Child Care Research Articles

Positioning Ethics When Direct Patient Care is Prioritized: Experiences from Implementing Ethics Case Reflection Rounds in Childhood Cancer Care.

Caring for children with cancer involves complex ethical challenges. Ethics Case Reflection (ECR) rounds can be offered to support teams to reflect on challenges and what should be done in patient care. A training course, for facilitators of ECR rounds, has been offered to healthcare professionals (HCPs) in childhood cancer care by a Nordic working group on ethics. During/after the course, the trainees implemented and facilitated ECR rounds in their clinical setting. The aim was to explore the trainees' experiences of implementing ECR rounds in childhood cancer care. HCPs, who participated as trainees in the course, participated in 3 focus group interviews (n = 22) and 27 individual interviews (n = 17). Interview data were analysed concurrently with data collection following classic grounded theory. Positioning ethics is the core category in this study, used to resolve the main concern of doing ethics in a context where direct patient care is prioritized. Being able to take time for ethics reflections, not perceived as the key priority, was considered a luxury in the clinical setting. Strategies for positioning ethics include allying, promoting ethics reflection, scheduling ethics reflection, and identifying ethical dilemmas. These strategies can be more or less successful and vary in intensity. The prioritisation of direct patient care is not surprising, but polarisation between care and ethics needs to be questioned and ethics reflection need to be integrated in standard care. Ethical competence seems to be central in doing ethics and more knowledge on the promotion of ethical competence in practice and education is needed.

Australian rural emergency nurses' care of paediatric patients: A qualitative study

BackgroundRural emergency nurses (RENs) are expected to provide care to paediatric patients presenting to their facilities however, as generalist nurses, they experience challenges and feelings that are unique to the rural context. Design and methodsAn exploratory qualitative study of 13 RENs via semi structured interviews of perceptions and experiences of caring for paediatrics and self-determination of autonomous practice, motivations and connectedness in care was the approach used. FindingsInductive thematic analysis of data identified four themes with sub-themes identified within each theme. The four themes were: Caring for Children, Professional Roles, Professional Care and Connection and Professional Development. ConclusionRENs describe feeling fear, stress and anxiety when caring for sick children, particularly when known to the patient and family in their community yet will self-determine autonomous practice and use gatekeeping in certain situations of paediatric care. RENs are motivated to increase their paediatric knowledge and skills, seeking paediatric education opportunities but face barriers in attendance such as travel and costs. RENs rely on connectedness with other rural nurses, seeking paediatric nursing guidance or telehealth support, particularly when performing multiple roles or in the absence of a doctor in the ED. Practice implicationsProvision of opportunities for RENs to lead education in paediatric nursing, that is contextually appropriate and co-designed with paediatric experts is preferred. This would yield greater REN engagement and participation in paediatric education for knowledge and skill proficiency, would increase rural nurse professional development and reduce feelings of fear and anxiety when caring for paediatrics.

Identifying and caring for minors who have been victims of incest in a pediatric unit for children at risk (Uaped)

The paediatric reception unit for children at risk plays an active role in raising awareness and training caregivers in the region, to facilitate the identification and care of children who are victims of sexual violence within the family (incest), within the hospital where it is based, and through its close links with child protection agencies. The nursery nurse is an essential member of this team, with her in-depth knowledge of children and their development from 0 to 18 years of age.

Does ED Type Matter in the Care of Children With DKA?

Does ED Type Matter in the Care of Children With DKA?

Group Antenatal Care Start-Up in the Indian Private Sector: An Implementation Journey to Improve Quality of Care

ABSTRACT Introduction The introduction of the innovative group antenatal and postnatal care model into the private health sector in India has the potential to pivot the experiences of families during pregnancy and beyond. Growing evidence worldwide shows this model moves fragmented healthcare systems toward a more integrated model to improve quality in care and outcomes for mothers and children. The aim of this study was to better understand the challenges and benefits of implementation of the group model of antenatal care in the Indian private health sector for the purpose of improving quality of care. Methods Through a collaborative innovation project led by a master’s student of public health and an international organization with expertise in implementing this model, an urban 35-bed private hospital in Pune was identified with readiness to explore the model with stakeholders, train hospital staff as facilitators, and initiate group antenatal care. Semi-structured interviews with facilitators, along with feedback from participants in cohorts and observation of the groups by the trainer, were done for qualitative analysis of themes related to the strengths and barriers in implementing the model. Results A total of 31 pregnant women participated in two cohorts over their second to third trimesters for group antenatal care with a team of three facilitators from November 2022 to June 2023. On review of experiences in implementing the model, the top strengths demonstrated were meeting of felt needs of the participants, high engagement, and relative advantage of the model. Challenges for implementation included for scheduling and attendance, adapting the model for compatibility, capacity-building, and need for more ongoing planning, monitoring, and evaluation. Conclusions Through this innovation project, important lessons were learned for robust planning for a future pilot study. Patient-centered and integrated antenatal care are markers of quality of care that this group model can bring not only in the private healthcare sector but throughout India.

“When Father Christmas Is the Gaslighter”

The article is written with, by, and for (m)others whose children have been labelled as having “special educational needs” (SEN). The term (m)others is used to pay attention to the continued impact of the gendered nature of care for (disabled) children at the level of the individual, but also to recognize gender as a social construct, and the many ways of being a (m)other (Anderson). The broad aim is to explore the ways in which special education systems across the global North construct (m)others of disabled children as “mad.” This discussion is timely given the high levels of conflict between parents/carers and global North special education systems in contemporary times. The article explores “madness” as a mechanism of social control produced in special education systems by paying close attention to “intimate encounters” between (m)others and practitioners that occur day-to-day in (special) education settings. The developing analysis is shaped by the concept of “gaslighting,” which offers a useful framework both for understanding deeply affecting and effecting “intimate encounters” between (m)others and practitioners, and for exposing the operations of power in special education systems. The conclusion reflects on what new understandings of (m)others’ madness have been revealed and how they have the potential to (re)shape practice.

Supporting the educational success of children in foster care: the educational advocacy program

ABSTRACT Children in foster care face a heightened risk of poor educational outcomes, yet published research on programs designed to improve outcomes remains scant. Findings from an evaluation of the Educational Advocacy Program (EAP) that works with foster and adoptive caregivers and educators to address unmet educational needs are presented to help fill this gap. Youth, services data, and contact information for caregivers and educators were drawn from EAP files for cases closed during 2018–2019 (n = 234). Surveys of identified educators and caregivers as well as district foster care liaisons were conducted. Youth information was linked to state administrative data on foster care placements. Descriptive and bivariate analyses of program outcomes, program satisfaction, and placement stability were completed. Caregivers and educators perceived benefits for themselves and youth served. EAP staff ratings of post-service youth function were congruent with caregiver ratings of youth school outcomes. Statistically significant decreases in youth placement moves were found during and after services compared to before EAP onset. While not a causal design, results indicate that EAP holds promise for supporting caregiver and educator collaboration and improving youth school and placement outcomes. Implications for future research and practice are discussed.

What does flexible work for men really mean?: a qualitative content analysis of key stakeholder accounts

ABSTRACT This article explores definitions and practice of flexible work and is part of a larger project about men’s flexible work. Flexible work is prevalent in workplace research, but evidence is lacking regarding how flexible work for men is interpreted and applied in practice. Gendered patterns of work and care more often position men in paid employment and less often in care and domestic responsibilities. Men’s use of flexible work could assist in balancing paid employment with unpaid domestic and care tasks. Qualitative content analysis (QCA) was undertaken to summarise participants’ descriptions of two key aspects of flexible work – forms of flexible work, and the reasons for flexible work. QCA was applied to 30 interviews about men’s flexible work with organisational leaders (n = 12, 3 women and 9 men) and men who use flexible work arrangements (n = 18). Participants typically discussed flexible work in their white-collar employment situations, most often in the form of part-time work and for the reason of caring for children. Participants’ descriptions of flexible work differed from how flexible work is commonly defined in policy and legislation, demonstrating that men use flexible work in ways not described in policy or legislation.

High Schools Tailored to Adults Can Help Them Complete a Traditional Diploma and Excel in the Labor Market

Over 18 million adults in the United States lack a high school credential. While some go on to attain the GED, diplomas are potentially more valuable. A network of high schools helps adults graduate by providing tailored curricula, nonacademic coaching, onsite child care, and transportation. After five years, earnings increase by 38 percent more for graduates than nonenrolling applicants. We address selection by conditioning on preapplication earnings and comparing to students who exit after positive shocks. Much of the wage gains can be accounted for by sectoral switching and evidence on credential completions is consistent with a human capital mechanism. (JEL I21, I26, J24, J31)

Clinical utility of anti-Müllerian hormone in female children and adolescents.

Anti-Müllerian hormone (AMH) is a dimeric glycoprotein that belongs to the transforming growth factor beta superfamily and plays essential roles in sexual differentiation and folliculogenesis. In the male embryo, AMH is produced by the Sertoli cells and induces the involution of the Müllerian ducts. In females, AMH is predominately produced by the granulosa cells of growing preantral and small antral follicles and regulates follicular maturation. Many recent studies have highlighted the significant role of this hormone in the diagnostic approach to female children and adolescents with various disorders that affect ovarian development and function. AMH is considered a valuable diagnostic tool in the management of female pediatric patients with conditions such as polycystic ovary syndrome, precocious puberty, ovarian tumors, differences in sex development, and premature ovarian insufficiency. Standardization of AMH assays, internationally approved reference values based on age and pubertal stage, and widespread availability of the test could further upgrade the clinical utility of AMH, rendering it a valuable tool in the armamentarium of physicians involved in the care of female children and adolescents, and promote future research.

Gambaran Praktik Pengasuhan Anak Kembar di Kabupaten Gayo Lues

The purpose of this study is to know the image of the practice of child care in gayo lues district. This study uses qualitative methods with a descriptive approach. Number of participants in the study are three subjects. The data is analyzed using thematic analysis techniques. The findings suggest that there are 7 themes illustrating the practice of foster care in gayo lues district, of which 7 include the following sub themes. Parenting stress that covers the subtheme of financial demands, the lack of time for yourself. Support system that includes sub themes of extended family help, husband support, local government assistance. Coping strategies that include the subtheme manage time through other work, not managing emotions in a healthy way. Teaching that includes sub themes that enhance understanding, direction and example. The culture that includes the sub theme educating children firmly, the high tone of voice and educating children independently. The vaforitism consists of the sub theme divide and contrast.

놀이기록 다시보기를 통한 유아교사의 유아놀이 변화 탐색

Objectives The research objectives of this study is to find out the reflection that the researcher as kindergarten early- child care teacher has, in the course of reviewing the individual play records, and changes in the viewpoints of teachers in early-child care on kid plays. Methods In order to achieve this goal, self-study among qualitative research methods is conducted in that one can re-see and reflect on one's beliefs, values, and play records through self-reflection. To achieve such ob-jectives, the researcher collected and analyzed the play records that were prepared through author's own ob-servation in class, the author's self-reflection journal, and any other materials. Results This research has classified changes in the viewpoints of teachers in early-child care on kid plays into six sub-factors, say, understanding kids from a new perspective, expanding and supporting kid plays, participating in plays from a spectator to a player, reestablishing the educational belief system of teachers in early-child care as a supporter, connecting the curriculum in plays, and learning outside. For the final factors as to it, this study has classified into three top factors, namely, understanding plays from the perspective of kids, reestablishing the edu-cational belief system teachers in early-child care, and the operation of play-centered curriculum. Conclusions By reviewing the play records, it was found that changes in the viewpoints of teachers in early-child care on kid plays brought about the significant change in actual kid plays. Given the research results, the play records that are being prepared in the current educational field would be instrumental. It is anticipated that this would con-tribute to implementing the kid play-centered curriculum which requires reinforcing plays, with the focus on kids.

Management of severe traumatic brain injury in pediatric patients: an evidence-based approach.

Traumatic brain injury (TBI) is a major cause of death and disability worldwide. The decision-making process in the management of severe TBI must be based on the best available evidence to minimize the occurrence of secondary brain injuries. However, healthcare approaches to managing TBI patients exhibit considerable variation. Over an 18-month period, a multidisciplinary panel consisting of medical doctors, physiotherapists, nutritional therapists, and nurses performed a comprehensive review on various subtopics concerning TBI. The panel identified primary questions to be addressed using the Population, Intervention, Control, and Outcome (PICO) format and applied the Evidence to Decision (EtD) framework criteria for evaluating interventions. Subsequently, the panel formulated recommendations for the management of severe TBI in children. Fourteen evidence-based recommendations have been devised for the management of severe TBI in children, covering nine topics, including imaging studies, neuromonitoring, prophylactic anticonvulsant use, hyperosmolar therapy, sedation and analgesia, mechanical ventilation strategies, nutritional therapy, blood transfusion, and decompressive craniectomy. For each topic, the panel provided clinical recommendations and identified research priorities. This review offers evidence-based strategies aimed to guide practitioners in the care of children who suffer from severe TBI.

Exploring Belief Systems in Kinship Fostering Practice in Igbo Indigenous Communities of Southeast Nigeria

ABSTRACTKinship fostering in Igbo indigenous communities is an enduring alternative child care practice that promotes collective responsibility for child care in a family environment. The practice is believed to be fundamental for family and community continuity. Weakening extended family ties and a lack of social work support services in this care arrangement have cast doubt on the continual viability of this alternative child care practice This is an exploratory study using grounded theory. In‐depth interviews with six community leaders and six senior public social welfare officers provided insight on belief systems promoting kinship fostering in Igbo indigenous communities. Findings were thematically analysed to show continuity of lineage, preservation of family name and challenges associated with kinship fostering. Belief systems on kinship fostering provides insights on how children are viewed in Igbo culture, which can help policymakers design intervention programme that are culturally relevant in child‐care formation in Nigeria given challenges in kinship fostering. The study promotes indigenous knowledge that is vital for social work education and practice in Nigeria. Further study suggests exploring the belief of foster children and their experiences in kinship fostering.

Concurrent predictors of behavioral inflexibility in minimally verbal and verbal autistic children.

Behavioral inflexibility (BI) refers to the rigid and inflexible patterns of behaviors that are a core aspect of autism. Few studies have investigated BI in autism separately from other restricted and repetitive behaviors (RRBs). The present study used a relatively new measure, the behavioral inflexibility scale (BIS; Lecavalier, L., Bodfish, J., Harrop, C., Whitten, A., Jones, D., Pritchett, J., Faldowski, R., & Boyd, B. (2020). Autism Research, 13(3), 489-499), to examine the relationship of BI and variables that are both core symptoms in autism as well as symptoms associated with cooccurring mental health conditions, atypical sensory experiences, and adaptive functioning in a sample of 87 children with autism. Additionally, we aimed to understand how these relationships may be related to autistic individuals' verbal status: minimally verbal (MV) or verbal. Results revealed that anxiety, attention deficit/hyperactive, depressive, oppositional defiance problems, and sensory differences were all significantly correlated with BI in the MV group. In contrast, only anxiety, depressive, and oppositional defiance problems were significantly correlated with BI in the verbal group. Linear regression analyses showed that oppositional defiance problems and atypical sensory experiences explained a significant proportion of the variance of BI in the MV group, whereas only depressive problems were significant in the verbal group after accounting for other mental health conditions. Overall, our findings demonstrate that multiple aspects of psychopathology are significantly related to BI and can have broader implications for interventions and mental health care in autistic children.

Exploring risk and resilience in school environments for students in kinship care

ABSTRACT Kinship care is provided by members of a child’s extended family or friend network when they can no longer live with their parents. This study explores risk and resilience in UK school environments for students in kinship care. Eight professionals experienced in working with students in kinship care and their schools took part in individual, semi-structured interviews. Interviews focussed on kinship students’ needs and how professionals perceive schools respond to those needs. Reflexive thematic analysis generated over-arching themes indicating that: children in kinship care have multiple needs and are looked after by kinship carers who find themselves “between a rock and a hard place”; in some schools kinship care is “under the radar”; other schools respond to kinship families with the attitude of “the apple doesn’t fall far from the tree”; and in some schools kinship care is “on the agenda”. A model is presented that integrates risk and protective factors within schools, generated from this study, with risk and protective factors for kinship students within families, identified by previous literature. Implications for educational psychology (EP) practice are presented, and further research needs discussed.

Navigating Reproductive Care in Patients With Inflammatory Bowel Disease: A Comprehensive Review.

Inflammatory bowel disease [IBD] is often diagnosed in patients during their reproductive years. It is crucial that both healthcare providers and patients are adequately informed to avoid misguided decisions regarding family planning. One of the most important aspects during conception and pregnancy is to maintain disease remission, as disease activity is associated with adverse pregnancy outcomes. Apart from methotrexate, most conventional drugs used in IBD are considered low risk during conception and pregnancy. For newer agents, evidence is still limited. If needed, surgery must not be postponed and should ideally be performed in specialized centres. In most patients, delivery should be vaginal except for patients with complex perianal disease, with an ileoanal pouch anastomosis, or if there is an obstetric contraindication. In children exposed to biological treatments during pregnancy, the risk of infections appears to be low, and psychomotor development is probably not affected. Regarding immunizations, the standard vaccination schedule for inactivated vaccines should be followed for children exposed to biologics in utero. In the case of live vaccines, such as rotavirus, decisions should be individualized and take into consideration the risk-benefit ratio, particularly in developing countries. In this review, we provide a comprehensive and updated overview of aspects related to fertility, pregnancy, breastfeeding, and the impact on the care of children born to mothers with IBD. Both the available evidence and areas of uncertainty are discussed, with the goal of assisting healthcare professionals caring for IBD patients during this important stage of their lives.

ASARA-A technology-driven maternal and child healthcare model of Araku

Tribal populations form 8.6% of total India’s population. The health indicators of tribal populations lag behind their non-tribal counterparts. Limited access to healthcare services, poor transportation facilities, increased out-of-pocket expenditures for health, distinct cultural practices and remote settlement among many others contribute to the poor health status of the tribal populations. However, to achieve sustainable development goals by 2030, it is extremely important to address the healthcare needs of the tribal population. The current paper is the first part of the model of care working paper series that discusses the components of the ASARA project to highlight the impacts of the decade long efforts towards improving maternal and child care in the region.

Design of a hazard prediction system with intelligent multimodal fusion based on artificial intelligence & internet of things technology: taking a crib as an example

Problem How to design an intelligent multimodal fusion hazard prediction system using AIoT (Artificial Intelligence & Internet of Things) technology to predict some potential dangers. This article will provide some ideas and methods. Introduction This article designs an intelligent multimodal fusion hazard prediction system based on AIoT technology. The system mainly consists of an IoT hardware device and an AI multimodal and multi-dimensional Hazard Prediction Algorithm. Method This article will take baby cribs as an example, using this system to empower traditional baby cribs and transform them into intelligent baby cribs. Results In this example, the system can detect the real-time status of the baby and predict upcoming dangers, including kicking the quilt, wetting the bed, fever, crying, climbing over the crib, and turning over. Hypothesis Assuming that intelligent systems can detect the status of infants in real-time and make predictions before potential dangers occur, to promptly alert parents. Perhaps it can prevent some irreversible dangers from occurring. Background This system solves the pain point problem of parents having to take care of their babies after working hard. Purpose In this scenario, the system provides a design scheme for an intelligent multimodal fusion hazard prediction system with a temporary care function. The application of this system to baby cribs not only reduces the burden on parents but also ensures the safety and comfort of the baby. Transferability At the same time, the system has transferability, and its design concept can be transferred to other application scenarios, such as hospital care for infants, young children, or elderly patients, as well as childcare stations for abandoned children in society. Significance This innovative system design scheme has a positive significance for family harmony and social development.

The Impact of Foster Care on Child Development: The Role of Sibling Separation

This paper explores the impact of sibling relationships on children’s development within the foster care system, focusing particularly on how sibling separation affects children of different ages emotionally, cognitively, and socially. To address this, the study synthesizes existing literature and theoretical models by combining the developmental stages of children with the role of siblings in child development. Findings reveal that sibling separation at different ages leads to distinct developmental challenges: infants experience severe disruptions in attachment and emotional regulation, middle childhood separations hinder cognitive and social skills development, and adolescent separations result in long-term relational and identity challenges. Previous research underscores the importance of maintaining sibling bonds in foster care, highlighting that these relationships can provide crucial emotional support and stability, mitigating the adverse effects of family disruptions. This study emphasizes the necessity for age-appropriate actions and support services in foster care to minimize the detrimental impacts of sibling separation and promote healthy development. Additionally, it calls for further longitudinal studies to track the developmental trajectories of children separated from their siblings and consider variables such as age differences between siblings and the dynamics of step-sibling relationships. This comprehensive understanding is essential for informing policies and practices that enhance the well-being of children in foster care.