Tips for Raising Responsible Children

responsible children

As a parent, what would you say is your top goal to accomplish with/for your children?

A common response is that parents want to help their children grow into responsible adults— which may include smaller goals such as helping them have skills necessary to be productive members of society, be healthy, happy, and able to take care of themselves.  To encourage and direct parents toward achieving this goal, Cornell University Extension (Jefferson County) has created a parent guide that identifies and breaks down 7 parenting tips. Let’s take a closer look.

Tip 1: Don’t do things for your children that they can do for themselves.

  • Even young children can help with chores and get themselves dressed in the morning.
  • Resist the urge to take over and solve all your child’s problems. Instead, help children learn to help themselves.

Tip 2: Be clear and consistent about your expectations.

  • Make sure your children understand the rules of the household.
  • Be consistent with your messages. If the rule is that children must finish homework before watching TV, then stick with it.
  • Give children advance notice if you expect certain behavior. This is helpful when taking them to the grocery store or on a family vacation, for example.

Tip 3Teach skills and give positive feedback.

  • Don’t just tell your child what to do—include how to do it. For example, a young child may need to be told to clean up their toys but showing them what you mean may work best.
  • Older children may benefit from written step-by-step instructions. For example, to clean the bathroom they may need to know: spray down the shower walls and floor with “X” cleaner, leave for 5 minutes and then rinse with warm water and use a squeegee to dry.
  • Positive and specific feedback for a task or assignment done well. For example: “I love the way you folded your clothes so neatly before putting them in the drawer.”

Tip 4: Create a home that helps children act responsibly.

  • Work with children to organize their space and belongings. This might mean providing bins and shelves they can reach.
  • Make sure children know where to find cleaning supplies to do their chores and clean up spills.
  • Set up an area for homework that is comfortable, well-lit and that minimizes distractions.

Tip 5: Teach children that mistakes are an opportunity to learn.

  • Everybody makes mistakes, so your children are likely to as well. Try not to over-react. Instead, view mistakes as a time to make new plans and better actions for the future.

Tip 6: Let children experience the natural consequences of their behavior.

  • When children don’t act responsibly, don’t be a “helicopter” parent who always rushes in to fix the mistake- unless it is dangerous to their personal safety.
  • Instead, let children experience the results of their actions.

Tip 7: Be a positive role model.

  • Speak positively about your work and chores. Don’t complain about all that you have to do. Instead, take pride in the things you do well.
  • If (When) you make a mistake, admit it—and then show children how you will correct it.

These statements summarize most of the excellent information found in this on-line publication found at: http://ccejefferson.org/parenting ,under “Resources for You”, “Raising Responsible Children”

A few take-away statements for parents included in the document include:

  • Children do best when they know what to expect.
  • Letting children know when they do well encourages responsible behavior.
  • Remember- you are in charge of your home.
  • Keep in mind, when children “choose” their behavior, they are also choosing the consequences.

Kathleen Riggs is the Utah State University Extension family and consumer sciences professor for Iron County. Questions or comments may be sent to kathleen.riggs@usu.edu or call 435-586-8132.

Four Reasons to Get Your Teen in the Kitchen

Teens in the Kitchen.jpgNot all teenagers want to help out in the kitchen. But encouraging them to do so is a worthy goal because of the many benefits.

Why get your teens in the kitchen?

Promotes conversation – When you cook with your children, you can model good communication.  Studies have shown that the more teens communicate with their parents on a daily basis, the less likely they are to participate in risky behaviors.

They’ll be more likely to eat It – Do you have picky eaters?  Teens will be more likely to try new things if they are able to help prepare the meals they are eating. They will also be getting a more balanced diet when meals are prepared in the home.

Promotes confidence in the kitchen – As teens grow into adulthood, the task of feeding themselves becomes their own. We need to prepare our kids with skills for the future to help make the transition into adulthood more successful. And the likelihood of them having to feed a family of their own one day is pretty high!

Reinforces science and math – What a great way to “trick” kids into doing math and science.  They have so much fun in the kitchen, many times they forget they are learning new skills and applying many math and science concepts. Help your teens develop a love of cooking and at the same time, they will be making connections to other aspects of their learning.

USU Extension’s Youth Can Cook Program

Do you have a teen looking for more cooking experience? Here are five reasons they should join the Youth Can Cook program.

1. Be part of a group!

Come and make friends with other teens who don’t attend your school, who view the world differently than you do, and are excited to learn! Youth Can Cook brings together teens from all over the county, giving them a chance to learn and grow in different and distinct ways.

2. Master Food Preserver Course – kitchen skills

Do you have a favorite salsa your grandma makes every fall? Or have you ever broken out a bottle of canned peaches in the middle of winter and had flashbacks to summer time? Food preservation gives us the ability to enjoy our favorite foods all year round! Teens will learn food preservation techniques from community Master Food Preservers. These skills will later be used  as part of their Youth Can Cook paid apprenticeship as they assist in future food preserver courses.

3. Food Safety Managers Certification

Jobs available to teens are likely to involve food, and working in a food establishment requires a food handler’s permit. As a part of the Youth Can Cook program, teens are guided through the Food Safety Managers course (ServSafe equivalent). Youth will participate in hands-on activities that help solidify the concepts learned. This is an $80 course that is free to program participants.

4. Job, life, and relationship skills

In a survey conducted by the National Association of Colleges and Employers, the data collected showed that teamwork/collaboration, oral and written communications, and critical thinking/problem solving were all identified as “absolutely essential” to be career ready.

Teens will leave the program with a fresh resume, interviewing and communicating skills, and the ability to navigate relationships in the job sector.

5. Paid apprenticeship & job reference

Teens will apprentice community educators to get a feel for what it’s like to work in the professional world. They will be given responsibilities and tasks to demonstrate the skills they learned throughout the program. The apprenticeship lasts 50 hours, and teens are paid $9.50 an hour — more than $2 over minimum wage.

Learn more about the Youth Can Cook program here.

Information for this article was submitted by Ashlee Christiansen, Youth Can Cook program coordinator, Washington County, and Katie Kapp, Youth Can Cook program coordinator, Salt Lake County



Quick and Easy Reading Pillow

Reading Pillow GraphicSnuggle up with a good book and a pillow.  Make this quick and easy pillow with a built-in pocket to hold a favorite book and maybe even a few toys and a snack.  Use it at home or on the go.  It makes the perfect personalized gift.  This is a great beginner’s project.  

Materials Needed:

  • ½ yard of fabric for front and back
  • Fat quarter of fabric for pocket
  • Matching thread
  • Iron-on letters, fabric for applique or embroidery machine for the letters
  • 16” x 16″ pillow form

Cutting Instructions:

(1) 16 1/2″ x 16 1/2″ fabric for front

(2) 16 1/2″ x 11″ fabric for back

(1) 16 1/2″ x 20″ for pocket

Sewing Instructions:

  1. Fold pocket fabric in half so that it measures 10″ x 16 1/2″.
  2. Apply letters by method of your choice — applique, purchased iron- on letters or with an embroidery machine.   Choose a word that you want on the pillow.  It can be “READ,” a name or whatever you want.
  3. The word should be approximately 3″ from the bottom edge and 3″ from the right edge.READ Pillow Image 1
  4. Hem one 16 1/2″ edge on both back pieces.  Fold over 1/4″ and press.  Fold over 1/4″ again and press so that the raw edge is enclosed.
  5. Stitch along each edge.
  6. Baste pocket piece to the bottom of the front fabric piece.READ Pillow Image 2
  7. Lay the front pocket piece right side up.
  8. Place the two back pieces right sides down onto the front piece so the corners and edges match on the top and the bottom and the hemmed edges overlap in the center. Overlap the two back sections.READ Pillow Image 3
  9. Pin in place.
  10. Sew 1/4″ seam on each side.
  11. Turn right sides out through the back enclosure and put pillow form inside.

Tips for a Safe Halloween

Today we’re sharing some Halloween safety tips for you and your little ghouls and goblins. Keep track of these tips by pinning them on Pinterest.


This article was re-published from October 2015, with information taken from cdc.gov.

10 Tips to Help Your Kids Do Better in School

Help your kids.jpgNow that the kids are back in school, here are some tips that may help promote a greater enthusiasm for learning this new school year.

  1.  Set an Example:  One of things we know, from years of observation, is that the family environment makes a huge difference in forming good attitudes toward school success in youth.  Let your kids see you involved in learning and reading.  Take a class online, go with them to the library, read to them at night, study their topics with them or learn a new language.

  2.  Promote Study Time:  Have a quiet place and perhaps set time to study every day.  Make sure youth are taking a short break during their study time.  Provide a simple snack or divergent activity for them during the break.  Be as consistent as possible about when it is study time.  Work with them on being as organized as possible in their homework and studying.  Have bins and shelves for completed assignments to make the process as systematic as possible.  It is also helpful to teach your children about keeping their school papers and assignments organized before they get home with them.  Help them learn how to break assignments and studying down into more manageable tasks.

  3.  Let Them Talk:  Studies have shown that children have higher IQ’s when given the opportunity to talk often about many different topics.  Provide a chance around the dinner table to discuss events of the day, concerns they have, or something they heard on the news.  Ensure that there is emotional safety in expressing themselves.  Let them tell you about their ‘high’ and ‘low’ points of the day.

  4.  Support a New Interest or Enrichment Activity:  Children who have a love of enrichment activities have a release from the doldrums of school.  These activities provide an added purpose to their studies and to their day.

  5.  Remain Supportive When They Get Low Grades:  True achievers seldom get perfect marks all the time.  Unconditional acceptance is the rule.  When your children are getting low grades, do your best to work with them, beside them, and for them.  This may mean getting tutoring help, working with the teacher more closely, and talking to the child about his or her roadblocks on the subject.  Be willing to hear them out, and do not compare them to their other siblings or peers who may be doing well in that subject.  Be sure to find the balance of encouraging better grades and putting undue pressure on them.  Be as constructive as possible on ways to do better next time.

  6.  Set Standards of Expectation and Goal Setting:  There is nothing wrong with parents defining a level of expectation for school performance.  Parents are to be parents, which sometimes means taking a proactive stand when children are not striving to do their best in school, which may mean disciplining for laziness, lack of hard work, and effort.  Encourage your kids to set their own performance goals for the school year.  Have them put them in writing and evaluate with them on a frequent basis.  Checking on their progress toward goal accomplishment shows them you care and are playing an active part in their success.  This also means attending back to school nights and parent/teacher conferences.

  7.  Engage Your Student in Learning, Not Just Reading:  It is really easy for us to read something, but do we remember the idea or concept before moving on to the next paragraph?  To help bridge the gap with your children between reading and learning, have them explain the concepts to you every few paragraphs.  Quiz them at breakfast the next morning. Help them realize that employers in later life do not want to have to repeat things over and over again to their employees.  Now is the time for them to understand they are responsible for their own learning.  Just as parents go to work every day, their job for now is learning.  Observe and encourage different learning styles. Are they visual learners, auditory learners, etc.?

  8.  Let Them Figure Things Out on Their Own:  Sometimes, in our goal to get study time over with, we jump in too quickly with the answers.  Encourage youth to look things up on their own, to read something again, or to learn from their mistakes.  Set up scenarios where they have to use some aspect of what they are studying to solve a problem.  Driving my kids to and fro was a great time to pose a math problem to them, or throw out a social studies issue that is current today for them to think on, or ask them their opinion on the life of some person in history.  Often as parents we are too quick to offer our advice on life’s problems to our kids.  We want to prevent them from making mistakes rather than letting  them learn the art of figuring things out.

  9.  Volunteer at the School:  Not only do teachers and faculty appreciate help at the school, but volunteering helps you get to know the teachers, the administrative staff, the lunchroom staff, other parents, AND it also sends a message to your children that their school experience is important to you.  This can also be helpful in having conversations with your child about things at school generally.  Maybe you will see why your child is less than impressed with a certain teacher, or that there are issues with others in the school setting.  Even if you work full-time outside the home, contact the PTA/PTO President and let him or her know you are interested in helping plan and implement activities at the school when you are not at work.  (As a working mom myself, I know how difficult this can be, but it has paid off so many times throughout the years, that I cannot omit mentioning it.)

  10.  Eat Together as a Family at Least 5 Meals a Week: Studies show that the more times a week children eat together with their family, the better they do in school, the more they stay clear of anti-social behaviors, and the more articulate they are in their communication skills.

Being actively engaged in the overall school experience does take time, thought, and energy.  But the rewards are worth it, for both them and you.

This article was written by Teresa Hunsaker, USU Extension family and consumer sciences educator, Weber County


Fall Bucket List


Cooler temperatures and colorful leaves are on their way. We’re welcoming fall with more than 50 fall things to do around Utah. Pick and choose your favorites to create your own custom fall bucket list. 

The weather is starting to cool off, the leaves are changing and there is so much fun to be had.  Utah is full of great experiences, whether you want to spend time out in the crisp fall air or stay home working on simple projects.  Whatever mood you are, in it is nice to have a list of exciting ideas to choose from, and we have more than 50 suggestions for you to build your own fall bucket list.


  • Drive the Alpine Loop or other local canyons to see the leaves
  • Explore a corn maze
  • Visit the local farmer’s market
  • Go on a hike to see the fall colors
  • Go camping in the colors
  • Go apple, pumpkin, squash, pepper or tomato picking at a local “pick your own” farm
  • Go pick your own pumpkin from a pumpkin patch
  • Practice recreational shooting
  • Go hunting
  • Go Trick-or-Treating
  • Tell scary stories around a campfire
  • Go on a hay ride
  • Join in a family and friend turkey bowl football game



  • Do fall cleaning
  • Decorate the house
  • Host a football watching party
  • Host a Halloween party
  • Gather family for Thanksgiving dinner
  • Rake up and play in the autumn leaves
  • Clean out garden beds to prepare for next year
  • Plant spring bulbs
  • Plant a tree — Autumn is a great time to plant a tree, but be sure to water well if it is a dry autumn.


  • Do a chili cook-off
  • Make apple cider
  • Harvest fall produce and preserve it by freezing, drying or canning (jams, jellies, whole fruit, etc.)
  • Throw a homemade doughnut party – invite friends and family over for fun and doughnuts everyone can enjoy. Try them  baked or fried.
  • Make caramel apples
  • Try a new recipe for Thanksgiving (pie, stuffing, etc.)
  • Throw a party where everyone brings a different kind of pie
  • Host a crock pot party
  • Try a new homemade soup, like  Apple & Butternut Squash Soup (page 7) to help keep you warm as the days get colder.


  • Pumpkin carving – A tradition that never gets old. Find your favorite printable template or draw freehand to make your pumpkin carving creation.
  • Decorate/paint pumpkins to look like a favorite book character – Painting and decorating pumpkins is just as fun. They also last longer without wilting.
  • Boo” ding dong ditch the neighbors – Leave a bag of goodies on someone’s front porch and run away – once you have been “boo-ed” you hang an image of a ghost near your front door so others know you have been “boo-ed.”
  • Start a fall gratitude journal
  • Create a new autumn decoration
  • Make a new Halloween costume
  • Sew homemade hand warmers


This is a way to transport yourself and your little ones into another world of fun, adventure and fantasy. Cuddle up with a blanket and enjoy some of these favorites this autumn.

  • Scary chapter books:
    • Scary Stories to Tell in the Dark by Alvin Schwartz
    • The Graveyard Book by Neil Gaiman
    • Coraline by Neil Gaiman
    • Doll Bones by Holly Black
  • Halloween picture books:
    • Room on the Broom by Julia Donaldson
    • The Little Old Lady Who Was Not Afraid of Anything by Linda D. Williams
    • Goodnight Goon: A Petrifying Parody by Michal Rex
    • Bear Feels Scared by Karma Wilson
    • Big Pumpkin by Erica Silverman
    • In a Dark, Dark Room and Other Scary Stories by Alvin Schwartz
    • The Hallo-wiener by Dav Pilkey
    • Bats at the Library by Brian Lies
    • Frankenstein by Rick Walton and Nathan Hale
    • Pumpkin Circle: The Story of a Garden by George Levenson and Samuel Thaler
    • A Very Brave Witch by Alison McGhee and Harry Bliss
    • One Witch by Laura Leuck

    • Curious George Goes to a Costume Party by Margaret Rey
    • Where is Baby’s Pumpkin? by Karen Katz
  • Thanksgiving picture books:
    • ‘Twas the Night Before Thanksgiving by Dav Pilkey
    • Turkey Trouble by Wendi Silvano
    • The Ugly Pumpkin by Dave Horowitz
    • A Plump and Perky Turkey by Teresa Bateman and Jeff Shelly


This article was written by Kirsten Lamplugh, Intern at the Salt Lake County USU Extension office, BS in Family and Consumer Sciences 

The Importance of One-on-One Time with Your Kids

One on One Time.jpg

Make your kids feel valued and loved by spending one-on-one time with them. Here are some ideas to get you started.

As a young adult, some of my favorite memories were when I had one-on-one time with my parents. Even now when I go home, I cherish the time when my mom and I run to the gas station to get drinks. The moments you spend with your kids will impact them in many positive ways. Here are six ideas of ways to spend quality time with your kids.


  1. Take them on a date. The first Christmas after I had moved away from home, my Christmas present from my dad was a date with him before I went back to the craziness of school. We went to dinner at my favorite restaurant then bowling. It was a good time for us to talk about how school was going, my plans for the future, etc.  


  1. Take them to run an errand with you. This can be as simple as going to the gas station to fill the tank. This gives you an opportunity to talk in the car. This can also be a teaching opportunity. For example, teach them how to pump the gas.


  1. Go on a trip with them. My parents took us each on a week-long graduation trip. They would  plan activities that were of particular interest to us. Since I love the theatre, my parents took me to see Fiddler on the Roof. It was a great experience to watch a show I have always loved the music to, but had never seen.


  1. Plan a family vacation. Though it’s a family trip, you can still make one-on-one time with each child. My mom and I are not big hikers while my dad and sisters are. So while they would hike, my mom and I would play card games together. Another example is going on a walk with one child before everyone else gets up.


  1. Birth day date. This idea is taken from the blog Your Modern Family. Each month, on the day the child was born, he or she gets to stay up an extra 20-30 minutes and chooses a special activity. For example, if your child was born on May 15, then on the 15th of every month it is his or her night to stay up. These activities are best when electronic free and can include such things as going for a walk, baking easy cookies, playing a board game, etc.


  1. Surprise your kids. Whether it is bringing lunch to school or getting ice cream together, there are many ways to spend one-on-one time with kids. This helps them know you love them, are a support system for them and that they can talk to you about anything. When they are younger, make an effort to spend one-on-one time with each of them. It can be tucking them into bed, after school homework time, etc. Put the phone away and focus on them. Your undivided attention will make them truly feel loved and appreciated.

This article was written by Kayla Orton, Utah State University Extension Family and Consumer Sciences Intern, Salt Lake County

Safe Babysitting Tips for Summer and Fall

Safe Babysitting Tips.jpgHelp prepare your older children to be responsible babysitters with these tips and ideas.

Is your son or daughter interested in babysitting? It’s important to help youth understand that watching kids is a big responsibility, and keeping them safe adds to their duties. Here are ideas to discuss with them to help keep the children they tend safe.


  • Always wear and reapply sunscreen. As a general guideline, the SPF number is the number of minutes you can go before you need to reapply the sunscreen.
  • Keep your eyes on the children at all times when you are around water, including ponds and swimming pools. Kids can get hurt even on slip and slides, so keep your eyes out for possible danger.
  • Be aware of hot cement. The cement can often get so hot that it burns the kids’ feet. If you want to have fun with sidewalk chalk, find a shady part of the sidewalk where children can draw their creations.
  • Be aware of strangers. Play in the backyard as much as possible. If this is not possible, keep an eye out for strangers and suspicious vehicles.
  • Drink plenty of water, especially if you are outside and sweating and losing water. Both you and the kids need to stay hydrated.
  • Be aware of the temperature outside. If it is above 90 degrees, it is probably safer to find something to do inside.
  • Prepare simple snacks that are healthy and safe. Make sure vegetables, fruits and hot dogs are cut up in small pieces. Don’t give children a treat on a stick unless they are sitting down to eat it. Running around and eating food on a stick could cause them to fall and jam the stick in their throat.
  • Have a first aid kit handy.
  • Have fun and be safe!

Another responsibility a babysitter has is dealing with tantrums, bad behavior and irrationality. These behaviors can often be handled through a time out. Attached is a recipe for a glitter “calm down jar” that also doubles as a timer. As kids focus on the settling glitter, it helps them calm down. Once all the glitter settles, the time out is over. It can be found here. Your youth may want to add a “calm down jar”  to their babysitting kit.

This article was written by Kayla Orton, Intern with Utah State University Extension – Salt Lake County


4 Simple Swaps for a Healthier Lunchbox

Lunch Swaps

What’s for lunch? If you’ve got kids going back to school, chances are you’re thinking about what you’ll send with them in their lunchboxes. Try these simple changes to make their lunches healthier.

With kids going back to school, it is time to get back into the habit of packing lunch boxes.  Here are some simple swaps that can help you make them more nutritious.

1)   Use water or low-fat milk instead of sugared-beverages. Water is great for keeping little ones hydrated.  You can add fruit or herbs to infuse it with flavor.  Let your kids pick their favorite ones to personalize their water bottles.  Low-fat milk is another great option that packs a nutritious boost with calcium and protein.

2)   Stick with whole grain bread and wraps instead of white.  Fiber in whole grains can help your kids feel fuller for longer.  Whole grain breads and wraps also maintain more vitamins and minerals.  

3)   Add whole fruit instead of fruit snacks.  As one of my favorite professors once said, “Grapes are nature’s candy.”  Fruit can be a sweet treat for your kids that provides much more nutrients and less preservatives and dyes than fruit snacks and other fruit-like candy.

4)   Include some veggies instead of no veggies.  Vegetables can be one of the more challenging food groups to get kids to eat.  Let them pick the vegetables they would like to pack.  Use dinnertime and snack time at home as opportunities to introduce them to a variety of vegetables to help them decide what kinds they like best.

Following these steps can help your lunchboxes follow USDA MyPlate recommendations and give your kids a balanced diet that will help get them through their school day.  As you prepare your lunchbox menus for the week, invite your kids to be involved.  They will be more invested in eating something, if they feel like they have a say in what goes in their lunchbox.    

These tips are great for adult lunches too.  Taking your own lunch to work can help you eat well and save money.


This article was written by LaCee Jimenez – Food $ense (SNAP-Ed) Coordinator

Sleep Superheroes

Sleep SuperheroesA light supper, a good night’s sleep, and a fine morning have often made a hero of the same man who, by indigestion, a restless night, and a rainy morning, would have proved a coward.

–Lord Chesterfield

As parents, we know our children need a healthy, balanced diet to perform well in school. However, do we recognize what a vital role sleep plays in student performance? Teenagers extend their waking hours to accommodate school, work, sports and social life, cutting back on hours meant for sleep. Yet, whether they are teenagers or younger kids, even Superheroes need sleep to be at their best! Research shows that:

  • Shortened sleep times seem to cause higher levels of anxiety (Silva, et al. 2017).
  • Shortened sleep times seem to cause an increase in feelings of hunger, but a decrease in food enjoyment (Silva, et al. 2017).
  • A one-hour increase of sleep time is associated with a 14 percent decrease in the odds of being obese (Timmermans, et al., 2017).
  • Teenagers who consistently went to bed late craved more high-sugar foods at breakfast, and then continued to eat 53 percent  more food throughout the day (Asarnow, et al., 2017).
  • These same teenagers, when they altered their habits and went to bed earlier, voluntarily chose healthier foods for breakfast (Asarnow, et al., 2017).

Less anxiety, decrease in obesity, healthier food choices…there’s no question that sleep should be  an important part of your Superhero’s diet!

This article was written by Cathy Merrill, Family and Consumer Sciences, Extension Assistant Professor, USU Extension, Utah County


Asarnow, L.D., Greer, S.M., Walker, M.P., & Harvey, A.G. (2017). The impact of sleep improvementon food choices in adolescents with late bedtimes. Journal of Adolescent Health, 60¸ 570-576.  Accessed at  http://dx.doi.org/10.1016/j.jadohealth.2016.11.018

Silva, A.A.S.C., do Vale Cardoso Lopes, T., Teixeira, K.R., Mendes, J.A., de Souza Borba, M.E., Mota, M.C.,

Waterhouse, J., Crispim, C.A. (2017). The association between anxiety, hunger, the enjoyment of eating foods and the satiety after food intake in individuals working a night shift compared with after taking a nocturnal sleep: A prospective and observational study. Appetite, 108, 255-262. Accessed at http://dx.doi.org/10.1016/j.appet.2016.10.005  

Timmermans, M., Mackenbach, J.D., Charreire, H., Bardos, H., Compernolle, S., De Bourdeaudhuij, I., Oppert, J.-M., Rutter, H., McKee, M., Lakerveld, J. (2017). Preventive Medicine, 100, 25-32. Accessed at http://dx.doi.org/10.1026/j.ypmed.2017.03.021