Food Allergy Guidelines for Schools and Childcare Facilities.

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

Beyond childcare: Changes in the amount and types of parent-child time over three decades.

Parents' time with children has increased over the past several decades, according to many scholars. Yet, research predominantly focuses on childcare activities, overlooking the majority of time that parents spend with children. Using time diaries from the 1986-2015 Canadian General Social Survey, we examine trends in the quantity and distribution of parents' childcare time and total co-present time in the company of children, as well as the behavioral or compositional drivers of these trends. Co-present time with children increased sharply since the mid-1980s, by 1 hour per day for fathers and 1.5 hours for mothers. This rise was driven not only by childcare activities, but also parents' time in housework and mothers' time in leisure with children present. Decomposition analyses indicate that changes in parenting behavior primarily explain these increases in co-present time. This study expands knowledge on intensive parenting through a more comprehensive understanding of parents' daily lives with children.

Selon de nombreux chercheurs, le temps que les parents passent avec leurs enfants a augmenté au cours des dernières décennies. Pourtant, la recherche se concentre principalement sur les activités de garde d'enfants, négligeant la majorité du temps que les parents passent avec les enfants. À l'aide d'agendas tirés de l'Enquête sociale générale canadienne de 1986 à 2015, nous examinons les tendances relatives à la quantité et à la répartition du temps passé par les parents à s'occuper des enfants et du temps total de coprésence en compagnie des enfants, ainsi que les facteurs comportementaux ou compositionnels de ces tendances. Le temps de coprésence avec les enfants a fortement augmenté depuis le milieu des années 1980, de 1 heure par jour pour les pères et de 1,5 heure pour les mères. Cette augmentation est due non seulement aux activités de garde d'enfants, mais aussi au temps consacré par les parents aux tâches ménagères et par les mères aux loisirs en présence des enfants. Les analyses de décomposition indiquent que les changements de comportement parental expliquent principalement ces augmentations du temps de coprésence. Cette étude élargit les connaissances sur la parentalité intensive par une compréhension plus complète de la vie quotidienne des parents avec les enfants.

Cuidado infantil, aislamiento y virtualización educativa durante la pandemia del COVID-19 en la Argentina

La pandemia de COVID-19 iniciada a finales de 2019 tuvo un impacto en la salud colectiva, aunque diferencial en función de la vulneración de derechos básicos de vastos sectores de la población y de las dificultades para el acceso a la atención en salud. Interpeló a los Estados y a las sociedades respecto de los obstáculos y las posibilidades de las políticas sanitarias integrales, las políticas del cuidado y la salud comunitaria. Asimismo, la complejidad socio-sistémica que evidenció la pandemia puso de manifiesto los límites del enfoque biomédico para afrontar la crisis sanitaria y la necesidad de considerar la perspectiva de la determinación social de la salud para la generación de respuestas adecuadas para garantizar los derechos de la población. Dentro de las poblaciones especialmente afectadas se encuentra la población infantil. En Argentina, INDEC determinó que, a fines del 2020, más de la mitad (57,7%) de las personas de 0 a 14 años eran pobres. Asimismo, durante la pandemia se profundizaron las brechas educativas, digitales y nutricionales y la exposición a situaciones de violencia. En este escenario, ante las recomendaciones de diversos organismos acerca del cuidado infantil en el período de cuarentena surgen interrogantes sobre las posibilidades y obstáculos para su desenvolvimiento. (AU)

Continuidad de cuidados en Salud Mental infanto-juvenil

El siguiente artículo indaga las condiciones de articulación de la red socio-sanitaria en las prácticas de salud mental infanto-juvenil en el subsector público de salud en la Ciudad de Buenos Aires, siguiendo el hilo de políticas específicas de continuidad de cuidados en la red de servicios de salud mental en los últimos veinte años y las derivas presentes en la recepción de la llamada niñez en riesgo en sus recorridos de vida, singulares y colectivos. (AU)

Primero los niños

Reflexiones sobre la primera infancia y el niño, y como deviene sujeto, a partir del goce, la palabra o el cuerpo; así como la función del analista, en esta transición.

Fathers' involvement in child care activities: Qualitative findings from the highlands of Madagascar.

Few studies have investigated fathers' roles in child care in Madagascar. This study explored the perceptions, attitudes, and practices regarding fathers' involvement in child care using qualitative methods. Ten focus group discussions were conducted among parents of children aged 6-23 months; seven were among mothers, and three among fathers. In-depth semi-structured interviews (n = 8) were also conducted with key informants. Discussions and interviews were audio-recorded and the verbatim transcripts in Malagasy were translated into English. Data were analyzed using the thematic analysis approach. Provision of financial and material support as well as teaching and playing with the child were the main perceived roles of fathers. In practice, fathers spent their time alone with their children playing and holding them when the mother was unavailable. Busy schedules and separation due to work were major barriers to fathers' involvement. Traditional gender roles for child care in which the mother is seen as primarily responsible for the child were salient across the data. Consequently, men involved in child care activities and their wives were often criticized by the community. Nevertheless, there was self-reported interest from both mothers and fathers in involving men more in child care. Interventions aimed to increase fathers' involvement in child care may be more successful when they focus on shifting the community perceptions on the division of responsibilities between fathers and mothers.

Who Is Caring for Health Care Workers' Families Amid COVID-19?

Amid the COVID-19 pandemic, women in medicine, including faculty, residents, medical students, and other health care workers (HCWs), are facing unparalleled challenges. The burdens of pandemic-associated increases in domestic and caregiving responsibilities, professional demands, health risks associated with contracting COVID-19, and the resulting psychosocial distress have exacerbated existing gender disparities at home, at work, and in academia. School and day care closures have created additional childcare needs, primarily for women, yet little support exists for parents and families. These increased childcare and domestic responsibilities have forced women HCWs, who make up the overwhelming majority of the workforce, to adapt their schedules and, in some cases, leave their jobs entirely. In this article, the authors detail how COVID-19 has exacerbated existing childcare accessibility and affordability issues as well as gender disparities. They argue that unless government and health care organization support for childcare increases, families, specifically women and children, will continue to suffer. Lack of access to affordable childcare can prevent HCWs from doing their jobs, including conducting and publishing academic scholarship. This poses incalculable risks to families, science, and society. COVID-19 should serve as a call to action to all sectors, including the government and health care organizations, to prioritize childcare provision and increase support for women HCWs, both now during the pandemic and going forward.

COVID-19 Transmission in US Child Care Programs.

OBJECTIVES: Central to the debate over school and child care reopening is whether children are efficient coronavirus disease 2019 (COVID-19) transmitters and are likely to increase community spread when programs reopen. We compared COVID-19 outcomes in child care providers who continued to provide direct in-person child care during the first 3 months of the US COVID-19 pandemic with outcomes in those who did not. METHODS: Data were obtained from US child care providers (N = 57 335) reporting whether they had ever tested positive or been hospitalized for COVID-19 (n = 427 cases) along with their degree of exposure to child care. Background transmission rates were controlled statistically, and other demographic, programmatic, and community variables were explored as potential confounders. Logistic regression analysis was used in both unmatched and propensity score-matched case-control analyses. RESULTS: No association was found between exposure to child care and COVID-19 in both unmatched (odds ratio [OR], 1.06; 95% confidence interval [CI], 0.82-1.38) and matched (OR, 0.94; 95% CI, 0.73-1.21) analyses. In matched analysis, being a home-based provider (as opposed to a center-based provider) was associated with COVID-19 (OR, 1.59; 95% CI, 1.14-2.23) but revealed no interaction with exposure. CONCLUSIONS: Within the context of considerable infection mitigation efforts in US child care programs, exposure to child care during the early months of the US pandemic was not associated with an elevated risk for COVID-19 transmission to providers. These findings must be interpreted only within the context of background transmission rates and the considerable infection mitigation efforts implemented in child care programs.

Reorganizações familiares no contexto do cuidado ao bebê com Síndrome Congênita do Zika Vírus / Reorganizaciones familiares en el contexto del cuidado al bebé con síndrome del Zika Virus / Family restructuring in the context of baby's care with Zika Virus Congenital Syndrome

O artigo trata de experiências de familiares no cuidado de crianças com Síndrome Congênita do Zika Vírus (SCZV) e objetiva analisar o impacto do nascimento do bebê com malformação, as reorganizações psíquicas parentais e seus desdobramentos no cuidado, particularmente o materno. Foi adotada abordagem psicossocial, de base psicanalítica, em diálogo com estudos do campo da Saúde Coletiva. São analisadas narrativas de familiares de 32 encontros grupais realizados em ambulatório de um Instituto de Pesquisa no Rio de Janeiro, Brasil, em 2017. O processo de análise pautou-se na psicossociologia e na análise temática. Angústias, incertezas e sobrecarga marcaram a experiência parental. As dificuldades de desenvolvimento do bebê levaram os pais a um modo singular de lidar com seus filhos e à construção de caminhos de esperança e resistência. O protagonismo materno tornou-se a base para lutas nas áreas social, de saúde e educação. (AU)

El artículo trata sobre experiencias familiares en el cuidado de niños con Síndrome Congénito del Zika Virus y su objetivo es analizar el impacto del nacimiento del bebé con malformación, las reorganizaciones psíquicas parentales y sus desdoblamientos en el cuidado, particularmente el materno. Se adoptó el abordaje psicosocial, de base psicoanalítica, en diálogo con estudios del campo de la Salud Colectiva. Se analizaron narrativas de familiares de 32 encuentros grupales realizados en ambulatorio del Instituto de Investigación en Río de Janeiro, Brasil, en 2017. El proceso de análisis se pautó en la psicosociología y el análisis temático. Angustias, incertidumbres y sobrecarga señalaron la experiencia parental. Las dificultades de desarrollo del bebé llevaron a los padres a un modo singular de lidiar con sus hijos y a la construcción de caminos de esperanza y resistencia. El protagonismo materno se convirtió en la base para luchas en las áreas social, de salud y de educación. (AU)

This paper addresses family members' experiences in the care of children with the Zika Virus Congenital Syndrome. It aims to analyze the impact of the birth of babies with malformations, the parents' psychological restructuring - especially the mothers' - and the implications in the baby's care. A psychosocial, psychoanalytical approach was adopted in dialogue with Public Health studies. We analyzed the narratives of family members who attended 32 group meetings conductedin an outpatient clinic of a Research Institute in Rio de Janeiro, Brazil, in 2017. The analysis was based on psychosociology and thematic analysis. Anguish, uncertainties, and overload marked parental experience. The baby's developmental difficulties led parents to a unique way of dealing with their children and building hope and resistance paths. Maternal leadership became the basis for struggles in the social, health, and education fields. (AU)

La pediatria que volem / No disponible

No disponible

Identificar práticas de enfermagem de qualidade no ambulatório de pediatria: revisão sistemáticada literatura / dentify quality nursing practices in the pediatric outpatient care: a systematic review

Introduction: Outpatient care philosophy has been growing in the past years. Looking to the premise of pediatric healthcare, the establishing of outpatient treatment has advantage, like shortening the deep impact caused by familiar environment detachment, everyday routines and habits. This paradigm implies an adaptation of nursing care services and practices, where quality improvement should focus on continuity of care at home. Objective: to identify recommendations evidence-based of good practices to child / family nursing interventions in an outpatient setting, that allows the definition of standards / quality indicators. Methodology: A Systematic Review of Literature was performed, supported on the Cochrane Handbook orientations of studies published between 2004-2017. The research was conducted on EBSCO and PUBMED databases and resulted in 97 studies. After applying relevance tests, 80 were excluded and 17 included in the methodology critical assessment, done independently by two reviewers and based on defined criteria. At end, five articles1,2,3,4,5 were included. Results: The recommendations identified for the quality of outpatient nursing care are mainly directed to surgical situations, namely, prevention and control of infections, given the high turnover of children; use of digital strategies for preoperative preparation, avoiding anxiety and promoting early discharge, by empowering the family; telephone contact to support and ensuring continuity of care; assessment of the post-surgical condition using the Ped-PADSS checklist, ensuring the early discharge. Conclusion: The results of this study allowed us to obtain recommendations for use in nursing practice of outpatient care and enable to the consequent quality improvement of nursing care provided to child and family

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Childcare Physical Activity Interventions: A Discussion of Similarities and Differences and Trends, Issues, and Recommendations.

Early childhood education and care (ECEC) settings have a pivotal role in the promotion of physical activity for young children, and thus, the number of ECEC-based physical activity interventions has exponentially increased in the last two decades. The aim of this study was three-fold: (1) to discuss some of the similarities and differences in ECEC-based physical activity interventions, (2) to highlight current trends and issues in the ECEC sector relating to such interventions, and (3) to provide recommendations for future interventions. Twenty-four individual studies are discussed. Most studies have targeted children aged between 3 and 5 years and involved children participating in additional physical activity opportunities while at childcare. In all studies, educators participated in some professional development either prior or during the intervention. Less the half of the studies discussed reported significant positive changes in physical activity outcomes. Those involved in developing future interventions will need to consider current national and international trends in the ECEC sector (e.g., over-crowded curriculum, administrative requirements, and more highly-qualified educators devoting time for business development), as well as creative and unique ways of delivering ECEC-based physical activity interventions.

Nurses' moral deliberation in the child care process.

OBJECTIVE: To understand the nurses' moral deliberation in the face of an ethical problem involving breastfeeding. METHOD: Qualitative study based on the methodological theoretical framework of deliberative bioethics. Data collection was through a vignette-based interview and results were organized by thematic analysis. RESULTS: Nurses tend to take over intermediate courses of action, although extreme courses of action are found as well. FINAL CONSIDERATIONS: When they tend to take extreme courses of action, nurses approach decisions focused on the child welfare to the detriment of the mother's need as a working woman.

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

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

La Ciudad de las Niñas y los Niños de Huesca, una oportunidad en el diseño de entornos y políticas públicas saludables / The City of Girls and Boys of Huesca (Spain), an opportunity for designing healthy environment and public policies

La Ciudad de las Niñas y los Niños es un proyecto internacional que pretende fomentar la autonomía y la participación infantil plena en la construcción de la ciudad. Tras aprobarse en 2011 en el pleno del Ayuntamiento de Huesca, se crearon el Consejo de las Niñas y los Niños y el Laboratorio de la Ciudad, órganos en los que hay representación de todos los colegios de Huesca. Para hacer explícito el trabajo sobre la salud se han incorporado actividades como «Caminos saludables», en la que se utiliza la técnica del mapeo de activos. Además del trabajo interdisciplinario entre distintas áreas del ayuntamiento, profesionales de los sectores educativo (colegios y universidad), sanitario y social, se observan impactos en el entorno físico urbano, con la remodelación de un parque, una calle y una plaza; y en los estilos de vida de los escolares, al aumentar el número de aquellos que van andando solos al colegio

The City of Girls and Boys of Huesca (Spain) is an international project that seeks to foster children's autonomy and full participation in the construction of the city. Following its formal approval at the City Council of Huesca, the Girls and Boys Board and the City Laboratory were created, both of which include children from all the schools of Huesca. To highlightthe work on health, activities such as "Healthy School Paths", in which the asset mapping technique is used, were incorporated. Besides the interdisciplinary work among different areas of the city council, professionals from education (schools and university), health and social services, effects on the urban physical environment, with one street, park and square remodelled; and on the children's lifestyles, with more children walking to school alone, have been observed

Maternal schizophrenia and out-of-home placements of offspring: A national follow-up study among Finnish women born 1965-1980 and their children.

Schizophrenia may affect a mother's ability to parent. We investigated out-of-home placements among children with a biological mother having schizophrenia, and their relation to maternal characteristics and adverse perinatal health outcomes of the offspring. For each Finnish woman born between 1 JAN 1965 - 31 DEC 1980 and diagnosed with schizophrenia before 31 DEC 2013 (n = 5214), five matched controls were randomly selected from the Finnish Central Population Register. Children born to these women were identified and followed till 31 DEC 2013. The Child Welfare Register, the Medical Birth Register and the Register of Congenital Malformations were used to gather information. Altogether 35.1% of children with an affected mother and 3.2% of control children were placed out of home during the follow-up. The incidence rate ratio (IRR) of out-of-home placement among children with an affected mother was 12.6 (95% confidence interval (CI) 10.80-13.46) when children with a non-affected mother served as a reference. Single motherhood (IRR 2.2, 95% Cl 1.88-2.60) and maternal smoking (IRR 1.9, 95% Cl 1.68-2.16), but not an adverse perinatal outcome of the offspring, increased the risk of out-of-home placement. To conclude, maternal schizophrenia is a strong risk factor for placement of children in out-of-home care.

Contribuições da Primeira Infância Melhor para o crescimento e desenvolvimento infantil na percepção das famílias / Contributions of Better Childhood for Growth and child development in family perception / Contribuciones de la Primera Infancia Mejor para el crecimiento y desarrollo infantil en la percepción de las familias

Objetivo: Conocer las percepciones de las familias atendidas por la primera infancia mejor sobre su impacto en el crecimiento y desarrollo del niño y el cuidado de la familia. Métodos: Estudio cualitativo realizado con 15 familias. Los datos fueron recogidos por entrevistas en Septiembre de 2016 seguido de análisis temático. Resultados: El crecimiento y el desarrollo son procesos que ocurren al mismo tiempo, reconocieron el apoyo de los visitantes, que las situaciones de vulnerabilidad y el cambio constante de los visitantes interfieren negativamente con el crecimiento y desarrollo del niño, el programa ofrece oportunidades para construir el aprendizaje y el fortalecimiento una atención familiar efectiva. Conclusión: Se recomienda que la enfermería se incluye con el equipo interdisciplinario y que lo primera infancia mejor se visto en la atención primaria como una estrategia para fortalecer la promoción de la salud y la atención integral a los niños y sus familias

Objective: To know the perceptions of the families served by best childhood first about their repercussions on children's growth and development and on the family care of children. Methods: Qualitative study carried in the household of 15 families. Data were collected by semi structured interviews in September 2016 followed by analysis of thematic content. Results: They identified that growing and developing are processes that occur together, acknowledged the support of the visitors, that situations of vulnerability and the constant exchange of visitors interfere in the growth and development of children, that the program offers the construction of learning and strengthening of Effective family care. Conclusion: It is recommended that nursing be included in the interdisciplinary team, and that the best childhood first be visualized in primary care as a strategy capable of strengthening the promotion of health and the integral care for the child and his family

Objetivo: Conhecer as percepções das famílias atendidas pelo Primeira Infância Melhor acerca de suas repercussões no crescimento e desenvolvimento infantil e no cuidado familial das crianças. Método: Estudo qualitativo realizado no domicílio de 15 famílias. Os dados foram coletados por entrevistas semi estruturadas, em setembro de 2016, seguidas da análise de conteúdo temática. Resultados: Identificaram que crescer e se desenvolver são processos que ocorrem em conjunto, reconheceram o apoio dos visitadores, que situações de vulnerabilidade e a troca constante dos visitadores interferem negativamente no crescimento e desenvolvimento infantil, que o programa oportuniza a construção do aprendizado e fortalecimento de um cuidado familial efetivo. Conclusão: Recomenda-se que a enfermagem esteja incluída junto à equipe interdisciplinar, e que o Primeira Infância Melhor seja visualizado na atenção primária como uma estratégia capaz de fortalecer a promoção da saúde e a integralidade do cuidado à criança e sua família

Nurses' moral deliberation in the child care process / Deliberación moral de los enfermeros en el proceso de cuidado de los niños / Deliberação moral de enfermeiros no processo de cuidar de crianças

ABSTRACT Objective: To understand the nurses' moral deliberation in the face of an ethical problem involving breastfeeding. Method: Qualitative study based on the methodological theoretical framework of deliberative bioethics. Data collection was through a vignette-based interview and results were organized by thematic analysis. Results: Nurses tend to take over intermediate courses of action, although extreme courses of action are found as well. Final considerations: When they tend to take extreme courses of action, nurses approach decisions focused on the child welfare to the detriment of the mother's need as a working woman.

RESUMEN Objetivo: Comprender la deliberación moral de los enfermeros que enfrentan un problema ético relacionado con la lactancia materna. Método: Investigación cualitativa, basada en el marco teórico metodológico de la bioética deliberativa. La recolección de datos se realizó mediante una entrevista basada en viñeta y los resultados se organizaron mediante el análisis temático. Resultados: Los enfermeros tienden a tomar cursos de acción intermedios, sin embargo, se encuentran cursos de acción extremos. Consideraciones finales: Cuando tienden a tomar cursos de acción extremos, los enfermeros abordan las decisiones sobre el bienestar del niño, en detrimento de las necesidades de la madre como mujer trabajadora.

RESUMO Objetivo: Compreender a deliberação moral de enfermeiros diante de um problema ético envolvendo o aleitamento materno. Método: Estudo qualitativo, fundamentado no referencial teórico-metodológico da bioética deliberativa. A coleta de dados foi através de entrevista orientada por vinheta e os resultados foram organizados por análise temática. Resultados: Os enfermeiros tendem a assumir cursos de ações intermediários, todavia, são encontrados cursos de ação extremos. Considerações finais: Quando tendem a cursos de ação extremos, os enfermeiros acercam-se das decisões voltadas para o bem-estar da criança, em detrimento das necessidades da mãe, enquanto mulher trabalhadora.

Qualificação do cuidado a puericultura: uma intervenção em serviço na Estratégia de Saúde da Família / Qualification of the childcare approach: an intervention in the Family Health Strategy Service / Calificación del cuidado de los niños: intervención en servicio en la Estrategia Salud de la Familia

Objetivo: O estudo apresenta o relato de experiência de uma intervenção que teve como objetivo qualificar a puericultura em uma Estratégia de Saúde da Família no município de Boa Vista/Roraima. Método: A intervenção envolveu toda a equipe e teve a duração de 16 semanas, entre março a julho de 2015, nos quais foram instituídas ações direcionadas à organização e gestão do serviço, ao monitoramento e avaliação, à qualificação da prática clínica e ao engajamento público. Resultados: As ações permitiram qualificar o cuidado a 411 crianças, obtendo-se 98,6% da cobertura de atendimento, assim como a qualificação da prática clínica, adesão as ações com 100% de monitoramento do estado nutricional e desenvolvimento psicomotor, além da ampliação das atividades de promoção da saúde. Conclusão: A experiência contribuiu para melhorar a organização do serviço e integração da equipe alcançando resultados efetivos de cobertura e de qualidade da atenção relacionados a assistência a criança

Objective: This paper aims to describe the experience report of an intervention used to qualify the childcare provided by a Family Health Strategy service in the municipality of Boa Vista, Roraima State, Brazil. Methods: The intervention involved the entire team and lasted 16 weeks, over the period from March to July 2015, in which actions were performed for the organization and management of the service, monitoring and evaluation, qualification of clinical practice and public engagement. Results: The actions allowed to qualify the care to 411 children, obtaining 98.6% of care coverage, as well as the qualification of the clinical practice, compliance with the actions with 100% of nutritional status monitoring and psychomotor development, and the intensification of activities for health promotion. Conclusion: The experience contributed to improve the service organization and team integration, then achieving an effective coverage and quality of childcare

Objetivo: Averiguar la exposición de los trabajadores de la salud a riesgos físicos presentes en un hogar de ancianos. Métodos: estudio exploratorio descriptivo, de campo con un enfoque cuantitativo y de carácter transversal utilizando un inventario, preparado de conformidad con los requisitos de las resoluciones de la Junta Colegiada de ANVISA No. 283/2005 y 50/2002. Resultados: El campo de estudio tiene inadecuaciones frente a las normas establecidas por las resoluciones específicas exponiendo los trabajadores de salud a riesgos físicos, tales como: inadecuada distribución de los muebles descargas eléctricas, de humedad, de niveles de presión sonora, de falta de espacio y alta temperatura, entre otros. Conclusión: la institución estudiada no está de acuerdo con la legislación pertinente, y es evidente la presencia de riesgo físico que puede afectar la salud de los trabajadores y comprometer su calidad de trabajo