There is a growing trend in European countries for childbearing to occur later in women’s lives. The recent increase in the use of ART, together with the long-term trend towards later childbearing, raises questions as to the acceptable age of childbearing in contemporary society. ART legislation varies considerably across Europe and age limits for access to fertility treatment are rarely defined. The legislation takes into account the preferences of potential parents; children’s preferences, however, are not ascertained. The (...) article discusses a research method used in a survey of older children and young adults. The objective of the survey was to answer the following questions: What age would children prefer their parents to be if they could choose? What are their reasons? Respondents were asked the following question: “How old would you like your mother and father to be when you are 20 (version for respondents younger than 16) or 25 (version for those older than 16) if you could wave a magic wand?” Furthermore, their reasons for wishing a change were identified through an open question, “Why would you like to change the age of your parents?”. (shrink)

BackgroundFor many decades, the debate on children’s competence to give informed consent in medical settings concentrated on ethical and legal aspects, with little empirical underpinnings. Recently, data from empirical research became available to advance the discussion. It was shown that children’s competence to consent to clinical research could be accurately assessed by the modified MacArthur Competence Assessment Tool for Clinical Research. Age limits for children to be deemed competent to decide on research participation have been studied: generally children (...) of 11.2 years and above were decision-making competent, while children of 9.6 years and younger were not. Age was pointed out to be the key determining factor in children’s competence. In this article we reflect on policy implications of these findings, considering legal, ethical, developmental and clinical perspectives.DiscussionAlthough assessment of children’s competence has a normative character, ethics, law and clinical practice can benefit from research data. The findings may help to do justice to the capacities children possess and challenges they may face when deciding about treatment and research options. We discuss advantages and drawbacks of standardized competence assessment in children on a case-by-case basis compared to application of a fixed age limit, and conclude that a selective implementation of case-by-case competence assessment in specific populations is preferable. We recommend the implementation of age limits based on empirical evidence. Furthermore, we elaborate on a suitable model for informed consent involving children and parents that would do justice to developmental aspects of children and the specific characteristics of the parent-child dyad.SummaryPrevious research outcomes showed that children’s medical decision-making capacities could be operationalized into a standardized assessment instrument. Recommendations for policies include a dual consent procedure, including both child as well as parents, for children from the age of 12 until they reach majority. For children between 10 and 12 years of age, and in case of children older than 12 years in special research populations of mentally compromised patients, we suggest a case-by-case assessment of children’s competence to consent. Since such a dual consent procedure is fundamentally different from a procedure of parental permission and child assent, and would imply a considerable shift regarding some current legislations, practical implications are elaborated. (shrink)

Young children with cancer are treated with interventions that can have a high risk of compromising their reproductive potential. ‘Fertility preservation’ for children who have not yet reached puberty involves surgically removing and cryopreserving reproductive tissue prior to treatment in the expectation that strategies for the use of this tissue will be developed in the future. Fertility preservation for prepubertal children is ethically complex because the techniques largely lack proven efficacy for this age group. There is professional difference of opinion (...) about whether it is ethical to offer such ‘experimental’ procedures. The question addressed in this paper is: when, if ever, is it ethically justifiable to offer fertility preservation surgery to prepubertal children? We present the ethical concerns about prepubertal fertility preservation, drawing both on existing literature and our experience discussing this issue with clinicians in clinical ethics case consultations. We argue that offering the procedure is ethically justifiable in certain circumstances. For many children, the balance of benefits and burdens is such that the procedure is ethically permissible but not ethically required; when the procedure is medically safe, it is the parents’ decision to make, with appropriate information and guidance from the treating clinicians. We suggest that clinical ethics support processes are necessary to assist clinicians to engage with the ethical complexity of prepubertal fertility preservation and describe the framework that has been integrated into the pathway of care for patients and families attending the Royal Children’s Hospital in Melbourne, Australia. (shrink)

For families all over the world, going through a pandemic has presented a number of challenges. In particular, social distancing measures involving the closure of schools and day care centers, as well as increasing work hours at home, made parents face very demanding situations. However, we know little about whether parents’ burnout levels are influenced by the age of their children. This study sought to determine whether levels of parental burnout are higher in families with at least one child under (...) the age of four than in families with older children. The second goal was to explore whether having children under 4 years of age moderates the relationship between parental cooperation and PB. A cross-sectional study was conducted with a sample of 651 participants since May 18th until August 27th, 2020. The main results showed that child age is a predictor of PB. Besides, having a child aged 0–4 years old moderates the relationship between parental cooperation and PB. Finally, it was found that in cases where there was at least one child under 4 years of age in the family, with one of the partners who worked remotely, the respondent’s PB rose by 7.9 points. The implications of these results with respect to the consideration of children’s ages in the different parental scenarios were discussed. (shrink)

Children’s exposure to the marketing of energy-dense nutrient-poor (EDNP) foods is a public health concern and marketing investment is known to be shifting to non-broadcast media, such as the Internet. This paper examines the perceptions of parents and children on ethical aspects of food marketing to which children are exposed. The research used qualitative methods with parent-child (aged between 8–13 years), from South Australia. Thirteen parent-child pairs participated in this research. Ethical concerns raised by parents and children included, the (...) marketing of EDNP foods, pester power and family conflict and the use of powerful techniques via the Internet. Their views on rights and responsibilities represented a complex mixture of idealistic and pragmatic positions. They appeared to be caught within the tensions of problematizing unhealthy food marketing to children, both as a social problem and as an individual problem. Their dilemmas are not dissimilar to the broader policy debate in Australia on the matter of food marketing to children. The stale-mate on statutory regulations to protect children from exposure to EDNP food marketing could be advanced by stronger use of ethical arguments to protect children from harmful exploitation and to protect parents from forces that undermine their authority. (shrink)

BackgroundWhile fertility preservation is recommended practice for paediatric oncology patients, it is increasingly being considered for transgender children and young people in paediatric care. This raises ethical issues for clinicians, particularly around consent and shared decision-making in this new area of healthcare.MethodsA systematic review of normative literature was conducted across four databases in June 2020 to capture ethical considerations related to fertility counselling and preservation in paediatric transgender healthcare. The text of included publications was analysed inductively, guided by the Qualitative (...) Analysis Guide of Leuven.ResultsTwenty-four publications were identified for inclusion. Four key ethical considerations emerged from this literature: access to fertility preservation, conscientious objection, decision-making capacity of children and young people, and shared decision-making.ConclusionIn the identified literature, there is consensus that transgender children and young people should not be refused access to fertility preservation services solely due to their gender identity, and that clinicians with conscientious objections to fertility preservation for this group have an obligation to refer on to willing providers. Factors that create ethical complexity in this area of paediatric care include the child’s age, mental health, and parents’ views. (shrink)

The goal is to present how shared decision-making in paediatric oncology occurs from the viewpoints of parents and physicians. Eight Swiss Pediatric Oncology Group centres participated in this prospective study. The sample comprised a parent and physician of the minor patient. Surveys were statistically analysed by comparing physicians’ and parents’ perspectives and by evaluating factors associated with children’s actual involvement. Perspectives of ninety-one parents and twenty physicians were obtained for 151 children. Results indicate that for six aspects of information (...) provision examined, parents’ and physicians’ perceptions differed. Moreover, parents felt that the children were more competent to understand diagnosis and prognosis, assessed the disease of the children as worse, and reported higher satisfaction with decision-making on the part of the children. A patient’s age and gender predicted involvement. Older children and girls were more likely to be involved. In the decision-making process, parents held a less active role than they actually wanted. Physicians should take measures to ensure that provided information is understood correctly. Furthermore, they should work towards creating awareness for systematic differences between parents and physicians with respect to the perception of the child, the disease, and shared decision-making. (shrink)

It has been argued that, when there is a probable imminent risk of loss of children’s fertility, their parents should take active steps to preserve their reproductive potential if possible – or even that children have a right to such interventions being undertaken on them on their behalf, as an expression of their right to an open future. In this chapter, I explore these proposals and some of their implications. I place the discussion of fertility preservation for children into (...) the more general context of the choices that parents might have to help keep their children’s future reproductive (and parenting) choices open. I discuss the role of desert and fairness in arguments for fertility preservation and their relevance for framings of infertility in general, as well as the relation between having a (slight) possibility to reproduce and becoming a parent. (shrink)

When faced with transgressions in their peer groups, children must navigate a series of situational cues (e.g., type of transgression, transgressor gender, transgressor intentionality) to evaluate the moral status of transgressions and to inform their subsequent behavior toward the transgressors. There is little research on which cues children prioritize when presented together, how reliance on these cues may be affected by certain biases (e.g., gender norms), or how the prioritization of these cues may change with age. To explore these questions, (...) 138 5- to 7-year-olds (younger children) and 8- to 10-year-olds (older children) evaluated a series of boy and girl characters who partook in physical or relational aggression with ambiguous or purposeful intent. Children were asked to provide sociomoral evaluations (i.e., acceptability, punishment, and intention attribution judgments) and social preferences. Transgressor gender only impacted children’s social preferences. Conversely, aggression form and transgressor intent shifted children’s sociomoral judgments: they were harsher toward physical transgressors with purposeful intent over those with ambiguous intent but made similar evaluations for relational transgressors regardless of intentionality. The present results suggest that gender is perhaps not uniformly relevant to children across all contexts, as other cues were prioritized for children’s sociomoral judgments. Since children likely have less familiarity with relational aggression compared to physical aggression, it follows that intent would only shift judgments about physical transgressors. This research provides insight about how children simultaneously navigate multiple cues in aggression contexts, which is likely reflective of their real-world experiences. (shrink)

The sources, extent and margins of parental obligations in taking decisions regarding their children’s medical care are subjects of ongoing debates. Balancing children’s immediate welfare with keeping their future open is a delicate task. In this paper, we briefly present two examples of situations in which parents may be confronted with the choice of whether to authorise or demand non-therapeutic interventions on their children for the purpose of fertility preservation. The first example is that of children facing cancer (...) treatment, and the second of children with Klinefelter syndrome. We argue that, whereas decisions of whether to preserve fertility may be prima facie within the limits of parental discretion, the right to an open future does not straightforwardly put parents under an obligation to take actions that would detect or relieve future infertility in their children—and indeed in some cases taking such actions is problematic. (shrink)

Fostering early literacy depends in part on engaging and inspiring children’s early interest in reading. Enriching the causal content of children’s books may be one way to do so, as causal information has been empirically shown to capture children’s attention. To more directly test whether children’s book preferences might be driven by causal content, we created pairs of expository books closely matched for content and complexity, but with differing amounts of causal information embedded therein. Three (...) and 4 years old participants ( n = 48) were read both books and their interests and preferences were evaluated. When asked to choose, children preferred the highly causal over the minimally causal books. Results are discussed in terms of broader implications for creating books that optimally engage young children, as well as guiding book selections parents and educators make in their endeavors to promote interest in reading and early literacy. (shrink)

Health behaviours of preschool children have a considerable impact on the shaping of habits later on in their lives. Parents’ and guardians’ role is to develop positive health patterns and represent exemplary models to be followed by children. The aim of the paper is to present the use of correspondence analysis for the assessment of the relationship between eating habits of parents and children, as well as for the determination of the most common situations in which preschool children consume fast-food (...) products and to find the relationship between the frequency of fast-food consumption and BMI values in preschool children. The tests were carried out with the use of an own survey carried out in kindergartens in Białystok among parents dropping off and picking up children. 149 correctly filled questionnaires were obtained. The statistical analysis employs the chi-squared test and correspondence analysis. Among the tested children, a statistically significant relationship between body weight and sex was obtained. In the group of children and parents consuming fast-foods, a statistically significant relationship between the frequency of children’s and parents’ consumption of the products in question was noticed. A statistically significant relationship between the age of introduction of fast-food products into the child’s diet and their BMI was found. A situation that was statistically significant as far as contribution to frequent consumption of fast-food products by children, i.e. at least once a week, were children and parents shopping together. The relationship between the frequency of fast-food consumption by parents and children was presented in the form of correspondence maps, as well as the relationship between the child’s BMI and the age when the first fast-food product is served, and the relationship between the child’s BMI and the frequency of their consumption of fast-foods. Unfortunately, despite the high awareness among parents of the harmful effects of fast-food products and the widespread health education programmes, a number of the children in kindergartens were overweight or even obese. For this reason, the quality of the educational programmes in kindergartens, as well as in various media outlets, needs to be improved, with emphasis put on their effectiveness, in order to minimise the problem of the occurrence of overweight and obesity in children. It is also important for parents rearing children to pay special attention not only to their children’s menus, but also to foods consumed in the presence of children. (shrink)

Kuwait is a high fertility country where the average number of desired children still exceeds 5. However, fertility behaviour is beginning to show a noticeable change and the current TFR is about 4·2 children. In order to understand the decline in fertility, the impact of perceived benefits and costs of children on Kuwaiti womens demographic and socioeconomic characteristics. The sociocultural, economic and political contexts that shape the mother’s perceptions of the benefits and costs of children are analysed and it is (...) concluded that the need for children as social and national capital is currently the most important driving force behind fertility desires and behaviour. (shrink)

The Chinese traditionally have valued sons over daughters, depending on their sons to support them in old age. Recent changes, however, suggest a shift toward greater gender equality, with daughters also keeping elderly parents. The present study, undertaken in 1979 in the People's Republic of China, assessed attitudes of 48 university staff members toward financial support for aged parents and living arrangements in old age, with an emphasis on gender differences. We found that most sons and daughters gave financial support (...) to their parents regularly and most men and women still believed adult children should share housing with their aged parents. In this sample, the sons assumed this responsibility far more than the daughters, and few of the respondents believed their parents should live with a daughter. However, when asked to project their own preferences in old age, sons thought they would prefer to live with a son, but daughters feel they would like to live with a daughter. These results are discussed in terms of two important cultural changes, the new marriage laws and the one-child policy, that were implemented at the time of the study. (shrink)

Introduction: Cognitive behavioral therapy for children and adolescents has shown efficacy in treating different psychiatric disorders. It has been added to multiple clinical guidelines as the first-line treatment. However, despite more studies of its efficacy, CBT is underutilized in clinical settings due to a lack of rigorous training programs and qualified CBT therapists. The limited knowledge of parents in this intervention and their negative attitudes toward it have been considered as possible reasons.Methods: This is a cross-sectional survey-based study among 464 (...) Saudi parents living in Riyadh city. We aimed to evaluate the preference, knowledge, and attitudes of Saudi parents toward CBT for their children. We compared the difference in the level of knowledge and attitudes toward CBT in relation to the characteristics of parents. An online questionnaire that included 39 questions was carefully reconstructed from four validated scales, approved by an expert panel, and piloted. Participants were recruited to participate through online social media.Results: Saudi parents had average knowledge about CBT; however, they had positive attitudes toward the therapy itself and its role in treating the behavioral issues of children. Male participants showed better knowledge than female participants. Participants with higher education and those with high income had more favorable attitudes toward CBT than others.Conclusion: The knowledge of parents is considered inadequate and indicated the need for more awareness and perhaps mass education. In contrast, they maintained positive attitudes and were interested in evidence-based treatment, with more preference toward non-psychopharmacological interventions. (shrink)

The present study investigated the cross-cultural variations in parents' views on the role of play in child development and the primary purpose of preschool education from Ethiopia and Hungary. It also examined the cross-cultural variations in preschoolers' executive functions, the frequency of their engagement in home activities, and the role of these activities in the development of EF skills. Participants included 266 preschoolers with their parents. The independent samples t-test showed that Ethiopian parents view fostering academic skills for preschooler significantly (...) more important than their Hungarian counterparts do. We also found that while Ethiopian parents hold the belief that academic and cognitive development is the major purpose of preschool education, Hungarian prioritize social-emotional development and entertainment. Additionally, preschoolers in Ethiopia were reported to engage in academic and arts and crafts activities after preschool significantly more frequently than their Hungarian counterparts. On the contrary, preschoolers in Hungary were found to engage in fine-motor activities, solitary play, sports and other physical activities significantly more frequently than their Ethiopian counterparts. No significant differences were found in EF skills between preschoolers from Ethiopia and Hungary. Results from hierarchical regression analyses showed that, after accounting for age and SES, preschoolers' frequency of pretend play and their parents' play support beliefs were found to be small to medium-sized predictors of inhibitory control skills in both samples. However, children's frequency of having breakfast at home was another significant predictor in the Ethiopian sample only. The frequency of participation in arts and crafts and other fine-motor activities were found to be important predictors of preschoolers' visual-spatial working memory skills in the Ethiopian and the Hungarian samples, respectively. We also found that, after controlling for SES, parental play support was an important factor associated with preschoolers' shifting skills only in the Hungarian sample. Based on the findings, we made important conclusions. (shrink)

The paper reports two studies investigating children’s acquisition of the wh -adjunct zenme in Mandarin. Unlike other Mandarin wh -words that correspond to a single meaning, zenme can be used to question either the manner or the cause of an event. Study 1 explored whether children understand that zenme is ambiguous between a causal and a manner reading. Study 2 examined whether they can use syntactic cues to disambiguate the two readings. The findings show that children as young as (...) 4 years of age access both the manner and the causal reading, but they prefer the former over the latter. Children exhibit a developmental trajectory when acquiring the mapping relations between the syntactic positions of zenme and its corresponding semantic interpretations: 5-year-olds can use syntactic cues to disambiguate the two readings; 3-year-olds, however, are still in the stage of working out how the syntactic positions are mapped onto the relevant semantic interpretations; the critical change occurs at around 4 years of age. The implications of the findings were then discussed in relation to the two major competing theories of child language acquisition. (shrink)

This study examined whether parents’ attribution of their child’s emotions (internalizing, externalizing) to dispositional causes is associated with children’s problem behaviour (internalizing, externalizing). The mediating roles of parents’ emotion-dismissing and -coaching reactions and the moderating role of child’s gender was also examined. Participants were 241 US parents with a child (43% girls) between the ages of 5 and 7. Parents were presented with vignettes in which a gender-neutral child displayed internalizing and externalizing emotions and were asked to imagine their (...) own child in the vignettes. Subsequently, parents indicated whether they attributed the child’s emotion to dispositional causes and the likelihood of reacting in an emotion-dismissing and -coaching way in each situation. Child problem behaviour was measured using the CBCL. Results show that parental dispositional attributions were associated with child internalizing and externalizing problems, and this association was consistently mediated by emotion-dismissing reactions. The association between parental dispositional attributions and emotion-dismissing, as well as its indirect effect on child internalizing problems, was stronger for boys than for girls, whereas the indirect effect via emotion-coaching was stronger for girls than for boys. Thus, the parental attribution process seems to be different for boys and girls. (shrink)

The present research examines how children’s time spent online is associated with their perceived life satisfaction accounting for their age, gender, socio-economic status (SES), emotional problems, country, and family environmental factors. This article is based on the data of the large scale cross-sectionalEU Kids Onlinesurvey from 16 European countries with nationally representative samples of children aged 9–17 (N= 11,200,Mage= 13.3, SD = 2.36; 50.6% boys, 49.4% girls). The results indicated that the time children spent online appeared to have no (...) considerable negative effect on their self-reported life satisfaction (SRLS). Comparatively, the positive effects of children’s SES and family environment accounted for 43% of the overall 50% of the variance in children’s SRLS scores. Considering that children’s SES alone accounted for 42% of the variance, children’s emotional problems, country of residence, and enabling parental mediation accounted for the remaining 3, 4, and 1% of the variance, respectively. In line with previous studies that urge caution when discussing the negative influence of time spent online on children’s mental health and overall wellbeing, the current findings suggest that social-ecological characteristics and how children use the Internet, need to be examined further. (shrink)

Poor nutrition habits have been reported in the childcare setting. While the literature advocates the need to carry out ‘Voice of the Child’ research, few studies have explored this methodology with regard to children and food, in particular in the pre-school setting. This article aims to outline the ethical issues raised by a research ethics committee and to discuss the impact of these issues on a study that hoped to determine the food perceptions of children (aged three to four years) (...) within an ongoing nutrition and lifestyle pre-school project in Ireland. Ethical approval was granted for this study but only upon the clarification of two aspects: that only hedonic symbols previously used in the literature could be included in the study; and that parental consent be obtained from both parents of each child. Children were shown food pictures and asked to use the hedonic symbols to answer questions posed to them on the food. Owing to the ethical constraints imposed by the requirement for two-parent consent, seven children, from a potential sample of 85, were eligible to partake in the study. These children did not seem to understand the hedonic symbols recommended for use by the ethics committee, therefore preventing the collection of in-depth qualitative data. The ethical constraints placed on this study impacted on both its design and its methodology and are discussed in relation to national and international ethical guidance and legislation. Future research with children regarding food choice must balance the need for strict ethical standards with the need to explore children’s views on this subject. (shrink)

Cognitive incompetence cannot adequately explain the special character of children's moral status. It is, in fact, because children lack preference structures that are sufficiently stable over time that they are not ’temporally extended agents’. They are best viewed as 'special agents’, and parents have the responsibility of fostering the development of temporally extended agency and other necessary related moral capacities. Parental authority should be exercised with the view to assisting children to acquire the capacities that facilitate their transition from 'special (...) agents’ to full and functioning members of the moral community. (shrink)

The overriding theme of the conference honoring Bob Cooter and his work is the question whether law and policy can change people’s preferences. The conventional “law and economics” answer is “no.” People have preferences that are fixed. What changes in law and policy do is to change how people behave by altering the costs and benefits people face in pursuit of their preferences. Put simply, the assumption of the “law and economics” model is that people respond to (...) financial incentives by changing how they act, not what they want. So, to take a simple example, imagine two people at the same starting point, both wanting to drive separately to visit a mutual friend. Their preference to get there promptly and safely is common to both of them, but how they act in pursuit of that goal may well differ. Moreover, government can alter how they drive to their friend’s by making changes such as putting in a freeway, or adding a new lane to the road, or installing lots of new traffic signals or stop signs along one route. The two people may have driven different routes previously, and they may alter their driving strategy in response to the policy changes government has adopted and may still decide that different routes are better for them. But they do not change their desire to see their friend in a prompt and safe manner. In this Article I offer a counterexample — an instance in which changes in law and policy can not only alter the behavior of some with fixed preferences, but also can impact the preferences of others. My example is about changes in society that can alter parenting style (of those parents with a fixed preference to have their children succeed) and can also change the underlying preferences that those children have as to how their lives should play out. (shrink)

This article explores tentatively how young children develop a sense of beauty and should be guided in doing so. Beauty is partly a matter of personal preference, but it implies a more profound and considered idea than what is pleasing or attractive. Beauty contributes to well-being and a flourishing life. Since ideas of beauty vary over time and are transmitted through culture and socialization, these are affected by socio-cultural factors such as gender, ethnicity, class and age. Children’s perceptions of (...) beauty often differ from those of adults. A sense of what is beautiful or otherwise is based mainly in emotional and sensory responses but also involves cognitive processes and judgements. Unconscious learning by immersion in beautiful environments helps children sense what is beautiful. They benefit from a wide range of opportunities and experiences and time to dwell on these and to re-present them kinaesthetically, visually and using language. While the arts and nature provide particularly fertile opportunities, aesthetic development can occur in most contexts. The role of adults should be more that of facilitator, providing opportunities, encouragement and example, than instructor. Implications for the education of the whole child are considered. (shrink)

Based on historical data pertaining to the Krummhörn population (eighteenth and nineteenth centuries, Germany), we compared reproductive histories of mothers according to whether the maternal grandmother (MGM) or the paternal grandmother (PGM) or neither of them was resident in the parents’ parish at the time of the mother’s first birth. In contrast to effects of PGMs, we discovered conditional differences in the MGM’s effects between landless people and wealthier, commercial farmers. Our data indicate that the presence of the MGM only (...) lowers the woman’s age at marriage (AAM) and her age at the birth of her first child (AFB) in the case of landless families. However, among commercial farmers, who can generally be characterized by a lower AAM and AFB, we found opposite tendencies for the MGM’s effect leading to a relatively small delay in AAM and AFB. Moreover, we also analyzed differences in the completed fertility (i.e., children ever born: CEB). Results indicate that landless families in general do have fewer CEB compared with commercial farmers except for those families in which the MGM has been present. Emphasizing that the adaptiveness of investment decisions should depend on the interaction of genetic, lineage-specific (intrinsic) and ecologically imposed (extrinsic) constraints, we conclude that kin strategies consequently address different fitness components under different conditions. (shrink)

Objective: The objective of the current study was to maximise the amount of information children and adolescents understand about the risks and benefits associated with participation in a biomedical research study.Design: Participants were presented with one of six hypothetical research protocols describing how to fix a fractured thigh using either a “standard” cast or “new” pins procedure. Risks and benefits associated with each of the treatment options were manipulated so that for each one of the six protocols there was either (...) a correct or ambiguous choice.Participants and setting: Two hundred and fifty one children, ages 6–15 , and 237 adults were interviewed while waiting for a clinic appointment at the Hospital for Sick Children.Results: Using standardised procedures and questionnaires, it was determined that most participants, regardless of age group, were able to understand the basic purpose and procedures involved in the research, and most were able to choose the “correct” operation. The younger children, however, showed an overall preference for a cast operation, whereas the older participants were more likely to choose the pins.Conclusions: By creating age appropriate modules of information, children as young as six years can understand potentially difficult and complex concepts such as the risks and benefits associated with participation in biomedical research. It appears, however, that different criteria were used for treatment preference, regardless of associated risks; older participants tended to opt for mobility whereas younger participants stayed with the more familiar cast operation. (shrink)

Research suggests that typically developing children begin to understand verbal irony around 5 or 6 years of age. Children's production of verbal irony, however, has not previously been examined. This study was a preliminary investigation of children's irony production, including both verbal and gestural (nonverbal) forms. We coded instances of irony in interactions within 118 family triads, each consisting of 1 parent and 2 children, aged 3 to 15 years. Triads performed an 8-min cooperative task with dominos. In this context, (...) gestural irony was used more frequently than verbal irony: 80% of the families used gestural irony at least once and 32% used verbal irony at least once. Children produced gestural irony as early as 4 years of age, and verbal irony as early as 5 years of age. Children's use of irony was not related to their general cognitive ability or vocabulary, but was related to use of irony by other members of the triad. Results suggest that social context is important to the emergence of irony production. (shrink)

The aim of our study was to examine the familial risk of dyslexia in Year 1 school beginners, whose parents had been diagnosed as dyslexic or exhibited symptoms of the specific difficulties in reading and writing without a formal opinion issued by a counselling centre. We found that both a dyslexia report and specific reading and writing difficulties with no formal diagnosis manifested by a family member, and parents’ reading preferences, predicted the risk of dyslexia in Year 1 children. (...) Moreover, the children at familiar risk of dyslexia, as compared with their peers at no risk, later began to babble, were less apt at self-help and liked drawing less at the age of 2-3 years, and experienced more problems with drawing a circle at the age of 3. Additionally, during Year 1 of education, they performed poorer in fine motor skills, linguistic perception and sound deletion, visual functions and attention. Such symptoms can be observed by parents and teachers during the child’s play and educational activities. Early intervention can enhance the child’s readiness to school entry, and facilitate effective and satisfactory learning, increasing their further educational opportunities and the quality of life. (shrink)

Children’s intentions should be respected. Parents are the key persons involved in decision-making related to their children. In Japan, the appropriate ages and standards for a child’s consent and assent, approval, and decision-making are not clearly defined, which makes the process of obtaining consent and assent for clinical research complex. The purpose of this paper is as follows: to understand the attitudes and motives of parents concerning children’s participation in medical research and the factors influencing their decision-making. We (...) also sought to clarify who has the right to be involved in decisions regarding children’s participation in research. A semi-structured Internet survey on parents’ opinions and attitudes and preferences concerning medical research involvement was conducted. Children were divided into three age groups (6–10-year-olds, 11–14-year-olds, and 15–18-year-olds), with three illness severity categories. Possible correlations between the number of children, children’s ages, parents’ educational levels, and parents’ attitudes were examined. Among the participants, 42.3% recognized the term “informed consent.” The proportion of participants who understood “informed consent” increased with educational level. Four out of five participants did not know, or had not heard of, the term “informed assent.” Furthermore, the percentage of those who understood the term “informed assent” increased with academic level. Participants generally believed in prioritizing parents’ opinions over children’s, and that parents and children would ideally reach a joint decision. Although many parents favored collaborative decision-making, they also wanted their own will reflected in the decision and felt they should receive important information before their children do. Decision-making was affected by the condition’s severity and prognosis. This indicates that most Japanese parents believe that their children have the right to know their disease name and treatment; nonetheless, they should be protected. Parents’ values and judgments regarding medical intervention involving their children varied. Children’s ability to consent to treatment and research believed to be in their best interests should be assessed appropriately. They should be permitted to provide consent or assent, and their views should be respected. Involving children in decision-making fosters more open communication and transparency between medical professionals, parents, and children. (shrink)

This study explored the lived experience of security and contentment, and their absence, for latency-aged children living in shared-time parenting arrangements following their parents’ separation. A descriptive phenomenological methodology was utilized. Sixteen children living in shared-time were interviewed about their experiences of two phenomena: “feeling secure and content living in shared-time” and “not feeling secure and content living in shared-time.” The eight richest protocols were selected for analysis. The two resultant general structures and their core constituents are presented, and individual (...) variations discussed. Central to each phenomenon is the parent/s’ capacity, or incapacity, to create and sustain a physical and emotional space in which the child feels secure and held in the mind, feels the arrangements are responsive to their needs, feels free to access the “absent” parent, and experiences integration between the two parental homes. Implications for phenomenological human science research are considered, including the use of descriptive phenomenology with children. (shrink)

Recent work has shown that preschool-aged children and adults understand freedom of choice regardless of culture, but that adults across cultures differ in perceiving social obligations as constraints on action. To investigate the development of these cultural differences and universalities, we interviewed school-aged children (4–11) in Nepal and the United States regarding beliefs about people's freedom of choice and constraint to follow preferences, perform impossible acts, and break social obligations. Children across cultures and ages universally endorsed the choice to (...) follow preferences but not to perform impossible acts. Age and culture effects also emerged: Young children in both cultures viewed social obligations as constraints on action, but American children did so less as they aged. These findings suggest that while basic notions of free choice are universal, recognitions of social obligations as constraints on action may be culturally learned. (shrink)

Since the onset of the COVID-19 pandemic, many parents have felt anxious, overwhelmed, and stressed out due to the changes in education and family and working routines. This work aimed to describe three dimensions of perceived parenting in the COVID-19 pandemic context, describe possible changes perceived by mothers in their children’s behavior during the social isolation phase, analyze if behavioral changes vary according to the dimension of perceived parenting, and analyze whether the characteristics of perceived parenting dimensions vary with (...) mother’s age, number of children and number of work hours. The purposive sample consisted of 646 mothers of school-aged children in Argentina. Questionnaires on sociodemographic and work-related data, and on children’s behavior were administered, as well as an instrument that assessed the three parenting dimensions. The sociodemographic and work-related variables of the study were described using descriptive statistics: measures of central tendency, frequencies, and percentages. The changes perceived in children’s behavior according to the reports given by the mothers regarding positive parenting, parenting stress, and school support were compared using the Mann Whitney’s U test, respecting the qualitative nature of the evaluated indicators. A factorial MANOVA was conducted to analyze the effect of mother’s age, ä number of children, and the number of work hours on parenting perceived by mothers. Parenting dimensions influenced the perceived children’s behavior. Mothers with higher positive parenting perceived more changes in their children’s behavior. In addition, those mothers who were more stressed out perceived more problems in almost all the measured behaviors than less stressed mothers. The mothers who reported to have provided more school support to their children perceived that they adapted better to online classes. Finally, mothers’ age and the number of children I parenting, particularly on parenting stress and school support, whereas work hours did not. A number of children affected stress and school support, and age only affected parenting stress. The only significant interaction regarding parenting was observed between the number of children and the number of work hours, which specifically affected parenting stress. Although social isolation due to COVID-19 affected children’s behavior, according to mothers, this might be partially linked to the number of children, mothers’ age, and the mothers’ parenting style. These initial findings may allow the identification of some protective factors and some risk factors of parenting in the Argentine context of a pandemic, and the design of preventive psychoeducational interventions to optimize the psychological wellbeing of families. (shrink)

BackgroundBiobanking biospecimens and consent are common practice in paediatric research. We need to explore children and young people’s (CYP) knowledge and perspectives around the use of and consent to biobanking. This will ensure meaningful informed consent can be obtained and improve current consent procedures.MethodsWe designed a survey, in co-production with CYP, collecting demographic data, views on biobanking, and consent using three scenarios: 1) prospective consent, 2) deferred consent, and 3) reconsent and assent at age of capacity. The survey was disseminated (...) via the Young Person’s Advisory Group North England (YPAGne) and participating CYP’s secondary schools. Data were analysed using a qualitative thematic approach by three independent reviewers (including CYP) to identify common themes. Data triangulation occurred independently by a fourth reviewer.ResultsOne hundred two CYP completed the survey. Most were between 16–18 years (63.7%, N = 65) and female (66.7%, N = 68). 72.3% had no prior knowledge of biobanking (N = 73).Acceptability of prospective consent for biobanking was high (91.2%, N = 93) with common themes: ‘altruism’, ‘potential benefits outweigh individual risk’, 'frugality', and ‘(in)convenience’.Deferred consent was also deemed acceptable in the large majority (84.3%, N = 86), with common themes: ‘altruism’, ‘body integrity’ and ‘sample frugality’. 76.5% preferred to reconsent when cognitively mature enough to give assent (N = 78), even if parental consent was previously in place. 79.2% wanted to be informed if their biobanked biospecimen is reused (N = 80).ConclusionProspective and deferred consent acceptability for biobanking is high among CYP in the UK. Altruism, frugality, body integrity, and privacy are the most important themes. Clear communication and justification are paramount to obtain consent. Any CYP with capacity should be part of the consenting procedure, if possible. (shrink)

Background: Pediatric guidelines recommend that children and adolescents participate in a developmentally appropriate way in end-of-life decision making. Shared decision making in pediatrics is unique because of the triadic relationship of patient, parents, and physician. The involvement of the patient may vary on a continuum from no involvement to being the sole decision maker. However, the effects of child participation have not been thoroughly studied. The aims of this literature review are to identify studies on end-of-life decision making in pediatrics, (...) to explore patient participation, and to assess the effects of such participation. Methods: Five databases—PubMed, PsycInfo, Medline, CINAHL, and Sociological Abstract—were searched for empirical studies on end-of-life decision making in pediatrics. Selected articles fulfilling the criteria were assessed for type of decision, participants’ characteristics, reports on participation of the minor patient, and outcome. Results: Fifty-seven articles on end-of-life decision making in pediatrics were identified. The majority of papers (n = 43, 75%) investigated parents’ and clinicians’ perspectives, while only 14 articles (25%) included perspectives of children and adolescents. Twenty-two articles (39%) reported some details on various forms of children's participation (e.g., receive information, plan care details, consulted before or after a decision was made). Positive (e.g., respect for patient's preferences) and negative (e.g., conflict due to diverging opinions) effects of children's participation in end-of-life decision making were reported. Conclusions: This systematic review highlights the need for research to identify factors that contribute to a favorable participation of minors in decision-making processes, as well as strategies to solve possible conflicts. More research should take into account the dynamics in the triadic process of decision making and emphasize children and adolescents’ perspectives. A better understanding of how to meaningfully involve children and adolescents in end-of-life decision making could facilitate the practice of patient participation in pediatrics. (shrink)

Viola and Ben, two pediatric oncology patients, need to undergo chemotherapy that might decrease their fertility. Both of them want to participate in the decisions related to their cancer treatment and fertility preservation. Should they be involved, and if so when and how?In many jurisdictions, children are not entitled to provide legally valid consent for medical decisions.1 As a result, others, usually parents, take on the role of surrogate decision-makers who act in their best interest. Still, it is important to (...) keep in mind that the age limit for competence set by legislation does not necessarily coincide with children’s clinical decision-making capacity: some children may be able to make certain health-care... (shrink)

ABSTRACT Objectives: To investigate whether Chinese adolescents in Hong Kong share similar perceptions with their Western counterparts regarding their capacity for autonomous decision‐making, and secondarily whether Chinese parents underestimate their adolescent children's desire and capacity for autonomous decision‐making. Method:‘Healthy Adolescents’ and their parents were recruited from four local secondary schools, and ‘Sick Adolescents’ and their parents from the pediatric wards and outpatient clinics. Their perceptions of adolescents' understanding of illnesses and treatments, maturity in judgment, risk‐taking, openness to divergent opinions, pressure (...) from parents and doctors, submission to parental authority and preference for autonomy in medical decision‐making are surveyed by a 50‐item questionnaire on a five‐point Likert scale. Results: Findings indicate that Chinese adolescents aged 14–16 perceive themselves to possess the necessary cognitive abilities and maturity in judgment to be autonomous decision‐makers like their Western counterparts. Paradoxically, although they hesitate to assert their autonomy, they are also unwilling to surrender that autonomy to their parents even under coercion or intimidation. Parents tend to underestimate their adolescents' preferences for making autonomous decisions and overestimate the importance of parental authority in decision‐making. Conclusion:‘14‐and‐above’ Chinese adolescents in Hong Kong perceive themselves as capable of autonomous decision‐making in medically‐related matters, but hesitate to assert their autonomy, probably because of the Confucian values of parental authority and filial piety that are deeply embedded in the local culture. (shrink)

Lavoie and Talwar examine the phenomenon of prosocial lie telling: lying with the intention to benefit others. They investigate how well children aged 4 to 11 are able to conceal information about a surprise gift from their parents based on these children’s responses to their parents’ questions. Lavoie and Talwar conclude that, as children’s theory of mind abilities and working memory improve, their ability to conceal information from others also develops.

The emotional experience and the type of communication about cancer within the family are important factors for successful coping with pediatric oncology. The main purpose is to study mother’s and children’s emotional experiences concerning cancer, whether they communicate openly about the disease, and relationships between the type of communication and the different emotions expressed by the children. Fifty-two cancer patients aged 6–14 years and their mothers were interviewed in separate sessions about the two central themes of the study: emotional (...) experiences and type of communication. Analyses of response categories were performed to subsequently compare the age-groups and the mother–child responses. According to the results, mothers expressed emotions such as fear, sadness, or anxiety, while children report sadness, pain, but also happiness. Significant positive correlations were observed between mothers’ sadness and older children’s sadness, mothers’ anxiety and children’s fear, and mothers’ anxiety and children’s happiness. Regarding communication type, mothers tend to hide information about the disease from younger children and to provide direct information to the older children. Children usually prefer to communicate their concerns to parents; however, children whose mothers convey anxiety are more likely to prefer to communicate with others. These results support the idea that parents should talk honestly with their children, explaining their illness in an age-appropriate way, and encouraging them to share their emotional experiences. Further studies are needed from a developmental perspective to understand the disease management of children and families. (shrink)

BackgroundMental illness among Malaysian children is gradually reaching a fundamentally alarming point as it persistently shows increasing trend. The existing literature on the etiologies of children’s mental illness, highlights the most common cause to be ineffective or impaired parenting. Thus, efforts to combat mental illness in children should focus on improving the quality of parenting. Documented interventional studies focusing on this issue, particularly in Malaysia, are scarce and commonly report poor treatment outcomes stemming from inconvenient face-to-face instructions. Consequently, proposing (...) an accessible online and digital-assisted parenting program is expected to reach a larger number of parents, as it can overcome substantial barriers. Hence, this study aims to develop a universal digital-assisted preventive parenting intervention called DaPI, that aims to enhance mental health of children in Malaysia.MethodsA total of 200 parents of children aged 10–14 years will be recruited and randomized into two groups either intervention or waitlist-control based on a 1:1 ratio for a duration of 8 weeks. Those in the intervention group will receive eight sessions of the DaPI program that focus mainly on parenting and children’s mental health. The primary outcome of this study will essentially focus on the changes in parent-reported parenting behavior and parental self-efficacy. The secondary outcome will be changes in children’s mental health. Assessments will be arranged pre- and post-intervention as well as at the 1-month follow-up. Analyses will be conducted using a paired t-test and multivariate analysis of covariance.DiscussionThe expected outcome will be the establishment of DaPI in promoting children’s mental health by targeting changes in parenting behavior and parental self-efficacy in Malaysia. Findings from this study will be beneficial for policymakers to invest in parenting programs that could provide support to parents in enhancing their child’s overall development.Clinical trial registration[www.irct.ir], identifier [IRCT20211129053207N1]. (shrink)

Adolescents who believe that their parents treat them differently from their siblings have poorer psychosocial well-being than otherwise. This phenomenon, which is known as parental differential treatment or PDT occurs in up to 65% of families. Past studies have examined socio-demographic variables (e.g., child gender, age, and birth order) as predictors of PDT, but these immutable characteristics do little to inform interventions and help these adolescents. Hence, this study extends past research by investigating links among parent empathy, parent perception of (...) PDT, child perception of PDT, child perception of fairness and child well-being (self-esteem, depression, anxiety, and trust in the relationship with parents). Furthermore, this study tests whether adolescent personality (openness, conscientiousness, extraversion, agreeableness and neuroticism), child empathy, and child perception of fairness moderate these links. This study will utilize a two-wave longitudinal design with a one-year lapse. Data will be collected from 760 Chinese adolescents studying from Secondary One to Secondary Three in 18 schools in Hong Kong and from their parents. We test our theoretical model via a multilevel structural equation model. This study both addresses (a) theoretical debates about relations among empathy, PDT, fairness, and psychosocial well-being and (b) focuses on modifiable factors and behaviors, to inform future interventions, such as parent education. (shrink)

The present study is couched within Rachman's three-pathway theory of fear acquisition. Besides the direct contact with the objects of fear, this model also includes two indirect pathways to fear acquisition: negative information transmission and modeling. The study aims to explore the contribution of these three factors to the level of children's fear of COVID-19. The sample consisted of 376 children, aged 7–19, and one of their parents. The survey was conducted online during the COVID-19 national state of emergency in (...) the Republic of Serbia. The children assessed their fear of COVID-19, general fearfulness, negative information transmission, and modeling by their parents, as well as the level of exposure to negative information outside their home. The parents assessed their own fear of COVID-19 and trait anxiety. Parents' anxiety, children's age, and children's general fearfulness were used as covariates. The results of our path analysis provide support for Rachman's notion of indirect pathways. The more the parents were afraid of COVID-19, the more they expressed this, which in turn led to an increase in the children's fear of COVID-19. Furthermore, children's exposure to negative information related to COVID-19, provided by their teachers and peers or stemming from the media, directly contributed to the level of children's fear. The results of the study emphasize the importance of caregivers' behavior during global health crises and provide some clues as to what caregivers may do to protect their children's mental health in such circumstances. (shrink)

While several studies have explored parents' perceptions of their children's participation in research, very few studies have described the children's own perceptions of their participation in research. The aim of this study was to describe children's perceptions of their participation in a comprehensive longitudinal clinical study. Semi-structured qualitative interviews were conducted with 17 children aged seven participating in the Copenhagen Prospective Study on Asthma in Childhood. The interviews were audiotaped, transcribed and analysed using the template analysis method. The children rated (...) their experiences with venepunctures on a Wong-Baker faces scale. The regular visits to the hospital and comprehensive clinical tests did not seem to have affected the children negatively. In particular, the children would happily engage themselves in medical tests mimicking play (moving, walking, running or playing with a computer). A majority of the children, however, disapproved of the venepunctures and some even refused to have it done. The results of this study indicate that participation in even comprehensive paediatric research can be a positive experience to the participants, with the most popular tests being those that required active participation from the children. (shrink)

Substantial gender disparities in career advancement are still apparent, for instance in the gender pay gap, the overrepresentation of women in parttime work, and the underrepresentation of women in managerial positions. Regarding the developmental origins of these gender disparities, the current study examined whether children’s views about future career and family involvement were associated with children’s own gender schemas and parents’ career- and family-related gender roles. Participants were 142 Dutch families with a child between the ages of 6 (...) and 12 years old. The families had different compositions. Children completed a computer task assessing gender stereotypes about toys and questionnaires on gender identity and their views about future career and family involvement. Parents reported their occupation, work hours, and task division in the home, which were combined in a composite variable reflecting gender-typicality of career and family involvement. Generalized estimation equations were used to take into account dependency between family members. Results revealed that parents’, and especially mothers’, gender-typical career and family involvement was associated with children’s gender-typical views about future career and family involvement. In addition, children’s felt similarity to the same gender was associated with children’s gender-typical expectations about career and family involvement. These findings suggest that parents’ career, work hours, and task division in the home, together play an important role in how their children envision their future work and family roles. Children themselves also play an active role in developing this vision for the future by their own gender identity, specifically by how similar they feel to individuals of the same gender. To reduce gender disparities in the occupational and domestic domain, programs need to be designed that focus on parental role modeling in the family as well as children’s gender identity development. (shrink)

This paper examines the quality and stability of the responsive parenting practices of mothers with infants and the longitudinal links between these practices and children’s self-esteem. Using data presented by the Panel Study on Korean Children, this study identified Korean mothers’ responsive parenting trajectories from birth to age three and examined their associations with children’s self-esteem at first grade. Korean mothers developed one of three responsive parenting patterns from birth to age three: low, moderate, or high. Children’s (...) self-esteem differed according to their mother’s responsive parenting trajectory. First-graders with mothers displaying the low responsive parenting trajectory were more likely to have lower self-esteem than children of mothers with the moderate responsive parenting trajectory and children of mothers with the high responsive parenting trajectory. The longitudinal link between mother-reported responsive parenting patterns during infancy and child-reported self-esteem at first grade was verified. This finding highlights the significance of early responsive parenting from mothers as a predictor of the self-esteem of children in later developmental stages. (shrink)

To cultivate children’s imagination, observation, thinking ability, and aesthetic consciousness, the questionnaire survey is adopted to analyze the design strategies and principles of children’s picture books based on augmented reality. Primarily, the related concepts and theories are expounded for the research content. Children in preschool aged 4–5 years are invited as primary participants in this work, and the psychological characteristics of the invited children are analyzed in depth. Then, a study is carried out on the existing AR (...) class='Hi'>children’s picture books. The problems existing in the design of AR children’s picture books are found, and then, related solutions are put forward based on the results of the questionnaire survey. Besides, a design is made on the strategies and interactive design principles of AR children’s picture books on mobile terminals that are more in line with the needs of children. The results show that 41.07% of parents do not understand AR technology, and 37.5% of preschool children indicate that they do not operate mobile devices independently. However, they need the assistance of parents to use this kind of picture book. A total of 44.64% of parents believe that the main problem of AR picture books in the current market is the lack of interesting interaction. Given the above problems, five principles are proposed for the design of AR children’s picture books based on mobile terminals, namely, easy operation principle, interesting principle, guiding principle, timely feedback principle, and safety principle. A set of universally applicable design methods are proposed for AR children’s picture books based on mobile terminals, which provides certain theoretical guidance for the development of related types of products. (shrink)

INTRODUCTION[|]The practice of medicine has evolved from old approach, in which all decisions for the patient are taken by physician, to a new approach, which includes patients to the medical decision-making process and endorses informed consent of the patients. In addition to healthcare professionals and patients, parents or legal representatives are stakeholders in the informed consent process of children. The knowledge and attitudes of physicians and medical school students about the informed consent period in children are important for the effectiveness (...) of the medical intervention and the biopsychosocial development of children. In this study, it was aimed to understand involvement of medical students and physicians in the informed consent process of children and their level of knowledge on children's rights and their attitudes in daily clinical practice.[¤]METHODS[|]The study is a descriptive study and n = 150 participants, who were randomly selected from senior medical school students working in medical school campus or university hospital and physicians serving pediatric patients, were included to this study. Questionnaires were applied for the measurement of participants' socio-demographic characteristics, education on pediatric patient rights, and legal provisions. The data were evaluated using SPSS 20.00 software.[¤]RESULTS[|]Of participants, 62% (n = 93) were phase 6 medical students, while 29.33% (n = 44) were resident physicians and the rest were faculty members (8.67%; n = 13). The proportion of physicians, who didn't received training on child rights, was 80.7% (n = 46) and statistically significantly higher than medical students (49.45%; n = 45) (p <0.001). However, participants who were not educated about the children's rights stated with higher ratio (44.83%; n=65), that informed consent should be obtained before medical intervention from individuals under 18 years of age, when they are compared to the the participants who received education (20.69%; n=30) (p = 0,019). The majority of participants (59.5%; n = 88) find the intervention in individuals under the age of 18 years in emergencies without consent of legal representatives ethically and legally appropriate (p <0.001). The participants believe that it is ethically and legally appropriate to conduct an intervention on an individual under the age of 18 years without the legal representative (36. 7%; n=54) (p <0.001).[¤]DISCUSSION AND CONCLUSION[|]This study compared the levels of knowledge and attitudes of participants, who were previously trained in or didn't received any training about children's rights and informed consent of children. However, the quality of the training of the participants on children's rights, was not questioned. This study showed that education on children's rights does not significantly increase the level of legal knowledge on children's rights. Having well-designed a subject focused on this theme in medical deontology and ethics education can increase the knowledge levels and improve the attitudes of medical students. This study sheds light on the issues that need to be focused in the medical faculties and the trainings of physicians and showed lack of information and need for development of attitudes regarding children's rights and informed consent in children.[¤]. (shrink)

BackgroundPublished data and practice recommendations on end-of-life care generally reflect Western practice frameworks; there are limited data on withdrawal of treatment for children in China.MethodsWithdrawal of treatment for children in the pediatric intensive care unit of a regional children’s hospital in eastern China from 2006 to 2017 was studied retrospectively. Withdrawal of treatment was categorized as medical withdrawal or premature withdrawal. The guardian’s self-reported reasons for abandoning the child’s treatment were recorded from 2011.ResultsThe incidence of withdrawal of treatment for (...) children in the PICU decreased significantly; for premature withdrawal the 3-year average of 15.1% in 2006–2008 decreased to 1.9% in 2015–2017. The overall incidence of withdrawal of care reduced over the time period, and withdrawal of therapy by guardians was the main contributor to the overall reduction. The median age of children for whom treatment was withdrawn increased from 14.5 months in 2006 to 40.5 months in 2017. Among the reasons given by guardians of children whose treatment was withdrawn in 2011–2017, “illness is too severe” ranked first, accounting for 66.3%, followed by “condition has been improved”. Only a few guardians ascribed treatment withdrawal to economic reasons.ConclusionsThe frequency of withdrawal of medical therapy has changed over time in this children’s hospital PICU, and parental decision-making has been a large part of the change. (shrink)

Empirical data from a large sample of Canadian youth aged 13 to 17 years suggest that, although the current privacy policy framework is having a positive effect on the extent to which young people are complying with the types of behavior promoted by adults as privacy protective, its primary focus on parental supervision is inadequate to fully protect children's online privacy. Respondents with high levels of either social interaction or identity play are more likely than those with lower levels to (...) divulge personal identifiers and display privacy-risky behavior, independent of their level of parental supervision. High levels of parental supervision, therefore, do not eliminate but merely reduce privacy-risky behaviors associated with social uses of the Internet. As such, parental supervision cannot adequately protect children who have integrated the Net most fully into their social lives, especially given the high premium that children place on the use of the Net to talk to friends and explore social roles. (shrink)

As people grow old, many risk becoming chronically lonely which is associated with e.g. depression, dementia, and increased mortality. Whoever else should help to protect them from this risk, various philosophers have argued that any children that they might have will often be among them. Proceeding on this assumption, this article considers what filial duties to protect ageing parents from loneliness consist of, or might consist of. I develop my answer by showing that a view that may be intuitively plausible, (...) namely that they simply require children to visit their ageing parents regularly when they can do so at reasonable cost and call, text, and/or email them from time to time, is defective in three respects. First, it ignores children’s potential responsibilities to encourage and/or facilitate social interaction between their parents and third parties. Second, it ignores their potential responsibilities to help provide their parents with non-human companionship. Third, it elides over their duties to coordinate their efforts to offer loneliness protection with others. What I end up proposing instead, then, is an approach for protecting ageing parents from loneliness that is multi-faceted. (shrink)