Early Childhood Care in the Former East Germany and Mental Stress in Adulthood.

BACKGROUND: It is still debated in Germany whether early childhood care outside the family might cause mental stress in adulthood. In the German Democratic Republic (GDR-the former East Germany before unification), children were often cared for outside the family from a very early age. METHODS: To determine the relation between early childhood care outside the family and mental stress in adulthood, we carried out a survey among 1575 persons who were born and socialized in the GDR. They were classified into four care groups according to the age at which they were first cared for outside the family. Associations with depressiveness, somatization disorders, and anxiety disorders in adulthood were tested with logistic regression analysis. Care group-specific prevalences of experiences of abuse and neglect in childhood were estimated with analysis of variance. RESULTS: Comparisons of persons cared for outside the family before the age of three, or from the age of three onward, with persons cared for within the family in their preschool years did not reveal any difference with respect to depressiveness (odds ratio [OR] = 0.95; 95% confidence interval [0.58; 1.55]; OR = 1.05 [0.63; 1.74]), somatization disorders (OR = 1.11 [0.74; 1.67]; OR = 1.09 [0.71; 1.66]), or anxiety disorders (OR = 0.87 [0.46; 1.64]; OR = 1.12 [0.59; 2.10]). Nor were there any intergroup differences with respect to experiences of abuse and neglect. Certain features of the very small group of children who had long-term care outside the family are discussed in the article. CONCLUSION: No relation was found between earlychildhood care in day-care centers in the GDR and mental stress in adulthood. The data were too sparse for any conclusions about specific aspects of care outside the home (e.g., quality or child-rearing norms).

Continuity and changes in grandchild care and the risk of depression for Chinese grandparents: new evidence from CHARLS.

Objectives: Although studies have researched the mental effects of intergenerational care, little is known about the impact of transformations in caregiving intensity on depression. This study explores grand-parents' depressive symptom outcomes in terms of changes over time in grandparental childcare, with considerations for subgroup differences. Method: Using data from the 2015-2018 China Health and Retirement Longitudinal Study on grandparents aged 45 and older, we adopted generalized estimating equations to estimate the effects of seven category changes [(1) continued to provide high-intensity or (2) low-intensity care at both waves; (3) never provided care; (4) started caregiving; (5) ended caregiving; (6) provided less intensive care; and (7) provided more intensive care] over time in grandparental childcare on depressive symptoms among 17,701 grandparents with at least one grandchild, as well as how the impact varies by gender and urban/rural areas. Results: Grandparents who decreased the intensity of care, stopped childcare, or offered continuous low-intensity care were associated with a lower level of depression compared with those providing no childcare. In addition, the benefit of continuous caregiving on mental health was especially noticeable in urban grandmothers. Conclusion: Providing continuous low-intensity, decreased-intensity grandparenting and the cessation of caregiving were associated with a decreased level of depression for Chinese grandparents; however, there were complex interactions at play. Policies aimed at supporting grandparenting should consider caregiving intensity transitions relevant to gender and urban/rural residence.

Impacts of the COVID-19 pandemic on the mother owl program of the VII health region of Pernambuco / Impactos da pandemia da COVID-19 no programa mãe coruja da VII região de saúde de Pernambuco

Resumo Objectives: to analyze the impacts caused by the COVID-19 pandemic on the Mother Owl Program of the VII Health Region of Pernambuco. Methods: descriptive, cross-sectional and quantitative study, carried out at the VII Regional Health Management, in Salgueiro-PE. Data were collected from the Mother Owl Information System, from August to November 2021, being related to women and children registered from 2019 to March 2021. Adopting a time frame for before and during the pandemic, the Student's t and chi-square tests in the analysis of continuous and categorical variables, respectively. Results: data from 581 women and 412 children were analyzed. Before the pandemic, there was a higher average number of prenatal consultations (p<0.001) and greater completeness in the children's race data (p<0.001). During the pandemic, there was a lower frequency of breastfeeding in the first hour of life (p<0.001) and of filling in the data regarding maternal education (p<0.001). In addition, no more than 7 childcare consultations were performed (p<0.001). Conclusions: the assistance of women and children was impacted, mainly with the drop in prenatal and childcare consultations, showing that COVID-19 had a negative impact on the health of people monitored by the Program and on the quality of information inserted in the system.

Resumo Objetivos: analisar os impactos causados pela pandemia da COVID-19 no Programa Mãe Coruja da VII Região de Saúde de Pernambuco. Métodos: estudo descritivo, transversal e quantitativo, realizado na VII Gerência Regional de Saúde, em Salgueiro-PE. Os dados foram coletados do Sistema de Informação Mãe Coruja, no período de agosto a novembro de 2021, sendo relacionados às mulheres e crianças cadastradas de 2019 a março de 2021. Adotando-se um marco temporal para antes e durante a pandemia, foram utilizados os testes t de Student e qui-quadrado nas análises das variáveis contínuas e categóricas, respectivamente. Resultados: foram analisados os dados de 581 mulheres e 412 crianças. Antes da pandemia constatou-se maior média de consultas de pré-natal (p<0,001) e maior completude nos dados de raça das crianças (p<0,001). Durante a pandemia ocorreu menor frequência da amamentação na primeira hora de vida (p<0,001) e do preenchimento dos dados referentes à escolaridade materna (p<0,001). Assim como, não foram realizadas mais que sete consultas de puericultura (p<0,001). Conclusões: a assistência das mulheres e crianças foi impactada, principalmente com a queda de consultas do pré-natal e da puericultura, evidenciando que a COVID-19 repercutiu negativamente na saúde das pessoas acompanhadas pelo Programa e na qualidade das informações inseridas no sistema.

Percursos de cuidado na atenção à saúde mental de crianças / Paths of care in children's mental health care / Caminos de cuidado en la atención mental de los niños

Os Centros de Atenção Psicossocial para a Infância e Adolescência (CAPSi) são locais que ofertam serviços na atenção secundária, sob a perspectiva da reforma psiquiátrica e seguindo as diretrizes do Sistema Único de Saúde (SUS). O presente trabalho apresenta os resultados de uma pesquisa qualitativa, desenvolvida a partir de um estudo de casos múltiplos, cujo objetivo foi compreender como se estabelece o percurso do cuidado na saúde mental da criança em contexto da atenção secundária. A coleta de dados ocorreu a partir de análise documental e entrevista semiestruturada, e as informações obtidas passaram por análise de conteúdo. Foram identificadas dificuldades na comunicação e no compartilhamento dos casos entre os diferentes níveis de atenção e na construção de um Plano Terapêutico Singular (PTS). Com relação ao desligamento das crianças, observou-se mais encaminhamentos e desistências que processos de alta, resultado que necessita problematização tendo-se em vista a possibilidade de cronificação dos casos. (AU)

Psychosocial Care Centers for Children and Adolescents offer services in secondary health care, under the perspective of psychiatric reform and by following Brazil's Unified Health System guidelines. This paper presents the results of a qualitative research that was developed through a multiple case study, in order to understand how the path is established in the context of secondary health care for children. Data were collected through documental analysis and semi-structured interview, then the informationwere processed by content analysis. There were identified difficulties in communication, in the process of sharing cases between different levels of health care as well as in the development of Singular Therapeutic Project. Regarding the disengagement of children from the service, there were more referrals and wavers than discharge processes, which needs to be problematized given the risk of chronification of the cases. (AU)

Los Centros de Atención Psicosocial para Niños y Adolescentes son lugares que ofrecen servicios de atención secundaria en salud, desde la perspectiva de la reforma psiquiátrica y siguiendo las pautas del Sistema Único de Salud en Brasil. El presente trabajo presenta los resultados de una investigación cualitativa, desarrollada a partir de un estudio de casos multiples, con el objetivo de comprender cómo se establece el camino de la atención en la salud mental del niños en este contexto de atención secundaria. La recopilación de datos se basó en análisis de documentos y entrevistas semiestructuradas, y la información obtenida pasó por un análisis de contenido. Se identificaron dificultades en la comunicación y el intercambio de casos entre los niveles de atención y la construcción de un Proyecto Terapéutico Singular. Con respecto a desvinculación de los niños, hubo más encaminamientos y abandonos que procesos de alta, un resultado que debe ser problematizado en vista de la posibilidad de cronificación de los casos en el servicio de salud mental. (AU)

Association of Child Masking With COVID-19-Related Closures in US Childcare Programs.

Importance: It is not known how effective child masking is in childcare settings in preventing the transmission of SARS-CoV-2. This question is critical to inform health policy and safe childcare practices. Objective: To assess the association between masking children 2 years and older and subsequent childcare closure because of COVID-19. Design, Setting, and Participants: A prospective, 1-year, longitudinal electronic survey study of 6654 childcare professionals at home- and center-based childcare programs in all 50 states was conducted at baseline (May 22 to June 8, 2020) and follow-up (May 26 to June 23, 2021). Using a generalized linear model (log-binomial model) with robust SEs, this study evaluated the association between childcare program closure because of a confirmed or suspected COVID-19 case in either children or staff during the study period and child masking in both early adoption (endorsed at baseline) and continued masking (endorsed at baseline and follow-up), while controlling for physical distancing, other risk mitigation strategies, and program and community characteristics. Exposures: Child masking in childcare programs as reported by childcare professionals at baseline and both baseline and follow-up. Main Outcomes and Measures: Childcare program closure because of a suspected or confirmed COVID-19 case in either children or staff as reported in the May 26 to June 23, 2021, end survey. Results: This survey study of 6654 childcare professionals (mean [SD] age, 46.9 [11.3] years; 750 [11.3%] were African American, 57 [0.9%] American Indian/Alaska Native, 158 [2.4%] Asian, 860 [12.9%] Hispanic, 135 [2.0%] multiracial [anyone who selected >1 race on the survey], 18 [0.3%] Native Hawaiian/Pacific Islander, and 5020 [75.4%] White) found that early adoption (baseline) of child masking was associated with a 13% lower risk of childcare program closure because of a COVID-19 case (adjusted relative risk, 0.87; 95% CI, 0.77-0.99), and continued masking for 1 year was associated with a 14% lower risk (adjusted relative risk, 0.86; 95% CI, 0.74-1.00). Conclusions and Relevance: This survey study of childcare professionals suggests that masking young children is associated with fewer childcare program closures, enabling in-person education. This finding has important public health policy implications for families that rely on childcare to sustain employment.

Associations between postpartum depression and assistance with household tasks and childcare during the COVID-19 pandemic: evidence from American mothers.

BACKGROUND: The early postpartum period is recognized cross-culturally as being important for recovery, with new parents receiving increased levels of community support. However, COVID-19-related lockdown measures may have disrupted these support systems, with possible implications for mental health. Here, we use a cross-sectional analysis among individuals who gave birth at different stages of the pandemic to test (i) if instrumental support access in the form of help with household tasks, newborn care, and care for older children has varied temporally across the pandemic, and (ii) whether access to these forms of instrumental support is associated with lower postpartum depression scores. METHODS: This study used data from the COVID-19 And Reproductive Effects (CARE) study, an online survey of pregnant persons in the United States. Participants completed postnatal surveys between April 30 - November 18, 2020 (n = 971). Logistic regression analysis tested whether birth timing during the pandemic was associated with odds of reported sustained instrumental support. Linear regression analyses assessed whether instrumental support was associated with lower depression scores as measured via the Edinburgh Postnatal Depression survey. RESULTS: Participants who gave birth later in the pandemic were more likely to report that the pandemic had not affected the help they received with household work and newborn care (p < 0.001), while access to childcare for older children appeared to vary non-linearly throughout the pandemic. Additionally, respondents who reported that the pandemic had not impacted their childcare access or help received around the house displayed significantly lower depression scores compared to participants who reported pandemic-related disruptions to these support types (p < 0.05). CONCLUSIONS: The maintenance of postpartum instrumental support during the pandemic appears to be associated with better maternal mental health. Healthcare providers should therefore consider disrupted support systems as a risk factor for postpartum depression and ask patients how the pandemic has affected support access. Policymakers seeking to improve parental wellbeing should design strategies that reduce disease transmission, while facilitating safe interactions within immediate social networks (e.g., through investment in COVID-19 testing and contact tracing). Cumulatively, postpartum instrumental support represents a potential tool to protect against depression, both during and after the COVID-19 pandemic.

Which representations of their gender group affect men's orientation towards care? the case of parental leave-taking intentions.

Men are currently underrepresented in traditionally female care-oriented (communal) engagement such as taking parental leave, whereas they are overrepresented in traditionally male (agentic) engagement such as breadwinning or leadership. We examined to what extent different prototypical representations of men affect men's self-reported parental leave-taking intentions and more generally the future they can imagine for themselves with regard to work and care roles (i.e., their possible selves). We expected prototypes of men that combine the two basic stereotype dimensions of agency and communion to increase men's communal intentions. In two experiments (N1 = 132, N2 = 233), we presented male participants with contrived newspaper articles that described the ideal man of today with varying degrees of agency and communion (between-subjects design with four conditions; combined agentic and communal vs. agentic vs. communal vs. control condition). Results of Experiment 1 were in line with the main hypothesis that especially presenting a combination of agency and communion increases men's expectations for communal engagement: As compared to a control condition, men expected more to engage in caretaking in the future, reported higher parental leave-taking intentions, and tended to expect taking longer parental leave. Experiment 2 only partially replicated these findings, namely for parental leave-taking intentions. Both experiments additionally provided initial evidence for a contrast effect in that an exclusive focus on agency also increased men's self-reported parental leave-taking intentions compared to the control condition. Yet, exclusively emphasizing communion in prototypes of men did not affect men's communal intentions, which were high to begin with. We further did not find evidence for preregistered mechanisms. We discuss conditions and explanations for the emergence of these mixed effects as well as implications for the communication of gendered norms and barriers to men's communal engagement more broadly.

Selected predictors of parental satisfaction with child nursing care in paediatric wards in Poland-Cross-sectional study.

BACKGROUND: Assessment of parental satisfaction with child nursing is the key issue in evaluation of the care quality, enabling the adjustment of the services provided to the needs and expectations of recipients, and thus ensuring safety and achieving better long-term health effects. AIM: Assessment of parental satisfaction with child nursing in paediatric wards including its determinants. MATERIAL AND METHODS: The study covered 1030 parents of children hospitalised in paediatric and surgical wards of seven hospitals of different levels of health security in Poland. The Polish adaptation of the Empathic standardised questionnaire for assessment of the level of parents' satisfaction with nursing care, developed by Latour et al. and the self-constructed summary of socio-demographic data were applied in the study. RESULTS: More than 90% of respondents expressed high level of satisfaction with nurses' Availability, the lowest, but still high score of respondents' satisfaction was observed for Parental Participation. The highest satisfaction was observed among the parents of children at the preschool, early school and puberty stage, admitted to the hospital on the elective basis, referred for diagnostic assessment and with the length of hospital stay less than 7 and longer than 28 days. Achieving preschool age was the strongest factor which increased assessment of satisfaction in most domains. CONCLUSIONS: There is a need for optimising nursing care especially in the area of parental participation. The nursing care' quality improvement plan in paediatric departments should focus particularly on early childhood patients and their parents who are the most critical in satisfaction' assessment.

Parenthood, Parental Benefits, and Career Goals Among Pediatric Residents: 2008 and 2019.

OBJECTIVES: Examine reported availability of parental benefits for pediatric residents and impact of parenthood on reported importance of characteristics of post-training positions and career goals in 2008 and 2019. METHODS: We analyzed data from American Academy of Pediatrics surveys of graduating residents in 2008 and 2019 querying (1) parenthood, (2) benefits during residency, (3) importance of parental benefits and job characteristics in post-training position, and (4) subspecialty career goal. Logistic regression was used to estimate independent effects of gender, partner status, and parenthood via derived predicted values (PVs). RESULTS: Of 1021 respondents, three-fourths were women. Respondents in 2019 were less likely than in 2008 to have children (24.5% vs 33.8%, P < .01). In 2019, respondents were less likely to report availability of maternity (PV = 78.5% vs 89.5%, P < .001) or parental leave (PV = 42.5% vs 59.2%, P < .001) and more likely to report availability of lactation space (PV = 77.8% vs 56.1%, P < .001.). Most residents reported control over work hours, family considerations, and number of overnight calls per month as essential or very important characteristics in post-training positions. Controlling for resident characteristics, parenthood was associated with importance of family considerations and overnight calls in post-training position. Parenthood did not associate with subspecialty career goals, but gender did. CONCLUSIONS: Residents are less likely to report availability of parental benefits during residency training in 2019. Most residents, both those with children and those without, consider parent friendly characteristics important in post-training positions. Parenthood does not correlate with subspecialty career goals independent from gender.

Childcare support and child social development in Japan: investigating the mediating role of parental psychological condition and parenting style.

In humans, support from partners and alloparents is crucial for successful child-rearing and optimal child development. However, the complex relationships among childcare support, children's outcomes and parental characteristics have not been fully examined. We investigate how three sources of partner and alloparental support-partner's childcare participation, support from children's grandparents and support from non-kin-can be associated with child social development. We hypothesize that the associations between childcare support from partners/alloparents and child social development are partly mediated by parental psychological condition and parenting style. To test this, we conducted path analyses on online survey data collected in 2016 from parents of 3- to 5-year-old children in Japan. We found no evidence that childcare support had direct positive effects on child social development. Rather, the benefit of childcare support was mediated by its effects on parental psychological condition and parenting style, which in turn improved children's outcomes. At the same time, we found some evidence that greater availability of childcare support was directly associated with more behavioural difficulties in children. Our findings reveal the complex pathways between childcare support, parental characteristics and children's outcomes in Japan, showing potential mechanisms behind parental and alloparental effects in industrialized populations. This article is part of the theme issue 'Multidisciplinary perspectives on social support and maternal-child health'.

Who actually cares for children in slums? Why we need to think, and do, more about paid childcare in urbanizing sub-Saharan Africa.

The early years are critical and inform the developmental trajectory of children. This is justifiably attracting growing policy attention. Much of this attention is focused on interventions and policies directed at parents, especially mothers. Yet emerging evidence suggests that increasing numbers of children in rapidly urbanizing low- and middle-income countries are now spending much of their day with other formal and informal childcare providers, including largely unregulated paid childcare providers. This paper summarizes the limited literature about the use of such paid childcare in low- and middle-income countries in sub-Saharan Africa, before considering possible reasons behind the lack of research evidence. Finally, key research gaps and their implications for public health practice are explored, with reference to the ongoing British Academy funded Nairobi Early Childcare in Slums research programme in Nairobi, Kenya. We argue that improving childcare may be an under-explored strategy to help some of the world's most disadvantaged children in the most important period of their lives, and that interventions in this largely informal market should be built on a rigorous research base. This article is part of the theme issue 'Multidisciplinary perspectives on social support and maternal-child health'.

Cirugía pediátrica durante la pandemia de SARS-CoV-2. Experiencia en un hospital de tercer nivel / Pediatric surgical activity during the SARS-CoV-2 pandemic: experience at a tertiary hospital

OBJETIVOS: Describir las características y demografía de los procedimientos quirúrgicos realizados en un hospital de tercer nivel durante la pandemia del SARS-CoV-2. Como objetivo secundario se estudia el impacto de la pandemia en las apendicitis agudas tratadas en nuestro centro y su comparación con un periodo previo al SARS-CoV-2. MATERIAL Y MÉTODOS: Estudio retrospectivo incluyendo a todos los pacientes intervenidos por parte del Servicio de Cirugía Pediátrica durante el periodo de pandemia. Abarca desde el primer día del estado de alarma hasta la desescalada de las restricciones. RESULTADOS: Se intervinieron un total de 61 pacientes en 58 días frente a 406 pacientes durante el mismo periodo de 2019 (p < 0,00001). El 59,01% de las intervenciones eran de carácter urgente. Un 5,1% de los pacientes tuvieron un test diagnóstico de SARS-CoV-2 positivo. Se realizaron 30 procedimientos distintos, siendo el más frecuente la apendicectomía (n = 13, 19,6% de los pacientes). El 61,5% de las apendicitis fueron complicadas frente a un 42,4% en periodo no COVID (p = 0,17). El abordaje quirúrgico fue abierto en un 46,1% de los pacientes frente al 6,1% no COVID (p = 0,004). No hubo diferencias estadísticamente significativas en la tasa de complicaciones o la estancia hospitalaria. CONCLUSIONES: Durante la pandemia por SARS-CoV-2 se ha producido una importante disminución del número de procedimientos diarios, pasando a ser más de la mitad de carácter urgente. La patología apendicular se ha presentado más evolucionada de lo habitual, habiendo una clara tendencia a la cirugía abierta frente a la laparoscopia

OBJECTIVES: The primary objective was to describe the characteristics and demographics of the surgical procedures carried out at a tertiary hospital during the SARS-CoV-2 pandemic. The secondary objective was to study the impact of the pandemic on the acute appendicitis cases treated at our healthcare facility and to compare them with a pre- SARS-CoV-2 period. MATERIALS AND METHODS: A retrospective study of all patients undergoing surgery at the pediatric surgery department in the pandemic period, from the beginning of the state of emergency in Spain until the first restrictions were removed, was conducted. RESULTS: A total of 61 patients underwent surgery in 58 days vs. 406 patients in the same 2019 period (p < 0.00001). 59.01% of surgeries were urgent. 5.1% of patients had a positive SARS-CoV-2 diagnostic test. 30 different procedures were carried out, with appendectomy being the most frequent one (n = 13, 19.6% of patients). 61.5% of appendicitis cases were complicated vs. 42.4% in the non-COVID period (p = 0.17). Surgical approach was open in 46.1% of patients vs. 6.1% in the non-COVID period (p = 0.004). No statistically significant differences were found in terms of complication rate or hospital stay. CONCLUSIONS: During the SARS-CoV-2 pandemic, a significant decrease in the number of daily procedures was noted, with more than half being urgent. Appendicular pathologies were in a more advanced stage than usual, with a clear trend towards open surgery vs. laparoscopy

Impacto inmediato de la pandemia por COVID-19 en cirugía pediátrica: análisis de un centro terciario / Immediate impact of the COVID-19 pandemic on pediatric surgery: analysis of a tertiary healthcare facility

INTRODUCCIÓN: La pandemia surgida como consecuencia del virus SARS-CoV-2 ha provocado una situación inaudita, el confinamiento de la población, el colapso de los recursos sanitarios, la suspensión de la actividad programada en los servicios quirúrgicos, el miedo al contagio y la demora en la atención de pacientes. El objetivo es analizar el impacto de esta situación en la actividad del Servicio de Cirugía Pediátrica de un centro de referencia. MATERIAL Y MÉTODOS: Se ha realizado un estudio comparativo de la actividad realizada en el ámbito de Cirugía Pediátrica de un centro de referencia español, incluyendo consultas ambulatorias, cirugía programada y actividad en urgencias durante el periodo de confinamiento (marzo-mayo 2020) frente al mismo periodo de tiempo en 2019. Se recogen el número de consultas e intervenciones, el tipo de cirugía practicada y/o anulada y el grado de evolución de las patologías atendidas. RESULTADOS: Se ha registrado un descenso del 98% de las cirugías programadas, del 84% de la presión asistencial desde urgencias pediátricas, un 55,24% menos de cirugías urgentes y un 82% la actividad ambulatoria en Consultas Externas. Se ha registrado un descenso en los traslados interhospitalarios del 94% y un incremento del 66% de la gravedad de la patología urgente. CONCLUSIONES: La pandemia por COVID-19 ha supuesto la anulación de la práctica totalidad de la actividad del Servicio de Cirugía Pediátrica, con la consiguiente demora en el tratamiento de patologías graves y un aumento en la morbilidad de procesos urgentes habituales

INTRODUCTION: The pandemic caused by the SARS-CoV-2 virus has led to an unprecedented situation, with population lockdowns, congestion of healthcare resources, cancellation of scheduled surgical activity, fear of contagion, and delays in patient care. The objective of this study was to analyze its impact on pediatric surgical activity at a reference healthcare facility. MATERIALS AND METHODS: A comparative study of activity in the pediatric surgery environment at a Spanish reference healthcare facility was carried out. It included outpatient consultations, scheduled surgeries, and activity at the emergency department during the lockdown period in Spain (March 2020-May 2020) vs. the same 2019 period. Number of consultations and surgeries, type of surgery performed and/or cancelled, and stage of the pathologies treated were collected. RESULTS: A 98% decrease in scheduled surgeries, an 84% decrease in healthcare burden from the pediatric emergency department, a 55.24% decrease in urgent surgeries, an 82% decrease in outpatient activity at external consultations, and a 94% decrease in inter-hospital referrals, along with a 66% increase in urgent pathology severity, were found. CONCLUSIONS: The COVID-19 pandemic cancelled virtually all pediatric surgery activity, which caused treatment delays in severe pathologies and increased morbidity in regular urgent procedures

Correlates of sedentary time in young children: A systematic review.

Background: Young children appear to spend large portions of their waking time being sedentary. Understanding the correlates of sedentary time would assist in developing effective interventions among young children. The purpose of this systematic review was to summarize the current literature on the correlates of objectively measured sedentary time in young children aged 1-5.99y. Methods: This review was registered with PROSPERO (registration no. CRD42017081374) and aligned with the PRISMA Statement for systematic reviews. Five electronic databases (MEDline, CINAHL Complete, PsycINFO, SportDiscus, Scopus) were searched up to October 26, 2017 for studies investigating correlates of sedentary time measured using objective devices. A semiquantitative approach was used to synthesize data. Results: Forty-five studies were retrieved comprising 13,430 participants, and 84 correlates of sedentary time in young children were evaluated. The associations between sex, sleep habits, daily patterns (childcare vs. non-childcare hours), childcare type and sedentary time were indeterminate. Thirty-nine correlates were consistently unrelated. Forty-one potential correlates were examined in too few studies (<4) to make confident conclusions. Parental sedentary behaviour was reported 3 times and maternal sedentary behaviour was reported once. Out of these four studies, three were positively associated with child sedentary time. Conclusions: Despite reviewing 45 studies that evaluated associations for 84 correlates, this review was unable to identify any consistent correlates of sedentary time in young children. Additional research is needed in this area to provide robust evidence of the correlates of sedentary time in young children, particularly for those examined in only a small number of studies.

Purchasing, consumption, demographic and socioeconomic variables associated with shifts in alcohol consumption during the COVID-19 pandemic.

INTRODUCTION AND AIMS: Restrictions introduced to reduce the spread of COVID-19 have had major impacts on the living circumstances of Australians. This paper aims to provide insight into shifts in alcohol consumption and associated factors during the epidemic. DESIGN AND METHODS: A cross-sectional convenience sample of 2307 Australians aged 18 and over who drank at least monthly was recruited through social media. Respondents were asked about their alcohol consumption and purchasing in 2019 prior to the epidemic plus similar questions about their experiences in the month prior to being surveyed between 29 April and 16 May 2020. RESULTS: Reports of average consumption before (3.53 drinks per day [3.36, 3.71 95% confidence interval]) and during (3.52 [3.34, 3.69]) the pandemic were stable. However, young men and those who drank more outside the home in 2019 reported decreased consumption during the pandemic, and people with high levels of stress and those who bulk-bought alcohol when restrictions were announced reported an increase in consumption relative to those who did not. DISCUSSION AND CONCLUSIONS: A reported increase in consumption among those experiencing more stress suggests that some people may have been drinking to cope during the epidemic. Conversely, the reported decrease in consumption among those who drank more outside of their home in 2019 suggests that closing all on-trade sales did not result in complete substitution of on-premise drinking with home drinking in this group. Monitoring of relevant subgroups to assess long-term changes in consumption in the aftermath of the epidemic is recommended.

Improving the mental health of abandoned children: Experiences from a global online intervention.

In today's world of global migration and urbanization, millions of children are separated from parents. Their mental health and future competences as citizens depend on the quality of care from foster parents and group home staff in nonparental care settings. Caregivers are challenged by poor work conditions, too many children, and a lack of knowledge about care for traumatized children. How can our profession match this challenge by upscaling interventions? Digital designs for applications of psychology are growing, recently accelerated by the COVID-19 crisis. From 2008, the author developed a blended learning intervention. In partnerships with nongovernmental organizations and government agencies, care recommendations from an international network of researchers are transformed into start-up seminars for staff, followed by a 6-month online classroom education. Students learn and practice how to train local caregiver groups in attachment-based care, using training sessions developed in local languages, adjusted to culture. At present, the author's Fairstart Foundation educated 500 staff from partners in 26 countries, who have trained the caregivers of some 40,000 children. The theoretical, logistic and technical steps from research to daily caregiver-child practices are described, to inspire discussions of how online designs and international partnerships may benefit underserved populations. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Social and child care provision in kinship networks: An agent-based model.

Providing for the needs of the vulnerable is a critical component of social and health policy-making. In particular, caring for children and for vulnerable older people is vital to the wellbeing of millions of families throughout the world. In most developed countries, this care is provided through both formal and informal means, and is therefore governed by complex policies that interact in non-obvious ways with other areas of policy-making. In this paper we present an agent-based model of social and child care provision in the UK, in which agents can provide informal care or pay for private care for their relatives. Agents make care decisions based on numerous factors including their health status, employment, financial situation, and social and physical distance to those in need. Simulation results show that the model can produce plausible patterns of care need and availability, and therefore can provide an important aid to this complex area of policy-making. We conclude that the model's use of kinship networks for distributing care and the explicit modelling of interactions between social care and child care will enable policy-makers to develop more informed policy interventions in these critical areas. "The moral test of government is how it treats those who are in the dawn of life, the children; those who are in the twilight of life, the aged; and those in the shadows of life, the sick, the needy and the handicapped." - Hubert Humphrey Jr.

'Intelligent' lockdown, intelligent effects? Results from a survey on gender (in)equality in paid work, the division of childcare and household work, and quality of life among parents in the Netherlands during the Covid-19 lockdown.

OBJECTIVE: The COVID-19 pandemic is more than a public health crisis. Lockdown measures have substantial societal effects, including a significant impact on parents with (young) children. Given the existence of persistent gender inequality prior to the pandemic, particularly among parents, it is crucial to study the societal impact of COVID-19 from a gender perspective. The objective of this paper is to use representative survey data gathered among Dutch parents in April 2020 to explore differences between mothers and fathers in three areas: paid work, the division of childcare and household tasks, and three dimensions of quality of life (leisure, work-life balance, relationship dynamics). Additionally, we explore whether changes take place in these dimensions by comparing the situation prior to the lockdown with the situation during the lockdown. METHOD: We use descriptive methods (crosstabulations) supported by multivariate modelling (linear regression modelling for continuous outcomes; linear probability modelling (LPM) for binary outcomes (0/1 outcomes); and multinomial logits for multinomial outcomes) in a cross-sectional survey design. RESULTS: Results show that the way in which parents were impacted by the COVID-19 pandemic reflects a complex gendered reality. Mothers work in essential occupations more often than fathers, report more adjustments of the times at which they work, and experience both more and less work pressure in comparison to before the lockdown. Moreover, mothers continue to do more childcare and household work than fathers, but some fathers report taking on greater shares of childcare and housework during the lockdown in comparison to before. Mothers also report a larger decline in leisure time than fathers. We find no gender differences in the propensity to work from home, in perceived work-life balance, or in relationship dynamics. CONCLUSION: In conclusion, we find that gender inequality in paid work, the division of childcare and household work, and the quality of life are evident during the first lockdown period. Specifically, we find evidence of an increase in gender inequality in relation to paid work and quality of life when comparing the situation prior to and during the lockdown, as well as a decrease in gender inequality in the division of childcare and household work. We conclude that the unique situation created by restrictive lockdown measures magnifies some gender inequalities while lessening others. DISCUSSION: The insights we provide offer key comparative evidence based on a representative, probability-based sample for understanding the broader impact of lockdown measures as we move forward in the COVID-19 pandemic. One of the limitations in this study is the cross-sectional design. Further study, in the form of a longitudinal design, will be crucial in investigating the long-term impact of the COVID-19 pandemic on gender inequality.

The Consequences of Living in Childcare Deserts: Evidence from Canada.

Our study addresses whether working parents with young children living in childcare deserts experience greater work-family conflict and psychological distress compared to those in more resourced areas. We use 2011 individual-level data from Toronto matched to census and administrative childcare data. Results suggest that mothers experience greater conflict than fathers when in high-resourced areas. Fathers who work long hours and reside in a desert report greater psychological distress than fathers in nondeserts. These patterns are contrary to the observed results for mothers' distress by childcare availability. Our study underscores the impact of childcare options and the importance of access for all.

Notre étude examine si les parents qui travaillent avec de jeunes enfants vivant dans des « déserts de garde d'enfants¼ éprouvent plus de conflits travail-famille et de détresse psychologique, par rapport à ceux vivant dans des régions avec plus de ressources. Nous utilisons les données individuelles de 2011 de Toronto appariées aux données du recensement et des services administratifs de garde d'enfants. Les résultats suggèrent que les mères vivent plus de conflits que les pères lorsqu'elles sont dans une région disposant de ressources plus importantes. Les pères qui travaillent de longues heures et résident dans un «désert de garde d'enfants¼ rapportent plus de détresse psychologique que les autres pères. Ces tendances sont contraires aux résultats observés pour les mères. Notre étude met en évidence l'impact des options de garde d'enfants et l'importance de l'accès pour tous.