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Abstract
UNICEF’s Convention on the Rights of the Child, approved on November 20, 1989.
... This program will contribute to gathering empirical evidence to identify the health literacy profile of children and determine age appropriate health literacy expectations of children. The design and implementation of HealthLit4Kids recognises the UN Convention on the Rights of the child and responds to the child's right to participate in research about their lives [18]. ...
... The Rights outlined in the UNCRC draw attention to children's rights not only in relation to basic human needs but also in terms of research about their lives. HealthLit4Kids responds to a number of articles of the UN Convention on the Rights of the Child (UNCRC), specifically 12, 13, 17 and 24 [18]. Through purposive alignment to the UNCRC Rights HealthLit4Kids can be confident its program will assist children to; ...
... 24. Have the right to the best health care possible, safe water to drink, nutritious food, a clean and safe environment, and information to help all children to stay well [18]. ...
Background:
Health attitudes and behaviours formed during childhood greatly influence adult health patterns. This paper describes the research and development protocol for a school-based health literacy program. The program, entitled HealthLit4Kids, provides teachers with the resources and supports them to explore the concept of health literacy within their school community, through classroom activities and family and community engagement.
Methods:
HealthLit4Kids is a sequential mixed methods design involving convenience sampling and pre and post intervention measures from multiple sources. Data sources include individual teacher health literacy knowledge, skills and experience; health literacy responsiveness of the school environment (HeLLO Tas); focus groups (parents and teachers); teacher reflections; workshop data and evaluations; and children's health literacy artefacts and descriptions. The HealthLit4Kids protocol draws explicitly on the eight Ophelia principles: outcomes focused, equity driven, co-designed, needs-diagnostic, driven by local wisdom, sustainable, responsive, systematically applied. By influencing on two levels: (1) whole school community; and (2) individual classroom, the HealthLit4Kids program ensures a holistic approach to health literacy, raised awareness of its importance and provides a deeper exploration of health literacy in the school environment. The school-wide health literacy assessment and resultant action plan generates the annual health literacy targets for each participating school.
Discussion:
Health promotion cannot be meaningfully achieved in isolation from health literacy. Whilst health promotion activities are common in the school environment, health literacy is not a familiar concept. HealthLit4Kids recognizes that a one-size fits all approach seldom works to address health literacy. Long-term health outcomes are reliant on embedded, locally owned and co-designed programs which respond to local health and health literacy needs.
... Young people with disabilities have needs very similar to the needs of all other young people, as clearly stated in Article 23 of the United Nations' Convention on the Rights of the Child (UNICEF, 2000). They need a safe and supportive environment, education, health services and access to sport and recreation. ...
Globally, almost 180 million young people between the ages of 10-24 live with a physical, sensory, intellectual or mental health disability significant enough to make a difference in their daily lives. The vast majority of these young people, some 150 million (80%) live in the developing world. Routinely excluded from most educational, economic, social and cultural opportunities, they are among the poorest and most marginalised of all the world's young people. This paper reviews issues that must be considered in assessing the needs of disabled young people and urges the inclusion of this all too frequently overlooked group in all international development policies and programming.
... Compounding the already difficult life circumstances of these young people is the fact that in many places homeless children are treated as societal outcasts, rather than being recognized as in need of care and protection. Indeed, the United Nations Convention on the Rights of the Child [4] recognises children as rights holders who should be supported to enact change in their own lives, no matter where they live or what their situations are. ...
This paper is based on data gathered from a 2006 survey of 1,098 "street children" in Northern Tanzania. It examines the role that school may play in preventing the migration of vulnerable youth to become homeless "street children". Specific focus is placed on the correlations found between children's attendance in school, their reports of abuse or support in their family, and their status of living "on the street" full-time or part-time.
This study is from quantitative interview data gathered from 1,098 children and youth between 5 and 24 years old on the streets of Moshi and Arusha, Tanzania, over a 48-hour period during the school year on October 26th and 27th, 2006. Respondents were given survey questions about their home, school and street life experiences, in order to measure the impact of outreach work being performed by a Tanzanian NGO. Interviewers used purposive sampling, approaching all young people who appeared to be under the age of 25 years within a number of precincts in each town known to be where 'street children' were known to congregate.
Results suggest that regular attendance in school may be a significant protective factor for children in preventing migration to the street life. Statistical analysis revealed that those young people who dropped out of school had nearly 8 times higher chances for ending up on the streets permanently than those who attended school daily.
This study supports the new concept of "multi-layered social resilience", providing evidence from research completed by one NGO on how community-based organizations can help enhance resilience in a broader social context, spanning individuals, households and community structures.
... Young people with disabilities have needs very similar to the needs of all other young people, as clearly stated in Article 23 of the United Nations' Convention on the Rights of the Child (UNICEF, 2000). They need a safe and supportive environment, education, health services and access to sport and recreation. ...
Globally, almost 180 million young people between the ages of 10-24 live with a physical, sensory,
intellectual or mental health disability significant enough to make a difference in their daily lives. The vast
majority of these young people, some 150 million (80%) live in the Developing world. Routinely excluded
from most educational, economic, social and cultural opportunities, they are among the poorest and most
marginalized of all the world's young people. Recent World Bank estimates suggest that individuals with
disability may account for as many as one in five of the world's poorest. Because of this, disability is now
increasingly recognized as a key development issue and its importance in relation to poverty, human rights
and the achievement of internationally agreed upon development goals is receiving mounting recognition.
This paper reviews issues that must be considered in assessing the needs of disabled young people and
urges the inclusion of this all too frequently overlooked group in all international development policies and
programming.
This paper contains cultural anthropological research on various discipline measures used within the classrooms in India, United Kingdom, China, Africa, and the United States. My recent visit to schools in India on study abroad programs prompted my desire to research across the globe different methods of classroom management discipline conducted within the schools. Findings suggest that corporal punishment is being favored among most countries. Hitting or yelling at a child, a common practice in some schools is not ethically acceptable by me, as an educator, nor by my students who witnessed several incidences whilst in India. We were caught in the ethics verses culturally acceptable norm dilemma. The purpose of this paper is not to devise specific discipline measures at this juncture, but rather to investigate the acceptable practices within the classrooms in the above stated countries. Implications for this only further my ethical obligations and challenges that lie ahead.
Data sourcesASSIA, EBSCO - CINAHL, Cochrane CENTRAL, EMBASE, ERIC, MEDLINE, SCOPUS, OpenGrey, Proquest - Social Services/ Sociological Abstracts, Web of Knowledge - Conference Proceedings Citation Index and ISI Science Citation/ Social Science Citation Index. There were no language restrictions and authors were contacted for primary data and additional information when required.Study selectionStudies were considered eligible if they were primary studies of children (0 to 18 years) with confirmed oral neglect and with detail of dental, intra- and extra-oral features. Exclusion criteria included; studies of sexual or physical abuse or those where there was oral neglect suspected but no detail was given. All characteristics associated with dental neglect were considered outcomes.Data extraction and synthesisEach article was independently reviewed by two reviewers from a panel of 22 trained reviewers with a third reviewer resolving any disagreement. A specifically designed tool for quality assessment was used.ResultsThree thousand eight hundred and sixty-three citations and abstracts were scanned, 83 studies were reviewed and nine (with 1595 children aged 0 to 15 years) met the inclusion criteria, including two case control studies. There were not enough data to allow meta-analysis to be carried out.The features most commonly recorded as being characteristics of dental neglect were; failure to seek, or delay in seeking dental treatment, failure to follow advice or complete treatment, and this often co-existed with an adverse impact of dental neglect on the child including pain and swelling. A 'threshold' level of dental caries, that allowed dental neglect to be defined, could not be established from the available literature.Conclusions
There was limited literature on this topic. The main characteristics of dental neglect highlighted were failure/delay in seeking dental care, with adverse consequences. However, due to a lack of research and additionally, a deficiency in the data on precise clinical features, it was not possible to make the distinction between dental caries and dental neglect.
Background:
Adolescents are often noted to have an increased risk of death during pregnancy or childbirth compared with older women, but the existing evidence is inconsistent and in many cases contradictory. We aimed to quantify the risk of maternal death in adolescents by estimating maternal mortality ratios for women aged 15-19 years by country, region, and worldwide, and to compare these ratios with those for women in other 5-year age groups.
Methods:
We used data from 144 countries and territories (65 with vital registration data and 79 with nationally representative survey data) to calculate the proportion of maternal deaths among deaths of females of reproductive age (PMDF) for each 5-year age group from 15-19 to 45-49 years. We adjusted these estimates to take into account under-reporting of maternal deaths, and deaths during pregnancy from non-maternal causes. We then applied the adjusted PMDFs to the most reliable age-specific estimates of deaths and livebirths to derive age-specific maternal mortality ratios.
Findings:
The aggregated data show a J-shaped curve for the age distribution of maternal mortality, with a slightly increased risk of mortality in adolescents compared with women aged 20-24 years (maternal mortality ratio 260 [uncertainty 100-410] vs 190 [120-260] maternal deaths per 100 000 livebirths for all 144 countries combined), and the highest risk in women older than 30 years. Analysis for individual countries showed substantial heterogeneity; some showed a clear J-shaped curve, whereas in others adolescents had a slightly lower maternal mortality ratio than women in their early 20s. No obvious groupings were apparent in terms of economic development, demographic characteristics, or geographical region for countries with these different age patterns.
Interpretation:
Our findings suggest that the excess mortality risk to adolescent mothers might be less than previously believed, and in most countries the adolescent maternal mortality ratio is low compared with women older than 30 years. However, these findings should not divert focus away from efforts to reduce adolescent pregnancy, which are central to the promotion of women's educational, social, and economic development.
Funding:
WHO, UN Population Fund.
THE LANCET • Published online January 3, 2004 • http://image.thelancet.com/extras/03art4174webappendix.pdf
To compare attitudes towards Kangaroo Mother Care (KMC) among staff in two high-tech neonatal intensive care units, which provided parents with different opportunities to get involved in their infants' care.
Questionnaires were completed by healthcare staff in Unit A, which provided parents with unrestricted access so that they could provide continuous KMC, and Unit B, where parents could only practice KMC intermittently.
Unit A staff were more positive about the benefits and use of KMC, including its use in unstable infants, and rated their knowledge and practical skills more highly than staff in the other unit. Unit B staff also appreciated the method, but expressed more hesitation in using it with unstable infants. In particular, they stressed the need to adapt the physical environment of the NICU to enable parents to stay with their infants and practice the method.
Staff working in the NICU that gave parents unrestricted access were more positive about KMC than staff in the NICU that offered limited opportunities for parents to stay with their children. This finding suggests that it is important to eliminate unjustifiable obstacles to the presence of parents in the NICU, so that they can provide KMC. This article is protected by copyright. All rights reserved.
Many of India's estimated 40 million migrant workers in the construction industry migrate with their children. Though India is undergoing rapid economic growth, numerous child protection issues remain. Migrant workers and their children face serious threats to their health, safety, and well-being. We examined risk and protective factors influencing the basic rights and protections of children and families living and working at a construction site outside Delhi.
Using case study methods and a rights-based model of child protection, the SAFE model, we triangulated data from in-depth interviews with stakeholders on and near the site (including employees, middlemen, and managers); 14 participants, interviews with child protection and corporate policy experts in greater Delhi (8 participants), and focus group discussions (FGD) with workers (4 FGDs, 25 members) and their children (2 FGDs, 9 members).
Analyses illuminated complex and interrelated stressors characterizing the health and well-being of migrant workers and their children in urban settings. These included limited access to healthcare, few educational opportunities, piecemeal wages, and unsafe or unsanitary living and working conditions. Analyses also identified both protective and potentially dangerous survival strategies, such as child labor, undertaken by migrant families in the face of these challenges.
By exploring the risks faced by migrant workers and their children in the urban construction industry in India, we illustrate the alarming implications for their health, safety, livelihoods, and development. Our findings, illuminated through the SAFE model, call attention to the need for enhanced systems of corporate and government accountability as well as the implementation of holistic child-focused and child-friendly policies and programs in order to ensure the rights and protection of this hyper-mobile, and often invisible, population.
intended to give the force of domestic law to the rights set out in the European Convention on Human Rights (ECHR) and to make Convention rights enforceable in Irish courts. The impact which this is likely to have on the Irish legal system will vary depending on the area of Convention rights under scrutiny and in this regard, it is relevant that Ireland's record before the European Court of Human Rights in family law cases is poor. 1 At the same time, a large degree of uncertainty surrounds the impact on child and family law of incorporation of Convention rights into Irish law. Evidence from the UK, where the Human Rights Act 1998 has been in force for over a year, suggests that its effect may not be dramatic - particularly when it is taking place at sub-Constitutional level - but that reference to the jurisprudence of the European Court of Human Rights may nonetheless make a positive contribution to the process of decision making in this area. 2 As the Bill passes through the Dáil, it is timely, therefore, to consider what the Convention and the case law of the European Commission and Court of Human Rights says about children. That is the aim of this article, which will address, in particular, the case law relevant to family law, the protection of children from abuse and issues of youth justice, detention and identity.
Purpose
– This study aims to verify the impact of cooperative learning as an intervention strategy towards the achievement of peace, equality and equity in the science classroom as part of the democratic process necessary for sustainable development.
Design/methodology/approach
– The study sample comprised 56 SSS 2 students in one public co‐educational secondary school in Lagos State. Using a students' gender equity and peace questionnaire, results indicate that cooperative learning is effective in achieving a good measure of equity and peace between sexes in the biology classroom. Furthermore, cooperative learning was observed not to have differential impact on students of different ability levels with respect to their achievement of gender equity in the biology classroom.
Findings
– The study concludes that cooperative learning mode is a gender friendly interaction pattern for all and should be encouraged at the secondary school level in order to empower all students to begin early to imbibe democratic values and behaviors necessary for peaceful coexistence and sustainable development.
Originality/value
– The study provides a unique insight into cooperative learning and gender equity in Lagos, Nigeria.
Western European health systems are not keeping pace with changes in child health needs. Non-communicable diseases are increasingly common causes of childhood illness and death. Countries are responding to changing needs by adapting child health services in different ways and useful insights can be gained through comparison, especially because some have better outcomes, or have made more progress, than others. Although overall child health has improved throughout Europe, wide inequities remain. Health services and social and cultural determinants contribute to differences in health outcomes. Improvement of child health and reduction of suffering are achievable goals. Development of systems more responsive to evolving child health needs is likely to necessitate reconfiguring of health services as part of a whole-systems approach to improvement of health. Chronic care services and first-contact care systems are important aspects. The Swedish and Dutch experiences of development of integrated systems emphasise the importance of supportive policies backed by adequate funding. France, the UK, Italy, and Germany offer further insights into chronic care services in different health systems. First-contact care models and the outcomes they deliver are highly variable. Comparisons between systems are challenging. Important issues emerging include the organisation of first-contact models, professional training, arrangements for provision of out-of-hours services, and task-sharing between doctors and nurses. Flexible first-contact models in which child health professionals work closely together could offer a way to balance the need to provide expertise with ready access. Strategies to improve child health and health services in Europe necessitate a whole-systems approach in three interdependent systems—practice (chronic care models, first-contact care, competency standards for child health professionals), plans (child health indicator sets, reliable systems for capture and analysis of data, scale-up of child health research, anticipation of future child health needs), and policy (translation of high-level goals into actionable policies, open and transparent accountability structures, political commitment to delivery of improvements in child health and equity throughout Europe).
The UK is a multicultural, multilingual society and the majority of paediatric speech and language therapists in England have at least one bilingual child on their caseload. There are many imperatives driving the profession to provide an equitable service for bilingual children. Evidence is beginning to emerge, however, that bilingual children with specific language impairment are not being identified and are, therefore, not accessing services. The situation facing clinicians in the UK is not unique: it is mirrored around the world.
This paper reviews the literature relating to speech and language services for bilingual children and begins by providing an overview of the forces driving the need to provide equity of service. All aspects of the therapeutic process are then examined, from referral to therapy, in order to identify features that are regarded as best practice. Whilst the focus is on delivery of services in the UK, research findings from around the world are considered.
Certain themes emerged during the review and their implications are discussed. In particular, the need for assessment tools, training and research is highlighted.
Features indicative of best practice are highlighted and tentative suggestions made that would enable services to address the challenges of serving bilingual paediatric caseloads.
Since Kant the foundation of human rights has been grounded on certain features of individuals that are construed as conferring human dignity, the protection of which is the main justification for and purpose of human rights. Most often those features are subsumed under the general heading of rationality, and, according to Kant, the possession of which renders humans uniquely capable of moral autonomy and therefore worthy of dignity. In this essay I will argue that a second, competing foundation for rights is also anticipated within Liberalism by Thomas Hobbes and elaborated upon by several twentieth-century schools of political thought, including feminism, post-modernism, and liberal communitarianism. These three appear to be rather strange bedfellows (not to mention as Hobbesian inheritors), but what they share provides a different basis for human rights. It is a foundation laid in two different features of human experience: the capacity of human beings to enter relationships with others; and second, the existential condition of vulnerability that results from this capacity. Though not unrelated to the capacity to reason, the ability to have relationships that cause vulnerability, in response to which persons need and therefore deserve rights, opens the door both to new and new types of human rights. It is my argument in what follows that if the capacity for relationships that delivers rights uniquely to human beings is a dynamic feature of human personality and itself capable of evolution and growth, it is logical to assume that the kinds of relationships for which humans are capable can also grow. Thus, as human relationships evolve, both in terms of interactions with each other and with, for instance, their environment, it is entirely possible that new rights will emerge, for instance environmental human rights, and that some rights might even be the property of whole groups rather than only of individuals.
New Zealand continues to grapple with poor and inequitable child health and wellbeing outcomes. The associated high economic costs, the long-term impact on adult health and New Zealand's international children's rights obligations provide further grounds for action. Although there have been many different reports offering solutions and some key areas of progress, gains have been limited and there has not been sufficient clarity and agreement on wider actions. The environment is complex and solutions cross agency and disciplinary boundaries. This paper reviews the current situation and proposes a set of actions to improve child health and equity. These include a group of recommendations on high-level leadership and coordination, actions to address social conditions, and a range of specific health and wellbeing actions. Progress will require the will, commitment and courage of many to acknowledge the issues and find a way forward. Preventing suffering and ensuring the wellbeing of our youngest citizens during their formative years is an ethical issue for our nation, an issue of what we value as a society, and the best investment for a highly productive, innovative and resilient nation for the future.
Psychiatrists have long had involvement with the political process, both individually and as a profession. They have made valuable contributions to debate over such issues as war, conflict, terrorism, torture, human rights abuse, drug abuse, suicide and other public health issues. However, they have also been complicit in some gross atrocities. Over several years there has been debate over the Australian Government's treatment of asylum seekers, and the Royal Australian and New Zealand College of Psychiatrists took the unusual step of publicly criticizing the Australian Government's policy on grounds of its toxicity leading to a diagnosis of collective depression syndrome, particularly among child detainees, but also adult detainees. The official Ministerial response was to deny that collective depression exists and to assert that the concept is meaningless. Can this intervention by psychiatrists be interpreted as a product of earlier political behaviors by psychiatrists? The willingness of psychiatrists to cooperate with other professions, notably psychologists, pediatricians, physicians and lawyers, is noted, as is presence of minority voices within the Australian psychiatric profession. The significance of the debate over the mental condition of asylum-seeking detainees is that its outcome has implications for how Australia sees itself and is seen by the rest of the world, that is, its national identity.
To review evidence of trauma and exile-related mental health in young refugees from the Middle East.
A review of four empirical studies: i) a qualitative study of 11 children from torture surviving families, ii) a cohort study of 311 3-15-year-old asylum-seeking children, iii) a qualitative study of 14 members of torture surviving families and iv) a follow-up study of 131 11-23-year-old refugees.
The reactions of the children were not necessarily post-traumatic stress disorder specific. Seventy-seven per cent suffered from anxiety, sleep disturbance and/or depressed mood at arrival. Sleep disturbance (prevalence 34%) was primarily predicted by a family history of violence. At follow-up, 25.9% suffered from clinically relevant psychological symptoms. Traumatic experiences before arrival and stressful events in exile predicted internalizing behaviour, witnessing violence and frequent school changes in exile predicted externalizing behaviour. School participation, Danish friends, language proficiency and mother's education predicted less long-term psychological problems.
Psychological problems are frequent in refugee children, but the extents are reduced over time in exile. Traumatic experience before arrival is most important for the short-term reaction of the children while aspects of life in exile are important for the children's ability to recover from early traumatization.
Background. The purpose of this paper is to contribute to a global perspective on corporal punishment by examining differences between mothers' and fathers' use of corporal punishment with daughters and sons in nine countries. Methods. Interviews were conducted with 1398 mothers, 1146 fathers, and 1417 children (age range = 7 to 10 years) in China, Colombia, Italy, Jordan, Kenya, the Philippines, Sweden, Thailand, and the United States. Results. Across the entire sample, 54% of girls and 58% of boys had experienced mild corporal punishment, and 13% of girls and 14% of boys had experienced severe corporal punishment by their parents or someone in their household in the last month. Seventeen percent of parents believed that the use of corporal punishment was necessary to rear the target child. Overall, boys were more frequently punished corporally than were girls, and mothers used corporal punishment more frequently than did fathers. There were significant differences across countries, with reports of corporal punishment use lowest in Sweden and highest in Kenya. Conclusion. This work establishes that the use of corporal punishment is widespread, and efforts to prevent corporal punishment from escalating into physical abuse should be commensurately widespread.
The UK government has recently consulted on proposals to prohibit access to health care for some asylum seekers. This discussion paper considers the wider ethical, moral, and political issues that may arise from this policy. In particular, it explores the relationship between immigration and health and examines the impact of forced migration on health inequalities. It will be argued that it is both unethical and iniquitous to use health policy as a means of enforcing immigration policy. Instead, the founding principle of the NHS of equal access on the basis of need should be borne in mind when considering how to meet the needs of this population.
It is important to have an accurate model for calculating limits to sperm donation so as to avoid inadvertent half-sibling mating and help protect the rights and welfare of the donor- inseminated child. The most highly developed model to date cannot be used as there is inadequate regulation of donor insemination among United States sperm banks.
60 years ago, the Universal Declaration of Human Rights laid the foundations for the right to the highest attainable standard of health. This right is central to the creation of equitable health systems. We identify some of the right-to health features of health systems, such as a comprehensive national health plan, and propose 72 indicators that reflect some of these features. We collect globally processed data on these indicators for 194 countries and national data for Ecuador, Mozambique, Peru, Romania, and Sweden. Globally processed data were not available for 18 indicators for any country, suggesting that organisations that obtain such data give insufficient attention to the right-to-health features of health systems. Where they are available, the indicators show where health systems need to be improved to better realise the right to health. We provide recommendations for governments, international bodies, civil-society organisations, and other institutions and suggest that these indicators and data, although not perfect, provide a basis for the monitoring of health systems and the progressive realisation of the right to health. Right-to-health features are not just good management, justice, or humanitarianism, they are obligations under human-rights law.
Intimate partner violence and child abuse are recognized both as public health concerns and as violations of human rights, but related government actions and inactions are rarely documented as human rights violations in the United States.
Men who abuse female partners are also highly likely to abuse the children of these women. However, family courts are reported to often ignore risks posed by abusive men in awarding child custody and visitation. Battered women involved in child custody litigation in Massachusetts (n = 39) were interviewed. A recurring pattern of potential human rights violations by the state was documented, corresponding to rights guaranteed in multiple internationally accepted human rights covenants and treaties.
The human rights framework is a powerful tool for demonstrating the need for legal, social, and political reform regarding public health concerns.
The aim of this study was to compare profiles of present mental health and previous exposure to violence among refugee children from the Middle East, whose asylum seeking families either did or did not obtain permission to stay in Denmark.
Shortly after arrival in Denmark, the parents of 311 Middle-Eastern children answered a structured interview on their children's exposure to organized violence and their mental health. The families were followed-up as concerns receipt of a residence permit.
At arrival in Denmark, the children's patterns of previous exposure to violence and present mental health was generally similar irrespective of the family getting a residence permit, as was the case for 90 families (60.4%) with 190 children (61.1%). In both groups an overwhelming majority, eight to nine out of 10 children, had been exposed to conditions of war and had stayed in a refugee camp, and seven out of 10 had witnessed violence. Half of the children had a tortured parent. Considerably more children of families who did not get a residence permit had lost a parent (30.6% versus 13.7%; P<0.001). In both groups about two-thirds suffered from anxiety and about 30% from sleep problems, and children whose families did not later on get a residence permit more often appeared sad or miserable (43.8% versus 27.9%; P<0.005).
The asylum-granting decision process seems to have divided the children into two groups with only superficial disparity as concerns their previous exposure to violence and their present mental health. There seems to be good reason to systematically integrate evidence on the children of refugee families in the treatment of applications for permission to stay.
Abstinence from sexual intercourse is an important behavioral strategy for preventing human immunodeficiency virus (HIV), other sexually transmitted infections (STIs), and pregnancy among adolescents. Many adolescents, including most younger adolescents, have not initiated sexual intercourse and many sexually experienced adolescents and young adults are abstinent for varying periods of time. There is broad support for abstinence as a necessary and appropriate part of sexuality education. Controversy arises when abstinence is provided to adolescents as a sole choice and where health information on other choices is restricted or misrepresented. Although abstinence is theoretically fully effective, in actual practice abstinence often fails to protect against pregnancy and STIs. Few Americans remain abstinent until marriage; many do not or cannot marry, and most initiate sexual intercourse and other sexual behaviors as adolescents. Although abstinence is a healthy behavioral option for teens, abstinence as a sole option for adolescents is scientifically and ethically problematic. A recent emphasis on abstinence-only programs and policies appears to be undermining more comprehensive sexuality education and other government-sponsored programs. We believe that abstinence-only education programs, as defined by federal funding requirements, are morally problematic, by withholding information and promoting questionable and inaccurate opinions. Abstinence-only programs threaten fundamental human rights to health, information, and life.
To investigate the seldom published views of children with type 1 diabetes about their condition and ways in which they share in managing their medical and health care with adults.
Semi-structured, tape recorded interviews, during 2003, with a purposive sample of 24 children aged 3-12 years who have type I diabetes and who attend two inner London hospitals and one hospital in a commuter town.
The children reported high levels of understanding, knowledge, and skill gained from their experience of living with diabetes and constantly having to take account of the condition and their paediatrician's guidance. Their key goals were to be "normal" and "just get on with their lives".
The interviews showed that children's experiences of diabetes tended to enable them to make informed, "wise" decisions in their own best interests, even at a young age. They achieved a complicated balance between the sometimes competing goals of social health "being normal" and physiological health in controlling glycaemia. Their competence supports approaches in children's rights and in policy makers' aims that people with diabetes--including children--gain more knowledge, skills, and responsibility for their own care in partnership with healthcare professionals. Consent is usually considered in relation to surgery; however the children showed how they constantly dealt with decisions about consent or refusal, compliance with, or resistance to their prescribed treatment. Their health depends on their informed commitment to medical guidance; more research is needed about the daily realities of children's committed and responsible co-management of their chronic illness.
The importance of micronutrient deficiencies or “hidden hunger” was clearly emphasized by the inclusion of specific goals on iron, vitamin A, and iodine deficiency at the 1990 World Summit for Children and other major international nutrition conferences. Significant progress has since been made toward eliminating vitamin A and iodine deficiencies, with less progress made toward reducing the burden of iron-deficiency anemia. The role of international agencies, such as the World Health Organization, United Nations Children's Fund, Food and Agricultural Organization, and World Bank in assisting countries to make progress toward the World Summit for Children goals has been very important. International agencies have played a critical role in advocating for and raising awareness of these issues at the international, regional, and national levels among policymakers and the general population. Using a rights-based approach, UNICEF and other agencies have been instrumental in elevating to the highest political level the discussion of every child's right to adequate nutrition. International agencies have also been very supportive at the national level in providing technical guidance for programs, including monitoring and evaluation. These agencies have played a critical role in engaging the cooperation of other partners, including bilateral donors, non-governmental organizations, and the private sector for micronutrient programs. Furthermore, international agencies provide financial and material support for micronutrient programs. In the future, such agencies must continue to be heavily involved in programs to achieve the newly confirmed goals for 2010.
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