“Coronavirus Changed the Rules on Everything”: Parent Perspectives on How the COVID-19 Pandemic Influenced Family Routines, Relationships and Technology Use in Families with Infants

This study explores how the first wave of the COVID-19 pandemic influenced family routines, relationships and technology use (smartphones and tablet computers) among families with infants. Infancy is known to be an important period for attachment security and future child development, and a time of being susceptible to changes within and outside of the family unit. A qualitative design using convenience sampling was employed. A total of 30 mothers in Perth, Western Australia participated in semi-structured interviews by audio or video call. All mothers were parents of infants aged 9 to 15 months old. Interviews were audio-recorded and transcribed, and data were analysed using thematic analysis to code and identify themes in an inductive manner. Families described staying home and stopping all external activities. Three themes relating to family interactions and wellbeing were found: enhanced family relationships; prompted reflection on family schedules; and increased parental stress. Two themes related to family device use were found: enabled connections to be maintained; and source of disrupted interactions within the family unit. Overall, participants described more advantages than downsides of device use during COVID-19. Findings will be of value in providing useful information for families, health professionals and government advisors for use during future pandemic-related restrictions.

Actual and Perceived Parental Knowledge and Child Delinquency: Does the Sex of the Parent, the Sex of the Child, and the Child’s Age Make a Difference?

Parental knowledge was tested as a possible deterrent to future delinquency in 3914 (51% male) early to mid-adolescent school children from the Longitudinal Study of Australian Children. Using three waves of data, parent-rated mother and father knowledge were tested as correlates of future delinquency, controlling for age, perceived parental knowledge, and the willingness of children to share their thoughts and feelings with parents. Variables from Wave 5 (age 12/13) were used to predict delinquency at Wave 6 (age 14/15), and variables from Wave 6 were used to predict delinquency at Wave 7 (age 16/17). Results showed that mother- but not father-reported knowledge effectively deterred future child delinquency. A significant sex x mother knowledge interaction was found in both analyses, indicating that boys experienced a stronger deterrent effect than girls. It was further demonstrated that the deterrent effect of parental knowledge on child delinquency was stronger in early adolescence than in middle adolescence.

MENGURANGI DEGRADASI MORAL DAN PENGUATAN KARAKTER ANAK MELALUI PERAN CATUR GURU DI TENGAH PANDEMI COVID-19

<p><em> Education is one of the most important things that is able to be a change in the world and in changing the younger generation to be better and have character. With the existence of an education that is complemented by religious teachings it self, it will streng then character and reduce the moral and ethical degradation or decline that occurs in every nation's future child. Cultivators of noble moral values, ethics and religious teachings must be planted from an early age so that children become accustomed to them and are able to understand behaviors that should be avoided and prohibited. Therefore the role of parents is very influential on the character of the child because the family is the primary or primary education that the child gets. In addition, to reduce the current moral degradation or deterioration that is prevalent in life, there is a need for cooperation between parents, educators and the government to be able to create a good young generation. In the teachings of Hinduism, there are many teachings that can be used as a guide for life and can be used as character strengthening for children and the younger generation, one of which is known as the teaching of Catur Guru, which is the teaching of how to be devoted, ethical and respecting these four teachers, including self-help teachers. , rupaka teachers, recitation teachers and wisesa teachers.</em></p>

Maternal responsiveness and directiveness in speech to 2-year-olds: Relationships with children’s concurrent and later vocabulary

This study investigated responsive and directive speech from 60 Finnish mothers to their 2-year-old children, as well as correlations with concurrent and later vocabulary. Possible gender differences with regard to both maternal speech and children’s vocabulary skills were considered. There were no gender differences in maternal utterance frequencies or in maternal utterance types. Girls scored statistically significantly higher in receptive and expressive vocabulary tests at 24, 30 and 36 months. The effect sizes were large. Maternal Other Utterances (fillers like yes, oh, umm) were correlated with children’s concurrent receptive vocabulary. However, there was no relationship between Other Utterances and children’s later vocabulary after controlling for vocabulary size at 24 months. This association may reflect an attempt by mothers to elicit speech from more linguistically advanced children. Furthermore, mothers’ Intrusive Directives towards 2-year-olds correlated negatively with receptive vocabulary at 30 months, particularly for boys. Surprisingly, Intrusive Attentional Directives correlated positively with expressive vocabulary in the group of 30-month-old girls. The results of this study demonstrate relationships between maternal verbal interactional style and both concurrent and future child vocabulary.

Characteristics of Pregnant Women and New Mothers Identified as Being At-Risk for Child Maltreatment in Early Pregnancy

Pregnant women and new mothers who have risk factors of child maltreatment are “at high risk for future child maltreatment.” Early detection of them is crucial to prevent it. This community-based, retrospective, cross-sectional, observational study aimed to identify the characteristics of pregnant women, and those in their postpartum period, identified as at-risk cases for child maltreatment. We used data from the municipal pregnancy registration system in City A and analyzed 206 cases identified as “at-risk for child maltreatment” from 1 April 2017 to 31 March 2018. They were categorized into two groups: a pregnancy group (131 cases, 63.6%) and a postpartum group (75 cases, 36.4%). Logistic regression analysis revealed that women who reported having poor relationships with their parents and participated in the interview in their early stages of their pregnancy were less likely to be registered as at-risk cases for child maltreatment after delivery. The results suggest that public health nurses (PHNs) can conduct interviews with pregnant women during the early stages of pregnancy to prevent child maltreatment in community settings. Additionally, to ensure safe delivery and childrearing environments, PHNs need to assess the family support capacity of each registered case and provide assistance to those without parental support.

Characterizing attitudes related to child-bearing in young women diagnosed with early breast cancer (EBC).

165 Background: Young women diagnosed with breast cancer face unique challenges. The desire to have a biologic child (bchild) is often a factor in treatment decisions at diagnosis and follow-up. The aim of this study is to characterize the intentions, attitudes, and decision factors considered by young women who desire to have a bchild after a diagnosis of EBC. Methods: This prospective study included young women diagnosed with stage 1-3 EBC under age 45 who saw an oncologist at UCSF’s Breast Care Center (BCC). Young women < 6 months from diagnosis were invited to complete a baseline REDCap survey on fertility, child-bearing, and family-building. Descriptive statistics were used to summarize responses. Chi square and independent samples t tests were used to compare demographics. Covariates were analyzed using odds ratios. Results: From Feb 2018 to Dec 2020, 166 eligible pts seen at the UCSF BCC were contacted, 143 pts consented, and 108 (75.5%) completed the baseline survey. Of the 108 pts, 57 (53%) were interested in having a bchild in the future. Age was the biggest driver of whether participants were interested in future child-bearing vs. not (Mean = 35.4 vs 40.9, p < 0.001) and was not influenced by stage, receptor status, or treatment. 73.6% (N = 42) of those interested in future child-bearing underwent or planned to undergo fertility preservation (FP). FP was associated with full time employment (p = 0.03) and higher education (p = 0.02). Of the 57 pts interested in future child-bearing (42 HR+, 11 TN, 12 HER2+), 30% wished to start trying to conceive within 2 years from diagnosis, and only 20% would wait 5 years or more. 43% (N = 18) of those with HR+ disease were willing to complete 5 years of hormone therapy (HT) before trying to conceive. Given hypothetical risk scenarios of an incurable cancer recurrence, 16.3% of participants were interested in a future bchild despite a 75-100% hypothetical risk of recurrence (ROR). Young women self-identified as Asian were less inclined to pursue child-bearing with increasing risk (OR = 0.3 vs. Caucasian, p = 0.04), while BRCA-carriers were more likely to remain interested in future child-bearing despite increasing risk (OR = 6.43 vs. non-carriers, p = 0.03). 59% would stop adjuvant HT early if the hypothetical absolute increased ROR from early discontinuation was < 10%. Conclusions: In this single-institution study, over half of young women with EBC expressed a desire to have a future bchild. This was independent of stage, receptor status, and treatment; the majority of women wished to conceive < 5 years from diagnosis. The desire for a future bchild decreased with increasing hypothetical risk of incurable recurrence; however, a subset wished to attempt child-bearing even when an incurable recurrence was certain. Having a bchild after EBC is a priority for many young women and should be addressed at diagnosis and throughout the continuum of care.

Is There a Moral Intention to Reproduce Someone Else?

"Moral intentions could be used as criteria for actions. In medical practice, moral intentions take an interesting form when the problem is related to post-mortem reproduction. This paper will attempt to 1) interpret the problem of intentions from principalist perspective in medical ethics; 2) relate the problem of intentions to post-mortem reproduction; 3) develop an existentialist account for intentions and post-mortem reproduction. Peter Zhu’s case is the latest ethical challenge in post-modern reproduction. Its moral sensitivity is high due to his presume intent to reproduce and the possibility for post-mortem reproduction using donors’ material and a surrogate mother. If we presume that the concept of presume intent lies with the general idea for intentions, we must tackle the problem from the perspective of respect for autonomy. The problem with intentions is that the prospective intentional action to reproduce belongs to one person only. Yet it appears that someone else is going to perform this action and someone else will finish it. Who should we hold responsible for this action: the person who intended to do it or the person who is intending to perform it and finish it? In Peter Zhu’s case, there are participants with different intentions that are with different moral value. The existentialist account of post-mortem reproduction and intending to reproduce will try to present why we should be careful with respect for autonomy. The ethical and existential consequences of such reproduction are that the future child would be brought to a life of suffering and vagueness. "

O-056 Evaluating the utility of screening human IVF embryos with polygenic risk scores for complex diseases

Study question It is now feasible to screen human IVF embryos with “polygenic risk scores” for predicting complex disease risk. What is the expected risk reduction? Summary answer Under some conditions, prioritizing embryos based on polygenic risk scores can lead to substantial disease risk reductions. However, only excluding high-risk embryos is less effective. What is known already Recent genetic studies have identified numerous mutations associated with complex diseases, leading to the development of accurate polygenic risk scores (PRSs) for disease risk prediction. Given that genomes of human IVF embryos can now be sequenced with relative ease, it has become technically feasible to use PRSs for prioritization of embryos for transfer. Clearly, such use is associated with ethical and social concerns, from inequality to eugenics. Nevertheless, polygenic embryo screening is already offered to consumers, with little research so far on expected outcomes. Our previous evaluation of screening IVF embryos for polygenic traits showed little current utility. Study design, size, duration This is a theoretical/computational study based on statistical genetics theory and simulations. Participants/materials, setting, methods We used the liability threshold model to estimate the disease risk given the PRS. We considered screening for a single disease (with known prevalence and PRS accuracy), and assumed that n viable embryos are available. We calculated the risk of the child given these parameters and the prioritization strategy, either when parents are random or when their disease status is known. We also used simulations based on genomic data from a schizophrenia case-control study. Main results and the role of chance We modeled the disease risk of a hypothetical future child when the PRSs of embryos are used for prioritization, relative to random selection. When selecting an embryo at random among those who do not have an extremely high risk (typically, top 2% of the PRS distribution), the relative risk reduction (RRR) is limited, and is under 10% for currently realistic scenarios. In contrast, selecting the lowest risk embryo for implantation results in substantial RRRs of ∼20-50% already with n = 5 embryos and realistic disease parameters. For example, the RRR for schizophrenia is &gt; 40% with current PRSs, a result we validated with simulated genomes of parents and children based on genotypes from a schizophrenia study. When one of the parents is known to be affected, selecting the lowest risk embryo out of n = 5 may restore the risk of the future child to nearly normal levels. Limitations, reasons for caution Our analytical modeling is based on several simplifying assumptions regarding the dependence of the risk on the PRS and the accuracy of the PRS. Further, the estimated risk reductions depend on the availability of n = 5 embryos that could lead to a live birth. Wider implications of the findings Under some conditions, prioritizing embryos for transfer based on polygenic risk scores could lead to substantial disease risk reductions. However, predicted outcomes vary considerably with prioritization strategies and disease and PRS parameters. The emerging ethical and social concerns and the challenges in communicating these results need to be urgently discussed. Trial registration number Not applicable

Couples’ experiences with expanded carrier screening: evaluation of a university hospital screening offer

Preconception carrier screening offers couples the possibility to receive information about the risk of having a child with a recessive disorder. Since 2016, an expanded carrier screening (ECS) test for 50 severe autosomal recessive disorders has been available at Amsterdam Medical Center, a Dutch university hospital. This mixed-methods study evaluated the experiences of couples that participated in the carrier screening offer, including high-risk participants, as well as participants with a general population risk. All participants received genetic counselling, and pre- (n = 132) and post-test (n = 86) questionnaires and semi-structured interviews (n = 16) were administered. The most important reason to have ECS was to spare a future child a life with a severe disorder (47%). The majority of survey respondents made an informed decision (86%), as assessed by the Multidimensional Measure of Informed Choice. Among the 86 respondents, 27 individual carriers and no new carrier couples were identified. Turn-around time of the test results was considered too long and costs were perceived as too high. Overall, mean levels of anxiety were not clinically elevated. High-risk respondents (n = 89) and pregnant respondents (n = 13) experienced higher levels of anxiety before testing, which decreased after receiving the test result. Although not clinically significant, distress was on average higher for carriers compared to non-carriers (p < 0.0001). All respondents would opt for the test again, and 80.2% would recommend it to others. The results suggest that ECS should ideally be offered before pregnancy, to minimise anxiety. This study could inform current and future implementation initiatives of preconception ECS.