Future Child Research Articles

The Future of Children in the Criminal Justice System: Restorative or Retributive Approach

The future of children within criminal justice systems raises fundamental questions about the best approach to both punishment and rehabilitation. This paper explores the competing paradigms of restorative and retributive justice, examining their impact on child offenders. Restorative justice focuses on rehabilitation, reconciliation, and reintegration into society, while retributive justice emphasizes punishment proportionate to the crime. Through an analysis of global case studies, legal frameworks, and criminological theories, this study assesses the effectiveness of each approach. It argues that restorative justice, though underutilized, offers more promising outcomes for reducing recidivism among child offenders, while retributive measures often fail to address the root causes of juvenile delinquency. The paper concludes by recommending a shift towards a more restorative model in juvenile justice systems, emphasizing the need for comprehensive policy reform to prioritize the long-term welfare of child offenders.

A REALIZAÇÃO DO PROGRAMA SAÚDE NA ESCOLA COMO FERRAMENTA PARA PROMOÇÃO DE EDUCAÇÃO EM SAÚDE DURANTE A FORMAÇÃO EM MEDICINA DE FAMÍLIA E COMUNIDADE: UM RELATO DE EXPERIÊNCIA

Introduction: The School Health Program (PSE), announced by the Ministry of Health in 2007, aims to promote health in partnership with educational institutions to improve the quality of life of the population, specifically school-aged children. This involves collaboration between health and education professionals, providing appropriate knowledge to reduce vulnerabilities that may compromise the development and the future of children and adolescents. Objective: To report the experience of a family medicine resident, part of a family health team (eSF) in the Federal District (DF), primarily promoting sexual education for children and adolescents in two public schools within the team's area of coverage. Methodology: This is a descriptive and qualitative study, of the experience report type, conducted during the two years of residency in Family and Community Medicine, from 2023 to 2024, in the satellite city of Sobradinho, Federal District. Results: The students involved, aged between 9 and 12 years, showed great interest in the topics addressed regarding sexuality and hygiene habits, adopting a participatory attitude, engaging in the exchange of experiences, raising questions, and discussing the subjects covered in the meeting and topics detailed in the adolescent health booklet. Conclusion: The necessity of partnership between health teams and education professionals was evident to provide health promotion, especially focused on sexual education, aiming to reduce negative outcomes and minimize future social and health damages in the vulnerable population of the DF.

COVID-19 impact on childhood vaccination attitudes in pregnant antenatal class attendants in Rome

Abstract Background The COVID-19 pandemic caused a decrease in vaccination rates, impacting vulnerable populations such as pregnant women (PW), who concern about future children’s immunisations. The aim of this study was to assess whether the pandemic led to changes in childhood vaccination attitudes among PW attending antenatal classes at the Fondazione Policlinico Universitario A. Gemelli in Rome. Specifically, it assessed the impact of the pandemic on the perceived usefulness of information sources, their trust in healthcare workers (HCWs) and the National Health Service (NHS), their perception of the risk of infection and severity of vaccine-preventable diseases (VPDs), and their vaccination intentions. Methods A repeated cross-sectional study was conducted across three flu seasons by administering an anonymous questionnaire: one before and two during the pandemic. Intention to vaccinate children was expressed as the percentage of PW who selected each vaccination from the questionnaire. Trust in HCWs and the NHS, and perception of the risk of infection and severity of VPDs were expressed as the percentage of PW who answered “quite” or “very”. For the usefulness of information sources, mean scores were calculated. To assess differences of the three periods a chi-square test was performed (p = 0.05). Results Course attendance surged from 105 to 340. Significant shifts in vaccination intentions were noted: 7.5% and 10% decreases for measles (p = 0.02) and pertussis (p = 0.004), respectively, from 2019-20 to 2020-21. Perceived contagion risk decreased, but perceived disease severity increased. A significant reduction in the proportion of PW suspecting economic interest behind NHS workers promoting vaccination, and an increase in the perceived usefulness of non-institutional websites and of the advice from non-NHS physicians were noted. Conclusions PW’s attitudes towards vaccinations might have been modified by COVID-19 pandemic, regarding risk perception and trust in NHS HCWs. Key messages • Our findings suggests that PW’s attitudes towards childhood vaccinations might be modified by the COVID-19 pandemic, in particular risk perception and trust in NHS healthcare workers. • These findings could help Public Health to develop evidence-based interventions and communication strategies, to maintain vaccine confidence and mitigate potential adverse effects.

Influenza and COVID-19 vaccines in pregnancy: investigation on associated factors and HAPA theory

Abstract Background Infections caused by influenza and COVID-19 during pregnancy represent a current public health problem as there are multiple populations at risk of complications: pregnant women, fetus, and future unborn children. The anatomical and physiological remodulation characteristic of pregnancy is responsible for the high pathological burden related to respiratory infections. Co-administration of influenza and COVID-19 vaccines may be beneficial because these two respiratory viruses cocirculate during cold weather. The need to explore pregnant women’s attitudes toward co-administration of influenza and COVID-19 vaccines and to evaluate factors associated with vaccine decision-making led to the conduct of this study. Methods In Palermo, Italy, during the 2021-2022 influenza season, a cross-sectional study was conducted to evaluate pregnant women’s intention to adhere to co-administration of influenza and COVID-19 vaccines. The determinants of vaccination attitudes were investigated through the administration of a questionnaire. The Health Action Process Approach theory (HAPA) was adopted to explore the cognitive behavioral aspects. Results Overall, 120 pregnant women were enrolled; average age 32 years, 98.2% (n = 118) of Italian nationality and 25.2% (n = 30) with obstetric or pathological conditions of pregnancy at risk. Factors significantly associated with attitudes toward co-administration of influenza and COVID-19 vaccines among pregnant women were: high level of education (OR = 13.96; p < 0.001), expectations of a positive outcome (OR = 2.84; p < 0.001) and self-efficacy (OR = 3.1; p < 0.001). Conclusions Vaccines co-administration could represent an advantageous preventive practice to facilitate vaccination logistics and allow full adherence to vaccinations recommended to pregnant women. Effective strategies to promote co-administration of influenza and COVID-19 vaccines could be focused on counselling about the expectation of positive outcomes of vaccine co-administration. Key messages • The need to explore pregnant women’s attitudes toward co-administration of influenza and COVID-19 vaccines and to evaluate determinants of vaccine decision-making led to the conduct of this study. • Vaccines co-administration could represent an advantageous preventive practice to facilitate vaccination logistics and allow full adherence to vaccinations recommended to pregnant women.

TƏLƏBƏLƏRİN AİLƏ HƏYATINA VƏ ÖVLAD TƏRBİYƏSİ İŞİNƏ HAZIRLANMALARI: PROBLEM BAXIMINDAN MÖVCUD ƏDƏBİYYATIN ÖYRƏNİLMƏSİ VƏ TƏHLİLİ

The desire of every parent is for their daughters and sons to have a successful marriage for love and a happy family. For this, young people must be prepared for family life. First in the family, then in educational institutions. They should also be taught how to raise children. The article talks about independent family life of students and the upbringing of their future children.

CANCaRe Africa: Working together to build a better future for children with cancer in Africa.

CANCaRe Africa: Working together to build a better future for children with cancer in Africa.

THE USE OF PREIMPLANTATION DIAGNOSIS IN THE GENERATION OF SAVIOR SIBLINGS: A multidisciplinary study

Preimplantation Genetic Diagnosis (PGD) is a technique used in IVF to analyze embryos and check for the presence of genetic diseases, allowing the selection of healthy embryos. The medicine baby is a child generated for the purpose of treating a sick sibling, being a relevant practice in the medical field because it enables the cure of certain pathologies through the donation of tissues such as blood and bone marrow. The importance of PGD is highlighted, as it allows diagnosing and selecting embryos without genetic diseases, although it is necessary to consider ethical limits to preserve the integrity and dignity of the future child. The objective of this study was to analyze the criteria used in the Preimplantation Genetic Diagnosis for the generation of a drug baby. An exploratory literature review was carried out in databases such as Pubmed, Virtual Health Library, Google Scholar and journals between the years 2012 and 2023, in addition, the film "A proof of love" was analyzed to complement the investigation. While PDG and the drug baby generation advance healthcare in revolutionary ways, it is important to address ethical and social issues comprehensively and sensitively by ensuring that scientific advances are used responsibly and for the benefit of all involved.

Future of children with chronic intestinal failure reaching adulthood with home parenteral nutrition. A French multicentric nation-wide study

Future of children with chronic intestinal failure reaching adulthood with home parenteral nutrition. A French multicentric nation-wide study

Technology-Based Child Abuse and Neglect Prevention Programs: A Systematic Review

Child abuse and neglect is a widespread social problem. The prevalence of this problem threatens the present and future of children. Although various prevention programs have been proposed in the literature as a solution to the problem of child abuse and neglect, recently, technological applications have been increasingly used in prevention and intervention studies for abuse and neglect. This study aims to review the current literature on technologically assisted programs for preventing child abuse and neglect. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was used to identify eligible studies. 22 evidence-based studies with pretest-posttest control were included in the review. The reviewed programs were structured to educate parents, children, and various professionals on appropriate parenting skills and child abuse and neglect. In the studies reviewed, web/internet-based applications were mostly used and effectiveness evaluation studies were mainly conducted on parents. With the exception of one study, the programs were found to be effective following interventions for abuse and neglect, and cognitive and behavioral improvements were noted in parents, children, and other professionals. As a result, it can be said that technology-based prevention programs are accepted practices for child abuse and neglect. To date, however, there is little data to support the use of such studies in preventive practices and strategies. More studies are needed to test the effectiveness of technological applications in preventing abuse among children and adolescents.

Navigating Challenges and Leveraging Technology: Experiences of Child Welfare Workers during the COVID-19 Pandemic

This qualitative study explores the experiences of child welfare workers during the COVID-19 pandemic through virtual interviews, focusing on the challenges and adaptations in their work and support systems. Participants reported significant difficulties in maintaining a healthy work–life balance, heightened stress, anxiety, and increased workloads due to sick leaves and burnout. This study highlights the dual role of technology as both a stressor and a crucial tool, with rapid integration posing challenges while also enabling continued support for children and families. Despite these challenges, workers demonstrated resilience and creativity, developing innovative solutions to navigate the new landscape. The findings underscore the importance of robust support systems, clear communication, and equitable access to technology. This study suggests integrating lessons learned during the pandemic into future child welfare practices to enhance resilience and adaptability in the face of future crises.

Association between maternal religious service attendance and pregnancy loss in the United States: a secondary analysis of the Future Families & Child Wellbeing Study.

Accumulating evidence suggests that spirituality and religiosity may be associated with improved health outcomes. However, few studies have examined maternal religiosity as a protective factor for perinatal outcomes. We explored the association between maternal religious attendance and pregnancy loss. Data were drawn from the Future Families & Child Wellbeing Study's first and second waves and medical records (n=1874). Religious attendance was a self-reported response to the question "About how often do you attend religious services?" Pregnancy loss was measured from responses to the second wave survey question, "Since focal child's birth, have you had any miscarriages/abortions/stillbirths?" Logistic regression estimated odds ratios (OR) and 95% confidence intervals (CI) for the association between maternal religious attendance frequency and pregnancy loss, overall and by race. Models were adjusted for sampling weights, religious preference, socioeconomic and behavioral factors. 8% (n=164) of mothers reported having a pregnancy loss. Of those with a pregnancy loss, 28% (n=46) attended services hardly ever and 20% (n=20) attended services once a week or more. Women who attended services more frequently had 58% increased odds of not experiencing a pregnancy loss (OR:1.58;95%CI:1.01,2.48) after adjusting for potential confounding. A post hoc analysis found no difference in pregnancy loss type or subsequent reproductive history based on attendance level. Results suggest that higher maternal religious attendance frequency may be a protective factor for pregnancy loss. Further research is needed to understand the association between maternal religious attendance and mechanisms for pregnancy loss.

Navigating the disclosure landscape: Parents' perspectives on healthcare professionals' role in supporting intersex children and families.

Intersex, an umbrella term, describes individuals with sex characteristics that cannot be exclusively categorized into binary definitions of male or female. The intersex community faces a lack of social visibility perpetuated by a history of medical discrimination and pathologization shaped by "normalizing" genital surgeries without the child's consent. Despite efforts to reform clinical practice, there remains a paucity of research centering the needs of the intersex community and their families. This study explored parents' perspectives on how healthcare professionals (HCPs), such as genetics professionals, can provide patient-centered education and support when parents first learn of their child's intersex variation, with the aim of offering recommendations to HCPs to promote parental adjustment and protect intersex children's right to autonomy. Thirteen qualitative semi-structured interviews were conducted with 14 parents of intersex children. Through reflexive thematic analysis, under the framework of an agency-based approach to intersex health, thematic categories were inductively conceptualized, including barriers and facilitators to HCPs' sensitivity and to parental adjustment in the early disclosure environment. Barriers to HCPs' sensitivity were imposed by educational, religious, or medical institutions, along with sociocultural prejudices and pathologizing language. Barriers to parental adaptation included uncertainty regarding their child's future, sociocultural gender norms, and unsuitable information provision. Incorporating parental needs in the disclosure environment can facilitate familial acceptance, including normalization of variations of sex characteristics (VSCs), enhanced medical education, facilitation of patients' navigation, and prioritization of parents' social support needs.

Enhancing Work-Life Balance of Teachers in Self-Financing Schools

Introduction: Teachers contribute significantly to the growth of schools and students by determining each child's future. Teachers support young minds and help them do great things. So, a teacher's work-life balance needs to be taken care of and is a must for every teacher. The school teachers can better balance their family and work life by adopting a work-life balance strategy. In order to maintain work life balance, teachers should prioritise their time and balance their work with their family, health, holidays, and other commitments. Objectives: To study the demographic factors on stress level among teachers, to assess the variables that affect work-life balance and to determine the consequences of not maintaining the work-life balance of teachers at self-financing schools.Method: The primary data were gathered using questionnaires, and a total of 200 samples were chosen. The methodology includes specific statistical tools such as percentage analysis, chi-Square, correlation, and one-way ANOVA for analysis and interpretation. Results: The analysis suggests that the factors affecting work-life balance, including heavy household work, financial commitments, childcare challenges, lack of recognition, job dissatisfaction, and family time constraints, are significantly correlated with higher stress levels among the teachers of self-financing schools. The findings suggest that achieving work-life balance is possible with the help of school support through counseling programmes, transparent flexible working hours, and accommodating leave for family emergencies. Conclusion: Neglecting work-life balance can have a negative impact on teachers in self-financing schools, limiting their ability to manage domestic tasks, causing physical health concerns, and leading to professional and personal errors. However, teachers can truly enjoy the blessings of life by developing the necessary life coping skills to effectively manage work-life balance

Investigating the interaction of zno nanoparticles with flagellum and fimbriae in multi-drug resistant uropathogenic bacteria encoding fli and fim genes.

Due to the increasing occurrence of drug resistant urinary tract infections (UTI) among children, there is a need to investigate alternative effective treatment protocols such as nanoparticles. Flagella and fimbriae are primary factors contributing the virulence of urinary tract infecting bacteria. The aim of this study was to assess the antibacterial effects of zinc oxide nanoparticles which have been synthesized using both chemical and green methods on multi-drug resistant (MDR) uropathogenic bacteria encoding fli and fim genes and investigating their binding ability to bacterial appendage proteins. A total of 30 urine culture samples were collected from children under 2 years old diagnosed with urinary tract infection. The isolates underwent antibiotic suseptibility assessment and the isolates demonstrating MDR were subjected to molecular amplification of fimG (fimbrial) and fliD and fliT (flagellal) genes. The confirmation of cellular appendages was achieved through silver nitrate staining. The antibacterial efficacy of the synthetized nanoparticles was assessed using the micro and macrodilution methods. The successful binding of nanoparticles to bacterial appendage proteins was confirmed through mobility shift and membrane filter assays. The dimensions of chemically synthesized ZnO nanoparticles and green nanoparticles were measured at 30nm and 85nm, respectively, with the exhibition of hexagonal geometries. The nanoparticles synthesized through chemical and green methods exhibited minimum inhibitory concentrations (MIC) of 0.0062-0.025g/L and 0.3g/L, respectively. The ability of ZnO nanoparticles to bind bacterial appendage proteins and to combat MDR uropathogenic bacteria are promising for new treatment protocols against UTI in children in future.

Climate emotions, parenting plans, and racial difference in the United States

IntroductionIncreasing attention is being paid to the relationship between climate change, emotional and mental distress, and feelings about raising children. These studies often overlook the role of demographics, race in particular, despite evidence that racial minority groups in the U.S. experience more detrimental climate impacts and express more climate concern than do white communities. This survey was conducted to elucidate the relationship between race, climate emotions, and parenting plans in the U.S. MethodsWe surveyed 2489 people in the U.S. between the ages of 22 and 35 in September 2021. Because we were interested in the role of race, we oversampled those who identified as non-white/people of color. The survey assessed participants’ emotions with respect to climate change, and their emotions with respect to birthing and raising children (parenting) in the context of climate change. ResultsNonwhite respondents were more likely than white respondents to report feeling traumatized as a response to climate change, and to plan to have fewer future children than they wanted as a result of their climate-related emotions. They were also more likely to report feeling more optimistic and hopeful in response to climate change and in response to raising existing children in the context of climate change. White women were least likely to report any positive emotions with respect to parenting during climate change. White men were most likely to report non-feeling emotions such as numbness, indifference, or being checked out. Christian respondents were more likely to report feeling positive emotions overall. ConclusionThis study highlights race as a statistically significant factor in the reporting of climate emotions and parenting plans. It demonstrates that climate change has contradictory impacts on the emotions of nonwhite people of color, while having a negative impact on childbearing plans. We call for further research into the role of race in climate-related emotions and parenting plans, particularly with respect to the impacts of traumatized feelings, as well as the roles of religion and positive emotions.

Anxiety and neural correlates of attention and self-regulation in pregnancy: a resting-state EEG study.

Pregnant women are particularly vulnerable to experiencing mental health difficulties, especially anxiety. Anxiety in pregnancy can be characterized as having two components: general symptomology experienced in the general population, and pregnancy-related anxiety more focused on pregnancy, delivery, and the future child. In addition, women also commonly report experiencing attentional control and self-regulation difficulties across the peripartum period. However, links between anxiety and neural and cognitive functioning in pregnancy remain unclear. The present study investigated whether anxiety is associated with neural markers of attention and self-regulation measured using electroencephalography (EEG). Specifically, we examined associations between general and pregnancy-related anxiety and (1) beta oscillations, a neural marker of attentional processing; and (2) the coupling of beta and delta oscillations, a neural marker of self-regulation, in frontal and prefrontal regions. A sample of 135 women in the third trimester of their pregnancy completed a resting-state EEG session. General anxiety was associated with increased beta oscillations, in line with research in the general population, interpreted as reflecting hyperarousal. Pregnancy-related anxiety was associated with decreased beta oscillations, interpreted as reflecting inattention and mind-wandering. Moreover, pregnancy-related anxiety, but not general anxiety, was linked to stronger delta-beta coupling, suggesting anxiety specifically related to the pregnancy is associated with investing greater effort in self-regulation. Our results suggest that general and pregnancy-related anxiety may differentially relate to neural patterns underlying attention and self-regulation in pregnancy.

Designing Digital Resources for Multimodal Composition in the Kindergarten Environment

In the contextual field of environmental composition in kindergarten, transforming it into a space for cognitive, social, emotional, i.e., holistic formation and development of the child, multimodality operates with authenticity, magnetism, multilevelity, multidimensionality, and dynamism to overcome schematicity and linearity of thinking, thus stimulating imagination. Leading the way is the understanding that the environmental composing of multimodality in kindergarten is the foundation of quality for the child’s cognitive, affective, sensory cognition and self-knowledge. This paper outlines the parameters of evaluating multimodal digital resources designed by students preparing for future kindergarten teachers. The starting points for their expertise in the relations of autonomy, coherence, justification, adequacy and authenticity as subjectively significant and objective wholes of multimodal composing are argued. Criteria and indicators for the expert evaluation of digital resources for multimodal environmental composing in kindergarten, as modeling and provoking and enriching the individual sensory experience of the child, as an opportunity to stimulate cognitive and personal activity are derived. It is necessary to conclude that through the design of multimodal digital resources, the existing contradictions in the starting conditions of the pedagogical interaction in the kindergarten will be overcome. The main recommendation points to the need for specific training of future children’s teachers for multimodal environmental composition of educational practices in kindergarten, synergizing different modalities, rather than their linear sequential environmental combination.

Parental decision-making in taking care of child health in Indonesia: Findings from a national survey

Background: The decision-making process to search for child health services involves interaction among the mother, partner, and other family members. Parental decision-making is highly complex since it involves an emotional consideration between the benefit and the child's future. The common problem in deciding the service is the lack of capabilities, such as facility, knowledge, and skill.Objective: The purpose of this study is to analyze the influence of socio-demographic factors on parents' decision-making in obtaining health services for their children Methods: This study design was cross-sectional data from the Indonesia Demographic and Health Survey (IDHS) of 2017, which was applied in this study. The respondents involved were 8,838 women aged 15-49 who had given birth in the last five years. This study employed descriptive, chi-square, and regression statistics analysis. The results were provided as adjusted odds ratios (AORs) with 95 percent confidence intervals. The statistical analysis utilized SPSS version 21.0 software (SPSS Inc., Chicago, IL, USA).Results: Bivariate analysis revealed a significant relationship between decision-making and age, living place, educational background, and wealth index (p-values 0.030, <0.001, 0.002, and 0.006), but not with health insurance ownership (p=0.242). After multivariate analysis, only age-related decisions were associated with a significant risk. It explained that younger group (15-29) has a 0.325 times chance of making a joint decision than the 40 to 49-year-old group (AOR: 0.325; 95%CI: 0.144-0.733). Conclusion: Parental decision-making regarding childcare is related to several factors, namely age, living place, educational background, and socioeconomic status. Health education is a strategy to promote child health in Indonesia by facilitating proper decision-making.

Navigating the Journey of Living with Young-Onset Dementia: Experiences of Spousal Caregivers.

Young-onset dementia (YOD) refers to dementia occurring before the age of 65, with Alzheimer's disease being the most common form, posing distinct challenges for spousal caregivers. This study aims to investigate the unique experiences of spousal caregivers of persons with YOD in China, where dementia-specific community care services and primary healthcare professionals are relatively lacking, in order to inform the tailored support services development. This qualitative-design study utilized semi-structured interviews with 11 spousal caregivers of persons with YOD dwelling in the community. Traditional content analysis was employed to analyze the interview data. Limited dementia-specific healthcare professionals and low public awareness made diagnosing and accepting YOD a prolonged and challenging journey. Spousal caregivers faced skepticism when seeking diagnosis, exacerbating their burden and emotional stress. Disparities in healthcare professionals and insufficient collaboration between institutions worsened the situation. YOD significantly impacted family dynamics and led to changes in emotional communication within the family. The stigma surrounding YOD raised concerns among spousal caregivers about their children's future in marriage and career, emphasizing genetic risks. In settings where dementia-specific community care services and primary healthcare professionals are limited and unevenly distributed, integrating support services at both the primary and community levels is crucial for families dealing with YOD in the community. Additionally, raising public awareness about YOD can foster a more understanding and supportive environment, addressing challenges related to stigma faced by affected families, contributing to increased investment in supporting resources, and encouraging individuals to seek help early on.

Telebehavioral Health for Caregivers of Children With Behavioral Health Needs to Address Caregiver Strain: Cohort Study.

Behavioral health conditions among children have worsened over the past decade. Caregivers for children with behavioral health conditions are at risk for two types of caregiver strain: (1) an objective strain, that results directly from the child's condition and (2) subjective strain, that arises from the caregiver's feelings regarding these events. This study aimed to evaluate the impact of a technology-enabled pediatric and family behavioral health service on caregivers' strain among a commercially insured population. We also explore the common symptom clusters of caregiver strain to better understand the caregiver presentation to inform future care planning. We examined changes in caregiver strain using the Caregiver Strain Questionnaire-Short Form 7 over the course of their child's web-based behavioral health care between 2021 and 2023 using a pre-post study design. Common caregiver strain symptom clusters were identified using Ward hierarchical agglomerative clustering. The majority of children were White 60.8% (1002/1647), female 53.6% (882/1647), and aged between 5 and 9 years (33.7%, 555/1647). Families fall broadly into 4 groups based on what drives caregiver strain the most, namely those experiencing (1) disrupted family relationships and time interruption, (2) missed work, (3) worried about their child's future and feeling tired and sad, and (4) financial strain. Caregiver strain, which was associated with the child's disease severity (P<.001), decreased significantly in all therapeutic groups. Web-based family-oriented behavioral health care can improve caregiver strain and reduce family and time disruptions, missed work, and financial strain. Sources of caregiver strain vary and may be overlooked when relying on the conventional scoring of the Caregiver Strain Questionnaire-Short Form 7.