Mediation of the association between social environmental characteristics of family childcare home and weight status in children by diet quality.

BACKGROUND: The food and beverages served in family childcare homes (FCCHs) may play an important role in the development of childhood overweight and obesity. This analysis examines whether children's diet quality mediates the relationship between foods and beverages served in FCCHs and preschool-aged children's weight status. METHODS: Trained and certified staff conducted observations for two days in each FCCH, using the Environment and Policy Assessment and Observation (EPAO) measure to determine the foods and beverages served to children (N = 370) in FCCHs (N = 120). They also used the Dietary Observation in Child Care (DOCC) protocol to assess children's food and beverage intake during childcare, from which we calculated the Healthy Eating Index-2015 (HEI), a measure of diet quality. Height and weight were measured for each child with parent consent from which the child's body mass index (BMI) z-scores were calculated. A multilevel mediation analysis was conducted to indicate whether children's diet quality mediates the relations between food and beverage served in FCCHs and preschool-aged children's weight status. RESULTS: Children's total HEI scores significantly mediated the relationship between the EPAO subscale Food Provided and children's BMI z-scores (B=-0.01, p < .05, 95% CI = [-0.03, - 0.002]). Further, the EPAO subscale Food Provided was positively associated with the total HEI score (B = 0.75, p < .01, 95% CI = [0.32, 1.18]). Total HEI scores were negatively associated with BMI z-score (B=-0.01, p < .05, 95% CI = [-0.02, - 0.001]). CONCLUSION: Children's diet quality did significantly mediate the relationship between the food served in FCCHs and children's weight status. More longitudinal studies with longer follow-up periods need to be conducted to confirm these relationships. Further, future studies need to examine the relationships between a broader spectrum of FCCH environmental characteristics and home environment with children's weight status, as well as other mediators including physical activity.

Impacts of grandparenting on older Chinese adults' mental health: a cross-sectional study.

BACKGROUND: The practice of grandparenting has been growing in popularity worldwide, particularly in Asian societies. Nevertheless, there is a lack of thorough studies investigating the mental health effects of grandchild care on grandparents, particularly within the family context. The present study aimed to explore the impact of grandparenting on depressive symptoms in older Chinese adults, taking into account the functional role of intergenerational support. METHODS: Using the China Longitudinal Aging Social Survey (CLASS, 2014 and 2018, N = 9,486), we employed the Pooled Ordinary Least Square method (POLS) to explore the association between depressive symptoms and grandparenting intensity as well as include the interaction terms to investigate the role of intergenerational support among grandparents aged from 60 to 80. RESULTS: After adjusting for control variables, both non-intensive (-0.17; 95% CI: -0.30, -0.03) and intensive (-0.69; 95% CI: -0.95, -0.43) childcare, as well as giving financial support to adult children (-0.06; 95% CI: -0.08, -0.04) and emotional closeness with them (-0.94; 95% CI: -1.15, -0.72), were found to have a positive impact on the mental health of grandparents. Giving financial support (non-intensive: -0.04, 95% CI: -0.07, -0.01; intensive: -0.06, 95% CI: -0.13, -0.01) and providing instrumental support to adult children (non-intensive: -0.12, 95% CI: -0.24, -0.01; intensive: -0.19, 95% CI: -0.37, -0.02) moderated the association between grandparenting and the mental health of older adults, regardless of care intensity. However, the moderating role of receiving financial support (-0.07; 95% CI: -0.12, -0.02) only existed when non-intensive childcare was provided. CONCLUSION: Grandchild care predicted better mental health in grandparents, mainly when they engaged in intensive grandparenting. Emotional closeness and providing financial support to adult children brought mental health benefits to grandparents involved in childcare. Giving financial support and providing instrumental support to adult children moderated the association between grandparenting and the mental health of older adults. However, the moderating role of receiving financial support from adult children only existed when non-intensive childcare was provided.

Childcare and Child Development in Japan.

For decades, the notion has persisted in developed countries that exclusive care by the mothers is best for the development of children up to 3 years of age. To examine the veracity of this "myth of the first three years" in Japan, we examined the effects of childcare facility use for children younger than 3 years on their development using the cohorts of the Longitudinal Survey of Newborns in the 21st Century conducted in Japan. Of the 47,015 respondents to the survey, we studied the children of 5,508 mothers with university/professional education to evaluate the relationships between primary early (< 2.5 years) childcare providers during weekday daytime hours and specific development indices for the ages of 2.5, 5.5, and 8 years. At the age of 2.5 and 5.5 years, children attending childcare facilities were judged as having more advanced developmental behaviors by their parents, such as being able to compose a two-word sentence (adjusted odds ratio [aOR]: 0.22) or to express emotions (aOR: 0.81), compared with those cared for by mothers. However, at the age of 8 years, children who attended childcare facilities as infants < 2.5 years showed more aggressive behavior in interrupting people (aOR: 1.20) and causing disturbances in public (aOR: 1.26) than those cared for by mothers (after adjustment for numerous child and parental factors). Although these results are generally consistent with previous studies, issues potentially involved with problem behavior such as quality of childcare require further investigation, as does the case of children of mothers with more modest educational attainment.

Evaluating the childcare needs of cancer patients undergoing radiation therapy.

PURPOSE: About one-fifth of newly diagnosed cancer patients are parents to young children. These patients are at higher risk of psychosocial stress and inability to attend treatment due to having to balance their own healthcare needs with childcare duties. This study aims to explore the impact of childcare on cancer parents and elicit their perspectives on potential supports. The results could help inform the implementation of suitable childcare programs to remove this barrier in accessing care. METHODS: Patients at a large Canadian cancer treatment center were screened by oncologists for having minor children at home. Secure electronic surveys were then distributed to consenting participants. Domains surveyed included patient demographics, childcare burden, impact on treatment, and preference for childcare supports. RESULTS: The mean age of correspondents was 43.9 (range 33-54), 46 patients (92%) were female, and breast cancer was the most common primary tumor. The median number of children per correspondent was two, and their mean age was 8.4. Balancing childcare with cancer treatment had a significant impact on self-reported stress levels for most correspondents. Twenty (40%) participants had to reschedule and 7 (14%) participants missed at least one appointment due to childcare conflicts. During the COVID-19 pandemic, access to childcare resources decreased while childcare responsibilities increased. Three-quarters of correspondents reported that a flexible childcare would make it easier for them to adhere to appointment schedules. CONCLUSION: Childcare is a significant psychosocial barrier for patients accessing cancer care. Our results indicate that most parents undergoing treatment may benefit from hospital-based childcare services.

Gardening in Childcare Centers: A Randomized Controlled Trial Examining the Effects of a Garden Intervention on Physical Activity among Children Aged 3-5 Years in North Carolina.

This study examined the effects of a childcare gardening intervention on children's physical activity (PA). Eligible childcare centers were randomly assigned to: (1) garden intervention (n = 5; year 1); (2) waitlist control (n = 5; control year 1, intervention year 2); or (3) control (n = 5; year 2 only) groups. Across the two-year study, PA was measured for 3 days at four data collection periods using Actigraph GT3X+ accelerometers. The intervention comprised 6 raised fruit and vegetable garden beds and a gardening guide with age-appropriate learning activities. The sample included a total of 321 3-5-year-olds enrolled in childcare centers in Wake County, North Carolina, with n = 293 possessing PA data for at least one time point. The analyses employed repeated measures linear mixed models (SAS v 9.4 PROC MIXED), accounting for clustering of the children within the center and relevant covariates (e.g., cohort, weather, outside days, accelerometer wear). A significant intervention effect was found for MVPA (p < 0.0001) and SED minutes (p = 0.0004), with children at intervention centers acquiring approximately 6 min more MVPA and 14 min less sedentary time each day. The effects were moderated by sex and age, with a stronger impact for boys and the youngest children. The results suggest that childcare gardening has potential as a PA intervention.

Quality of early childcare and education predicts high school STEM achievement for students from low-income backgrounds.

High-quality early childcare and education (ECE) has demonstrated long-term associations with positive educational and life outcomes and can be particularly impactful for children from low-income backgrounds. This study extends the literature on the long-term associations between high-quality caregiver sensitivity and responsiveness and cognitive stimulation (i.e., caregiving quality) in ECE settings and success in science, technology, engineering, and mathematics (STEM) in high school. Using the 1991 National Institute of Child Health and Human Development Study of Early Child Care and Youth Development (n = 1,096; 48.6% female; 76.4% White, 11.3% African American, 5.8% Latine, 6.5% other), results demonstrated that caregiving quality in ECE was associated with reduced disparities between low- and higher-income children's STEM achievement and school performance at age 15. Disparities in STEM school performance (i.e., enrollment in advanced STEM courses and STEM grade point average) and STEM achievement (i.e., Woodcock-Johnson cognitive battery) were reduced when children from lower-income families experienced more exposure to higher caregiving quality in ECE. Further, results suggested an indirect pathway for these associations from caregiving quality in ECE to age 15 STEM success through increased STEM achievement in Grades 3 through 5 (ages 8-11 years). Findings suggest that community-based ECE is linked to meaningful improvements in STEM achievement in Grades 3 through 5 which in turn relates to STEM achievement and school performance in high school, and caregiving quality in ECE is particularly important for children from lower-income backgrounds. This work has implications for policy and practice positioning caregivers' cognitive stimulation and sensitivity in ECE settings across the first 5 years of life as a promising lever for bolstering the STEM pipeline for children from lower-income backgrounds. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Outcomes From Healthy Eating and Physical Activity Recognition Programs in Early Child Care and Education: A Scoping Review.

OBJECTIVE: Recognition programs are designed to incentivize early care and education (ECE) settings to implement childhood obesity prevention standards, yet little is known regarding their efficacy. This scoping review details characteristics, methodologies, and criteria used to evaluate recognition programs, identifies gaps in evaluation, and synthesizes existing evidence. DATA SOURCE: A public health librarian created the search strategies for six databases: Ovid MEDLINE, AGRICOLA, CAB Abstracts, PAIS Index, ERIC, and Scopus. STUDY INCLUSION AND EXCLUSION CRITERIA: Inclusion criteria include recognition program, ECE setting, nutrition or physical activity, and qualitative or quantitative outcomes. Exclusion criteria include programming without recognition component, no ECE setting, no nutrition or physical activity outcome, case studies, or not written in English. DATA EXTRACTION: Three researchers independently extracted and complied data into an Excel spreadsheet. DATA SYNTHESIS: Tables were created describing location, recognition program criteria, award incentive, study design, study sample, risk of bias, and outcomes (e.g., menu nutrition) evaluated in each study. RESULTS: Three unique recognition programs (described in 7 studies) provided technical assistance, incentives, and training. While outcome measures and study designs varied across programs, it is clear that recognition programs are well accepted and feasible, and one study demonstrated beneficial weight outcomes. CONCLUSION: Although additional evaluation is needed, recognition programs may be a promising strategy to improve obesity prevention practices in ECE.

The Role of Maternal Grandmothers' Childcare Provision for Korean Working Adult Daughters.

Despite the Korean government's investment in childcare facilities for dual-earner households, maternal grandmothers are increasingly taking on the responsibility of caring for their grandchildren. This trend is examined in the current research. While many studies have been conducted on grandparents' experiences providing childcare for their grandchildren, significantly less research has been conducted on adult daughters' experiences with their mothers' childcare provision. This study utilized the concepts of intergenerational solidarity and a life-course approach to understand the experiences of 24 working adult daughters in Korea (ages 30-43) whose mothers provide childcare. Three major themes were identified following a grounded theory approach: gratitude vs. guilt, dependence vs. independence, and closeness vs. disagreement. The results indicated that adult daughters were found to have ambivalence toward their mothers, reflecting the lack of alternative options for childcare. The results from this study suggest that not only improving the quality of public childcare services, but also diversifying services to reflect the needs of dual-income families.

Conceptualización y percepción de enfermería sobre el cuidado del niño / Nursing Conceptualization and Perception about Child Care

Introducción: El cuidado es la esencia de enfermería y se fundamenta en la relación terapéutica enfermera-niño-familia, con abordaje integral en el contexto hospitalario. Objetivo: Discutir en base a la literatura cómo enfermería conceptualiza y percibe el cuidado del niño. Métodos: Revisión sistemática de artículos publicados entre 2010 y 2020 en las bases de datos SciELO, BVS, REDALYC, ERIC, Science Direct y LILACS. En la estrategia de búsqueda se utilizó el diagrama de flujo Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). Se revisaron 275 artículos (español, portugués e inglés), tras aplicar criterios de inclusión y exclusión, se obtuvieron 20. Conclusiones: El cuidado del niño tiene diversas dimensiones para su comprensión: significado del cuidado, las competencias de la enfermera, la participación de la madre y los factores que intervienen en el cuidado, con una visión humanística e integradora, mediante una relación empática entre la enfermera-madre-niño, con conocimientos científicos actualizados, experticia en los procedimientos, aplicación de principios éticos y valores, la comprensión de la psicología infantil, gran sensibilidad humana y manejo del estrés, sin dejar de lado la familia y el juego terapéutico(AU)

Introduction: Care is the essence of nursing and is based on the nurse-child-family therapeutic relationship, with a comprehensive approach in the hospital setting. Objective: To discuss, based on the scientific literature, how nursing conceptualizes and perceives child care. Methods: A systematic review was carried out of articles published between 2010 and 2020 in the SciELO, BVS, REDALYC, ERIC, Science Direct and LILACS databases. The PRISMA flowchart (Preferred Reporting Items for Systematic Review and Meta-Analyses) was used in the search strategy. A total of 275 articles published in Spanish, Portuguese and English were reviewed. After applying inclusion and exclusion criteria, twenty articles were chosen. Conclusions: Child care has several dimensions for its understanding: meaning of care, the nurse's competences, the mother's participation, and factors involved in care; with a humanistic and integrative vision, through an empathic nurse-mother-child relationship, with updated scientific knowledge, expertise in procedures, application of ethical principles and values, understanding of child psychology, great human sensitivity and stress management, without neglecting the family and therapeutic play(AU)

A multi-component tailored intervention in family childcare homes improves diet quality and sedentary behavior of preschool children compared to an attention control: results from the Healthy Start-Comienzos Sanos cluster randomized trial.

BACKGROUND: Childcare settings are important environments for influencing child eating and physical activity (PA). Family childcare homes (FCCH) care for many children of low-income and diverse racial/ethnic backgrounds who are at greater risk for poor diet quality, low PA, and obesity, but few interventions have targeted this setting. The aim of this study was to assess the efficacy of a multicomponent intervention conducted in FCCH on the diet quality and PA of 2-5 year old children in their care. TRIAL DESIGN: Cluster randomized trial. METHODS: The cluster-randomized trial, Healthy Start/Comienzos Sanos (2015-2019) evaluated an 8-month nutrition and PA intervention that included four components: (1) monthly telephone calls from a support coach using brief motivational interviewing, (2) tailored reports, newsletters and videos, (3) group support meetings, and (4) active play toys. After completing baseline measurement, FCCH were randomized into intervention or comparison groups in matched pairs. Both groups received the same intervention components but on different topics (intervention: nutrition/PA vs. comparison: reading readiness/literacy). Evaluation staff were blinded to group assignment. Child primary outcome measures collected at baseline and 8-months included: 1) Healthy Eating Index (HEI-2015) scores calculated from diet observation, and 2) accelerometer measurement of PA. Process measures were collected from field data and provider surveys. Generalized Estimating Equation Models assessed changes in HEI-2015 scores and PA over time by experimental condition. RESULTS: Ethnically diverse FCCH providers (n = 119) and 2-to-5-year-old children in their care (n = 377) were included in the final analysis. Process evaluation showed high participation in all intervention components except for group meetings. Compared to children in comparison group FCCH, children in intervention FCCH increased total HEI-2015 scores by 7.2 points (p < .001) including improvement in component scores for vegetables (0.84 points, p = .025) and added sugar (0.94 points, p = .025). For PA, compared to children in the comparison group, children in intervention FCCH decreased sedentary time by 5.7% (p = .021). CONCLUSIONS: The multicomponent Healthy Start intervention was effective in improving diet quality and sedentary behavior of children in FCCH, which demonstrates the promise of obesity prevention interventions in this setting. Future research could include enhancing the Healthy Start intervention to strengthen the PA component, considering virtual peer support, and determining how to best translate and disseminate the intervention into FCCH nationally. TRIAL REGISTRATION: National Institutes of Health, NCT02452645 . Registered 5 May 2015.

Adult outcomes of sustained high-quality early child care and education: Do they vary by family income?

Experimental research demonstrates sustained high-quality early care and education (ECE) can mitigate the consequences of poverty into adulthood. However, the long-term effects of community-based ECE are less known. Using the 1991 NICHD Study of Early Child Care and Youth Development (n = 994; 49.7% female; 73.6% White, 10.6% African American, 5.6% Latino, 10.2% Other), results show that ECE was associated with reduced disparities between low- and higher-income children's educational attainment and wages at age 26. Disparities in college graduation were reduced the more months that low-income children spent in ECE (d = .19). For wages, disparities were reduced when children from low-income families attended sustained high-quality ECE (d = .19). Findings suggest that community-based ECE is linked to meaningful educational and life outcomes, and sustained high-quality ECE is particularly important for children from lower-income backgrounds.

Aspectos esenciales para realizar los cuidados en guarderías privadas desde la perspectiva de las cuidadoras / Essential Aspects, from the Perspective of Childcare Workers, for Providing Care in Private Daycare Centers

Introducción: El nuevo modelo económico cubano ha posibilitado la aparición de guarderías privadas, pero se desconocen qué aspectos deben ser considerados como esenciales para ejercer los cuidados desde la perspectiva de las cuidadoras Objetivo: Explorar aspectos esenciales para realizar los cuidados en guarderías privadas desde la perspectiva de las cuidadoras. Métodos: Estudio cualitativo de tipo exploratorio, realizado entre junio y septiembre de 2021 con 12 cuidadoras que laboran en guarderías privadas del municipio Santa Clara, provincia Villa Clara, Cuba. Los datos se obtuvieron mediante dos rondas de entrevistas; las narrativas fueron procesadas mediante análisis de contenido. Resultados: De la primera entrevista se manifestaron las siguientes categorías: higiene y protección para el cuidado, alimentación del niño, rutinas (sueño), problemas relacionados con el cuidado y rutinas (juego). De la segunda entrevista emergieron tres categorías: necesidad de un manual para la preparación, necesidad de un sitio digital para consulta y necesidad de curso de formación. Conclusiones: Se destaca la necesidad de garantizar en la guardería la higiene adecuada y disminuir el riesgo de accidentes; la preparación de alimentos y dietas; las rabietas, caídas y la fiebre como problemas más comunes; las rutinas de descanso y la rutina de juego y su influencia para el desarrollo armónico de los niños, además que las cuidadoras deberían recibir formación a través de un manual específico para guarderías privadas; algún sitio de consulta en internet y un curso preparatorio(AU)

Introduction: The new Cuban economic model has made possible the appearance of private daycare centers, but there is lack of knowledge concerning what aspects, from the perspective of childcare workers, should be considered as essential to perform caregiving. Objective: To explore, from the perspective of childcare workers, essential aspects of care in private daycare centers. Methods: Qualitative and exploratory study carried out between June and September 2021 with twelve childcare workers from private daycare centers in Santa Clara Municipality, Villa Clara Province, Cuba. The data were obtained through two rounds of interviews; the answers were processed through content analysis. Results: The following categories emerged from the first interview: hygiene and protection for care, child feeding, routines (sleep), problems related to care and routines (playing). Three categories emerged from the second interview: the need for a training manual, the need for a virtual consultation site, and the need for a training course. Conclusions: The need is highlighted to guarantee adequate hygiene in the daycare center and reduce the risk of accidents; diet and food preparation; tantrums, falls and fever as the most common problems; rest and playing routines, as well as their influence on harmonious child development; together with the fact that childcare workers should receive training through a specific manual designed for private daycare centers, any type of virtual consultation site and training course(AU)

Ecografía clínica multiventana: diagnóstico inusual en la UCIP / Unusual diagnostic in PICU by POCUS head-to-toe

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Physical Activity and Screen Time Practices of Family Child Care Providers: Do They Meet Best Practice Guidelines?

Background: Child care settings significantly influence children's physical activity (PA) and screen time (ST) behaviors, yet less research has been conducted in family child care homes (FCCHs) than in child care centers. While a few studies have measured family child care providers' (FCCPs') PA practices, none have used observation to assess which specific evidence-based, best practice guidelines FCCPs met or did not meet, and no previous studies have included Latinx providers. This article examines FCCPs' adherence to PA and ST best practice guidelines using primarily observational methods with diverse FCCPs (including Latinx). Methods: We examined baseline data from a cluster randomized trial including surveys and observational data collected at the FCCH to assess whether providers met specific PA and ST best practices from the Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) and the American Academy of Pediatrics. Results: Providers completed a telephone survey and participated in two full-day observations (n = 127; 72% Hispanic). Overall, only 4 of 14 PA and ST best practices were met by >50% of providers including: leading a planned PA class more than once a week; no ST during meal or snack; not modeling sedentary behavior; and providing families with information about children's ST. Best practices least likely to be met (<20% of providers) include: providing children with >60 minutes of outdoor play daily; providing children with >45 minutes of adult-led PA each day; participating in outdoor PA with children; participating in indoor PA with children; prompting and praising children for being active; and talking with children informally about the importance of PA. Conclusions: While FCCPs engage in some positive PA and ST practices, many providers do not meet best practice guidelines. There is a need for more research about how to overcome providers' personal and environmental barriers for meeting these guidelines as well as interventions and supports to overcome these barriers. Clinical Trial Registration Number NCT0245645.

Modelo de implementação sistemática do brinquedo terapêutico em unidades pediátricas hospitalares / Modelo de implementación sistemática del juego terapéutico en unidades hospitalarias de pediatria / Model for the systematic implementation of therapeutic play in pediatric hospital units

Resumo Existe consenso na literatura sobre a importância do uso do brinquedo terapêutico (BT), recomendando-se a sua sistematização no planejamento do cuidado pediátrico, contudo há lacunas no conhecimento sobre como sistematizar esse cuidado e implementa-lo em unidades hospitalares. Objetivos Propor um modelo de implementação sistemática do BT para unidades pediátricas hospitalares e descrever as etapas desse processo. Método estudo descritivo, de abordagem qualitativa, desenvolvido em unidades de internação e terapia intensiva pediátricas, apoiado pela ferramenta PDCA (Plan, Do, Check e Action). Os dados foram coletados por meio da observação da dinâmica dos atendimentos da unidade e entrevista com onze dos profissionais do grupo de referência de BT e, a seguir procedeu-se a análise temática. Resultados a implementação do BT evidenciou resultados positivos, seja na perspectiva dos integrantes do grupo de referência, seja na percepção de aumento da frequência na prática de realização do BT ou, ainda, pelo reconhecimento da família e da instituição. Conclusão e implicações para a prática As etapas percorridas no processo de implementação do BT em unidades pediátricas fornecem subsídios para direcionar profissionais de diferentes instituições a implementar de forma sistemática esta prática lúdica.

Resumen Existe consenso en la literatura sobre la importancia del uso de juguetes terapéuticos (JT), recomendándose su sistematización en la planificación del cuidado pediátrico, sin embargo existen lagunas en el conocimiento sobre cómo sistematizar este cuidado e implementarlo en las unidades hospitalarias. Objetivos Proponer un modelo para la implementación sistemática de PT para unidades hospitalarias de pediatría y describir los pasos de este proceso. Método estudio descriptivo, con enfoque cualitativo, desarrollado en unidades de hospitalización y cuidados intensivos pediátricos, apoyado en la herramienta PDCA (Plan, Do, Check and Action). Los datos fueron recolectados a través de la observación de la dinámica de atención en la unidad y entrevista con once profesionales del grupo de referencia de JT, seguida del análisis temático. Resultados la implementación de la JT mostró resultados positivos, ya sea desde la perspectiva de los miembros del grupo de referencia, ya sea en la percepción de mayor frecuencia en la práctica de la realización de la JT o, incluso, por el reconocimiento de la familia y la institución. Conclusión e implicaciones para la práctica Los pasos dados en el proceso de implementación de la PT en las unidades pediátricas brindan subsidios para orientar a los profesionales de diferentes instituciones a implementar sistemáticamente esta práctica lúdica.

Abstract There is a consensus in the literature on the importance of using therapeutic play, recommending its systematization in pediatric care planning, however, there are gaps in knowledge about how to systematize this care and implement it in hospital units. Objectives to propose a model for the systematic implementation of therapeutic play for pediatric hospital units and describe the steps of this process. Method descriptive qualitative study, developed in pediatric hospitalization and intensive care units, supported by the PDCA (Plan, Do, Check and Action) tool. Data were collected through observation of the dynamics of care at the unit and an interview with 11 professionals from the reference group, followed by thematic analysis. Results the implementation of therapeutic play showed positive results, from the perspective of the members of the reference group, in the perception of increased frequency in the practice of performing therapeutic play, and due to the recognition of the family and the institution. Conclusion and implications for practice the steps taken in the process of implementing TP in pediatric units provide support to guide professionals from different institutions to systematically implement this playful practice.

As crianças no hospital colônia infantil de oliveira (mg): uma história institucional (1931-1974) / Los/as niños/as del hospital colonia infantil de oliveira (mg): una historia institucional (1931-1974) / The children at the colony hospital of oliveira (mg): an institutional history (1931-1974)

Resumo: Este estudo objetiva resgatar os registros de práticas institucionais destinadas a crianças e adolescentes internados no antigo Hospital Colônia de Neuropsiquiatria Infantil de Oliveira (HCNPO), em Minas Gerais, no período de 1931 a 1974. Para isso, foi feito um estudo de caso a partir da análise documental de fontes primárias e bibliográficas sobre a instituição e as políticas referentes ao cuidado da loucura. Constata-se que a situação de saúde dos/as internos/as era caracterizada pela negligência e a violência do modelo asilar, com condições precárias de higiene, poucas atividades terapêuticas e deficientes medidas de socialização das crianças. Conclui-se que o HCNPO falhou em cuidar, proteger e estimular o desenvolvimento desses sujeitos, alvos de políticas que justificaram a intervenção social sobre seus corpos, tanto como "menores" quanto como "loucos".

Resumen: Este estudio tiene como objetivo recuperar los registros de prácticas institucionales hacia niños y adolescentes hospitalizados en el antiguo Hospital Colonia de Neuropsiquiatria Infantil de Oliveira (HCNPO), en Minas Gerais, de 1931 a 1974. Para eso, se realizó un estudio de caso a partir del análisis documental de fuentes primarias y bibliográficas sobre la institución y políticas relacionadas con el cuidado de la locura. Resulta que la situación de salud de los/as internos/as se caracterizó por la negligencia y la violencia del modelo de asilo, con malas condiciones de higiene, pocas actividades terapéuticas y medidas de socialización insatisfactorias para los niños. En conclusión, HCNPO no cuidó, protegió y estimuló el desarrollo de estos sujetos, blanco de políticas que justificaban la intervención social en sus cuerpos, tanto como "menores" cuánto como "locos".

Abstract: This study aims to retrieve the records of institutional practices towards children and adolescents hospitalized at the former Hospital Colônia de Neuropsiquiatria Infantil de Oliveira (HCNPO), in Minas Gerais, from 1931 to 1974. For that, a case study was made from the documentary analysis of primary and bibliographic sources on the institution and policies related to the care of madness. As it turns out, the health situation of the inmates was characterized by negligence and the violence of the asylum model, with poor hygiene conditions, few therapeutic activities and unsatisfactory socialization measures for the children. In conclusion, HCNPO failed to care for, protect and stimulate the development of these subjects, targets of policies that justified social intervention on their bodies, both as "minors" and as "mad".

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.

Food Allergy Guidelines for Schools and Childcare Facilities.

Among controversial new recommendations: doing away with categorical food bans.

An mCARE study on patterns of risk and resilience for children with ASD in Bangladesh.

Community-wide lockdowns in response to COVID-19 influenced many families, but the developmental cascade for children with autism spectrum disorder (ASD) may be especially detrimental. Our objective was to evaluate behavioral patterns of risk and resilience for children with ASD across parent-report assessments before (from November 2019 to February 2020), during (March 2020 to May 2020), and after (June 2020 to November 2020) an extended COVID-19 lockdown. In 2020, our study Mobile-based care for children with ASD using remote experience sampling method (mCARE) was inactive data collection before COVID-19 emerged as a health crisis in Bangladesh. Here we deployed "Cohort Studies", where we had in total 300 children with ASD (150 test group and 150 control group) to collect behavioral data. Our data collection continued through an extended COVID-19 lockdown and captured parent reports of 30 different behavioral parameters (e.g., self-injurious behaviors, aggression, sleep problems, daily living skills, and communication) across 150 children with ASD (test group). Based on the children's condition, 4-6 behavioral parameters were assessed through the study. A total of 56,290 behavioral data points was collected (an average of 152.19 per week) from parent cell phones using the mCARE platform. Children and their families were exposed to an extended COVID-19 lockdown. The main outcomes used for this study were generated from parent reports child behaviors within the mCARE platform. Behaviors included of child social skills, communication use, problematic behaviors, sensory sensitivities, daily living, and play. COVID-19 lockdowns for children with autism and their families are not universally negative but supports in the areas of "Problematic Behavior" could serve to mitigate future risk.

Mechanisms and management considerations of parent-chosen feeding approaches to infants with swallowing difficulties: an observational study.

Videofluoroscopy swallow studies (VFSS) and high-resolution manometry (HRM) methods complement to ascertain mechanisms of infant feeding difficulties. We hypothesized that: (a) an integrated approach (study: parent-preferred feeding therapy based on VFSS and HRM) is superior to the standard-of-care (control: provider-prescribed feeding therapy based on VFSS), and (b) motility characteristics are distinct in infants with penetration or aspiration defined as penetration-aspiration scale (PAS) score ≥ 2. Feeding therapies were nipple flow, fluid thickness, or no modification. Clinical outcomes were oral-feeding success (primary), length of hospital stay and growth velocity. Basal and adaptive HRM motility characteristics were analyzed for study infants. Oral feeding success was 85% [76-94%] in study (N = 60) vs. 63% [50-77%] in control (N = 49), p = 0.008. Hospital-stay and growth velocity did not differ between approaches or PAS ≥ 2 (all P > 0.05). In study infants with PAS ≥ 2, motility metrics differed for increased deglutition apnea during interphase (p = 0.02), symptoms with pharyngeal stimulation (p = 0.02) and decreased distal esophageal contractility (p = 0.004) with barium. In conclusion, an integrated approach with parent-preferred therapy based on mechanistic understanding of VFSS and HRM metrics improves oral feeding outcomes despite the evidence of penetration or aspiration. Implementation of new knowledge of physiology of swallowing and airway protection may be contributory to our findings.