From entertainment to extortion: Tunisian children's online experiences.

BACKGROUND: Information and communication technologies (ICTs) have become a fundamental part of children's lives and development. However, children need to acquire the skills and knowledge to manage the risks that technology presents. OBJECTIVES: This child-centric research on children's online experiences aims to understand the benefits Tunisian children derive from the internet, the risks and harms to which they are exposed, and how aware and resilient Tunisian children are to these online risks and harms. PARTICIPANTS AND SETTING: 113 children, aged 13-17, participated in focus groups in five governorates across Tunisia. METHODS: Qualitative data was collected from 16 focus group discussions then data was analyzed using inductive and deductive thematic coding. RESULTS: The internet offers Tunisian children educational, social, entertainment, and mental health benefits, in addition to personal development and commercial opportunities. Hacking and the use of fake Facebook profiles were highlighted as facilitators of online bullying, sexual harassment, and extortion, all of which disproportionately affected girls. Children demonstrated personal responsibility for their online activity but recognized that children and parents should have greater awareness about the risks the internet poses. CONCLUSIONS: The young people included in the study reported that they enjoy numerous benefits from internet access and demonstrate some resilience to online risks and harms. However, there is a need for societal and institutional change, through a combination of awareness raising, targeted support for children and parents, and improving the capacity of key actors to prevent online violence while ensuring an effective response and victim support.

Experiences of parents and stakeholders in caring for, and supporting children with special needs in Ghana.

We studied the caring, parenting, and support services for children with special needs in Ghana. Many of the study participants reported re-adjusting their lives in virtually every domain-social, economic, and emotional to deal with and manage the new realities. How parents navigate this space varied considerably from setting to setting. Regardless of individual and interpersonal resources, community, institutional, and policy circumstances seemed to exacerbate notions of disability. In many instances, parents had a low depth of suspicion about the precursors to disabling events in their children. Parents are constantly pursuing health care, including a cure for their children with disabilities. Views about "otherness" were noted, and these tended to undermine medical interpretations/explanations of disability generally, which in turn affected formal education and health-seeking for children. Institutional arrangements exist to encourage parents to invest in their children regardless of their perceived abilities. However, these do not seem to be sufficient, particularly for health and formal education. Programming and policy implications are highlighted.

A Vignettes-Based Exploration of Attitudes of Parents Toward Reporting of Child Sexual Abuse in Ghana.

Reporting child sexual abuse (CSA) to law enforcement institutions is the ideal child protection imperative. The role of parents in this process is unquestionably profound. Yet, there is limited evidence on parental perspectives on reporting CSA to law enforcement agencies in developing country contexts. We apply vignettes to describe the views of parents about reporting CSA perpetrated by "family members, schoolteachers, and strangers." Data was collected from 89 parents from four culturally diverse regions of Ghana. A systematic inductive approach was used to determine patterns and similarities in participants' attitudes toward reporting. We note that the attitudes of participants about reporting CSA varied considerably; these are influenced by the nature of social relationships between the victim and perpetrator. In a seeming order of severity, CSA perpetrated by a family member was viewed less seriously compared to victimization by a teacher or a stranger. The desire to preserve familial/kin ties and reputation and keeping to the cultural heritage of resolving "disputes and disagreements" amicably were primary norms against reporting CSA. However, attitudes toward reporting CSA by teachers were influenced by expectation of higher moral standards, which made reporting CSA by a teacher a reasonable cause of action. Positive attitudes toward reporting CSA by "strangers" were prevalent. Child protection programs must recognzse the segmented attitudes toward CSA and tackle the deep-seated cultural and social norms through social and behavioral change communication (SBCC).

Reassessment of dextran sulfate in anti-Xa assay for unfractionated heparin laboratory monitoring.

Background: Anti-Xa assays are used for unfractionated heparin (UFH) monitoring. Dextran sulfate (DS) is used in some assays to overcome the artifactual preanalytical release of platelet factor 4. However, the practical implications of this test modification have not been studied extensively. Objectives: To investigate the impact of the presence of DS in the anti-Xa assay for UFH laboratory monitoring. Methods: We studied factor Xa inhibition, using an assay without DS (Stago Liquid Anti-Xa), in normal pool plasma spiked with various concentrations of UFH (up to 1 IU/mL) in the presence of increasing concentrations of DS (up to 2560 µg/mL). We also investigated the effect of DS on FXa inhibition measured after the addition of UFH and heparin antagonists (protamine and Polybrene; Sigma Aldrich). Eventually, we compared the anti-Xa levels measured using the assay without DS to those measured with an assay containing DS (BIOPHEN Heparin LRT, Hyphen BioMed). Results: DS per se had a detectable anti-Xa effect. FXa inhibition in UFH-spiked plasma linearly increased with increasing concentrations of added DS, with a plateau at approximately 160 µg/mL DS, at which the apparent anti-Xa level had almost doubled. In the presence of heparin antagonists, the addition of DS increased anti-Xa levels, corresponding to the dissociation of the UFH-antagonists complexes in vitro. With the anti-Xa assay containing DS, UFH inhibition was not detected. Conclusion: In the presence of high concentrations of DS, FXa inhibition was much higher than that predicted from added UFH amounts, presumably related to the greater availability of UFH for interaction with antithrombin. While the relevance of measuring this "masked" heparin has not been demonstrated, the presence of DS renders the result inaccurate in the presence of protamine or Polybrene.