Violence against children in Indonesia remains a crucial issue that requires a data-driven approach for more targeted interventions. This study aims to cluster provinces in Indonesia based on the number of cases of violence and the types of violence committed, namely physical, psychological, and sexual violence. The method used in this study is the K-Means Clustering algorithm, an unsupervised learning technique in data mining that is able to find hidden patterns in large data sets. Data was obtained from the Ministry of Women's Empowerment and Child Protection's Gender and Child Information System (SIGA), which covers 38 provinces. The clustering results produced three main groups: a cluster with high levels of violence consisting of the provinces of North Sumatra, DKI Jakarta, West Java, Central Java, and East Java; a cluster with moderate levels of violence consisting of 16 provinces; and a cluster with low levels of violence covering 17 provinces. These findings are expected to form the basis for the development of evidence-based child protection policies geographically and thematically.
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.
The case of sexual violence against children from the perspective of international law highlights the importance of protecting children from all forms of sexual exploitation and sexual abuse. The purpose of this paper is to understand the forms of international law rules regarding cases of sexual violence against children and how international law prosecutes the perpetrators. The discussion of cases of sexual violence against children shows that these cases have serious and widespread impacts, with nearly 1.7 billion children worldwide experiencing violence. To address this issue, it is necessary to strengthen the legal framework that considers all behaviors related to Child Sexual Abuse and Male Sexual Abuse (CSAM) as criminal acts. Increasing resources in law enforcement, cooperation with the private sector, education, and relevant research are also important to increase our awareness of sexual violence. The conclusion that can be drawn is that children are indeed a new generation that will continue the continuity of nations and states, so it is only fair for us and law enforcement to ensure that all human rights of children are fulfilled.
High-quality mother-child interactions during the first 2,000 days, from conception to age 5 years, are considered crucial for preventing obesity development during early life stages. However, mother-child dyads interact within and are influenced by broader socio-ecological contexts involved in shaping child development outcomes, including nutrition. Hence, the coexistence of both undernutrition and obesity has been noted in inequitable social conditions, with drivers of undernutrition and overnutrition in children sharing common elements, such as poverty and food insecurity. To date, a holistic life-course approach to childhood obesity prevention that includes an equitable developmental perspective has not emerged. The World Health Organization (WHO) Nurturing Care Framework provides the foundation for reframing the narrative to understand childhood obesity through the lens of an equitable nurturing care approach to child development from a life-course perspective. In this perspective, we outline our rationale for reframing the childhood narrative by integrating an equitable nurturing care approach to childhood obesity prevention. Four key elements of reframing the narrative include: (a) extending the focus from the current 1,000 to 2,000 days (conception to 5 years); (b) highlighting the importance of nurturing mutually responsive child-caregiver connections to age 5; (c) recognition of racism and related stressors, not solely race/ethnicity, as part of adverse child experiences and social determinants of obesity; and (d) addressing equity by codesigning interventions with socially marginalized families and communities. An equitable, asset-based engagement of families and communities could drive the transformation of policies, systems and social conditions to prevent childhood obesity.
Helen Skouteris, Heidi J. Bergmeier, Scott D. Berns et al.
Social movements, such as the “#MeToo movement,” have the potential to foster awareness and inspire policy and advocacy efforts regarding issues that impact physical, mental, and emotional health. News stories surrounding the #MeToo movement have most noticeably been focused on sexual violence against women in entertainment, media, and politics. Nonetheless, the #MeToo movement has led to an increased recognition of and empathy for victims of sexual violence across society.1 The movement started in 2006 when Tarana Burke, a civil rights activist, coined the phrase “#MeToo” as a means of creating solidarity among victims of sexual violence.1 As accusations accumulate throughout Hollywood; Washington, DC; and the world, Burke’s circle of solidarity has been widened substantially. The movement has gained such significance that those at TIME magazine chose the “Silence Breakers” as the 2017 Persons of the Year.1 In the magazine, Burke and those (particularly celebrities) who have courageously disclosed their traumatic experiences and demonstrated support for and solidarity with other victims were highlighted.1The #MeToo movement has become widespread and potentially transformational; however, there is potential for further progress. As health care providers for children, we hope the movement can be expanded and used to focus attention toward the sexual violence that children, both girls and boys, experience. According to the Centers for Disease Control and Prevention, 42.2% of all women who are sexually assaulted in the United States experienced their first assault before they reached 18 years old.2 Sexual violence against children encompasses a broad spectrum of exploitative as well as nonexploitative sexual acts ranging from online and off-line harassment to forced sexual intercourse3 and permeates our entire nation and global community. In the most recent United Nations International Children’s Emergency Fund report on global violence against children, it is estimated that 120 million girls (10% of girls) have been forced to conduct sexual acts at some point in their lives, with the majority of adolescents admitting to experiencing their first act between 15 and 19 years old and 20% experiencing their first act between 10 and 14 years old.3 More than 70% of children do not disclose their experiences or seek help or services to obtain treatment or prevent additional episodes.3 Furthermore, the United Nations International Children’s Emergency Fund report reveals that in the United States, ∼35% of girls and 20% of boys have experienced sexual violence before their 18th birthday.3 A clear opportunity has arisen, and the pediatric community stands in position as the ideal advocate to increase awareness of sexual violence against children.The pediatrician has many potential roles in increasing awareness of sexual violence against children. From a clinical perspective, practitioners should remain up to date on the evidence-based literature, particularly the various clinical guidelines on the evaluation of children who are exposed to sexual violence.4,5 Per the guidelines from the American Academy of Pediatrics, if a patient and caregiver present with a concern of sexual abuse, the clinician should interview and examine the patient alone without the caregiver present in a trustworthy, nonjudgmental, and objective manner.4 Child victims of sexual violence face many difficult challenges in reporting their experiences, particularly if they have caregivers who do not believe them, which can lead to self-blame.5 Just as the #MeToo movement has led to an emphasis on trusting women and believing their experiences, we must do the same with girls and boys who are traumatized. In most cases, the pediatrician’s primary responsibility will be to determine if there is adequate concern of sexual violence to make necessary referrals to the appropriate government agencies and specialty child maltreatment clinics.4 Such multidisciplinary clinics provide comprehensive, trauma-informed medical and forensic evaluations.5 However, if neither a specialty clinic nor child abuse expert is available, the general clinician’s responsibilities in evaluating and managing these patients will likely be expanded. In such cases, proficiency in the clinical guidelines on sexual violence would be even more important.4Pediatricians and their colleagues may also take on broader nonclinical roles in increasing awareness of sexual violence against children. Clinicians may educate children, parents, teachers, and other adult caregivers about the prevention, recognition, and appropriate response to sexual violence against children. Potentially relevant topics include the dangers of online sexual predators and dating violence in teenagers. Practitioners can also use medical education to teach trainees how to appropriately screen for and recognize sexual violence among patients in their practices.Pediatricians can advocate for and impact policy at all levels of government. They can work with various local governmental agencies to help educate caregivers and children about sexual violence. At the state and federal levels, pediatricians and advocates can inform politicians about the acute and chronic health impacts of sexual violence on our children as well as its economic consequences. A 2014 study by the Centers for Disease Control and Prevention revealed significant economic costs and losses associated with child maltreatment in the hundreds of billions of dollars; factors include increased health care, child welfare, and criminal justice expenditures and productivity losses.6 Advocates may also engage with federal policy makers about the importance of continuing to support and fund legislation already in place that is focused on preventing and responding to sexual violence, including the Violence Against Women Reauthorization Act of 2013 and the Family Violence Prevention and Services Act.7Moreover, policy makers should be encouraged to continue to create new legislation in response to newly exposed threats that make our children vulnerable. The episode regarding Larry Nassar, a physician at Michigan State University and team doctor for United States of America Gymnastics who was accused and convicted of sexually abusing 150 young athletes, serves as an example. Less than 1 week after Nassar’s sentencing, the US House of Representatives passed new legislation (US Federal Bill S.534) that was used to install additional protections and remedies for young amateur athletes who are victims of abuse.8 This episode also reveals the unsettling realization that perpetrators of sexual violence against children exist within our health care profession, and we have a responsibility to recognize and report concerning behaviors when they occur within our professional community.Given the global nature of sexual violence against children, there is a need to advocate for the health of children worldwide. The US government plays a critical role in global child-health initiatives and programs. Therefore, pediatricians may advocate at the federal level for the maintenance of global-health funding even in the wake of political uncertainty. Such efforts at the federal level require collaboration with other advocates, professional societies, and nonprofit organizations. From a policy and research standpoint, specific goals that can be emphasized in combatting sexual violence against children globally include enhancing the surveillance of both online and off-line sexual violence and educating adult caregivers and communities to change specific cultural norms, which have been drivers for violence against children globally.3It is critical that through their various clinical, research, educational, and advocacy roles, pediatricians continue to increase awareness of sexual violence against children just as the #MeToo movement has done for women. The #MeToo movement has been particularly effective because it has led to an emphasis on women’s autonomy, giving women the power to choose when and how they disclose their experiences of sexual violence and creating solidarity. Because of legal restrictions and mandated reporting laws, children don’t have that same autonomy and consequential solidarity. In the absence of this autonomy and agency, pediatricians are in the ideal position to represent and protect these children.
Nickolas Theophilos Agathis, Carolyn Payne, Jean L. Raphael
This service evaluation examined a modified, 10-week Nurturing Attachments group provided by an NHS service for children in care. Areas of evaluation included child outcomes, child–carer relationships, foster carers’ self-efficacy and carers’ experiences of the course. The groups ran 12 times, from September 2017 to July 2023. Eighty-two foster carers provided data at week one, 54 at week 10 and 29 at a two-month follow-up, highlighting a high rate of attrition. Carers completed the Strengths and Difficulties Questionnaire, the Child-Parent Relationship Scale and the Brief Parental Self-Efficacy Scale at the three time points and provided qualitative comments. Quantitative data were analysed using repeated-measures analysis of variance tests (ANOVAs) and t-tests; qualitative comments were collated and summarised. From week one to week 10, significant improvements were found for carer self-efficacy (p = .04, Cohen’s d = .40), carer–child closeness (p = .04, Cohen’s d = .30) and child peer problems (p = .03, Cohen’s d = .30). Children’s dependency significantly decreased from week 10 to follow-up (p = .02, np 2 = .15). Carers also reported an increased understanding of attachment and trauma, and feelings of support from fellow carers. Findings are further discussed in relation to the limitations, previous literature, clinical implications and future research.
Matthew Hershon, Anita Holtom-Viesel, Claudine Fox
Adolescents and young adults have unique needs which differ from those of children or adults. In the United Kingdom, we have dedicated services, which are diverse in how they are managed and delivered. A multiple-case study was conducted in young people’s cancer services in four geographical regions of England. Data collection included: semi-structured interviews with healthcare professionals ( n = 41) and young people ( n = 29); and observation (total = 120 hours). Thematic analysis was used to synthesize and interpret five emerging themes describing the way a culture of adolescent and young adult-specific care developed. To develop a cultural attitude which embraced and promoted core values, leadership was needed, as well as high patient volume accessing a service. Time was essential, an adolescent and young adult-centered culture of care does not happen overnight, it needs time and dedicated staff to evolve, but once in place, services have a significant impact on the experience of care.
Drawing on Matteo Cattaneo's notion of w/o/andering and Alison Clark's work on slow knowledge, the authors explore how wandering and wondering can serve as a pedagogical practice to nurture children's existential resilience within early childhood education and care. The inquiry is based on a filmed and observed walk in the local surrounding environment undertaken by a group of 13 children (aged three to four) and three adults in an early childhood education and care setting. Through an engagement with speculative vignettes, thinking with theory becomes a method for exploring how the courage to deviate from pre-planned routes, both physical and mental, holds possibilities for pockets of wonder. Such pockets emerge when educators and children allow themselves to dwell in moments that do not necessarily aim at producing concrete answers or predetermined knowledge outcomes. Instead, these moments cultivate an attentiveness to the extraordinary within the seemingly ordinary, nurturing children's attunement to the human and more-than-human world in ways that deepen their sense of connection, curiosity, and existential resilience.
OBJECTIVE: This study sought to evaluate the effectiveness of Family Nurture Intervention (FNI) in the NICU on enhancing early brain activity of preterm infants. This unit-wide implementation of FNI is referred to as Family Nurture Care (FNC). METHODS: This was a single-center prospective phased effectiveness study conducted in two sequential phases in the NICU (NCT03267043). In Phase I, all mother-infant dyads received the baseline standard care (SC), and in Phase II, all mother-infant dyads received SC supplemented with FNC starting at NICU admission. Preterm infants (25-34 weeks gestational age) and their mothers were eligible for participation. Preterm infants (25-34 weeks gestational age) were sequentially assigned to receive standard care (SC, Phase I) or FNC (Phase II) during their NICU stay. The primary outcome was EEG power assessed at two ages, ∼35 weeks (SC, n = 34; FNC, n = 28) and near to term (SC, n = 28; FNC, n = 27). FNC consisted of repeated calming sessions (∼3 times/week) facilitated by nurture specialists during which mothers engaged in emotional expression during clothed or skin-to-skin holding, vocal soothing, and eye contact. EEGs were collected from 128 leads. EEG power was computed using fast Fourier transforms. RESULTS: Infants receiving FNC were found to have significantly higher brain activity (EEG power) at 35 weeks in the left frontal polar region. The effects at lower frequencies 4-15 Hz ranged from 26% to 44% with effect sizes exceeding 0.60. CONCLUSIONS: FNI is practicable as standard of care in the NICU and leads to enhanced brain activity early in life. SIGNIFICANCE: FNC is designed to facilitate the emotional connection and coregulation between mothers and infants in the NICU, resulting in profound effects on early brain development.
Christiana Farkouh‐Karoleski, Michael M. Myers, Philip G. Grieve et al.
The article reveals the most pressing issues regarding the protection of children from domestic violence. The problem of protecting such children has certain difficulties. This is due to the fact that the vast majority of affected children are children from disadvantaged families, as a rule, few people want to protect this category of people. It is suggested to pay special attention to the peculiarities of the method of interviewing a child who has experienced domestic violence, to the procedure of interviewing such children. A list of grounds that are undesirable to use when communicating with children is identified, and recommendations for interviewing children affected by violence are provided. The main types of violence against children, subjects who commit violence against children, dangerous consequences for the society where domestic violence against children is actively manifested are described. It is stated that in accordance with international standards and world practice, the interview of a child who is a victim of violent crimes, domestic violence or witnessed violence should be conducted in a child-friendly atmosphere, where they feel protected and comfortable. The "green room" was described as a specially equipped room for interviewing such children. The legal status of the child is determined, the circumstances, causes and types of domestic violence against children are established. Suggestions for improving the use of tactics in the survey of this category of minors in order to effectively protect the rights and interests of the latter. The problems considered in the work relate to both theory and practice. There are two consequences for children who have experienced domestic violence, which are manifested simultaneously: harm to the victim and harm to society.
