Trackers for Adverse Events in Child Mental Health: descriptive analysis using the global trigger tool

Abstract The goal of this study is to identify the global trigger tool trackers used to place the adverse drug events presented in children that use psychotropic drugs accompanied by Child-adolescent Psychosocial Care Centers. This is a descriptive study carried out with the secondary data of 112 child care records that began in January 2017 in two Child-adolescent Psychosocial Care Centers. A median of medicine per child was 1.71 and among the most used we were to risperidone 100%, followed by valproic acid and periciazine with 16% each. A total of 42 adverse drug events were found in 36 medical records, being agitation 29.7% and agressive 16.2%, being the most frequent, and in 45.2% of infants presenting only one event. 50 were trackers detected in 83.3%, two records that identified adverse drug events. In 38.8% were found only one tracker, the most found ones were: combination of psychotropic medicines 32%, abrupt reduction of medicine dose 22% and abrupt cessation of medicine 12%. Finally, the present study showed that the global trigger tool evidenced adverse drug events by means of the detection of trackers in children and that it had to offer interventions to improve the quality of psychiatric therapy within two community services.

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.

Quality of Nutrition Environments, Menus and Foods Served, and Food Program Achievement in Oklahoma Family Child Care Homes.

Child care environments foster children's healthy eating habits by providing exposure to healthy foods and feeding practices. We assessed the healthfulness of nutrition environments, menu/meal quality, and the achievement of Child and Adult Care Food Program (CACFP) guidelines and best practices in Oklahoma CACFP-enrolled family child care homes (FCCHs) (n = 51). Two-day classroom observations were conducted. Healthfulness of classroom nutrition environments was assessed using the Environment and Policy Assessment and Observation (EPAO). Foods served to and consumed by children were quantified using the Dietary Observations in Child Care (DOCC) tool. Nutrient analysis was performed to determine total energy for foods listed on menus, served to, and consumed by children. Menu and meal food variety and CACFP Guideline Achievement Scores were determined. Average nutrition environment score was 11.7 ± 1.2 (61.5% of maximum possible score). Energy (kcals) from menus and consumed by children was insufficient to meet two-thirds of their daily reference intake. Children were exposed to 1.7 vegetables and 1.3 fruits per meal. CACFP Guideline Achievement Scores were 66.3% ± 7.8 for menus and 59.3% ± 7.6 for mealtimes. Similar to previous research, our findings indicate a need for improved FCCH nutrition practices. Tailored interventions for FCCHs are needed.

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.

COVID-19 Pandemic Among Immigrant Latinx Farmworker and Non-farmworker Families: A Rural-Urban Comparison of Economic, Educational, Healthcare, and Immigration Concerns.

COVID-19 has revealed social and health inequities in the United States. Structural inequalities have increased the likelihood of immigrants contracting COVID-19, by being essential workers and through poverty that forces this population to continue working. Rural and urban immigrant families may face different concerns. Using a telephone survey in May 2020 of 105 Latinx families in an existing study, quantitative and qualitative data were gathered on work and household economics, childcare and education, healthcare, and community climate. Analyses show that, although rural and urban groups experienced substantial economic effects, impacts were more acute for urban families. Rural workers reported fewer workplace protective measures for COVID-19. For both groups, fear and worry, particularly about finances and children, dominated reports of their situations with numerous reports of experiencing stress and anxiety. The experience of the pandemic is interpreted as an example of contextual vulnerability of a population already experiencing structural violence through social injustice. Policy implications are highlighted.

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).

Protocolo Estadual de Pré-Natal de risco habitual

A publicação reúne informações obtidas e organizadas pela SES-RJ por meio da Subsecretaria de Atenção Integral à Saúde, da Superintendência de Atenção Primária à Saúde e do núcleo técnico-científico Telessaúde RJ, fluxogramas, protocolos clínicos e diretrizes estabelecidas pelo Ministério da Saúde para orientar o cuidado oferecido nas unidades de Atenção Primária do estado, dos direitos da gestante à atenção nutricional, passando pela saúde bucal, aspectos psicológicos e práticas integrativas e complementares em saúde. O documento inclui ainda orientações para casos de gestantes com sintomas de síndrome gripal no contexto da pandemia de Covid-19. O protocolo poderá ser utilizado na íntegra pelos gestores estaduais e municipais ou adequado de acordo com as realidades e especificidades de cada região.

School nurses' perceptions regarding barriers and facilitators in caring for children with chronic diseases in school settings: A mixed studies review.

This study aimed to understand school nurses' perceptions regarding barriers to and facilitators for health care services for children with chronic diseases in school settings. Using the PubMed, Cumulative Index to Nursing and Allied Health Literature, Embase, and Web of Science databases, a mixed studies review was conducted for literature published between January 2011 and June 2020. We performed a mixed-methods systematic review using a convergent integrated approach. A quality appraisal of the included studies was conducted using a mixed-methods appraisal tool. Twenty-seven articles (10 qualitative, 10 quantitative, and seven mixed-methods) that met the inclusion criteria were analyzed. Integrated findings that emerged from data synthesis were categorized into four levels (intrapersonal level, interpersonal level, institutional level, and community and public policy level) based on a socio-ecological model framework. This mixed systematic review provides a comprehensive understanding of school nurses' perceived barriers and facilitators when providing school health care for students with chronic diseases and how these barriers and facilitators interact across multiple systems. Further policies and strategies should be developed to provide effective school health services considering this study's findings.

Content development for a physical activity and sedentary behaviour e-learning module for early childhood education students: a Delphi study.

BACKGROUND: Early childhood educators play a prominent role in promoting healthy activity behaviours in childcare. However, they have expressed that they lack the appropriate pre-service training to confidently lead physical activity (PA), and minimize sedentary behaviour (SB), in childcare. As such, the purpose of this Delphi study was to generate and reach agreement on content areas for inclusion in a PA and SB e-Learning module for Early Childhood Education (ECE) students. METHODS: Purposeful sampling of Canadian/international researchers was used to form two expert panels: a PA/SB expert panel (n = 26), and a Canadian ECE panel (n = 35). The PA/SB experts suggested their top 12 PA/SB topics for the module via online survey. These topics were then pooled to generate a list of 19 content areas. In a second online survey, both panels of experts rated the importance of each content area (0 = unimportant to 5 = very important). Mean ratings (M) were ranked separately for each panel, and then ratings were pooled to create an overall ranking of the 19 content areas. Inter-panel agreement of importance rankings was visually represented as a scatterplot and quantified using Spearman's rho (rs). RESULTS: The top-rated content area was Outdoor Play (M = 4.77 ± 0.64), followed by Benefits of PA in the Early Years (M = 4.75 ± 0.66), and Factors Influencing PA and SB in Childcare (M = 4.71 ± .74). Monitor PA and Sedentary Time Within Your Classroom had the lowest combined score (M = 3.77 ± 1.44). There was moderate-to strong inter-panel agreement for content area importance rankings (rs = 0.60, 95% CI: 0.20 to 0.83). The majority of the ECE expert panel considered this training important for ECE students (94.3%), aligning with ECE curriculum objectives (91.4%) and accreditation standards (78.8%), and complementary to the present ECE curriculum (88.6%). CONCLUSIONS: Providing PA and SB training to ECE students is a proactive way to ensure healthy movement behaviours are prioritized in childcare programming. With the PA/SB expert-developed content areas, and endorsement by the ECE expert panel, implementing this training within ECE programs is a necessary next step.

Infant and Toddler Child-Care Quality and Stability in Relation to Proximal and Distal Academic and Social Outcomes.

This study considered the quality and stability of infant and toddler nonparental child care from 6 to 36 months in relation to language, social, and academic skills measured proximally at 36 months and distally at kindergarten. Quality was measured separately as caregiver-child verbal interactions and caregiver sensitivity, and stability was measured as having fewer sequential child-care caregivers. This longitudinal examination involved a subsample (N = 1,055) from the Family Life Project, a representative sample of families living in rural counties in the United States. Structural equation modeling revealed that children who experienced more positive caregiver-child verbal interactions had higher 36-month language skills, which indirectly led to higher kindergarten academic and social skills. Children who experienced more caregiver stability had higher kindergarten social skills.

Health and Safety in a Family Child Care Network: An Analysis of Violation Data of Routine, Full Unannounced Inspections.

OBJECTIVE: To analyze how engagement with a staffed family child network is associated with compliance on health and safety regulations among family day care (FDC) homes. METHODS: Publically available data on health and safety inspection violations on FDC homes were merged with engagement data from a staffed family child network. Descriptive analysis, logistic regression, and latent class analysis were used. RESULTS: Network FDC homes, compared to non-network FDC homes, were less likely to have health and safety violations in the areas of Child/Family/Staff Documentation (43.1% vs. 53.6%, p = 0.001) and Indoor Safety (36.0% vs. 42.6%, p = .041). Controlling for area median income and for decades since obtaining license, network FDC homes had fewer violations, fewer violation categories, and less variety of violation categories. Additionally, FDC homes which were not engaged with the staffed family child network but were in the city or town in which the network offered services, performed better compared to FDC homes in cities or towns without network resources. CONCLUSIONS FOR PRACTICE: The better compliance among network FDC homes and among FDC homes in cities and towns where the network offers services, suggests that the network is having positive effects on health and safety quality in FDC homes. A staffed child care network may be a means to improve child care quality and may be a means of improving educational and health outcomes for children.

Mothers mothering in prison: an experience report of the nursing care project.

OBJECTIVES: to report the experience of designing and implementing the nursing care project with mothers and babies in prison. METHODS: this is an experience report about the nursing care project with mothers and children in prison, having as a guiding axis Winnicottian concepts about the mother-baby relationship. RESULTS: nursing consultations were held in childcare, thematic conversation circles and the manufacture of artifacts to encourage child development, as well as women's health care. The positive impact of the project has made it a health education program. FINAL CONSIDERATIONS: elaborating the nursing care project encouraged other ways of providing care and implementing it, using Winnicottian concepts. It is recommended that training institutions consider the prison and the individuals there as a field in the learning process of health professionals.

Impact of changes to the Child and Adult Care Food Program on children's dietary intake in family child care homes.

OBJECTIVE: To estimate the impact of recent changes to the Child and Adult Care Food Program (CACFP) meal pattern on young children's diets in family child care homes (FCCHs) serving racially/ethnically diverse children. DESIGN: In a natural experimental study of thirteen CACFP-participating FCCHs, we used digital photographs taken of children's plates before and after meals matched with menus to measure children's dietary intake both prior to implementation of the new meal patterns (summer/fall of 2017) and again 1 year later (summer/fall of 2018). Generalised estimating equations tested for change in intake of fruits, vegetables, whole grains, 100 % juice, grain-based desserts, meat/meat alternates and milk, adjusting for clustering of observations within providers. SETTING: FCCHs in Boston, MA, USA. PARTICIPANTS: Three- to 5-year-old children attending FCCHs. RESULTS: We observed 107 meals consumed by twenty-eight children at the thirteen FCCHs across an average of 2·5 (sd 1·3) d before the CACFP policy change, and 239 meals consumed by thirty-nine children across 3·8 d (sd 1·4) 1 year later. During lunch, fruit intake increased by about a third of a serving (+0·38 serving, 95 % CI 0·04, 0·73, P = 0·03), and whole grain intake increased by a half serving (+0·50 serving, 95 % CI 0·19, 0·82, P = 0·002). No changes were seen in other meal components. CONCLUSION: Young children's dietary intake in CACFP-participating FCCHs improved following the CACFP meal pattern change, particularly for fruits and whole grains, which were targets of the new policy. Additional research should examine impacts of the changes in other child care settings, age groups and locales.

Preschool Quality Effects on Learning Behavior and Later Achievement in Germany: Moderation by Socioeconomic Status.

This study investigates whether children's preschool experiences are associated with later achievement via enhanced learning behaviors using data from a German longitudinal study following children (N = 554) from age 3 in preschool to age 8 in second grade. There were two main findings. First, results suggest that more positive learning behaviors at school entry mediate effects of teacher-child interactions in preschool on second-grade achievement. Second, these effects varied by parental socioeconomic status (SES) indicating that low-SES children benefited the most. The findings highlight the role of preschool classroom environments in shaping the school readiness of children with socioeconomic risk factors.

The Effect of Upgrades to Childcare Outdoor Spaces on Preschoolers' Physical Activity: Findings from a Natural Experiment.

Physical inactivity is a significant risk factor for childhood obesity. Preventing obesity in the early years reduces the risk of developing chronic health conditions later. Early childhood education and care (ECEC) services are important settings to establish good preschooler physical activity behaviors. This natural experiment investigated the influence of ECEC outdoor physical environment upgrade on preschoolers' physical activity (aged 2-5 years). Centers implemented upgrades without researcher input. Physical activity was measured by 7-day accelerometry for intervention (n = 159; 6 centers) and control (n = 138; 5 centers) groups. ECEC outdoor space was assessed using a modified Environment and Policy Assessment and Observation (EPAO) Instrument. Key outcomes were measured at baseline and 6-12 months follow-up. Fixed sandboxes, balls, portable slides, portable floor play equipment (e.g., tumbling mats), and natural grassed areas were positively associated with activity levels; fixed tunnels and twirling equipment were negatively associated with activity levels (all p < 0.05). Post-upgrade portable play equipment (balls, twirling equipment, slides, floor play equipment) increased intervention preschoolers' moderate-vigorous physical activity (MVPA) levels compared to control (p < 0.05). Intervention preschoolers were more active than control at follow-up (58.09 vs. 42.13 min/day increase in total physical activity; 30.46 vs. 19.16 min/day increase in MVPA (all p < 0.001)). Since few preschoolers meet daily activity recommendations while at ECEC, the findings may help ECEC providers to optimize outdoor physical environments and encourage more active play among preschoolers.

Inclusive early childhood education and care: a longitudinal study into the growth of interprofessional collaboration.

Inclusive early childhood education and care (ECEC) requires interprofessional collaboration between professionals with diverse professional backgrounds. Following developments in human services, there is a growing interest in the role of interprofessional teams in community-based settings for young children. In a three-year longitudinal study, we investigated interprofessional collaboration (IPC) between staff from childcare, education and youth care. At the individual level, a survey was used for the analysis of IPC competences. At the network level, we investigated professional relationships between individuals using social network analysis. Results of a multilevel mixed linear model showed an increase in interdependence and reflection on process of individual staff, followed by the progressive development of perceived team performance. Smaller networks with higher density and professionals' centrality predicted more positive perceptions of inclusive ECEC. We discuss our findings in the context of growing interest in interprofessional teams in ECEC.

Mothers mothering in prison: an experience report of the nursing care project / Madres maternando en la prisión: relato de experiencia de lo proyecto asistencial de enfermería / Mães maternando na prisão: relato de experiência do projeto assistencial de enfermagem

ABSTRACT Objectives: to report the experience of designing and implementing the nursing care project with mothers and babies in prison. Methods: this is an experience report about the nursing care project with mothers and children in prison, having as a guiding axis Winnicottian concepts about the mother-baby relationship. Results: nursing consultations were held in childcare, thematic conversation circles and the manufacture of artifacts to encourage child development, as well as women's health care. The positive impact of the project has made it a health education program. Final Considerations: elaborating the nursing care project encouraged other ways of providing care and implementing it, using Winnicottian concepts. It is recommended that training institutions consider the prison and the individuals there as a field in the learning process of health professionals.

RESUMEN Objetivos: informar la experiencia de elaborar e implementar proyecto asistencial de enfermería con madres y bebés en la cárcel. Métodos: se trata de relato de experiencia sobre proyecto asistencial de enfermería con madres e hijos en la prisión, teniendo como eje orientador conceptos winnicottianos sobre la relación madre-bebé. Resultados: se realizaron consultas de enfermería en puericultura, ruedas de conversación temáticas y confección de artefactos para el estímulo al desarrollo infantil, además de cuidados a la salud de la mujer. El impacto positivo del proyecto lo convirtió en un programa de educación en salud. Consideraciones Finales: elaborar el proyecto asistencial de enfermería estimuló otros modos de prestar cuidados e implementarlo, utilizando los conceptos winnicottianos, se mostró apropiado. Se recomienda que instituciones formadoras consideren la prisión y los individuos que allí están como campo del proceso de aprendizaje de los profesionales de salud.

RESUMO Objetivos: relatar a experiência de elaborar e implementar o projeto assistencial de enfermagem com mães e bebês na prisão. Métodos: trata-se de um relato de experiência sobre o projeto assistencial de enfermagem com mães e filhos na prisão, tendo como eixo norteador conceitos winnicottianos sobre a relação mãe-bebê. Resultados: foram realizadas consultas de enfermagem em puericultura, rodas de conversa temáticas e confecção de artefatos para o estímulo ao desenvolvimento infantil, além de cuidados à saúde da mulher. O impacto positivo do projeto tornou-o um programa de educação em saúde. Considerações Finais: elaborar o projeto assistencial de enfermagem estimulou outros modos de prestar cuidados e implementá-lo, utilizando os conceitos winnicottianos. Recomenda-se que instituições formadoras considerem a prisão e os indivíduos que lá estão como campo do processo de aprendizagem dos profissionais de saúde.