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For children and young people their online life is as real to them as their real life. This article considers the positives and negatives of online life, why children in care are more vulnerable, and the specific impact for child protection and health. It provides advice and guidance for healthcare professionals working with children. There are useful resources about managing disclosures and safeguarding concerns. We will consider how to incorporate online life in a paediatric medical history and the impacts of online use on physical and emotional health. [ABSTRACT FROM AUTHOR]

A reluctance to speak about child sexual abuse that occurs in domestic settings complicates the dissemination of accurate prevention information to families. Fiction can provide context that assists to translate evidence-based prevention strategies in everyday ways, but to do so safely necessitates careful consideration of ethics. Five modern works of fiction were analysed to determine how intrafamilial child sexual abuse was elucidated and how the novels aligned with empirical findings. The results are considered with respect to developing a child safe approach to literature – a framework for critiquing literature that prioritises children's rights to safety over authorial rights to creative expression. Consideration is also given to how child welfare organisations, practitioners, policy makers and researchers might harness a child safe approach to fiction to disseminate accurate prevention information. PRACTICE IMPACT STATEMENT: This review of modern works of fiction about intrafamilial child sexual abuse considers how the abuse is represented by contemporary authors. Reviewing fiction through a child safe lens permits critical examination of the myths reinforced or dispelled by the work. Adopting a child safe approach to fiction potentially affords practitioners, researchers, agencies and advocates an avenue to disseminate accurate prevention information that can reach individuals in everyday settings. [ABSTRACT FROM AUTHOR]

The ability to identify and report child abuse and neglect at schools plays a significant role in protecting children and reducing the consequences of violence and abuse. This research examines how preschool teachers identify and report child abuse and neglect by focusing on their knowledge and skills in available preventions and interventions. The study sample included 25 preschool teachers from both public and private kindergartens in Türkiye. Thematic analysis was conducted on the interventions around child abuse and neglect using semi-structured interviews. The thematic analysis revealed three themes: (a) challenges in protecting children; (b) being able to identify neglect and abuse; and (c) contributing factors in child protection. Many participants demonstrated an ability to identify the consequences of child abuse and neglect. Key barriers to protecting children were the teachers' difficulties in reporting abuse, struggles within the school environment, parents' normalization of violence and abuse and resistance to changing their behaviors toward children. Based on these findings, a multilevel intervention approach was recommended to address child abuse and neglect in school settings, emphasizing the need for coordinated responses. [ABSTRACT FROM AUTHOR]

Researchers have paid little attention to child supervision in Laos, an ethnically‐diverse country with a community‐informal child protection system, and where many young children are regularly home alone or with another child. To explore what constitutes (in)adequate child supervision and its perceived effects, we conducted individual interviews with community leaders and professionals (n = 23) and focus group discussions with parents/adult caregivers (n = 74) and 12–17 year‐old children (n = 51) in six rural villages in Saravane and Borikhamxay provinces. Adults and children in both provinces described similar understandings and support systems of child supervision. Mothers are the main caregivers of young children, and literate fathers contribute to supervising school‐age children. Grandparents, older siblings and other relatives, teachers, and village authorities contribute substantively to child supervision. The main aims of supervision are child safety, socialization and moral development in cultural context. Parental unavailability due to employment, farming and migration; limited infrastructure; and lack of material resources are the main barriers to adequate supervision and may result in injuries, school dropout, teenage pregnancy and illicit drug use. Understanding the determinants, consequences, and patterns of child supervision across cultural and socio‐economic groups is needed to inform culturally acceptable strategies to support children and families. [ABSTRACT FROM AUTHOR]

Scholars and advocates are at odds about how to achieve higher levels of child safety and permanency. Calls for change include the recent upEND focus on eradication of child welfare services to a radical refocusing of the present system towards prevention/early intervention. To clarify the implications of reform over abolition, we seek to portray a future in which the abolition of child welfare has occurred, in juxtaposition to maintaining four core elements of established child maltreatment programmes around the world: (1) receiving and responding to community signals about the risk to children; (2) assessment of need coupled with a proportionate response; (3) rights protections to ensure fairness when placement outside the family is required; and (4) procedures for accountability and quality improvement. For each of these functions, we outline abolitionist advocates' positions and implications for children and parents. Across these elements, we delineate how assigning these responsibilities to communities, as suggested by upEND, would likely (1) exaggerate racial and economic inequities and (2) create structural barriers that would increase harm to children. We suggest several evidence‐informed enhancements to practice, research and policy that would mitigate these inequities while also increasing safety and permanency. [ABSTRACT FROM AUTHOR]

In situations where parents do not accept support while their family situation is assessed as unsafe (for instance in cases of child abuse and neglect), it is sometimes necessary to offer mandatory support to families. The aim of the current study is to investigate how parents perceive the results of mandatory support from Child Protection Services (CPS) and which elements of the mandatory support parents mark as crucial for the results of the support. In‐depth semi‐structured interviews were conducted with 18 parents. Parents report mixed feelings about the results of the mandatory support. According to parents, reaching alignment with professionals about the problem definition, as well as the aims of CPS at the start of mandatory CPS, is a crucial element contributing to results of CPS. Additionally, the perceived quality of the support (both on the organizational and professional level) is simultaneous important conditions for a positive view on the support of parents. Implications for practice include the importance of multi‐directed partiality of professionals to reach an agreement about the problems definition and the aims of the mandatory CPS involvement. [ABSTRACT FROM AUTHOR]

Cow's milk protein allergy (CMPA) affects 2% to 3% of infants and is managed with hypoallergenic formulas. The 2022 recalls of infant formulas due to factors including contamination led to specialty formula shortages, highlighting CMPA management challenges. Understanding health care providers' (HCPs) decision-making in transitioning to alternative formulas during shortages is crucial. Limited attention has been given to how pediatric physicians make these choices. This study utilized US HCPs' de-identified survey data to assess driving factors when switching extensively hydrolyzed formulas during shortages. A total of 104 eligible HCPs participated, including general pediatrics, pediatric allergy/immunology, and pediatric gastroenterology specialists. Safety, tolerability, and efficacy were identified as top factors for switching formulas. Formula 1 was considered well-tolerated, patient-accepted, and safe by all HCPs. Most expressed strong belief in Formula 1's safety and effectiveness. Findings inform CMPA management during shortages, offering guidance to HCPs for suitable formula selection and enhanced infant care. [ABSTRACT FROM AUTHOR]

BACKGROUND: Disparities in school attendance exist for children with medical complexity (CMC) due to COVID‐19. Longitudinal changes in family‐reported school safety perceptions and predictors of full‐time, in‐person school attendance are unknown. METHODS: This was a prospective, longitudinal cohort study with 3 survey waves (June 2021‐June 2022) among English‐ and Spanish‐speaking families of CMC aged 5 to 17 years and pre‐pandemic school attendance. Changes in Health Belief Model perceptions and full‐time in‐person school attendance were estimated using multivariate generalized linear modeling with repeated measures. RESULTS: Among 1601 respondents (52.9% of 3073 invited), 86.8% participated in all 3 surveys. School safety perceptions improved with time; however, perceived susceptibility to COVID‐19 increased. Full‐time in‐person school attendance rose from 48.4% to 90.0% from wave 1 to 3 (p <.0001), and was associated with motivation, benefits, and cues. For example, families with low compared to high motivation for in‐person attendance had 76% versus 98% predicted probability for child's school attendance, respectively at wave 3 (p <.0001). IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: Probability of full‐time in‐person school attendance was associated with several health belief model perceptions. School health policy and programs may benefit from promoting family motivation, benefits, and cues during future respiratory illness epidemics including COVID‐19. CONCLUSIONS: In‐person school attendance improved for CMC over time. Opportunities exist to continue optimizing in‐person attendance and family‐perceived safety for CMC at school. [ABSTRACT FROM AUTHOR]

Purpose: Children's exposure to intimate partner violence (IPV) is a form of child abuse and can have serious detrimental consequences on their health and well-being. Research has shown that a strong relationship with a caring adult, often the mother, is a protective factor against those consequences. For this reason, this study attempts to understand the overall experiences of victimized mothers with perpetrators, professionals, and institutions in the years following IPV disclosure. Methods: We conducted 20 semi-structured individual interviews in Switzerland in 2020 with former patients who had been provided with a clinical forensic consultation between 2011 and 2014. The participants had reported IPV between 2011 and 2014 and had at least one minor child at the time. Results: Victimized mothers continued to experience harmful behaviors from perpetrators/fathers after IPV disclosure. They reported feeling in danger and that the perpetrators/fathers benefited from a certain level of impunity. In parallel, the mothers were held accountable for the safety and well-being of their children in this context. These overall and multi-year experiences had short-term and long-term negative impacts on the mothers' and children's health, financial and administrative situation, relationship, and on school life. In this sample, the years following IPV disclosure were characterized by an enduring sense of ordeal. Conclusions: The professional and institutional handling of IPV situations, in relation to both victims and perpetrators, can endanger victimized mothers and their children and put them at risk of adverse consequences after IPV disclosure. Avenues for change to better protect mother and child and to provide relief to the mothers as an important protective factor for their children are discussed. [ABSTRACT FROM AUTHOR]

Summary: An emerging field of research seeks to understand the experiences of non-offending adults who experience sexual attraction towards children. Research indicates that this largely hidden population can experience significant mental ill health and suicidal ideation, yet are reluctant to seek professional mental health support. Furthermore, mental ill health has been identified as a factor that can increase the likelihood of offending. This study, undertaken by a social work practitioner researcher, aimed to assist in understanding suicidality factors within this population, and to identify how statutory mental health services could be developed for this client group, thus contributing to child protection and suicide prevention agendas. A qualitative analysis was undertaken of data gathered from an online forum used by adults who have sexual attraction towards children, and are committed to non-offending. The data related to forum members' experiences of suicidality, and key themes were identified through thematic analysis. Findings: The study found that a pattern of suicidal ideation commonly appears to manifest and identified risk and protective factors that can influence suicidality. The benefits of peer support and the strengths and limitations of professional support were also identified. Applications: The findings from this study contribute to an improved understanding of this client group for mental health practitioners. The findings also lay the foundation for further investigations, to inform the development of mental health services to facilitate improved outcomes for this client group, and for child protection. [ABSTRACT FROM AUTHOR]

Background: Only 5–10% of emergency medical services (EMS) patients are children, and most pediatric encounters are low-acuity. EMS chart review has been used to identify adverse safety events (ASEs) in high-acuity and high-risk pediatric encounters. The objective of this work was to evaluate the frequency, type, and potential harm of ASEs in varied acuity pediatric EMS encounters. Methods: This cross-sectional study evaluated pediatric (ages 0–18 years) prehospital records from 15 EMS agencies among three states (Colorado, Connecticut, and Rhode Island) between November 2019 and October 2021. Research associates used a previously validated tool to analyze electronic EMS and hospital records. Adverse safety events were recorded in six care categories, grouped into four levels for analysis: assessment/diagnosis/clinical decision-making, procedures, medication administration (including O2), and fluid administration, and defined across five types of ASEs: Unintended injuries or consequences, Near misses, Suboptimal actions, Errors, and Management complications (UNSEMs). Type and frequency of ASEs in each category were rated in three harm severities: Harm Unlikely, Mild/Temporary, or Permanent/Severe. Three physicians verified ASEs determined by research associates. Frequency of ASEs and harm likelihood are reported. Results: Records for 508 EMS patients were reviewed, with 63 (12.4%) transported using lights and sirens. At least one clinical intervention beyond assessment/diagnosis/clinical decision-making was documented for 183 (36.1%, 95% CI: 31.8, 40.4) patients. A total of 162 ASEs were identified for 112 patients (22.1%, 95% CI: 18.5, 25.7). Suboptimal actions were the most frequent UNSEM (n = 66, 40.7%; 95% CI: 33.1, 48.3). For ASEs, (n = 162), the most frequent associations were with procedures 39.5% (95% CI: 32.0, 47.0) or assessment/diagnosis/clinical decision making, 32.1%, (95% CI: 24.9, 39.3). Among care categories, fluid administration was associated with significantly more UNSEMs (58.1%, 95% CI:53.8, 62.4). Most ASEs were determined to be 'Harm Unlikely' 62.4% (95% CI: 54.4, 70.4), with assessment/diagnosis/clinical decision making having significantly fewer ASEs with documented harm (22.4%, 95% CI: 10.7, 34.1) compared to other care categories. Conclusion: Over 20% of pediatric EMS encounters had an identified ASE, and most were unlikely to cause harm. Most frequent ASEs were likely to be associated with procedures and assessment/diagnosis/clinical decision-making. [ABSTRACT FROM AUTHOR]

Background: Early support for children and families in need can improve children's health and development. In a Swedish region, a new working model called Safe Environment for Every Kid (SEEK) was introduced in the Child Health Services to facilitate the early identification of psychosocial risk factors. Objective: The aim of this study was to describe the adoption and introduction of the SEEK model in the Child Health Services of Region Jönköping County. Methods: Quantitative data were analysed using descriptive statistics, whereas qualitative data were analysed separately by a thematic approach. The results were then interpreted together with documents (including CHS management meeting notes and documents describing planning and training sessions) using an exploratory mixed‐methods approach to give a comprehensive description of the adoption and introduction of the SEEK model. Results: The results show that the SEEK model improved coordination and collaboration, which led to better integrated care for children and families. The structure was regarded as supportive when introducing the SEEK model in Child Health Services. The questionnaire, as part of the SEEK model, was used in 88% of possible health visits. The most reported reason for not using it was a lack of time. Conclusions: The desire to make a difference and thereby promote better health and development for children was a crucial factor for the nurses in adopting the SEEK model in their clinical practice. The design using coaches was also appreciated and supported the adoption and introduction of the SEEK model. Patient or Public Contribution: Parents and healthcare professionals did not contribute to the research process. The results are based on dialogues between CHS nurses and parents after the parents filled in the SEEK questionnaire, providing an understanding of professional relationships when dealing with challenging issues. [ABSTRACT FROM AUTHOR]

This article critically examines safety and innovation in out-of-home care, with a particular focus on addressing the entrenched overrepresentation of Aboriginal and Torres Strait Islander children and young people in the child welfare system. Grounded in the practical insights of safe house workers and managers, the purpose of this article is to share an innovative practice case study—the Tangentyere Safe House in Alice Springs, Northern Territory, Australia. As a case study within an Aboriginal Community-Controlled Organisation, Tangentyere Safe House emerges as a site for understanding the confluence of cultural safety, familial connections, and strategies to mitigate overrepresentation. Key themes explored include promoting cultural safety and supporting connections with the family of origin. Through a methodological lens that privileges practice-based knowledge, this article captured the on-the-ground experiences of those actively engaged in child safety. The findings underscore the innovative practices employed by Tangentyere Safe House in navigating out-of-home care within an Indigenous context to argue for a holistic and culturally informed approach to child protection interventions, drawing attention to the practical strategies employed by safe house workers. The article showcases the central role of Aboriginal Community-Controlled Organisations in providing care alongside families in out-of-home care. IMPLICATIONS The innovative approach of the Tangentyere Safe House highlights the importance and unique role of Aboriginal Community-Controlled Organisations in out-of-home care. The role of Aboriginal Community-Controlled Organisations should be formally recognised in the Aboriginal and Torres Strait Islander Child Placement Principle hierarchy. Frontline safe house workers' knowledge and expertise regarding Aboriginal and Torres Strait Islander children in out-of-home care can inform all stakeholder involvement including police interventions. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses articles in the issue on topics including, "therapeutic responses to trauma and prevention of harm in contemporary out-of-home care", "Child Protection Staff Perspectives of the SOFT Program: Touch, Textures, Weights, and Pressures".

The article discusses the Aboriginal Children in Aboriginal Care program in Victoria, Australia, highlighting its significance in empowering Aboriginal communities with the legal authority over the care and protection of Aboriginal children. It states that by following amendments to the Children, Youth and Families Act 2005 the program aims to ensure that Aboriginal people and organizations are involved in decisions affecting their children, promoting self-determination and cultural connection.

A scoping review on the short-term (during care) outcomes of residential care at the user level (children and their families) was conducted. The objective was to understand the extent and type of recent research focusing on outcomes during residential care placement as a child protection intervention and map the findings of the original studies. In six databases, 2,693 records of recent peer-reviewed articles with an abstract in English were found. A total of seventeen original studies were included in the review. In the studies, three distinct types of interventions were identified—implemented interventions, innovations and service as usual (SAU). The findings revealed variations in researchers' definitions of the concept of effectiveness and heterogeneity in methodology. Three studies were randomised control trials, two were quasi-experimental and twelve other designs were quantitative, qualitative or mixed methods studies. Most of the interventions in the original studies, brought about positive change in different dimensions of the wellbeing or functioning of users. The most robust designs were used in studying previously assessed interventions designed to combat specific problems. Whilst studies on SAU have demonstrated improvements in various aspects, the inherent complexity and diversity of residential care make the assessment of effectiveness a challenging task. [ABSTRACT FROM AUTHOR]

Safety behaviors attenuate the effects of exposure therapy. Less is known about how safety behaviors interact with parenting behaviors in relation to anxious children's fear responses. We examined if child safety behaviors interact with maternal punitive responses to explain unique variance in children's fear downregulation—defined as self-reported reduction of anxious arousal—during an anxiety-provoking task. Anxious children ages 8–12 (N = 105; 57.1% female; 61.9% racial minority) completed a diagnostic interview and structured speech task. Mothers reported how often they responded punitively to children's negative emotions. Independent observers coded child safety behaviors used during the speech, and a fear downregulation score was computed per child by subtracting post-speech fear scores from pre-speech fear scores. The interaction between child safety behaviors and maternal punitive responses predicted unique variance in subjective fear downregulation, such that increased use of safety behaviors during the speech task was associated with more difficulties downregulating subjective fear only among children whose mothers reported moderate and high use of punitive responses. Maternal punitive responses to children's negative emotions may promote child safety behavior use to avoid anxiety, resulting in greater difficulties downregulating fear. Our findings provide preliminary evidence for targeting child safety behaviors and parenting behaviors during child anxiety treatment. Highlights: Higher child safety behaviors were associated with more difficulty downregulating fear. Higher maternal punitive responses were associated with more difficulty downregulating fear. Maternal punitive responses interacted with safety behaviors to predict fear downregulation. Parental emotion socialization practices may be important treatment targets. [ABSTRACT FROM AUTHOR]

Background: Child maltreatment is a significant global problem concerning over 25% of children around the world. Traditionally, the assessment of children's welfare was characterized by the creation of instruments and models from the deficit-based theoretical framework. Purpose: This study aims to develop an instrument to measure protective factors (the Adolescent and Children Risk of Abuse and Maltreatment Protective Factors Scale, ACRAM-PFS) and gather evidence on its psychometric properties. ACRAM-PFS is an 18-items scale for the assessment of protective factors of child maltreatment developed from the socioecological framework. Method: Structural validity, reliability and convergent-related validity were studied for this measure in a sample of 616 children and adolescents, with age ranging from 0 to 18 years old (M = 12.14; SD = 5.22). Cases were informed by 286 child welfare workers. The sample was split in two subsamples, one to perform an Exploratory Factor Analysis (EFA) and the second to perform a Confirmatory Factor Analysis (CFA). Results: The CFA corroborate the three-factor structure that includes the children and adolescents' resources, the family/caregiver's resources and the community resources (χ2 = 278.005, df = 132, p <.001, CFI = 0.955, SRMR =.084, RMSEA =.061, [90% CI:.051-.071]). Results of convergent-related validity indicated significant correlation with CTQ-SF and protective factors dimension of C-CAPS. Discussion: The results support that ACRAM-PFS is a rigorous measure for assessing protective factors for child maltreatment. The scale can serve as a key tool for designing strengths-based intervention strategies tailored to the actual needs of children and adolescents. The present study provides the implications for the development of protective factor scales in the field of child welfare. [ABSTRACT FROM AUTHOR]

This study examined the contribution of early vs. concurrent maternal guidance of emotion dialogues with their children to the security and coherence of the children's attachment representations as adolescents. Maternal Sensitive Guidance was assessed from mother-child emotion dialogues when participants were preschoolers (approximate age 4 years) and young adolescents (approximate age 12.5 years), along with an assessment of adolescents' attachment representations using the Friends and Family Interview (FFI). Mothers' Sensitive Guidance in preschool predicted adolescents' coherence in the FFI, secure maternal (but not paternal) representations, and a positive representation of sibling relationships. In contrast, mothers' concurrent Sensitive Guidance was related only to adolescents' sibling relationships. These results highlight the significance of mothers' sensitive guidance of emotion dialogues during the early years for their children's later attachment representations, and point to the need for further examination of mothers' role when they guide emotion dialogues with their adolescents. [ABSTRACT FROM AUTHOR]

Under processes of responsibilisation and individualisation in the 'risk society', as well as discourses of intensive motherhood, mothers are expected to make 'good' decisions regarding their children's health. Consequently, decision-making concerning childhood vaccination becomes an emotionally challenging process, as mothers strive to minimise risk while simultaneously promoting and protecting health. Existing research shows that a substantial number of parents of young children have concerns regarding childhood vaccination. This article aims to examine how mothers who identify as vaccine hesitant dynamically construct risk, emotion, and responsibility when accounting for their decisions about childhood vaccination. Based on 15 in-depth interviews conducted in Belgium, this article reports the findings of a discourse analysis. For the latter, we draw on positioning theory and Lupton's emotion-risk assemblage. The findings report three storylines that mothers discursively construct when discussing risk and responsibility in relation to childhood vaccination, namely a health promotion, a maternal protection and a critical healthcare consumer storyline. These storylines help to clarify the fluid and multidimensional nature of the mothers' accounts of vaccine hesitancy. Furthermore, the findings provide empirical evidence for the use of the emotion-risk assemblage, as we find that vaccine hesitant mothers construct risk in relation to feelings of safety, control, empowerment, anxiety, fear, worry, intuition, vulnerability, being overwhelmed, pity and contempt. Overall, the findings demonstrate that when accounting for their decisions concerning childhood vaccination, hesitant mothers assume responsibilities within a context of social and gendered vulnerability, which affects their constructions of risk. [ABSTRACT FROM AUTHOR]

Understanding the extent to which caregivers perceive active shooter lockdown drills in K–12 schools as physically and emotionally safe for their children is pertinent, yet little empirical evidence exists. Negative parental perceptions of drills can lead to decreased student participation and compliance and amplify public concerns associated with school safety. This article introduces the Lockdown Impact Scale for Caregivers (LIS-C), a novel instrument developed to assess caregiver perceptions of K–12 school lockdown drills. Utilizing a national sample of 999 caregivers, this study validates the LIS-C through exploratory and confirmatory factor analyses, revealing a three-dimensional construct that includes perceived impact, school safety, and expressed concern. The development and validation of the LIS-C provide school-based mental health professionals with a psychometrically sound tool to address caregiver concerns, paving the way for a more informed and intentional implementation of lockdown drills. This research underscores the pertinence of examining caregiver perceptions to foster a safer and more supportive school environment. [ABSTRACT FROM AUTHOR]

Background: Data regarding rural youths' experience with firearms, including safety training, is highly limited despite their frequent presence in homes. Our objective was to investigate rural adolescents' use of firearms and whether they had received formal firearm training. Methods: A convenience sample of 2021 National FFA (formerly Future Farmers of America) Convention & Expo attendees were given an anonymous survey at the University of Iowa Stead Family Children's Hospital injury prevention booth. The survey explored their use of rifles/shotguns and handguns and whether they had completed a certified firearm safety course. Descriptive and comparative analyses, including multivariable logistic regression analyses, were performed on compiled data. Results: 3206 adolescents ages 13–18 years participated with 45% reporting they lived on a farm or ranch. The vast majority of participants (85%) had fired a rifle/shotgun; 43% reported firing them > 100 times. Of those that had fired rifles/shotguns, 41% had done so before 9 years old. Most had also fired a handgun (69%), with 23% having fired handguns > 100 times. Of those that had fired handguns, 44% had done so before 11 years. Average age for first firing rifles/shotguns was 9.5 (SD 3.1) years, and 11.1 (SD 3.0) years for handguns. Males, non-Hispanic Whites, and those living on farms or in the country had significantly greater percentages who had fired a rifle/shotgun or a handgun. Significant differences were also seen by U.S. census region. Over half (64%) reported having gone hunting. Of those that had used a firearm, 67% had completed a firearm safety training course. Overall, 23% were/had been members of a school or club shooting team and of these, 87% had taken a safety course. Conclusions: Most FFA member participants had fired both rifles/shotguns and handguns, many at very young ages. Significant differences in firearm use were noted by demographic factors including the home setting (i.e., farms and ranches) and their U.S. census region. Nearly one-third of adolescent firearm users had not received formal safety training. Promoting firearm safety should include advising families on when it is developmentally appropriate to introduce youth to firearms and on the importance of firearm safety training. [ABSTRACT FROM AUTHOR]

Understanding child maltreatment on a national level is complicated by lack of consistency in definitions of abuse and reporting by state. Adolescents experience child maltreatment, but responses to their maltreatment likely differ from younger children due to differences in development and vulnerability. The present study examined state variations of adolescent child protective systems reports using data from the 2015–2019 NCANDS. We calculated the rates of maltreatment reports, substantiations, and maltreatment subtypes per 1,000 adolescents in the population. Findings revealed wide variations across all three measured rates. Examining state variations involved with CPS is critical to informing policy and practice solutions. [ABSTRACT FROM AUTHOR]

In Lebanon, a country facing multilayered crises and an increase in reported cases of child maltreatment, the availability of a unified and comprehensive child safeguarding protocol in healthcare facilities remains limited. Healthcare providers are frontline in recognizing and detecting child abuse and neglect (CAN) cases in hospital settings. Therefore, the adoption of a child protection system in healthcare settings is much needed. We attempted to establish a program for child safeguarding identification, intervention and monitoring mechanisms in Lebanese teaching hospitals. Despite high levels of need, the establishment of this program faced major challenges in the context of multiple national emergencies. The latter included fragmentation of the child protection system and the collapse of the health sector. This paper aims to share these challenges and extract lessons learned for future implementation of a unified child safeguarding protocol in Lebanese hospitals. Key Practitioner message: In countries where child protection services are already fragmented, multilayered crises further weaken the system while CAN risks increase. We recommend:An implementation model based on a thorough needs' assessment and feasibility study.A close collaboration with stakeholders to prevent pitfalls.Setting a clear, simple and comprehensive referral system between the social and healthcare systems where frontliner staff in both sectors are trained.Adopt a paediatric disaster preparedness framework.Harmonizing national policies and procedures with NGOs and community [ABSTRACT FROM AUTHOR]

The article shares insight on preparing for social work practice. It recognizes the role of social workers in countering violence triggered by racism and remembers the legacy of community leader and former social worker Rhaune Laslett, particularly her leadership of the Voluntary Neighbourhood Service Unit. It points out the importance in social work education to develop an understanding of the exercise of power, as well as the need for professional development through research and training.

Developing sound evidence of program effectiveness can be difficult for many programs initiated by schools and communities, and impedes many beneficial programs from broader dissemination. This paper shares results of an evaluation approach used with a bullying and victimization prevention program with elementary school children called the radKIDS® Personal Empowerment and Safety Education Program. The purpose of this study was to examine indicators of initial effectiveness of the radKIDS® program for elementary school child safety skill development and instructor training to reduce child victimization and associated trauma and empower healthy psychosocial child development. The study involved 330 active radKIDS® instructors surveyed during two separate two-week periods, resulting in 148 completed questionnaires (45%). Instructors rated their perceptions of what children effectively learned in radKIDS®, the effectiveness of instructor training, and on Social Emotional Learning (SEL) competencies addressed in the program. Evaluation findings confirmed the theoretical model of the program, and that the developmental safety domains impacting children in radKIDS® differs from those in other bullying prevention interventions focused on SEL and other competencies. Recommended areas of improvement for the program included making training less time consuming and more flexible in delivery, provide more practice opportunities and time on skill acquisition during training, and increase supervision and guidance during program implementation. [ABSTRACT FROM AUTHOR]

BACKGROUND: Youth violence, victimization, and bullying are pervasive in schools across the United States and are detrimental for learning and healthy development. K‐12 school safety is an increasingly urgent issue to research and understand from multiple perspectives. Physical and psychological safety in school is linked to better student and school outcomes and is fundamental to fostering well‐being and prosocial behavior. METHODS: Despite research demonstrating positive outcomes associated with school safety, there is no comprehensive conceptual model in the literature that considers precursors, strategies, mechanisms, and outcomes of school safety together. The current paper presents an equity‐centered comprehensive model of school safety, which is intended as a holistic representation of the multiple factors and pathways that contribute to school safety and positive youth development. RESULTS: This model can guide research and practice through an equity‐centered and comprehensive approach. This model can enable practitioners, researchers, and policymakers to make informed decisions and reach consensus regarding planning and decisions related to reducing violence and establishing supportive school environments. CONCLUSION: Our model suggests that a comprehensive approach can ensure the safety and well‐being of students and staff. By thinking ecologically, schools, communities, and stakeholders can ensure that all aspects of the school context are included in school safety. [ABSTRACT FROM AUTHOR]

BACKGROUND: Unintentional injuries are the leading cause of morbidity and mortality among children and adolescents in the United States. Traditional injury education interventions for children often are inaccessible due to cost and logistics in underserved communities, exacerbating injury disparities. A new approach is needed to close this gap for families with preschool children. CONTRIBUTIONS TO THEORY: Collaborating with Head Start preschools optimizes engagement and accessibility to families in underserved communities. Involving caregivers and community organizations addresses the limitations of conventional interventions and community‐specific injury prevention concerns. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: Pop‐up Safety Town offers a more affordable model for injury prevention education, particularly in underserved regions. The model's approach, using adaptable education, mobile and reusable materials, and volunteer staffing, offers greater potential for achieving sustainable impact in these underserved communities. CONCLUSIONS: Pop‐up Safety Town presents a novel upstream solution to address disparities in injury prevention education in underserved communities. [ABSTRACT FROM AUTHOR]

This study was aimed at exploring the lived experiences of out-of-school children engaged in begging and scavenging in Pakistan. There is a dearth of existing literature in the context of Pakistan on out of school children who are engaged in begging, scavenging and other hazardous activities. The research also offers an extensive understanding of the responsible factors and possible consequences of engagement in these activities on out-of-school children. In this qualitative study, 21 out-of-school children of district Swat Pakistan aged 5 to 18 years, comprised of both boys and girls engaged in such activities were recruited through a purposive sampling. The respondents were interviewed using an interview guide, and the data was analyzed through a thematic analysis technique. The study was guided by poverty theories, including 'structure theory' and 'culture of poverty theory,' which served as the theoretical framework. The research findings reveal that child begging and scavenging are primarily caused by poverty, high inflation, forced labor, and earning responsibilities. The findings further suggest that these children are exposed to maltreatment, scolding, abuse, and exploitation which also create detrimental effects on their health. We also found some positive aspects of their experiences related to their contribution towards their families, their adaptability, and resilience in the face of many challenges. The study findings make a significant contribution to the existing literature on out-of-school children and their engagement in begging and scavenging activities in a less-explored cultural context of Pakistan. The study findings can be used to inform stakeholders, including policymakers, educational practitioners, and child welfare specialists about the requisite awareness, protection, and needs of at-risk children in Pakistan. [ABSTRACT FROM AUTHOR]

In India, child sexual abuse is a widespread, serious, and long-growing problem. Children are generally abused by the people known to them and less likely by strangers. A majority of people remain numb about the issues because of fear, denial from the community and social stigma and also result in less reported cases among the victims. Our aim was to assess early adolescent girl's knowledge on child sexual abuse and self-protection and assess the effectiveness of interactive education programs. For the study, we adopted one group of pre-test and post-test designs. A total of 30 early adolescent girls from a selected school participated. The intervention consisted of interactive education program using role-play, discussion, storytelling, and audiovisual aids. Knowledge about CSA and self-protection was assessed pre- and post-intervention. There were significant changes in the knowledge score of pre-test from post-test (t = -7.632, P < 0.001) following interactive sessions. Also, the mean for self-protection was significantly lower than the post-test mean. After the intervention, there were significant changes in the knowledge score of pre-test from post-test (t = -5.722, P < 0.001). The results also show that the education of parents and monthly family income had significant association with the pre-intervention knowledge level. Interactive education program effectively increases the knowledge level on CSA and self-protection. [ABSTRACT FROM AUTHOR]

Summary: This study evaluated the feasibility of 'Social Workers in Schools', an intervention that involved social workers being based within schools across three local authorities in England (SWIS). Schools make a large number of referrals to Children's Social Care and play an important role in recognizing risks to children and protecting them from harm, but it is unusual for social workers to be based in schools in the U.K. and to do statutory work. We evaluated the pilots on the basis of the feasibility of implementing SWIS, how promising it was in terms of reducing the need for statutory intervention, and the extent to which it be scaled. We used a mixed methods approach, with a process evaluation and a difference in differences analysis of indicative impact on key social care outcomes. In addition, we estimated the cost of implementing and maintaining SWIS. Findings: We found high levels of acceptability among those involved, and examples of how SWIS enhances the way safeguarding issues are addressed. There was also some evidence that it may reduce the need for social care interventions, though this needs ratifying with more and better data. Applications: The study suggests that SWIS is a promising intervention. Both the qualitative and quantitative findings suggest it may have the intended policy impact, but this needs to be tested on a larger scale and with a more rigorous counterfactual comparison. Such a study—a randomized-controlled trial involving 21 local authorities—was commissioned in 2020. [ABSTRACT FROM AUTHOR]

There are widespread concerns about the online harms to children operating online. As such, governments have enacted laws to require online service providers to deploy age verification to prevent such harms. We investigate the following three research questions regarding this topic: (1) To what extent have different governments legislated age verification controls? (2) Do governments embrace a responsibilization strategy when it comes to online age verification? and (3) How does the UK public feel about online age verification legislation? We find that governments are applying a responsibilization strategy, which has led to widespread deployment of privacy-invasive or ineffective age verification. The former violates the privacy of underage users, with the latter undermining the overarching aims of the legislation. We have also found general disengagement and a lack of trust in the government amongst the public with regards to new online age verification laws within the UK. To conclude, despite governments globally looking to put more robust online age verification mechanisms in place, there remains a general lack of privacy preservation and affordable technological solutions. Moreover, the overarching aims of the online safety and age verification legislative changes may not be satisfied due to the general public stakeholder group's disengagement and lack of trust in their government. [ABSTRACT FROM AUTHOR]

The article examines the evidence in addressing gaps and priorities in mental health provision from a child mental health service perspective across war conflicts, sociocultural systems and contexts. Topics discussed include the impact of war conflict and interventions on children and youth, the design and implementation of service provision in low- and middle-income countries, and the principles of service provision.

Sexuality education is important for children's well-being, peer relationships and safety, yet pre-teenagers and their diverse experiences have remained largely overlooked within the field. In Finland, the national curriculum obliges schools to prevent sexual harassment and homo- and transphobic violence, to provide knowledge on gender diversity, and to support children and youth in developing their sexuality and gender identities. However, there are severe deficiencies in sexuality education that reinforce heteronormativity and leave pre-teenage children to cope with the pressures of normative cultures on their own. Drawing on our creative praxis with Northern-Finnish pre-teenage schoolchildren aged 10–13 years, we explore the ways in which pre-teenagers' knowledge of age, sexuality and gender, including their diversity, are negotiated and how pre-teenagers disseminate this knowledge to their peers. We also analyse pre-teenagers' political expression with respect to non-normative genders and sexualities via our arts-based Friendship Workshops. Based on our analysis, we discuss ways in which to develop sexuality education that takes into account pre-teenage children, their diversity, and their safety. [ABSTRACT FROM AUTHOR]

Walking to school promotes the health of school‐aged children. The safety and comfort of the walking environment are lacking in China due to the prioritization of motorized traffic. This paper focuses on the choice of walking routes for school‐aged children commuting in old urban areas of China. A walking route choice model is constructed by combining a weighted Voronoi diagram and the closest facility analysis in ArcMap. The walking route choices of school‐aged children from home to school and the flows along routes are analysed. Based on the model results, targeted design suggestions for updating existing street spaces are proposed. [ABSTRACT FROM AUTHOR]

Burn injuries related to lithium-ion batteries from personal mobility devices, such as electric bikes and electric scooters, have emerged as a global concern. By examining the literature, this study aims to provide an overview of the demographics, patterns, and outcomes of personal mobility device-associated burns. A Singaporean cohort revealed burns resulting predominantly from fires occurring due to the combustion of unattended personal mobility device batteries during charging. In contrast, an Israeli cohort showed a higher total body surface area and highlighted the vulnerability of limbs to burn injuries in such incidents. A Beijing cohort, consisting of pediatric patients indicated potential child safety concerns regarding personal mobility device usage. Finally, a Shanghai cohort demonstrated the potential dangers of personal mobility device battery chargers. The observed differences between those experiencing burn injuries and the broader population of personal mobility device riders in terms of age and gender suggest that younger males may be at higher risk, perhaps due to risky practices such as leaving personal mobility devices unattended while charging. This review emphasizes the need for safety education, adherence to regulations, and responsible consumer choices to mitigate burn injuries. Recommendations include promoting child safety measures, using certified personal mobility devices, and cautious handling of DIY conversion kits. Further large-scale studies are essential to gain comprehensive insights and develop effective safety strategies to protect personal mobility device riders from burn injuries. [ABSTRACT FROM AUTHOR]

In its recent development, the Pictorial Scale of Perceived Water Competence (PSPWC) showed good face and construct validity. However, additional reliability and validity research is needed, including test-retest reliability and a demonstration of the relationship between PSPWEC test scores and actual water competence. Toward that aim, we administered the PSPWC to 124 children, aged 5–8 years. We repeated this test administration after one week for a subset of 55 children to determine its test-retest reliability, and the remaining 69 children also performed the fully aligned Actual Aquatic Skills Test (AAST) in an indoor swimming pool to provide data for our investigation of the relationship between PSPWC scores and actual water competence. We found good test-retest reliability, both at the global level (ICC = 0.81, n = 55) and at the level of individual skills (Weighted kappa coefficients from 0.58 to 0.90), with no significant differences between these two test scores. We also found a moderate positive relationship between PSPWC and AAST total scores (r =.64, n = 69), with no significant difference between total scores of actual and perceived water competencies. Children overestimated their competence in three specific skills: the back star, swimming on the front, and diving in deep water. While these results underline specific situations in which children's higher self-perceptions of their water competence are a risk factor for their water safety, these data confirm that the PSPWC is reliable for measuring children's perceived competencies in aquatic education and drowning prevention, and there is further support for its validity through a moderate correlation with actual water competencies. [ABSTRACT FROM AUTHOR]

Cycling remains a popular activity for children and youth around the world, combining the fun of moving at speed with numerous health and societal benefits. However, cycling is also associated with risk for serious injury and death. Over the past decade, research has increasingly shown that improving safety for cyclists depends, in large part, on the environment they are cycling in as well as on individual safety measures such as helmet use. The pandemic provided greater opportunity for many children and youth to engage in cycling, and refocused public attention on safer cycling infrastructure such as protected bike lanes. This statement reviews the evidence supporting safer cycling infrastructure for children and youth along with the physical and mental health benefits of cycling. The advantages of active transportation for young people, and how the built environment influences their cycling safety and uptake, are discussed. An overview of measures individuals can take to improve cycling safety is followed by recommendations for clinicians, the cycling community, parents, and policy-makers. [ABSTRACT FROM AUTHOR]

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Firearm injuries are the leading cause of death among children and adolescents in the US. Safe storage of firearms in the home is one of the most effective ways of preventing firearm injuries in children. This feasibility study was conducted in both the pediatric and general Emergency Departments of a large urban academic medical center in a community with high rates of firearm injuries in children. The objective was to pilot a survey seeking to describe sociodemographic characteristics, firearm specific risk factors, and firearm storage practices of households with children in the community. One hundred participants completed a survey containing items regarding participant demographics, household features, firearm ownership, firearm characteristics, and storage practices. Descriptive statistics were used to define sociodemographic characteristics of the enrolled population, comparing those with firearms to those without, and to describe firearms and storage practices of firearm owners in households with children. Of 100 participants, 30 lived in households with firearms and children. Most firearms in homes with children were stored locked and unloaded most of the time; however, 30% of participants with firearms and children in the home reported not consistently storing a firearm locked and unloaded. The most common reason given for not storing a firearm in the safest manner possible was that storing a firearm locked and unloaded would make it difficult to access quickly. Engaging families with children in discussions around firearm prevention during Emergency Department visits is feasible and may have implications for future efforts to promote safe firearm storage practices. [ABSTRACT FROM AUTHOR]

The implementation of human research involving children and adolescents necessitates a nuanced understanding of the distinct ethical complexities and sensitivities that arise. This study aimed to conduct a comprehensive review of ethical guidelines for research with these populations by extensively examining existing standards and applied studies. The review revealed a myriad of challenges inherent in the involvement of children and adolescents as research subjects. The most important ethical challenges relate to the principles of bioethics and their compliance with human studies involving children/adolescents, informed consent, and risk assessment in studies on children/adolescents. To facilitate appropriate participation of youth in research endeavors, meticulous planning is required, in conjunction with a re-examination of the definitions of ethical principles in pediatric research, close monitoring of potential risks and benefits, and the utilization of a combination of innovative and traditional approaches to obtain informed consent that adheres to ethical standards. Performing research with children and adolescents requires special considerations to address the unique ethical issues that can emerge. By adhering to ethical guidelines tailored specifically to these vulnerable populations, researchers can help ensure that studies are conducted in an appropriate and responsible manner. [ABSTRACT FROM AUTHOR]

This article examines the efficacy of a supportive housing program aiming to provide mothers in violent relationships with the practical resources to minimize child protection intervention. Drawing on qualitative interviews with program mothers, child safety officers, and program practitioners, we explore the extent to which the program enabled mothers and children to live free from fathers' violence and disengage from the child protection system. We find that, although valuable, the program did not fully mitigate the risks posed by violent fathers. We therefore argue that responsibility must be shifted onto violent fathers to change their behavior and build their parenting capacities. [ABSTRACT FROM AUTHOR]

In a recent issue of Child Maltreatment (2023 vol. 28 (4)), an editorial by Palusci et al. and a commentary by Briggs et al. were published. These two publications express the American Professional Society on the Abuse of Children (APSAC) Board's and the Child Maltreatment editorial team's stance relative to Diversity, Equity, Inclusion and Justice (DEIJ). The current commentary expresses a range of concerns regarding how APSAC and Child Maltreatment plan to advance DEIJ through their editorial policies. [ABSTRACT FROM AUTHOR]

When children are killed or seriously harmed from abuse or neglect, there is pressure to 'learn the lessons' to prevent similar events. England has a long-established system of locally-based multi-agency reviews for this, but the recurrence of tragedies and repetitive findings raise questions about its effectiveness. Reflecting and building on our research into reviews completed between 2017 and 2021, we analyse the complexity that routine criticisms of inter-agency working disguise, and argue that reviews are shaped by their multiple, competing functions. The stated purpose is to improve practice. Within this are other overt but ambiguous goals: establishing what happened, accountability, reassurance and commemoration. Then there are covert functions: to dissipate public outrage, deflect attention from underlying causes, and distort understandings of the work by making it seem straightforward. Reviews would benefit from paying more attention to the dynamics of frontline practice and the local actions to implement the lessons. [ABSTRACT FROM AUTHOR]

Background: Accidental suffocation and strangulation in bed continues to be a critical issue in Black communities, despite the widespread initiatives to promote safe sleep. Doulas are in an ideal position to promote safe sleep, particularly in hard-to-reach communities that are more distrusting of conventional medical providers. Little is known about their practices and perspectives for putting infants down to rest. This study informs this gap in the literature. Purpose: The purpose of this study was to explore doulas' perspectives and practices in the field of putting infants down to sleep. The researchers aimed to determine whether Black caregivers that work with doulas are likely to encounter safe sleep education. Methods: The researchers used a descriptive approach to inquiry. They conducted three focus groups with a total of 17 Black doulas. The researchers independently and critically reviewed the transcriptions and observation notes from each group to identify codes. They then triangulated the results using Artificial Intelligence-driven tools. Findings: The study found four themes: (1) Individualized Services, (2) Cultural Sensitivity, (3) Negotiating Safety, and (4) Safe Sleep Education. Conclusions: The study concluded doulas have a commitment to promoting safe sleep. The researchers found that doulas engage in practices that help caregivers to integrate safe sleep practices into their lifestyle and to adapt them to meet their needs. The researchers also documented a desire for more information and instruction on safe sleep among practicing doulas. Significance: Scholars recognize that doulas play a vital role in infant and maternal health in Black communities, but little is known about their role in promoting safe sleep. This study contributes to this knowledge base, revealing that doulas uphold a commitment to safe sleep practices and are integral in helping Black caregivers negotiate safe sleep. [ABSTRACT FROM AUTHOR]

The aim of this systematic integrative review was to review existing research on children in domestic violence shelters, and specifically to examine previous research on how shelters contribute to children's life situation after leaving a violent home. The review includes 28 scientific articles published between 1984 and 2021. These were thematically analyzed and discussed using a children's rights perspective to identify strengths and limitations in existing research and social work practice. The analysis resulted in five themes: (1) safety and security, (2) health, behavior, and support, (3) schooling, (4) spare time and shelter environment, and (5) social relationships. Safety and security is a theme of great importance, and if this aspects is lacking, it can adversely affect other areas of the children's lives. Overall, the children feel safe at the shelters, and they appreciate the playgrounds and activities offered by the shelter. They often make friends at the shelter. The children's right to be protected from violence appears to be prioritized, but the studies show the importance of also acknowledging children's rights to support, education, recreational time, and social relationships, to improve their life situation at the shelter. [ABSTRACT FROM AUTHOR]

BACKGROUND: Despite recommendations and laws for child restraint use in motor vehicles, evidence of low restraint use remains, and there is a lack of evidence addressing the effectiveness of restraint use education. OBJECTIVE: This project aims to measure the impact of an education initiative on child passenger restraint use. METHODS: This pre- and postintervention study was conducted in six elementary schools in a Southwestern U.S. metropolitan area over 5 months from October 2022 to March 2023. Motor vehicle restraint use was collected from occupants arriving at elementary schools during the morning drop-off times. Participants were provided one-on-one education regarding child passenger safety guidelines and state laws. Comparison data were collected 1–3 weeks later at the same schools to evaluate the education provided. RESULTS: A total of 1,671 occupants in 612 vehicles were observed across six schools, with 343 adults and 553 children preintervention and 306 adults and 469 children postintervention. Overall restraint adherence in children improved postintervention from 42.3% to 56.1%, a 32.6% increase (p = <.001). In the primary age group of 4–8 years, restraint adherence improved postintervention from 34.8% to 54.2%, a 55.8% increase (p = <.001). CONCLUSIONS: The study results demonstrate that one-on-one education increases child passenger restraint use. [ABSTRACT FROM AUTHOR]

Technology-facilitated child sexual abuse (TF-CSA), or child sexual abuse that occurs online or through electronic communication, is a preventable public health problem that can be addressed within youth-serving organizations (YSOs). This study is a review of a purposive sample of organizational policies and practices designed to prevent TF-CSA collected from 13 national and local YSOs in the United States. Documents were coded to identify practices to prevent TF-CSA related to YSO activities or YSO staff, volunteers, or participants. Qualitative analysis indicated that YSOs included seven common practices to prevent TF-CSA in their documents. These practices included transparent electronic communication between youth and YSO staff; codes of conduct and online behavior agreements related to youth; monitoring the YSO's online presence; parental controls for youth online activity; safety behaviors for online activity for staff, parents, and youth; parent and youth trainings for youth online engagement and prevention of TF-CSA; and practices to address staff policy violations. Most prevention practices documented by YSOs identified in this study are consistent with emerging literature on TF-CSA prevention. Key gaps include protections for youth from groups inequitably burdened by TF-CSA and evaluation of the implementation and effectiveness of practices in preventing TF-CSA across settings and populations. [ABSTRACT FROM AUTHOR]