIRST physician training, and our data collection plan for our research study. Results: Physician training resulted in attitudinal shifts and measurable behavioral changes. Trained providers made referrals to CHWs for approximately 5–10% of well-child care visits. The majority (84%) of referrals were for multiple risk factors, most commonly ACEs and socioeconomic concerns. The most common ACEs were parental divorce/separation, parent–child verbal abuse, and caregiver mental health problems. Conclusions: FIRST training improves counseling, education and referrals for children exposed to ACEs. Our research study will evaluate the impact of the FIRST intervention and address important questions about associations between specific ACEs, protective factors, and biomarkers of toxic stress. Full article

Background/Objectives: Single-parent families represent a growing and particularly vulnerable family structure within community and primary health care contexts. These families often experience cumulative burdens related to caregiving overload, socioeconomic constraints, social isolation, and fragmented support networks, which directly affect health and well-being. This integrative review aimed to synthesize and critically analyse direct and conceptually transferable evidence relevant to Family Health Nursing interventions supporting single-parent families in community and primary health care contexts, identify existing knowledge gaps, and inform the development of a relational empowerment model. Methods: An integrative literature review was conducted following PRISMA 2020 guidelines. A comprehensive search was performed across three electronic databases (PubMed, CINAHL, and Scopus) covering publications from 2020 to 2025. Inclusion criteria comprised peer-reviewed empirical studies and reviews addressing nursing or health interventions relevant to single-parent families in community or primary health care contexts. Data were extracted and synthesized thematically, with attention to theoretical frameworks, intervention characteristics, and reported outcomes. Results: Twenty-nine studies met the inclusion criteria. The synthesis revealed four main thematic domains: (1) caregiving burden and psychosocial vulnerability, (2) access to and coordination of community-based resources, (3) nurse–family relational processes, and (4) empowerment-oriented nursing interventions. Theoretical underpinnings frequently included family systems perspectives, the Calgary Family Assessment and Intervention Models, and empowerment-oriented frameworks. Conclusions: Nursing interventions for single-parent families in community health settings should prioritise relational empowerment approaches that acknowledge family diversity, contextual vulnerability, and dynamic caregiving demands. The proposed relational empowerment model offers a practice-informed framework to guide Family Health Nursing interventions, education, and policy development, supporting more responsive and equitable care for single-parent families. Full article

Patients with Lyme disease often face uncertainty when navigating the healthcare system during pregnancy and when seeking healthcare for their children exposed to Lyme disease in utero. Little is known about these families’ experiences. This qualitative study explored the perspectives of 27 parents in the United States who had acute or chronic Lyme-related diagnoses while pregnant. Semi-structured interviews were coded and thematically analyzed. Six themes characterized positive patient–physician interactions: (1) validation of patient experiences, (2) transparency, (3) willingness to learn, (4) shared decision making, (5) empathy, and (6) continuity of care. These findings offer guidance for clinicians counseling patients facing prognostic uncertainty related to Lyme disease and similarly complex conditions. Full article

Background/Objectives: This study examines gender differences in healthcare utilization and financial burden across family structures under Korea’s near-universal health insurance system. Methods: Using 2010–2018 Korea Health Panel data, we applied a two-part model to estimate initiation of care, conditional utilization, and expected out-of-pocket expenditures. Results: Single fathers were less likely to initiate care, whereas single mothers had higher unmet needs and substantially greater conditional and expected out-of-pocket spending, with expected expenditures approximately 46% higher than those of two-parent households. Conclusions: We document stage-specific disparities in healthcare utilization and financial burden across family structures even under near-universal coverage, indicating the need for policies that strengthen both access and financial protection for single-parent households. Full article

Pharmaceuticals and personal care products (PPCPs), as persistent organic pollutants, are widely present in various aquatic environments. Their long-term presence in aquatic environments poses a potential threat to ecosystems and human health. This study established an efficient, green, and cost-effective photocatalytic method using P25 titanium dioxide (P25TiO₂) to simultaneously degrade five representative PPCPs (methyl paraben (MeP), carbamazepine (CBZ), bisphenol A (BPA), diclofenac (DFC), and triclosan (TCS), while elucidating the reaction mechanisms. Under sunlight irradiation, degradation rates for all five PPCPs reached 100%, achieving near-complete mineralization with total organic carbon (TOC) removal rates exceeding 95%. This demonstrates the system’s exceptional capability to not only degrade the parent compounds but to thoroughly convert them into benign inorganic substances. We systematically investigated the effects of catalyst concentration, initial pollutant concentration, light intensity, pH, and various common inorganic anions (chloride, sulfate, bicarbonate, phosphate) and humic acid (HA) on the degradation process. Additionally, mechanistic studies indicated that hydroxyl radicals (·OH) are the primary active species in the system. The degradation rate differences among various persistent organic pollutants (DFC > BPA > TCS > CBZ > MeP) primarily stem from variations in the reactivity of different functional groups within their molecular structures toward ·OH. In summary, this study provides a promising and practical solution for treating complex medical wastewater containing five typical PPCPs. Full article

This study explored the challenges and support needs of adolescents identified as living with perinatally acquired HIV based on clinical history and early childhood treatment records to generate evidence that can inform the development of an adolescent-centred support programme. A mixed-methods, sequential exploratory design was employed. In the qualitative phase, semi-structured interviews were conducted with 21 APHIV (mean age 15.5 years, range 12–19; 61.9% female) recruited from health facilities in rural Limpopo, South Africa. In the quantitative phase, a survey informed by qualitative findings was administered to 186 APHIV. Life Course Theory informed the conceptual framework of this study and guided the development of the interview guide as well as the interpretation of adolescents’ lived experiences. Data saturation was reached after twenty-one in-depth interviews. The qualitative analysis generated themes related to HIV/AIDS knowledge and support systems, which were subsequently interpreted through key Life Course Theory constructs, including time and place, agency, timing, and linked lives. The findings revealed that the life trajectories of older adolescents were more strongly shaped by the historical circumstances surrounding their HIV diagnosis and disclosure compared with those of younger adolescents. The results further highlighted gaps in treatment literacy, challenges in disclosure processes, emotional distress, and variability in family and health-care support. Most adolescents reported that their HIV-positive status was disclosed by someone other than their parents, while some discovered their status independently. The findings provide empirical evidence on informational, psychosocial, and support needs that can guide the design of adolescent-centred interventions for adolescents living with perinatally acquired HIV. This study recommends the development of context-specific, adolescent-centred support programmes that integrate psychosocial support, family engagement, and improved communication with healthcare providers to strengthen adherence and well-being among APHI. Full article

Background: Chinese immigrant families of autistic children in the United States face intersecting barriers related to language, culture, immigration, and fragmented service systems. Yet little is known about how Chinese immigrant parents engage in advocacy or how such efforts relate to disability and human rights. Methods: This qualitative study draws on in-depth interviews with fourteen Chinese immigrant parents of autistic children across multiple U.S. regions. Data were triangulated with analyses of publicly recorded advocacy events and parent-produced textual materials. Reflexive thematic analysis was used to examine motivations for advocacy, advocacy practices, and structural, linguistic, and cultural constraints. Results: Advocacy rarely emerged as an intentional or identity-driven pursuit. Instead, parents were compelled into advocacy through institutional exclusion, service denial, and unmet care needs. Parents engaged in diverse forms of advocacy, including migration, negotiation within institutions, information translation, community-building, and grassroots organizational leadership. Cultural norms shaped advocacy strategies, producing quiet, relational, and collective forms of action often overlooked in dominant rights-based models. Conclusions: Interpreted through a disability justice lens, parental advocacy functions as burdened and unequally distributed labor compensating for systemic failures. Findings underscore the need for institutional reforms that reduce reliance on families’ capacity to fight for access, dignity, and care. Full article

Background: Oral health during adolescence is a key determinant of long-term well-being and health equity. Despite widespread recognition of its importance, disparities in knowledge, motivation, and access to care persist. This study was conducted in Salt (Catalonia, Spain), a municipality with a population of approximately 33,000, characterized by a low average household disposable income (€12,512 per capita) and a high proportion of immigrant residents (37.76%). These sociodemographic characteristics may influence adolescents’ oral health behaviour, perceptions, and access to dental care. The study aimed to explore adolescents’ knowledge, habits, and attitudes towards oral health in this context, with barriers and protective factors, to inform community-based health promotion strategies. Methods: A qualitative descriptive study was conducted using focus group discussions with Spanish adolescents aged between 12 and 16, following ethical approval and informed consent from legal guardians. Data were systematically analysed using thematic analysis. Results: The adolescents had moderate oral health literacy, with basic knowledge of dental caries and prevention, but notable gaps in their knowledge regarding systemic consequences and complementary resources. Oral health behaviours and practices were shaped by social, economic, and normative influences, while parental involvement, community support, and school-based initiatives emerged as key assets for the promotion of oral health. Conclusions: While adolescents in Salt show awareness of oral hygiene, structural, motivational, and informational barriers limit comprehensive oral health practices. Interventions should move beyond knowledge-based education towards culturally adapted, participatory, and asset-based approaches to promote sustainable improvements in adolescent oral health. Full article