BACKGROUND Adolescents face a variety of potential harms in the online environment, including exposure to distressing illegal material, cyberbullying, image-based abuse, and “sextortion.” Various agencies provide on-demand helpline and information services for children and adolescents to support them with navigating online (and offline) harms. OBJECTIVE This study examined whether a chat-based conversational agent (chatbot) might be a useful additional tool for meeting the needs of adolescents at risk from online harms. We developed a prototype chatbot—including both conversational and menu-driven user options—and evaluated users’ trust in the chatbot. In this context, trust relates to perceptions of the chatbot’s usability and the value of the information and support it provides. METHODS Participants (n=224; mean age 16.8 years) interacted with the chatbots and evaluated them in terms of user trust: perceived usability and utility (ie, relevance of support resources provided). RESULTS Most participants (conversational chatbot: 141/224, 63% and menu-driven chatbot: 142/224, 63%) showed a willingness to click on the chatbots’ recommended support links. Participants with higher trust in the chatbots were more likely to click the links for recommended support services (with extreme evidence for large effects: δ=0.73, 95% credible interval [CrI] 0.46-1.00 and δ=0.78, 95% CrI 0.50-1.07, for the conversational and menu-driven chatbots, respectively; Bayes factor [BF10]>50,000), and participants who clicked the links, compared with those who did not, reported higher rates of positive attitudes toward their decision (with extreme evidence for large effects: δ=0.87, 95% CrI 0.58-1.15 and δ=0.84, 95% CrI 0.54-1.12, for the conversational and menu-driven chatbots, respectively; BF10>3,000,000). The conversational and menu-driven chatbots differed little in perceived trust or effectiveness. CONCLUSIONS Chatbots represent a promising additional tool to help adolescents access mental health–related support services and navigate online harms. However, establishing trust is critical.
Meriel Charles, James D. Sauer, Erin Roehrer et al.
Objectives: To investigate if Aboriginal people are equally included in new forms of vaccine safety post-marketing surveillance that support safety signal detection and confidence in the vaccine program by comparing the use of Vaxtracker active adverse events following immunisation (AEFI) surveillance between Aboriginal and non-Aboriginal parents of vaccinated children. Methods: In 2016, automated AEFI surveillance was conducted to monitor seasonal influenza vaccine in children aged 18 months to less than 5 years and for DTPa vaccine after the inclusion of a new dose at 18 months of age. To explore reasons for non-response, Aboriginal Immunisation Officers contacted the parents/carers of 24 (48.0%) Aboriginal children and 31 (26.7%) non-Aboriginal children who did not respond to the online survey. Results: There were differential response rates for both vaccines between Aboriginal and non-Aboriginal enrolees; 56.4% vs 76.8% (p=0.005) and 55.1% vs 78.2% (p Conclusion: New systems of vaccine safety surveillance may not adequately include Aboriginal people. Implications: Vaccine safety surveillance systems need to be designed to ensure high levels of participation and response from Aboriginal people.
Hunter New England Population Health, Patrick M. Cashman, Sally-Anne Munnoch et al.
PURPOSE: Adults and children with intellectual disability (ID) are vulnerable to preventable morbidity and mortality due to poor quality healthcare. While poor quality care has been commonly identified among children with ID, evidence of the patient safety outcomes for this group is lacking and therefore explored in this review. DATA SOURCES: Systematic searches of six electronic bibliographic research databases were undertaken from January 2000 to October 2017, in addition to hand searching. STUDY SELECTION: Keywords, subject headings and MeSH terms relating to the experience of iatrogenic harm during hospitalisation for children with ID were used. Potentially relevant articles were screened against the eligibility criteria. Non-English language papers were excluded. DATA EXTRACTION: Data regarding: author(s), publication year, country, sample, health service setting, study design, primary focus and main findings related to measures of quality and safety performance were extracted. RESULTS OF DATA SYNTHESIS: Sixteen studies met the inclusion criteria, with three themes emerging: the impact of the assumptions of healthcare workers (HCWs) about the child with ID on care quality and associated safety outcomes; reliance on parental presence during hospitalisation as a protective factor; and the need for HCWs to possess comprehensive understanding of the IDs experienced by children in their care, to scientifically deduce how hospitalisation may compromise their safety, care quality and treatment outcomes. CONCLUSION: When HCWs understand and are responsive to children's individual needs and their ID, they are better placed to adjust care delivery processes to improve care quality and safety during hospitalisation for children with ID.
Female genital mutilation (FGM) has historically been seen as a health concern limited to women living in other parts of the world. However, with the rising number of migrants, refugees and asylum seekers, countries like New Zealand, Australia and Europe have seen a surge in the number of women and girls affected by FGM seeking medical care. This topic is increasingly becoming relevant to primary health-care providers in this country and therefore a good understanding of this practice is important.
Abstract There is a growing body of literature about kinship care in the Western world; however, much of it focuses on grandparent care. A lesser known aspect of kinship care is the care of children by nonrelatives known to the child or their family. What little research exists about this group suggests that such placements are less stable than familial kinship care. This article reports a research study in Victoria, Australia, that explored nonfamilial kinship care through analysis of administrative data, interviews with young people and carers, and focus groups with kinship care support workers. It emerged that current administrative databases are not yet able to reliably identify the carer relationship, and thus the extent of such care arrangements cannot accurately be determined. Interviews and focus groups revealed that nonfamilial kinship care is diverse and qualitatively different from familial kinship care, bearing some similarities to foster care yet managed very differently. It is suggested that policymakers need to pay more attention to conceptualizing nonfamilial kinship care within kinship care policy frameworks and that greater attention is needed to the individual support needs of children in such placements and their carers.
Science, technology, engineering and mathematics (STEM) is an emerging field of research within early childhood education and care across the world. It aligns with approaches to support early learning and skill development, given the recognition of the importance of the first five years of life. In this study we explored the framework documents in Australian early childhood education to understand more about STEM in early childhood education and care. Our study is interested in the frequency of STEM, as well as the meanings associated with STEM with regards to child learning. We engage with a content analysis, looking at latent as well as manifest coding. Key themes emerge associated with the absence of some STEM areas, compared to others, as well as the positioning of STEM learning areas. More specifically, digital technologies dominate the other three disciplines of STEM. It is anticipated that by providing policy understanding, conversations can commence to support the implementation of STEM in early childhood education and care.
A commitment to long-standing child-centred ideologies and recent emphases on academic outcomes have both perpetuated narrow interpretations of play-based pedagogy in early childhood education. Instead, teachers might proactively and spontaneously deepen children’s thinking and understandings related to children’s own interests and motivations during thoughtful pedagogical interactions that arise from play. This paper draws on findings from a qualitative case study in Aotearoa, New Zealand where teachers used their professional expertise to engage with children’s thinking and understandings. We analyse the professional knowledge, strategies and skills teachers brought to these relational and play-based interactions. We offer new conceptualising of teaching in highlighting the need to position a sophisticated blending of play, learning and teaching within participatory and relational pedagogies as a core practice of early childhood education. Further, we argue that two constructs – everyday and scientific concepts, and the zone of proximal development – position theoretically ways in which teachers’ knowledge, expertise and engagement might contribute to these ‘in the moment’ rich, thoughtful understandings of what we term relational play-based pedagogy.
This paper explores teacher enjoyment and the notion of the intentional teacher in early childhood education. The research is part of a wider interrogation challenging existing discourses associated with the intentional teacher. A mixed-method research design was used to gather perspectives from early childhood teachers in relation to their experiences of enjoyment in their teaching practices and the connection with being an intentional teacher. Findings from participant responses highlight important aspects associated with early childhood teacher enjoyment and intentionality. The connection between enjoyment and intentional teaching was reflected in reports of ways of doing or acting, as well as in ways of being associated with teacher identity. Connection was made between experiences of enjoyment and intentional teaching through contributing, adding value, and personal impact. Association was also made with promoting social justice. Whilst small in scale, the research highlights the importance of challenging existing and potentially limiting discourses of the intentional teacher by giving attention to how intentional teaching is generated, as an internal encounter associated with ways of being and becoming and the role that enjoyment plays within this process.
BACKGROUND: Early childhood development is influential for life course capability. Children exposed to child maltreatment and at high risk of harm may be removed for their safety, but the effect on child development is uncertain. OBJECTIVES: To assess developmental vulnerability at school commencement across five developmental domains to ascertain whether removal of children with substantiated maltreatment to foster/kinship care is likely protective, or not, of developmental vulnerabilities. METHODS: The study drew on linked-data for a South Australian population birth cohort (2003 to 2014) N = 74,751. For children exposed to substantiated child maltreatment meeting study criteria (N = 2011, mean age = 5.7 years, 50.7 % boys), the effect of placement in foster/kinship care (N = 666) on developmental vulnerability was explored using generalized linear models, adjusted for child and family covariates, maltreatment severity and propensity score. RESULTS: Children placed in care had a reduced risk of developmental vulnerability on the Physical Health and Wellbeing (aRR = 0.73 [0.64, 0.84]), Language and Cognitive Skills (school based) (aRR = 0.79 [0.68, 0.92]), and Communication Skills and General Knowledge (aRR = 0.81 [0.70, 0.94]) domains, compared to children who were not removed. However, these children had increased risk of vulnerability on Social Competence (aRR = 1.14 [1.01, 1.29]) and Emotional Maturity (aRR = 1.20 [1.05, 1.37]) domains. CONCLUSIONS: These findings suggest placement in out-of-home care supported physical health and wellbeing, communication and cognitive but not social and emotional early childhood development. These results highlighting the need for professional therapeutic support for children in care and better attending to the physical development, communication and cognitive skills in maltreated children remaining at home.
Krystal Lanais, Emmanuel Sumithran Gnanamanickam, Miriam Maclean et al.
AIMS: To evaluate gaps in measles immunisation coverage for children <5 years in Aotearoa New Zealand. METHODS: In this cross-sectional study, we extracted coverage rates for the first measles, mumps and rubella (MMR1) vaccine and second MMR vaccine (MMR2) from the National Immunisation Register for birth cohorts 2017 to 2020. We described measles coverage rates per birth cohort, and stratified per district health board (DHB), ethnicity and deprivation quintile. RESULTS: Coverage for MMR1 declined from 95.1% for those born in 2017 to 88.9% for those born in 2020. The coverage for MMR2 was below 90% for all the birth cohorts, with the lowest MMR2 coverage in the birth cohort of 2018 (61.6%). MMR1 coverage was lowest for children of Māori ethnicity and coverage declined over time: 92.8% for those born in 2017 to 78.4% for those born in 2020. Six DHBs had average MMR1 coverage <90% including Bay of Plenty, Lakes, Northland, Tairāwhiti, West Coast and Whanganui. CONCLUSIONS: Immunisation coverage rates for measles are insufficient to prevent a potential measles outbreak in children <5 years. Concerningly, the coverage for MMR1 is declining, especially in Māori children. Catch-up immunisation programmes are urgently needed to improve immunisation coverage.
Tony Walls, Nienke N. Hagedoorn, Andrew T. Anglemyer
