Child Care Workers Research Articles

Altruistic Vaccination: Insights from Two Focus Group Studies.

Vaccination can protect vaccinated individuals and often also prevent them from spreading disease to other people. This opens up the possibility of getting vaccinated for the sake of others. In fact, altruistic vaccination has recently been conceptualized as a kind of vaccination that is undertaken primary for the benefit of others. In order to better understand the potential role of altruistic motives in people's vaccination decisions, we conducted two focus group studies with a total of 37 participants. Study 1 included three focus groups on the subject of HPV vaccination for boys. Study 2 included three focus groups on the subject of pertussis and measles vaccination for childcare workers. We found substantial evidence of other-regarding motives across all focus groups, which suggests that altruistic motives could be an important factor when it comes to people's vaccination decisions. We address the significance of these findings for vaccination policy surrounding HPV vaccination for boys and vaccination for childcare workers. We also extend the findings to normative work on vaccination for the sake of others more generally.

Gender Essentialism at Work? The Case of Norwegian Childcare Workers

Abstract We examine the influence of gender essentialism, a key explanation of gender segregation in the labor market, by zooming in on childcare work, which remains a female-dominated occupation. Building on the assumption that gender essentialism is expressed through people’s perceptions of what jobs and tasks are suitable for men and women, we ask the following question: are childcare workers gender essentialists? We answer this question by investigating the attitudes and work-task participation of 2,549 Norwegian childcare workers. The results show that the workers did not display gender-essentialist attitudes. Male and female workers reported significantly different levels of participation in some work tasks, but the main conclusion is that gender is not an organizing principle of work-task participation. These results contradict findings from previous studies and contribute to ongoing debates about the causes of segregation because attitudes and behaviors are often evoked as explanations for the status quo.

The Play Workforce in Wales – An Exploratory Demographic Study

An online survey of 211 playworkers, 90 childcare and early years workers, and 90 ‘other play’ professionals provided demographic data from 391 people involved in the play workforce in Wales. This was the first extensive survey of the Welsh play workforce since 2008 and was part of a larger Welsh play workforce study. Results of the study found the play workforce in Wales is predominately white, female with no disabilities. Differences within the play workforce exist in relation to the average age where playworkers are younger compared to childcare/early years workers and ‘other play’ professionals. There is a significant difference between the average years employed, hourly rate for both full-time and part-time employment, and types of play-related qualifications when comparing playworkers with childcare/early years workers and ‘other play’ professionals. The results from the study can contribute to both the statutory Play Sufficiency Assessment each of the 22 local authorities has to undertake as well as the current play review. The study could be replicated in England, Scotland, and Northern Ireland.

Progress of the social service professions in South Africa's developmental social welfare system: Social work, and child and youth care work

AbstractThis paper examines the progress of the social service professions delivering developmental social welfare in South Africa, a subject we have followed closely over the last 20 years. Being policy‐driven, developmental social welfare stemmed from expert social analyses that resulted in technically oriented solutions, including the broadening of social service professions. Twenty years on, it is hard to see developmental social welfare, as envisaged in government policy, in action, since the practice reality does not differ drastically from the prior apartheid system with the government's heavy reliance on social security as a poverty‐alleviation measure. The expanded social security budget has led to underfunded services and a crisis for social service professionals. This paper focuses on the regulated professions of social workers, and child and youth care workers. Our examination of critical issues for these occupational groups revealed that South Africa still has a long way to go in building a strong social service workforce.

Acceptance of Different Self-sampling Methods for Semiweekly SARS-CoV-2 Testing in Asymptomatic Children and Childcare Workers at German Day Care Centers

Closure of day care centers (DCCs) to contain the COVID-19 pandemic has been associated with negative effects on children's health and well-being. To investigate the acceptance of self-sampling methods for continuous SARS-CoV-2 surveillance among asymptomatic children and childcare workers (CCWs) in DCCs. This nonrandomized pilot study included children and CCWs at 9 DCCs in Wuerzburg, Germany, from May to July 2021. Twice weekly testing for SARS-CoV-2 was conducted by self-sampled mouth-rinsing fluid (saliva sampling [SAL], with subsequent pooled polymerase chain reaction test) plus nasal rapid antigen self-test (RAgT) (group 1), SAL only (group 2), or RAgT only (group 3) in children and CCWs. Main outcomes were rates for initial acceptance and successful (≥60% of scheduled samples) long-term participation. The probability of SARS-CoV-2 introduction into DCCs was modeled as a function of age-adjusted background incidence and DCC size. Of 836 eligible children, 452 (54.1%; 95% CI, 50.7%-57.4%) participated (median [IQR] age: 4 [3-5] years; 213 [47.1%] girls), including 215 (47.6%) in group 1, 172 (38.1%) in group 2, and 65 (14.4%) in group 3. Of 190 CCWs, 139 (73.2%; 95% CI, 66.4%-79.0%) participated (median [IQR] age: 30 [25-46] years; 128 [92.1%] women), including 96 (69.1%) in group 1, 29 (20.9%) in group 2, and 14 (10.1%) in group 3. Overall, SARS-CoV-2 PCR tests on 5306 SAL samples and 2896 RAgTs were performed in children, with 1 asymptomatic child detected by PCR from SAL. Successful long-term participation was highest in group 2 (SAL only; children: 111 of 172 [64.5%]; CCWs: 18 of 29 [62.1%]). Weekly participation rates in children ranged from 54.0% to 83.8% for SAL and from 44.6% to 61.4% for RAgT. Participation rates decreased during the study course (P < .001). The probability of SARS-CoV-2 introduction into a DCC with 50 children was estimated to reach at most 5% for an age-adjusted SARS-CoV-2 incidence below 143. Self-sampling for continuous SARS-CoV-2 testing was well accepted, with SAL being the preferred method. Given the high number of negative tests, thresholds for initiating continuous testing should be established based on age-adjusted SARS-CoV-2 incidence rates. German Registry for Clinical Trials Identifier: DRKS00025546.

Measuring Work-related Risk of Coronavirus Disease 2019 (COVID-19): Comparison of COVID-19 Incidence by Occupation and Industry-Wisconsin, September 2020 to May 2021.

BackgroundWork-related exposures play an important role in SARS-CoV-2 transmission, yet few studies have measured the risk of COVID-19 across occupations and industries.MethodsDuring September 2020 – May 2021, the Wisconsin Department of Health Services collected occupation and industry data as part of routine COVID-19 case investigations. Adults aged 18-64 years with confirmed or probable COVID-19 in Wisconsin were assigned standardized occupation and industry codes. Cumulative incidence rates were weighted for non-response and calculated using full-time equivalent (FTE) workforce denominators from the 2020 American Community Survey.ResultsAn estimated 11.6% of workers (347,013 of 2.98 million) in Wisconsin, ages 18-64 years, had COVID-19 from September 2020 to May 2021. The highest incidence by occupation (per 100 full-time equivalents) occurred among personal care and services workers (22.4), healthcare practitioners and support staff (20.7), and protective services workers (20.7). High risk sub-groups included nursing assistants and personal care aides (28.8), childcare workers (25.8), food and beverage service workers (25.3), personal appearance workers (24.4), and law enforcement workers (24.1). By industry, incidence was highest in healthcare (18.6); the highest risk sub-sectors were nursing care facilities (30.5) and warehousing (28.5).ConclusionsThis analysis represents one of the most complete examinations to date of COVID-19 incidence by occupation and industry. Our approach demonstrates the value of standardized occupational data collection by public health, and may be a model for improved occupational surveillance elsewhere. Workers at higher risk of SARS-CoV-2 exposure may benefit from targeted workplace COVID-19 vaccination and mitigation efforts.

Sensory modulation dysfunction in child victims of trauma from four residential care sites in southern Gauteng, South Africa

INTRODUCTION: The ability to modulate sensory input or the way an individual responds to sensory information, to create an appropriate adaptive response may be influenced by exposure to trauma. The study aimed to describe sensory modulation dysfunction in child victims of trauma in clinical settings in a residential urban South African setting. METHOD: A descriptive quantitative research design was implemented. Using purposive sampling, child victims of trauma from four residential care sites were selected. The Child Sensory Profile"™ 2 was completed on 128 children by childcare workers. RESULTS: Of the participants 91.4 % (117) were identified with sensory modulation dysfunction with only 8.6% (11) participants displaying no symptoms and scoring 'just like the majority of others' in all categories of the summary scores. More than 50% of the participants presented with sensory thresholds and self-regulation according to Sensory Avoidance, Sensory Sensitivity and Low Registration Quadrants that were 'more than others and much more than others'. Over 50% of participants also displayed difficulty in Touch Sensory Processing and Social-Emotional and Attentional Behaviours, in the 'more than others and much more than others' range. The sensory profile for this sample of Child Victims of Trauma, differed significantly from typical children 'just like the majority of others', indicating a vigilant sensory subtype with increased sensory sensitivity and sensory avoiding. CONCLUSION: A high percentage of child victims of trauma presented with sensory modulation dysfunction, mostly with low thresholds for sensory input. Sensory Modulation dysfunction leads to a disruption in self-regulation and adaptive behaviour affecting participation in occupations

Case Study on the Employment of a Person with Intellectual Disability in Childcare Work in Japan

Background: In recent years, it has become necessary to promote the employment of persons with intellectual disabilities in new occupations.&#x0D; Objective: This study aimed to analyze the case of a person with an intellectual disability employed in childcare work and examine it from the perspective of issues in securing employment for the disabled.&#x0D; Method: As a case study, an in-depth interview was conducted to survey a director of the Center for Early Childhood Education and Care, which had been hiring persons with intellectual disabilities and organizing the employment process for about four years.&#x0D; Results: The person with intellectual disability was assigned to perform direct support work, mainly childcare work, and was aided by staff members responsible for guidance and the verbalization of job instructions. In addition, the staff provided specific guidance for solving problems that occurred in daily life. The work could be carried out smoothly.&#x0D; Conclusion: While many people with intellectual disabilities are engaged in indirect support work, participating in direct support work, mainly childcare work, may positively affect their career development. Additionally, in focusing on the workplace, it is important to reconsider daily life issues from the viewpoint of long-term stability in the workplace and improve the methods used for transition support. The data were collected from a single case, which may limit the generalisability of the findings.

Consensus on Nasal Irrigation in Infants: A Delphi Study.

Nasal irrigation is regularly used in infants to relieve upper airway symptoms. However, because there is no consensus on good practice, nasal irrigation in infants is described and applied heterogeneously among clinicians and between clinical trials. The aim of this study was to establish consensus regarding the use of nasal irrigation in infants. A panel of Belgian physiotherapists and physicians experienced in performing nasal irrigation in infants were surveyed using the Delphi technique. Three survey rounds were used. Participants rated their level of (dis)agreement to each statement in each round using a 6-point Likert scale. Consensus was defined for statements which collected at least 75% of responses in agreement or disagreement. The questionnaire of Round 1 was built on nasal irrigation practice habits previously collected from parents, childcare workers, and healthcare professionals. Questionnaires from rounds 2 and 3 were amended based on experts written feedback. Thirty experts (12 physicians and 18 physiotherapists) completed all 3 questionnaires. Consensus was achieved for 47 of 75 statements (63%) distributed over the following domains: "contraindications," "indications and frequency of use," "irrigation means," "solution preparation," "solution volume," "realization of the technique," and "assessment of the efficacy of nasal irrigation." This study provides the first well-constructed consensus on good practice on nasal irrigation in infants. Consensus on several statements across different domains were established but require validation in future trials. This study also proposes direction for future research focusing on statements that did not reach consensus.

KiESEL – The Children’s Nutrition Survey to Record Food Consumption for the youngest in Germany

BackgroundWith KiESEL, the Children’s Nutrition Survey to Record Food Consumption, the German Federal Institute for Risk Assessment (BfR) collected representative food consumption data for children aged six months up to five years. KiESEL was one of five modules of KiGGS Wave2 (German Health Interview and Examination Survey for Children and Adolescents) conducted by the Robert Koch Institute (RKI). The objective was to update the consumption data for children in Germany and to fill a data gap for the age group of five-year-old children. The study provides an up-to-date and comprehensive database that will be used for exposure assessment, as part of risk assessment of Germany’s youngest consumers.MethodsIn the years 2014 to 2017, 1104 children from all over Germany participated in KiESEL. During home visits, survey staff conducted a questionnaire-based interview including a food propensity questionnaire (FPQ) on seldom eaten foods and questions concerning consumption outside home, dietary habits and diet during first year. The interviewer measured the children’s height and weight. Families and childcare workers filled out a food record, covering three consecutive days and one independent day. Data are based on the FPQ and present consumption frequencies. Depending on the question, socioeconomic status (SES) and migration background were considered.Results1104 participants had an interview and filled out the questionnaire on usual food intake, seldom eaten foods and consumption away from home. They were included in sample1. 1008 of these participants additionally reported food consumption of at least three days (sample2). 91.2% of the children follow no special diet and 0.8% are vegetarians. 7% of the older children consuming soya-drink. For some foods differences in consumption across SES or migration status were noted. Children from families with higher SES consume more often soya-based substitute milk as families with lower SES (p < 0.00005).ConclusionsKiESEL gathered up-to-date consumption data for more than 1000 children living in Germany, aged six month up to including five years. The data will be used for risk assessments of the BfR and provided to national and international partners.

“We may share the number of diaper changes”: A Privacy and Security Analysis of Mobile Child Care Applications

Mobile child care management applications can help child care facilities, preschools, and kindergartens to save time and money by allowing their employees to speed up everyday child care tasks using mobile devices. Such apps often allow child care workers to communicate with parents or guardians, sharing their children’s most private data (e. g., activities, photos, location, developmental aspects, and sometimes even medical information). To offer these services, child care apps require access to very sensitive data of minors that should never be shared over insecure channels and are subject to restrictive privacy laws. This work analyzes the privacy and security of 42 Android child care applications and their cloud-backends using a combination of static and dynamic analysis frameworks, configuration scanners, and inspecting their privacy policies. The results of our analysis show that while children do not use these apps, they can leak sensitive data about them. Alarming are the findings that many third-party (tracking) services are embedded in the applications and that adversaries can access personal data by abusing vulnerabilities in the applications. We hope our work will raise awareness about the privacy risks introduced by these applications and that regulatory authorities will focus more on these risks in the future.

Prevalence, incidence, and risk factors associated with cytomegalovirus infection in healthcare and childcare worker: a systematic review and meta-analysis

BackgroundCytomegalovirus (CMV) is transmitted by direct contact with body fluids from infected individuals. Transmission of CMV in households, particularly those with young children, contributes significantly to CMV infection in the general population. However, little is known about the contribution of occupational healthcare or childcare exposure to risk of CMV infection.ObjectivesTo determine CMV seroprevalence, incidence of primary infection, and associated risk factors in healthcare and childcare workers.MethodsSix electronic databases were searched systematically for publications on CMV infection in healthcare and childcare workers until March 7, 2022. Two authors independently evaluated the literature for quality and inclusion in our analyses. The pooled results for seroprevalence, incidence, and relative risk (RR) were determined using a random effects model. Heterogeneity among studies was quantified and further investigated in subgroup analysis and meta-regression. Publication bias was assessed using funnel plot. Statistical analyses were preformed using R version 4.05.ResultsForty-eight articles were included in this meta-analysis (quality assessment: 18 good, 14 fair, and 16 poor). Pooled CMV seroprevalence was 59.3% (95% CI: 49.8–68.6) among childcare workers and 49.5% (95% CI: 40.3–58.7) among healthcare workers, and pooled incidences of primary CMV infection per 100 person-years were respectively 7.4 (95% CI: 3.9–11.8) and 3.1 (95% CI: 1.3–5.6). RR for primary infection compared to controls were 3.4 (95% CI: 1.3–8.8) and 1.3 (95% CI: 0.6–2.7) for healthcare and childcare workers, respectively. The odds of CMV seropositivity were 1.6 (95% CI: 1.2–2.3) times higher for childcare workers compared to controls, but not significantly different between healthcare workers and controls (0.9; 95% CI: 0.6–1.2). CMV seropositivity in both groups was significantly associated with having one or more children residing at home, marital status, ethnicity, and age.ConclusionsChildcare workers, but not healthcare workers, have an increased risk of prevalent and incident CMV infection, a risk that is further increased with the presence of at least one child living at home. These findings suggest that enforcing simple, conventional hygienic measures in childcare settings could help reduce transmission of CMV, and that special precautionary measures for preventing CMV infection may not be required for pregnant healthcare workers.Systematic review registrationPROSPERO CRD42020139756

RURAL WOMEN IN HOUSEHOLD PRODUCTION SYSTEM: SOCIO-PERSONAL PROFILE, CONSTRAINTS AND SUGGESTIONS WITH EXTENSION STRATEGIES

Rural women are the invisible lifeline of the agrarian rural community. They are not only the pioneer of the home but they give incomparable contribution in agriculture also. To study the socio personal profile, constraints faced by rural women during their participation in household production system, suggestions to develop extension strategies, a study with ex post facto research design was conducted in three talukas named Vansda, Chikhali and Khergam of Navsari district. The interview schedule was prepared and pre-tested to collect the data. Total 120 respondents were surveyed through personal interview technique from their home, farm, office or any other workplace. Majority of the rural women were found in middle age groups belonged to joint and medium size of family, had education up to middle school level and medium level of farming experience with marginal size of land holding. They had medium level of social participation, extension participation, utilization of source of information with medium level of risk orientation, innovativeness, market orientation and self-confidence. It was found that the prescribed roles of women in society was perceived by the respondents as main constraint followed by Higher time consumption for household work, Child care and agricultural work at same time were increase work load, Poor educational background, Dominance of male members in family. Out of all suggestions to overcome the constraints mentioned by rural women, majority of them said that Transformation of society through awareness programmes on gender issues followed by Family members should give support and guidance, Due importance should be given to women in decision making, should be appointed that provide all the information about government schemes.

Représentations d'attachement, comportements extériorisés et pro-sociaux d'enfants ayant vécu de la maltraitance et issus de la population générale

IntroductionMaltreatment engendered by parental figures may undermine attachment within parent-child relationships and has been associated with the emergence of behavioural problems. These symptoms have been negatively correlated with pro-social behaviour. ObjectiveThis study aims to report attachment representations, behavioural problems and pro-social behaviour of school aged children that have been victims of maltreatment and who receive services from the Enfant and Youth Protection Centre (EYPC) in Quebec and the therapeutic, educative and pedagogic institute (TEPT) in France. The study also aims to examine the links between these variables and to compare these children with the general population (GP) regarding these variables. MethodEighty children, aged 6 to 12 years old, divided in three groups (GP: n = 40; EYPC: n = 27; TEPI: n = 13) participated in the study. Parents and childcare workers completed measures on externalized and pro-social behaviours. Children participated in an activity exploring their attachment representations. ResultsSignificant associations were found between pro-social and externalized behaviors, as well as between attachment representations concerning the child's emotional dysregulation and two other variables: maternal attachment representations (supportive and rejecting) and pro-social behaviour. Furthermore, no significant differences were found between the attachment representations of children from the GP and those that have been victims of maltreatment and who receive services from EYPC and TEPI. However, significant differences were found between these groups regarding pro-social and externalized behaviours. ConclusionThe present study furthers our knowledge about the influence of maltreatment on children's attachment representations and behaviour.

Vaccine Effectiveness of CanSino (Adv5-nCoV) Coronavirus Disease 2019 (COVID-19) Vaccine Among Childcare Workers-Mexico, March-December 2021.

BackgroundBeginning in March 2021, Mexico vaccinated childcare workers with a single-dose CanSino Biologics (Adv5-nCoV) COVID-19 vaccine. Although CanSino is currently approved for use in 10 Latin American, Asian, and European countries, little information is available about its vaccine effectiveness (VE).MethodsWe evaluated CanSino VE within a childcare worker cohort that included 1,408 childcare facilities. Participants were followed during March–December 2021 and tested through SARS-CoV-2 RT-PCR or rapid antigen test if they developed any symptom compatible with COVID-19. Vaccination status was obtained through worker registries. VE was calculated as 100% × (1−hazard ratio for SARS-CoV-2 infection in fully vaccinated vs. unvaccinated participants), using an Andersen-Gill model adjusted for age, sex, state, and local viral circulation.ResultsThe cohort included 43,925 persons who were mostly (96%) female with a median age of 32 years; 37,646 (86%) were vaccinated with CanSino. During March–December 2021, 2,250 (5%) participants had laboratory-confirmed COVID-19, of whom 25 were hospitalized and 6 died. Adjusted VE was 20% (95% CI = 10–29%) against illness, 76% (42–90%) against hospitalization, and 94% (66–99%) against death. VE against illness declined from 48% (95% CI = 33–61) after 14–60 days following full vaccination to 20% (95% CI = 9–31) after 61–120 days.ConclusionsCanSino vaccine was effective at preventing COVID-19 illness and highly effective at preventing hospitalization and death. It will be useful to further evaluate duration of protection and assess the value of booster doses to prevent COVID-19 and severe outcomes.

Jämställdhet och mäns medellivslängd

The average life expectancy of men in Sweden has rapidly approached that of women over the past twenty years. Deaths related to the consumption of alcohol and tobacco as well as to suicide have decreased among both sexes. However, this means that more men than women are being saved to live longer lives, since these causes of death are more common among men than women. Surprisingly, the relatively strong status of women in Swedish society may be an important factor underlying the levelling out of the gender differences in average life expectancy. As women's entry into the labour märket during the 1960s and 1970s resulted in an expansion of women's life space into previously male domains, this has also resulted in men's increased engagement with child care and household work during the 1980s and 1990s. The fact that men have taken on a more concrete responsibility for child care may in turn have significance for attitudes towards taking risks in traffic and the over-consumption of alcohol and smoking, both among men and in society in general. An overall greater impact by women's views on which societal issues should receive high priority is perhaps of even more importance. For example, the relatively prominent position of women in society led to early priority being given to child safety issues. All in all, this means that we have a society where health risks are viewed from a more "feminine" perspective than was previously the case, and that both women and men adopt more pronounced attitudes towards safety and care, which influences trends in health. This article shows that gender differences in average life expectancy are caused by factors that are highly sensitive to social change. There is no reason to mystify the fact that women live longer than men by attributing it to something inaccessible in women's biological nature. There is a great and still undeveloped potential in the study of how gender differences in average life expectancy arise/exist that can lead to new perspectives in our knowledge about the determinants of public health. Improved public health is one of many arguments for a more gender equal society.

Affording managed opportunities for independence to build looked-after young people’s resilience: perceptions and experiences of care workers

PurposeThe purpose of this study is to explore the contribution of what the authors have termed, “managed opportunities for independence” (MOI) in building the resilience of young people in care.Design/methodology/approachThe study used a qualitative, grounded theory methodology. Nine child and youth care workers were purposively sampled from various child and youth and care centres in South Africa.FindingsFindings indicate that MOI contribute to the development of resilience of young people in care.Originality/valueCare-leaving literature recognizes that too much protection does not adequately prepare young people for independent living. There is also increasing attention to the resilience processes that enable care-leavers to thrive during the transition from care to independent living. However, there is limited empirical research that looks at how in-care programmes develop young people’s resilience. In addition, very little is said about what it means for child and youth care practice. This study’s focus on the contribution of “managed opportunities for independence” in building the resilience of young people in care provides a foundation for understanding the care-leaving process better.

The Role of Housing Tenure Opportunities in the Social Integration of the Aging Pre-1970 Migrants in Beijing.

This study focuses on the social integration of the pre-1970 first-generation migrants in reformist China, who were born before the year 1970 while getting old in the destination cities. The pre-1970 first-generation migrants are not a homogeneous group but are composed of: (a) those over 45 years old and still working but facing age discrimination; and (b) the elderly granny as nanny assuming the domestic and child-care work for their sons or daughters in the destination cities. We conceptualized and re-defined the aging migrants’ social integration into three dimensions (i.e., participation practices, communication contacts, and subjective perceptions), and used the 2017 Migrant Dynamics Monitoring Survey (MDMS) data from Beijing to measure and explain the varied integration levels among a total of 1267 aging migrant samples in the Beijing metropolis. It is proven that housing tenure matters and housing tenure entitlement would be conductive to beefing up aging migrants’ integration. However, informal housing should not be “stigmatized” as a segregated world, since those dwelling in the informal housing have reported a higher probability of perceiving a fully integrated status (namely subjective well-being, SWB) than those living in the dormitory-like housing. Additionally, an employment-income paradox is found, which shows that higher economic achievement is NOT equivalent to a higher social integration status for the aging migrants.

Understanding barriers and facilitators to clinical trial participation among Black patients with multiple myeloma.

12137 Background: Currently, Black patients make up 20% of people living with multiple myeloma, yet they represent only 6% of participants in clinical trials.1 The underrepresentation of Black patients in clinical trials can contribute to outcome disparities thereby negatively impacting health equity in cancer treatment and outcomes.2 This project examined attitudes towards clinical trials among Black multiple myeloma patients and caregivers. Findings will inform the development of programs aimed at increasing clinical trial participation in this population. Methods: In 2021, the Cancer Support Community conducted an online survey to gain insights on barriers, facilitators, and perceptions of clinical trials among Black multiple myeloma patients and caregivers/care partners. Survey questions were informed by insights from prior focus groups. 94 patients and 101 caregivers were surveyed. Results: Most participants were male (62%) and African American (90%). 5% identified as African Caribbean and 5% as Black and Hispanic. The average age was 46 years. Just over half (51%) currently or previously participated in clinical trials. Of those who chose not to participate in a trial, the most common reasons were fear of side effects (46%) and fear of receiving a placebo (38%). Another barrier to participation reported was discomfort with being randomly assigned to a treatment (56%). Participants reported a significant level of distrust in medical research and doctors, saying that it was “very or somewhat likely” that doctors provide treatment as part of an experiment without patient consent (41%) and that they might be used as a “guinea pig” (25%). Of note, 57% of respondents said COVID had changed their attitude towards participating in clinical trials. 14 of 16 factors mentioned in our focus groups were affirmed by more than half of respondents as facilitating participation in a clinical trial. The top factors were: Understanding potential side effects (66%) My health care team speaks to me about trials (65%) Compensation offered for transportation, childcare, or time off work (62%) My family/community support my decision (61%). Conclusions: These findings are consistent with previous research which found that cancer patients reported the biggest attitudinal barriers to clinical trial participation were fear of side effects, distrust in medical research, and random assignment to clinical trial groups.3 Our study highlights that Blacks and African Americans living with multiple myeloma value multifactorial efforts to increase clinical trial participation: logistical and financial interventions, patient/provider communication, and culturally sensitive support and education programs. These programs can also work to improve health equity by reducing barriers to overall care and encouraging Blacks and African Americans living with multiple myeloma to be active members of their health care team.

Socioecology shapes child and adolescent time allocation in twelve hunter-gatherer and mixed-subsistence forager societies

A key issue distinguishing prominent evolutionary models of human life history is whether prolonged childhood evolved to facilitate learning in a skill- and strength-intensive foraging niche requiring high levels of cooperation. Considering the diversity of environments humans inhabit, children’s activities should also reflect local social and ecological opportunities and constraints. To better understand our species’ developmental plasticity, the present paper compiled a time allocation dataset for children and adolescents from twelve hunter-gatherer and mixed-subsistence forager societies (n = 690; 3–18 years; 52% girls). We investigated how environmental factors, local ecological risk, and men and women’s relative energetic contributions were associated with cross-cultural variation in child and adolescent time allocation to childcare, food production, domestic work, and play. Annual precipitation, annual mean temperature, and net primary productivity were not strongly associated with child and adolescent activity budgets. Increased risk of encounters with dangerous animals and dehydration negatively predicted time allocation to childcare and domestic work, but not food production. Gender differences in child and adolescent activity budgets were stronger in societies where men made greater direct contributions to food production than women. We interpret these findings as suggesting that children and their caregivers adjust their activities to facilitate the early acquisition of knowledge which helps children safely cooperate with adults in a range of social and ecological environments. These findings compel us to consider how childhood may have also evolved to facilitate flexible participation in productive activities in early life.