Caretaking Practices Research Articles

Polio, PPI, polio vaccine-Injectable form and Global Polio Vaccine Switch—what do the caretakers know about it?

Background: Before Global switch of polio vaccine and inactivated polio vaccine (IPV) introduction, beneficiaries must have knowledge about the change and its benefits over the preexisting facilities. Through this study we are trying to assess the knowledge of the caretakers regarding polio, pulse polio immunization (PPI), polio vaccine switch and polio vaccine injection so that new knowledge can be hanged on the peg of their preexisting knowledge. Objectives: 1. To assess knowledge and practice of caretakers about PPI, polio disease, polio vaccine-injectable form, and polio vaccine switch. 2. To find association of the knowledge and practice of respondents about PPI, polio disease, polio vaccine-injectable form and polio vaccine switch with their literacy. Materials and Methods: A cross-sectional study was carried out at pulse polio booth on NID, 2016. Caretakers were interviewed to assess their knowledge and practice about polio disease, polio vaccination, it’s availability in injectable form, and upcoming global polio switch through semi open-ended, pretested questionnaire. Data were entered in excel sheet, analyzed using SPSS version 20, and appropriate statistical tests were applied. Result: Maximum children were brought to the PPI booth by their grandparents and mothers (73%), source of information to maximum respondents was health staff and television (69%), correct knowledge about the parameters such as whether polio drops be given with mild illness (54%) and signs and symptoms of polio (59%) was fair, but many still consider PPI an overdose (18%), and as a replacement to routine immunization (18%). Respondents’ knowledge was poor about the mode of transmission of disease (7%), eradication status of polio (14%), injectable form of polio vaccine (5%), and polio vaccine switch (30%), and significant association was found between the literacy level and the knowledge of the respondents (p-value < 0.05). Conclusion: Although government is ready to launch IPV and switch to bivalent oral polio vaccine but knowledge of the caretakers is poor, which can threaten its acceptability.

Knowledge and practice among the caretakers of bedridden patients on prevention of urinary tract infection

INTRODUCTION: Urinary tract infection (UTI) is one of the major complications of immobility or bedridden condition. Between 46-59% of spinal cord injury patients develop urinary tract infection during the first year of trauma. UTI is a second most common type of infection, accounting for nearly 25% of all infections and a serious health problem affecting millions of people each year. The findings of the study might be helpful to the long term care health institution for the development the strategies to involve the caretakers to prevent urinary tract infection in bedridden patients. OBJECTIVE: The purpose of the study was to find out the level of knowledge and current practice of caretakers of bedridden patients on prevention of urinary tract infection. METHODS: The descriptive and cross-sectional study design was adopted in this study. A self-prepared structured interview questionnaire and observation checklist was used to collect data from 30 caretakers of hospitalized bedridden patients of Nepal Orthopedic Hospital and Spinal Injury Rehabilitation Center Jorpati implying purposive &amp; convenient sampling technique. RESULTS: Out of30 caretakers, no one had adequate (&gt;80%) knowledge and 46.6% had moderate (50-80%) knowledge and 53.3% had low (&lt;50%) knowledge on meaning, high risk group, contributing factors, signs &amp; symptoms, consequences and preventive measures of UTI as a whole. Caretaker's preventive practices of UTI for their bedridden patients were not satisfactory except encourage the patient for drinking 2-3 liters water per day. CONCLUSION: Majorities (53.3%) of the caretakers of bedridden patients had low level knowledge on preventive measures of UTI. Similarly UTI preventive practices of caretakers were also not satisfactory. Therefore, awareness raising programme on preventive measures of UTI need to be organized specially for caretakers.DOI: http://dx.doi.org/10.3126/jucms.v2i1.10488 Journal of Universal College of Medical Sciences (2014) Vol.2(1): 24-29

Feeding and oral hygiene habits of children attending daycare centres in Bangalore and their caretakers oral health knowledge, attitude and practices

Caretakers in day-care centers play a significant role in imparting good oral hygiene practices and also extend a working relationship with parents with regard to their children's oral health. As a result of this, caregiver's dental knowledge, attitudes, beliefs and practices affect the child's oral condition. A descriptive cross-sectional study involved caretakers working in day-care centers of Bangalore. Fifty-two day-care centers were randomly selected from the different zones of Bangalore city, from which 246 caretakers provided consent for participation. A comprehensive, closed-ended, self-administered questionnaire was employed which was designed to collect the sociodemographic details and to evaluate the oral health knowledge, attitudes, practice of caretakers. The institutional review committee approved the study. Data were entered using SPSS 13.01. Seventy-nine percent of the subjects had good knowledge of child's tooth eruption time, clinical presentation of dental caries and the role of fluoride in caries prevention. Yet, half of the subjects found routine dental examination after all the milk teeth have erupted in the oral cavity insignificant and 41% strongly agreed that dentist should be consulted only when the child has a toothache. In spite of the good knowledge, 77% preferred to use pacifier dipped in honey/sugar if the children acted troublesome. Analogous to this, 45% gave milk/juice with sugar before the child's nap time. The results of this study indicate that caretaker's attitude toward oral health care needs is far from acceptable standards to mirror any positive impact on the children.

Incidence and seasonality of hypothermia among newborns in southern Nepal.

To quantify incidence, age distribution, and seasonality of neonatal hypothermia among a large population cohort. Longitudinal cohort study. Sarlahi, Nepal. A total of 23 240 newborns born between September 2, 2002, and February 1, 2006. Main Exposures Community-based workers recorded axillary temperature on days 1 through 4, 6, 8, 10, 12, 14, 21, and 28 (213 636 total measurements). Regression smoothing was used to describe axillary temperature patterns during the newborn period. Hypothermia incidence in the first day, week, and month were estimated using standard cutoffs. Ambient temperatures allowed comparison of mild hypothermia (36.0 degrees C to <36.5 degrees C) and moderate or severe hypothermia (<36.0 degrees C) incidence over mean ambient temperature quintiles. Measurements lower than 36.5 degrees C were observed in 21 459 babies (92.3%); half (48.6%) had moderate or severe hypothermia, and risk peaked in the first 24 to 72 hours of life. Risk of moderate or severe hypothermia increased by 41.3% (95% confidence interval, 40.0%-42.7%) for every 5 degrees C decrease in average ambient temperature. Relative to the highest quintile, risk was 4.03 (95% confidence interval, 3.77-4.30) times higher among babies exposed to the lowest quintile of average ambient temperature. In the hot season, one-fifth of the babies (18.2%) were observed below the moderate hypothermia cutoff. Mild or moderate hypothermia was nearly universal, with substantially higher risk in the cold season. However, incidence in the hot season was also high; thus, year-round thermal care promotion is required. Research on community, household, and caretaker practices associated with hypothermia can guide behavioral interventions to reduce risk.

Accompagnement des intervenants médicopsychosociaux et collaboration des parents et des familles d’accueil dans l’éducation des enfants

Care-taking practices have evolved in an attempt to ensure continuity in the child’s relationships, to intensify cooperation with his natural and foster families and to improve social and educational support to them. Family situations with children in care who received early intervention (therapeutic, social and medical support, parenthood support) were studied. Interviews of these parents still show the ambivalence of their speech and the impact of early intervention in their adjustment to the placement situation. Cooperation is not an usual state and needs permanent support.

From phenotype to genotype

From phenotype to genotype

How does home management of asthma exacerbations by parents of inner-city children differ from NHLBI guideline recommendations? National Heart, Lung, and Blood Institute.

1) To describe the asthma morbidity, primary care practices, and asthma home management of inner-city children with asthma; 2) to determine the responses of parental caretakers to asthma exacerbations in their child; and 3) to compare these responses to the recommendations of the National Heart, Lung, and Blood Institute (NHLBI) asthma guidelines for home management of acute exacerbations of asthma. A 64-item telephone survey was administered between July 1996 and June 1997 to 220 parental caretakers of 2- to 12-year-old children who had been hospitalized with asthma at an inner-city medical center from January, 1995 to February, 1996. Sociodemographics, primary care practices, asthma morbidity, and asthma home management were assessed. Parents were asked what they would do if their child "began wheezing and breathing faster than usual." Morbidity measures indicated that there were an average of 2.5 +/- 4.5 emergency department visits for asthma in the last 6 months, 1.6 +/- 2.2 hospitalizations for asthma in the last 12 months, and 18.1 +/- 17.9 asthma-related school absences in the previous school year. Most, but not all, of the families had primary care providers and most had phone access to them. Half of the families (51%) reported having been given a written asthma action plan. Only 30% of families with children age 5 years and older had peak flow meters. In contrast, almost all families (97%) had equipment for inhalation of beta-agonists. Only 39% of the 181 children with persistent symptoms were receiving daily antiinflammatory agents as recommended in the guidelines of the NHLBI. In response to the scenario of an acute exacerbation of asthma, no one mentioned that they would refer to a written plan, only 1 caretaker would measure peak flow and 36% would give beta-agonists. Two percent would give oral steroids initially, and 1 additional person would do so if wheezing continued 40 minutes later. Only 4% responded that they would contact their clinician. Reports of actual practice differed from the scenario responses in that more people began beta-agonists and oral steroids in response to an exacerbation in the past 6 months than said they would in response to the scenario. In this population of previously hospitalized inner-city children with asthma, the NHLBI guidelines for the home management of asthma exacerbations are not being followed. Interventions are needed to affect both clinician and caretaker practices.

Gastroesophageal reflux.

1. Susan R. Orenstein, MD* 1. 2. *Professor of Pediatrics, Children’s Hospital of Pittsburgh, Division of Pediatric Gastroenterology, Pittsburgh, PA. 3. Dr. Orenstein receives research grant support from the Janssen Research Foundation. Thirty years ago, gastroesophageal reflux disease was virtually unknown; today, it seems necessary to consider it a potential cause of an enormous range of symptoms. Not long ago, reflux was diagnosed simply by ordering an upper gastrointestinal barium study; now the complexity of differentiating between gastroesophageal reflux (GER) episodes and gastroesophageal reflux disease (GERD) mandates an understanding of the strengths and weaknesses of a variety of tests. Several decades ago, few options for therapy of reflux existed, and those that did were not very effective or even frankly detrimental; currently, the range of proven therapeutic options is greater, and the pediatrician must exercise finesse in prescribing these options. It has been useful to consider the symptoms, diagnostic complexity, and therapy of reflux as an“ iceberg” (Figure⇓ ). The largest section at the bottom represents common, easily diagnosed, and easily treated cases; the tip of the iceberg represents those cases that occur less frequently, provide considerable diagnostic and therapeutic challenges, and require subspecialist consultation. Exactly where the demarcation occurs between these sections of the iceberg depends on the individual pediatrician’s expertise and the local availability of subspecialty expertise. Each section that follows will consider both infantile GERD (which is more common) and childhood GERD. Figure 1. The GERD iceberg. Reprinted with permission from Orenstein SR. Di Lorenzo C, Hyman P, Flores A. Pediatric Gastroesophageal Reflux: A Guide for Primary Care Physicians . Slide-lecture program sponsored and distributed by American Pseudo-obstruction and Hirschsprung’s Disease Society, Inc., Medfore MA, 1996. ### INFANTS Regurgitation is the classic symptom of reflux in infancy. However, we now understand that infantile regurgitation is not necessarily GERD (reflux disease) and that GERD may occur without any regurgitation, even in infancy. Other symptoms also should prompt the pediatrician to consider the possibility of GERD affecting an infant (Table 1⇓ ). ### CHILDREN During …

The Quechua Manta Pouch: A Caretaking Practice for Buffering the Peruvian Infant Against the Multiple Stressors of High Altitude

The manta pouch--a caretaking practice of tightly swaddling and enclosing the infant in a set of cloths and blankets--and other caretaking practices are described for high-altitude resident (> 4,000 m) Quechua mother-infant pairs (N = 14). The manta pouch modifies the microenvironment inside the pouch so that, compared to the ambient environment, the temperature is higher and more stable, the humidity is higher, the partial pressure of O2 is lower, and stimulation levels are reduced. As the infant gets older, the characteristics of the pouch are modified such that the infant is increasingly exposed to ambient conditions. These caretaking practices may benefit the infant by buffering the infant from the multiple ecological stressors of high altitude, but they may also incur costs by exposing the infant to additional microenvironmental stressors (e.g., higher CO2 levels) and by reducing stimulation and limiting infant movement.

Practices and representations of child care and motor development among West Africans in Paris

AbstractMassage techniques and postural manipulation used by West African women immigrants in Paris were studied, with the aim of demonstrating that culturally regulated caretaking practices have an influence on infant motor development. Twenty‐five infants were observed between the ages of 3 and 12 months and 9 and 15 months. Frequency of massage and its accompanying set of physical exercises were found to be related to age at onset of independent walking. The findings show that infants receiving daily massage walk significantly earlier than infants who do not receive massage, thus confirming other reports that vestibular and postural stimulation have a positive effect on motor development. These results are discussed in relation to the observed frequencey of contact and of physical games with the caregiver for a smaller sample of three infants, and to parental expectations about the age of acquisition of certain cognitive and motor abilities. African immigrant mothers expect their infants to sit and to walk earlier than French mothers. The conclusion emphasizes the contribution of social anthropology, which shows that in all cultures, physical development and body changes elicit symbolic practices and a search for explanation.

Factors Contributing to False Allegations of Child Sexual Abuse in Custody Disputes

This paper describes the mechanisms and psychodynamics underlying the increasingly observed phenomenon of false or unsubstantiated allegations of child sexual abuse initiated during child custody disputes. Misinterpretation of normal caretaking practices involvmg physical or affectionate contact between parent and child during bathing, toileting, dressing, hugging, or kissing is often at the core of the abuse allegation. This article reviews a number of possible situations involving false allegations and the impact on the children and families involved.

CRYING IN !KUNG SAN INFANTS: A TEST OF THE CULTURAL SPECIFICITY HYPOTHESIS

The pattern of crying and fretting behavior during the first two years is described for 46 !Kung San infants from a hunter-gatherer society in northwestern Botswana. Despite markedly different caretaking practices predisposing to quieter infants, crying and fretting were significantly greater during the first three months, and a peak pattern was present. Measurement of crying 'intensity' indicated that it was predominantly short and fretful. The results support the concept that the early peak pattern is not specific to infants in western industrialized societies, and may represent a behavior universal to the human species. The caretaking differences between societies primarily appear to affect crying duration rather than its frequency and pattern in early infancy.

The early crying paradox

In contemporary Western societies, infants in the first 3 months cry more than at any other time during their life. Although this crying is believed to function to assure nutrition, protection, and mother-infant interaction thought to be essential for later attachment, it also predisposes to complaints of excessive crying ("colic"), discontinuing breast-feeding, and, in the extreme case, child abuse. A resolution of this apparent paradox is proposed based on evidence that elements of caregiving are important determinants of some aspects of early crying. It is argued that early human crying under caretaking conditions typical in Western societies is characterized by prolonged crying bouts, that it is specifically the length of crying bouts (rather than frequency or pattern) that is affected by caregiving practice, and that prolonged crying bouts are probably not characteristic with caretaking practices typical in non-Western societies and possibly in our evolutionary past. It is suggested that caregiving behaviors may recruit normal physiological functions that potentiate cry bout duration in Western caregiving contexts, but reduce it in others. Frequent, short bouts are sufficient, and probably better suited than long bouts, to promote all the positive and presumably adaptive functions claimed for infant crying. Furthermore, they may have provided a mechanism by which infants could enhance their own fitness.

Multiple Caretaking of Efe (Pygmy) Infants

Two models of the human infant's caretaking requirements—the continuous care and contact model and the caretaker‐child strategy model—are discussed in terms of the caretaking practices observed among the Efe (Pygmies) of northeastern Zaire. The Efe1 engage in a system of multiple care which begins at birth and continues through at least the first 18 weeks of life. An important aspect of this care includes being suckled by lactating and nonlactating women. The data suggest that the continuous care and contact model is too rigid a formulation of the infant's caretaking environment, and lend support to the strategic model. Efe caretaking practices are discussed in terms of the cultural, ecological, and physiological constraints acting on these people.

The Cultural Context of Motor Development: Postural Manipulations in the Daily Life of Bambara Babies (Mali)

The present study is the first exploratory step of a larger investigation focusing on the influence of culturally-related caretaking practices on motor development. Four Bambara infants between 4 and 23 weeks of age were observed for two full days with a paper-and-pencil event-recording technique and with video films. We took down the infant's 'postural time-table', i.e., the different spatial positions experienced during everyday life (prone, supine, sitting, standing...) and the different postural adjustments required by maternal manipulations during caretaking and transportation.

Sex differences in the recognition of infant facial expressions of emotion: The primary caretaker hypothesis

Although much research has been devoted to studying sex differences in functioning (e.g., Maccoby and Jacklin 1974), most efforts have been directed toward documenting or elucidating the proximate causes of sex differences. Few attempts have been made, however, to explain the ultimate causes of these differences or the selective pressures that have led to the development of psychological differences between males and females [for exceptions see Symons (1979) and Daly and Wilson (1983)]. Toward this end of blending psychology with evolutionary theory we develop what we call the “primary caretaker hypothesis,” which predicts that the sex that through evolutionary time has dominated infant caretaking will differentially exhibit skills that are important in caretaking (e.g., the ability to rapidly recognize infant emotional expressions). Evidence is advanced to show that females dominate childcare in nonhuman primates and humans and that a high level of care of infants is crucial, given universally high infant mortality rates throughout our evolutionary history and the number of potential hazards impairing infant development. The prompt and accurate recognition of infant emotional cues—especially in the face—is an important component of caretaking practices, and thus selective pressures should result in greater proficiency in this ability in the sex that caretakes most. An experimental procedure is described where informants were tested in their speed and accuracy of identifying infant facial expressions of emotion. A statistical analysis of the results revealed that females were significantly more accurate and rapid than males in their discrimination of facial expressions and that previous experience in childcare had no effect on this sex difference. Follow-up research concerning the “primary caretaker hypothesis” is proposed.

Infant Psychiatry: A New Synthesis

This volume consists of 22 reprinted articles exploring a multitude of aspects of infant development. Many outstanding child psychiatrists have contributed. The following findings are among the highlights: Korner and Grobstein emphasize the individual differences at birth, and although the observations were derived from single children, future field data will help test statistically how generally true these relationships are. Blank focuses on the mother's role in infant development, emphasizing immediate effects of care-taking practices as opposed to their possible long-term consequences. Wolff concentrates in Piaget's sensorimotor theory of intelligence. Anthony picks up an extremely important topic of how children cope in families with a psychotic parent. Caplan et al focus their attention on perinatal stress, cognitive organization, and ego function in prematurely born children. The editors indicate why the reprinted papers were selected: (1) they were regarded as a classic and often quoted, (2) each represents a pioneering effort, which

Ritualization in the human infant-mother bond

My purpose is to point up the significance of some of the very earliest forms of ritual behaviour manifested in human ontogeny. These occur within the context of the early mother-infant relationship and, because in fact any aspect of the interactions between mother and infant may become ritualized, I must first distinguish between two broad kinds of ritual behaviour in this context. Both may be said to be patterns of behaviour which occur with great regularity and little deviation in specific kinds of situation. The first kind are essentially culturally prescribed and consist of maternal care-taking practices that show a rigidity and conformity in both form and repetitiveness that may far exceed the requirements for mutual personal adjustment between the infant and his mother. These ritualized practices, in both primitive and modern societies, are all methods of coping with the young infant’s helplessness, fragility and susceptibility to illness, and their prime function has to do with promoting the infant’s immediate survival. Among primitive societies, for example, one of the commonest sources of ritual practice by mothers is ‘evil-eye’ (e.g. Romney &amp; Romney 1963). This arises from the infant being stared at by witches or by other women who may be jealous of the infant. Its symptoms may be vomiting or fever, and death may ensue. Various protective practices are adopted by mothers in different societies: for example, putting a black dot on the baby’s temple or foot, putting scissors or crossed sticks at the head or foot of the crib to cut any evil powers, or putting a string of nuts around the baby’s waist to ward off any evil. In our own society, one of the most widespread care-taking rituals is scheduled feeding according to the clock, which is still often maintained with the strictest regularity and rigidity