Vulnerable Children Research Articles

Special needs school community preparedness facing earthquake (Case study: Special needs school in a very high earthquake’s seismicity region in DIY)

Background: DIY is a province in Indonesia that is very susceptible to earthquakes. In 2006, a seismic event measuring 6.2 on the moment magnitude scale struck DIY, causing injuries and extensive damage to both the structural and non-structural elements of several buildings, including one in the education sector. The problem of structural damage to educational facilities is a significant worry, especially in school communities that cater to vulnerable children, such as those in special needs schools (SLB), who are more susceptible to harm during disasters. This study aims to assess the level of preparedness and accessibility of the special needs school community located in a very high seismic region of earthquakes in the DIY, in the event of an earthquake. Methods: The structural assessment took the form of a binary question, requiring a simple yes or no response. Findings: To reduce the risk of earthquakes in the special needs education sector, a review of the preparedness of the special needs school building and community was carried out by implementing “Satuan Pendidikan Aman Bencana (SPAB)” or Disaster Safe Education Unit guidelines. The findings suggest that SLB Sekar Melati Muh. Imogiri (78,26) was classed as having moderate earthquake risk, whereas SLB Dharma Bhakti Piyungan (88,55), SLB Insan Mandiri Dlingo (90,29), and SLB Purworaharjo (88,41) featured infrastructure that was rated as very vulnerable. With respect to SLB Dharma Bhakti Piyungan (64,52), SLB Insan Mandiri Dlingo (60,11), and SLB Purworaharjo (76,94), their average community readiness index scores put them in the intermediate capability category for earthquake preparedness. SLB Sekar Melati Muhmmadiyah Imogiri, however, was categorized as having a low capacity for earthquake readiness with an average index score of 56,92 for community preparedness. Conclusion: special needs school communities should raise their level of preparedness by undertaking seismic socialization and regular simulations to boost the community's understanding of earthquakes and reduce the likelihood of harm following an earthquake. Novelty/Originality of this Study: The study breaks new ground by assessing earthquake preparedness and accessibility in special needs schools within a high-seismicity region, addressing a critical gap in disaster risk reduction for vulnerable populations.

Assessing Trace Elements Bioaccumulation in Coastal River Fish and Shellfish: Implications for Human Health and Risk Evaluation.

The presence of heavy metal contaminants in fish and shellfish in aquatic environments poses a risk to human health due to trophic transfer. This study determined the levels of various trace elements (Fe, As, Cr, Zn, Cu, Ni, Pb, and Cd) in the muscles, gills, and liver of hilsa (Tenualosa ilisha) and prawn (Macrobrachium rosenbergii) samples obtained from the Tetulia River, Bangladesh. The results showed that the level of trace elements in different body parts differed significantly (P < 0.05) between species, displayed below recommended threshold levels. The cumulative low to higher hierarchic concentration of the trace elements was as follows: Fe > Zn > Cu > Cr > Ni > Pb > As > Cd. Hilsa had significantly (P < 0.05) higher bioaccumulated trace elements compared to prawn. With the exception of Ni and Cd, the estimated daily intakes (EDI) for both adults and children were below the recommended daily allowance (RDA), which exhibits that other trace elements do not cause harm to human health. Furthermore, the hazard index (HI) and total hazard quotient (THQ) were also found to be within acceptable limits, taking into account the higher vulnerability of children to toxicity compared to adults. Notably, the HI suggested that children were approximately four times more susceptible to both carcinogenic and non-carcinogenic effects compared to adults. Ultimately, the levels of carcinogenic risk were deemed acceptable, despite the estimated values suggesting susceptibility to adverse effects in both adults and children. This study concluded that fish and shellfish may not pose a health risk to consumers, highlighting the importance of further monitoring of trace elements in the catchment area.

Invisibilized victims: the sexual exploitation of children and adolescents in the European context / Víctimas invisibilizadas: la explotación sexual de niños, niñas y adolescentes en el contexto europeo

This scoping review explores key aspects arising from recent research on child sexual exploitation (CSE) within the European context. CSE represents a form of sexual violence occurring across all regions and countries, impacting the most vulnerable children and adolescents. The exploiter or exploiters respond to the victim’s unmet basic needs and lead them to believe that they are engaging in a consensual exchange and relationship. This social issue affects between 1% and 2.5% of European boys and girls, with these figures being notably higher among specific high-risk groups. Preventing situations of CSE, identifying them and intervening effectively with their victims is only possible if Europe acknowledges and addresses the reality of this serious issue of personal and social vulnerability that affects a significant number of boys and girls within our borders. It has been invisible for far too long.

Childhood maltreatment and vulnerability to substance use disorders: The mediating role of psychological security.

Understanding the factors associated with the propensity for drug dependence might be helpful in providing the best strategies for substance use prevention among youth. The present study was conducted to examine the association between childhood maltreatment (CM) and susceptibility to substance use disorders (SUDs), taking into account the mediating role of psychological safety. In this cross-sectional study, multistage cluster sampling was employed to recruit 400 male students from the three universities of Tabriz in 2019. Research instruments included the valid and reliable scales of substance abuse, childhood trauma, and mental safety. Data were analyzed using Pearson correlation, and structural equation modeling. The results showed positive significant relationships between vulnerability to SUDs, CM, and low levels of psychological safety. The evaluation of our hypothetical research model using fit indices showed that the model fits well the measurement model (CFI=0.97, GFI=0.95, RMSEA=0.058). Our proposed theoretical model suggested psychological security as a mediator between CM and SUDs. CM explained addiction in college students through reducing psychological security. Investigating these interactive processes seems to be detrimental, considering that they may enhance our understanding of the ways to reduce the risk.

The Impact of Data Suppression Rules on Data Access and Re-Identification Risk in Adoption and Foster Care Analysis and Reporting System Annual Files.

One of the most widely used data sources for research on foster care and adoption is the Adoption and Foster Care Analysis and Reporting System (AFCARS). County identifiers in AFCARS are suppressed for all counties with fewer than 1000 cases to prevent the re-identification of vulnerable children, but this also impacts researchers' ability to study smaller communities and analyze how local environments may affect out-of-home placements. This study uses non-public AFCARS datasets to assess, for the first time, how data suppression rules impact data access and re-identification risk. It compares the long-standing 1000-case threshold against a wide range of potential alternatives and finds substantial data access gains coupled with moderate risk increases for thresholds between 400 and 700. Adopting a 700-case threshold leads to a 50% increase in the number of identifiable counties while also keeping the percentage of fostered children who face an elevated risk of re-identification below 1%. Making data from a substantial number of rural counties available to researchers requires much larger threshold changes, which in turn increases re-identification risks.

Orphans and vulnerable children’s nutrition in Nigeria with overlap with biological relations with the household head

ABSTRACT This research analyses the 2013 Nigeria Demographic and Health Survey Data. The multilevel logistic regression is used as the model estimation technique. The study investigates how the intersection of being a paternal orphan or vulnerable child and having close versus distant biological relations with the household head impacts wasting. Findings indicate that paternal orphans or vulnerable children who are grandchildren face the greatest significant probability of wasting compared to paternal orphans or vulnerable children who are biological children and non-orphans/non-vulnerable children who are grandchildren. Grandparent-headed households are not meeting the nutritional needs of paternal orphans and vulnerable children who are grandchildren. Policy needs to focus on directing monetary, food, and health resources to grandmothers caring for orphaned and vulnerable grandchildren.

The effect of ambient temperature on lipid metabolism in children: From a prospective cohort study

BackgroundDyslipidemia is increasingly recognized as an essential risk factor for cardiovascular diseases. However, few studies illustrated the effects of ambient temperature exposure (TE) on lipid levels in children. The study aimed to examine the association between ambient TE and lipid levels in children. MethodsBased on a prospective cohort, a total of 2423 children (with 4466 lipids measure person-time) were collected from 2014 to 2019. The meteorological observation data and adjusted variables were collected. Mixed-effect models and generalized additive mixed model (GAMM) were applied to investigate the association between ambient TE and lipid levels. ResultsA significant negative association was observed between TE and low-density lipoprotein cholesterol (LDL-C) or total cholesterol (TC) levels both in all children [LDL-C, β(95%CI) = −0.350(-0.434,-0.265), P < 0.001; TC, β(95%CI) = −0.274(-0.389,-0.160), P < 0.001] and by different sex group. However, no significant association was found in low-density lipoprotein cholesterol (HDL-C) or triglycerides (TG) levels. The estimated optimal ambient TEs for LDL-C were 18.273 °C and 18.024 °C for girls and boys, respectively. For TC, the optimal ambient TEs were 17.949 °C and 18.024 °C, respectively. With ambient TE decreased, the risk of dyslipidemia increased for both boys [OR = 0.032(0.006,0.179), P < 0.001] and girls [OR = 0.582(0.576,0.587), P < 0.001]. ConclusionThis study provided a comprehensive illustration about the associations between ambient TE and lipid levels in different sex and ages from a prospective cohort study. The findings will provide evidence for the government to prevent dyslipidemia in vulnerable children through regulating TE.

Comparative analysis of tobacco industry cigarette marketing expenditures in the United States, 2009–2018

Anti-tobacco campaigns face challenges as tobacco marketing consistently outpaces funding for public health presentation initiatives. In 2017, tobacco companies spent around $1 million every hour to promote cigarettes and smokeless tobacco in the US. That same year, they were also mandated to sponsor and disseminate Federal court ordered Corrective Statements (CSs) advertisements in outlets such as newspapers and major television networks. Thus, it is crucial to monitor the marketing activities of the tobacco industry to bolster effective tobacco control efforts. Cigarettes marketing expenditures were obtained from the Federal Trade Commission Cigarettes reports and adjusted for inflation using the Consumer Price Index Inflation Calculator. Temporal trends during 2009–2018 period were assessed using Joinpoint regression at (p < 0.05). The costs of publishing the CSs in print were estimated based on the cost of a full-page advertisement with similar specifications. Between 2009 and 2018, the total adjusted cigarette marketing expenditures exhibited no significant changes (AAPC = −1.5). Spending on print advertisements decreased from 0.43% in 2009 to 0.1% in 2018. Magazine cigarette marketing expenditures underwent a relative percentage decline of 80% (AAPC = −13.5;p < 0.05). In 2018, the tobacco industry allocated approximately $8.5 million for print advertisements to promote cigarettes. We estimated that it cost $5.5 million to disseminate the CSs in print the same year, constituting 0.06% of the overall expenditure on cigarette marketing and promotion. Several traditional cigarettes advertising categories have seen reduced funding over the past decade. Nevertheless, the total marketing expenditure remained unaffected. In response to marketing regulations, tobacco companies shifted their funds to less regulated channels. In 2018, a significant portion of promotional expenditures were directed toward various price discounts, which could potentially expose vulnerable children and youths to cigarette marketing. Lastly, the impact of CSs was weakened by delayed implementation and shift in consumer attention from traditional media to other digital channels.

Prevalence of malocclusions and parafunctional habits in pediatric patients with developmental dyslexia.

The study aimed to assess the prevalence of dental malocclusion, orthodontic parameters, and parafunctional habits in children with developmental dyslexia (DD). Forty pediatric patients (67.5% boys and 32.5% girls, mean age: 11.02 ± 2.53 years, range: 6-15 years) with DD were compared with 40 age- and sex-matched healthy participants for prevalence of dental malocclusion, orthodontic parameters, and parafunctional habits. Dental examinations were performed by an orthodontist. Pediatric patients with DD exhibited a significantly higher prevalence of Angle Class III malocclusion (22.5% vs. 5.0%, P = 0.024), deep bite (27.5% vs. 7.5%, P = 0.019), midline deviation (55.0% vs. 7.5%, P < 0.0001), midline diastemas (32.5% vs. 7.5%, P = 0.010), wear facets (92.5% vs. 15.0%, P < 0.0001), self-reported nocturnal teeth grinding (82.5% vs. 7.5%, P < 0.0001), nail biting (35.0% vs. 0.0%, P < 0.0001), and atypical swallowing (85.0% vs. 17.5%, P < 0.0001) compared to that in healthy controls. Pediatric patients with DD showed a higher prevalence of Class III malocclusion, greater orthodontic vertical and transverse discrepancies, and incidence of parafunctional activities. Clinicians and dentists should be aware of the vulnerability of children with dyslexia for exhibiting malocclusion and encourage early assessment and multidisciplinary intervention.

Assessing the effect of COVida orphans and vulnerable children support services on viral load coverage and suppression among children and adolescents living with HIV in four provinces in Mozambique

ABSTRACT Orphans and vulnerable children (OVC) programs focusing on improving HIV outcomes for children and adolescents living with HIV (C&ALHIV) may improve viral load (VL) testing coverage, a critical step toward achieving VL suppression. In Mozambique, we conducted a retrospective medical record review comparing VL testing coverage and suppression between C&ALHIV receiving OVC support and two cohorts of non-participants constructed using propensity score matching. We collected data for 25,783 C&ALHIV in Inhambane, Maputo City, Nampula, and Tete between October 2020-September 2021. Unadjusted rates of VL testing were 62.9% among OVC participants compared with 39.2% and 50.4% of non-participants in OVC support and non-OVC support districts, respectively. In multivariate models, OVC participants were 18 and 10 percentage points more likely to have received a VL test than non-participants in OVC districts (p < 0.01) and non-OVC districts (p < 0.01), respectively. OVC participants under 5 years old were significantly more likely to have received a VL test than their same-age counterparts in both comparison groups. Overall, the OVC program did not demonstrate significant effects on VL suppression. This approach could be replicated in other contexts to improve testing coverage. It is crucial that clinical partners and governments continue to share data to enable timely monitoring through OVC programming.

Conceptualizing the social networks of children of parents with serious mental illness: a thematic analysis.

Social networks, defined as the set of active and significant ties surrounding an individual, influence the wellbeing of vulnerable children. The best evidenced mechanism through which this occurs is where networks act as a vehicle to access social support. Little is known about the content and function of social networks of children of parents with severe and enduring mental illness (COPMI). COPMI are a frequently under-identified vulnerable child population at risk of negative outcomes. This qualitative study investigates the structure, role and function of these children's networks. Researchers conducted 17 semi-structured egocentric social network interviews. Interviews incorporated personal network mapping as a data collection method. COPMI were recruited through third sector organizations and interviewed across three sites in England. Data was analyzed using an inductive thematic analysis. Five network features were identified (i) parents as primary providers of support (i) limited networks and diminished connections over time (iii) substitutable ties (formal and informal) (iv) peer connections as source of both support and strain (v) coping strategies: self-censorship, avoidance and animals. Children of parents with severe and enduring mental illness networks are structurally typical of vulnerable children in that they are limited, rely on parents as primary ties but allow for some substitution of support ties. COPMI-specific features included peer relationships at times as source of strain and network level coping strategies used to manage wellbeing, including pets. This latter reflects previous findings in vulnerable adult populations so far unevidenced in children. Little evidence as to the mechanistic effect at work within networks was collected. However, COPMI were clearly shown to be engaged in active management and strategising in network navigation approaches, indicating the need to engage with children in this capacity, rather than approaching them as passive recipients of support. As such, effective network level interventions for this group are likely to prioritize access to beneficial substitute ties when support is limited. Additionally, interventions that promote network navigation skills and help foster productive coping strategies can capitalize on the child's active management role within their network.

Effects of extreme climate events and child mortality on total fertility rate in Bangladesh

Floods, storms, and temperature extremes are examples of extreme weather events that have a substantial influence on a country's demographic dynamics, including migration, fertility, and mortality. Changes in population size, composition, and distribution may result from these occurrences. This study, which spans the years 1966–2018, looks at how Bangladesh's total fertility rate (TFR) is affected by extreme weather events and child mortality, including neonatal, infant, male infant, and under-five mortality. We use data from secondary publicly accessible sources, such as the World Bank and The Emergency Events Database (EM-DAT), and we investigate the correlations using the autoregressive integrated moving average model (ARIMA), complemented by bivariate and multivariable analyses.Our findings from the univariate analysis are noteworthy. Total extreme climate events (β = −0.345, 95 % CI: 0.510, −0.180), as well as individual extreme climate events, such as extreme temperatures (β = −1.176, 95 % CI: 1.88, −0.47), floods (β = −0.644, 95 % CI: 1.0729, −0.216), and storms (β = −0.351, 95 % CI: 0.63159, −0.07154), exhibited negative associations with the TFR. Additionally, factors such as contraceptive prevalence rate (CPR) (β = −0.085, 95 % CI: 0.09072, −0.07954) and gross national income (GNI) per capita (β = −0.003, 95 % CI: 0.0041123, −0.0024234) were negatively correlated with the TFR. Conversely, various categories of child mortality, namely, infants (β = 0.041, 95 % CI: 0.040474, 0.042748), males (β = 0.038, 95 % CI:0.037719, 0.039891), and under-five (β = 0.026, 95 % CI:0.025684, 0.026979) – are positively associated with TFR. Controlling for two pivotal confounding factors, time and GNI per capita, yielded consistent results in the multivariate analysis. These findings provide insight on the dual impact of extreme weather events, which can reduce TFR while also raising it through infant mortality. This phenomena may be due to the increased vulnerability of younger children in climate-event-prone areas, prompting parents to seek additional children as both a replacement for lost offspring and an insurance mechanism against future child loss.

Clinical characteristics of COVID-19 in children: a large multicenter study from Iran.

During the COVID-19 pandemic, pediatric cases typically exhibit milder symptoms and lower mortality rates. However, the delay in pediatric vaccination poses major risks for children. This multicenter study aimed to comprehensively analyze demographic characteristics, clinical features, disease severity, and risk factors for ICU admission in Iran. This observational study enrolled children aged 0-21 years with confirmed or probable COVID-19 diagnoses, referred from selected hospitals across 17 counties in Mazandaran province, Iran, between February 19 and August 14, 2021. Patients were categorized into mild, moderate, severe, or critical cases based on clinical and radiographic criteria. Data were extracted from medical records and analyzed using statistical methods. Logistic regression analysis was performed to identify factors associated with ICU admission and disease severity. Among the 1,031 children included in the study, 61 were diagnosed with MIS-C. The distribution of patients by severity was 156 mild, 671 moderate, and 204 severe/critical cases. Age distribution significantly differed across severity groups (P < 0.001), with 55.19% aged over 5 years and 54% being male. 11.44% had underlying diseases. Fever (71.97%) was the most common symptom, followed by cough (34.43%) and dyspnea (24.83%). Within the inpatient group, 19.77% required ICU admission, with 0.91% mortality, including 3 MIS-C cases. Children with underlying diseases, gastrointestinal symptoms, and obesity had 4.16, 3.10-, and 2.17-times higher likelihood of ICU admission, respectively. Our study emphasized the importance of recognizing pediatric COVID-19 severity and symptoms. While fever, cough, and dyspnea prevailed, mortality rates were relatively low. However, comorbidities, obesity, and gastrointestinal symptoms linked to ICU admission, stressing early intervention. BMI also impacted disease severity and admission rate. Vaccination and targeted interventions are essential for protecting vulnerable children and easing healthcare strain.

The association between overprotective parenting, parental perceptions of child vulnerability and growth and development of children with congenital heart disease

Abstract Background Congenital Heart Disease (CHD) is the most prevalent childhood birth defect, leading to health concerns in growth and development post-surgery. Parents mostly shoulder the responsibility for post-hospitalization care. The chronic nature of caring for a child with CHD induces significant stress, fostering perceptions of the child as highly vulnerable and resulting in overprotective behaviors. These behaviors could restrict the child's developmental opportunities, affecting overall growth and development. Purpose The purpose was to investigate the association between parental perceptions of child vulnerability, overprotective parenting, and growth and development of children with CHD. Methods The study employed a cross-sectional, comparative design. The total sample included 186 [93 CHD and 93 healthy controls] parents and their child aged 1-5 years. Data on parenting practices were gathered using the Child Vulnerability Scale and Parental Protection Scale. Child development was examined using the Ages and Stages Questionnaire-3. Growth and other clinical variables were gathered from the medical records. Data were analyzed using descriptive statistics, correlational and mediation analyses. Results CHD parents exhibited higher overprotective parenting (p=0.008) and perceived their child as more vulnerable (p&amp;lt;0.001) than healthy controls. In CHD, parental perception of child vulnerability was associated with worse gross motor (p=0.010) and problem-solving development (p=0.011), while among the controls, overprotective parenting was negatively associated with height (p=0.027) and weight (p=0.003). The path analyses revealed direct effects but no mediating or moderating effects of perceived child vulnerability and overprotectiveness on growth and development of the child with CHD. Higher parental perceptions of child vulnerability were associated with lower height (b1= -0.253, 95% CI: -0.397 to -0.087) and weight (a2= -0.098, 95% CI: -0.195 to 0.003). The higher the parental stress, the greater the perceptions of child vulnerability were (d1= 0.108, 95% CI: 0.058 to 0.160) and the worse communication skills of the child (cʹ2= -0.250, 95% CI: -0.422 to 0.091). Higher education level of the parents was associated with less perceptions of child vulnerability (d1= -1.562, 95% CI: -2.753 to -0.623), better fine motor development (c2=6.948, 95% CI: 4.137 to 9.552) and less overprotective parenting (f1=-1.874, 95% CI: -3.186 to -0.499). Higher perceptions of child vulnerability were associated with lower personal-social development (b1= -0.378, 95% CI: -0.803 to 0.046). Top of Form. Conclusion Healthcare providers should consider the diverse parental and child factors identified to initiate interventions aimed at parenting practices, realistic perceptions of their child’s condition, and reducing parental stress to optimize growth and development in children with CHD.

Social mobility and CCT programs: The Bolsa Família program in Brazil

We investigate long-term outcomes related to social mobility and their determinants for low-income Brazilian households. More precisely, the first cohorts of beneficiaries of the Conditional Cash Transfer (CCT) program Bolsa Família (BFP); children aged between 7 and 16 in 2005, who are tracked for over a decade, until 2019. We use individual-level administrative data to analyze our two indicators of social mobility: (i) future emancipation from federal government social programs, and (ii) access to the formal labor market. We observe that formerly vulnerable children, beneficiaries of the CCT, find themselves in better socioeconomic conditions in adulthood. While 64 % of them, aged between 21 and 30 years in 2019, were no longer beneficiaries of federal government social programs, 45 % accessed the formal labor market at least once between 2015 and 2019. We also compare the characteristics of the formal employment they access with those of non-BFP beneficiaries during the same period. They have worse employment conditions, although better than informal positions typical of their parents. Furthermore, we investigate the association between local sociodemographic characteristics and individual social mobility. We find significant territorial heterogeneity associated with differences in better health and education infrastructures, and local economic activity.

Promoting Professional Wellbeing in an Emancipatory Perspective. A Research-Training Experience among Professionals Working with Vulnerable Children and their Families

Although most professionals who have chosen to work with children and families living in vulnerable situations are motivated by a genuine desire to care for people, when they go through some emotionally challenging experiences, they are also exposed to various syndromes such as compassion fatigue, vicarious trauma and burnout. The aim of this article is to present a research-training course that has been implemented to promote greater professional wellbeing and the co-construction of supportive working communities among social work professionals. In line with a critical-emancipatory approach, a research-training pathway was chosen, which also allowed the outcomes of the pathway to be evaluated using qualitative interviews and validated tests. The study involved 75 professionals from central-northern Italy. The analysis of the data collected showed that workshops and various activities proposed gave the professionals the opportunity to share their vulnerability with others, and to feel a greater sense of belonging to a supportivecommunity.

A critique of the efficacy of the right to shelter for street children in Kenya

The right to housing or shelter is a fundamental right that has been given recognition at national, regional, and international levels. In Kenya, everyone's right to access adequate housing and basic shelter is enshrined in the Constitution of Kenya, 2010 and various international and regional human instruments, but there is no specific legislation or policy that caters to the right of street families and children to access housing or shelter. The gap that exists in law and policy deepens the vulnerability of street families and children, who are being left behind and not included in governmental socioeconomic programmes and interventions targeting vulnerable and marginalised persons. For example, street children are often excluded from planning, budgeting, and national decisions relating to socio-economic rights that include shelter. This article considers how Kenya's street children's right to shelter may be protected. Accordingly, it recommends measures that could be taken to protect their right to shelter, as well as other socio-economic rights, and thereby create a pathway to realising the values of equality and human dignity enshrined in the Constitution.

Systematic risk ranking of microbiological hazards in infant foods

Ensuring food safety, particularly for vulnerable groups, like infants and young children, requires identifying and prioritizing potential hazards in food chains. We previously developed a web-based decision support system (DSS) to identify specific microbiological hazards (MHs) in infant and toddler foods through a structured five-step process. This study takes the framework further by introducing systematic risk ranking (RR) steps to rank MH risks with seven criteria: process survival, recontamination, growth opportunity, meal preparation, hazard-food association evidence, food consumption habits of infants and toddlers in the EU, and MH severity. Each criterion is given a semi-quantitative or quantitative score or risk value, contributing to the final MH risk calculation via three aggregation methods: semi-quantitative risk scoring, semi-quantitative risk value, and outranking multi-criteria decision analysis (MCDA). To validate the criteria and ranking approaches, we conducted a case study to rank MH risks in infant formula, compared the results of the three risk ranking methods, and additionally evaluated the ranking results against expert opinions to ensure their accuracy. The results showed strong agreement among the three methods, consistently ranking Salmonella non-Typhi and Cronobacter spp. and Shiga-toxin-producing Escherichia coli as the top MH risks in infant formulae, with minor deviations. When MHs were ranked after an initial hazard identification step, all three methods produced nearly identical MH rankings, reinforcing the reliability of the ranking steps and the selected criteria. Notably, the risk value and MCDA methods provided more informative MH rankings compared to the risk scoring method. The risk value and risk scoring methods were implemented into an online tool, called the MIcrobiological hazards risk RAnking decision support system (Mira-DSS), available at https://foodmicrobiologywur.shinyapps.io/MIcrobial_hazards_RAnking/. In conclusion, our framework enables the ranking of MH risks, facilitating intervention comparisons and resource allocations to mitigate MH risks in infant foods, with potential applicability to broader food categories.

UNCHARTED THRESHOLDS FOR A FLEDGED CHILD AND YOUTH CARE PROFESSION

In the child and youth care sector, protecting vulnerable children is a key priority, one that requires a skilled workforce capable of meeting diverse and complex needs. Starting with an acknowledgement of the field’s struggle for identity, this article briefly recounts highlights of our journey to achieving recognition as a profession, with an emphasis on the South African context. The profession’s early phase is described along with the key developments that have shaped the scope of practice, leading to a discussion of current matters that have the potential to transform the field, and ideas regarding priorities that may need to be considered for a longer-term agenda. Reflections on a journey that builds on lessons from South Africa as they connect to a wider global context are shared. The initiatives shared within this journey reflect a resilient sector that has contributed to the creation of employment opportunities for child carers. They also provide some milestones for the formalising of a sector that requires regulation because of the vulnerable population it serves. From the emerging priorities, pointers for the next steps in the profession’s journey are offered.

A person-centered, transdiagnostic schema and mode profile approach to predict outcome in time-limited schema group therapy

Objective This study employs a person-centered transdiagnostic approach to examine how schema and mode profiles predict symptom severity reduction in schema group therapy for patients with personality disorders and enduring clinical syndromes. Method We analyzed symptom reduction in 248 patients across three formats of manualized, time-limited schema group therapy. Latent profile analysis and mixed multilevel modeling were used to determine the extent to which schema/mode classes predict symptom reduction, and whether the inclusion of individual schemas and modes enhances these predictions. Results No significant differences in treatment outcomes were found across the group modalities. A three latent profile solution for schemas and modes showed external validity with clinical variables and demonstrated that declines in symptom severity varied by schema and mode class, even after adjusting for baseline symptom severity. Adding the Vulnerability to Harm schema and Vulnerable Child mode to the model increased the explained variance. Conclusion Patients with more severe personality problems show more substantial symptom reduction. Both schema and mode profiles significantly contribute to predicting post-treatment symptom levels. Understanding these profiles may help therapists tailor interventions more effectively, consistent with Young’s theoretical model. Trial registration: ISRCTN.org identifier: ISRCTN17262253.