Ter um fiho durante a pós-graduação em enfermagem: perspectivas e desafios / Having a child during graduate nursing: perspectives and challenges / Tener un hijo durante la carrera de enfermería: perspectivas y retos

Objetivo: compreender como enfermeiras percebem a vivência de uma gravidez e os primeiros meses após o nascimento de um filho durante o mestrado/doutorado. Método: estudo qualitativo, exploratório-descritivo, desenvolvido com nove pós-graduandas em enfermagem de uma universidade pública do estado do Paraná. A coleta de dados foi realizada nos meses de agosto e setembro de 2022, a partir de entrevistas individuais semiestruturadas que foram audiogravadas, transcritas e submetidas à análise de conteúdo, modalidade temática proposta por Bardin. Resultados: emergiram três categorias temáticas: 1) Enfrentando desafios: conciliar tarefas é uma necessidade; 2) Rede de apoio como facilitadora na conciliação da maternidade com os estudos e; 3) Aumento do tempo de licença-maternidade, flexibilização e apoio interno para inclusão de mulheres mães na ciência. Conclusão: as vivências da maternidade vivenciadas por mulheres na pós-graduação foram pautadas na sobrecarga das mães pesquisadoras, repercutindo em atrasos no cumprimento de prazos, dificuldade em manter a amamentação e preocupação com a saúde dos filhos, refletindo em escolhas e renúncias da maternidade nesta etapa da vida.

Objective: to understand how nurses perceive the experience of pregnancy and the first months after the birth of a child during their master's/doctoral studies. Method: qualitative, exploratory-descriptive study, developed with nine graduate students in nursing at a public university in the state of Paraná. Data collection was carried out in August and September 2022, based on semi-structured individual interviews that were audio-recorded, transcribed and submitted to content analysis, the thematic modality proposed by Bardin. Results: three thematic categories emerged: 1) Facing challenges: reconciling tasks is a necessity; 2) Support network as a facilitator in reconciling motherhood with studies and; 3) Increased maternity leave, flexibility and internal support for the inclusion of women mothers in science. Conclusion: the experiences of motherhood experienced by women in graduate school were based on the overload of research mothers, resulting in delays in meeting deadlines, difficulty in maintaining breastfeeding and concern for the health of their children, reflecting on choices and waivers of motherhood in this life stage.

Objetivo: comprender cómo las enfermeras perciben la experiencia del embarazo y los primeros meses después del nacimiento de un hijo durante sus estudios de maestría/doctorado. Método: estudio cualitativo, exploratorio-descriptivo, desarrollado con nueve estudiantes de postgrado en enfermería de una universidad pública del estado de Paraná. La recolección de datos se realizó en agosto y septiembre de 2022, a partir de entrevistas individuales semiestructuradas que fueron grabadas en audio, transcritas y sometidas a análisis de contenido, modalidad temática propuesta por Bardin. Resultados: emergieron tres categorías temáticas: 1) Enfrentar desafíos: conciliar tareas es una necesidad; 2) Red de apoyo como facilitadora en la conciliación de la maternidad con los estudios y; 3) Aumento de la licencia de maternidad, flexibilidad y apoyo interno para la inclusión de mujeres madres en la ciencia. Conclusión: las experiencias de maternidad vividas por las mujeres en el posgrado se basaron en la sobrecarga de las madres investigadoras, resultando en retrasos en el cumplimiento de los plazos, dificultad para mantener la lactancia materna y preocupación por la salud de sus hijos, reflexionando sobre las opciones y renuncias de la maternidad en esta etapa de la vida.

The evolutionary novelty of childcare by and with strangers.

Alloparenting by and with genetically unrelated individuals is evolutionarily novel; thus, the Savanna-IQ Interaction Hypothesis predicts that more intelligent parents are more likely to resort to paid childcare by strangers. Analyses of individual data (National Child Development Study) in the United Kingdom (Study 1) and macrolevel data from the United States (Study 2) and economically developed Organization for Economic Cooperation and Development (OECD) nations (Study 3) confirmed the hypothesis. Net of education, earnings, sex, current marital status, and number of children, more intelligent British parents were more likely to resort to paid childcare at ages 33 and 42; net of female labor force participation rate, median household income, median cost of childcare, and mean education, U.S. states with higher average intelligence had higher proportions of children (ages 0-4) in paid childcare; and net of maternal employment, gross domestic product (GDP) per capita, cost of childcare, and female educational attainment, OECD nations with higher average intelligence had higher proportions of infants (ages 0-2) in paid childcare. The results were remarkably consistent; both across the 50 U.S. states and 45 economically developed OECD nations, a one IQ point increase in the average intelligence of the population was associated with a 1.8% increase in the proportion of children in paid childcare. Contrary to earlier findings, there was some suggestive evidence that the experience of paid daycare might harm the cognitive development of children. The studies point to the importance of evolutionary perspective in developmental psychology and child development.

Experiencias comunitarias, crianzas compartidas y políticas de cuidado / Experiências comunitárias, políticas compartilhadas de pais e cuidados / Community experiences, shared upbringing and care policies

RESUMEN En el presente artículo, escrito en el contexto de la pandemia 2020-2021 y en el marco del cumplimento del Aislamiento Social Preventivo y Obligatorio (ASPO), analizamos dos experiencias comunitarias vinculadas al cuidado de las infancias y adolescencias que se desarrollan en las provincias de Neuquén y Río Negro (Patagonia Argentina). Dicho análisis es resultado de una investigación cualitativa realizada desde la perspectiva de la Psicología Social Crítica y las Políticas Públicas en la que buscamos recuperar los saberes sociales que estas iniciativas comunitarias pueden aportar al diseño y reformulación de las políticas públicas de cuidado. Específicamente, las experiencias que aquí presentamos son: la Asociación Civil GAIA-Nueva Crianza, conformada por familias de niñes y adolescentes trans; y la Asociación Civil Lazos Azules, integrada por familias de niños y adolescentes con TEA (Trastorno del Espectro Autista). Si bien las dos asociaciones son muy diferentes entre sí, ambas coinciden en estar protagonizadas por familias que, a partir de haber escuchado y prestado atención a las necesidades de sus hijo/a/es, se organizaron colectivamente para visibilizar la realidad de sus niño/a/es y adolescentes generando distintas acciones. Dichas acciones tienden no sólo a hacer efectivos los derechos de las infancias y adolescencias, especialmente aquellos vinculados a la identidad, la educación y la salud, sino que están orientadas a incidir en las políticas públicas de cuidado a nivel local desde lo que Boaventura de Sousa Santos denomina la sociología de las emergencias y desde lo que Rita Segato designa como una politicidad en clave femenina anfibia.

RESUMO. Neste artigo, escrito no contexto da pandemia 2020-2021 e no quadro do cumprimento do Isolamento Social Preventivo e Obrigatório (ASPO), analisamos duas experiências comunitárias relacionadas com o cuidado de crianças e adolescentes que ocorrem nas províncias de Neuquén e Río Negro (Patagônia Argentina). Esta análise é resultado de uma pesquisa qualitativa realizada na perspectiva da Psicologia Social Crítica e das Políticas Públicas, na qual buscamos resgatar o conhecimento social de que essas iniciativas comunitárias podem contribuir para o desenho e reformulação das políticas públicas de atenção. Especificamente, as experiências que aqui apresentamos são: a Associação Civil GAIA-Nueva Crianza, formada por famílias de crianças e adolescentes trans; e a Associação Civil Lazos Azules, formada por famílias de crianças e adolescentes com TEA (Transtorno do Espectro do Autismo). Embora as duas associações sejam muito diferentes entre si, ambas coincidem no fato de serem lideradas por famílias que, depois de ouvir e atentar para as necessidades dos filhos, se organizam coletivamente para tornar visível a realidade dos filhos. a / es e adolescentes gerando diferentes ações. Essas ações tendem não só a efetivar os direitos da criança e do adolescente, especialmente aqueles vinculados à identidade, educação e saúde, mas visam influenciar as políticas públicas de atenção em nível local a partir do que Boaventura de Sousa Santos denomina a sociologia das emergências e do que Rita Segato designa como feminilidade anfíbia chave de politicidade.

ABSTRACT In this article, written in the context of the 2020-2021 pandemic and in compliance with the Preventive and Compulsory Social Isolation (ASPO), we analyze two community experiences related to the care of children and adolescents that take place in the provinces of Neuquén and Río Negro (Argentinian Patagonia). This analysis is the result of a qualitative study carried out from the perspective of Critical Social Psychology and Public Policy, in which we seek to recover the social knowledge that these community initiatives can contribute to the design and reformulation of public care policies. Specifically, the experiences we present here are the GAIA-Nueva Crianza Civil Association, made up of families of trans children and adolescents; and the Lazos Azules civil association, made up of families of children and adolescents with ASD (autism spectrum disorder). Although the two associations are very different from each other, they both coincide in being led by families who, after having listened and paid attention to the needs of their children, they organized collectively to make visible the reality of their children and adolescents by generating different actions. These actions tend not only to make effective the rights of children and adolescents, especially those linked to identity, education and health, but are also aimed at influencing public care policies at the local level, from what Boaventura de Sousa Santos calls the sociology of emergencies and from what Rita Segato designates amphibious feminine key politicity.

Autonomia política como prática de cuidado: a gramática da educação zapatista / La autonomía política como práctica del cuidado: la gramática de la educación zapatista / Political autonomy as a practice of care: the grammar of zapatista education

RESUMO. Este artigo tem como objetivo discutir, com bases em diferentes registros, a gramática presente na discursividade de informes oficiais do Movimento Zapatista, no que tange especificamente à educação zapatista, em especial desde a noção de autonomia como modo de organizar esta dimensão da vida em sociedade, entendendo a autonomia como resistência à tutela do Estado na gestão da escola e, micropoliticamente, a ruptura da tutela do processo educativo pelo promotor de educação. Observamos, a partir do estudo das Declarações da Selva Lancadona e da Escuelita Zapatista, que estas fundam-se numa crítica aos modelos estatais de governo da educação, refutando a perspectiva intercultural, defendendo a pluridiversidade. Este modo de compreender o processo educativo, e o modo de praticar o cuidado nos leva a uma compreensão mais ampla para a psicologia, refletindo sobre possibilidades de conexão entre novas invenções psi no trabalho junto à infância e à psicologia da educação.

RESUMÉN Este artículo tiene como objetivo discutir, a partir de diferentes registros, la gramática presente en el discurso de los informes oficiales del Movimiento Zapatista, con respecto específicamente a la educación zapatista, especialmente desde la noción de autonomía como una forma de organizar esta dimensión de la vida en sociedad, entendiendo la autonomía como resistencia a la tutela del Estado en la gestión de la escuela y, micropolíticamente, la ruptura de la tutela del proceso educativo por parte del promotor de la educación. Observamos, a partir del estudio de las Declaraciones de la Selva Lancadona y Escuelita Zapatista, que estos se basan en una crítica a los modelos estatales de gobierno en educación, refutando la perspectiva intercultural, defendiendo la pluridiversidad. Esta forma de entender el proceso educativo, y la forma de practicar el cuidado, nos lleva a una comprensión más amplia de la psicología, reflexionando sobre las posibilidades de conexión entre los nuevos inventos psi en el trabajo con los niños y la psicología de la educación.

ABSTRACT. This article aims to discuss, based on different records, the grammar present in the discourse of Zapatista Movement official reports, specifically regarding the Zapatista education, especially from the idea of autonomy as a way of organizing this dimension of life in society, understanding this autonomy as resistance to State tutelage in the management of schools, as well as the rupture of the educational process tutelage by the promoters of education in micropolitical terms. We observed, based on the study of the Statements of the Selva Lancadona and Escuelita Zapatista, that these are centered on a criticism of state models of government in education, refuting the intercultural perspective, defending pluridiversity. This way of understanding the educational process, and the way of practicing care, leads us to a broader understanding of psychology, reflecting on possibilities of connection between new psychology inventions at work with children and the psychology of education.

COVID-19 and Parent-Child Psychological Well-being.

BACKGROUND AND OBJECTIVES: The outbreak of coronavirus disease 2019 has changed American society in ways that are difficult to capture in a timely manner. With this study, we take advantage of daily survey data collected before and after the crisis started to investigate the hypothesis that the crisis has worsened parents' and children's psychological well-being. We also examine the extent of crisis-related hardships and evaluate the hypothesis that the accumulation of hardships will be associated with parent and child psychological well-being. METHODS: Daily survey data were collected between February 20 and April 27, 2020, from hourly service workers with a young child (aged 2-7) in a large US city (N = 8222 person-days from 645 individuals). A subsample completed a one-time survey about the effects of the crisis fielded between March 23 and April 26 (subsample n = 561). RESULTS: Ordered probit models revealed that the frequency of parent-reported daily negative mood increased significantly since the start of the crisis. Many families have experienced hardships during the crisis, including job loss, income loss, caregiving burden, and illness. Both parents' and children's well-being in the postcrisis period was strongly associated with the number of crisis-related hardships that the family experienced. CONCLUSIONS: Consistent with our hypotheses, in families that have experienced multiple hardships related to the coronavirus disease 2019 crisis, both parents' and children's mental health is worse. As the crisis continues to unfold, pediatricians should screen for mental health, with particular attention to children whose families are especially vulnerable to economic and disease aspects of the crisis.

Well-being of Parents and Children During the COVID-19 Pandemic: A National Survey.

BACKGROUND: As the coronavirus disease pandemic spread across the United States and protective measures to mitigate its impact were enacted, parents and children experienced widespread disruptions in daily life. Our objective with this national survey was to determine how the pandemic and mitigation efforts affected the physical and emotional well-being of parents and children in the United States through early June 2020. METHODS: In June 2020, we conducted a national survey of parents with children age <18 to measure changes in health status, insurance status, food security, use of public food assistance resources, child care, and use of health care services since the pandemic began. RESULTS: Since March 2020, 27% of parents reported worsening mental health for themselves, and 14% reported worsening behavioral health for their children. The proportion of families with moderate or severe food insecurity increased from 6% before March 2020 to 8% after, employer-sponsored insurance coverage of children decreased from 63% to 60%, and 24% of parents reported a loss of regular child care. Worsening mental health for parents occurred alongside worsening behavioral health for children in nearly 1 in 10 families, among whom 48% reported loss of regular child care, 16% reported change in insurance status, and 11% reported worsening food security. CONCLUSIONS: The coronavirus disease pandemic has had a substantial tandem impact on parents and children in the United States. As policy makers consider additional measures to mitigate the health and economic effects of the pandemic, they should consider the unique needs of families with children.

[Study on occupational stress response of orphans and disabled children care workers in Nanjing].

Objective: To explore the status quo of occupational stress and its influencing factors of nursing staff for orphaned and disabled children in Nanjing, and to put forward measures for adverse reactions to occupational stress, so as to ensure the psychological health of this occupational population. Methods: From February to May 2017, 236 nursing assistants for orphans and disabled children in Nanjing social welfare home were selected by cluster sampling method. The occupational stress index(occupational stress indictor, OSI) was used to investigate occupational stress response and occupational stress factors. Partial correlation and multiple linear regression were used for statistical analysis. Results: The scores of job satisfaction, mental health and depressive symptoms in occupational stress reaction were (43. 99±6. 83) , (36. 09±4. 59) and (17. 31±2. 44) re- spectively. In terms of job satisfaction, work monotony, logic and compound change were the contributing fac- tors (P<0. 05) , task strategy and task control were negative factors (P<0. 05) ; on mental health, opportunities were raised and participation in decision-making Self-esteem, technology utilization, environmental control, time management, task strategy and support of colleagues as contributing factors (P<0. 05) , ambition and role conflicts as negative factors (P<0. 05) ; on depression, work input, participation Decision-making, promotion opportunities and behavioral characteristics were protective factors (P<0. 05 ) . Conclusion: Occupational stress among caregivers of orphans and disabled children cannot be ignored. Occupational stress reaction is serious. Occupational stress factors should be reduced and individual stress coping ability should be enhanced.

Prevalence and predictors of expulsion in home-based child care settings.

This study explored the prevalence of expulsion in home-based child care (HBCC) settings using a nationally representative sample of HBCC providers from the National Survey of Early Care and Education. In addition to prevalence, enrollment and provider characteristics that predicted expulsion were examined. Although there is increasing awareness of the prevalence of early childhood suspension and expulsion in early care and education settings and the negative effects it has on children's development, few studies have included or focused on HBCC, where many children receive care. This study highlights that many home-based providers, especially listed providers, report that they expelled at least one child within the last year. Significant predictors of expulsion emerged, including enrollment characteristics such as caring for children with disabilities, enrolling more children, and caring for children unrelated to the provider. Provider characteristics, including years of experience, provider education, and provider age, also predicted provider report of expulsion. These results provide insight as to possible strategies that may be effective in reducing expulsion rates in this caregiving context.

Este estudio exploró la prevalencia de expulsión en escenarios de cuidado infantil con base en el hogar usando una muestra nacionalmente representativa de proveedores de cuidado infantil con base en el hogar de la Encuesta Nacional de Cuidado y Educación Temprana. Además de la prevalencia, se examinaron el número de inscripciones y las características del proveedor que predecían la expulsión. A pesar de que aumenta el conocimiento acerca de la prevalencia de la suspensión y expulsión en la temprana niñez en escenarios de cuidado y educación temprana y de los efectos negativos que la misma tiene en el desarrollo de los niños, pocos estudios han incluido o se han enfocado en el cuidado infantil con base en el hogar, donde muchos niños reciben el cuidado. Este estudio subraya el hecho de que muchos proveedores con base en el hogar, especialmente proveedores que son parte de una lista, reportan que ellos expulsaron por lo menos un niño dentro del último año. Surgieron significativos factores de predicción de la expulsión, incluyendo características de la inscripción tales como el cuidar a niños con discapacidades, el inscribir a más niños y el cuidar a niños que no están relacionados con el proveedor. Las características del proveedor, incluyendo los años de experiencia, la educación del proveedor y la edad del proveedor, también predijeron el reporte del proveedor sobre la expulsión. Estos resultados aportan una percepción en cuanto a las posibles estrategias que pudieran ser efectivas para reducir el porcentaje de expulsión en este contexto de prestación de cuidado.

Cette étude a exploré la prévalence de l'expulsion dans les contextes de crèches à domicile / familiales en utilisant une échantillon représentatif de l'Inventaire national américain des crèches et des institutions éducatives appelé National Survey of Early Care and Education. En plus de la prévalence, l'admission et les caractéristiques de l'assistante maternelle prédisant l'expulsion ont été examinées. Bien qu'il y ait une prise de conscience de la prévalence de la suspension et de l'expulsion de la petite enfance dans les contextes de modes de garde de l'enfant ainsi que des effets négatifs que celles-ci peuvent avoir sur le développement de l'enfant, peu d'études ont porté sur les soins en crèches familiales, où beaucoup d'enfants sont accueillis. Cette étude met en évidence le fait que bien des crèches familiales, et surtout celles qui apparaissent sur les listes de crèches, signalent avoir renvoyé au moins un enfant en une année. Des facteurs de prédiction importants ont émergé, y compris les caractéristiques de l'inscription et de l'admission comme le fait de prendre soin d'enfants handicapés, le fait d'accepter plus d'enfants, et le fait de prendre soin de plus d'enfants sans lien avec la crèche. Les compte rendus d'expulsion montrent que les caractéristiques de l'assistante maternelle, y compris les années d'expérience, l'éducation, et l'âge étaient également des facteurs de prédiction d'expulsion. Ces résultats donnent une idée de stratégies possibles qui peuvent s'avérer efficaces pour la réduction des taux d'expulsion dans ce contexte de mode de soin.

The implications of childcare on grandparents' health self-management in a Chinese elderly population.

Grandparents caring for grandchildren has become a common experience in China. However, the health implications of grandparenting, especially for health self-management, remain unclear. A cross-sectional study was conducted to investigate the effects of grandparenting on health self-management in older adults in China. Information on socioeconomic characteristics, grandparenting, and health self-management was collected through interviewer-administered questionnaires. Age less than 50, male gender, higher education level, being a local resident, having a chronic illness, and supporting themselves financially were all factors that were significantly positively associated with health self-management (P < .05) in grandparents. Grandparenting characteristics, including caring for grandchildren at night, a caregiving burden of more than 50%, poorly behaved grandchildren, caring for grandchildren more than 6 hours per day, and caring for grandchildren less than 1 year in age were significantly negatively associated with health self-management in grandparents (P < .05). Multiple regression analyses indicated that grandparent age, receiving financial support from children, being a local resident, education level, grandchild behavior and age, and being an urban resident were all statistically significant factors associated with health self-management in grandparents involved in grandparenting. Taken together, these results suggested that financial condition and caregiving burden might be the major factors affecting health self-management in grandparents involved in grandparenting.

Center-based childcare expansion and grandparents' employment and well-being.

Grandparents, especially grandmothers, are highly involved in childcare globally. There is a rising interest in studying the relationship between providing care and grandmothers' economic well-being in social science and health literature. However, little is known about how grandmothers' behavior responds to a government's family policy. This paper examines the effects of a large government-led formal childcare expansion on the well-being of working-age grandparents living with their adult children in China. We exploit the variation in program intensity across provinces and years and find that a higher coverage rate of center-based childcare increases the employment of grandmothers. By contrast, grandfathers' employment is not responsive. Further investigation reveals that the effect is stronger among the women who were richer, more educated, lived in urban areas, and paternal grandmothers. We find that the childcare expansion decreases grandmothers' chance of having chronic disease and depression.

Productive aging of Korean older people based on time use.

This study differentiated the diversified aspects of older adulthood in terms of productive activities and examined which attributes of the elderly shaped these dissimilarities of productive aging. This research shed light on the multi-dimensional nature of the productive activities of the Korean elderly, using the 2014 Time Use Survey produced by Statistics Korea. This study selected 3766 older adults aged 65 and older who resided in city areas. The results revealed that the time used for productive activities for older adults were different based on objective factors. These differences were clear enough to be classified into distinctive clusters. When analyzed in terms of the amount of time spent, gender of the elderly turned out to be the most discriminating factor. As for the dimension of labor, gender division of labor still existed during older adulthood in that older men were more active in doing paid work, whereas care of family was assigned as women's responsibility. Furthermore, most of the elderly did not participate in productive activities, and this possibility rose as one's age increased.

Caring for the elderly at work and home: Can a randomized organizational intervention improve psychological health?

Although job stress models suggest that changing the work social environment to increase job resources improves psychological health, many intervention studies have weak designs and overlook influences of family caregiving demands. We tested the effects of an organizational intervention designed to increase supervisor social support for work and nonwork roles, and job control in a results-oriented work environment on the stress and psychological distress of health care employees who care for the elderly, while simultaneously considering their own family caregiving responsibilities. Using a group-randomized organizational field trial with an intent-to-treat design, 420 caregivers in 15 intervention extended-care nursing facilities were compared with 511 caregivers in 15 control facilities at 4 measurement times: preintervention and 6, 12, and 18 months. There were no main intervention effects showing improvements in stress and psychological distress when comparing intervention with control sites. Moderation analyses indicate that the intervention was more effective in reducing stress and psychological distress for caregivers who were also caring for other family members off the job (those with elders and those "sandwiched" with both child and elder caregiving responsibilities) compared with employees without caregiving demands. These findings extend previous studies by showing that the effect of organizational interventions designed to increase job resources to improve psychological health varies according to differences in nonwork caregiving demands. This research suggests that caregivers, especially those with "double-duty" elder caregiving at home and work and "triple-duty" responsibilities, including child care, may benefit from interventions designed to increase work-nonwork social support and job control. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Physical and mental health of Chinese grandparents caring for grandchildren and great-grandparents.

The increasing worldwide prevalence and intensity of grandparenting has attracted an attention to its health implications for caregivers against the backdrop of population aging. Thanks to prolonged life expectancy and reduced infant mortality, extended families that comprise four generations, co-residential or not, are no longer rare in China. The current study examines health consequences when Chinese grandparents provide care to not only grandchildren but also their own elderly parents or parents-in-law (i.e., great-grandparents). Drawing on data from the 2011-2013 China Health and Retirement Longitudinal Study (CHARLS), mental health was captured by levels of life satisfaction and depressive symptoms, and physical health was measured by levels of high sensitivity C-reactive protein (CRP), hypertension, high-risk pulse rate, and diabetes. Overall grandparents who cared for grandchildren only had better mental and physical health, compared with non-caregivers. There was some evidence that the 'sandwich' grandparents who cared for both grandchildren and great-grandparents reported greater life satisfaction, fewer depressive symptoms, and reduced hypertension compared with non-caregivers. The health advantage of caregiving was most pronounced in urban grandfathers whose caregiving conformed to the norm of filial piety and who did so most likely to seek emotional reward instead of an intergenerational time-for-money exchange. In contrast, rural grandmothers were the most vulnerable group and their health disadvantage seemed to arise from caring for great-grandparents. These findings highlight the importance of rural-urban context and gender role in studying the health effects of intergenerational caregiving on Chinese grandparents.

Productive aging in India.

With its sociocultural, institutional, and demographic contexts, India offers a unique opportunity to study the dynamics and experiences of aging, especially as it is poised to have a large increase in the number of persons aged 60 and above in the next half a century. In this paper, we focus on the concept of productive aging that emphasizes the active participation of older persons in society. We examine the correlates of productive aging in India, drawing on data from the Building Knowledge Base on Population Aging (BKPAI) survey of 9852 men and women aged 60 years and above in seven states of India in 2011. The productive activities that we examine pertain to four domains: work, contribution to household financial matters, grandparenting, and social engagement. The findings highlight the importance of gender, family structure, and socio-economic status in these different aspects of productive aging. Importantly, the findings show that the effect of the correlates is not the same across the different measures of productive aging. We find that women are less likely than men to engage in all productive activities except for grandparenting, and that living with children and adverse health reduce the likelihood of current employment or financial contributions, but not of social engagement or grandparenting. Greater wealth at older ages reduces the likelihood of employment but increases the likelihood of social engagement and ties. The study contributes to the understanding of opportunities and constraints of productive aging in India and has implications for intergenerational relationships, support and dependencies in old age.

Mixed blessings: A qualitative exploration of mothers' experience of child care and feeding in the rapidly urbanizing city of Addis Ababa, Ethiopia.

Many studies have drawn attention to the vital role mothers have in safeguarding the health and nutritional wellbeing of their children. However, little is known about mothers' experiences and the challenges they face in fulfilling this role in rapidly urbanizing cities in Africa. This study aims to explore child care and feeding practices of mothers with children under five years of age in Addis Ababa, Ethiopia. This qualitative study was conducted using a semi-structured interview guide. A total of thirty-six interviews were conducted with purposively selected participants. All interviews were audio recorded, transcribed verbatim and translated for analysis. We used a thematic analysis approach, which was guided by a resilience framework. The findings are presented as three major themes. 1) 'Mixed blessings-balancing motherhood's expectations'. While mothers identified positively with the social recognition and sense of fulfillment of being a 'good mother', they were ambivalent/torn about earning the necessary income from outside work and fulfilling their duties at home. 2) 'Instabilities due to rampant urban sprawl'. While women expressed a keen desire to balance work and motherhood, the disintegrating social capital, due to large in-migration, market fluctuations and abrupt/forced resettlements to new housing units had left mothers without support for childcare, stressed and exhausted. 3) 'Anchored by faith: a source of resilience to cope with adversities'. In the face of the multiple adversities, mothers cited their strong faith as their most reliable foundation for their resilience. In summary, the societal and environmental changes accompanying the rapid urbanization in low income settings makes combining child care and working outside the home very challenging for mothers. As a result they suffer from fatigue and feelings of isolation. Efforts to improve child feeding and care in urban low-income settings need to consider context appropriate strategies that support mothers with small children.

Development, Psychometric Assessment, and Predictive Validity of the Postpartum Childcare Stress Checklist.

BACKGROUND: Childcare stress has been shown to predict postpartum depression; however, there is little research exploring and validating the dimensions of childcare stress instruments such that preventive interventions can be created. OBJECTIVES: The aim of this study was to develop and psychometrically test an instrument to measure parental perceptions of postpartum childcare stress. METHODS: Using research based on postpartum stress and childcare stress, the Postpartum Childcare Stress Checklist (PCSC) was developed, and content validity was judged by experts. The PCSC was psychometrically assessed in a cohort of 541 women in a health region near Vancouver, Canada, who were followed to 8 weeks postpartum in 2002. The psychometric assessment analyses comprised internal consistency, exploratory factory analysis, concurrent validity, and predictive validity. RESULTS: The 19-item PCSC had good internal consistency (Kuder-Richardson Formula 20 coefficient: 0.81). Exploratory factor analysis revealed the following dimensions: (a) relationship with the partner, (b) caring for the infant, (c) maternal social interactions, and (d) establishing a new routine. Predictive validity analyses showed that PCSC total and subscale scores at 4 weeks were positively correlated with depressive symptomatology, anxiety, and perceived stress and negatively correlated with global and partner support at 8 weeks postpartum. DISCUSSION: The PCSC is a measure of childcare stress with excellent reliability and validity. Upon further testing, it may be used to identify women and couples in need of greater support, individualize postpartum care, and evaluate the effectiveness of preventive interventions.

Adult psychosocial outcomes of men and women who were looked-after or adopted as children: prospective observational study.

OBJECTIVE: To investigate whether men and women who were looked-after (in public care) or adopted as children are at increased risk of adverse psychological and social outcomes in adulthood. DESIGN, SETTING: Prospective observational study using the Avon Longitudinal Study of Parents and Children, which recruited pregnant women and their male partners in and around Bristol, UK in the early 1990s. PARTICIPANTS: 8775 women and 3654 men who completed questionnaires at recruitment (mean age: women 29; men 32) and 5 years later. EXPOSURE: Childhood public care status: looked-after; adopted; not looked-after or adopted (reference group). OUTCOMES: Substance use (alcohol, cannabis, tobacco) prepregnancy and 5 years later; if ever had addiction; anxiety and depression during pregnancy and 5 years later; if ever had mental health problem; social support during pregnancy; criminal conviction. RESULTS: For women, 2.7% were adopted and 1.8% had been looked-after; for men, 2.4% and 1.4%, respectively. The looked-after group reported the poorest outcomes overall, but this was not a universal pattern, and there were gender differences. Smoking rates were high for both the looked-after (men 47%, women 58%) and adopted (men 44%, women 40%) groups relative to the reference group (both 28%). The looked-after group were at increased risk of a high depression score (men: 26% vs 11%, OR 2.9 (95% CI 1.5 to 5.6); women: 24% vs 9%, 3.4 (2.2 to 5.0)). A high anxiety score was reported by 10% of the reference women, compared with 26% of those looked-after (3.0 (2.0 to 4.5)) and 17% of those adopted (1.8 (1.2 to 2.6)). Looked-after men and women reported the lowest social support, while criminal convictions and addiction were highest for looked-after men. Adjustment for adult socioeconomic position generally attenuated associations for the looked-after group. CONCLUSIONS: The needs of those who experience public care as children persist into adulthood. Health and social care providers should recognise this.

Qualitative Evaluation of Individual and Group Well-Child Care.

OBJECTIVE: Individual well care (IWC) is the standard delivery model for well-child care in the United States. Alternative models, such as group well care (GWC), may create opportunities to enhance care for babies. The purpose of this study was to evaluate parents' perceptions of social/wellness benefits and system challenges of IWC and GWC. METHODS: Since 2014, we have provided both IWC and GWC at an urban academic practice serving a low-income minority community. We conducted a mixed method study involving surveys and 18 focus groups (11 IWC groups, n = 32 parents; 7 GWC groups, n = 33 parents). Parents completed surveys before convening focus group discussions. Survey results were analyzed using independent t tests; focus groups were digitally recorded, transcribed, and analyzed to identify themes. RESULTS: Both groups had similar demographics: parents were mostly female (91%) and black (>80%); about half had incomes < $20,000. Parents' mean age was 27 years; children's mean age was 11 months. There were no significant differences in overall scores measuring trust in physicians, parent empowerment, or stress. IWC parents' themes highlighted ways to improve care delivery, while GWC parents highlighted both satisfaction with care delivery and social/wellness benefits. GWC parents strongly endorsed this model and reported unique benefits, such as garnering social support and learning from other parents. CONCLUSIONS: Parents receiving both models of care identified ways to improve primary care delivery. Given some of the benefits reported by GWC parents, this model may provide the means to enhance resilience in parents and children in low-income communities.