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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]

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]

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]

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]

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]

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]

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]

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]

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]

Water safety skills are vital for the safety and well-being of all individuals but especially for individuals with autism spectrum disorder (ASD). Research regarding on-deck water safety behaviors and water safety skills for individuals with ASD levels 2 and 3 is limited. Therefore, the purpose of this study was to evaluate the effects of behavior analytic strategies in teaching water safety skills to children diagnosed with ASD level 2 and 3. A multiple-probe design across three participants was utilized in which participants did not enter intervention until their baseline data were stable and the participant before had stable intervention data. Each participant engaged in 100% of the measured water safety behaviors by the end of the study. The results suggest that this intervention may increase safe on-deck behavior in a community pool setting. Suggestions for future research and implications for practice are discussed. [ABSTRACT FROM AUTHOR]

This scoping review aims to summarize current research on help-seeking behaviors and patterns among children who have experienced commercial sexual exploitation of children (CSEC) victimization and/or are at high risk of exploitation. Because the literature on help-seeking specific to CSEC victimization is limited, the current review was expanded to summarize findings from help-seeking research for children who have experienced harms that often co-occur with CSEC, such as maltreatment and homelessness. The authors searched three large article databases (PsycInfo, Ovid MEDLINE, and Web of Science) for articles that were (a) empirical; (b) measured or used the term "help-seeking" in their framing and/or results; (c) included children between the ages of 12 and 18; (d) primarily focused on children from the United States; (e) published in English. Ultimately, 22 articles met all inclusion criteria and were included in the final review. Results suggest that cisgender white females are the most likely to seek help, followed by sexual and gender minority children. Cisgender male children were the least likely to engage in help-seeking behaviors. Universally, children were more likely to engage in informal help-seeking rather than formal help-seeking, with younger children being more likely to reach out to parents and older children more likely to reach out to friends. Importantly, ethnically diverse children were under-represented, leading to limited information about how and why these children seek help. Implications for help-seeking by children impacted by commercial sexual exploitation are discussed, providing guidance for programming and research related to CSEC prevention. [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]

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]

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]

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]

Recently, there have been reports of children without placement (CWOP) in foster care, often resulting in youth sleeping in hotels or child protective service offices. This study explored perspectives of the current crisis among child welfare practitioners who managed CWOP cases. We conducted interviews with 11 child welfare practitioners who had graduated from two universities in a Southern state. Themes aligned with the trauma-informed framework and highlighted challenges related to organizational climate, workforce development, and trauma-informed services. Implications include strategies for cross-sector collaboration, specific training, and continued research to support a healthy, trauma-informed workforce that can better meet youth needs. [ABSTRACT FROM AUTHOR]

Research has documented trends in bullying victimization for sexually diverse adolescents in the US, but trends regarding school social unsafety are understudied and there is a dearth of research examining these trends for gender diverse adolescents. This study aimed to identify disparities in bullying victimization and feelings of social unsafety in schools for sexually and gender diverse adolescents. Data stem from the 2014 (N = 15,800; M age = 14.17, SD = 1.50), 2016 (N = 22,310; M age = 14.17, SD = 1.49), and 2018 (N = 10,493; M age = 14.02, SD = 1.52) survey cycles of the Social Safety Monitor, a Dutch cross-sectional school-based study. Findings indicate that sexual orientation disparities remained relatively small, but stable over time, while gender diverse adolescents remained more likely to be victimized and feel unsafe in school, with larger disparities overall. Monitoring these trends is highly relevant, especially considering recent negative developments regarding societal acceptance of sexual and gender diversity. [ABSTRACT FROM AUTHOR]

Global guidelines emphasize the critical role of responsive caregiving in terms of reducing violence against children and promoting early childhood development. However, there is an absence of global evidence synthesis on the effects of early childhood parenting programs for children with developmental disabilities. This systematic review and meta-analysis aims to investigate the effectiveness of parenting interventions delivered for preschool-age children with developmental disabilities in reducing violence against children, altering violence-related factors, and promoting child development. We searched for randomized controlled trials with inactive control. Estimates were pooled using robust variance estimations. Meta-regressions were conducted to explore sources of heterogeneity. In all, 33 studies met the inclusion criteria. The results showed that parenting programs improved child behavior, parental mental health, parenting practices, parental self-efficacy, parent–child interaction, child language skills, and child social skills post-intervention. No studies provided data on the actual occurrence of violence against children. Effects might vary by diagnosis, delivery modality, and world region. The findings supported the delivery of parenting programs to alter factors associated with violence against children and promote child language and social skills for families of young children with developmental disabilities, especially attention deficit hyperactivity disorder, autism, intellectual disability, and language disorders. More research using rigorous methods, long-term follow-ups, and transparent reporting is needed, particularly within more low- and middle-income countries. [ABSTRACT FROM AUTHOR]

Purpose: School social work, in various forms, is well established internationally and has a growing evidence base. Yet existing research focuses on professional perspectives rather than those of students. This study aims to fill this gap by exploring secondary school student perspectives of having social workers in schools (SWIS). It was undertaken in England as part of the SWIS trial, which tested whether secondary school-based social workers could improve child safety and well-being, identify issues more quickly and reduce the need for statutory services. Design/methodology/approach: A mixed-methods approach comprised a survey (n = 1,998 students) and interviews (n = 27 students). Surveys included questions on awareness, understanding, interaction with and attitudes towards the school-based social workers. Interviews involved a Q-sort activity followed by semi-structured questions on general attitudes and experiences. The Q-sort characterised prominent perspectives and how many students subscribed to them. Findings: Students were broadly positive about having a social worker in their school in the survey and interviews. Two prominent perspectives on SWIS were identified. The first (n = 17) was defined by students feeling positively overall and strongly agreeing that they trusted the social worker. The second (n = 4) was mixed in sentiment, defined by some anxiety about working with the social worker. In interviews, students relayed that social workers were easily accessible, offered emotional support and acted as a bridge between school and home. Originality/value: To the best of the authors' knowledge, this study is the first to quantify student perspectives on having social workers at school and evidence attitudes and experiences about school-based social work as practiced during the SWIS trial. [ABSTRACT FROM AUTHOR]

This article explores the synergies between relationship‐based practice and contextual safeguarding when working with young people experiencing extra‐familial risk and harm (EFRH). The article draws on data from interviews, observations, policy reviews and case files from two sites in England who are testing contextual safeguarding approaches to EFRH, including a children and families social work department and a voluntary and community sector organisation. The findings evidence how relationship‐based practice in contextual safeguarding facilitates practitioners' understanding of places and their peers. The discussion draws on the theory of social defences to evidence that despite willingness and commitment to relationship‐based practice, without systemic and cultural organisational support to respond to EFRH, efforts to do so may undermine and cause harm to practitioners engaging in this work. [ABSTRACT FROM AUTHOR]

Purpose: Our objective was to investigate rural adolescents' use of firearms and whether they had received firearm training. Methods: 2019 Iowa FFA Leadership Conference attendees were surveyed. Descriptive and comparative analyses were performed. Results: One thousand three hundred and eighty‐two FFA members aged 13‐18 years participated. The vast majority (85%) had fired a rifle/shotgun; 58% reported firing them >20 times. Of those who had fired rifles/shotguns, 32% had done so before 9 years old; 79% before 13 years. Most had also fired a handgun (62%), with 30% having fired handguns >20 times. Of those who had fired handguns, 34% had done so before 11 years old. The average age for first firing rifles/shotguns was 10.1 (SD 2.9) years, and 11.9 (SD 2.8) years for handguns. Males, older teenagers, and those living on farms or in the country had significantly greater percentages that had fired a rifle/shotgun or a handgun. Greater proportions of males had used firearms >20 times and started firing them at younger ages. Over half (55%) reported having gone hunting. Of those, 24% first hunted before 9 years old; 48% before 11 years. Of those who had used a firearm, 61% had completed a firearm safety training course. For hunters, 80% had taken a course. Conclusions: Most participants had used firearms, and many did so at very young ages. Substantial numbers had not received formal training. The authors believe that families should be counseled when it is developmentally appropriate to introduce youth to firearms, and all should take firearm safety training before using them. [ABSTRACT FROM AUTHOR]

The Family Intensive Treatment (FIT) team model provides intensive team-based, family-focused, comprehensive services to families in the child welfare system with parental substance misuse issues. The current evaluation study examined the effect of FIT on child safety, permanency, and parental wellbeing. A longitudinal quasi-experimental design with a two-group comparison using propensity score matching was used. Compared to a group of similar parents/caregivers receiving child welfare services (N = 2976), parents/caregivers who received FIT (N = 3025) were less likely to have new allegations of child maltreatment within 6 and 12 months after participating in the FIT program. There was no significant association between FIT receipt and recurrence of verified (i.e., substantiated) maltreatment: the rates of verified maltreatment were very similar for the parents/caregivers in the FIT group and the parents/caregivers in the comparison group. Similarly, no significant differences were found when the rates for foster care reentry were examined. In contrast, children of parents/caregivers who received FIT achieved permanency faster and at a greater rate compared to their counterparts. In addition, participation in the FIT program predicted improvement in parental/caregiver emotional protective capacity and overall protective capacity and showed a positive tendency in improvement of parental/caregiver behaviors related to their protective role. Finally, parents/caregivers who received FIT demonstrated significant improvements over time in several wellbeing domains including Daily Living Activities, Mental Health and Addiction, and Adult and Adolescent Parenting. [ABSTRACT FROM AUTHOR]

The processes used by social workers to collect, interpret and use stakeholder information in child protection cases are an unexplored but essential part of the decision-making process. This study focuses on social workers' efforts to integrate the knowledge of other professionals. This article draws on a framework for managing knowledge across organisational boundaries and a process-oriented conceptualisation of knowledge integration. The analysis of ten interviews with social workers shows that the process of knowledge integration affects the basis of social workers' decision making. We argue that knowledge possessed by other professionals is often viewed as easily transferrable and correctly received, when in fact this knowledge is often complex and subjective and requires extra effort to obtain, understand and integrate into case-specific situations. This implies a need to recognise information processing as an influencing factor in decision making within child protection that pertains to both practice and research. [ABSTRACT FROM AUTHOR]

Background: Access to a coordinated range of strengths-based, culturally appropriate community-led primary mental health and Social and Emotional Wellbeing services is critical to the mental health and wellbeing of young Aboriginal and Torres Strait Islander people, and is a policy commitment of the Australian government. However, complex and fragmented service networks and a lack of standardised service data are barriers in identifying what services are available and what care they provide. Method: A standardised service classification tool was used to assess the availability and characteristics of Social and Emotional Wellbeing services for young Aboriginal and Torres Strait Islander people in two regions in Queensland, Australia. Results: We identified a complex pattern of service availability and gaps in service provision. Non-Indigenous non-governmental organisations provided a significant proportion of services, particularly 'upstream' support, while Aboriginal Community Controlled Organisations were more likely to provide 'downstream' crisis type care. Most services provided by the public sector were through Child Safety and Youth Justice departments. Conclusions: Our findings demonstrate the complexity of current networks, and show that non-Indigenous organisations are disproportionately influential in the care received by young Aboriginal and Torres Strait Islander people, despite community goals of self-determination, and government commitment to increasing capacity of Aboriginal Community Controlled Organisations to support their local communities. These findings can be used to support decision making and planning. [ABSTRACT FROM AUTHOR]

National and state governments in settler colonial countries are increasingly committing to policies and practices aimed at strengthening Indigenous frameworks, programmes and leadership in child protection services. However, research‐based information on Indigenous child welfare services and programmes is sparse. This qualitative literature review explores and documents key features of Indigenous child welfare and protection models and/or frameworks in an international context, with a specific focus on Indigenous children, young people, families, and communities. Twenty‐four publications meeting the inclusion criteria were included in the analysis. Published frameworks, models, services, interventions and/or programmes within the broader area of child welfare and children protection that are Indigenous‐designed and/or led or developed in partnership or collaboration with Indigenous peoples were identified. The review highlights 11 key dimensions that underpin the frameworks, models, services, interventions and/or programmes. Findings of the review also reveal commonalities across Indigenous cultures and contexts that from an Indigenous perspective are considered fundamental to supporting Indigenous children, young people and families involved with child protective services. Additionally, the findings point to the critical need for ongoing advocacy for Indigenous‐designed and led services and programmes, including support for Indigenous research, evaluation and intellectual leadership. [ABSTRACT FROM AUTHOR]

In 2018, the child welfare system in Ontario, Canada, expanded the age of protection to include 16 and 17 year olds for the purpose of mitigating risk of harm for older adolescents. To date, there is little information regarding investigations of older adolescents, particularly in Ontario; this study will address this gap. Data used for this analysis were drawn from the Ontario Incidence Study of Reported Child Abuse and Neglect‐2018. The Ontario Incidence Study of Reported Child Abuse and Neglect‐2018 sample data were weighted to derive an annual incidence estimate of 155 649 maltreatment‐related investigations conducted in Ontario in 2018. Child, caregiver, household, and investigation characteristics were compared across three age groups: children (0–10), younger adolescents (11–15), and older adolescents (16–17). Characteristics and differences in the likelihood of a service response (referral to nonchild welfare services, transfer to ongoing child welfare services, or placement in out‐of‐home care during the investigation) were examined descriptively and using chi‐square automatic interaction detection. Half of investigations involving older adolescents received a service response, and they were more likely to receive a service response when there were concerns about future risk of harm, where there were concerns about the relationship between the adolescent and their caregivers, where internalizing or externalizing symptoms were noted, where caregivers had few social supports, and where the household experienced economic hardship. These findings suggest that older adolescents are being triaged for circumstances that reflect concerns about their vulnerability, including mental health needs, attachment concerns, and caregiver isolation. [ABSTRACT FROM AUTHOR]

Summary: Background: Food and nutrition security interventions have been demonstrated to optimize health, prevent and treat chronic diseases among adult populations. Despite the increasing prevalence and intersection of food insecurity and childhood obesity in the United States, there are few food and nutrition security interventions targeted to children and families. Objectives: The primary purpose of this phase I randomized, crossover trial was to assess the safety, acceptability and satisfaction of a meal kit delivery program among children with obesity living in households with food insecurity. Secondarily, we assessed the feasibility of our study design, recruitment and retention to inform future larger scale trials. Methods: We delivered 6 weeks of healthy meal kits, which included fresh pre‐portioned ingredients and simple picture‐based recipes (two recipes/week) in English or Spanish to prepare one‐pot, under 30‐min meals (after preparation ~ 10 servings/week). Results: Caregivers received and prepared the meal kits and reported overall satisfaction with the meal kit delivery program. Conclusion: A meal kit delivery intervention for children with obesity and food insecurity is acceptable and a phase I randomized, crossover trial is feasible. [ABSTRACT FROM AUTHOR]

Background: Newborns of parents with intellectual disabilities face higher risks in their environment for child unsafety, despite parents' good intentions. To help parents prevent unsafe circumstances, a good understanding of the risk factors faced by these parents is needed. Methods: This casefile study examined (1) which risk factors were present for expectant parents with intellectual disabilities in child protection, (2) which domains of risk factors, and (3) whether a cumulation of risk factors was related to child safety. Results: Expectant parents with intellectual disabilities in child protection before the child was born often experienced a cumulation of risk factors. Child, family, and care factors best predicted child safety. A cumulation of risk factors over multiple life domains increased the risks for child unsafety. Conclusions: To reduce the risks of unsafe parenting conditions for newborns, preventive interventions for expectant parents with intellectual disabilities should address their needs from an ecological perspective. [ABSTRACT FROM AUTHOR]

We examined the Life Model of residential care for trauma-affected foster youth with life-skill deficits. Staff interviews described implementation. The Community-Oriented Programs Environment Scale, completed by youth and staff, assessed the care environment. The Child Assessment of Needs and Strengths, the Life Assessment, and discharge data were available for 42 youth. Results from the COPES indicated moderate-high scores on relationship, personal growth, and system maintenance. Paired-samples t-tests showed improvements in functioning, behavioral/emotional needs, and strengths. RMANOVAs of the Life Assessment showed youth experienced growth in spirituality/culture, education, vocation, and overall development. Most youth discharged to family-based placements or independent living. [ABSTRACT FROM AUTHOR]

Recent changes to the law in England require all primary schools to teach Relationships Education and all secondary schools to teach Relationships and Sex Education (RSE). Our focus in this article is on the voices of teachers and other educational professionals in relation to this change. Discussion in three focus groups held with 16 educational professionals, indicated concerns regarding some of the challenges associated with the implementation of the new legal requirements, as well as recognising fresh opportunities afforded to teachers for engaging with children and young people. Through analysis, it was noted that participants considered how lessons on relationships and sex should cover LGBTQ+ (lesbian, gay, bisexual, transgender, queer/questioning, others) issues, with strategies advanced for building bridges between schools and parents/communities. Our research indicates a difference between the importance of Relationships Education/RSE and the perceptions of those charged with teaching it, as well as the view that the laudable aims underpinning the new provisions in England will only be realised if appropriate support and training is given to teachers. [ABSTRACT FROM AUTHOR]

Using original data, this article explores the ethical issues that arose during a school 'life histories' study of 'lower‐attaining' of 23 primary school pupils in England, from age seven until they were aged 12 and attending secondary school. These children were viewed as being particularly vulnerable, not only due to their age but also due to being designated as 'lower‐attaining' in English and maths by their teachers, alongside the fact they were participating in a longitudinal study. The research involved 230 interviews, class observations and filming. This article seeks to answer the question: 'How can a researcher minimise causing harm whilst conducting interviews with particularly vulnerable children'? Formerly, the fear of causing harm to vulnerable children has at times led ethics review boards to be overly cautious about vulnerable children participating in empirical research. Yet conversely this caution has denied these children their participatory rights and their opportunity to contribute to expanding our knowledge about particularly vulnerable children. The article considers the ethical issues that arose before data collection especially in relation to dealing sensitively with the fact the children were designated as being 'lower‐attaining'. It also considers the ethical issues that arose during data collection in relation to safeguarding issues and distress occurring during an interview. The significance of this article is in its honest deconstruction of these ethical issues, including the research team's responses to them. Several practical recommendations are made to aid researchers to help to minimise causing harm when conducting research among particularly vulnerable children. [ABSTRACT FROM AUTHOR]

Background: Children with medical complexity (CMC) have unique, and often unmet, housing needs that place them at risk for housing insecurity and poor health outcomes. Yet, little is known about how families with CMC discuss their housing needs with healthcare providers. We sought to understand: (1) how housing is currently discussed between CMC caregivers and healthcare providers, and (2) how CMC caregivers want such conversations to occur. Methods: From August to November 2020, we conducted semi‐structured interviews with parents/guardians of CMC (<26 years old) in Maryland as part of a larger study to understand their housing experience. Four questions on communication with providers about housing were developed a priori and included in this analysis. Qualitative content analysis was applied to interview transcripts. Results: Among 31 completed interviews, most participants were female (90%), lived in single‐family homes (68%) and were from a mix of neighbourhood types (urban 19%, suburban 58%, rural 22%). Their children ranged in age from 6 months to 22 years, had a mix of insurance types (public 65%, private 29%, both 6%) and nearly all required medical equipment or technology. Four themes emerged: (1) Current housing conversations are rare and superficial, (2) Ideal housing conversations would result in thoughtful care plans and concrete supports, (3) Frequency and initiation of housing conversations are best tailored to family preferences and (4) Value of housing conversations are limited by lack of provider knowledge and time. Conclusions: Conversations about housing needs for CMC happen in limited ways with healthcare providers, despite a desire on the part of their caregivers. Such conversations can give meaningful insights into the family's specific housing challenges, allowing providers to appropriately tailor care plans and referrals. Future work is needed to capture provider perspectives, design CMC‐specific housing screeners and develop interdisciplinary referral strategies. [ABSTRACT FROM AUTHOR]

This paper focuses on art productions by children participating in an art-based wellbeing intervention project in Kashmir. Drawing on feminist security studies, we conducted narrative analysis to explore how children represent in/security. The locations of in/security were the environment, the body, and the socio-political realm. Children articulated nuanced and complex representations of the natural and social world, influenced by local and global forces, and created their own meanings and practices of in/security. [ABSTRACT FROM AUTHOR]

This study assessed the effectiveness of Safe@Home, an in-home intervention to (1) prevent out-of-home placement for children at imminent risk of placement, and (2) minimize time in out-of-home care for children already in foster care. Using Coarsened Exact Matching, children who received Safe@Home were matched to a comparison group of children served before Safe@Home was available in their community. All children were determined by the child welfare agency to be unsafe and in need of immediate intervention. The matched samples (Safe@Home n = 510, Comparison n = 851) showed strong baseline equivalence on child age, race/ethnicity, previous history of child welfare involvement, and safety threats. Children who received Safe@Home experienced lower rate of out-of-home placements, higher rate of permanency with a parent (sustained for 12 months after the end of Safe@Home), fewer days in out-of-home care, and shorter time to case closure relative to children who received treatment as usual. There was no effect of Safe@Home on post-permanency outcomes of maltreatment and entry or re-entry after case closure. [ABSTRACT FROM AUTHOR]

This article discusses findings from a qualitative study designed to evaluate the effectiveness of a Child Sexual Exploitation (CSE) awareness-raising programme targeted at young people. Drawing on data from in-depth interviews with practitioners involved in a multi-agency team established to reduce vulnerability to CSE, we elucidate that, in addition to being directed by professional codes, practitioners' perceptions and judgements were also influenced by gendered assumptions and underlying anxieties about childhood sexuality. The empirical data presented suggest that attitudes towards young people and intervention decisions are partially steered by cultural values that connect not only to personal morals but also influence decisions made in conjunction with professional risk analytic frameworks. Our analysis indicates that broader investigation of the commingling of personal and professional values in safeguarding contexts is required, alongside the creation of protected spaces for professional reflection and dialogue amongst practitioners to support decision-making. [ABSTRACT FROM AUTHOR]

This paper concerns parenting assessments which are integral to child-safeguarding professional processes in England, and which involve Deaf parents whose primary language is British Sign Language (BSL). In an under-researched area of social work, the research aim was to contribute to the existing literature by eliciting the practice wisdom of specialist professionals. Specifically, it draws upon their linguistic and cultural knowledge of the Deaf community when they are involved in parenting assessments with Deaf parents who are subject to safeguarding concerns. Data about these professionals' actual experiences of navigating Deaf cultural-competency in contemporary child protection practices were collected through seven video-recorded, semi-structured interviews conducted in BSL. Using interpretive phenomenological analysis, data were analysed in their source language (BSL). This article focusses on one key theme, termed 'Professional Recognition', which incorporates a) the identification of specialist roles and b) the impact of referral processes and protocols on assessment outcomes. The findings highlight participants' perspectives on the benefits and disadvantages of their specialist role in this context. Although their brokerage skills, cultural competence, linguistic fluency and specialist knowledge of the Deaf community are highly regarded and valued by some colleagues, there is insufficient recognition of their existence by the majority. Secondly, participants are concerned by the inefficiency and inconsistency of the referral processes and protocols which they consider have adverse effects on assessment outcomes, and consequently the parents involved. [ABSTRACT FROM AUTHOR]

Human milk (HM) is a highly evolutionary selected, complex biofluid, which provides tailored nutrition, immune system support and developmental cues that are unique to each maternal–infant dyad. In the absence of maternal milk, the World Health Organisation recommends vulnerable infants should be fed with screened donor HM (DHM) from a HM bank (HMB) ideally embedded in local or regional lactation support services. However, demand for HM products has arisen from an increasing awareness of the developmental and health impacts of the early introduction of formula and a lack of prioritisation into government‐funded and nonprofit milk banking and innovation. This survey of global nonprofit milk bank leaders aimed to outline the trends, commonalities and differences between nonprofit and for‐profit HM banking, examine strategies regarding the marketing and placement of products to hospital and public customers and outline the key social, ethical and human rights concerns. The survey captured information from 59 milk bank leaders in 30 countries from every populated continent. In total, five companies are currently trading HM products with several early‐stage private milk companies (PMCs). Products tended to be more expensive from PMC than HMB, milk providers were financially remunerated and lactation support for milk providers and recipients was not a core function of PMCs. Current regulatory frameworks for HM vary widely, with the majority of countries lacking any framework, and most others placing HM within food legislation, which does not include the support and care of milk donors and recipient prioritisation. Regulation as a Medical Product of Human Origin was only in place to prevent the sale of HM in four countries; export and import of HM was banned in two countries. This paper discusses the safety and ethical concerns raised by the commodification of HM and the opportunities policymakers have globally and country‐level to limit the potential for exploitation and the undermining of breastfeeding. Key messages: The number and scope of human milk (HM) profit‐making companies is increasing globallyCurrent regulatory frameworks for HM vary widelyProducts offered by private milk companies (PMCs) are generally more expensive than from HM banksSome PMCs are adopting marketing practices traditionally associated with breast milk substitute companies.The health benefits of HM‐based fortifiers compared to bovine milk‐based fortifiers are unclear and may be marginal [ABSTRACT FROM AUTHOR]

The low participation of nonresident fathers in family- and child-oriented social work interventions is well documented, as are the adverse effects of their absence on the outcomes of these interventions and the welfare of their families. However, research on the reasons for this low participation tends to focus on the views and perceptions of social workers and fathers. We propose a systemic approach focusing on families rather than fathers, and institutional aspects of the welfare system, such as workplace culture and administrative barriers, rather than social workers' views. Using an institutional ethnography in six Israeli Departments of Social Services, we examined work procedures and routines with regard to separated families in Israel's social welfare and child protection system. Our findings show that social workers often fail to include nonresident fathers in their interventions with separated families. Using the theoretical framework of the mother-based intervention, we show how the organisation of services promotes a focus on mothers. These findings, we claim, have dire consequences for both fathers and mothers. Fathers are denied the opportunity to take an equal part in the lives of their children, while mothers are expected to bear the entire burden of the intervention's requirements. [ABSTRACT FROM AUTHOR]

Drowning remains a prominent global pediatric health concern, necessitating preventive measures such as educational initiatives for children and caregivers. In this study, we aimed to assess the feasibility and educational effectiveness of an interactive puppet show centered on teaching water safety to children and parents. A 30 min original theater performance, featuring two actors and three puppets (a girl, a crab, and a lifeguard), was conducted. Subsequently, 185 children (aged 4 to 8) and their 160 parents (134 mothers and 26 fathers) participated in this quasi-experimental study. Pre- and post-show tests were administered to evaluate knowledge and behaviors regarding aquatic environments. Prior to the puppet show, 78% of the children exhibited basic aquatic competency. Only 33% considered swimming alone risky. Following the intervention, 81.6% of the children changed their perception of the risks of solo beach activities, showing improved knowledge regarding contacting an emergency number (from 63.2% to 98.9%, p < 0.001). The intervention increased parents' intention to visit lifeguard-patrolled beaches and improved their CPR knowledge with regard to drowning victims by 58.8%. In conclusion, a drowning prevention puppet show positively impacted children and parents, potentially enhancing safety behaviors during water-related leisure activities, warranting its consideration part of comprehensive drowning prevention strategies. [ABSTRACT FROM AUTHOR]