5-year Olds Research Articles

‘Until now, nobody’s ever actually said straight out how do you feel about them’: children’s experiences of the impact of high-stakes testing through participatory methods

ABSTRACT Research into the impact of high-stakes testing is often adult-centric. Using participatory methods with 10–11-year olds, this paper demonstrates how research with children provides a more nuanced understanding of the impacts of high-stakes testing on wellbeing, curriculum and pedagogy. This paper also demonstrates how children have an implicit understanding of the mechanisms of neoliberalism and how these mechanisms lead to competition with peers, which can exclude lower attaining children. We recommend further participatory research with children to inform wider policy and that schools develop children’s emotional literacy to help them to manage peer relations around high-stakes testing.

The influence of valence and relationship on children's verification of gossip.

Given that children do not always trust gossip, do they spontaneously check what they are told? We provided 5- (N = 32) and 6-year olds (N = 32) with gossip concerning characters in a cartoon they were watching, and examined whether they verified the gossip by actively re-watching the relevant episodes. Six-year olds were more likely to verify gossip than 5-year olds. When gossip targeted their favourite characters, children were more likely to verify negative when compared with positive gossip. However, when gossip targeted children's disliked characters, they showed no such valence bias. These results indicate that children's verification of gossip increases with age, and they evaluate claims selectively.

The Global Adolescent Fertility Decline is Counteracted by Increasing Teen Births in Sub-Saharan Africa.

There is a lack of understanding of the persistence of elevated teen fertility rates in certain regions and countries, in contrast to the significant decline observed in other regions globally. This report considers fertility trends among 15- to 19-year olds in the period 1950-2020 and explores potential driving factors behind the significant shifts that occurred over this period. The countries where teen fertility remains high are those with fast-growing populations, primarily located in sub-Saharan Africa. Countries with higher teen fertility are typically characterized by limited use of modern contraception, lower education levels, and early marriage. Sub-Saharan Africa has emerged as the world region with the most teen births, increasing its proportion of global teen births from 12 percent in 1950 to 47 percent in 2020, a time during which this region's share of the global adolescent (15-19) population grew from 7.5 percent to 19 percent. By 2035, 67 percent of all teen births globally are projected to occur in this region. Consequently, the future number of births to teenage mothers will to a large extent depend on the development in sub-Saharan Africa over the coming decades.

Reflective practice and feedback – empowering university students’ teaching of dance in UK state schools

ABSTRACT A mixed methods approach for gathering data was adopted to report Level 5, 2nd (N = 34; F27, M7) and Level 6, 3rd (N = 29; M5, F24) year University students’ (N = 63) reflections of dance practice at Leeds Beckett University in the north of England. Five research instruments were utilised to gather data: questionnaires (including both open and closed questions), semi-structured interviews, reflective logs, pictorial evidence and observations. Reflections from practising primary (N = 9; F7, M2) and secondary (N = 8; M1, F7) teachers and their young people (N = 904, 5 to 18-year olds) also informed the students’ practice. The students’ production of original dance teaching resources (N = 17) delivered at the University based professional development days, attended by delegates (N = 121) from across the UK, served to qualify the suitability of the teaching and resources. The collaboratively created resources are highlighted as beneficial to enhance learning, teaching, self-efficacy, resilience and employability. The main aim and question therefore being realised, how to support and enhance the learning and teaching of dance in UK schools.

Worth a Shot: Experience and Lessons From an Unsuccessful Pediatric Immunization Quality Improvement Effort in a Large Health System During the COVID-19 Pandemic.

During the coronavirus disease of 2019 (COVID-19) pandemic, routine childhood immunization rates dropped dramatically across the world, and the Military Health System (MHS) was no exception. In the MHS, which is a large, universally covered, low-to-no-cost health system, the immunization rates with the measles, mumps, and rubella (MMR) vaccine remain below the rate necessary to prevent community transmission of measles. We aimed to improve childhood immunization rates in the MHS with an expansive quality improvement project. Measles, mumps, and rubella immunization rates served as proxy outcome measures for routine immunization rates tracked by the Center for Disease Control multi-immunization combination measures. The tracked measure was the percentage of 16- to 18-month olds and 6-year olds who had received MMR #1 and MMR #2, respectively. Various countermeasures were implemented throughout the study period, and standard quality improvement analyses informed the effect of countermeasures. By January 2023, the percentage of 16- to 18-month olds and 6-year olds who had received MMR #1 and MMR #2 was 85% and 91%, respectively, with no positive shift in immunization rates despite various countermeasures introduced during the study period. For reference, the MMR immunization rates of commercial health maintenance organization and commercial preferred provider organization for 24-month-old populations were 92% and 90.3%, respectively. On chart review, the most common cause for under-immunization (55%) was vaccine abandonment. MMR #1 rates rose to 92% in 24-month olds. Measles, mumps, and rubella immunization rates within the MHS remained below commercial health system rates and below public health standards required for herd immunity despite various countermeasures throughout the COVID-19 pandemic. Immunization rates increased with age, suggesting that children within the MHS eventually catch up despite potential barriers.

Recovery from Addiction on a University Campus – a UK Perspective

ABSTRACT Between 30 and 40% of 18-year olds in England, Wales and Northern Ireland enter tertiary education (university) each year. Young adulthood (ages 15 to 25) is the usual period in which problems with alcohol, drugs or other behaviors begin to emerge, and yet these issues have received limited study in the UK. Government policy dictates that a full continuum of treatment and recovery services should be available in each area of the country, but uptake of these services by university students appears to be limited. In this discussion paper we describe the background to, and components of, the Collegiate Recovery Program (CRP), an initiative that has grown rapidly in the USA in the past decade. We then describe how the first UK University-led CRP was set up, before outlining what has been learnt so far and the potential challenges facing this approach.

The Prevalence of IgE-Mediated Food Allergy and Other Allergic Diseases in the First 10 Years: The Population-Based, Longitudinal HealthNuts Study

There are limited longitudinal data on the population prevalence of allergic conditions during childhood, and few studies have incorporated the reference standard oral food challenge to confirm food allergy. To describe the population prevalence of IgE-mediated food allergy, eczema, asthma, and rhinitis at ages 6 and 10 years in Melbourne, Australia. The HealthNuts study recruited 5,276 1-year-old infants in Melbourne, Australia, with repeat assessments at ages 6 and 10 years. At ages 6 and 10 years, carers completed a questionnaire on symptoms and doctor diagnosis of allergic conditions (International Study of Asthma and Allergies in Children). Children were invited to attend a clinic assessment including skin prick test, lung function tests, and oral food challenges when indicated. To minimize the impact of attrition bias, prevalence estimates among participants at ages 6 and 10 years were weighted to reflect characteristics of the whole cohort at recruitment. In total, 4,455 and 4,065 families participated at ages 6 and 10 years, respectively (84% and 77% of the original cohort). Of those, 73% and 55% of participants ages 6 and 10 years, respectively, completed clinical assessments. Overall, 36.5% (95% CI, 34.8-38.2) and 38.2% (95% CI, 36.5-40.1%) of 6- and 10-year-olds had at least one current allergic disease, and around one third of those had two or more allergic diseases. Food allergy occurred in 6.4% (95% CI, 5.6-7.2) of 6-year olds and 6.3% (95% CI, 5.5-7.2) of 10-year-olds. Among infants with challenge-confirmed food allergy in infancy, 45% had persistent disease at age 10 years. The prevalence of current diagnosed asthma at ages 6 and 10 years were 12.1% (95% CI, 10.9-13.3) and 13.1% (95% CI, 11.9-14.4), respectively, current eczema decreased slightly from 15.3% (95% CI, 14.1-19.7) at age 6 years to 12.9% (95% CI, 11.7-14.2) at age 10 years, and current rhinitis increased from 15.1% (95% CI, 13.9-16.5) at age 6 years to 25.0% (95% CI, 23.4-26.7) at age 10 years. Allergic diseases affect 40% of primary school-age children; one third have multiple allergic diagnoses. Challenge-confirmed food allergy prevalence remains high, and 45% of infants with food allergy have persistent disease to age 10 years.

Periodontal health literacy in Germany-Results of a telephone survey.

Assess the periodontal health literacy of German adolescents, adults and senior residents. The prevalence of periodontitis is high. One explanation for this may be that people lack periodontal health literacy (PHL). This was a cross-sectional descriptive study. Former participants of the 5th German Oral Health Study (n = 333 16-year-olds, n = 307 39-48-year-olds, n = 332 69-78-year-olds) participated in a computer-assisted telephone interview. Open-ended questions (OEQs) were used to assess the participants' current knowledge. Corresponding single- and multiple-choice questions (SCQs and MCQs) supplemented the OEQs to allow detailed analyses of the nature of the knowledge gaps. Less than 10% of the participants in the three age groups could explain the term 'periodontitis' or select the correct answer in an SCQ. Responding to the OEQs, 89% of 16-year olds, 64% of 39-48-year-olds, and 59% of 69-78-year-olds, could not name any consequence of periodontitis, and 83%, 51%, and 60%, respectively, could not name any risk factors. The OEQs regarding proper oral hygiene behaviour revealed that participants lacked awareness regarding important aspects of oral hygiene (e.g., systematics) or areas to which they should pay attention to (e.g., interdental spaces and gingival margins). The survey revealed PHL deficits in German adolescents, adults, and seniors and a need for community-based measures to improve PHL in all age groups. Dental teams should be aware that their patients might lack the PHL necessary for understanding and adherence to professional dental advice, and that they might even lack PHL regarding the proper use of oral hygiene devices.

Young people with LGB identity and their sense of belonging: Evidence from Northern Ireland – A society emerging from violent social conflict

In 2023 Northern Ireland celebrated the 25th anniversary of the Belfast Good Friday Agreement (GFA) which is regarded as a milestone of the Northern Ireland peace process. Via the 1998 Northern Ireland Act, the peace process saw equality and anti-discrimination legislation being implemented in Northern Ireland that legislates that public authorities must carry out their duties with due regard to equality of opportunity, including between persons of different sexual orientations and gender identities. Using time series data from 2013 to 2023 taken from the annual Young Life and Times (YLT) survey conducted among a randomized sample of 16-year olds in Northern Ireland (N = 15,162), this article explores the extent to which same-sex attracted young women and men express a sense of belonging to, and influence in, their local neighborhoods and Northern Ireland. We argue that the sense of belonging and influence can be used as suitable policy indicators to assess how same-sex attracted young people fare in Northern Ireland, a society emerging from significant violent conflict. The YLT dataset allows us to track, if any change in attitudes can be detected over the last decade. Our analysis shows that there was an increase in the proportion of young people, especially among young women, expressing same-sex attraction. However, our study also indicates that, regardless of gender, LGB 16-year olds consistently felt a lesser sense of belonging and influence than their non-LGB individuals. We found no LGB-specific differences among respondents with different religious affiliations. LGB respondents disproportionately rejected both Protestant and Catholic faiths and community affiliations, unlike their non-LGB counterparts. Our findings are a strong indicator that religion still plays a major part in the relationship between ethno-national communities in Northern Ireland and that there still is a long way to go until LGB young people feel valued and feel that they belong.

Stimulant Patterns, Alone or with Other Psychotropic Classes, in Medicaid-Insured Youth Continuously Enrolled for 3-8 Years.

Objective: Little U.S. pharmacoepidemiologic study is based on treatment during continuous enrollment for periods more than a year. This study aims to show pediatric patterns of stimulant use (alone or with other psychotropic classes) from Medicaid administrative claims data for stimulant patterns of 3- to 8-year continuous enrollees. Methods: A retrospective cohort study was derived from Medicaid enrollment, pharmacy, and diagnosis claims data (2007-2014) in a mid-Atlantic state. Youth aged 2-17 years with 3-8 years of continuous enrollment treated with stimulants were compared with a date-matched comparison group treated without stimulants. Major outcomes include prevalence and duration of stimulant use and patterns of stimulant polypharmacy across relatively long enrollments (3-8 years). Results: Among 264,518 unique 2- to 17-year olds with 3-8 years of continuous enrollment, 16.5% had stimulant prescription dispensings, doubling the annual national prevalence of 8.1%. Subgroup analysis showed that the highest prevalence of stimulant use was for 6- to 11-year olds (20.4%), foster care eligible youth (42.3%), and those with 7-8 years of continuous enrollment (20.1%). Externalizing psychiatric disorders were far more common in those treated with stimulants than in those treated without stimulants. The duration of stimulant exposure overall was a median of 487 days, half that of foster care stimulant users. Stimulant polypharmacy with two or more psychotropic classes concomitantly characterized 29.8% of stimulant users. Among those with three or four or more class polypharmacy, 85% and 88%, respectively, had concomitant stimulant and antipsychotic use. The adjusted odds ratio (AOR) of three or more class polypharmacy significantly increased in 12- to 17-year-old age group (AOR = 1.8), foster care eligibility (AOR = 4.5), and among those with the longest enrollment (AOR = 1.7). Conclusions and Relevance: Stimulant prevalence in Medicaid-insured youth with continuous enrollment of 3-8 years was twice as common as in annual data sets. Future research should investigate three to five interclass stimulant polypharmacy effectiveness in reliably diagnosed community populations.

A 16-week school-based intervention improves physical fitness in Slovenian children: a randomized controlled trial.

Introduction: The aim of this study was to evaluate the effects of a 16-week school-based physical activity (PA) intervention on physical fitness (PF) (speed, hand-eye coordination, flexibility) of 8- to 9-year-olds. Methods: A total of seventy-eight boys and girls (boys: n = 45, aged 8.4 ± 4.9years; girls: n = 42, aged 8.6 ± 0.5years) from a school in Slovenia were randomly assigned to either a group with an after-school PA program (EXP) or a control group (CON) that participated exclusively in mandatory physical education (PE). The EXP group engaged in the extracurricular PA program for 60 min twice a week for 16 weeks, concurrent with regular PE classes. The program primarily involved elementary PE games that included elements of athletics (e.g., skipping, push- off running, hopping, crossstepping, and jumping) and gymnastics (e.g., handstand, forward roll, backward roll, hand support jumps, squat jump on a vault box, climbing on horizontal bars, incline benches and ropes, crawling, and jumping rope). Standardized tests appropriate for this age group were used to assess PF, including the sit and reach test (SAR), the 30-meter sprint, and the alternate hand wall toss test at distances of 1.0 and 2.0 m (AHWT 1.0 and 2.0). Results: There was a significant group-time interaction for SAR test (EXP group increase: +1.6 cm, +6.3%; CON group decrease: -0.1cm, -0.4%; p < 0.001, ηp2 = 0.361), and the 30m sprint (EXP group improvement: -0.4 s, -6.3%; CON group decrease: +0.1 s, +1.6%; p < 0.001, ηp2 = 0.193). Similarly, the EXP group improved by +2.1 points (+25.6%) in the 1.0 m wall throw with the alternating hand, while the CON group showed only minimal changes (-0.2 points, -2.4%; p < 0.001, ηp2 = 0.545). No significant interaction was found for the 2.0m toss (EXP and CON group both -0.1 points, -2.6%; p = 0.888, ηp2 = 0.001). Post-hoc analyses with paired t-tests revealed that the EXP group showed significant improvements in SAR test (p < 0.001), 30 m sprint (p < 0.001) and AHWT 1.0 test (p < 0.001), while the CON group showed no significant changes in SAR test (p = 0.533), 30 m sprint (p = 0.150), AHWT 1.0 test (p = 0.186) and AHWT 2.0 test (p = 0.430). Discussion: The results of the study showed that the extracurricular program with only two additional weekly sessions significantly improved the components of PF in 8- to 9-year olds. Significant improvements were observed in the areas of flexibility, speed and coordination, as shown in the SAR test, 30-meter sprint and 1.0-meter handwall toss tests. However, no similar improvements were observed in the 2.0-meter handwall toss, which illustrates the specific areas of impact of the program.

Exploring EEG resting state as a function of boredom proneness in pre-adolescents and adolescents.

Boredom is a prominent experience commonly reported in school settings and associated with poor academic achievement. Little is known, however, about the age-related trajectory of boredom. Here we examined self-reported ratings of boredom in a cross-sectional sample of 8 to 15-year olds (n = 185) as a function of resting state EEG. Results indicated that reports of boredom in school rose as a function of age. Resting state EEG showed a decrease in theta power with age perhaps reflective of increased control. While no effects were evident in beta and alpha bands, we did observe an interaction between boredom and age for frontal asymmetry such that for those higher in boredom, the asymmetry increased with age. Finally, for theta to beta ratios there were main effects of age (i.e., a decrease in theta/beta ratio with age) and boredom such that those higher in boredom had higher theta/beta ratios over frontal and central brain areas. The results are discussed in the context of prior work on school-related boredom and provide several important avenues for further research.

Trends in age-specific varicella incidences following the introduction of the general recommendation for varicella immunization in Germany, 2006–2022

BackgroundIn Germany, general childhood varicella vaccination has been recommended since 2004. A feared effect of low vaccination coverage is a possible shift in incidence from children to teenagers and young adults who are at higher risk of severe outcomes. If true, this shift would possibly necessitate changes to the national immunization strategy.We aimed to evaluate the effects of the general vaccination recommendation on age-specific varicella incidences in Germany in general and examine specifically whether a shift from children to teenagers (15 to 19 years) has occurred.MethodsTrends in age-specific incidences were evaluated using triangulation with the following datasets: national mandatory notification data (N) (2014–2022), billing data of the statutory health insurance associations (I) (2009–2017) and data from a doctor's sentinel system (S) (2006–2017). Similar clinical case definitions were used in N and S, while I used ICD-10-codes. Age groups were stratified as available in all three systems. Incidences per year were calculated based on the total population (N), the number of statutory health insured (I), and extrapolated from S to the total population.ResultsDuring all years of observation, age-specific incidences have dropped significantly across all age-groups for S und I. The age groups (under 10 years) with initially highest incidences were the ones with the strongest reductions (under 1 year: -90%, 1–4 years: -95.5%, 5–9 years: -89.2% for S; -67.7%, -78%, -79.3% for I). A single 53.1% increase in the low incidence in S among 15–19-year olds observed in 2017 compared to 2016 could not be confirmed in N or I. Increases in incidences during the first two years of N are probably due to improved notification behaviour over these years. In 2019, all age-specific incidences increased (N), with 15 to 19-year olds showing the highest relative increase (28.2%).ConclusionsSince the introduction of the general vaccine recommendation against varicella, incidences across all age-groups have declined significantly. Available data indicate no evidence for a shift in disease incidence to older age groups. Every incidence increase beyond childhood age should however be followed up closely. So far, children and adolescents have both benefitted from the current vaccination strategy.

The Craniofacial Collaboration UK: Developmental Outcomes in 7- and 10-Year-Old Children With Metopic Synostosis.

The Craniofacial Collaboration (CC-UK) is a shared initiative across the Psychology teams attached to 4 highly specialized craniofacial centers in the United Kingdom. The CC-UK aims to address key limitations in the existing craniofacial literature by analyzing data for homogenous samples of children with craniosynostosis. This article presents the fifth wave of CC-UK data collection, focused on 7- and 10-year olds who have undergone primary corrective surgery for metopic synostosis (MS). Data for children with sagittal synostosis and MS have previously been presented at 3 and 5 years. This paper continues to build on this with consideration to older age groups, presenting the first CC-UK analysis of cognitive assessment data using the Wechsler Abbreviated Scale of Intelligence-Second Edition. Results show that the majority of children with MS fall within the average ranges across behavioral and neurodevelopmental domains. However, several domains indicated a trend of heightened concern when compared with normative data, particularly for parent-reported outcomes, suggesting that there may be some subtle difficulties for children with MS. Consideration of how these findings compare with that of previous CC-UK analyses is explored. Further, implications for clinical practice and future research are considered, with the need for longitudinal analyses, as well as data from multiple perspectives (eg, school, parents, and self) at older age points to establish patterns over time. Through collaboration across the highly specialized craniofacial centers, the CC-UK hopes to work toward this goal moving forward.

Effectiveness of BNT162b2 Vaccine Against Omicron-SARS-CoV-2 Subvariants in Children 5-11 Years of Age in Quebec, Canada, January 2022 to January 2023.

In premarketing clinical trials conducted before Omicron emergence, BNT162b2 vaccine efficacy against COVID-19 was 90% in children. We conducted postmarketing evaluation of 1- and 2-dose vaccine effectiveness (VE) against Omicron BA.1, BA.2 and BA.4/5 subvariants in 5- to 11-year olds. We estimated VE against SARS-CoV-2 infection using a test-negative design. Specimens collected between January 9, 2022, and January 7, 2023, from children 5-11 years old in Quebec, Canada, and tested by nucleic acid amplification test were eligible. We estimated VE by time since last vaccine dose, interval between doses and by period of Omicron subvariant predominance. A total of 48,826 NAATs were included in overall analysis. From 14-55 to 56-385 days postvaccination, 2-dose VE against symptomatic infection decreased from 68% (95% CI, 62-74) to 25% (95% CI, 11-36). Two-dose VE with restriction to specimens collected from acute care hospitals (emergency rooms or wards) did not decline but was stable at ~40%. VE against symptomatic infection remained comparable at any interval between doses but increased with longer interval among children tested in acute care settings, from 18% (95% CI, -17 to 44) with 21- to 55-day interval to 69% (95% CI, 43-86) with ≥84-day interval. Two-dose VE against symptomatic infection dropped from 70% (95% CI, 63-76) during BA.1, to 32% (95% CI, 13-47) with BA.2 and to nonprotective during BA.4/5 dominance. In children 5-11 years of age, VE against symptomatic infection was stable at any interval between doses but decreased with time since the last dose and against more divergent omicron subvariants.

Ungdomskriminalitetsnævnet

In 2018, the Danish Parliament passed a political reform addressing serious youth crime. As part of the reform, the Youth Crime Board was established in 2019. The objective of the Youth Crime Board is to prevent youth crime by appointing targeted individual preventive actions for young individuals aged 10-17 who are suspected of (10- to 14-year olds) or who have received a custodial sentence (15- to 17-year olds) for having committed violent offences or other serious offences. The Board consists of a judge, a police employee, and a municipal employee who have the authority to determine if a referred child/adolescent is to be enrolled in a prevention and rehabilitation programme (forbedringsforløb), to impose an immediate reaction (straksreaktion) on the child/adolescent, to decide on a combination of the two or to decide on no action. In this essay, we highlight some of the most important experiences from the first three years with the Youth Crime Board – what works, and what does not – based on the findings from five out of six partial evaluations of the Board conducted by the Ministry of Justice’s Research Division. We also touch upon the legislative changes that recently have been made to the Youth Crime Board as a consequence of these findings.

A Morphometric Study Analyzing the Anterior Epidural Space Volume Throughout Childhood

BACKGROUND: Following disc herniations, fragments migrate into the anterior epidural space within the lumbar spine. Although the volume of this area has been previously described in the adult population, the volume is relatively unknown within children. OBJECTIVES: Investigate the relative volume in the lumbar anterior epidural space within the growing spine by using imaging studies. STUDY DESIGN: Retrospective chart review. SETTING: University Medical Center in Lubbock Texas. A teaching hospital affiliated with Texas Tech University Health Sciences Center. METHODS: We conducted a retrospective review of the charts of pediatric patients seen at our institution from 2018 through 2020. Charts chosen for our investigation contained computed tomography imaging of the lumber spine, showing no deformities. Thirty patients were stratified equally among 3 age groups, 2-5 years old, 10-12 years old, and 16-18 years old. The anterior epidural space was measured in each patient 3 times using the previously reported method used by Teske et al (1). Results were compared with a combination of analysis of variance (ANOVA) and single tail paired t test. RESULTS: There was a statistically significant difference in the anterior epidural space size among age groups at all levels of the lumbar spine. When comparing only 2 groups together, the younger age group had anterior epidural space sizes significantly smaller than the other age group for all levels of the lumbar spine. The 10-12 age group had a significantly smaller space in the anterior epidural space than the 16–18-year olds only at the level of L2, L4, and L5 (P = 0.048,0.039, and 0.031, respectively). Within the 16–18-year age group, the anterior epidural space was significantly different between L4 and L3 and L2 and L3 (P &lt; 0.001 and P = 0.019, respectively). LIMITATIONS: Our study is limited by its retrospective nature and the sample size of the patient groups. Furthermore, the use of computed tomography imaging and not making physical measurements limits our accuracy. CONCLUSION: The volume of the anterior epidural space is smaller in the pediatric population than the adult population. The inability of herniated discs to fit within the epidural space in children and adolescents could potentially be the cause of the increased failure of conservative treatment for pediatric lumbar disc herniations. KEY WORDS: Anterior epidural space, lumbar herniated disc, low back pain, fossa corporis vertebralis dorsalis, free disc fragment, lumbar spine anatomy

Digital play on children’s terms: A child rights approach to designing digital experiences

Children have the right to play (UN Convention on the Rights of the Child, 1989), yet their opportunities to play on their own terms (free play) are under pressure, including online. Drawing on an analysis of the qualities of children’s free play across time and cultures, a nationally representative survey of UK 6- to 17-year olds compared their experiences of play across digital and non-digital contexts to identify design features that enhance or undermine children’s digital play and propose evidence-based recommendations for digital products and services likely to be used by children. Children viewed digital play more critically than non-digital play although both were judged poorly on key qualities of ‘intrinsically motivated’, ‘voluntary’, ‘risk-taking’ and ‘safety’. Logistical regression analysis shows that rights-respecting design features contribute to children’s enjoyment of digital play more than premium or freemium designs do, thus supporting Playful by Design recommendations that can benefit children.

Multiple Perspectives on Motivating Parents in Pediatric Primary Care to Initiate Participation in Parenting Programs

ObjectiveTo use multiple perspectives to identify the key components of pediatric primary care conversations for motivating parents to utilize parenting programs. We aim to develop an actionable framework that primary care clinicians (PCCs) can follow for effective conversations with parents. MethodsWe conducted focus groups and interviews with researchers (n = 6) who have experience delivering parenting interventions through primary care, clinical personnel in federally qualified health centers (FQHCs) (n = 9), parents of 3–5-year olds who receive services at a FQHC pediatric clinic (n = 6), and parent educators (n = 5). Groups and interviews were informed by nominal group technique, and researchers triangulated consolidated strategies across the groups. ResultsKey strategies for PCCs to motivate parents to utilize parenting programs followed three steps: 1) learning about a parent’s questions and concerns, 2) sharing resources, and 3) following up. PCCs can learn about parents’ needs by empathizing, listening and responding, and asking questions that acknowledge parents' expertise. When sharing resources, PCCs can motivate participation in parenting programs by explaining each resource and its benefits, providing options that support parents' autonomy, and framing resources as strengthening rather than correcting parents' existing strategies or skills. Finally, PCCs can continue to engage parents by scheduling follow-up conversations or designating a staff member to check-in with parents. We provide examples for each strategy. ConclusionsFindings provide guidance from multiple perspectives on strategies to motivate parents in pediatric primary care setting for utilizing parenting programs.

Recent trends in asthma diagnosis, preschool wheeze diagnosis and asthma exacerbations in English children and adolescents: a SABINA Jr study

BackgroundAsthma-related burden remains poorly characterised in children in the UK. We quantified recent trends in asthma prevalence and burden in a UK population-based cohort (1‒17-year-olds).MethodsThe Clinical Practice Research Datalink Aurum...