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1.
Dis Model Mech ; 13(6)2020 06 23.
Artigo em Inglês | MEDLINE | ID: mdl-32764155

RESUMO

The outbreak of COVID-19 has stalled both the basic, clinical and non-COVID medical research. The scientific community has shown extraordinary flexibility and resilience in responding to the pandemic. However, funding restructuring, risk of infection, cancelation of scientific conferences and delayed experiments have already proven detrimental to the career opportunities of early-career scientists. Moreover, school closures and a lack of systematic support for childcare have been additional challenges for early- and mid-career researchers who have young children. This Editorial describes an early-career researcher's experience and highlights how after efficiently contributing to 'flattening the curve' of COVID-19 infections, the research community has an opportunity for growth and re-structuring.


Assuntos
Betacoronavirus , Pesquisa Biomédica , Infecções por Coronavirus/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Pesquisa Biomédica/economia , Criança , Cuidado da Criança/economia , Cuidado da Criança/provisão & distribução , Pré-Escolar , Humanos , Pessoal de Laboratório Médico , Cidade de Nova Iorque/epidemiologia , Pesquisadores
2.
BMC Med ; 18(1): 218, 2020 07 15.
Artigo em Inglês | MEDLINE | ID: mdl-32664927

RESUMO

BACKGROUND: School closures have been enacted as a measure of mitigation during the ongoing coronavirus disease 2019 (COVID-19) pandemic. It has been shown that school closures could cause absenteeism among healthcare workers with dependent children, but there remains a need for spatially granular analyses of the relationship between school closures and healthcare worker absenteeism to inform local community preparedness. METHODS: We provide national- and county-level simulations of school closures and unmet child care needs across the USA. We develop individual simulations using county-level demographic and occupational data, and model school closure effectiveness with age-structured compartmental models. We perform multivariate quasi-Poisson ecological regressions to find associations between unmet child care needs and COVID-19 vulnerability factors. RESULTS: At the national level, we estimate the projected rate of unmet child care needs for healthcare worker households to range from 7.4 to 8.7%, and the effectiveness of school closures as a 7.6% and 8.4% reduction in fewer hospital and intensive care unit (ICU) beds, respectively, at peak demand when varying across initial reproduction number estimates by state. At the county level, we find substantial variations of projected unmet child care needs and school closure effects, 9.5% (interquartile range (IQR) 8.2-10.9%) of healthcare worker households and 5.2% (IQR 4.1-6.5%) and 6.8% (IQR 4.8-8.8%) reduction in fewer hospital and ICU beds, respectively, at peak demand. We find significant positive associations between estimated levels of unmet child care needs and diabetes prevalence, county rurality, and race (p<0.05). We estimate costs of absenteeism and child care and observe from our models that an estimated 76.3 to 96.8% of counties would find it less expensive to provide child care to all healthcare workers with children than to bear the costs of healthcare worker absenteeism during school closures. CONCLUSIONS: School closures are projected to reduce peak ICU and hospital demand, but could disrupt healthcare systems through absenteeism, especially in counties that are already particularly vulnerable to COVID-19. Child care subsidies could help circumvent the ostensible trade-off between school closures and healthcare worker absenteeism.


Assuntos
Absenteísmo , Cuidado da Criança/economia , Infecções por Coronavirus/epidemiologia , Pessoal de Saúde/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Instituições Acadêmicas , Betacoronavirus , Criança , Simulação por Computador , Estudos de Viabilidade , Previsões , Geografia , Mão de Obra em Saúde , Humanos , Unidades de Terapia Intensiva , Determinação de Necessidades de Cuidados de Saúde , Pandemias , Estados Unidos/epidemiologia
4.
J Grad Med Educ ; 12(2): 162-167, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32322349

RESUMO

Background: Parenting issues can affect physicians' choice of specialty or subspecialty, as well as their selection of individual training programs, because of the distinctive challenges facing residents and fellows with children. Specific information about how residents perceive these challenges is limited. Objective: We sought to better understand the challenges associated with parenting during residency and fellowship training in order to inform policy and research. Methods: In 2017, a voluntary online questionnaire was distributed to all 2214 Partners HealthCare graduate medical education trainees across 285 training programs. The survey queried attitudes of and about trainees with children and assessed needs and experiences related to parental leave, lactation, and childcare. Responses were compared between subgroups, including gender, surgical versus nonsurgical specialty, parental status, and whether the respondent was planning to become a parent. Results: A total of 578 trainees (26%) responded to the questionnaire. Of these, 195 (34%) became parents during training. An additional 298 (52%) planned to become parents during training. Respondents overwhelmingly agreed that their institution should support trainees with children (95%) and that doing so is important for trainee wellness (98%). However, 25% felt that trainees with children burden trainees without children. Childcare access, affordability, and availability for sufficient hours were identified as key challenges, along with issues related to parental leave, lactation facilities, and effect on peers. Conclusions: This survey highlights trainees' perspectives about parenting during their clinical training, signaling parental leave, lactation facilities, and childcare access and affordability as particular challenges and potential targets for future interventions.


Assuntos
Bolsas de Estudo/organização & administração , Internato e Residência/organização & administração , Poder Familiar , Adulto , Atitude do Pessoal de Saúde , Cuidado da Criança/economia , Cuidado da Criança/estatística & dados numéricos , Pré-Escolar , Educação de Pós-Graduação em Medicina , Bolsas de Estudo/estatística & dados numéricos , Feminino , Humanos , Lactente , Internato e Residência/estatística & dados numéricos , Lactação , Masculino , Massachusetts , Determinação de Necessidades de Cuidados de Saúde , Licença Parental/estatística & dados numéricos , Gravidez , Inquéritos e Questionários
5.
Demography ; 56(4): 1247-1272, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31286428

RESUMO

Despite evidence from other regions, researchers and policy-makers remain skeptical that women's disproportionate childcare responsibilities act as a significant barrier to women's economic empowerment in Africa. This randomized control trial study in an informal settlement in Nairobi, Kenya, demonstrates that limited access to affordable early childcare inhibits poor urban women's participation in paid work. Women who were offered vouchers for subsidized early childcare were, on average, 8.5 percentage points more likely to be employed than those who were not given vouchers. Most of these employment gains were realized by married mothers. Single mothers, in contrast, benefited by significantly reducing the time spent working without any loss to their earnings by shifting to jobs with more regular hours. The effects on other measures of women's economic empowerment were mixed. With the exception of children's health care, access to subsidized daycare did not increase women's participation in other important household decisions. In addition, contrary to concerns that reducing the costs of childcare may elevate women's desire for more children, we find no effect on women's fertility intentions. These findings demonstrate that the impact of subsidized childcare differs by marital status and across outcomes. Nonetheless, in poor urban Africa, as elsewhere, failure to address women's childcare needs undermines efforts to promote women's economic empowerment.


Assuntos
Cuidado da Criança/economia , Emprego/estatística & dados numéricos , Empoderamento , Mães/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Adulto , Pré-Escolar , Países em Desenvolvimento , Características da Família , Feminino , Humanos , Lactente , Quênia , Estado Civil/estatística & dados numéricos , Fatores Socioeconômicos
7.
Int J Occup Med Environ Health ; 32(3): 281-290, 2019 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-31180070

RESUMO

It is estimated that every third person living in Europe suffers from allergic diseases. Allergies are a growing health problem in Poland where 40% of the population have allergy symptoms, including 12% afflicted with asthma. The actual cost of allergic diseases is difficult to estimate due to the lack or incompleteness of the relevant data. The aim of this review is to present estimates of the indirect costs of allergic diseases in Poland and globally, using asthma, allergic rhinitis and atopic dermatitis as examples. The analysis also includes the impact of allergic diseases on the costs to the social welfare system and employers. The literature review of the indirect costs of allergic diseases shows that the indirect costs of a disease, which substantially exceed the direct costs, increase with the disease activity and severity. Interestingly, some studies have found that the indirect costs of lost productivity due to hours missed from work to take care of a sick child could be threefold higher than those of absence due to a worker's own illness. The indirect costs of a disease can be significantly reduced by early diagnosis and appropriate treatment. Int J Occup Med Environ Health. 2019;32(3):281-90.


Assuntos
Asma/economia , Efeitos Psicossociais da Doença , Dermatite Atópica/economia , Rinite Alérgica/economia , Absenteísmo , Asma/epidemiologia , Criança , Cuidado da Criança/economia , Dermatite Atópica/epidemiologia , Humanos , Presenteísmo , Qualidade de Vida , Rinite Alérgica/epidemiologia
9.
BMC Public Health ; 19(1): 598, 2019 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-31101035

RESUMO

BACKGROUND: There is a growing interest in the costs of informal care; however, the results of previous studies mostly rely on self-reported data, which is subject to numerous biases. The aim of this study is to contribute to the topic by estimating the indirect costs of short-term absenteeism associated with informal caregiving in Poland with the use of social insurance data on care absence incidence. METHODS: The human capital method was used to estimate the indirect costs of caregiving from a societal perspective. The incidence of caregiving was identified based on the Social Insurance Institution's data on absence days attributable to care provided to children and other family members. Gross domestic product (GDP) per worker was used as a proxy of labour productivity. Deterministic one-way sensitivity analysis was performed. RESULTS: The indirect costs of short-term caregivers' absenteeism in Poland was €306.2 million (0.116% of GDP) in 2006 and increased to €824.0 million in 2016 (0.180% of GDP). The number of care absence days grew from 5.9 million (0.45 days per worker) in 2006 to 10.6 million (0.70 days per worker) in 2016. Approximately 85% of the total costs were attributable to child care. The results of the sensitivity analysis show that the indirect costs varied from the base scenario by - 30.8 to + 15.8%. CONCLUSION: Informal short-term caregiving leads to substantial productivity losses in the Polish economy, and the dynamic upward trend of care absence incidence suggests that the costs of caregiving are expected to rise in the future.


Assuntos
Absenteísmo , Cuidadores/economia , Cuidado da Criança/economia , Efeitos Psicossociais da Doença , Gastos em Saúde/estatística & dados numéricos , Adulto , Criança , Eficiência , Feminino , Produto Interno Bruto , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Polônia/epidemiologia , Previdência Social/economia , Fatores de Tempo
10.
Indian J Pediatr ; 86(7): 599-607, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30945236

RESUMO

Epilepsy is a chronic neurological disorder which affects not only the health of the affected child, but also has an economic, psychological and emotional impact on the family as a whole. In the transition from Person with Disability (PWD) act (1995) to Rights of Persons with Disabilities act (RPWD act) (2016), which covers all aspects of life of a person with any disability, epilepsy has been excluded from the list of disorders, resulting in a loss of many of the benefits that were earlier available to persons with epilepsy, causing concern to all caregivers of persons with epilepsy. Additionally, physicians/ pediatricians/ neurologists are not really aware of the benefits that are available to persons with epilepsy, especially children. To address these issues, an expert group meeting of pediatric neurologists and epileptologists in India along with social workers/epilepsy educators legal experts, parents, and teachers was held. The implication of epilepsy being dropped as a disability, was discussed, and most of the experts concurred that epilepsy should be considered as a disability, depending of the type of seizures or the epilepsy syndrome. Also, the current status of income tax benefits, child care benefits, travel concession, schooling and health insurance for children with epilepsy in India were also discussed. The importance of creating awareness on these issues was stressed on. Here authors present the group consensus statement on these legal and social aspects about the care of children with epilepsy.


Assuntos
Consenso , Epilepsia/psicologia , Neurologia , Cuidadores/psicologia , Criança , Cuidado da Criança/economia , Cuidado da Criança/normas , Creches , Avaliação da Deficiência , Família , Humanos , Imposto de Renda , Índia , Neurologistas , Pais/psicologia , Pediatras , Médicos , Guias de Prática Clínica como Assunto , Convulsões/psicologia
11.
Pediatr Diabetes ; 20(1): 93-98, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30471084

RESUMO

Optimal care for children and adolescents with type 1 diabetes is well described in guidelines, such as those of the International Society for Pediatric and Adolescent Diabetes. High-income countries can usually provide this, but the cost of this care is generally prohibitive for lower-income countries. Indeed, in most of these countries, very little care is provided by government health systems, resulting in high mortality, and high complications rates in those who do survive. As lower-income countries work toward establishing guidelines-based care, it is helpful to describe the levels of care that are potentially affordable, cost-effective, and result in substantially improved clinical outcomes. We have developed a levels of care concept with three tiers: "minimal care," "intermediate care," and "comprehensive (guidelines-based) care." Each tier contains levels, which describe insulin and blood glucose monitoring regimens, requirements for hemoglobin A1c (HbA1c) testing, complications screening, diabetes education, and multidisciplinary care. The literature provides various examples at each tier, including from countries where the life for a child and the changing diabetes in children programs have assisted local diabetes centres to introduce intermediate care. Intra-clinic mean HbA1c levels range from 12.0% to 14.0% (108-130 mmol/mol) for the most basic level of minimal care, 8.0% to 9.5% (64-80 mmol/mol) for intermediate care, and 6.9% to 8.5% (52-69 mmol/mol) for comprehensive care. Countries with sufficient resources should provide comprehensive care, working to ensure that it is accessible by all in need, and that resulting HbA1c levels correspond with international recommendations. All other countries should provide Intermediate care, while working toward the provision of comprehensive care.


Assuntos
Serviços de Saúde do Adolescente , Cuidado da Criança , Diabetes Mellitus Tipo 1/economia , Diabetes Mellitus Tipo 1/terapia , Recursos em Saúde/estatística & dados numéricos , Adolescente , Serviços de Saúde do Adolescente/economia , Serviços de Saúde do Adolescente/estatística & dados numéricos , Criança , Cuidado da Criança/economia , Cuidado da Criança/métodos , Assistência Integral à Saúde/economia , Assistência Integral à Saúde/estatística & dados numéricos , Países em Desenvolvimento/economia , Países em Desenvolvimento/estatística & dados numéricos , Complicações do Diabetes/economia , Complicações do Diabetes/mortalidade , Complicações do Diabetes/terapia , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/epidemiologia , Humanos , Instituições para Cuidados Intermediários/economia , Instituições para Cuidados Intermediários/estatística & dados numéricos , Mortalidade , Pobreza/economia , Pobreza/estatística & dados numéricos , Unidades de Autocuidado/economia , Unidades de Autocuidado/estatística & dados numéricos
12.
Child Care Health Dev ; 44(3): 370-377, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29327378

RESUMO

BACKGROUND: Families and caregivers of children with special healthcare needs (CSHCN) often experience financial difficulties, have unmet physical and mental health needs, and are at increased risk of marital problems due to the stress caused by carrying for their child. Within the larger population of CHSCN, young people with cerebral palsy (CP) have more unmet needs due to the complexity and potential severity of the disability. The purpose of this study was to identify factors associated with differences in insurance coverage and impact on the family of children with CP and other CHSCN. METHODS: The data were taken from the National Survey of Children with Special Health Care Needs, which was designed to examine state- and national-level estimates of CSHCN. Three variables examined differences in insurance coverage between those children diagnosed with CP versus all other CSHCN: insurance coverage for the previous year, current insurance coverage, and adequacy of insurance coverage. Four variables representing different indicators of family impact were used to assess differences between children with CP versus all other CSHCN: out-of-pocket expenses for healthcare, family financial burden, hours per week that family members spent caring for the child, and impact on family work life. RESULTS: The results of this study showed significant differences between households with a child with CP and a child with another health special need in terms of insurance coverage, indicating a tendency of children with CP to be insured the entire year. As for the impact on the family in households with children with CP versus other CSHCN, there were significant differences in all four variables that were analysed. CONCLUSIONS: There is limited evidence highlighting differences between the impact of caring for a child with CP and caring for other CSHCN. Caring for a child with CP has a significant impact on the family, despite insurance coverage.


Assuntos
Paralisia Cerebral/economia , Crianças com Deficiência , Financiamento Pessoal/estatística & dados numéricos , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Cobertura do Seguro/estatística & dados numéricos , Seguro Saúde/estatística & dados numéricos , Adolescente , Cuidadores , Paralisia Cerebral/epidemiologia , Paralisia Cerebral/reabilitação , Criança , Cuidado da Criança/economia , Efeitos Psicossociais da Doença , Crianças com Deficiência/reabilitação , Família , Feminino , Pesquisas sobre Serviços de Saúde , Gastos em Saúde/estatística & dados numéricos , Gastos em Saúde/tendências , Acesso aos Serviços de Saúde/economia , Acesso aos Serviços de Saúde/estatística & dados numéricos , Necessidades e Demandas de Serviços de Saúde/economia , Pesquisa sobre Serviços de Saúde , Humanos , Cobertura do Seguro/economia , Seguro Saúde/economia , Masculino , Assistência Médica/estatística & dados numéricos , Estados Unidos/epidemiologia
13.
Artigo em Inglês | MEDLINE | ID: mdl-29165332

RESUMO

The purpose of this study was to estimate the economic burden of violence against children in South Africa. We assembled summative estimates of lifetime prevalence, calculated the magnitude of associations with negative outcomes, and thereby estimated the economic burden of violence against children. According to our calculations, 2.3 million and 84,287 disability-adjusted life-years (DALYs) lost in South Africa in 2015 were attributable to nonfatal and fatal violence against children, respectively. The estimated economic value of DALYs lost to violence against children (including both fatal and nonfatal) in South Africa in 2015 totalled ZAR173 billion (US $13.5 billion)-or 4.3% of South Africa's gross domestic product (GDP) in 2015. In addition, the reduced earnings attributable to childhood physical violence and emotional violence in South Africa in 2015 were ZAR25.2 billion (US $2.0 billion) and ZAR9.6 billion (US $750 million), respectively. In addition, South Africa spent ZAR1.6 billion (US $124 million) on child care and protection in fiscal year 2015/2016, many of which costs are directly related to violence against children. This study confirms the importance of prioritising violence against children as a key social and economic concern for South Africa's future.


Assuntos
Maus-Tratos Infantis/economia , Criança , Cuidado da Criança/economia , Serviços de Proteção Infantil/economia , Pré-Escolar , Feminino , Humanos , Masculino , Prevalência , Anos de Vida Ajustados por Qualidade de Vida , África do Sul/epidemiologia
15.
J Agromedicine ; 22(4): 376-383, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28759340

RESUMO

The goal of this project was to protect children while parents work in agriculture by improving off-farm services for children of migrant and seasonal farm workers. Large agricultural enterprises have policies forbidding children in the worksite. At the same time, their employees, who are trying to generate income, seek as many work hours as possible but often lack viable options for childcare services. As employers strive to increase their labor pool, and workers seek off-farm childcare, there is mutual interest in improving access to childcare services in agricultural regions dependent on large numbers of full-time and seasonal workers. This report describes the employers' perspectives on childcare needs of hired farm workers' families and their barriers and motivators to facilitating off-farm childcare services. Using descriptive survey research methodology, data were collected from a convenience sample of 102 agribusiness owners and Human Resource directors attending an agricultural conference regarding labor laws or personnel management. Results revealed significant differences for those companies employing more than 25 workers compared to their counterparts. Primary motivators for offering childcare as an employment benefit were improved employee morale, enhanced company reputation, and a more stable workforce. A major barrier was that half of large-scale enterprises lack guidance on how to provide childcare options for their workers. Survey results are being used to facilitate collaboration among employers, farm workers, and childcare providers to offer a safe, nurturing environment for children while their parents work in agriculture.


Assuntos
Cuidado da Criança , Fazendas , Adolescente , Adulto , Criança , Cuidado da Criança/economia , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Migrantes , Recursos Humanos , Adulto Jovem
16.
J Health Econ ; 55: 219-231, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-28811120

RESUMO

This paper tests the effectiveness of performance pay and bonuses among government childcare workers in India. In a controlled study of 160 ICDS centers serving over 4000 children, we randomly assign workers to either fixed bonuses or payments based on the nutritional status of children in their care, and also collect data from a control group receiving only standard salaries. In all three study arms mothers receive nutrition information. We find that performance pay reduces underweight prevalence by about 5 percentage points over 3 months, and height improves by about one centimeter. Impacts on weight continue when incentives are renewed and return to parallel trends thereafter. Fixed bonuses are less expensive but lead to smaller and less precisely estimated effects than performance pay, especially for children near malnutrition thresholds. Both treatments improve worker effort and communication with mothers, who in turn feed a more calorific diet to children at home.


Assuntos
Cuidado da Criança/organização & administração , Saúde da Criança/estatística & dados numéricos , Reembolso de Incentivo , Adulto , Cuidado da Criança/economia , Transtornos da Nutrição Infantil/epidemiologia , Transtornos da Nutrição Infantil/prevenção & controle , Pré-Escolar , Feminino , Humanos , Índia/epidemiologia , Masculino , Estado Nutricional , Salários e Benefícios , Magreza/epidemiologia
17.
Obesity (Silver Spring) ; 25 Suppl 1: S26-S38, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-28229539

RESUMO

OBJECTIVE: Appetite regulation is influenced by the environment, and the environment is shaped by food-related policies. This review summarizes the environment and policy research portion of an NIH Workshop (Bethesda, MD, 2015) titled "Self-Regulation of Appetite-It's Complicated." METHODS: In this paper, we begin by making the case for why policy is an important tool in efforts to improve nutrition, and we introduce an ecological framework that illustrates the multiple layers that influence what people eat. We describe the state of the science on how policies influence behavior in several key areas: the federal food programs, schools, child care, food and beverage pricing, marketing to youth, behavioral economics, and changing defaults. Next, we propose novel approaches for multidisciplinary prevention and intervention strategies to promote breastfeeding, and examine interactions between psychology and the environment. RESULTS: Policy and environmental change are the most distal influences on individual-level appetite regulation, yet these strategies can reach many people at once by changing the environment in which food choices are made. We note the need for more research to understand compensatory behavior, reactance, and how to effectively change social norms. CONCLUSIONS: To move forward, we need a more sophisticated understanding of how individual psychological and biological factors interact with the environment and policy influences.


Assuntos
Regulação do Apetite/fisiologia , Apetite , Comportamento de Escolha , Dieta/psicologia , Comportamento Alimentar/psicologia , Política Nutricional/legislação & jurisprudência , Adolescente , Criança , Cuidado da Criança/economia , Cuidado da Criança/normas , Pré-Escolar , Custos e Análise de Custo/economia , Dieta/economia , Meio Ambiente , Preferências Alimentares/psicologia , Serviços de Alimentação/economia , Serviços de Alimentação/normas , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Política Nutricional/economia , Instituições Acadêmicas/economia , Instituições Acadêmicas/normas
18.
Fed Regist ; 81(190): 67438-595, 2016 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-27726322

RESUMO

This final rule makes regulatory changes to the Child Care and Development Fund (CCDF) based on the Child Care and Development Block Grant Act of 2014. These changes strengthen requirements to protect the health and safety of children in child care; help parents make informed consumer choices and access information to support child development; provide equal access to stable, high-quality child care for low-income children; and enhance the quality of child care and the early childhood workforce.


Assuntos
Cuidado da Criança/economia , Cuidado da Criança/legislação & jurisprudência , Bem-Estar da Criança/economia , Bem-Estar da Criança/legislação & jurisprudência , Desenvolvimento de Pessoal/economia , Desenvolvimento de Pessoal/legislação & jurisprudência , Apoio ao Desenvolvimento de Recursos Humanos/economia , Apoio ao Desenvolvimento de Recursos Humanos/legislação & jurisprudência , Criança , Pré-Escolar , Programas Governamentais/economia , Programas Governamentais/legislação & jurisprudência , Humanos , Estados Unidos
19.
An. pediatr. (2003. Ed. impr.) ; 84(4): 189-194, abr. 2016. tab
Artigo em Espanhol | IBECS | ID: ibc-151004

RESUMO

Objetivo: Estudiar el impacto de la crisis económica sobre las familias de los niños que acuden a las consultas de Atención Primaria y su relación con el nivel socioeconómico. Pacientes y métodos: Estudio descriptivo observacional mediante cuestionario. Se han recogido 453 encuestas de niños entre 1 y 7 años de edad pertenecientes a 4 consultas de Atención Primaria de Madrid. Se analizaron datos crudos, comparaciones entre grupos y análisis multivariante. Resultados: En el análisis multivariante, las variables relacionadas con no comprar medicamentos prescritos son: tener menor nivel de ingresos OR=0,118 p<0,0001 y de estudios OR=0,464, p=0,001; con la disminución del gasto en alimentación: tener menos ingresos OR=0,100, p<0,0001 y el número de miembros de la familia OR=1,308, p=0,045; con vacunarse frente a rotavirus sin financiación influye el tener mayor nivel de ingresos OR=2,170, p=0,0001 y de estudios OR=1,835, p=0,013 y no ser inmigrante OR=0,532, p=0,037. La presencia de problemas de salud desde la crisis está relacionada con encontrarse en paro OR=4,079, p=0,032 y tener menor nivel de estudios R=0,678, p=0,042 y de ingresos OR=0,342, p<0,0001. En todos los casos los modelos presentaron una significación estadística para p<0,0001. Conclusiones: La crisis tiene mayor impacto en el grupo con menor nivel de ingresos en todas las variables analizadas. Influye el tener menor nivel de estudios y el número de miembros de la familia en la disminución de gasto en alimentación, el ser inmigrante en la no vacunación por rotavirus y el estar en paro en la presencia de problemas de salud en la familia. En resumen la crisis ha aumentado las desigualdades de acuerdo con el nivel socioeconómico (AU)


Objective: To study the impact of the economic crisis on the families of the children who attend Primary Health Care and its relationship with their socioeconomic status. Patients and methods: Observational descriptive study was conducted by analysing the results of 453 questionnaires, given to the parents of children between 1 and 7 years old who attended 4 paediatric clinics in Madrid. The raw data was analysed, and comparisons between groups and multivariate analysis were performed. Results: In the multivariate analysis, the variables related to the non-acquisition of prescribed medication are: lower income level OR=0.118, p<.0001 and lower educational level OR=0.464, p<.001; the variables related to the reduction of food expenditure are: lower income level OR=0.100, p<.0001 and a higher number of family members OR=1.308, p=.045; the variables related to anti-pneumococcal vaccination without public funding are: higher income level OR=2.170, p=.0001, higher educational level OR=1.835, p=.013, and not being an immigrant OR=0.532, p=.037. The presence of health problems from the beginning of the economic crisis is related to unemployment OR=4.079, p=.032, lower educational level R=0.678, p=.042, and income level OR=0.342, p<.0001. In all cases, the models achieved a statistical significance of p<.0001. Conclusions: The economic crisis has greater impact on the group with the lowest income level in all analysed variables. The lower educational level and higher number of family members has an impact on the reduction in food expenditure. The fact of being an immigrant has an impact on not receiving the anti-pneumococcal and rotavirus vaccination. Unemployment leads to an increase in health problems in the family. To sum up, the economic crisis has increased inequalities according to socioeconomic status (AU)


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Avaliação em Saúde/métodos , Valor da Vida/economia , Cuidado da Criança/economia , Cuidado da Criança , Saúde da Criança , Atenção Primária à Saúde/economia , Atenção Primária à Saúde , Epidemiologia Descritiva , Estudo Observacional , Espanha
20.
Scand J Psychol ; 57(3): 233-42, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26991664

RESUMO

This research investigated how a couple decides which parent stays home as a childcare provider by attempting to determine the economic value on maternal care versus paternal care while examining the potential effects of nationality, gender role attitudes, and social support. We collected data from 240 American participants and 250 Norwegian participants who were asked to decide how much a mother needs to earn to allow her husband to stay at home to provide childcare and how much a father needs to earn to allow his wife to stay at home and provide childcare, in addition to items assessing gender role attitudes. No effect of social support was found, but Norwegians were slightly more likely than Americans to place a heavier earning burden on the husband. There were few differences in gender role attitudes by nationality. The impact of public policy and social desirability on the results and childcare decision making are discussed.


Assuntos
Cuidado da Criança/economia , Relações Pais-Filho , Poder Familiar , Adolescente , Adulto , Criança , Economia Comportamental , Pai , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mães , Noruega , Fatores Sexuais , Apoio Social , Fatores Socioeconômicos , Estados Unidos , Adulto Jovem
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