Vulnerable Children Research Articles

Exploring the health challenges of affected people in the 2023 Khoy earthquake: a content analysis

BackgroundAn earthquake has significant effects on health and livelihood of people. It is important to identify health needs and challenges of earthquake victims and use them to prepare for other possible earthquakes. Therefore, the purpose of this study is to explain the challenges and health needs of earthquake victims in Iran.MethodsThis was a qualitative study with 25 participation who were affected by the earthquake in Khoy City, and were selected using purposive sampling by snowball method technique in 2023. The study data was collected through open and semi-structured interviews. To analyze the data, the conventional content analysis with an inductive approach was used.ResultsThe results show two main categories. The main categories “Management as a missing link in unexpected events” includes 9 subcategories: “The challenge of access to emergency resources and health facilities”, “Feeling of abandonment in medical personnel”, “Weakness in the structural safety and infrastructure of the health system”, “Logistical challenges”, “Risk management training”, “Crisis response management challenges”, “Weakness in the intelligent relief system”, “Management of secondary incidents”, and “Need to provide medical services and disease prevention”. Also, the main categories “Emotional actions of people in crisis” consist of 5 subcategories: “Overexcitement”, “Psychological vulnerability of children”, “Physical complaints caused by stress”, “Confusion caused by the lack of reliable information sources” and “Negative effects of living together with several families”.ConclusionTo help deal with threats and other challenges in the earthquake crisis, countries should try to improve their capacity to manage natural disasters.

What long-term health outcomes can we anticipate for children who have been in social care?

Abstract The concept of cumulative disadvantage suggests that setbacks in one area of life not only lead to further challenges within that domain but also increase vulnerability to adversities across different domains, as highlighted in life course studies. In the context of children with a history of childhood social care (CSC) experience, research consistently shows poorer long-term health outcomes compared to peers without such experiences. This disparity persists into middle age and can affect subsequent generations, underscoring the enduring impact of early-life adversity. Dr Viviane S. Straatmann, a social epidemiologist based in Sweden and enriched by her experience in studying the health and social life of vulnerable children in diverse international settings, will offer insights from life-course and intergenerational epidemiological studies. She will explore the intricate web of disadvantages preceding children’s entry into social care, shedding light on the complex interplay between early-life adversity, cumulative disadvantage, and long-term health outcomes. Participants will engage in reflective dialogue on pertinent questions, such as how cumulative disadvantage informs interventions for children with CSC backgrounds, the potential mechanisms underlying the contribution of early-life adversities to long-term health disparities, and the ways intergenerational studies can inform strategies for breaking the cycle of disadvantage.

Humanitarian Architecture in Service of Children: Designing an Orphanage for Vulnerable Children in Yaoundé

This research explores the impact of humanitarian architecture in designing an orphanage for vulnerable children in Yaoundé, Cameroon. In a context where millions of children are affected by social, economic, and political crises, particularly in Sub- Saharan Africa, humanitarian architecture emerges as a viable response to ensure their protection and well-being. The literature review highlights the key principles of humanitarian architecture, such as user-centered design, the use of local and sustainable materials, and the creation of resilient spaces in times of crisis. Through case studies, including projects in Burkina Faso and Mali, this research examines how architectural approaches can be integrated into educational and care facilities to improve the living environment of vulnerable children. The work concludes with design proposals for an orphanage in Yaoundé, focusing on adaptation to the local climate, material sustainability, and community participation, aiming to strengthen the resilience and autonomy of children.

A Retrospective Analysis of Human Cutaneous Leishmaniasis Epidemiology During 2016 - 2021 in Hoveyzeh County, Khuzestan Province, Iran

Background: Leishmaniasis, a significant neglected tropical disease, is caused by obligate intracellular protozoa of the Leishmania genus. Objectives: This research aimed to investigate the epidemiology of cutaneous leishmaniasis (CL) from 2016 to 2021 in Hoveyzeh county. Methods: This study is a retrospective, cross-sectional, descriptive study based on available data. The study population included all individuals treated and followed up in health care centers who were clinically diagnosed with CL and confirmed by laboratory tests. Results: Among the 628 individuals diagnosed with CL, 324 (51.6%) were male, and 304 (48.4%) were female. The average age of the patients was 16.58 ± 15.17 years. The highest proportion (45.4%) of cases occurred in the 0 - 10-year age group, highlighting the vulnerability of children, while those above 50 years had the lowest incidence (3.7%). Approximately 68.2% of patients resided in urban areas, with the remainder living in rural settings. The hand was the most frequently affected area (44.5%), and the maximum number of lesions reported in a single individual was 25. Most patients (46.82%) were treated with topical glucantime along with cryotherapy. Disease incidence showed seasonal variation, with the highest number of cases reported in autumn (54%) and a significant peak in December (22%). The highest incidence year was 2016 (30.3%). Conclusions: Effective strategies to combat this disease should include comprehensive public awareness campaigns focused on health education, early recognition of symptoms, and transmission methods. Promoting personal protective measures is crucial for disease prevention efforts.

Challenging Child-Friendly Urban Design: Towards Inclusive Multigenerational Spaces

The ongoing Covid-19 pandemic has not only presented novel challenges but has also brought to light previously unaddressed issues, such as children’s rights, their interdependence on adults, and the vulnerability of children concerning their mental well-being. The pandemic has served to accentuate the distinction between those spaces that have traditionally been designated for children or adults, and the manner in which they coexist. Some researchers posit that this phenomenon can be attributed to the emphasis placed on so-called child-friendly spaces. This article presents a critical examination of and challenge to the concept of child-friendly places, advocating for a shift towards multigenerational places. This critique draws on data from an observational study conducted in a community playground in Brno, Czechia. The concept of territorial production was employed as a tool to unveil the intricate assemblage of ever-changing control over territories and power dynamics within the playground among its visitors. The findings offer valuable insights into the practices through which children assert temporary control over spaces that are considered to be communal. Teenagers employ loud music or personal belongings to mark their territory, while younger children utilise movement to establish control. Territorial production coexists with those of the adults who also frequent the site. This highlights the necessity to create environments that are conducive to the needs of both children and adults, discouraging the design of exclusive spaces for children. The promotion of a multigenerational city can foster inclusivity, whereby the diverse needs and behaviours of different age groups within shared spaces are recognised and accommodated.

Impact of residential solid fuel usage and fuel conversion on children's lung function.

Solid fuel combustion exposure is a leading global health risk factor, yet evidence on its effects, especially on vulnerable children, is sparse. This large-scale, multi-center prospective study aimed to address this gap by involving 9997 schoolchildren across China between 2013 and 2015. Here we show that lung function levels exhibited a marginally significant decline among children exposed to solid fuel usage. Specifically, FVC and FEV1 decreased by 21.2 mL (95% CI: -15.7, 58.1) and 24.1 mL (-8.4, 56.6), respectively. Additionally, PEF, FEF25 and FEF75 decreased by 25.7 mL/s (-46.5, 98.0), 32.7 mL/s (-42.7, 108.2), and 35.4 mL/s (-5.9, 76.7), respectively. Persistent exposure to solid fuel usage in children led to greater lung damage. Children with allergy history were more susceptible to solid fuel exposure. Our study highlights the adverse impact of solid fuel usage on children and the need to promote clean fuel usage for this vulnerable population.

Thinking with Children: Climate Change and the Democratic Politics of Renewal and Risk

AbstractClimate change poses serious political challenges to liberal democracies arising from the problem of short-termism and the priority accorded to the vested interests of present adults over the vulnerabilities of children and future generations. This article aims to analyse the justifications, benefits, and policy implications of centring children in climate change politics in order to overcome these problems. The central argument is that ‘thinking with children’ introduces normative vantage points for tackling climate change based on taking responsibility for future harms. Such a vantage point also produces new sites of contestation shaped by adult representations of the renewal and risk embodied in children. First, we outline what “thinking with children” means for democratic politics, focussing on how child-as method approaches centre the injustices faced by children and youth and the implications for the renewal of democracy. We then analyse how this normative shift to centre children addresses the problems of vested interests and short-termism by de-naturalising present adult interests, foregrounding impacts on young people as the future demos, and giving long-term priority to the affectedness of future generations. Finally, we analyse the policy implications that thinking with children offers, using a recent landmark court case in Australia to propose independent legal standing for children in public interest cases and the introduction of Child Impact Assessments in climate policymaking.

‘Being a Social Worker … It's in My DNA’ Retaining Experienced Child and Family Social Workers: The Role of Professional Identity

ABSTRACTThe retention of experienced child and family social workers is a significant issue in the United Kingdom, the United States and Europe. Failure to retain experienced practitioners has serious implications for the protection and support of vulnerable children. Existing research and workforce interventions have focused on the support of early‐career social workers to prevent exit. Relatively few studies have examined what can be learned from experienced social workers who have remained in the profession long‐term. This study captures the voices of experienced stayers. Data consist of interviews with social workers (n = 58) across 11 local authorities in England who have remained in practice for ≥8 years. Findings suggest that a strong sense of professional identity (PI) sustains social workers and promotes retention. For experienced social workers, staying in the profession long‐term involves navigating a series of identity challenges over the course of their career, conceptualized here as Critical Career Episodes (CCEs). Based on these findings, we suggest that retaining experienced social workers involves support to navigate CCEs alongside meaningful opportunities for learning and development. We identify three key factors that support and sustain ongoing PI development and support retention: generativity, specialism and mobility. The article concludes with recommendations to support workforce retention.

Social Vulnerability Index and Dental Caries in Children: An Exploratory Study.

This retrospective cross-sectional study evaluated the association between caries outcomes in a pediatric population visiting a dental clinic and the social vulnerability index, an area-based measure capturing 4 main social determinants of health: socioeconomic status, household composition/disability, minority status/language, and housing/transportation. The Centers for Disease Control Social Vulnerability Index (SVI) and electronic dental record data of children (0 to 18 y) reporting a caries diagnosis at the Children's Hospital Colorado in 2020 were extracted for 9,201 children. Logistic regressions were used to test the association between SVI and the presence or absence of dental caries, adjusting for age, sex, ethnicity, and race. Children with a caries diagnosis had a greater mean overall SVI percentile (62.0, standard deviation [SD] = 29.1) compared with patients without a caries diagnosis (59.1, SD = 29.8; P < 0.001). With each 10-point increase in the overall SVI percentile, having a caries diagnosis visit was 2.7% more likely compared with having a visit without a caries diagnosis (odds ratio [OR] 1.027, 95% confidence interval [CI] 1.012, 1.042; P = 0.0004). Those with an overall SVI percentile between 51 and 75 were 23% more likely to have a caries diagnosis compared with those with a percentile ≤25 (OR 1.23, 95% CI 1.07, 1.42; P = 0.003), and those with a percentile >75 were 23.6% more likely to have a caries diagnosis compared with those with a percentile ≤25 (OR 1.236, 95% CI 1.09, 1.40; P = 0.001). Children (0 to 18 y) living in socially vulnerable environments or areas were more likely to have a caries diagnosis at their dental exam. This study showed an association between social determinants of health demonstrating social vulnerability and dental caries in children. Ultimately, understanding upstream factors for children living in socially vulnerable areas could support policymakers in creating more effective policies to support socially vulnerable populations.

Collateral kids: Weighing the lives of children in targeting

Abstract The principle of proportionality under international humanitarian law prohibits an attack if the expected harm to civilian persons and objects is excessive in relation to the anticipated concrete and direct military advantage. In this article we argue that, when applying the principle of proportionality, the incidental harm to a child must be given a higher value as compared to incidental harm to an adult. This reflects the broader framework of international humanitarian law, which creates stratifications amongst different groups of civilians and provides special protection for children in times of war. This aligns with the practice of many militaries, which tends to implicitly assign a heightened worth to the lives of children due to moral and political considerations. Such reasons stem from the perceived vulnerability of children as well as their moral innocence reflecting harmlessness and blamelessness. Indeed, harm to children’s lives tends to generate a greater backlash among the community to which they belong and, as a result, a military disadvantage. We argue that the greater weight assigned to the lives of children in proportionality assessments is not simply a matter of morality or strategic calculations, but in fact a requirement from a more wholistic interpretation of international humanitarian law.

Between arts-based methods and hermeneutics: Navigating the ethics of participation in research with vulnerable children

Children are underrepresented in research, mainly because of the ethical issues that their participation raises. This is even more true when it comes to marginalized migrant children. For the sake of justice, researchers must think about methods for including children and their families and reflect on the ethics of knowledge building in these contexts. This article returns to the hermeneutics of Hans Georg Gadamer as an interpretation practice which values understanding rather than explanation. It also focuses on the concept of play which can be truth revealing and which is understood as the very being of artistic practices. This allows us to first emphasize the compatibility of hermeneutics and art-based approaches, and their ethical value when it comes to bringing clinical and research issues together. This article highlights that methods based on art and play itself are ethical in the way that they can both provide well-being and reveal a truth that is as useful to the participant as it is to the researcher. This article also addresses how the researcher, in the process of understanding, is “at play” in the research situation which places him in an active role. The play allows a participatory truth to emerge, a truth resulting from a dialogue. This leads us to recognize the ethical value of participation in research with children.

Going beyond dichotomous political discourses about children’s participation and voice: unfolding the complexities of children’s needs in and around supervised contact in Denmark

ABSTRACT This article presents the first results of a Danish research project Supervised Contact: Support and sustainable development in vulnerable children’s everyday life (SOUL) (2023–2026). Supervised contact (SC) takes place when contact between children in out-of-home care and their parents is considered important but where the parents are not capable of taking responsibility for the contact by themselves without the risk of violating the child’s best interest. Based on qualitative data deriving from practice research seminars and interview studies, we analyse and discuss the complexities of children’s needs in and around SC. A major point is that there is a need to strengthen collaborative practices supporting children in making sense of SC and the relationship to their parents. This need goes beyond dichotomous political discourses in Denmark currently projecting a contradiction between children’s and parents’ right to participation and voice: a contradiction which may reinforce the child’s experience of being positioned in a conflict of interest and loyalty. Avoiding this is of great importance for the child’s experience of genuine participation and voice in SC and for the capacity of social work to promote empowerment and democratic participation.

Dietary exposure to metals/metalloids and persistent organic pollutants in Spanish preschool and primary school children

Diet is a primary source of pollutant exposure. Given children's vulnerability to their effects, this study assessed dietary intake of metals/metalloids and different persistent organic pollutants in children in Tarragona (Spain), compared it with the health-based guideline values (HBGV), and identified the main dietary sources. The analysis included 533 preschoolers and 443 primary school children from the EPINED and ECLIPSES studies. Dietary intake of cadmium (Cd), methylmercury (MeHg), lead (Pb), inorganic arsenic (inAs), polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs), dioxin-like polychlorinated biphenyls (DL-PCBs), and non-dioxin-like polychlorinated biphenyls (NDL-PCBs) was estimated using validated food frequency questionnaires and a database from the Catalan Agency for Food Safety. Preschoolers and primary school children exceeded the relevant reference value for InAs and DL-PCBs. Only preschoolers exceeded the limit for MeHg and PCDD/Fs. Cd, Pb, and NDL-PCBs intakes did not exceed the limits in either age group. Salted cereals/potatoes were the main source of InAs; fish for MeHg and DL-PCBs; and milk/yogurt for PCDD/Fs, followed by white fish in preschoolers and fatty fish in primary school children. The findings highlight that dietary exposure to some pollutants poses a significant risk to these children, emphasizing the need for public health policies to reduce pollutants in their diets.

Rethinking Orphanages: Drawing Inspiration from Cameroon’s Culture and Traditions

This article explores the concept of rethinking orphanages in Cameroon, drawing inspiration from the country’s rich cultural and traditional practices, it argues that the current model of orphanages often falls short of providing a holistic and culturally appropriate environment for children. By examining Cameroonian cultural values and practices related to child-rearing, kinship, and community support, the article proposes alternative approaches to caring for orphaned and vulnerable children. These approaches emphasize community-based care, extended family involvement, and the preservation of cultural identity. The articles conclude by highlighting the potential benefits of such a paradigm shift for the well-being of children and the strengthening of Cameroonian communities.

“One Video Could Start a War”: A Qualitative Interview Study of Public Perceptions of Deepfake Technology

ABSTRACTWhat is the public's perception of deepfake technology's impact on society? This study reports findings from a reflexive thematic analysis of qualitative interviews with 33 US adults. Among the themes that represent participants' perception of the technology's impact on society, the following most salient themes are reported: increase in political misinformation; increased political and ideological polarization of society; increase in the number of conspiratorial videos; increased potential of harm to marginalized groups and individuals; and children's vulnerability to being deceived via deepfakes. In addition, a summary theme collating public perspectives on positive implications of deepfake technology is presented. This study lays the groundwork for further qualitative and quantitative investigations of deepfake technology's impact on society as understood from the perspective of society's foremost constituents—people.

Autistic children and their parents in the context of war: Preliminary findings.

While existing literature on the intersection of trauma and autism is limited, emerging evidence suggests heightened vulnerability of autistic children to the psychological consequences of traumatic events, including an elevated risk of developing posttraumatic stress disorder (PTSD). Additionally, parents of autistic children often experience elevated levels of negative emotional states, compared to parents of typically developing children. This study investigates the impact of terrorism and war on autistic and non-autistic children and their parents, presenting preliminary results from the initial data collection phase of a year-long longitudinal investigation of the experience of autistic children and their parents following Hamas' 7 October 2023 attack on Israel. Data gathered within 30days of the initial attack reveal that both autistic and non-autistic children exhibited clinically significant post-traumatic stress symptoms, with autistic children demonstrating a more pronounced manifestation. Moreover, parents of autistic children reported significantly higher levels of depression, anxiety, and stress in the aftermath of the events, compared to an independent cohort of parents of autistic children assessed prior to the crisis. These results underscore the heightened susceptibility of autistic children to post-traumatic stress and the unique challenges confronted by their parents during times of conflict. The study highlights the imperative for tailored support services for autistic children and their families amidst traumatic incidents and stresses the need for further research in comparable contexts globally.

Effect of the COVID-19 pandemic on malnutrition in socially vulnerable children in Brazil.

This article aims to evaluate the effect of the COVID-19 pandemic on malnutrition among children under two years of age enrolled in the Bolsa Família Program (BFP). Ecological study of interrupted time series (ITS), with low weight for age, stunting, and overweight as time-dependent variables of malnutrition, extracted monthly (Jan/2008 to June/2021) from the Food and Nutrition Surveillance System. The COVID-19 pandemic was the exposure, dichotomized into pre-pandemic and pandemic. In RStudio, the trend was obtained by Prais-Winsten regression, and the effect of the pandemic on the time-dependent variables was determined by SARIMA modeling, estimating the regression coefficients (RC) adjusted for trend and seasonality (α = 5%). The pandemic was associated with an increase in: i) low weight for age in the South (RC = 0.94; p < 0.001) and Southeast (RC = 1.97; p < 0.001); ii) height deficit in the Midwest (RC = 2.4; p = 0.01), South (RC = 2.15; p < 0.001) and Southeast (RC = 2.96; p < 0.001); and iii) and overweight in the North (RC = 1.51; p = 0.04), Midwest (RC = 2.29; p = 0.01), South (RC = 2.83; p < 0.001), and Southeast (RC = 0.72; p = 0.04). The pandemic increased underweight in the South and Southeast, and the double burden of malnutrition in the Midwest, South, and Southeast. In the Northeast and North, higher rates of malnutrition still persist.

Sakkyndige psykologers refleksjoner om Barnesakkyndig kommisjons kvalitetssikrende funksjon

The future of many vulnerable children depends on the quality of child welfare decisions, where reports from independent child welfare experts may carry considerable weight. Before these reports are used in child welfare decision-making processes, they are quality-assessed by the Expert Commission on Children. In the present study, 12 psychologists working as independent child welfare experts were interviewed about their experiences of the Expert Commission on Children’s quality assurance function. Based on qualitative thematic analyses, the informants’ statements were sorted into two main themes. The first main theme circled around experiences that the Commission enhances the quality of the experts’ work by having a ‘Sharpening support function’, contributing to a more unified and consistent practice. Under the second main theme, ‘What type of quality?’, concerns were raised that the Commission, due to lack of access to the factual basis of the reports, cannot accurately evaluate their professional or substantial quality. The informants suggested alternative quality assurance methods, such as feedback loops between the Commission and the experts, and that the Commission should instead undertake an in-depth examination of a smaller sample of reports. The findings are discussed in the context of the broader debate surrounding quality indicators for child welfare work. Keywords: independent expert, assessment, child welfare, quality assurance, Commission for child welfare experts

Child Welfare Practices and Foster Care: Relational Realities

‘Dark sides of kinship’ such as the abuse some kids are subject to by, or while in the care of, their biological parents remain prevalent in our day and age. However, society’s tolerance of these types of occurrences has greatly diminished. To assuage familial tragedies, formal state-run foster homes can alleviate the harmful effects caused by ‘negative kinships’ by offering safe havens to vulnerable children. This remedy is hardly a panacea though. By exploring three ethnographic examples and further readings from an anthropological lens, we argue that despite the protective essence foster homes entail in theory, much harm emerges from them in practice. The caretaking involved in foster care, although generally benevolent, promotes a semblance of normality that may equally mask darker aspects of the relational reality behind the precarious and sometimes deceptive ‘kin solidarity’ produced within these institutionalized settings. Furthermore, contemporary foster care in the West showcases how politics and kinship are entangled. This can be challenging throughout the fostering process, but especially when services - and, thus, associated relationships - are terminated. To increase the effectiveness of the protection granted to children who are severely affected by ‘negative kinships,’ including improving their potential prospects and well-being, we argue that it is critical that work be done to better identify and understand their embodied relational experiences.

Virtual Posyandu Program during the Pandemic Maintained Children’s Growth and Development

Background: Posyandu program suspension due to COVID-19 has resulted in a decrease in monitoring children’s growth, leading to undetected problems. Understanding mothers' eating behavior plays a crucial role in preventing malnutrition, we must continue the program as a health promotion medium to enhance mothers' understanding and track children's growth and development. Objectives: This research aimed to determine the effectiveness of virtual Posyandu program in strengthening cadre health promotion services for nutritionally vulnerable children in Jember Regency agricultural area during the absence of offline Posyandu. Methods: The research was carried out September 2022-January 2023, implementing a 21-day intervention on 169 respondents from Puskesmas Arjasa and Paleran (representing two different socio-cultures). The cadres utilized the application to enhance children's nutritional health and instruct parents on its usage. The success parameter is that there were significant differences between the growth and development of children pre- and post-program. Growth variables were assessed by measuring nutritional status according to Ministry-of-Health Regulation, before and after the intervention, while development variables were assessed using a Developmental Pre-Screening questionnaire (DPSQ). Results: The virtual Posyandu program in both Puskesmas demonstrated significant differences (p&lt;0.001) in children's growth and development parameters, such as height-for-age, weight-for-height, and DPSQ, between the pre- and post-program periods. Despite the challenges posed by the pandemic, the program has effectively maintained children's growth and development. Conclusions: Balitagrow© Android-based application in virtual Posyandu program effectively maintained children’s growth and development in pandemic era and worth continuing to be developed according to user needs.