Parental Restriction Research Articles

Parental involvement in Mexican-origin adolescents' romantic relationships: An examination of parents' cultural orientations and parent-youth relationships.

Romantic relationships are normative in adolescence, and parents can play a role in supporting or restricting adolescents' romantic experiences. This study examined parents' involvement in adolescents' romantic relationships in a sample of 226 Mexican-origin families. Findings indicated that, on average, mothers were more supportive of adolescents' romantic relationships than fathers, and parents were more supportive of daughters than of sons. Fathers' (but not mothers') Mexican cultural orientations were associated with greater restrictions on adolescents' romantic relationships. For mothers of boys, higher levels of familism values were linked to lower levels of support, and for fathers of boys, more traditional gender role attitudes were associated with less support. Also, more parent-youth conflict was associated with greater support from mothers but greater restrictions from both mothers and fathers. Finally, less granted autonomy in early adolescence was associated with greater parental restrictions. Discussion focuses on the nature of mothers' and fathers' involvement in adolescents' romantic relationships. Implications for research and practice highlight the importance of recognizing cultural and relational factors that shape mothers' and fathers' parenting around adolescent dating.

How Perceived Child-Friendly Communities Alleviate Adolescents' Psychological Reactance.

When children enter adolescence, their personality traits easily give rise to psychological reactance (PR). PR involves a desire for autonomy and independence, as well as an aversion to parental and social rules and restrictions. Factors that influence PR include physiological, familial, and social aspects. However, most studies on adolescent noncompliance have primarily focused on rebellious behavior. Little research has examined motivational state reactance, although its interaction with environmental perception can significantly affect adolescents' lives. This study aimed to explore the relationship between the perceived friendliness of the community environment and cognitive processing at different quality of life (QoL) levels in relation to PR among adolescents. Propensity score matching was performed on a sample of 3546 adolescents, collected in Sanya, China. The results show that child-friendly communities (CFCs) had a significantly negative impact on adolescents' PR levels. Additionally, QoL had a moderating effect, meaning that the higher the QoL, the stronger the role of a CFC in alleviating PR. In contrast to claims that PR is determined by temperament or character profiles, this study reveals the importance of environmental shaping through triadic reciprocal determinism and a focus on the key role of the community environment.

Effect of fast-food environments on children's eating behaviour: A random effect within between analysis within the Generation R Study.

Focussing on appetitive traits associated with obesity, this study aimed to estimate the association between the fast-food environment and satiety responsiveness, enjoyment of food and food responsiveness. We used data from the Generation R Study. We included 2008 children with repeated measurements at the age of 4-10 years old. Three eating behaviour subscales from the Child Eating Behaviour Questionnaire (CEBQ) were used as outcomes. Geographical Information System data were used to map individual-level exposure to fast-food outlets within 400 m from home. Random Effect Within Between (REWB) models were used to derive estimates. We tested for moderation of the associations with parental restriction at baseline using the parent-reported Child Feeding Questionnaire (CFQ). We did not find evidence of between-associations of fast-food exposure and eating behaviour subscales. Considering within-associations, an increase in absolute fast-food exposure was associated with a significant marginal increase in satiety responsiveness (β: 0.02 [95% confidence interval: 0.00-0.03]). No moderation by parental restriction was found. In environments with ubiquitous fast-food outlets, an increased exposure to fast-food outlets does not seem to have a substantial impact on eating behaviour. Further research is needed to better understand how fast-food exposure contributes to overweight.

Children’s access to urban greenspace: a survey of factors and measures

ABSTRACT Access to greenspace impacts children’s physical, social, and mental health. Numerous factors affect children’s access to urban greenspaces, often distinct from those affecting the general population, including parental restrictions, limited routine activity-space, and particular preferences. Most accessibility measures, however, employ the same principles for children and the general population, and a comprehensive exploration of factors and corresponding measures remains lacking. We conduct a scoping review and workshops with researchers and practitioners to identify factors affecting children’s access to greenspace, synthesize them into a conceptual model, and assess how existing accessibility measures address these factors. We focus on children aged 6–11 years old. Our analysis indicates children’s access involves a trade-off between reachability, determined by the route connecting the child’s starting setting to greenspace, and attractiveness, determined by how the greenspaces adhere to the child’s, and their companions’, preferences and motivations for visiting. Safety perceptions are important throughout. Existing accessibility measures predominantly emphasize reachability, neglecting personal characteristics and motivations. Based on our findings, we propose future directions for developing child-centered accessibility metrics. Our overview of metrics can facilitate decision-making in the selection of suitable measures, while our conceptual model can foster shared understanding of factors affecting children’s access to urban greenspace.

Benefits and Harms of Proposed Social Media Legislation

This Viewpoint identifies potential strategies to address issues in adolescents’ use of social media and cautions against the premature adoption of some strategies, such as parental permissions and age restrictions.

The impact of family factors and communication on recreational sedentary screen time among primary school-aged children: a cross-sectional study

BackgroundChildhood obesity is increasingly recognized as a major public health challenge worldwide, and excessive sedentary screen time is emerging as a key risk factor. This study aimed to assess the recreational screen sedentary time of Chinese primary school-aged children and investigate the relationship between screen-related family factors and the outcome variable.MethodsOur study used data from a cross-sectional survey collected from fifth-grade students and their parents in Beijing, China, from April to May 2018 (n = 2,373). The questions included basic demographic information, family socioeconomic status, students’ and parents’ sedentary and exercising habits, within-family communicational factors, and health belief patterns. The recreational screen sedentary time of the children was compared across demographic groups. The study employed multivariate linear regression models to examine associations between children’s screen time and various family factors, as well as the moderating effect of overall family communication.ResultsOur findings revealed an average daily recreational screen sedentary time of 2.4 h among participants. Screen time significantly varied across demographic categories, including children’s sex, age, residence, parents’ education, household income, family size, and primary family member. After adjustment, the proportion of child-owned digital devices (p < 0.01), child’s personal room (p < 0.05), family screen-viewing together (p < 0.01), and parental screen time (p < 0.01) were positively related to children’s recreational sedentary screen time. Parental restrictions on screen time (p < 0.001) and attitudes toward reducing sitting time (p < 0.01) were correlated with a decrease in children’s screen time. The overall family communication environment significantly moderated the effects of parental practice of restricting children’s screen time (p < 0.001), positive reinforcement by parents (p < 0.05), and parents’ recreational sedentary screen time (p < 0.001).ConclusionsOur findings underscored the significance of family dynamics, parental practices, and communication in shaping children’s screen time behaviors, providing valuable insights for tailored interventions and strategies to reduce childhood obesity.

Parenting Practices Are Associated With Out-of-School Physical Activity in US Adolescents in 2014.

Lack of physical activity (PA) is associated with obesity, diabetes, hypertension, cardiovascular diseases, and cancer. Parenting practices influence PA in young children. However, there is little evidence available for adolescents. We examined whether parenting practices were associated with out-of-school PA (OSPA) in US adolescents. This cross-sectional 2019 study analyzed data from the 2014 FLASHE study, a web-based, quota-sampled survey of parent-adolescent dyads. Inclusion required survey completion and parents to live with their teen (ages 12-17y old). Physically limited adolescents were excluded. Dyads were stratified by teen age. Exposures included parental modeling, monitoring, facilitation, restriction, guided choice, and pressure. The outcomes of interest were OSPA Youth Activity Profile scores. Odds ratios (ORs) with 95% confidence intervals (CI) were calculated using adjusted logistic regressions. A total of 1109 dyads were included. Guided choice increased odds of OSPA for 15- to 17-year-olds (OR = 2.12; 95% CI, 1.17-3.84). Facilitation increased odds of OSPA for 12- to 14-year-olds (OR = 2.21; 95% CI, 1.13-4.33). Monitoring decreased odds of OSPA for 15- to 17-year-olds (OR = 0.34; 95% CI, 0.20-0.57) and 12- to 14-year-olds (OR = 0.45; 95% CI, 0.27-0.74). Friend support increased odds of OSPA in 15- to 17-year-olds (OR = 4.03; 95% CI, 2.29-7.08) and 12- to 14-year-olds (OR = 3.05; 95% CI 1.69-5.51). Future interventions should prioritize (1)shared decision making for older teens, (2)access to PA opportunities for younger adolescents, and (3)promoting peer PA and friend support for everyone.

Role Of Self-efficacy As A Mediator In The Relationship Between Parental Restriction And The Quality Of Cross-Ethnic Friendships

Role Of Self-efficacy As A Mediator In The Relationship Between Parental Restriction And The Quality Of Cross-Ethnic Friendships

Prospective associations between early childhood parental feeding practices and eating disorder symptoms and disordered eating behaviors in adolescence.

Nonresponsive parental feeding practices are associated with poorer appetite self-regulation in children. It is unknown whether this relationship extends beyond childhood to be prospectively associated with the onset of eating disorder (ED) symptoms in adolescence. This exploratory study therefore investigated prospective associations between early childhood parental feeding practices and adolescent ED symptoms and disordered eating behaviors. Data were from two population-based cohorts with harmonized measures: Generation R (Netherlands; n = 4900) and Gemini (UK; n = 2094). Parents self-reported their pressure to eat, restriction and instrumental feeding (i.e., using food as a reward) at child age 4-5 years. Adolescents self-reported their compensatory behaviors (e.g., fasting, purging), binge-eating symptoms, restrained eating, uncontrolled eating, and emotional eating at 12-14 years. Associations between feeding practices and ED symptoms were examined separately in each cohort using generalized linear models. In Gemini, pressure to eat in early childhood was associated with adolescents engaging in compensatory behaviors. In Generation R, parental restriction was associated with adolescents engaging in compensatory behaviors, restrained eating, uncontrolled eating, and emotional eating. Instrumental feeding was associated with uncontrolled eating and emotional eating in Generation R. Nonresponsive parental feeding practices were associated with a greater frequency of specific ED symptoms and disordered eating in adolescence, although effect sizes were small and findings were inconsistent between cohorts. Potentially, the cultural and developmental context in which child-parent feeding interactions occur is important for ED symptoms. Further replication studies are required to better understand parents' role in the development and maintenance of ED-related symptoms. Prospective research examining how early childhood parental feeding practices might contribute to adolescent ED symptoms is limited. In two population-based cohorts, nonresponsive feeding practices (restriction, instrumental feeding, pressure to eat) predicted increased frequency of some ED symptoms and disordered eating behaviors in adolescence, although associations were small and further replication is required. Findings support the promotion of responsive feeding practices, which may benefit young children's developing relationship with food.

Changes in the menstrual hygiene management facilities and usage among Bangladeshi school girls and its effect on school absenteeism from 2014 to 2018

ABSTRACT Background The lack of menstrual hygiene management (MHM) information and facilities in schools is a major contributor to adolescent girls’ school absenteeism in low- and middle-income countries like Bangladesh. Objectives This paper examines the changes over time in school MHM facilities, knowledge and perceptions among adolescent girls, in relation to school absenteeism between 2014 and 2018 in Bangladesh. Methods We examined changes in MHM and school absenteeism among schoolgirls using nationally representative data from the Bangladesh National Hygiene Baseline Survey 2014 and National Hygiene Survey 2018. Given the repetitive nature of our data and its clustering within participants, our method included performing descriptive analysis, bivariate analysis, and multivariate Generalised Estimating Equation (GEE) modelling to analyse these changes. Results Results showed that adolescent girls’ menstruation-related absenteeism decreased between 2014 and 2018. Percentage of adolescents who missed school decreased from 25% to 14% (PD: −11; CI: −16 to −6.1), while the average number of missed days reduced from 2.8 to 2.5 (PD: −0.33; CI: −0.57 to −0.10). In the GEE model, we found that living in rural areas (coef: −5.6; CI: −10.06 to −1.14), parental restrictions on going outside (coef: 4.47; CI: 0.75 to 8.2), education levels of girls (coef: −9.48; CI: −14.17 to −4.79), girl’s belief that menstruation affects school performance (coef: 23.32; CI: 19.71 to 26.93), and using old cloths (coef: −4.2; CI: −7.6 to −0.79) were significantly associated with higher absenteeism. However, participant’s age, type of school, knowledge of menstruation before menarche, receiving information regarding MHM, separate place for changing absorbents, and separate latrine and urine facility were not significantly associated with the changes in absenteeism over time. Conclusion This paper emphasised the associations between changes in school absenteeism, parental restrictions on students, students’ education levels, and menstruation-related misperceptions. Ongoing research, policy reviews, and targeted interventions to improve MHM perceptions among girls are required to provide long-term benefits for adolescent girls in Bangladesh.

Diet restriction in parents shapes the lives of their offspring: a laboratory study using a predatory mite (Acari: Phytoseiidae)

Environmental influences experienced by organisms are known to influence the phenotype of offspring through transgenerational plasticity or parental effects, and recent studies have revealed the significance of diet stress experienced by parents in shaping the life course of their progeny. In this laboratory study using a predatory mite, Phytoseiulus persimilis Athias-Henriot, we investigated the influence of parental diet restriction on offspring life history traits. We found that parental mites exposed to food reductions of 50% (Low diet) during both immature development and adult stages produced F1 offspring with reduced survival rates and fecundity compared to those from parents on abundant (High) diets. Sexually dimorphic responses emerged in response to parental diet restriction, whereby a reduced diet led to extended developmental periods for both male and female offspring while simultaneously reducing male size at maturity and increasing female size at maturity. We also found that diet restriction experienced by F0 individuals at both immature and adult stages manifested as reduced egg volumes and a less female-biased sex ratio in the F1’s offspring (i.e. the F2). There were additional significant interactions between the dietary history of parents and the dietary experiences of P. persimilis offspring themselves on various traits, including post-oviposition period, fecundity, and individual egg volume. These findings suggest that the dietary experiences of parents can modulate their offspring’s response when facing diet restriction. This study provided insights into non-genetic inheritance and transgenerational plasticity, highlighting the intricate interplay between environmental stressors and phenotypic responses.

Psychometric evaluation of the Parental Reflective Functioning Questionnaire in Polish mothers.

Parental reflective functioning (PRF) refers to a parent's capacity to reflect on and understand the inner mental states of their child, their own mental states with regard to their child, and how these mental states may influence their behavior and interactions. This capacity has been shown to foster secure attachment in children and their socio-emotional development. The present study examined the psychometric properties of the Polish translation of the Parental Reflective Functioning Questionnaire (PRFQ), a brief screening measure of PRF, in a large community sample of Polish mothers of children aged 0-5 years (N = 979). Confirmatory factor analysis supported the hypothesized three-factor structure of the PRFQ, which consists of three subscales: prementalizing modes, certainty about mental states, and interest and curiosity in mental states. However, item loadings suggested that the 15-item version fitted the data better than the original 18-item version. These three PRFQ subscales exhibited satisfactory and moderate six-month test-retest reliability. They also correlated in theoretically expected ways with several criterion measures such as maternal attachment, maternal parenting stress, parental role restriction, depression severity, and borderline symptoms. In conclusion, this study is the first to provide preliminary evidence for the reliability and validity of the PRFQ as a measure of parental reflective functioning in Polish mothers.

Sweet rules: Parental restriction linked to lower free sugar and higher fruit intake in 4–7-year-old children

In the Netherlands, 4–8-year-old children consume proportionally the highest amounts of free sugars among all age groups, and in European countries, children’s sugar intake exceeds the World Health Organization’s recommendation. Restricting children’s access to sugary products could help reduce this consumption. However, it is unclear whether and how restriction is linked to children’s sugar intake and sweet taste preference. This study investigated the relationship between parental restriction of sugary products, children’s free sugar and fruit intake, as well as their sweet taste preference. Parents (N = 243) of 4–7-year-old children were asked to complete a survey that asked for their child’s consumption of fruits and free-sugar-containing products via a three-day food recall (three specified, non-consecutive days). Parental restriction was assessed via the Restricted Access Questionnaire. In a subset of children (N = 60), psycho-hedonic functions were mapped using the Monell two-series forced-choice paired comparison tracking test to estimate children’s optimal sweet taste preference. Regression analyses showed that more restricted children consumed less free sugars but more fruits than less restricted children as reported by the parents (p < 0.05). Parental restriction was unrelated to children’s sweet taste preference. In conclusion, our results imply that restriction is negatively linked to free sugar intake, positively linked to fruit consumption, and unrelated to sweet taste preference in 4–8-year-olds. Future research is needed to determine the causal and long-term effects of parental restrictions on children's sugar intake and sweet taste preference.

Meeting preschool screen time recommendations: which parental strategies matter?

High levels of screen use by preschoolers may contribute to adverse health and developmental outcomes. Little is known about which parental strategies may be protective against intensive screen use by children. Our aim is to estimate whether parent strategies for mediating child screen time including restrictive and instructive mediation and social coviewing, predict preschooler adherence to the screen time recommendation of ≤1 h/day during the COVID-19 pandemic. We also examine if parent restrictive mediation interacts with child temperament characteristics. Our sample is composed of 315 Canadian parents of preschoolers surveyed during the COVID-19 pandemic. Parents provided measures of child adherence to screen time guidelines at ages 3.5 (baseline) and 4.5 years. Parents also reported how often they used restrictive and instructional mediation, and social coviewing to manage their child's screen use. Control variables include child sex and temperament (effortful control, negative affectivity, extraversion), educational attainment, and parenting stress at age 3.5. A logistic regression revealed that parental restrictiveness was associated with a 4 time increase in the odds of adherence to screen time guidelines, OR = 4.07 (95% CI [1.70-13.03]). Parental social coviewing decreased the chances of adherence by 80% (OR = 0.20, 95% CI [0.09-0.48]). Furthermore, children not meeting recommendation at 3.5 were 98% less likely to respect the recommendation 1 year later (OR = 0.02, 95% CI [0.01-0.07]). Results were adjusted for child sex, temperament, baseline screen time, and parent education and stress The interaction between the restriction mediation and child temperament on later screen time was not significant. Our results indicate that some parental strategies may be more effective than others for managing preschooler screen time. Parent use of restrictive mediation was most likely to forecast child adherence to later screen time recommendations. The present results may contribute to the development of targeted family-based interventions designed to promote healthy development from a young age.

Class cohesion and teacher support moderate the relationship between parental behavioral control and subjective well-being among adolescents

Previous studies indicate that parental behavioral control can alleviate deviant issues in adolescents, but whether it facilitates their positive development and the underlying mechanisms within this process remain unclear. This study sought to examine the role of class cohesion (i.e., the closeness of the social relations and connections among peers in the classroom) and teacher support (i.e., perceived care and help from teachers) from the school setting as moderators of the association between parental behavioral control and the subjective well-being of Chinese adolescents. A total of 2,503 junior high school students (Mage = 12.99 years, SD = 0.62, 51.98% boys) from 47 grade 7 classes in central China completed questionnaires. Results of the hierarchical linear model showed that: (1) both parental solicitation and parental restriction at the individual level were significantly positively associated with adolescents’ subjective well-being; (2) both class cohesion and teacher support at the class level were significantly positively associated with adolescents’ subjective well-being; and (3) both class cohesion and teacher support significantly moderated the relationship between parental solicitation and adolescents’ subjective well-being. The theoretical and practical implications of these findings are discussed.

Parental Perspectives on Impact of Parental Presence Restrictions in the Neonatal Intensive Care Unit During the COVID-19 pandemic: A Cross-Sectional Study.

To describe parental experiences in the neonatal intensive care unit (NICU) during the COVID-19 restrictions. We explore what parents found most challenging, the impact these restrictions had on them and their infant, and how they coped. A cross-sectional online survey was completed by parents of infants who required care in a Canadian NICU during the early period of the COVID-19 pandemic. Data from 3 questions were coded using thematic analysis. Participants ( n = 161) were primarily mothers (93%), with an average length of stay of 32.1 days. Three themes were identified from responses: (1) emotional and physical closeness of the parents to their infant; (2) physical and psychosocial well-being of the infant and parent; and (3) how parents coped, and strategies for moving forward. Parents reported that parental restriction policies adversely impacted their perceived physical and emotional closeness with their infant and their infant's physical and psychosocial well-being. Parents reported that being able to be present with their infant, having their partner able to be present with them, and effective communication helped them cope. Despite the need for some restrictive policies to control the spread of the virus, the benefits and risks to the overall well-being of the parents and infants must be weighed.

64 Consensus Practice Recommendations Regarding Parental Presence in Canadian NICUs to Inform Ongoing and Post Pandemic Policies

Abstract Introduction/Background In March 2020, parental presence restriction policies were introduced in Canadian NICUs as institutions aimed to prevent COVID-19 transmission during the emerging global pandemic. However, parental presence in NICUs is necessary for maximizing parent and infant health outcomes, and there continues to be significant variation in parental restriction across Canadian NICUs. Objectives To identify the impact of parental restriction policies in Canadian NICUs on parents, infants, and healthcare providers and co-create practice recommendations for ongoing pandemic management and post-pandemic policies. Design/Methods A national survey was conducted to assess the impact of Canadian NICU restriction policies. Recommendations were developed through Delphi and Values and Preferences research methods. For the first Delphi survey, participants rated 50 items of importance from the national survey on a scale from 1 (very low importance) to 5 (very high). On the second Delphi survey, participants ranked the top 20 items from highest relative to lowest importance. A literature review was conducted for the top 10 items, and evidence of known benefits and harms was presented to the panel of decision-makers during the Values and Preferences consensus meetings. Participants voted on the inclusion of each item as a national recommendation and discussed additional caveats. A vote of 80% or more was deemed a consensus. Results Parents (n=426) and healthcare providers (n=205) completed a national survey, from which a list of reported impacts was derived. After two separate Delphi rounds (n=39, and n=20), a series of 10 recommendations with the highest rated importance were identified. A representative panel of decision-makers (n=20), including parents of NICU infants, NICU healthcare providers and managers, and infectious disease and public health policy-makers, took part in a Values and Preferences task. Items of importance included 7 strong recommendations (parents as essential caregivers, providing skin-to-skin contact, direct or mothers’ own expressed milk feeding, attending medical rounds, mental health and psychosocial services access, food and drink access, and inclusion of parent partners in pandemic response planning) and 6 conditional recommendations (providing hands-on care tasks, touch, two parents present at the same time, use of communication devices, and in-person access to medical rounds and mental health and psychosocial services). Consensus was reached on all items in favour of inclusion in national recommendations for Canadian NICUs. Conclusion These recommendations will guide ongoing and future pandemic management and policies with respect to parental presence and involvement in their infants’ care.

Why do children comply with parental restrictions in the personal domain?

Numerous studies have shown that children judge some issues as personal and up to them to decide, yet they often comply with parental restrictions regarding these choices. The current study investigated children’s judgments and justifications in response to stories where hypothetical mothers prohibited children’s personal choices. Semi-structured interviews were conducted with 123 U.S. children (56 male) ranging from 5 to 9 years of age (M = 6.80 years). Responses were examined as a function of age, type of domain explanation, and whether punishment was specified or not. Across ages, and when presented initially without a prohibition, children judged personal activities as acceptable and wrong for the hypothetical mother to prohibit, based mainly on personal reasons. However, when mothers were described as giving prudential or social–conventional explanations for restricting children’s choices, most children reported that the actor should comply regardless of domain condition. Children rated prudential explanations as more acceptable than conventional explanations, provided mostly domain-consistent justifications for their judgments, and attributed more negative emotions to being unable to pursue personal choices in the conventional condition than in the prudential condition. In addition, justifications but not judgments varied by punishment condition in interaction with maternal explanation domain. Children also believed that they themselves should comply with maternal prohibitions more than the hypothetical story actor should. Thus, although prototypical issues were viewed as personal, children across middle childhood thought that children should and would comply when mothers provide explanations for maternal prohibitions and more so for prudential explanations than for conventional explanations.

O-202 Early reproductive outcomes of the first birth cohorts conceived with in-vitro fertilisation in Sweden

Abstract Study question Are early reproductive outcomes of individuals conceived with IVF different from the general population or from spontaneously conceived individuals born to couples with infertility? Summary answer The first birth cohorts from IVF were more likely to experience infertility and use assisted reproduction also when accounting for parental factors and infertility What is known already In-vitro fertilisation has helped countless couples overcome involuntary childlessness, but little is yet known of the reproductive outcomes of their offspring. Deviations could occur as a result of the transmission of, or reaction to, parental traits and behaviors, or adverse effects of the procedures. A few small studies of young adults conceived with intra-cytoplasmic sperm injection due to male factor infertility have indicated lower sperm quantity (but not quality) compared to spontaneously conceived males, and no differences in reproductive hormones or antral follicle count in females. Study design, size, duration This nation-wide cohort study considered all individuals in the Swedish Medical Birth Register, born between 1985 and 1996 (N = 1,291,795). Linkage of population-registers allowed prospective follow-up of potential reproductive outcomes, migration from Sweden or death, until the end of 2017. Participants/materials, setting, methods Parental infertility and IVF use was identified from maternal self-report and IVF-clinic reporting to the Medical Birth Register, which was also used for outcome ascertainment, along with registers over family relations, outpatient specialist care, and assisted reproduction. Individuals conceived with IVF were compared to spontaneously conceived individuals of the same age. Comparisons were also adjusted for parents’ age, education and country of origin and further restricted to only concern individuals whose parents experienced infertility. Main results and the role of chance Compared to spontaneously conceived of the same age, individuals conceived with IVF were less likely to have had any biological children across all studied birth cohorts (Hazard ratio (HR) 0.67 95% Confidence interval (CI) 0.62–0.74 overall), but adjustment for parental factors and comparison to individuals with parental infertility attenuated the differences to the null. Among individuals followed until at least age 30, those that had been conceived with IVF were more likely to have received a diagnosis of infertility (HR 2.03, 95% CI 1.15–3.58), also after adjustment for parental factors (HR 2.08, 95% CI 1.18–3.66) and restriction with respect to parental infertility (HR 1.82, 95% CI 1.03–3.24). While there was no substantial difference in mean age, the first recorded birth was more likely to have been preceded by infertility and IVF assistance when individuals had been conceived with IVF themselves (Odds ratio (OR) 2.89, 95% CI 1.47–5.66 and OR 3.83, 95% CI 1.48-9.93 respectively in adjusted comparison to individuals with parental infertility). Corresponding elevated risks were not observed in any of the birth cohorts for which follow-up did not extend beyond their 20s (born 1988-1996). Limitations, reasons for caution Since not even the first IVF birth cohorts have completed their expected reproductive period, these findings merely represent an indication of the early reproductive outcome of the first generation conceived with IVF in Sweden. Information on type and severity of parental infertility was not available. Wider implications of the findings Finding the earliest birth cohorts conceived with IVF at elevated risk of infertility and of using IVF for their first birth, also when accounting for parental infertility, stresses the need for further monitoring as more cohorts enter and pass through the expected reproductive period. Trial registration number Not applicable

Emotional Affinity of Children Toward Nature

The aim of the current study is to investigate the role of emotional closeness towards nature in a sample of children from Iraq aged (4-9) years, passion towards nature develops through experiences with nature during childhood and that contact with nature, which can vary from green spaces in cities to landscapes have a really positive impact on many aspects of children's lives from social interaction with each other to cooperation and play freely. The theoretical part, describes the basics in which children’s affinity towards nature is developed by national curriculum, both in Iraq and Romania. The results showed that in nature, children become expressive and eager to play with each other freely and break free of parental restrictions. Our results support the idea that closeness and experiences in nature are one possible way to stimulate pro-environmental intentions in children. This extends to previous studies showing that growing up near nature and spending time in nature are predictors of pro-environmental attitudes and behaviors.