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Introduction: Mother-to-child transmission of hepatitis B infection is one of the major routes of hepatitis B virus (HBV) infection in Africa. Amusingly, Africa is the only region yet to meet the World Health Organization's target of reducing the prevalence of HBV infection to less than 1% among children under 5 years of age by 2020. In Ghana, little has been documented about midwives' views on the factors impacting the successful implementation of mother-to-child transmission via HBV prevention programs. Objective: This study explored midwives' views on the challenges associated with the prevention of mother-to-child transmission of HBV infection in the La-Nkwantanang municipality. Methods: The study adopted an exploratory descriptive qualitative design and involved 14 midwives who were purposively recruited from a primary-level health facility in the La-Nkwantanang Municipality, Accra. Individual face-to-face interviews were conducted using an in-depth interview guide. The data were content analyzed using the six steps recommended by Braun and Clark. Results: Three main themes, namely, health professional or midwife factors and patient and health facility factors, negatively impacted the prevention of maternal-to-child transmission program. The five subthemes identified in this study included lack of awareness, financial constraints, and unavailability of logistics and protocols. The study recognized that midwives face many challenges even though they have a strong desire to prevent vertical transmission of HBV. Conclusion: The implementation of a mother-to-child transmission program is negatively impacted by many intrinsic, client, and health facility factors. Midwives who act as major stakeholders need to be periodically trained on the components and protocols for managing pregnant women living with HBV. The necessary logistics and management protocols need to be urgently provided. The skills and education obtained from the training will empower midwives to be knowledgeable about how to deliver quality care and provide education and support for HBV-infected pregnant women. The provision of logistics needed for the successful implementation of the program could avert delays associated with the administration of the hepatitis B birth dose vaccine and immunoglobulin to exposed newborns. [ABSTRACT FROM AUTHOR]

Background: Childhood, adolescent and young-adult (AYA) cancer survivors often experience health problems due to late or long-term effects of their cancer or the treatment thereof. The general population gains health benefits from immersion in nature, and nature-based programmes seem to be an intervention that can promote health among childhood and AYA cancer survivors. Objective: To explore the impact of the WAYA wilderness programme on the health of childhood and AYA cancer survivors. Methods: The study had a qualitative approach, with data from individual interviews (n = 18) 3 months after completion of the WAYA programme. In addition, case report data was collected during follow-up talks (1, 2 and 12 months after the programme) (n = 19). The WAYA programme consisted of an 8-day expedition, followed 3 months later by a 4-day base camp. The programme included activities such as hiking, backpacking, kayaking, rock climbing, bushcraft and mindfulness. Data was analysed according to a qualitative content analysis. The consolidated criteria for reporting qualitative research (COREQ) were followed. Results: An overarching theme was identified: "Personal growth from challenges in nature supported by deep connections with others". In 4 additional themes, participants' experiences describe how deep personal connections arose, as they developed a feeling of being able and competent in nature. Nature provided a space that supported relaxation and respite from everyday challenges and stimuli, which also led to an experience of being more connected to nature. Conclusion: The WAYA programme was experienced as being of support to childhood and AYA cancer survivors. The programme provided them with skills and tools to be safe in nature. When connected to nature, the participants developed trust and self-confidence, personal growth, relaxation and recovery from stress. Their engagement in outdoor activities continued after completion of the programme, when they returned to everyday life at home. [ABSTRACT FROM AUTHOR]

Objective: We aimed to investigate the difference between the bacterial profiles of the nasal cavities and adenoid surfaces of children with chronic rhinosinusitis (CRS). We also intended to determine and analyze the potential correlation between the pre- and post-adenoidectomy differences in the nasal bacterial profile and clinical prognosis. Methods: The clinical information of pediatric patients was collected. All the children underwent adenoidectomy (with or without tonsillectomy), and swab samples were collected during the operation. Visual analog scales (VAS) were used at 3, 6, and 12 months postoperatively. At the 12-month follow-up examination, swab samples were collected again. PCR amplification was performed of the v3-v4 variable regions of 16S rRNA of the collected specimens, as well as high-throughput sequencing using the Illumina platform. The species information was obtained by OTUs clustering, species annotation, and α-diversity analysis. Results: Twenty-two male and eight female pediatric patients were included in the investigation The most abundant genus level bacterial representatives on the nasal surface before adenoidectomy were Moraxella catarrh, Streptococcus pneumoniae, Haemophilus influenzae, and Staphylococcus aureus, whereas on the surface of adenoids, they were Streptococcus pneumonia, Haemophilus influenza, Nucleobacter, and Moraxella catarrhalis. One year postoperatively, the bacteria with the highest abundance on the nasal surface at the genus level were Moraxella catarrhalis, Streptococcus pneumonia, Staphylococcus aureus, and non-culturable Dolosigranulum. One year postoperatively, the bacterial richness in the nasal cavity was significantly higher than at baseline (P <.05). Furthermore, the subjective nasal score of all children significantly decreased at 3, 6, and 12 months postoperatively (P <.01). Conclusion: The preoperative bacterial abundance of the nasal cavity and the adenoid surfaces was similar, showing a clear correlation. No single specific bacterium was established to be a dominant species associated with the development of CRS in children. The post-adenoidectomy bacterial richness in the nasal cavity was significantly increased, which may be closely related to the relief of postoperative sinusitis symptoms. [ABSTRACT FROM AUTHOR]

Background: Lockdown was a unique experience that affected many aspects of life, particularly during the challenge of Ramadan fasting (RF). Studying this can increase understanding of the effects of lifestyle changes on quality of life (QoL) for children with type 1 diabetes (T1D) during RF. Methods: A cross-sectional study that assessed the effect of lockdown on lifestyle and QoL on fasting children living with T1D during Ramadan in the Middle East and North Africa region (2020-2021). We compared the child (self) and parent (proxy) reports using PEDQoL v3.0 disease specific questionnaire during lockdown and non-lockdown periods, and assessed correlations with lifestyle changes using regression and gap analyses. Results: A total of 998 reports from 499 children with T1D aged 8 to 18 years (study = 276, control = 223), and their parents during RF in lockdown and non-lockdown periods. Fathers were more involved in their children's care during lockdown (P =.019). Patients had better compliance with treatment (P =.002), a reversed sleep pattern (P =.033), increased food intake (P ⩽.001), and less exercise (P <.001). Children and parents perceived better QoL during lockdown (P ⩽.001) with no differences between their reports in "Diabetes Symptoms", "Treatment Adherence," and "Communication" domains. Self and proxy reports were different in all domains during non-lockdown (P = <.001-.009). In gap analysis, although not statistically significant, the gap was approximated between children's and parents' perceptions in all domains during lockdown. Conclusion: COVID-19 lockdown had a positive impact on QoL of children living with T1D during RF, possibly due to lifestyle changes and superior psychosocial family dynamics. [ABSTRACT FROM AUTHOR]

We conducted a secondary analysis of the data derived from a cross-sectional survey among parents of school-age children in Japan. The present study explored variables associated with parents' satisfaction with the local parenting environment. Multivariable logistic regression was used by entering parental satisfaction as a dependent variable and basic and parenting-related items as independent variables. A total of 2218 respondents were stratified by self-determined financial circumstances. A higher proportion of respondents stated low satisfaction with the local parenting environment and support schemes among the financially struggling group (50.4%) than among the non-struggling group (33.8%). Among the financially struggling group, the variables significantly associated with low satisfaction were a lack of parenting support (adjusted odds ratio [aOR] = 1.612) and being unable to use after-school children's clubs (aOR = 1.747). Our exploratory analysis suggests that after-school children's clubs can be expected to play a role in widening social networks and community connectedness among parents struggling financially. This role should be reflected in municipal welfare policy. [ABSTRACT FROM AUTHOR]

Background: More information is needed regarding return to preinjury sport levels and patient-reported outcomes after tibial spine avulsion (TSA) fracture, which is most common in children aged 8 to 12 years. Purpose: To analyze return to play/sport (RTP), subjective knee-specific recovery, and quality of life in patients after TSA fracture treated with open reduction with osteosuturing versus arthroscopic reduction with internal screw fixation. Study Design: Cohort study; Level of evidence, 3. Methods: This study included 61 patients <16 years old with TSA fracture treated via open reduction with osteosuturing (n = 32) or arthroscopic reduction with screw fixation (n = 29) at 4 institutions between 2000 and 2018; all patients had at least 24 months of follow-up (mean ± SD, 87.0 ± 47.1 months; range, 24-189 months). The patients completed questionnaires regarding ability to return to preinjury-level sports, subjective knee-specific recovery, and health-related quality of life, and results were compared between treatment groups. Univariate and multivariate logistic regression analyses were conducted to determine variables associated with failure to return to preinjury level of sport. Results: The mean patient age was 11 years, with a slight male predominance (57%). Open reduction with osteosuturing was associated with a quicker RTP time than arthroscopy with screw implantation (median, 8.0 vs 21.0 weeks; P <.001). Open reduction with osteosuturing was also associated with a lower risk of failure to RTP at preinjury level (adjusted odds ratio, 6.4; 95% CI, 1.1-36.0; P =.035). Postoperative displacement >3 mm increased the risk of failure to RTP at preinjury level regardless of treatment group (adjusted odds ratio, 15.2; 95% CI, 1.2-194.9; P =.037). There was no difference in knee-specific recovery or quality of life between the treatment groups. Conclusion: Open surgery with osteosuturing was a more viable option for treating TSA fractures because it resulted in a quicker RTP time and a lower rate of failure to RTP as compared with arthroscopic screw fixation. Precise reduction contributed to improved RTP. [ABSTRACT FROM AUTHOR]

Objectives: This study examines the relationship between social engagement and loneliness in female and male autistic children and adolescents in school-based social settings. Secondary aims sought to explore the emergence of loneliness across different age groups and differences in social engagement and loneliness between genders. Methods: This study conducted an analysis of previously collected data from two multi-site randomized control trials. This study included 58 autistic students (29 females, 29 males) between the ages 6 through 18 years. Female and male participants were matched on age and intelligence quotient. Concurrent mixed methods were used to examine participants' social engagement and loneliness. Results: Findings revealed a significant relationship between joint engagement and loneliness, such that autistic students reported more loneliness when they were mutually engaged with social groups than when they were isolated or alone. Positive correlations between joint engage and loneliness were identified in elementary-age girls and secondary-age boys, suggesting that being mutually engaged with peers leads to increased loneliness. Negative correlations between parallel and loneliness identified in secondary-age boys suggested that boys in close proximity to peers felt less lonely than boys who were mutually engaged with peers. Qualitative analysis of social behaviors indicated that elementary girls and secondary boys were more likely to be mutually engaged or in close proximity to activities, but they had difficulty sustaining this engagement throughout the entire social period. Secondary girls and elementary boys, on the other hand, were more likely to be solitary and less likely to engage with peer groups. Conclusion: Study findings highlight the relationship between social engagement and loneliness in school-based autistic populations, and that more engagement itself can lead to more loneliness for younger girls and older boys. The influence of age and gender on engagement and loneliness highlights a need to tailor social interventions to leverage existing social strengths. [ABSTRACT FROM AUTHOR]

Background & Aims: Early gesture plays an important role in prelinguistic/emerging linguistic communication and may provide insight into a child's social communication skills before the emergence of spoken language. Social interactionist theories suggest children learn to gesture through daily interactions with their social environment (e.g., their parents). As such, it is important to understand how parents gesture within interactions with their children when studying child gesture. Parents of typically developing (TD) children exhibit cross-racial/ethnic differences in gesture rate. Correlations between parent and child gesture rates arise prior to the first birthday, although TD children at this developmental level do not yet consistently exhibit the same cross-racial/ethnic differences as their parents. While these relationships have been explored in TD children, less is known about the gesture production of young autistic children and their parents. Further, studies of autistic children have historically been conducted with predominantly White, English-speaking participants. As a result, there is little data regarding the gesture production of young autistic children and their parents from diverse racial/ethnic backgrounds. In the present study, we examined the gesture rates of racially/ethnically diverse autistic children and their parents. Specifically, we explored (1) cross-racial/ethnic differences in the gesture rate of parents of autistic children, (2) the correlation between parent and child gesture rates, and (3) cross-racial/ethnic differences in the gesture rates of autistic children. Methods: Participants were 77 racially/ethnically diverse cognitively and linguistically impaired autistic children (age 18 to 57 months) and a parent who participated in one of two larger intervention studies. Naturalistic parent–child and structured clinician–child interactions were video recorded at baseline. Parent and child gesture rate (number of gestures produced per 10 min) were extracted from these recordings. Results: (1) Parents exhibited cross-racial/ethnic differences in gesture rate such that Hispanic parents gestured more frequently than Black/African American parents, replicating previous findings in parents of TD children. Further, South Asian parents gestured more than Black/African American parents. (2) The gesture rate of autistic children was not correlated with parent gesture, a finding that differs from TD children of a similar developmental level. (3) Autistic children did not exhibit the same cross-racial/ethnic differences in gesture rate as their parents, a result consistent with findings from TD children. Conclusions: Parents of autistic children—like parents of TD children—exhibit cross-racial/ethnic differences in gesture rate. However, parent and child gesture rates were not related in the present study. Thus, while parents of autistic children from different ethnic/racial backgrounds appear to be conveying differences in gestural communication to their children, these differences are not yet evident in child gesture. Implications: Our findings enhance our understanding of the early gesture production of racially/ethnically diverse autistic children in the prelinguistic/emerging linguistic stage of development, as well as the role of parent gesture. More research is needed with developmentally more advanced autistic children, as these relationships may change with development. [ABSTRACT FROM AUTHOR]

Background: Despite the well-established diagnostic and therapeutic applications of endoscopic ultrasound (EUS) in adults, data about its use in children are limited. In this study, we tried to assess the feasibility, safety, and clinical impact of EUS in pediatric patients. Methods: Data of pediatric patients (<18 years) referred for EUS over a 3-year period to the endoscopy units of four Egyptian tertiary centers were retrospectively analyzed. Significant impact was defined as a new diagnosis or treatment attributed to the EUS procedure. Results: Twenty-four diagnostic and five therapeutic EUS procedures were conducted in 29 children with a median age of 9 years. Indications for EUS included assessment of solid pancreatic mass (n = 3), pancreatic cyst (n = 2), suspected chronic pancreatitis (n = 9), pancreatic pseudocyst (PPC) (n = 5), recurrent hypoglycemia (n = 1), bile duct mass (n = 1), subepithelial lesion (esophageal, duodenal or anorectal) (n = 4), mediastinal mass (n = 1), pelvic mass (n = 3), and mass at splenic hilum (n = 1). Therapeutically, five patients underwent cystogastrostomy for symptomatic PPC with 100% technical and clinical success. EUS was able to diagnose 21 out of the other 24 patients. EUS-guided tissue acquisition was performed in 11 patients with definitive histopathological diagnosis in 10 patients (91%). There was no procedure-related major complication, while minor complications occurred in two cases (transient pain in one case, temporary fever, and vomiting in two cases). Conclusion: Standard linear EUS equipment and accessories can be used safely and effectively in selected pediatric patients for diagnostic and therapeutic purposes. [ABSTRACT FROM AUTHOR]

Introduction: COVID-19 pandemic-caused burden among the pediatric age group was less in terms of severity and mortality; indirect impacts of the pandemic on the mental health of children are huge and largely unnoticed. The main objective of this exploratory study was to analyze the association between screen time exposures among preschool children aged 3-6 years during the lockdown period in Tamil Nadu, India. Materials and Methods: An exploratory and anonymous population-based e-survey through social networks, including social media platforms (Facebook, LinkedIn, and WhatsApp) and researchers' acquaintances (email), using a snowball sampling strategy was conducted among parents of preschool children (aged 3-6 years) residing in different states of Tamil Nadu. Data were collected using Google Forms, and statistical, analysis was conducted. Results: Among 427 study participants, the mean age of screen introduction was 19.88 ± 11.73 months, and the mean age of independent operation of screen devices was 3.29 ± 1.16 years. Demanding extra attention (25.53%), temper tantrums (21.31%), increased aggressiveness (19.90%), more fussy (18.74%), altered night sleep (18.5%), and clinging (18.27%) were the frequently reported behavioral changes apart from increased screen time (60.88%) and decreased physical activity (28.80%) during the lockdown period. Conclusion: Excessive screen time beyond the recommended 1 h/day was seen in 94.1% of children, and screen exposure was inversely correlated with the duration of outdoor play. Among the behavioral changes, temper tantrums and fussiness were found to be significantly associated with increased recreational screen time. [ABSTRACT FROM AUTHOR]

Introduction: Substance withdrawal is one of the most common advert events in the Pediatric Intensive Care Unit (PICU), as the administration of potent opiates and sedative drugs is frequently performed several times each day. Objectives: The present study explored the challenges in nursing care of children with substance withdrawal syndrome in the PICU. Method: The study has an explorative and descriptive semi-structured qualitative interview design, with a strategic selection of informants. It was conducted at one out of three pediatric intensive care units in Sweden. Results: Three different main themes were identified describing the different challenges regarding withdrawal symptoms: monitor the child's interest, work with structured support, and understand the observation. Conclusions: There is a discrepancy between the medical perspective and the nursing care perspective regarding children in PICU suffering from withdrawal syndrome. The lack of joint guidelines, language, and nursing diagnoses may lead to subjective evaluations and increase suffering for these children. [ABSTRACT FROM AUTHOR]

Objective: The COVID-19 pandemic led to a substantial drop in US children's preventive care, which had not fully rebounded by the end of 2020. We sought to estimate the overall prevalence of missed, skipped, or delayed preventive checkups among households with children in the last 12 months because of the pandemic. Methods: We used data from the US Census Bureau's Household Pulse Survey, Phase 3.1 (collected April–May 2021). The analytic sample included 48 824 households with ≥1 child or adolescent aged <18 years. We estimated both national and state-level prevalences, examined associations with sociodemographic and household characteristics, and described reasons for missed or delayed preventive visits. Results: Overall, 26.4% (95% CI, 25.5%-27.2%) of households reported that ≥1 child or adolescent had missed or delayed a preventive visit because of COVID-19; percentages varied by state, from 17.9% in Wyoming to 37.0% in Vermont. The prevalence of missed or delayed preventive visits was significantly higher among respondents who reported material hardships (ie, not caught up on rent/mortgage, difficulty paying usual household expenses, children not eating enough because of lack of affordability) than among respondents who did not report material hardships. The most common reasons for missing or delaying preventive visits were concern about visiting a health care provider, limited appointment availability, and the provider's location being closed. Conclusions: Programs and policies could reduce gaps in children's preventive care caused by the pandemic, with a particular focus on addressing social determinants of health. [ABSTRACT FROM AUTHOR]

BACkgRounD: Little is known about the individual differences in susceptibility to, or lifetime frequency of clinically distinguishable influenza in children. MeThoDS: Rapid enzyme linked immunoassay-confirmed influenza pediatric cases (n = 96) in season 1 (2017-2018) were compared to age-matched (mean 7.7 years) controls (n = 171) with no evidence of influenza in season 1. The 2 cohorts were again studied in season 2 (2018-2019) for influenza outcomes and influences. Medical records, questionnaires, and interviews were used to determine past influenza disease and vaccine histories. ReSulTS: After season 2, known lifetime influenza illnesses per year of age averaged 22.6% in cases and 5.6% in controls, with 62% of controls still having never experienced known influenza. Having had prior influenza was marginally significant as a risk for season 1 influenza in cases versus controls (P = .055), yet a significant risk factor in controls for season 2 (P = .018). Influenza vaccine rates were significantly higher in controls than in cases for season 1, with a greater female vaccine benefit. Lack of previous influenza had greater calculated effectiveness (52%) than vaccination (17%-26%) in escaping season 2 influenza. Lifetime rates of vaccination did not correlate with lifetime rates of known influenza in either cohort. ConCluSIonS: Lifetime clinically distinguishable influenza rates varied among children, with many escaping it for years even without being immunized against it. Findings of less than expected clinical influenza, no correlation between vaccination frequency and disease frequency, sex differences, and an association between past clinical influenza and current risk, point to innate differences in individual influenza experiences. [ABSTRACT FROM AUTHOR]

Background: Play is central to children’s lives. Children living with palliative care needs experience disruption in their play. In this study, we sought to discover the characteristics and patterns of children’s play when receiving care in children’s hospital wards and hospices in Kuwait and the United Kingdom. Methods: A qualitative nonparticipatory observation design was used. Thirty-one children were observed, between the ages of 5 and 11years, all diagnosed with life-limiting or life-threatening conditions and receiving palliative care. The data were analysed using content analysis. Results: The children’s illnesses were negatively impacting their ability to have typical play for their age and development. The children’s interactive play was with grown-ups and very rarely with other children. This was associated with isolation precautions, the child’s need for assistance and a lack of play resources that match children’s physical and cognitive abilities. This gave rise to their engagement in more sedentary, solitary play. The findings of the study did not indicate significant cultural differences between the two countries. Conclusion: Children living with palliative care needs may be socially isolated due to their illnesses and their play participation can be limited. Understanding the influencing factors that determine these children’s play is essential for implementing effective modifications to enhance their play routines. [ABSTRACT FROM AUTHOR]

Objective: Identify factors that impact parents' decisions about allowing an unaccompanied child to ride in an autonomous vehicle (AV).Background: AVs are being tested in several U.S. cities and on highways in multiple states. Meanwhile, suburban parents are using ridesharing services to shuttle children from school to extracurricular activities. Parents may soon be able to hire AVs to transport children.Method: Nineteen parents of 8- to 16-year-old children, and some of their children, rode in a driving simulator in autonomous mode, then were interviewed. Parents also participated in focus groups. Topics included minimum age for solo child passengers, types of trips unaccompanied children might take, and vehicle features needed to support child passengers.Results: Parents would require two-way audio communication and prefer video feeds of vehicle interiors, seatbelt checks, automatic locking, secure passenger identification, and remote access to vehicle information. Parents cited convenience as the greatest benefit and fear that AVs could not protect passengers during unplanned trip interruptions as their greatest concern.Conclusion: Manufacturers have an opportunity to design family-friendly AVs from the outset, rather than retrofit them to be safe for child passengers. More research, especially usability studies where families interact with technology prototypes, is needed to understand how AV design impacts child passengers.Application: Potential applications of this research include not only designing vehicles that can be used to safely transport children, seniors who no longer drive, and individuals with disabilities but also developing regulations, policies, and societal infrastructure to support safe child transport via AVs. [ABSTRACT FROM AUTHOR]

Objective: Clinicians may specify the diagnosis of conduct disorder (CD) as "with limited prosocial emotions" (LPE). This specifier is thought to identify youths with particularly severe and stable symptomatology. However, few studies have examined the clinical usefulness of the LPE specifier among children with childhood-onset CD. The current study examines whether the LPE specifier distinguishes children with particularly severe and persistent symptoms among those with childhood-onset CD. The study also aims to test whether the LPE specifier aids in identifying children with subclinical CD whose conduct problems are at risk of increasing.Method: Two hundred sixty-four children showing at least one CD symptom before age 10 were divided based on the presence of CD and the specifier. Children with and without the specifier were compared on number of CD symptoms (assessed at study inception) and trajectory of conduct problems (assessed over 4 years). The analyses controlled for oppositional defiant and attention deficit hyperactivity symptomatology.Results: Compared with children with CD but without LPE, children with CD and the LPE specifier did not differ on likelihood of endorsing most symptoms nor on total numbers of symptoms. Moreover, they did not show a more stable pattern of conduct problems across the 4 years. Children with subclinical CD with and without the LPE specifier were also similar in terms of their symptoms, severity, and evolution of their problems.Conclusions: Among youths with childhood-onset CD, the specifier appears to offer limited value in identifying those with particularly severe and stable CD symptomatology. [ABSTRACT FROM AUTHOR]

Background: Although there are several valid and reliable dietary screeners to measure child intake patterns, there is a paucity of brief assessment tools targeting under- and overconsumed foods.Objective: To compare the Fueling Learning through Exercise study (FLEX) dietary questionnaire, a screener designed to assess consumption patterns in third to fifth graders, to a validated dietary assessment tool.Methods: The FLEX dietary questionnaire was developed to assess fruit, vegetable, snack, and beverage consumption and was compared to the Block Kids Food Screener (BKFS). Correlations were analyzed using Pearson correlation coefficient. Agreement was assessed using Bland-Altman plots.Results: The sample (n = 63) had mean age of 9.9 years (SD 0.7). Most participants were non-Hispanic white (70%) and eligible for free/reduced price lunch (57%). Correlations between food group categories were significant for all groups ( P < .05) except fruits ( r = 0.51) and sugar-sweetened beverages (SSBs) ( r = 0.21). We found moderate-to-strong correlations between reported vegetable, salty snack, sweet snack, total beverage, milk, and fruit juice consumption (0.62, 0.59, 0.69, 0.47, 0.48, and 0.46, respectively). The FLEX screener reported systematically higher mean servings per day (0.24-1.1) compared to the BKFS (0.05-0.51).Conclusion: Based on these correlations, the FLEX dietary questionnaire performs similarly to a validated tool in assessing intake of under- and overconsumed food groups in a diverse third to fifth grade population. Overall serving size discrepancies are likely due to more relevant food items on the FLEX questionnaire and a more child-friendly format. This study highlights the need to update older diet screeners to reflect current child consumption patterns. [ABSTRACT FROM AUTHOR]

Background: Assessing micronutrient powder (MNP) consumption is the key for monitoring program performance; no gold standard exists for assessing consumption in nutrition programs.Objective: To compare estimates of MNP consumption assessed by maternal report versus observed unopened MNP sachets in the household.Methods: Cross-sectional household surveys of children aged 6 to 23 months were conducted to assess an MNP project in Nepal; eligible children received 60 sachets per distribution. Mothers reported the number of sachets consumed and showed unused sachets. Directly observed difference (DOD) of MNP consumption was calculated by subtracting the number of observed unopened sachets from 60. Spearman correlation coefficient, categories of MNP consumption, and end digit preference were assessed.Results: A total of 205 mothers did not show remaining unopened sachets despite reporting that all were not consumed. For the remaining 605 children, median consumption was 60.0 sachets by DOD and maternal report; the correlation coefficient was 0.91. With consumption grouped into categories of 0 to 14, 15 to 29, 30 to 44, and 45 to 60 sachets, the percent categorized into the same groupings by DOD and maternal report was 100%, 80.6%, 80.7%, and 91.2%, respectively. Excluding those who consumed 60 sachets, 16.9% and 8.0% by report and 14.2% and 6.1% DOD, ended with 0 and 5, respectively.Conclusion: Had the observation of unused sachets been used alone to assess MNP consumption, 205 children would not have been assessed. Estimates of MNP consumption by DOD and maternal report were similar in this population with high intake adherence. [ABSTRACT FROM AUTHOR]

Objectives: Recent literature has suggested a marked shift towards increased meniscus repair relative to meniscectomy over the last decade in younger populations. Children and adolescents are more profoundly impacted by the outcomes of meniscus preservation, in terms of long-term joint health, given the subsequent decades of high activity levels, risk of meniscus re-injury, and progression towards degenerative joint disease in the setting of meniscus deficiency. The purpose of this study was to provide a comprehensive assessment of meniscus tear patterns and repair techniques utilized in children and adolescents to better elucidate features of this common injury and national trends in treatment. Methods: A prospective, multi-center registry of 4 different arthroscopic surgeries—discoid meniscus surgery, non-discoid meniscus repair [medial meniscus repair (MMR) or lateral meniscus tear (LMR)], anterior cruciate ligament reconstruction (ACLR), and tibial spine repair (TSR)—performed by 32 surgeon-investigators at 20 different academic centers over 30 months, was queried for all cases of non-discoid meniscus repair, which were further categorized according to whether they were performed in isolation (I-MR), or in conjunction with ACLR or TSR. Variables collected included patient demographic features (age, sex, BMI), compartment (lateral, LMT; medial, MMT), zone (white-white, red-white, red-red), pattern (longitudinal/vertical, complex/degenerative, radial, oblique/parrot's beak, horizontal/cleavage), displacement (yes/no), location (anterior, body, posterior, root), repair technique (all-inside, inside-out, outside-in, other), repair implant/construct (menisco-capsular implants/sutures, meniscal-based sutures), and number of implants/sutures. Descriptive statistics and comparative analysis were performed for I-MR vs. ACLR-MR vs. TSR-MR and MMR vs. LMR. Results: Of 1374 meniscus repairs (mean 15.1 years old, range 5-19, 44% Female), 763 (55.5%) were performed for LMT and 611 (44.5%) for MMT, with 184 of all cases (15%) representing bicompartmental meniscus repair (LMR+MMR). ACLR-MR (n=817, 66.9%) was significantly more common than I-MR (n=373, 30.6%), which was significantly more common than TSR-MR (n=31, 2.5%, p=0.001). I-MR had a higher incidence of anterior horn, meniscal body tears, inside out repairs, and outside in repairs (all p<0.001). Of MMTs that underwent repair 81.2% were vertical/longitudinal, while LMTs that underwent repair were comprised of 49.6% vertical/longitudinal, 24.2% complex/degenerative, and 13.9% radial (Table 1). While the most common tear zone for repaired menisci was the red-white zone, 18% of LMR and 13.4% of MMR were in the white-white zone. The posterior horn was one of the most common locations of a repairable lesion (45.1% LMT and 43.9% MMT) with 12.8% of LMT repairs and 6.2% of MMT repairs performed on the posterior root. 70% of repairs were performed with all-inside technique, which was the predominant technique for all tear patterns in both MMT and LMT. Only 14.1% of repairs were performed with inside-out technique, but 70% of these cases were for displaced tears. The average number of implants/sutures for non-displaced tears was 4.0, compared with 5.9 for displaced tears. While a majority of repairs used meniscocapsular repair techniques, 11.1% of meniscus repairs were based on meniscal-based sutures including 20.8% of radial tear repairs. 14 different implants were used by study surgeons (Figures 1 and 2). Conclusions: Amongst tears selected for repair in children and adolescents, LMT is more common than MMT, and the majority of cases arise in conjunction with ACLR, compared to isolated tears. The predominant tear pattern is vertical in MMTs (80%). By percentage, radial tears are seven times more common and posterior root tears are twice as common in lateral meniscus tears. Given the high and increasing frequency of this injury and procedure, nationally, the variation detected in repair techniques and implants utilized represent potential opportunities for optimization of care and reduction in health care costs. Table 1. Medial and lateral mensicus tear types and fixation techniques used. () indicated percentage of repair technique type for each tear type [ABSTRACT FROM AUTHOR]

Background: The relationship between physical therapy (PT) visit utilization and performance during single-legged hop testing after anterior cruciate ligament reconstruction (ACLR) in young patients is unclear. Purpose: To examine the effect of PT utilization on hop testing performance in pediatric and adolescent patients after ACLR. Methods: A retrospective review of patients who underwent primary ACLR between 2013 and 2019 at 5 institutions was conducted. All patients followed a structured rehabilitation protocol as directed by the treating institution and completed a return to sport (RTS) test which included single-legged hop testing. PT frequency was assessed both overall and by time period (first 6 weeks, week 7-month 3, 3-6 months, and 6-12 months). PT visits were recorded up until the time of hop testing. To account for variability, the average number of visits attended per week during the observed time was calculated for each patient. The effect of PT visit rate on the odds of passing a hop test was assessed using multivariable logistic regression controlling for time to test, age, sex, and insurance status. Passing was defined as achieving a limb symmetry index (LSI) ≥ 90% on all available tests (single hop, triple hop, crossover hop, and timed hop, if performed), as well as passing just the single hop test. The primary predictor of interest included the average rate of PT visits at the time of hop test (≥1 visit per week vs. <1 visit per week). Results: 289 patients were identified (mean age, 15.7 ± 1.9 years). The mean time from surgery to the first PT visit was 0.36 ± 0.24 months. RTS testing was performed at a mean of 8.0 ± 1.9 months. Patients averaged 0.98 ± 0.38 visits per week until the RTS test. Mean LSIs for the single hop, triple hop, crossover hop, and timed hop were 96.3 ± 8.2, 97.1 ± 6.5, 98.5 ± 7.8, and 98.2 ± 7.4, respectively. 68.9% of patients passed all performed test; 85.5% passed the single hop test. The weekly rate of PT visits had no statistically significant effect on the odds of passing all performed hop tests (OR, 0.98; 95% CI, 0.56-1.71) or the single hop test (OR, 1.05; 95% CI, 0.51-2.18). Furthermore, the distribution of PT visits did not affect hop testing performance (Table 1). Conclusion: The rate and distribution of PT visit utilization was not associated with hop testing performance in pediatric and adolescent patients after ACLR. Table 1. Adjusted Odds Ratios (95% CI) for Passing Hop Test (All Performed and Single Hop Only), by PT Weekly Visit Rate During 1st 6 weeks, 7 weeks to 3 months, After 3 Months [ABSTRACT FROM AUTHOR]

Objective To determine (i) if electrospray mass spectrometry–mass spectrometry with the SpOtOn Diagnostics Ltd reagent kit for sickle cell screening could be integrated into the English newborn screening programme, under routine screening conditions, and provide mass spectrometry–mass spectrometry results which match existing methods, and (ii) if common action values could be set for all manufacturers in the study, for all assessed haemoglobins, to indicate which samples require further investigation. Methods Anonymised residual blood spots were analysed using the SpOtOn reagent kit as per manufacturer’s instructions, in parallel with existing techniques at four laboratories. Mass spectrometry–mass spectrometry instrumentation at Laboratories A and B was AB Sciex (Warrington, UK) AP4000, and at Laboratories C and D, Waters Micromass (Manchester, UK), Xevo TQMS and Premier, respectively. Results There were 23,898 results accepted from the four laboratories. Excellent specificity at 100% sensitivity was observed for haemoglobin S, haemoglobin C, haemoglobin E and haemoglobin OArab. A common action value was not possible for Hb C, but action values were set by manufacturer. The two haemoglobin DPunjab cases at Laboratory D were not detected using the common action value. Conversely, false-positive results with haemoglobin DPunjab were a problem at the remaining three laboratories. Conclusions This multicentre study demonstrates that it is possible to implement mass spectrometry–mass spectrometry into an established screening programme while maintaining consistency with existing methods for haemoglobinopathy screening. However, one of the instruments investigated cannot be recommended for use with this application. [ABSTRACT FROM AUTHOR]

Substance abuse in childhood and adolescence is a major problem defining the future of the youth in both developed as well as developing nations. Studies in developed nations have focussed on this issue since long, and the trend is now taking direction towards the developing nations specially India. Even though a large number of studies are not available on this topic from India, but a review of these studies can define the future course of action and help in planning other studies as well as health related strategies. [ABSTRACT FROM AUTHOR]

In this exploratory study, teachers’ use of standards-based, discourse practices and their students’ mathematics learning in inclusive elementary mathematics classrooms were examined. Two beginning teachers (one third-grade teacher, one fourth-grade teacher) and six students identified with disabilities or as low performing in mathematics participated in this study (three students from each classroom). Six classroom observations of teachers took place over 4 months focusing on a subset of indicators associated with Walshaw and Anthony’s framework of mathematics classroom discourse practices. Follow-up interviews were also conducted. Curriculum-based and state-accountability measures were collected on the six target students in these settings. Different patterns of student performance emerged across the two classrooms in which teachers were observed using different types and degrees of standards-based discourse practices during mathematics lessons. Findings suggest indicators of effective mathematics teaching in inclusive general education classrooms to be validated by future research efforts. [ABSTRACT FROM PUBLISHER]

Background: The Palestinian economy has dramatically deteriorated at all levels since the Al-Aqsa Intifada (uprising) began in 2000, resulting in an unprecedented catastrophe to the livelihoods of the Palestinians residing in the West Bank and Gaza. It was also marked by lack of household physical and financial access to food and health care, which placed children at increased risk of malnutrition and poor health. This prompted a significant increase in food aid from 2002 until the summer of 2003.Objectives: To assess the nutritional status of children 6 to 59 months of age after 1 year of food assistance.Methods: In the West Bank and Gaza, a nationally representative sample of children 6 to 59 months of age was randomly selected with a validated multistage clustered design, with the Health Survey 1999 sample used as the sampling frame. The sample was stratified according to governorate, place of residence (urban, nonurban, or refugee camp), locality, and size of locality (number of households). A cross-sectional survey of nutritional status was carried out. Data were collected by interviews with the primary caregivers of the children. Measurements were made of children's weight and height or length. Food-intake data were collected by the 24-hour food-recall method with the use of a booklet of photographs of foods commonly eaten in Palestine.Results: A total of 3,089 children were assessed, of whom 3.1% in the West Bank and 3.9% in the Gaza Strip were suffering from acute malnutrition; the prevalence of chronic malnutrition was 9.2% in the West Bank and 12.7% in the Gaza Strip (p = .02). Sex, refugee status, locality, and maternal education were not significantly associated with acute malnutrition by logistic regression analysis, whereas infants 6 to 23 months of age were significantly at risk. Calorie and protein intakes were generally lower than recommended dietary allowances.Conclusions: The prevalence rates of both acute and chronic malnutrition among children in the West Bank and Gaza are significantly higher than the national Palestinian averages. There is a need to establish nutritional surveillance systems to monitor the nutritional status of children in conflict areas. [ABSTRACT FROM AUTHOR]

Background: Urban agriculture is an important livelihood strategy to increase access to and availability of food in urban settings.Objective: We examined the impact of sociodemographic and farming variables on the household food security and nutritional security of an index child aged 2 to 5 years. Our hypothesis was that dietary quality (percentage of energy from animal-source foods [%ASF] and dietary diversity) would have an impact on infection (as measured by C-reactive protein [CRP]), which in turn would have an impact on biochemical indices (hemoglobin and retinol) and anthropometric indices (weight-for-age z-score [WAZ] and body mass index z-score [ZBMI]). We examined the relationships among urban agricultural activities, household food security, and child nutritional security.Methods: We conducted a cross-sectional survey of 296 households within each randomly selected study zone in Kampala, Uganda. Correlations were calculated and bivariate and exploratory path analysis was conducted to explore relationships.Results: Household food security score was significantly positively correlated with the number of tropical livestock units (r = 0.142, p = .017), dietary diversity (r = 0.230, p < .001), %ASF (r = 0.185, p = .002), and WAZ (r = 0.149, p = .017). Exploratory path analysis demonstrated a significant positive relationship between household food security and %ASF, which in turn was positively associated with retinol. Consumption of animal-source food was significantly negatively associated with C-reactive protein level, which in turn was significantly negatively associated with hemoglobin level, and hemoglobin was significantly positively associated with WAZ.Conclusions: Our findings are supportive of efforts to enhance access to land for urban farming and engagement in activities aimed at improving the quality of dietary intake of urban residents, in particular by increasing consumption of animal-source foods. [ABSTRACT FROM AUTHOR]

Background: Anemia currently affects 2 billion people throughout the world. Although the immediate causes of anemia among children are known (including malnutrition and infections), the importance of contextual determinants and their relationships with individual effects have rarely been explored.Objective: To identify anemia risk factors at the individual, household, and community levels among Beninese and Malian children, using simple and multilevel regression methods.Methods: An analysis was undertaken of nationally representative data collected in 2001 in Benin (n = 2,284) and Mali (n = 2,826) by the Demographic and Health Surveys. Sixteen potential risk factors for anemia were considered at the individual, household, and community levels. Comparative analyses were carried out using simple and multilevel logistic regression models.Results: Simple and multilevel logistic regression analyses yielded broadly similar results. Risk factors for moderate to severe anemia included incomplete immunization, stunted growth, recent infection, absence of bednet, low household living standard, rural residency (Mali), low maternal education, and low community development index (Benin). In addition, multilevel analysis indicated a clustering level of anemia in communities (intraclass correlation) of 14% and 19% in Benin and Mali, respectively.Conclusions: Risk factors for child anemia appeared at all three levels (individual, household and community). Community-level clustering seemed to be low. Therefore, interventions to address anemia need not be village- or region-specific. Identifying a successful and replicable program is now a priority in child survival endeavors. It is likely that such a program would include a focus on improving immunization coverage, increased bednet usage, and reduced protein-energy malnutrition. [ABSTRACT FROM AUTHOR]

We ( Marsh & Craven, 1997 ) have claimed that academic self-concept and achievement are mutually reinforcing, each leading to gains in the other. Baumeister, Campbell, Krueger, and Vohs (2003) have claimed that self-esteem has no benefits beyond seductive pleasure and may even be detrimental to subsequent performance. Integrating these seemingly contradictory conclusions, we distinguish between (a) older, unidimensional perspectives that focus on global self-esteem and underpin the Baumeister et al. review and (b) more recent, multidimensional perspectives that focus on specific components of self-concept and are the basis of our claim. Supporting the construct validity of a multidimensional perspective, studies show that academic achievement is substantially related to academic self-concept, but nearly unrelated to self-esteem. Consistent with this distinction, research based on our reciprocal-effects model (REM) and a recent meta-analysis show that prior academic self-concept (as opposed to self-esteem) and achievement both have positive effects on subsequent self-concept and achievement. We provide an overview of new support for the generality of the REM for young children, cross-cultural research in non-Western countries, health (physical activity), and nonelite (gymnastics) and elite (international swimming championships) sport. We conclude that future reviews elucidating the significant implications of self-concept for theory, policy, and practice need to account for current research supporting the REM and a multidimensional perspective of self-concept. [ABSTRACT FROM AUTHOR]

Background: The nutritional status of children is a good indicator of the overall well-being of a society and reflects food security as well as existing health-care and environmental conditions. In Pakistan, it is estimated that nearly 40% to 50% of children under the age of five are stunted. Due to greater economic opportunities available to the urban population as compared to the rural, it was believed that economic resources existed in poor urban Pakistani households but that the households lacked the skills and knowledge to translate their resources into good care and feeding practices.Objective: This study aimed 1) to assess the prevalent care and feeding practices among children aged 6 to 18 months residing in the squatter settlements of Karachi and 2) to identify care and feeding practices, as well as any other underlying factors, associated with stunting.Methods: A cross-sectional survey was conducted in eight settlements between October and December 2000. A total of 433 mothers of eligible children were interviewed with the use of structured questionnaires. Final analysis using multiple logistic regression was conducted on 399 mother-child pairs.Results: Female children were nearly three times more likely to be stunted than male children. Households that were food insecure with hunger were also three times more likely than other households to have a stunted child. Lack of maternal formal schooling (adjusted prevalence odds ratio, 2.9; 95% confidence interval, 1.4 to 3.8) and large household size (adjusted prevalence odds ratio, 1.7; 95% confidence interval, 1.0 to 3.8) were also associated with stunting. Even though certain care and feeding practices were significant at the univariate level, they were not significant in the final multivariate analysis and so were excluded from the final model.Conclusions: In households where food insecurity exists, knowledge of care practices may not be sufficient, and interventions such as food subsidies must precede or accompany educational efforts. Further follow-up is required to explore the effect of gender differences on child care. [ABSTRACT FROM AUTHOR]

This article presents an overview of a research-informed family resilience framework, developed as a conceptual map to guide school counselors' preventive and interventive efforts with students and their families. Key processes that characterize children's and families' resilience are outlined along with recommendations for how school counselors might apply this family resilience framework in their work. [ABSTRACT FROM AUTHOR]

In the archaeological record, it seems children are rarely seen. If they are, children are referred to, to explain symbolism, rituals, past lifeways, and behavior of a society or culture rather than the past lifeways of children and their relationship to family and society. This lack of investigation suffers in all forms of archaeological research. However, this bias appears to be unconscious rather than intentionally applied. Archaeology, generally, involves the nameless and faceless rather than the individual. The archaeological signature of children appears minimal. It is adults, or more succinctly, society that generates material remains. This paper discusses interpretation of sites within the context of different archaeologies, thereby providing researchers with information that may not usually be considered when approaching interpretation of sites to visitors. [ABSTRACT FROM AUTHOR]

After decades of debate, a consensus is emerging about the way self-esteem develops across the lifespan. On average, self-esteem is relatively high in childhood, drops during adolescence (particularly for girls), rises gradually throughout adulthood, and then declines sharply in old age. Despite these general age differences, individuals tend to maintain their ordering relative to one another: Individuals who have relatively high self-esteem at one point in time tend to have relatively high self-esteem years later. This type of stability (i.e., rank-order stability) is somewhat lower during childhood and old age than during adulthood, but the overall level of stability is comparable to that found for other personality characteristics. Directions for further research include (a) replication of the basic trajectory using more sophisticated longitudinal designs, (b) identification of the mediating mechanisms underlying self-esteem change, (c) the development of an integrative theoretical model of the life-course trajectory of self-esteem. [ABSTRACT FROM AUTHOR]

This article looks at the process of doing research 'from scratch." The author began a project investigating children of Ethiopian origin living in Israel to see how ones who attended a kindergarten program years earlier differed from those who had not attended. However, the problem from the outset was that there may not be a difference to find. In this article, the author compares inductive, deductive, and abductive reasoning, and argues that abductive reasoning is the proper technique when nothing is known about the research at the outset. [ABSTRACT FROM AUTHOR]

Two challenges for researchers of school-based action are to identify effective approaches to prevent problem behaviors and promote positive youth development and to support the widespread implementation and sustainability of evidence-based preschool through high school practice. In this article, the authors describe integrated social, emotional, and academic education as a useful framework for conceptualizing school-based positive youth development programming. We then review findings from selected exemplary studies and research syntheses to support this perspective. We conclude with guidelines for implementing integrated social, emotional, and academic learning programs. [ABSTRACT FROM AUTHOR]

This symposium focuses on scholarship on children and poverty. It highlights the very high quality of research on children's poverty being published as of November 1998. Much, but not all, of this research has been organized by the Russell Sage Foundation in an effort to focus the social science community on one central social problem in the U.S. Over 14 million U.S. children lived in poverty in 1997. At the same time, a record high proportion of poor children's families are working poor families, headed by someone who worked at least part-time part of the year. These facts reveal both child poverty's stubborn resistance to economic growth in the U.S. and the growing importance of expanding help for the working poor as a central strategy for ending child poverty. Child poverty is linked to school failure, criminal behavior, poor health, and a variety of social problems among teenagers and adults. The coming years will offer important opportunities for enacting new public policies to reduce the prevalence of child poverty in the U.S. For research to contribute more effectively to public debate, scholars must carefully assess the current policy context, explore topics that are currently overlooked, and think ahead about dissemination strategies.

This paper critiques the literature on the relationship between sibling structure and academic abilities and achievement since Cicirelli's (1978) earlier commentary on this topic. Assessed is the extent to which the confluence model, a theoretical explanation of the influence of sibling structure, fits the empirical observations made recently on the association between sibship structure and intellectual development. Since the studies reviewed in general tend to refute the confluence model, alternative interpretations of the impact of sibling structure on academic consequences are presented. Implications for future research are also provided. [ABSTRACT FROM AUTHOR]

This article describes bow knowledge of children's thinking in mathematics, derived by using a cognitive science research paradigm, was used by a first- grade teacher to make instructional decisions. Children in the classroom learned mathematics to a level that exceeds what is recommended by the NCTM Standards (NCTM, 1989). The study is situated in the Cognitively Guided Instruction (CGI) project chain of inquiry. We describe the teacher's knowledge, beliefs, and method for using research-based knowledge of children's thinking in addition and subtraction in her classroom. We describe her mathematics curriculum, the expectations she bad of children, and the way her classroom was structured to enable her to continually assess children's thinking and knowledge. The article includes statements of the teacher that indicate the importance of the research-based knowledge to her as she taught. The article ends with some speculation about bow knowledge of children's thinking can influence curriculum reform. [ABSTRACT FROM AUTHOR]

This study examined the effects of three modes of story reconstruction training on the development of children's story comprehension. One hundred and eight children in grades K-2 were assigned randomly to one of three training conditions: thematic-fantasy play, adult-lead discussion, or drawing. Children were read three books on separate occasions and exposed to the appropriate conditions in relation to each book Story comprehension data, as measured by a two-factor, criterion-referenced test and a retell task, collected after the third session, were analyzed. Second graders' performance on all comprehension measures was superior to the younger children's comprehension. Thematic-fantasy play was the most effective facilitator of all measures of comprehension, particularly for kindergarteners. Enacting spec(lie play roles seemed to have a direct effect on the ability to retell stories. [ABSTRACT FROM AUTHOR]

This study investigated the effects of the first season of Sesame Street on readiness in kindergarten children. Metropolitan Readiness Test (MRT) scores of children from one school district, who had attended kindergarten in the two years prior to the first broadcast season, were compared with the scores of children who had attended kindergarten in 1970, the year of the first season of Sesame Street. In each comparison total MRT scores and the six subtest scores were analyzed separately. There was a significant difference found in favor of the 1970 group on the Alphabet Subtest. There were no significant differences in favor of this group found on any of the other sub tests nor on the total test. No significant interaction was found between age and exposure to Sesame Street. A significant interaction effect in favor of the 1970 boys was found on the Alphabet Subtest. The scores of children from an advantaged community were found to be significantly higher on the Alphabet Subtest in 1970 than the Alphabet Subtest scores of similar advantaged groups from previous years. The scores of the kindergarten children of 1970 from the summer Head Start program were not significantly different, on any of the subtests nor on the total test, than the scores of the summer Head Start groups from previous years. [ABSTRACT FROM AUTHOR]

This article sketches the international labor and accompanying family migration in the Federal Republic of Germany and identifies policy issues and preliminary findings of research with respect to the adaptation problems of the children of the foreign workers. [ABSTRACT FROM AUTHOR]

The article highlights the emphasis given on the accessibility of research for children during the meetings of the Open Section in Great Britain. E. Shinebourne, consultant pediatrician at the Brompton Hospital in London, England, believes that research could make clinical practice more ethical. It is said that therapeutic research inferred a procedure involving a specific patient who have a disease or malfunction.

The article reports on the children's biased evaluations of lucky versus unlucky people and their social groups. A window into the origins of attitudes and preferences toward social groups that vary in privilege are provided by understanding how children think about other people who experience luck or misfortune.

The article cites a research on children and housework. The research suggests that most children are doing very little of household chores, but adjudges that girls are doing most of the work. Other findings of the research came from sociologist Alice Rossi linking housework with teaching the habits of serving others.