Child Contact Research Articles

The Contribution of Chest Radiography to the Clinical Management of Children Exposed to Tuberculosis.

Rationale: Although World Health Organization guidelines emphasize contact investigation for tuberculosis (TB)-exposed children, data that support chest radiography as a useful tool are lacking. Objectives: We evaluated the diagnostic and prognostic information of chest radiography in children exposed to TB and measured the efficacy of isoniazid preventive therapy (IPT) in those with relevant radiographic abnormalities. Methods: Between September 2009 and August 2012, we enrolled 4,468 TB-exposed children who were screened by tuberculin skin testing, symptom assessment, and chest radiography. Those negative for TB disease were followed for 1 year for the occurrence of new TB diagnoses. We assessed the protective efficacy of IPT in children with and without abnormal chest radiographs. Measurements and Main Results: Compared with asymptomatic children with normal chest films, asymptomatic children with abnormal radiographs were 25.1-fold more likely to have coprevalent TB (95% confidence interval [CI], 1.02-613.76) and 26.7-fold more likely to be diagnosed with incident TB disease during follow-up (95% CI, 10.44-68.30). Among the 29 symptom-negative and CXR-abnormal child contacts, 20% (3/15) of the isoniazid recipients developed incident TB, compared with 57% (8/14) of those who did not receive IPT (82% IPT efficacy). Conclusions: Our results strongly support the use of chest radiography as a routine screening tool for the evaluation of child TB contacts, which is readily available. Radiographic abnormalities not usually considered suggestive of TB may indicate incipient or subclinical disease, although TB preventive treatment is adequate in most cases.

SARS-CoV-2 Circulation in the School Setting: A Systematic Review and Meta-Analysis.

The contribution of children to viral spread in schools is still debated. We conducted a systematic review and meta-analysis of studies to investigate SARS-CoV-2 transmission in the school setting. Literature searches on 15 May 2021 yielded a total of 1088 publications, including screening, contact tracing, and seroprevalence studies. MOOSE guidelines were followed, and data were analyzed using random-effects models. From screening studies involving more than 120,000 subjects, we estimated 0.31% (95% confidence interval (CI) 0.05–0.81) SARS-CoV-2 point prevalence in schools. Contact tracing studies, involving a total of 112,622 contacts of children and adults, showed that onward viral transmission was limited (2.54%, 95% CI 0.76–5.31). Young index cases were found to be 74% significantly less likely than adults to favor viral spread (odds ratio (OR) 0.26, 95% CI 0.11–0.63) and less susceptible to infection (OR 0.60; 95% CI 0.25–1.47). Lastly, from seroprevalence studies, with a total of 17,879 subjects involved, we estimated that children were 43% significantly less likely than adults to test positive for antibodies (OR 0.57, 95% CI 0.49–0.68). These findings may not applied to the Omicron phase, we further planned a randomized controlled trial to verify these results.

Household Transmission and Symptomology of Severe Acute Respiratory Syndrome Coronavirus 2 Alpha Variant among Children—California and Colorado, 2021

ObjectiveTo assess the household secondary infection risk (SIR) of B.1.1.7 (Alpha) and non-Alpha lineages of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among children.Study designDuring January to April 2021, we prospectively followed households with a SARS-CoV-2 infection. We collected questionnaires, serial nasopharyngeal swabs for reverse transcription polymerase chain reaction testing and whole genome sequencing, and serial blood samples for serology testing. We calculated SIRs by primary case age (pediatric vs adult), household contact age, and viral lineage. We evaluated risk factors associated with transmission and described symptom profiles among children.ResultsAmong 36 households with pediatric primary cases, 21 (58%) had secondary infections. Among 91 households with adult primary cases, 51 (56%) had secondary infections. SIRs among pediatric and adult primary cases were 45% and 54%, respectively (OR, 0.79; 95% CI, 0.41-1.54). SIRs among pediatric primary cases with Alpha and non-Alpha lineage were 55% and 46%, respectively (OR, 1.52; 95% CI, 0.51-4.53). SIRs among pediatric and adult household contacts were 55% and 49%, respectively (OR, 1.01; 95% CI, 0.68-1.50). Among pediatric contacts, no significant differences in the odds of acquiring infection by demographic or household characteristics were observed.ConclusionsHousehold transmission of SARS-CoV-2 from children and adult primary cases to household members was frequent. The risk of secondary infection was similar among child and adult household contacts. Among children, household transmission of SARS-CoV-2 and the risk of secondary infection was not influenced by lineage. Continued mitigation strategies (eg, masking, physical distancing, vaccination) are needed to protect at-risk groups regardless of virus lineage circulating in communities.

Child transmission of SARS-CoV-2: a systematic review and meta-analysis

BackgroundUnderstanding of the role of children in COVID-19 transmission has significant implications for school and childcare policies, as well as appropriate targeting of vaccine campaigns. The objective of this systematic review was to identify the role of children in SARS-CoV-2 transmission to other children and adults.MethodsMEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, and Web of Science were electronically searched for articles published before March 31, 2021. Studies of child-to-child and child-to-adult transmission and quantified the incidence of index and resulting secondary attack rates of children and adults in schools, households, and other congregate pediatric settings were identified. All articles describing confirmed transmission of SARS-CoV-2 from a child were included. PRISMA guidelines for data abstraction were followed, with each step conducted by two reviewers.Results40 of 6110 articles identified met inclusion criteria. Overall, there were 0.8 secondary cases per primary index case, with a secondary attack rate of 8.4% among known contacts. The secondary attack rate was 26.4% among adult contacts versus 5.7% amongst child contacts. The pooled estimate of a contact of a pediatric index case being infected as secondary case was 0.10 (95% CI 0.03-0.25).ConclusionsChildren transmit COVID-19 at a lower rate to children than to adults. Household adults are at highest risk of transmission from an infected child, more so than adults or children in other settings.

Child sexual exploitation material offenders, one-size-fits-all for? Exploring tailored clinical dimensions based on cognitive and behavioural criminogenic factors.

Interventions for individuals involved in sexual offending behaviours are likely to be more effective if adapted to focus on their specific characteristics, suggesting that men who engage in sexual offences against children over the Internet should be treated differently from those who have actual physical contact against children. The goal of this study is to explore possible associations between the criminogenic cognitions and behaviours of men using online child sexual exploitation material (CSEM) and variables relevant to intervention. We hypothesised that antisocial tendencies, sexual, emotional and relational problems and self-regulation problems, as well as cognitive distortions would be associated with CSEM use. Ninety-eight men who had been convicted of at least one online CSEM-related offence, but no child contact sexual offences, at any time between 2001 and 2020 were recruited in the province of Quebec (Canada). Cases were reviewed to identify cognitive and behavioural criminogenic factors according to a coding sheet developed after reference to prior literature. Variables were extracted from official criminal records, sexological and psychological reports, as well as investigative and forensic reports and interviews. Exploratory factor analysis was carried out to identify potentially relevant dimensions. Analysis confirmed five distinct factors which, together, accounted for 60% of the variance: dissocial traits, dysfunctional intimacy, passive alienation (internalised sense of alienation), normless alienation (social norms experienced as alien) and coping with threat. Because online CSEM-related offenders present heterogeneous risks and needs, a 'one-size-fits-all' intervention is unlikely to be optimal for most of them. Our findings suggest a way of classifying risks and needs to facilitate more focused interventions. Future research should evaluate the relative effectiveness of general interventions compared to those tailored towards the dimensions of risks and needs identified in this study.

Estimating adults and children's potential health risks to heavy metals in water through ingestion and dermal contact in a rural area, Northern Tunisia.

High concentrations of heavy metals (HMs) in water (e.g., As, Cr, and Cd) are harmful to human health, especially to children. HMs' (As, Cd, Mn, Fe, Cu, Hg, Zn, Cr, and Se) values have been determined from the water of the Guenniche plain (Tunisia); then the carcinogenic risk (CR) and non-carcinogenic Risk (N-CR) were estimated through ingestion and dermal contact for adults and children. The analysis results show that the Hg, As, and Cd in 50% of the ephemeral streams (ESs) exceeded one of the WHO and NT guidelines for safe water, as is the case with Hg and Cd in 25% of the shallow groundwater wells (SGW). In all samples, the N-CR of all HMs, and the CR due to the dermal contact controlled by As, for both age brackets, are deemed to fall far short of the threshold set by USEPA. The CR due to the ingestion pathway caused by As, Cr, and Cd contamination indicates a "high" to "very high" risk on its users in roughly 50% of all the samples (ESs and SGW) for both age brackets by exceeding 10-5. Overall, the SGW samples close to the floodplain area of the ESs pose a real CR to both age groups, which is more serious for children. Therefore, the SGW are not recommended for drinking use, with an urgent call for a solution by the policy-makers to improve the water quality of the region.

Maternal Attitudes Toward Child Interethnic Relations in the Netherlands: Facilitating Intergroup Contact Effects?

Ethnic diversity and interethnic contact are increasing in Europe. Intergroup contact theory suggests interethnic contact to improve interethnic attitudes, but for young children, parental attitudes toward child interethnic relations might be an important factor determining whether they are exposed to these potentially positive contact effects. This study therefore examined maternal attitudes toward child contact with different ethnic outgroups among 251 mothers (137 White Dutch, 69 Turkish-Dutch, and 45 Afro-Dutch) of a 6- to 10-year-old child ( M = 7.51, SD = 0.98). Furthermore, associations between maternal attitudes toward child interethnic relations and child outgroup rejection were examined, as well as mediation effects of child actual outgroup contact. Neutral to positive maternal attitudes toward child interethnic relations were found, with relatively more negative attitudes among Turkish-Dutch than White Dutch and Afro-Dutch mothers, and toward child relations with Muslims as compared to another outgroup among White Dutch and Afro-Dutch mothers. Furthermore, results did not indicate that maternal attitudes were related to child actual outgroup contact or child outgroup prejudice and no support for the intergroup contact theory was found. These results suggest that intergroup contact theory does not easily apply, highlighting the need for more research on children in various populations and contexts using different measures and informants. Patterns from the present study suggest that most improvement in terms of maternal attitudes fostering child interethnic relations can be made in the interethnic relations including ethnic groups in the Netherlands that predominantly identify as Muslim.

"When She Says Daddy": Black Fathers' Recidivism following Reentry from Jail.

We report on the findings of a mixed methods longitudinal study of 84 African American fathers of young children who were enrolled into the study during the father’s jail stay. Participants were assessed using interviews, self-report measures, and administrative records on frequency of father–child contact, father–caregiver relationship quality, family support, paternal pre-incarceration employment, fathers’ plans to live with the child upon reentry, history of substance abuse, and new convictions one year following release from jail. Qualitative analysis revealed three primary identities of fathers during incarceration: father as nurturer, father as protector, and father as provider. Qualitative analysis of interview data detailed the ways in which the context of incarceration and the presence of the criminal justice system interacts with these identities to impact family structure, parent–child visits, plans for release, and motivation for desistance. Quantitative analysis indicated heterogeneity among fathers, with links between parent–child contact and desistance conditional on fathers’ plans for coresidence with children as well as family support and relationship quality. Taken together, the findings highlight the strengths of African American fathers and their families despite the risks associated with incarceration, including the importance of family support and children as motivation for desistance. The results have implications for how the justice system weighs the bidirectional influences of fathers and families.

Kinect v2-Assisted Semi-Automated Method to Assess Upper Limb Motor Performance in Children.

The interruption of rehabilitation activities caused by the COVID-19 lockdown has significant health negative consequences for the population with physical disabilities. Thus, measuring the range of motion (ROM) using remotely taken photographs, which are then sent to specialists for formal assessment, has been recommended. Currently, low-cost Kinect motion capture sensors with a natural user interface are the most feasible implementations for upper limb motion analysis. An active range of motion (AROM) measuring system based on a Kinect v2 sensor for upper limb motion analysis using Fugl-Meyer Assessment (FMA) scoring is described in this paper. Two test groups of children, each having eighteen participants, were analyzed in the experimental stage, where upper limbs’ AROM and motor performance were assessed using FMA. Participants in the control group (mean age of 7.83 ± 2.54 years) had no cognitive impairment or upper limb musculoskeletal problems. The study test group comprised children aged 8.28 ± 2.32 years with spastic hemiparesis. A total of 30 samples of elbow flexion and 30 samples of shoulder abduction of both limbs for each participant were analyzed using the Kinect v2 sensor at 30 Hz. In both upper limbs, no significant differences (p < 0.05) in the measured angles and FMA assessments were observed between those obtained using the described Kinect v2-based system and those obtained directly using a universal goniometer. The measurement error achieved by the proposed system was less than ±1° compared to the specialist’s measurements. According to the obtained results, the developed measuring system is a good alternative and an effective tool for FMA assessment of AROM and motor performance of upper limbs, while avoiding direct contact in both healthy children and children with spastic hemiparesis.

Longitudinal social contacts among school-aged children during the COVID-19 pandemic: the Bay Area Contacts among Kids (BACK) study

BackgroundThe San Francisco Bay Area was the first region in the United States to enact school closures to mitigate SARS-CoV-2 transmission. The effects of closures on contact patterns for schoolchildren and their household members remain poorly understood.MethodsWe conducted serial cross-sectional surveys (May 2020, September 2020, February 2021) of Bay Area households with children to estimate age-structured daily contact rates for children and their adult household members. We examined changes in contact rates over the course of the COVID-19 pandemic, including after vaccination of household members, and compared contact patterns by household demographics using generalized estimating equations clustered by household.ResultsWe captured contact histories for 1,967 households on behalf of 2,674 children, comprising 15,087 non-household contacts over the three waves of data collection. Shortly after the start of shelter-in-place orders in May 2020, daily contact rates were higher among children from Hispanic families (1.52 more contacts per child per day; [95% CI: 1.14–2.04]), households whose parents were unable to work from home (1.82; [1.40–2.40]), and households with income < $150,000 (1.75; [1.33–2.33]), after adjusting for other demographic characteristics and household clustering. Between May and August 2020, non-household contacts of children increased by 145% (ages 5–12) and 172% (ages 13–17), despite few children returning to in-person instruction. Non-household contact rates among children were higher—by 1.75 [1.28–2.40] and 1.42 [0.89–2.24] contacts per child per day in 5–12 and 13–17 age groups, respectively, in households where at least one adult was vaccinated against COVID-19, compared to children’s contact rates in unvaccinated households.ConclusionsChild contact rates rebounded despite schools remaining closed, as parents obtained childcare, children engaged in contact in non-school settings, and family members were vaccinated. The waning reductions observed in non-household contact rates of schoolchildren and their family members during a prolonged school closure suggests the strategy may be ineffective for long-term SARS-CoV-2 transmission mitigation. Reductions in age-assortative contacts were not as apparent amongst children from lower income households or households where adults could not work from home. Heterogeneous reductions in contact patterns raise concerning racial, ethnic and income-based inequities associated with long-term school closures as a COVID-19 mitigation strategy.

Impact of BNT162b2 Vaccination and Isolation on SARS-CoV-2 Transmission in Israeli Households: An Observational Study.

Several studies have characterized the effectiveness of vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. However, estimates of their impact on transmissibility remain limited. Here, we evaluated the impact of isolation and vaccination (7 days after the second dose) on SARS-CoV-2 transmission within Israeli households. From December 2020 to April 2021, confirmed cases were identified among health-care workers of the Sheba Medical Centre and their family members. Recruited households were followed up with repeated PCR for at least 10 days after case confirmation. Data were analyzed using a data augmentation Bayesian framework. A total of 210 households with 215 index cases were enrolled; 269 out of 667 (40%) susceptible household contacts developed a SARS-CoV-2 infection. Of those, 170 (63%) developed symptoms. Compared with unvaccinated and unisolated adult/teenager (aged >12 years) contacts, vaccination reduced the risk of infection among unisolated adult/teenager contacts (relative risk (RR) = 0.21, 95% credible interval (CrI): 0.08, 0.44), and isolation reduced the risk of infection among unvaccinated adult/teenager (RR = 0.12, 95% CrI: 0.06, 0.21) and child contacts (RR = 0.17, 95% CrI: 0.08, 0.32). Infectivity was reduced in vaccinated cases (RR = 0.25, 95% CrI: 0.06, 0.77). Within households, vaccination reduces both the risk of infection and of transmission if infected. When contacts were unvaccinated, isolation also led to important reductions in the risk of transmission.

Changes in social contacts in England during the COVID-19 pandemic between March 2020 and March 2021 as measured by the CoMix survey: A repeated cross-sectional study.

During the Coronavirus Disease 2019 (COVID-19) pandemic, the United Kingdom government imposed public health policies in England to reduce social contacts in hopes of curbing virus transmission. We conducted a repeated cross-sectional study to measure contact patterns weekly from March 2020 to March 2021 to estimate the impact of these policies, covering 3 national lockdowns interspersed by periods of less restrictive policies. The repeated cross-sectional survey data were collected using online surveys of representative samples of the UK population by age and gender. Survey participants were recruited by the online market research company Ipsos MORI through internet-based banner and social media ads and email campaigns. The participant data used for this analysis are restricted to those who reported living in England. We calculated the mean daily contacts reported using a (clustered) bootstrap and fitted a censored negative binomial model to estimate age-stratified contact matrices and estimate proportional changes to the basic reproduction number under controlled conditions using the change in contacts as a scaling factor. To put the findings in perspective, we discuss contact rates recorded throughout the year in terms of previously recorded rates from the POLYMOD study social contact study. The survey recorded 101,350 observations from 19,914 participants who reported 466,710 contacts over 53 weeks. We observed changes in social contact patterns in England over time and by participants' age, personal risk factors, and perception of risk. The mean reported contacts for adults 18 to 59 years old ranged between 2.39 (95% confidence interval [CI] 2.20 to 2.60) contacts and 4.93 (95% CI 4.65 to 5.19) contacts during the study period. The mean contacts for school-age children (5 to 17 years old) ranged from 3.07 (95% CI 2.89 to 3.27) to 15.11 (95% CI 13.87 to 16.41). This demonstrates a sustained decrease in social contacts compared to a mean of 11.08 (95% CI 10.54 to 11.57) contacts per participant in all age groups combined as measured by the POLYMOD social contact study in 2005 to 2006. Contacts measured during periods of lockdowns were lower than in periods of eased social restrictions. The use of face coverings outside the home has remained high since the government mandated use in some settings in July 2020. The main limitations of this analysis are the potential for selection bias, as participants are recruited through internet-based campaigns, and recall bias, in which participants may under- or overreport the number of contacts they have made. In this study, we observed that recorded contacts reduced dramatically compared to prepandemic levels (as measured in the POLYMOD study), with changes in reported contacts correlated with government interventions throughout the pandemic. Despite easing of restrictions in the summer of 2020, the mean number of reported contacts only returned to about half of that observed prepandemic at its highest recorded level. The CoMix survey provides a unique repeated cross-sectional data set for a full year in England, from the first day of the first lockdown, for use in statistical analyses and mathematical modelling of COVID-19 and other diseases.

Children's Spiritual Coping and its Effects on Children's Grief, Personal Growth, and Mental Health 2-24 Months after the Death of a Parent, Grandparent, or Sibling

<h3>Methods</h3> Children (N= 97; 8-18 years old; 63.9% Hispanic, 22.7% Black, 13.4% White) were recruited for this study through a pediatric hospital, children's bereavement camps, support groups, snowball sampling, and personal contacts. IRB approval was obtained from Florida International University, and Nicklaus Children's Hospital through WIRB. Inclusion criteria included having experienced the death of a parent, grandparent, brother, or sister within the past two years, able to read and write English, and currently in their age appropriate grade level in school +/- 1 year. Exclusion criteria included: 1) conditions that render a child unable to participate verbally; 2) living in foster care before or after the death; 3) history of psychiatric conditions; and 4) death of more than one family member in the previous 2 years because the child will be dealing with multiple deaths at the same time. One child from each eligible family participated in the study. Measures from Child included the Child Depression Inventory, Spiritual Coping Strategies Scale, and the Hogan Inventory of Bereavement. Parents completed a demographic form. Differences in children's use of Spiritual and Religious Coping subscales were measured with 2-sample t-tests by child age, gender, participation in religious rituals and practices, and oneway ANOVA with Scheffe post-hoc comparisons for race/ethnicity, and relationship of child to the deceased. Pearson's product moment correlations were used to determine relationship between spiritual coping strategies and the outcomes of grief, personal growth, anxiety, and depression, and were also used to determine grief and the outcomes of personal growth, anxiety, and depression. <h3>Results</h3> Children's greater use of spiritual coping, but not religious coping, and greater grief were significantly related to greater personal growth and greater anxiety. Children who participated in religious rituals used less religious coping strategies than children who did not participate. Younger age and being Black were significantly related to greater anxiety. <h3>Discussion</h3> The results of this multicultural/multiethnic study provide insight regarding the effects of children's spiritual coping after parent, grandparent, or sibling death on their grief, personal growth, and mental health which has not been widely studied and the knowledge base is limited. Learning how children's spiritual coping strategies increases their personal growth and age and racial differences that exist with respect to grief and anxiety in bereft children will enhance the health care provider's knowledge base regarding the grieving process in children. Further research is needed to determine if children's spiritual coping strategies remain related to greater personal growth more than two years after the deaths.

Inconclusive Findings in Studies of the Link Between Media Coverage of Mass Trauma and Depression in Children.

Purpose of ReviewThis paper reports a review of the empirical research examining the association between mass trauma media contact and depression in children, the factors that may influence the association, and the difficulties encountered in the study of media effects on depression.Recent FindingsAll of the included studies assessed general population samples. Pre-COVID-19 research focused primarily on television coverage alone or on multiple media forms including television, while COVID-19 media studies examined various media forms including social media. Most studies used cross-sectional design and non-probability sampling. The review revealed inconclusive findings across studies.SummaryThe study of mass trauma media effects on depression in children is complicated by a number of potential confounding factors and by the relatively high prevalence of depression in the general population. Media contact was a relatively minor consideration among other interests in the extant studies which failed to explore numerous issues that warrant attention in future research.

An integrated approach to the bioavailability, ecological, and health risk assessment of potentially toxic elements in soils within a barite mining area, SE Nigeria.

Monitoring and assessment of soil quality are important in mining areas. In this study, indexical, spatiotemporal, and chemometric models were developed to monitor and assess the pollution level and health risk of potentially toxic elements (PTEs) within the Iyamitet-Okurumutet mine province, SE Nigeria. Surface soils were sampled within the mine area and analyzed for pH, cation exchange capacity, organic matter, and PTEs (Pb, Zn, Cd, Mn, Fe, Ba) following standard techniques. It was revealed that the soils are slightly acidic and the enrichment of PTEs except for Cd (4.08mg/kg-1) was within recommended standards. Contamination factor, enrichment factor, and pollution index suggest that the soils are moderately polluted. Geospatial maps and ecological risk indices revealed that higher ecological risk imprints seem to increase towards the south-eastern parts of the area. Chemometric analysis revealed that PTE enrichment in the soil is majorly influenced by anthropogenic activities. Further, bioavailability/bioaccessibility risk assessment index (BRAI) and health risk assessment models were developed to quantify the bioavailable/human bioaccessible portion of elements in soils and the associated health risks. The BRAI ranged from high (3 ≥ 5) to very high (> 5) risk of human bioaccessibility; hence, greater amount of PTEs will be bioaccessible for absorption into the human gastrointestinal system than they would for plants uptake. The hazard index and lifetime cancer risk (LCR) revealed that most of the samples present high chronic cancer risks from dermal contact and ingestion for children and adults. The LCR values ranged between 1.0E-6 and 1.0E - 04, with the children population showing greater vulnerability to cancer risks.

Exploring Family Support Work and Its Staff in Children’s Therapeutic Residential Care

ABSTRACT This is a small-scale case study set out to explore a unique role within children’s residential care in England, that of the Placement Family Support Worker and the family support work they conduct for the children in placement. This subject was explored through semi-structured interviews with seven Keyworkers and two Placement Family Support Workers in a children’s therapeutic residential care service consisting of four children’s homes. It was found that not every home had a Placement Family Support Worker, often due to staff resources and funding, and so often the children’s Keyworker would manage the family support work themselves. In either case, family support work was seen to be highly valuable and significant for the children’s development and relationships. It was found, however, that it would be more beneficial to have an independent Placement Family Support Worker managing family support work for each child in the home rather than Keyworkers for objectivity, healthy relationship management, organization, workload, multi-agency manageability, and the specific skills required. In addition to this, it was felt that emotional and practical support from the other staff in the home and management improved the quality of this work. Practice Implications Children’s residential care homes are recommended to employ a dedicated placement family support worker to manage family support work and contacts for children in placement. Independent placement family support workers will be a resource in developing, maintaining and strengthening relationships between children in placement and their family, alternatively, through objective observations of contact they can advise on continued contact as beneficial or detrimental or even reunification. There needs to be a drive toward consistent practice (initially through standardised data collection methods) and appropriate training for those conducting family support work (including social work skills or prior experience in social work). Due to the complexity of the role and relationship management involved, dedicated spaces for reflection are needed for those conducting family support work.

Feasibility of a randomized clinical trial evaluating a community intervention for household tuberculosis child contact management in Cameroon and Uganda

BackgroundOne of the main barriers of the management of household tuberculosis child contacts is the necessity for parents to bring healthy children to the facility. We assessed the feasibility of a community intervention for tuberculosis (TB) household child contact management and the conditions for its evaluation in a cluster randomized controlled trial in Cameroon and Uganda.MethodsWe assessed three dimensions of feasibility using a mixed method approach: (1) recruitment capability using retrospective aggregated data from facility registers; (2) acceptability of the intervention using focus group discussions with TB patients and in-depth interviews with healthcare providers and community leaders; and (3) adaptation, integration, and resources of the intervention in existing TB services using a survey and discussions with stakeholders.ResultsReaching the sample size is feasible in all clusters in 15 months with the condition of regrouping 2 facilities in the same cluster in Uganda due to decentralization of TB services. Community health worker (CHW) selection and training and simplified tools for contact screening, tolerability, and adherence of preventive therapy were key elements for the implementation of the community intervention. Healthcare providers and patients found the intervention of child contact investigations and TB preventive treatment management in the household acceptable in both countries due to its benefits (competing priorities, transport cost) as compared to facility-based management. TB stigma was present, but not a barrier for the community intervention. Visit schedule and team conduct were identified as key facilitators for the intervention.ConclusionsThis study shows that evaluating a community intervention for TB child contact management in a cluster randomized trial is feasible in Cameroon and Uganda.Trial registrationClini calTr ials. gov NCT03832023. Registered on February 6th 2019.

Criminal law policy in the framework of children contact with the law

The dynamics of criminal law in Indonesia are currently experiencing complexity, because there are still children who commit legal acts such as violence, destruction, or child delinquency that results in murder. However, this is triggered by the unstable psychological and mental state of the child, the surrounding environment or way of life that grows and develops in people's lives as well as civility in communicating and socializing with people's lives. Distortion of children who are in conflict with the law when they have to prioritize attitudes, morals and skills, so there needs to be a criminal law policy in order to prioritize human values and skills (soft skills) when they are processed in correctional institutions. This research is focused on fostering skills and creativity for children who are in conflict with the law at the correctional institution at the UPT for Social Protection and Rehabilitation Marsudi Putra Surabaya. This study uses a sociological juridical approach by emphasizing research that aims to obtain legal knowledge empirically by going directly to the object. If you look at the results and analysis of the findings, that children who are in conflict with the law have felt mentally and psychologically destroyed, so they need to be triggered by skill activities such as making crafts and technology in the penitentiary at the UPT for Social Protection and Rehabilitation Marsudi Putra Surabaya. Law Number 11 of 2012 concerning the Juvenile Criminal Justice System (SPPA) mandates the formation of the Child Special Guidance Institution (LPKA). This is an improvement step towards fostering children who are in conflict with the law, because before LPKA was formed, it was still found that child prisoners were placed in one penitentiary joining adult inmates. At the Social Protection and Rehabilitation UPT Marsudi Putra Surabaya, the reality is that LPKA has been formed by carrying out activities that support productivity and skills. What happened to the Directorate General of Corrections at the Ministry of Law and Human Rights to: first, prepare LPKA officers from various disciplines, such as psychologists, crimonologists, criminal experts, and sociologists; second, increasing training related to fostering children in conflict with the law for LPKA officers; and third, increasing cooperation with relevant agencies in providing guidance for children in conflict with the law. Law Number 11 of 2012 concerning the Juvenile Criminal Justice System (UU SPPA) aims to create a court that truly guarantees the protection of the best interests of children in conflict with the law. The SPPA Law is a substitute for Law No. 3 of 1997 concerning Juvenile Courts (Children Court Law), because the Juvenile Court Law is considered no longer in accordance with legal needs in society and has not comprehensively provided special protection to children in conflict with the law.

Variation in health visiting contacts for children in England: cross-sectional analysis of the 2–2½ year review using administrative data (Community Services Dataset, CSDS)

ObjectiveThe 2–2½ year universal health visiting review in England is a key time point for assessing child development and promoting school readiness. We aimed to ascertain which children were least...

Frequency of diabetes team contacts in children and adolescents using insulin pumps

Background: The purpose of this study is to assess if a relationship exists between A1c within target (£ 7.5%) and frequency of patient-initiated contact with diabetes team, in children with type 1 diabetes (T1DM) on an insulin pump. Additionally, to determine factors impacting frequency of contact. Methods: This was a retrospective study of children with T1DM on an insulin pump. Frequency of contact, type of contact, and A1c were collected. Study participants filled out a questionnaire at study entry. Results: One hundred and seventy-six participants were enrolled, with a mean age of 13 years. The median duration of T1DM was 6 years with a median duration of pump use, 3.6 years. One hundred and sixteen subjects (66%) contacted the diabetes team for insulin dose adjustments between clinic visits with a mean (standard deviation [SD]) of 1.2 (± 1.7) contacts, 90% of which were by e-mail. There was no significant relationship between achieving target A1c and frequency of contact. However, increasing age and longer duration of pump use were associated with decreased frequency of contact. Common barriers to contact included being too busy and technical problems with software. Conclusions: There was no significant relationship between the frequency of patient-initiated contact with diabetes team and A1c. Overall, there was low frequency of contact in the cohort. Older children and children with longer duration of pump use had fewer contacts with low rates of self-directed pump adjustments. These results raise the importance of defining strategies to increase patient engagement and empower diabetes data review.