Parents' perceptions of risk and the influence on children's everyday activities

Parents say they just want their children to be happy but there is evidence and growing concern across disciplines that children in Western countries are experiencing unhappiness (e.g., anxiety, depression) in increasing numbers. In a society that is increasingly risk-averse, parents’ perceptions of risk can have an impact on the everyday activities they offer children. The primary purpose of this qualitative study was to develop a detailed understanding of parents’ perceptions of risk gathered from 47 parents and teachers. Some of the children they discussed were typically developing; others lived with disability. I asked the adults about their perceptions of risk and they frames they used for viewing it: as a barrier to or a catalyst for developing practical skills to achieve health, happiness and well-being and resilience. Participants’ narratives were subjected to constant comparative analysis using an adaptation of Charmaz’s approach to social analysis and Packer’s perspectives on qualitative methods of analysis. The first two chapters of this thesis comprise an introduction and an extended review of literature related to happiness and well-being. These are followed by two journal articles(Chapter 3 and 4 ) that include detailed accounts of (a) parents’ perceptions of everyday risks, the costs and benefits, and (b) their struggles and the strategies they used to offer children age-appropriate risk-taking opportunities. Risk reframing is described in a third journal article (Chapter 5) as a process used to help educators and parents shift their perspective of everyday risk as danger and threat to one of challenge, uncertainty and opportunity by helping them to disrupt their automatic protective responses. I conclude (Chapter 6) by discussing the costs and benefits of offering children opportunities for age-appropriate risk taking to achieve common goals for children: health, happiness and well-being and resilience

The Sydney Playground Project: popping the bubblewrap - unleashing the power of play: a cluster randomized controlled trial of a primary school playground-based intervention aiming to increase children\u27s physical activity and social skills

Background In the Westernised world, numerous children are overweight and have problems with bullying and mental health. One of the underlying causes for all three is postulated to be a decrease in outdoor free play. The aim of the Sydney Playground Project is to demonstrate the effectiveness of two simple interventions aimed to increase children\u27s physical activity and social skills. Methods/Design This study protocol describes the design of a 3-year cluster randomised controlled trial (CRCT), in which schools are the clusters. The study consists of a 13-week intervention and 1 week each of pre-and post-testing. We are recruiting 12 schools (6 control; 6 intervention), with 18 randomly chosen participants aged 5 to 7 years in each school. The two intervention strategies are: (1) Child-based intervention: Unstructured materials with no obvious play value introduced to the playground; and (2) Adult-based intervention: Risk reframing sessions held with parents and teachers with the aim of exploring the benefits of allowing children to engage in activities with uncertain outcomes. The primary outcome of the study, physical activity as measured by accelerometer counts, is assessed at baseline and post-intervention. Additional assessments include social skills and interactions, self-concept, after school time use and anthropometric data. Qualitative data (i.e., transcriptions of audio recordings from the risk reframing sessions and of interviews with selected teacher and parent volunteers) are analysed to understand their perceptions of risk in play. The control schools have recess as usual. In addition to outcome evaluation, regular process evaluation sessions are held to monitor fidelity to the treatment. Discussion These simple interventions, which could be adopted in every primary school, have the potential of initiating a self-sustaining cycle of prevention for childhood obesity, bullying and mental ill health

The German National Registry of Primary Immunodeficiencies (2012-2017)

Introduction: The German PID-NET registry was founded in 2009, serving as the first national registry of patients with primary immunodeficiencies (PID) in Germany. It is part of the European Society for Immunodeficiencies (ESID) registry. The primary purpose of the registry is to gather data on the epidemiology, diagnostic delay, diagnosis, and treatment of PIDs. Methods: Clinical and laboratory data was collected from 2,453 patients from 36 German PID centres in an online registry. Data was analysed with the software Stata® and Excel. Results: The minimum prevalence of PID in Germany is 2.72 per 100,000 inhabitants. Among patients aged 1–25, there was a clear predominance of males. The median age of living patients ranged between 7 and 40 years, depending on the respective PID. Predominantly antibody disorders were the most prevalent group with 57% of all 2,453 PID patients (including 728 CVID patients). A gene defect was identified in 36% of patients. Familial cases were observed in 21% of patients. The age of onset for presenting symptoms ranged from birth to late adulthood (range 0–88 years). Presenting symptoms comprised infections (74%) and immune dysregulation (22%). Ninety-three patients were diagnosed without prior clinical symptoms. Regarding the general and clinical diagnostic delay, no PID had undergone a slight decrease within the last decade. However, both, SCID and hyper IgE- syndrome showed a substantial improvement in shortening the time between onset of symptoms and genetic diagnosis. Regarding treatment, 49% of all patients received immunoglobulin G (IgG) substitution (70%—subcutaneous; 29%—intravenous; 1%—unknown). Three-hundred patients underwent at least one hematopoietic stem cell transplantation (HSCT). Five patients had gene therapy. Conclusion: The German PID-NET registry is a precious tool for physicians, researchers, the pharmaceutical industry, politicians, and ultimately the patients, for whom the outcomes will eventually lead to a more timely diagnosis and better treatment

Reframing healthy risk taking: parents’ dilemmas and strategies to promote children’s well-being

This paper reports findings of a qualitative study regarding dilemmas adults experience in balancing protecting children and offering age-appropriate risk taking opportunities. It outlines strategies adults used to manage their own uncertainties as they supported children to become autonomous. Twenty seven parents of typically developing children and 10 parents of children living with social or physical disabilities engaged in a card sort; they identified and prioritized attributes for their children as a prelude to semi-structured, in-depth interviews about how risk helps children reach these goals. Eight teachers of the typically-developing children also participated in interviews about risk in everyday life and their observations of parents’ views about children’s risk taking. We took a hermeneutic interpretive approach to analyzing interview transcripts to gain an understanding of these adults’ dilemmas and strategies they used to offer children age-appropriate occupations with gradually increasing challenge and responsibility. This study provides unique insights into ways adults manage uncertainties and employ strategies to offer children practice in managing risks in everyday life. These practices supported children in developing qualities and characteristics that contributed both to children’s own well-being and to collective well-being of families, schools and communities

The Sydney Playground Project: A playful approach to promoting health and wellbeing

If you needed to change your lifestyle to increase physical and mental wellbeing, you would probably prefer that the change involved an increase in doing something you enjoy and would like to do more often. To make the lifestyle change even more appealing, wouldn\u27t it be great if all your friends and peers were involved, not just others who had been identified as at risk for problems? In this chapter, we examine the role of play in promoting children\u27s wellbeing, particularly in terms of increased physical activity

Everyday uncertainties: reframing perceptions of risk in outdoor free play

This paper reports the results of risk reframing, an intervention to offer parents and educators a context for building new and complex perceptions of risk in children\u27s outdoor free play. Our objective was to alter these adults\u27 perceptions of risk to increase the sustainability of an innovative child-centred playground intervention. Qualitative data in the form of audio-recordings of risk-reframing sessions, brief participant evaluations and field notes kept by project staff were collected and either transcribed in their entirety or summarised in brief written reports. These data were subjected to constant comparative analysis to identify emergent themes. Results suggest that educators and parents benefit from opportunities to share risk perceptions and discuss the costs and benefits for offering outdoor free play to children to achieve their common goals for children: health, happiness and resilience

Taking a risk with playful places for children: Removing 'surplus safety' from the school ground

In recent decades a critical tension has developed between two essential considerations for children’s health and well-being: physically active play and safety. ‘Risk anxiety’ or ‘surplus safety’ has placed these two goals in conflict. Risk anxiety has contributed to the reduction of exciting, challenging and stimulating outdoor play. Play spaces, including within school grounds, are now more commonly a reflection of what adults perceive as a safe environment than of the innate desires of children to have a stimulating and challenging play space. This paper sets the stage for and then describes a simple, low-cost intervention aimed at increasing active risk-taking play in school grounds. The intervention, known as the Sydney Playground Project (SPP), involved two components: altering adults’ perceptions of risk associated with active play through a risk reframing intervention; and introducing readily available loose materials to the school ground to capture children’s motivations for play. This intervention aimed to change the micro-geographies of the school ground in terms of the physical space and the socio-cultural environment (the climate of risk acceptance). The paper provides evidence from early analyses of the results which indicates that it is possible to change school ground spaces and other spaces children use for play, with minimal cost in ways that encourage active play

Increasing physical activity in young primary school children - it's child's play : A cluster randomised controlled trial

Objective To explore the effects of an innovative school-based intervention for increasing physical activity. Methods 226 children (5–7 years old) randomly selected from 12 Australian primary schools were recruited to a cluster randomised trial with schools randomly allocated to intervention or control conditions. The 13-week intervention comprised: (1) altering the school playground by introducing loose materials and (2) a teacher–parent intervention exploring perceptions of risk associated with children's free play. The primary outcomes were total accelerometer counts and moderate–vigorous physical activity during break times. Testing took place in Sydney, 2009–2010. Results 221 participants were tested at baseline. Mixed-effect multilevel regression revealed a small but significant increase from the intervention on total counts (9400 counts, 95% CI 3.5 − 15.2, p = 0.002) and minutes of MVPA (1.8 min, 95% CI 0.5–3.1, p = 0.006); and a decrease in sedentary activity (2.1 min, 95% CI 0.5–3.8, p = 0.01) during break times. We retested children in one intervention school after 2 years; they maintained the gains. Conclusions Capturing children's intrinsic motivations to play while simultaneously helping adults reconsider views of free play as risky provided increases in physical activity during break times. Using accelerometry as the sole measure of physical activity may underestimate the effect

Self-reported mental well-being of mothers with young children during the first wave of the COVID-19 pandemic in Germany: A mixed-methods study.

Wandschneider L, Batram-Zantvoort S, Alaze A, et al. Self-reported mental well-being of mothers with young children during the first wave of the COVID-19 pandemic in Germany: A mixed-methods study. Women's Health. 2022;18: 17455057221114274.OBJECTIVES: Mothers of young children have been identified as a particularly vulnerable group during the COVID-19 pandemic. We aimed to explore how occupational, psychosocial and partnership-related factors were associated with their self-reported mental well-being during the first COVID-19 wave.; METHODS: Five hundred fifty participants of the BaBi cohort study (est. 2013, Bielefeld, North-Rhine Westphalia, Germany) were invited to complete an online survey and to take part in email interviews (April-May 2020). With survey data, we assessed self-reported mental well-being through validated instruments (eight-item Patient Health Questionnaire; short version of the Symptom Checklist) and ran linear regression models for occupational, psychosocial and partnership-related factors. We performed content analysis on the interviews' data to further understand the determinants of the women's mental well-being.; RESULTS: One hundred twenty-four women participated in the survey; of which 17 also participated in the interviews. A perceived lack of support in childcare was associated with higher levels of depressive symptoms, while having a higher internal locus of control was associated with lower levels. Psychological distress was higher in those reporting lack of emotional or childcare support. Interviews confirmed the interplay of potential stressors and highlighted the difficulties to reconcile different expectations of motherhood.; DISCUSSION: Occupational, psychosocial and partner-related factors can act (to varying degree) both as resources and stressors to the self-reported mental well-being of mothers of young children. These impacts took different forms and created opportunities or challenges, depending on specific life circumstances, such as work or family situations, relationships and own psychosocial resources. Although not representative, our study contributes to building the COVID-19 evidence base, delineating the mental health toll of the pandemic on mothers of young children and the factors that contribute to it