Parental Agreement Research Articles

108 Palliative care for neonates: Retrospective mixed methods review of infant death in the Neonatal Intensive Care Unit

Abstract Background Neonatal palliative care is an under researched yet growing field in the provision of intensive care to neonates. There are currently no studies which explore infant death in the Neonatal Intensive Care Unit (NICU) itself where a shift from intensive to palliative care may occur. Objectives The purpose of this study was to explore the circumstances of infant death in the NICU and understand current utilization of specialist palliative care in this area. It aimed to characterize the infants’ clinical course and add unique understanding by analyzing documentation related to end of life care. Design/Methods A retrospective chart review of infants who died in a single centre NICU between January 2017 and March 2018 was undertaken. Infants of any gestational and post-natal age were included, excluding infants who died prior to arrival to the NICU or were discharged or transferred prior to death. Chart notes relating to prognosis, advanced care planning, and palliative interventions were sampled, coded, and collated for thematic analysis. Results Twenty-five infants met study criteria. Of these, 92% were preterm with more than half below 28 weeks gestation. Median age at death was 5.2 days (IQR 1, 26.2). All infants required ventilator support with planned withdrawal occurring in 60%. Specialist palliative care was involved in 28%; these infants tended to be older (mean age at death = 78 days). Most infants were labelled as “critical” 2-5 days prior to death. Seventy-six percent of infants were held on their last day of life with 72% of families having memory making documented as part of their care. Qualitative excerpts revealed themes of hope and acceptance, parental presence, and framed discussion. Within these emerged concepts of “parental agreement” and “palliative language/approach”. Conclusion There is a growing need for both primary and specialist palliative care in the NICU. This study highlights an under researched area and generates many more important questions. By exploring documented language, we aim to understand and improve the ability to frame the discussion while ensuring quality end of life care for dying infants and their families in the NICU.

Organization in Time Among Adolescents: Is There an Adolescent–Parent Agreement, and What About Gender Differences?

Abstract Date Presented 03/27/20 Adolescents divide their time among occupation domains essential for developing daily life management and well-being into adulthood. The Time Organization and Participation Scale (TOPS) assesses self-perception and emotional implications of time-organization abilities. This study’s results present TOPS’s internal reliability for adolescents and their parents and identify gender-related differences. Time organization should be considered for assessing and developing interventions among adolescents. Primary Author and Speaker: Liron Lamash Additional Authors and Speakers: Sara Rosenblum Contributing Authors: Tsameret Ricon

The predictive role of marital satisfaction on the parental agreement.

AimThe aim of this study was to investigate the predictive role of marital satisfaction on similarities in parenting styles.DesignThe present cross‐sectional study was conducted on 617 Iranian father–mother dyads in 2018.MethodsDuring a systematic sampling method, Afrooz Marital Satisfaction Scale and Parenting Styles and Dimensions Questionnaire were administered. The data were analysed using a t test, a chi‐square test, one‐way ANOVA and logistic regression.ResultsResults showed that 71.47% of the couples exhibited agreement in parenting styles and that 82.50% reared their children in an authoritative manner. The logistic regression indicated that increased marital satisfaction among fathers (AOR: 3.19; CI: 2.06, 4.92) and mothers (AOR: 2.74; CI: 1.76, 4.25) could elevate the odds of correspondence in parenting styles. The findings suggest that agreement on parenting styles should be considered when evaluating marital satisfaction in couples. Intervention targeting marital satisfaction to improve parental agreement is recommended.

Patterns of Food Parenting Practices Regarding Fruit and Vegetables among Parent-Adolescent Dyads.

Background: The study's objective was to determine patterns of food parenting practices regarding fruit and vegetables (FV) and their associations with demographic characteristics and dietary intake in parents and adolescents (12-17 years). Methods: Dyadic survey data from Family Life, Activity, Sun, Health, and Eating, a cross-sectional, Internet-based study, conducted in 2014 were analyzed using latent class analysis. Self-report model covariates included adolescent age and parent and adolescent sex, BMI, FV intake, and FV legitimacy of parental authority (FV-LPA). Results: Based on 1657 parent-adolescent dyads, 5 latent classes were identified representing use of all 6 to use of few FV parenting practices. Parent and adolescent responses agreed in four classes. The high use class was the reference class. Compared with early adolescent dyads, middle adolescent dyads had 58% and 66% lower odds of belonging to moderate and low use classes. Compared with female parent dyads, male parent dyads had over three times greater odds of belonging to low use class. Compared with female adolescent dyads, male adolescent dyads had 44% lower odds of belonging to disagreeing class. The odds of belonging to one of the other four classes were 19%-63% lower for every one cup equivalent increase in parent FV intake. Compared with dyads with high parental or adolescent agreement with FV-LPA, dyads with low agreement had 2.5-7 times the odds of belonging to another class. Conclusions: Distinct patterns of FV parenting practices exist and are associated with parent and adolescent demographic characteristics, dietary intake, and FV-LPA.

Adolescent-Parent Agreement on Callous-Unemotional Traits in Adolescents with Attention-Deficit/Hyperactivity Disorder.

This study examined the levels of agreement between the reports of 207 adolescents with attention-deficit/hyperactivity disorder (ADHD) and their parents regarding the adolescents’ callous–unemotional (CU) traits and investigated the factors influencing adolescent–parent agreement. Adolescent–parent agreement about CU traits in three dimensions according to the Chinese version of the Inventory of Callous and Unemotional Traits was examined. The influence of demographic characteristics, comorbid conduct disorder (CD), oppositional defiant disorder (ODD), and ADHD symptoms on adolescent–parent agreement was also examined. The results indicated that adolescent–parent agreement on the CU trait of uncaringness was moderate, whereas agreement on the CU traits of callousness and unemotionality was poor. Adolescent–parent agreement on the three dimensions of CU traits varied depending on the adolescents’ sex and comorbid CD and ODD symptoms as well as parental age. Therefore, multiple sources of information are required when assessing the severity of CU traits in adolescents with ADHD. The factors influencing the levels of the agreement should also be considered.

Health-Related Quality of Life in Craniofacial Conditions: Concordance Between Child and Parent Reports.

Craniofacial conditions (CFCs) profoundly influence health-related quality of life (HRQoL). In children with CFCs, patient-reported outcome measures have become an integral adjunct to more objective surgical outcome measures. Patient-reported outcome measures are designed to assess HRQoL domains. Few studies have evaluated parent and child agreement about HRQoL in the context of CFCs. The aims of this study were to explore the impact of CFCs on HRQoL domains in children and their parents and to determine whether patient and parent perspectives converge. The Craniofacial Conditions Quality of Life Scale (CFC-QoL) is a newly developed 5-domain survey available in child self-report and parent report and in English- and Spanish-language versions. The 5 domains are the following: social impact, psychological function, physical function, family impact, and appearance impact. Children with CFCs (ages 7-21 years) and parents of children with CFCs were recruited via the craniofacial care team clinic at a major metropolitan children's hospital. All children and parents completed the CFC-QoL Scale in their preferred language of English or Spanish. Scale internal consistencies were calculated for child patients and parents, for English and Spanish versions. Scores on the 5 domains were compared for children and parents across English versus Spanish versions. For children with CFCs (N = 75), the sex was distributed almost equally. Patients were mostly Hispanic (69.3%), and their ages ranged from 7 to 21 years old (M = 13.2, SD = 3.62). The mean values for patient and parent scores were low, suggesting good HRQoL across all 5 domains. Pearson correlation coefficients were computed to explore the interrelationships between patient and parent report for each of the 5 CFC-QoL subscales. For the total sample, patient and parent scores were significantly and moderately positively correlated for all subscales. When analyzed separately based on sex, ethnicity, and diagnostic group, the correlation patterns were not identical to those found for the total sample. When analyzed separately for diagnostic group, there was less consistency in patterns, with patient-parent dyads showing different levels of agreement based on child's diagnostic grouping. Although there is substantial agreement between parents and patients when considered on a group level, there is moderate agreement between patients and parents when considered at the dyadic level, underscoring the importance of measuring and considering both perspectives.

The impact of unplanned school closure on children's social contact: rapid evidence review.

BackgroundEmergency school closures are often used as public health interventions during infectious disease outbreaks to minimise the spread of infection. However, if children continue mixing with others outside the home during closures, the effect of these measures may be limited.AimThis review aimed to summarise existing literature on children’s activities and contacts made outside the home during unplanned school closures.MethodsIn February 2020, we searched four databases, MEDLINE, PsycInfo, Embase and Web of Science, from inception to 5 February 2020 for papers published in English or Italian in peer-reviewed journals reporting on primary research exploring children’s social activities during unplanned school closures. Main findings were extracted.ResultsA total of 3,343 citations were screened and 19 included in the review. Activities and social contacts appeared to decrease during closures, but contact remained common. All studies reported children leaving the home or being cared for by non-household members. There was some evidence that older child age (two studies) and parental disagreement (two studies) with closure were predictive of children leaving the home, and mixed evidence regarding the relationship between infection status and such. Parental agreement with closure was generally high, but some disagreed because of perceived low risk of infection and issues regarding childcare and financial impact.ConclusionEvidence suggests that many children continue to leave home and mix with others during school closures despite public health recommendations to avoid social contact. This review of behaviour during unplanned school closures could be used to improve infectious disease modelling.

Assessing readiness for independent self-care in adolescents with type 1 diabetes: Introducing the RISQ

AimTo design and evaluate psychometrics of adolescent self-report and parent proxy-report questionnaires assessing readiness for independent self-care in adolescents with type 1 diabetes (RISQ-T and RISQ-P). Methods178 adolescents with type 1 diabetes (ages 13–17 years) and their parents completed the 20-item RISQ-T and 15-item RISQ-P, along with diabetes-specific measures of parent involvement, self-efficacy, burden, and treatment adherence. Evaluation of psychometric properties included calculation of internal consistency, adolescent and parent agreement, test-retest reliability, concurrent and predictive validity. ResultsThe RISQ-T (α = 0.78) and RISQ-P (α = 0.77) demonstrated sound internal consistency. Higher RISQ-T and RISQ-P scores (indicating more adolescent readiness for independent self-care) showed significant associations with less parent involvement in diabetes care (adolescent r = −0.34; parent r = −0.47; p < .0001), greater adolescent diabetes self-efficacy (adolescent r = 0.32; parent r = 0.54; p < .0001), less parent-endorsed diabetes-related burden (parent r = −0.30; p < .0001), and greater treatment adherence (adolescent r = 0.26, p = .0004; parent r = 0.31, p < .0001). Adolescent and parent scores were significantly correlated (r = 0.35; p < .0001); test-retest reliability was reasonable (ICC RISQ-T r = 0.66; RISQ-P r = 0.71). Higher baseline RISQ-P scores significantly predicted reduced family involvement after six months (β = −0.14, p = .02). ConclusionsRISQ-T and RISQ-P demonstrate sound psychometric properties. Surveys may help inform diabetes teams of the level of support needed to facilitate shift to independent self-management.

Self and parent-proxy rated health-related quality of life (HRQoL) in youth with obesity: are parents good surrogates?

Consideration of health-related quality of life (HRQoL) and wellbeing outcomes is important to guide healthcare services for youth with obesity, yet youth perspectives may differ from their parents. This study compared youth and parental HRQoL reports and evaluated levels of concordance across HRQoL domains and as a function of youth age, youth gender and parent informant (mother and father). 376 youths with obesity, recruited from community (N = 223) and hospital settings (N = 153), and their parents (N = 190 mothers; N = 91 fathers), completed the PedsQL. Parental and youth agreement across subgroup dyads (mother; father; child gender; child age) were evaluated using Wilcoxon signed-rank test, intra-correlations coefficients (ICCs) and Bland-Altman plots. Compared to norms, HRQoL levels (youth self-report and parental proxy reports) were lower in all domains. Both mother and fathers' HRQoL reports were significantly lower than youths, most notably in physical HRQoL. Youth-parent concordance ranged from poor to moderate (ICC = 0.230-0.618), with lowest agreement for Physical HRQOL. Mothers were better proxies with ICCs being significant in all domains. Youth-father ICCs were significant only for Social (ICC = 0.428) and School (ICC = 0.303) domains. Girl-mother agreement was significant across all domains, while girl-father agreement was significant only in the Social domain (ICC = 0.653). Both mothers and fathers were poor raters for boys, and younger youths (aged ≤ 12), with non-significant ICCs in most HRQoL domains. Parents are poor surrogates for youth HRQoL. Clinicians should be cognizant that parents are not necessarily accurate proxies for youths, and exercise caution when interpreting parent-proxy scores.

Parental Psychological Factors and Quality of Life of Children With Inflammatory Bowel Disease

Parents have a central role in the management of children with inflammatory bowel disease (IBD). Alterations in parental psychological well-being may affect the patient's health-related quality of life (HRQoL). This study aimed to evaluate the correlation between maternal and paternal distress, anxiety, depression and pain catastrophizing and the HRQoL of patients with IBD. Children with IBD ages 8 to 18 years and their parents were prospectively recruited. Children answered questionnaires on HRQoL while parents completed an assessment of distress, anxiety, depression, and pain catastrophizing. Univariate and multivariate regression models analysis were used to evaluate correlations between parental measures and patient's HRQoL and between the factors related to children health and parental psychological suffering. One hundred patients (45 Crohn disease, 55 ulcerative colitis), 90 mothers and 62 fathers were enrolled. Parents had high levels of distress while anxiety, depression, and pain catastrophizing levels were relatively low. Parental distress had the most substantial correlation with children's HRQoL and was associated with patients' disease activity and recent flares. On multivariate regression analysis, parental factors explained less than 20% of the variance in the children's HRQoL scores. Mothers suffered from psychological alterations more frequently than fathers, but the parental inter-rater agreement was strong in regards to distress and anxiety. Parental distress is high and correlates with the HRQoL of children with IBD. Interventions aimed at evaluating and managing parental distress should be considered during the management of children with IBD.

Fractional exhaled nitric oxide and forced expiratory volume in 1 second/forced vital capacity have predictive value of asthma exacerbation in Korean school children.

BackgroundThe incidence of asthma exacerbation (AE) and the predictive value of spirometry and fractional exhaled nitric oxide (FeNO) in school children have not been evaluated.ObjectiveWe sought to evaluate the efficacy of spirometry measurement and FeNO monitoring for predicting AE in school children in the Cheongju area in Korea.MethodsWith parental agreement, we studied 170 students aged 7–12 years. Children were evaluated by an asthma specialist using baseline spirometry, skin prick test, seasonal FeNO measurement, and asthma control test. The study participants underwent a physical examination and their medical history was also evaluated by the specialist. They were assessed for asthma control status during regular doctor visits for 1 year.ResultsIn total, 160 children (94.1%) completed follow-up and FeNO monitoring. Of which, 26 children (16.3%) had AE. AE was associated with male children and children with allergic rhinitis (p < 0.05). While, children with AE tended to have higher FeNO than those without AE, no significant difference was found. The maximum value of FeNO ≥35 ppb was associated with AE (p < 0.05). Children with AE had a significantly decreased baseline forced expiratory volume in 1 second/forced vital capacity (FEV1/FVC), %predicted, forced expiratory flow at 25%–75% of FVC (FEF25%–75%). FEV1/FVC < 80% was associated with AE in children regardless of inhalant allergen sensitization (all p < 0.05).ConclusionBaseline spirometry had a predictive value of AE in school children. Sensitive spirometric parameters such as FEV1/FVC and FEF25%–75% can be used as prognostic factors to predict future childhood AE. FeNO value ≥ 35 ppb during monitoring was associated with AE in school children.

Parental egalitarian attitudes towards gender roles affect agreement on girls taking STEM fields at university in Japan

ABSTRACTWomen are still in the minority in Science, Technology, Engineering and Mathematics (STEM) fields in many countries, including Japan. Parental gender role attitudes are a potential influence on whether high school girls choose STEM fields and which fields they choose. However, this has not yet been closely examined in the Japanese context. We used an online questionnaire to investigate whether parental agreement regarding girls’ choice of STEM fields was affected by stereotypical parental gender role attitudes. We found that Japanese parents with egalitarian gender role attitudes generally agreed with girls’ freedom to choose their field of study (not just limited to STEM fields). Parents that agreed thought that girls could find employment across all fields. However, parents that disagreed expressed a variety of reasons, including negative perceptions of STEM fields such as lack of employment opportunities (biology, mathematics, physics and information science) and unsuitability for women (engineering). These results suggest that improving such field-specific negative perceptions may contribute to increase parental support for girls’ choice of STEM fields.

Examining parent and child agreement in the diagnosis of adolescent depression.

The diagnosis of depression in adolescents relies on identifying the presence of specific core and additional symptoms. Symptoms can be identified using structured or unstructured interviews and a range of questionnaire measures, which are completed by the young person and by a parent or carer. The aim of this research was to examine the inter- and intra-rater reliability of parent report and adolescent self-report of depression symptoms. In a sample of parent-child dyads, where young people aged 13-17 were referred to a mental health service for depression, we examined adolescents' (n=46) and parents' (n=46) independent responses to the Schedule for Affective Disorders and Schizophrenia in School-Age Children (Journal of the American Academy of Child and Adolescent Psychiatry, 36, 1997, 980) and the Mood and Feelings Questionnaire (Journal of the American Academy of Child and Adolescent Psychiatry, 27, 1988, 726). In the clinical interview, diagnostic criteria were more often met based on the adolescent's report, and adolescents endorsed more symptoms of depression than their parents. Tentative results also suggest that parent-child agreement about specific symptoms was low. Comparing different measures of depression revealed that adolescent report on the questionnaire and interview was significantly correlated. However, there was no significant correlation between parent questionnaire and interview report. These results suggest that relying solely on parents to identify depression in their children may result in young people with depression being missed and therefore untreated. Young people themselves should be encouraged and enabled to recognise the symptoms of depression and have an established pathway to services that offer assessment and treatment. Key Practitioner Message Diagnosis of depression in adolescents requires the identification of specific symptoms and can be identified using interviews or questionnaires. Previous research has suggested that parents and young people provide differing reports regarding symptoms of adolescent depression. Results indicated that diagnostic criteria were more often met based on young person report and that parents reported significantly less symptoms. Parent-child agreement about specific symptoms was found to be low. Assessment of adolescent depression should not rely solely on parental report. Young people should be encouraged and enabled to recognise symptoms of depression and be able to access mental health services.

Is Gender Identity Discrimination a Religious Freedom Issue?

Currently, there are certain provisions in Australian law that exempt faith-based organisations from the operation of laws that prohibit discrimination on grounds of gender identity or 'being transgender'. This paper explores whether there is a religious basis for discrimination on the ground of gender identity, with particular reference to how faith-based schools make decisions about children and young people who seek to transition to a new gender identity – with or without parental agreement. While it has long been the case that a very small proportion of people, from early childhood right through to adulthood, identify as feeling they are of the opposite sex, there are reasons to be concerned about the number of adolescents who are now claiming to be 'transgender' – especially natal females. The research indicates that many of these children and young people have multiple mental health problems or are on the autism spectrum, and may have experienced abuse and other adverse life events. There is also some evidence for social contagion amongst friendship groups. The etiology of transgender identification remains poorly understood from a medical perspective. Identification with a gender identity different to natal sex is often accompanied by various beliefs that are incapable of either validation or falsification by science. These include that biological sex and gender are two different things; that gender is what you feel, that gender is fluid, and that it is possible to be “non-binary”. These beliefs conflict not only with religious understandings of the created order, but also with a mainstream understanding that gender is innate and people are not just 'assigned' a gender at birth. The Christian response to children or young people who are experiencing gender identity issues must be pastoral and compassionate, and focused on their best interests; but this does not mean agreeing with their beliefs. There is thus a basis for a religious exemption to prohibitions on discrimination based upon gender identity, if the law is understood to require that the person be accepted as the gender with which they now identify. However, if the law is understood as requiring only that a person should not engage in discriminatory conduct (for example refusing service in a restaurant), then there is no valid basis for a religious exemption. Beyond the issue of religious exemptions, there are compelling reasons not to legislate that any professional working with children or young people has to accept a young person’s self-identified gender identity against his or her professional judgment. Schools need to be free to adopt a pastoral approach, guided by appropriate health professionals, and based upon their assessment of what is in the best interests of the child or young person.

Practitioner perspectives on implementing an alternative response in statutory child protection: The role of local practice context and leadership teams in shaping practice

Internationally, there is growing interest in the adoption of alternative responses that divert families, when safe to do so, away from the courts and out-of-home care system. However, it is widely recognised that the crisis-driven nature of statutory child protection in conjunction with the dominance of risk-adverse practice can inhibit practitioners' abilities to implement such interventions. In Queensland (Australia), ‘intervention with parental agreement’ (IPA) is an alternative response that allows the statutory child protection authority to work with families without a court order. Drawing on the perspectives of 30 practitioners recruited from the statutory child protection authority and tertiary non-government family support services, this paper explores the local factors that shape how IPA policy is implemented in practice. In particular, the paper considers the mechanisms that the leadership team within a statutory child protection office can use to shape a local practice culture that supports and is conducive to collaborative IPA practice.

Parental influence is the most important predictor of child's orthodontic treatment demand in a preadolescent age.

The aim was to explore the predictive value of objective treatment need, impaired quality of life, and parental influence on orthodontic treatment demand in preadolescents and adolescents. A secondary goal was to validate 16-item Child Perceptions Questionnaire for the 11-14year age group (CPQ11-14): item-impact and stepwise-regression short-forms. A convenience sample of 287 participants (55% female) was used for validation. Internal consistency, test-retest reliability, and convergent validity were evaluated. Predictors of treatment demand were explored in 197 orthodontic patients: 93 preadolescents (51% females), 104 adolescents (55% females). Hierarchical linear regression and multilevel logistic regression models were used to explore the predictive power of age, gender, objective treatment need, impaired quality of life and parental influence on treatment demand. CPQ11-14 regression short-form had acceptable psychometric properties. Significant linear predictors of treatment demand were impaired emotional well-being (EW) (β = 0.335, p = 0.002), parental influence (β = 0.221, p = 0.002), and malocclusion severity (β = 0.152, p = 0.025). In logistic regression, parental influence was revealed as the most important predictor of treatment demand in preadolescents, OR = 7.7 (95% confidence interval CI 2.4-25.1; p = 0.001); objective treatment need in adolescents, OR = 4.5 (95% CI 1.5-12.9; p = 0.006). The increase of impairment in EW by one scalar point increased treatment demand by 1.4 (95% CI 1.1-1.9; p = 0.017) in preadolescents; 1.3 (95% CI 1.0-1.7; p = 0.021) in adolescents. Greater parental agreement and motivation for treatment could result in higher preadolescents' cooperation. Orthodontic treatment in adolescents might be more effective with the patient-oriented approach.

Mixed Messages: Inconsistent Parental Mediation Indirectly Predicts Teens’ Online Relational Aggression

ABSTRACTAlthough the predictors of off-line relational aggression have been examined in prior work, less is known about the factors that contribute to online relational aggression perpetration and victimization. This study examined parental restrictive and active mediation of teenagers’ social media use as potential predictors of these outcomes. We were particularly interested in understanding whether parental agreement about media rules and the consistency with which mediation was implemented had implications for teens’ social media use, conflict with parents, and experience with online relational aggression. We conducted an online survey of 814 adolescents from the United States (14- to17-year-olds), asking about perceived agreement between parents about media rules, parental mediation styles, the teens’ social media use, and their experiences with online relational aggression. Results showed that parental rule agreement negatively predicted inconsistent parental mediation. Inconsistent parental mediation predicted more adolescent social media use and more parent-teen conflict over media rules, which in turn, predicted both online victimization and perpetration.

Complex ultrasound diagnosis of pelvic organs in girls-adolescents with obesity

Aim. To assess the state of pelvic organs in girls-adolescents with obesity.&#x0D; Materials and methods. The study included the data from 120 girls-adolescents aged 13–17 years with informed agreement of parents. The main group joined 100 girls with obesity of different degrees, the control group – 20 girls without obesity. The study was implemented on the basis of the Department of Obstetrics and Gynecology I of Azerbaijan Medical University, Research Center “SaglamNǝsil”. In addition to general clinical examination, including the study of anamnesis, reproductive function, general and gynecological examination, there were used echography of the small pelvic, US dopplerometry of the utero-ovarian arteries. Statistical analysis was performed using MS Excel, SPSS and Statistica (version 10.0) Software Package.&#x0D; Results. The compared results of USI of the small pelvis detected significant increase in the size of the uterus and ovaries in girls-adolescents with obesity. After normalization of weight, the sizes of the uterus and ovaries normalized as well.&#x0D; Conclusions. USI of pelvic organs permits to identify different disorders and take the corresponding measures for their elimination at the right moment.

Mediation in matters concerning parental responsability and international child abduction. Recognition and enforcement of agreements concluded during return proceedings.

Mediation, as an alternative means of dispute settlement, is an assisted decision-making process which typically takes the form of facilitated negotiation. The mediator assists the parties in making decisions concerning the issues of their dispute and about the appropriate norms for the regulation of future relationships. This article examines the implications of in international child abduction cases. It begins with the analysis of mediation,as a means of dispute settlement, in general (2). Then, it reviews the RomanianLaw no 192/2006 on mediation and the organisation of the mediator's profession (3). We then address the importance of in family matters (4); we define the concepts (5),present the advantages (6) and disadvantages (7) of in the international and national context. Afterwards, we discuss the implication of internal mediation, in the national context, in relationship with settlements of family-related disputes (8). We address the law applicable to settlements and the choice of law in related cases especially in cross-border cases, pointing out the difference between the law applicable to the agreement and the one applicable to the parental agreement (9). Lastly, we present the practices considered to be effective in child abduction cases, taken into account the Malta process and Declarations, and discuss the recognition and enforcement of the agreement concluded during return proceedings (10).

Interest in Research Participation Among Caregivers of Children with Neurodevelopmental Disorders

The goal of this study was to examine caregiver agreement to hear about local research opportunities by joining a clinical research registry. Data from this cross-sectional study were gathered, between 2014 and 2017, across two outpatient clinics: (1) a multidisciplinary Autism Spectrum Disorder (ASD) clinic (N = 5228) and (2) a general psychology clinic serving youth with, or at risk for, a neurodevelopmental disorder (NDD; N = 5040). Overall, more than 8 in 10 caregivers agreed to join the registry. Several child clinical characteristics, as well as racial and sociodemographic factors, were predictive of parental agreement. Findings suggest caregivers of youth with ASD and NDD are amenable to joining the local research enterprise, however further work is needed to understand why some caregivers decline.