Care Institutions Research Articles

Deinstitutionalisation of foster care in Poland. Experiences of selected foster care organisers in the Zachodniopomorskie Voivodeship

Placing a child in foster care is a last resort and should take place after all possible forms of support and assistance have been exhausted. However, if a child is placed under the care and upbringing of foster care, it is necessary to create conditions as close as possible to those of a family. Since 2000, the Polish foster care system has been subject to the process of deinstitutionalisation. The organisers of foster care were obliged to take actions aimed at reducing the importance of the foster care system in the full childcare system, a smooth transition to a system where full community-level childcare is provided. The aim of the article is to present the foster care system and directions of changes in foster care in quantitative terms and to evaluate the organisation of foster care in the context of the process of its deinstitutionalisation. The conclusions were based on statistical data analysis on the foster care system, which constituted the background for discussions by organisers of foster care in selected poviats of the Zachodniopomorskie Voivodeship. The system of foster care in Poland is based on family foster care. Reducing the number of institutional foster care facilities is possible, but in the current system, it is only likely to partially eliminate them. The most significant identified challenge of the foster care system is the dropping number of foster families. Additionally, the deinstitutionalisation of foster care requires, above all, measures to increase the effectiveness of the support system and upbringing of the child and natural family in the local environment.

Factors Associated with Preferred Place of Care and Death in Patients with Parkinson's Disease: A Cross-Sectional Study.

A significant proportion of people with Parkinson's disease (PwPD) die in hospital settings. Although one could presume that most PwPD would favor being cared for and die at home, there is currently no evidence to support this assumption. We aimed at exploring PwPD's preferences for place of end-of-life care and place of death, along with associated factors. A cross-sectional study was conducted to investigate PwPD's end-of life wishes regarding their preferred place of care and preferred place of death. Using different approaches within a generalized linear model framework, we additionally explored factors possibly associated with preferences for home care and home death. Although most PwPD wished to be cared for and die at home, about one-third reported feeling indifferent about their place of death. Preferred home care was associated with the preference for home death. Furthermore, a preference for dying at home was more likely among PwPD's with informal care support and spiritual/religious affiliation, but less likely if they preferred institutional care towards the end of life. The variation in responses regarding the preferred place of care and place of death highlights the need to distinguish between the concepts when discussing end-of-life care. However, it is worth noting that the majority of PwPD preferred care and death at home. The factors identified in relation to preferred place of care and death provide an initial understanding of PwPD decision-making, but call for further research to confirm our findings, explore causality and identify additional influencing factors.

Real world data in mechanical thrombectomy: who are we losing to follow-up?

BackgroundMissing outcome data (MOD) is a common problem in clinical trials and registries, and a potential bias when drawing conclusions from these data. Identifying factors associated with MOD may help...

Professionals’ account-making of institutional care for youths. Intertwined discretionary spaces and blurred collaborative practice

ABSTRACT In this article, the account-making of social workers and institutional care staff on locked institutional care for youth is analysed, based on empirical material consisting of 10 interviews with 25 members of the two professions. The study departs from a Swedish context where locked institutional care for youth is mainly provided for individuals who are in compulsory care due to criminality, drug abuse, or other socially destructive behaviour. The analytical framework draws on account theory and Emerson’s concept of institutional care as a ‘last resort’. The results show that both social workers and staff use similar justifications and excuses, relating to organizational resources and rules and to assessments and decisions made by the other professional group; but also, that different layers of accounts overlap between professionals’ account-making stories and can change as care proceeds. The results are discussed in relation to the pooled discretion that is exercised when different professional groups are involved in care decisions, and the organizationally specialized care setting resulting in intertwined discretionary spaces and blurred practice, with consequences for the quality of care and challenges in holding professionals accountable.

Foster Care Leads to Lower Irritability Among Adolescents with a History of Early Psychosocial Deprivation.

Irritability reflects a propensity for frustration and anger, and is a transdiagnostic symptom of both externalizing and internalizing psychopathology. While early adverse experiences are associated with higher levels of irritability, experiences of early psychosocial deprivation and whether family-based placements can mitigate the impact on subsequent irritability, remain underexplored. The current study examined irritability in 107 16-year-olds with a history of institutional care from a randomized controlled trial of foster care as an alternative to institutional care and 49 community comparison children. At age 16 years, irritability was assessed using parent- and self-report forms of the Affective Reactivity Index. Compared to community adolescents, those with a history of institutional care exhibited significantly elevated irritability levels. Among those who experienced institutional care, those randomized to foster care had lower levels of irritability compared to participants randomized to the care-as-usual group, and this effect persists after controlling for baseline negative emotionality. These findings suggest a causal link between high-quality foster care and lower irritability following psychosocial deprivation. Additionally, longer duration in institutional care and non-family placement at age 16 years were associated with higher levels of irritability, highlighting the role of caregiving in explaining variation in irritability in adolescence. Policies that support long-term, high-quality family placements for children without regular caregivers should be prioritized.

Effects of dependent care theory-based post-surgical home care intervention on self-care, symptoms, and caregiver burden in patients with primary brain tumor and their caregivers: a randomized controlled trial

PurposeThis study aimed to examine the effect of dependent care theory-based post-surgical home care intervention on self-care, symptoms, and caregiver burden in primary brain tumor patients and their caregivers.MethodsA parallel-group randomized controlled trial was conducted with patients who underwent surgery for a primary brain tumor between March 2019 and January 2020 in a tertiary hospital and with caregivers who cared for them at home. Eligible patients and caregivers were determined by block randomization. Outcome measures included validated measures of self-care agency (Self-Care Agency Scale), symptoms and interference by symptoms (MD Anderson Symptom Inventory Brain Tumor-Turkish Form), and caregiver burden (Caregiver Burden Scale). Two-way analysis of variance was used in repeated measurements from general linear models compared to scale scores.ResultsSelf-care agency was significantly higher in the intervention group than in the control group in the first and sixth months after surgery (p < 0.05). The severity of the patients’ emotional, focal neurologic, and cognitive symptoms and interference by symptoms were significantly lower in the intervention group than in the control group (p < 0.05). Caregiver burden was significantly lower in the intervention group in the first, third, and sixth months after surgery (p < 0.05).ConclusionDependent care theory-based post-surgical home care intervention increased patients’ self-care and reduced symptoms and their effects. It also reduced the caregiver burden. Dependent care theory can guide the nursing practices of nurses who provide institutional and/or home care services to patients with chronic diseases and their caregivers.Trial RegistrationNCT05328739 on April 14, 2022 (retrospectively registered).

Safeguarding adults within institutional settings: a narrative overview of the literature focused on the care of people with mental ill-health and learning difficulties

PurposeInstitutional abuse is a worldwide phenomenon with the UK also subject to several high-profile abuse scandals perpetuated on people with learning disabilities and/or mental health conditions living within institutional settings. This study aims to provide a broad perspective of safeguarding practices within institutional care to inform practice and service development in this area.Design/methodology/approachA narrative overview was undertaken of a range of empirical evidence, discussion papers, enquiry reports, reports from regulatory bodies and professional guidance to explore safeguarding practices within institutional care for individuals with learning disabilities and/or mental health conditions.FindingsA range of literature was identified that exposed and explored abuse in this context. Three key themes were identified: failings within institutional care; safeguarding issues and concerns; and good practice within institutional care. Whilst guidance is available, standards are explicit and protocols facilitate improvement potential in this area, a consistent message was that statutory recommendations for reform have not been effective.Originality/valueThis paper provides an important resource for practitioners and service providers involved in institutional care. An accessible overview of both the empirical evidence and grey literature on adult safeguarding within institutional settings is provided, along with a range of standards and resources that specify practice in these settings.

Differences in the Elderly Care Service Demand,Preference,and Tendency Between Urban and Rural Areas in the Pearl River Delta

Objective To understand the differences in the demand,preference,and tendency for elderly care services between urban and rural areas in the Pearl River Delta (PRD),and to provide reference for the planning and balanced allocation of elderly care resources in urban and rural areas. Methods Using the multi-stage stratified random sampling method,we selected 7 community health service centers in 2 prefecture-level cities in the PRD and conducted a questionnaire survey on the elderly care service demand,preference,and tendency among 1919 regular residents aged 60 years and above who attended the centers. Results A total of 641 urban elderly residents (33.4%) and 1278 rural elderly residents (66.6%) were surveyed in the PRD.The urban and rural elderly residents showed differences in the child number (χ2=43.379,P<0.001),willingness to purchase socialized elderly care services (χ2=104.141,P<0.001),and attitudes to the concept of raising child to avoid elderly hardship (χ2=65.632,P<0.001).The proportion (71.8%) of rural elderly residents who prefer family-based elderly care was higher than that (57.1%) of urban elderly residents (χ2=41.373,P<0.001).The proportion (62.2%) of urban elderly residents clearly expressing their willingness to choose institutions for elderly care was higher than that (44.0%) of rural elderly residents (χ2=57.007,P<0.001).Compared with family-based elderly care,the willingness to choose institutional or community-based in-house elderly care was low among the urban elderly residents with surplus monthly household income or balanced income and expenditure;urban males,those with college education background or above,and those who purchased socialized elderly care services tended to prefer community-based in-house elderly care.In rural areas,the elderly residents who had local household registry were prone to choose institutional or community-based in-house elderly care,while those who had more than one child and those who were satisfied with the current living conditions were less willing to choose community-based in-house elderly care. Conclusions It is suggested that the urban-rural differences in the elderly care service demand,preference and tendency should be fully considered in the planning and allocation of urban and rural elderly care resources.Efforts remain to be made to develop diversified social elderly care services tailored to the characteristics of urban and rural areas.

310 The Derivo 2 Heal Embolization Device in the Treatment of Ruptured and Unruptured Intracranial Aneurysms: A Retrospective Multicenter Analysis

INTRODUCTION: The Derivo 2 Flow diverter has been previously described for the treatment of intracranial aneurysms. To overcome the risk of in-stent thrombosis and thrombo-embolism as a well-known risk of intracranial flow diverter implantation, the device was modified by adding an antithrombogenic fibrin-heparin coating. The fibrin network aims at surface passivation, reduction of inflammatory reactions and building a scaffold for endothelial cells. The covalently bound heparin reduces the thrombogenicity by locally reducing platelet activation and inhibtion of the coagulation cascade. METHODS: We perform a retrospective multicenter, single-arm trial at seven neurovascular centers. Patients treated with the D2H for unruptured or ruptured intracranial aneurysms are included in the study. The primary endpoint is angiographic aneurysm occlusion at six months as assessed by the O’Kelly-Marotta (OKM) grading scale. Clinical outcome is evaluated after intervention and at six months with major morbidity defined as modified Rankin Scale scores (mRS) of 3-5. RESULTS: Between October 2021 and March 2023 56 patients with ruptured and unruptered intracranial aneurysms were treated with the D2H embolization device and included in our analysis. All patients were subjected to the regular antiplatelet pre- and post-treatment medication as per standard of care in the respective institutions with no deviations being reported. No differences in terms of technical device properties were observed. By the time of the conference, data evaluation will be completed and clinical as well as safety results including angiographic follow-up will be available. CONCLUSIONS: The Derivo 2 heal Flow Diverter is a promising antithrombogenic coated device for the treatment of ruptured and unruptured intracranial aneurysms. Early post-interventional and long-term results will provide further insight into the effect of antithrombogenicity and endothelial healing.

Perceived helpfulness of various sources of help for 5 mental illnesses

Introduction1 in 8 people worldwide live with a mental illness (MI). This is expected to rise with increasing societal pressures. Despite the availability of evidence-based treatments, MIs remain undertreated. In Singapore, efforts such as the ‘It’s OK to Reach Out’ campaign was launched to encourage help-seeking. Help-seeking behavior is complex; determined by an interplay of factors including perceptions towards help sources. As seeking ineffective sources contributes to unmet needs, understanding beliefs towards various sources of help is vital.ObjectivesThe study aims to examine perceived helpfulness of various sources of help for 5 mental illnesses and changes in perceptions towards them over time.MethodsThe Mind Matters 2023 (M2) is an ongoing nationwide survey of mental health literacy among Singapore residents aged 18-65 years. Analysis is based on a preliminary sample (N=2500). Interviewers read a vignette depicting 1 of 5 randomly assigned MIs- depression (DP), schizophrenia (SZ), obsessive-compulsive disorder (OCD), alcohol abuse (AA) or dementia (DT). Respondents were asked to rate whether 10 Professional/Informal sources and 12 Actions were ‘helpful, ‘harmful’ or ‘neither’ for the person in the vignette. Frequencies of helpful ratings were compared with the first Mind Matters study (M1) conducted in 2015 (N=3006).ResultsIn M2, seeing a psychiatrist, psychologist and counsellor were rated helpful most frequently (79%-96%) while seeking traditional medicine and religious advisors were rated the least (12%-60%) across the vignettes, except for DT where doctor and close family (81%-85%) replaced psychologist and counsellor (66%-70%). Compared to M1, phone counselling saw an increase in helpfulness rating across all vignettes (p&lt;.05) except AA. For Actions, reading about how others dealt with similar problems was rated helpful most frequently (76%-89%) while dealing with problems on one’s own was rated the least across all vignettes (3%-11%) in M2. Compared to M1, being more social saw an increase in helpfulness (p&lt;.001) rating for DP but a decrease for AA (p&lt;.001). Admission to an institution was associated with a decrease in helpfulness rating for DP (p=.006) and OCD (p=.04) but increase for AA (p=.03).ConclusionsThe findings suggest recognition that MIs would be helped by professionals and self-reliance is ineffective to address these problems. Increased perceived helpfulness of telephone counselling was promising as studies have shown high client satisfaction coupled with its potential in reducing some barriers to care. Differences in directional changes in helpfulness rating for institutional care and socialising for DP and AA may represent understanding of the importance of behavioral activation and stimulus control for these MIs respectively. Literacy regarding help-seeking sources has improved in Singapore over the last 8 years which may translate into increments in seeking appropriate care.Disclosure of InterestNone Declared

Strategie wspierania zdolnych podopiecznych pieczy zastępczej

The issue of gifted children growing up in a natural family environment has been addressed quite widely. However, small amount of research regarding gifted children residing in the foster care environment is noticeable. At the same time, the issue of having, developing and supporting abilities is extremely significant, especially with regard to pupils of foster care environments deprived of their primary developmental environment, which is the family. Foster care environments can also effectively support the potential of their pupils. The publication is an attempt to answer the question of what support activities are undertaken in the foster care environment in relation to gifted pupils? The research method is case studies. The research indicates various forms of support for gifted pupils: the organization of additional activities, depending on the interests or abilities of the pupil or the financial support as the one they need for the future process of independence, as well as emotional support and others. At the same time, some differences are visible between the activities of institutional and family care, as the latter definitely more often uses the help of psychological and pedagogical counseling centers or organizations supporting gifted students, even if in the form of funded scholarships.

An exploratory study of Saudi parents' perceptions and beliefs about institutional and home care for children with disabilities

Quality care is critical to the quality of life and well-being of persons with disabilities. However, children with disabilities face unprecedented challenges which include access to assistive technology and rehabilitative devices, social exclusion, and negative attitudes in their various care settings. The present qualitative study seeks to understand parents' perceptions of home or institutional care for children with disabilities. The study utilized an exploratory qualitative approach paradigm with five focus groups in the Qassim region of Saudi Arabia. Framework data analysis identified opposing and supporting perspectives for home and institutional-based care. Beneficial aspects of home care relate to cultural upbringing and the opportunity to acquire social and daily living skills. Families believe there are benefits of institutional care because such care settings have specialists and resources to support persons with disabilities. They argue for these resources to be linked to disability cases in families to optimize the development of children with disabilities. The study concluded that a dedicated care team to support families to cater to the needs of their children with disabilities at home is preferred over institutional-based care.

Rural-urban differences in use of health services before and after dementia diagnosis: a retrospective cohort study

BackgroundRural-urban differences in health service use among persons with prevalent dementia are known. However, the extent of geographic differences in health service use over a long observation period, and prior to diagnosis, have not been sufficiently examined. The purpose of this study was to examine yearly rural-urban differences in the proportion of patients using health services, and the mean number of services, in the 5-year period before and 5-year period after a first diagnosis of dementia.MethodsThis population-based retrospective cohort study used linked administrative health data from the Canadian province of Saskatchewan to investigate the use of five health services [family physician (FP), specialist physician, hospital admission, all-type prescription drug dispensations, and short-term institutional care admission] each year from April 2008 to March 2019. Persons with dementia included 2,024 adults aged 65 years and older diagnosed from 1 April 2013 to 31 March 2014 (617 rural; 1,407 urban). Matching was performed 1:1 to persons without dementia on age group, sex, rural versus urban residence, geographic region, and comorbidity. Differences between rural and urban persons within the dementia and control cohorts were separately identified using the Z-score test for proportions (p < 0.05) and independent samples t-test for means (p < 0.05).ResultsRural compared to urban persons with dementia had a lower average number of FP visits during 1-year and 2-year preindex and between 2-year and 4-year postindex (p < 0.05), a lower likelihood of at least one specialist visit and a lower average number of specialist visits during each year (p < 0.05), and a lower average number of all-type prescription drug dispensations for most of the 10-year study period (p < 0.05). Rural-urban differences were not observed in admission to hospital or short-term institutional care (p > 0.05 each year).ConclusionsThis study identified important geographic differences in physician services and all-type prescription drugs before and after dementia diagnosis. Health system planners and educators must determine how to use existing resources and technological advances to support care for rural persons living with dementia.

Study protocol: randomized controlled trial of an individualized music intervention for people with dementia in the home care setting

BackgroundStudies suggest that individualized music listening is an effective, non-pharmacological intervention for improving the quality of life of people with dementia in the institutional care setting. Noting that most people with dementia live at home, we conduct a randomized controlled trial to assess the feasibility and effectiveness of an app-based individualized music listening intervention for people with dementia in the home care setting. The intervention is delivered by family caregivers.MethodsWe will recruit N = 130 dyads consisting of one person with dementia living at home and their family caregiver. After a baseline assessment, dyads are randomly assigned by gender to either the intervention or control group. People with dementia in the intervention group listen to individualized music playlists for 20 min every other day for six weeks via the self-developed Individualized Music and Dementia app. The control group receives standard care. All dyads complete paper-and-pencil questionnaires six weeks before the start of the intervention (T0), directly before the intervention (T1), directly after the intervention (T2), and six weeks later (T3). During the intervention period, all caregivers also complete daily ecological momentary assessments via the app. During three home visits, a trained project member will observe the dyads and collect hair samples. After the intervention, semi-structured interviews will be conducted to collect information about participants’ experiences with the app and intervention. The primary outcome is the attainment of individual goals established during the baseline assessment. Secondary outcomes are the well-being, physiological stress and quality of life of people with dementia and their caregivers; people with dementia’s behavioural and psychological symptoms of dementia, resistance during care, and reactions to the music; caregivers’ burden of care, positive aspects of care, and caregiving self-efficacy; and the quality of the caregiver-care recipient interaction.DiscussionOur study will assess the extent to which an app-based individualized music listening intervention is feasible and effective for enhancing the well-being and quality of life of people with dementia living at home and their family caregivers.Trial registrationGerman Clinical Trials Register DRKS00025502 and ISRCTN registry ISRCTN68084105, https://doi.org/10.1186/ISRCTN68084105

Institutional Care for our Elders: A Conversation with Dr. Ellen Badone

Institutional Care for our Elders: A Conversation with Dr. Ellen Badone

Evidence-based practice criteria’s effect on the implementation of the Family First Prevention Services Act in Nebraska and Colorado

Child abuse, particularly neglect, is often preventable because many causes of harm stem from poverty, lack of social connections, substance use disorders, mental illness, lack of childcare, and other family support shortages. Prevention of child abuse and neglect starts with family support in these areas. The federal government recognized this need for prevention, and through considerable bipartisan support, passed the Family First Prevention Services Act on February 9, 2018. The Family First Prevention Services Act was designed to divert investment away from long-term foster care and toward programs that prevent unnecessary placement and child protective services interventions. The Family First Prevention Services Act restricts the state’s use of federal funds for institutional foster care placements and uses those savings to fund reimbursements for evidence-based family preservation. The requirement for evidence-based prevention is a first in child-welfare federal law, and compliance with this requirement requires public-private partnership with agencies implementing the models, infrastructure, and evaluation standards that most states must build to be eligible for the new funding. This evaluation research analyzed how the stringent guidelines for prevention funding and the requirement of federally approved evidence-based practice programming affect the implementation of the Family First Prevention Services Act in Nebraska and Colorado.

Racial disparities among mild stroke survivors: predictors of home discharge from a retrospective analysis

ABSTRACT Background Half of all strokes are classified as mild, and most mild stroke survivors are discharged home after their initial hospitalization without any post-acute rehabilitation despite experiencing cognitive, psychosocial, motor, and mobility impairments. Objectives To investigate the demographic and clinical characteristics of mild stroke survivors and their association with discharge location. Methods This is a retrospective analysis of mild stroke survivors from 2015–2023 in an academic medical center. Demographic characteristics, clinical measures, and discharge locations were obtained from the electronic health record. The Social Vulnerability Index was used to measure the community vulnerability. Associations between variables and discharge location were examined using bivariate logistic regression analysis. Results There were 2,953 mild stroke survivors included in this study. The majority of participants were White (65.46%), followed by Black (19.40%). Black stroke survivors and individuals with higher social vulnerability had a higher proportion of discharges to skilled nursing facilities (p = 0.001). Black patients and patients with high vulnerability in housing type and transportation were less likely to be discharged home. Conclusions Mild stroke survivors have a high rate of home discharge, potentially because less severe stroke symptoms have a reduced need for intensive care. Racial disparities in discharge location were evident, with Black stroke survivors experiencing higher rates of institutionalized care and lower likelihood of being discharged home compared to White counterparts, emphasizing the importance of addressing these disparities for equitable healthcare delivery and optimal outcomes.

Abstract 1301: Comparing VA and safety-net hospital patient-reported care metrics and provider recommendations to address social determinants of health and demographics

Abstract Background: The Jesse Brown Department of Veterans Affairs Medical Center (JBVA) and Sinai Chicago, a safety-net hospital nearby, serve veterans and patients with significant social needs on Chicago's South and West sides. Both institutions are adopting the 4R Oncology Model (Right Info/Care/Patient/Time) for patient-facing care planning and self-management, proven to enhance supportive and health maintenance care delivery (Trosman JCOOP 2021). This abstract depicts a baseline survey of JBVA veterans’ and Sinai Chicago patients' experiences in planning and delivering guideline-directed supportive and health maintenance care for new cancer diagnoses, informing 4R implementations. Methods: Patients at JBVA and Sinai Chicago were surveyed from February to September 2023 with participants receiving a $25 gift card. An analysis was conducted using Fisher’s two-tailed exact test. Results: The two institutions yielded a 67% survey response rate. Key patient demographics and oncologic and supportive care metrics are outlined in the table below. At JBVA, fewer than 50% of veterans knew their cancer stage at diagnosis, and 63% were aware of their care goals. Furthermore, only 17% of veterans received recommendations for support services offered by JBVA. “Emotional distress or worry” support recommendations were received by &amp;lt; 50% of patients at both institutions. Conclusions: The baseline survey uncovered gaps in care planning, supportive services, and health maintenance care in both institutions, catering to patients with challenging social determinants of health. The implementation of the 4R Oncology Model is designed to address these gaps, providing a personalized care sequence that establishes a clear roadmap through the patient's care trajectory, ultimately enhancing patient-centered care. Further results will be shared when available. Metric Combined% of pts(n=60) JBVA% of pts (n=30) SINAI% of pts(n=30) PVALUE Patient knew stage of their cancer 67 43 86 0.0005 Patient knew goal of their care 77 63 86 0.0442 Cancer care provider recommended to: Get Nutrition consult about how to eat during cancer treatment 35 27 42 0.2997 Talk to your primary care provider about staying as healthy as possible during care treatment 62 57 67 0.4523 Get support for transportation, food, housing, insurance, or other practical needs 44 17 67 0.0001 Get help to stop smoking or vaping* 29 28 31 1.0 Get help for emotional distress or worry* 37 24 46 0.1078 Demographics Age 59 66 53 0.0001 Male 69 93 39 0.0004 Black 59 83 39 0.0001 Hispanic 32 0 58 0.1103 High School education or less 68 57 78 0.1854 Household income less than $30,000 ** 70 59 81 0.1305 Live Alone 37 47 29 0.0001 *of those who reported needing help, **of those who shared income level Citation Format: Neha Hippalgaonkar, Michael Weinfeld, Christine Weldon, Julia Trosman, Cindy Chan, Sarah Khan, Swetha Paduri, Vijay Reddy, Auradha Sakhuja, Paramjeet Khosla, Mary Pasquinelli, Lawrence Feldman. Comparing VA and safety-net hospital patient-reported care metrics and provider recommendations to address social determinants of health and demographics [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 1301.

Looking beneath the surface: associations between varied outdoor surfaces and children’s diverse play behaviours in early childhood education and care institutions

This study assumes that surfaces in outdoor environments in early childhood education and care (ECEC) institutions exert an important influence on children’s play diversity. Gibson (1979) claims that surfaces are important because they are where most action occurs; some surfaces may lead to a diversity of play behaviours, while others afford a narrower range of actions. This study was conducted as part of a three-year mixed-methods project. The sample consisted of 464 video observations (mean duration: 122 seconds) of 79 children’s free play in the outdoor environments of eight ECEC institutions. Multilevel regression analysis, controlled for children’s age and gender, indicated that functional play was positively associated with surfaces resistant to deformation (e.g. rubber) and that constructive play was positively associated with surfaces with low resistance to disintegration (e.g. sand or forest floor). These results can help develop and design outdoor environments that facilitate children’s play diversity in ECEC.

Comprehensive Analysis of Family-Based Childcare Options for Orphaned Children

This article delves into the challenges faced by orphans in Nigeria, specifically focusing on their psychological development and overall welfare. In 2003, there were an estimated 7 million orphans in the country, a number projected to rise to 8.2 million by 2010. This increase underscores the significant challenges posed by factors such as HIV/AIDS, conflict, and poverty. Globally, the orphan crisis is alarming, with predictions suggesting that by 2020, as many as 200 million children worldwide could be without parental care. The study emphasizes the importance of offering childcare options within family settings rather than relying solely on institutional care, which can have profound effects on the psychosocial development of children. Traditional orphanages, serving as residential centers, grapple with issues like overcrowding, discrimination, and instances of abuse, often leaving thousands of children disconnected from their families. This underscores the necessity to revamp childcare systems and explore new models entirely. The article advocates for a family-centric approach, which includes adoption, community-based upbringing, and initiatives to strengthen existing families. This alternative promises a more supportive environment for orphaned children to thrive mentally and socially. From an economic standpoint, family-oriented childcare is not only more humane but also economically prudent, offering lower costs compared to institutionalized care. Hence, there's a pressing need to redirect ocus towards these alternatives. Keywords: Orphans, Foster family, psychosocial welfare, Institution care, and Abandoned and child welfare.