Child Care Patterns Research Articles

Local Wisdom in Pregnancy, Childbirth, Childcare in Mee Tribe, Papua

The culture of the Mee tribe in the pattern of child care begins with the process of pregnancy, childbirth and when the child enters school age. This study aims to find the concept of value and wisdom in the Mee tribe community for the developmental strength of the nation's children in Paniai Papua in the process of pregnancy, childbirth, and parenting. This study uses a qualitative approach. This research was conducted on the Mee Tribe in Paniai District, which is in the mountainous region of Papua, Indonesia in May-October 2018. Data collection was carried out by in-depth interviews and observations. Interviews were conducted on 25 informants selected by purposive procedures, which consisted of mothers, pregnant women, nursing mothers, tribal heads and health workers. The Mee tribe marks pregnancy as the initial process of the birth of a new life in the family so it is very important to maintain the health of the baby, mother and family safety. For that, food, equipment, activities, and customs must be considered because it is believed to determine the process of pregnancy. When pregnant, the mother of the Mee tribe consumed a lot of shrimp which was her own catch. In the pattern of parenting, mothers carry out a care procession that strongly emphasizes local wisdom and culture, such as using noken, leaves, stoves and embers and the presence of large events involving large families and villages in welcoming children born.

Short-term exposure to sulfur dioxide and the risk of childhood hand, foot, and mouth disease during different seasons in Hefei, China

BackgroundSulfur dioxide (SO2) is an important component of air pollution, adversely impacting human health worldwide. This study aimed to examine the association between short-term exposure to SO2 and childhood hand, foot, and mouth disease (HFMD) in Hefei, China. MethodsA Poisson generalized additive model (GAM) combining the time-series regression analyses was used to fit the SO2-HFMD association. The effect of SO2 was estimated using the single-day lag models (lag0, lag1, lag2) and the moving average lag models (lag01, lag02) We also conducted stratified analyses by season, ages (0–4 years old, 5–14 years old), gender (male, female), childcare patterns (scattered children, kindergarten children) and residence areas (urban, rural). Two-pollutant models were adopted to test the robustness of the results. ResultsThere was a statistically significant association between SO2 and the risk of childhood HFMD. For total cases, the relative risk (RR) at lag0 was 1.038 (95% confidence interval (CI): 1.018–1.057) in whole-period and 1.088 (95% CI: 1.059–1.118) in cold season. During cold season, we observed significant associations between SO2 and HFMD among all subgroups except for children aged 5–14 years old and the adverse effects occurred on lag0, lag1, lag01, lag02. However, in hot season, SO2 were significant only for females (lag01 with RR = 1.054; 95%CI = 1.007–1.101) and scattered children (lag01 with RR = 1.054; 95%CI = 1.007–1.101). In general, females and scattered children appeared to be more vulnerable to SO2. ConclusionsThis study suggests a significant association between SO2 and HFMD. especially during cold season. Compared with males and kindergarten children, females and scattered children are at higher risk of developing HFMD.

Shortcomings in Long-Term Management: A Retrospective Analysis of Follow-Up of Children Diagnosed With Celiac Disease

Introduction: American College of Gastroenterology clinical guidelines for the diagnosis and management of celiac disease recommend multiple visits in the first year with annual visits thereafter. In addition, at minimum, patients should consult a registered dietitian with knowledge of a gluten-free diet (GFD) at diagnosis. The aim of this study was to describe patterns of follow-up care for children diagnosed with celiac disease at a Celiac Disease Center. Methods: Medical records of children (<18 years) with biopsy-confirmed celiac disease diagnosed between 2010 and 2014 were reviewed from diagnosis through December 2017. Demographics, clinic visit dates, symptoms at diagnosis and last clinical visit, and celiac serologies were recorded. “Lost to follow-up” was defined as no follow-up visit with a gastroenterology (GI) care provider for an interval greater than 18 months. Results: Of 241 subjects, the median age at diagnosis of celiac disease was 9.7 years (IQR 6.2-13.3 years) and 153 (63%) were female. The median time until lost to follow-up was 2.8 years (IQR 1.0-4.7 years). This included 22 (9%) who did not attend any follow-up visit with GI after their diagnostic endoscopy. An additional 21 subjects were lost to follow-up within one year of diagnosis. There were also gaps in GFD education as 40 (17%) did not have a documented consultation with a registered dietitian. Of the 61 subjects who were lost to follow-up more than one year after diagnosis, 16 (26%) had abnormal celiac serology at their last GI visit; median time since diagnosis 20 months (IQR 12-29 months). After lost to follow-up, 24 subjects had celiac serologies ordered by non-GI providers within the hospital network with 8 (33%) having abnormal results a median 44 months (IQR 39-72 months) after diagnosis. None of these subjects reengaged with the GI department, even those who were found to have elevated celiac antibodies. In contrast, only 7% (7/104) of subjects who were adherent to follow-up had an abnormal celiac serology at last recorded GI visit. Conclusion: This study demonstrates that follow-up of children with celiac disease is poor. Even those who are lost to GI follow-up more than one year after diagnosis cannot be presumed to be well as they were more likely to meet serologic criteria for non-responsive celiac disease than those who continued to follow-up with their GI provider. More studies are needed to understand factors contributing to loss of contact with GI providers.

Bringing the Real World Into Developmental Science: A Commentary on Weber, Fernald, and Diop (2017).

This article examines the parent intervention program evaluated by Weber etal. (2017) and argues that there are scientific and ethical problems with such intervention efforts in applied developmental science. Scientifically, these programs rely on data from a small and narrow sample of the world's population; assume the existence of fixed developmental pathways; and pit scientific knowledge against indigenous knowledge. The authors question the critical role of talk as solely providing the rich cognitive stimulation important to school success, and the critical role of primary caregivers as teachers of children's verbal competency. Ethically, these programs do not sufficiently explore how an intervention in one aspect of child care will affect the community's culturally organized patterns of child care.

Patterns of health care for children with asthma: A qualitative study

Background: Many children across the world, struggle with asthma, especially when the condition worsens due to lack of adherence to treatment strategies, the reason for which however may not be completely understood. Hence the objective of the study is to explore the perceptions of caregivers and patients about pediatric asthma and its control to trace possible factors that lead to poor adherence to asthma control. Methods: A qualitative study using conversational style interview for a group of 8 children and their guardians was conducted .In the discussion pre set questions were put forward to explore the perceptions of care givers and patients regarding asthma control management. The discussion was recorded with consent and later transcribed, coded and analyzed. Results: The focus group discussion revealed that patient compliance is not perfectly maintained due to various factors. Patients have mixed responses to the restrictions ranging from co-operative to rebellious behavior. Large amount of anxiety exists among the parents with regards to the disease exacerbation and long course of treatment. Frequent hospital visits have been perceived to be cumbersome by them and they perceive a need for the use of such questionnaires as a home based asthma control monitoring system. Conclusion: The focus group discussion reveals that proper counseling system and home based asthma control monitoring system need to be put into place to offer all round asthma control. Also use of questionnaires at home on a regular basis will reduce the number of hospital visits saving time and cost.

Custody Stalking: A Mechanism of Coercively Controlling Mothers Following Separation

This paper adds to our understandings of women’s post-separation experiences of coercive control through the introduction of a new concept—custody stalking. It is defined as a malevolent course of conduct involving fathers’ use of custody and/or child protection proceedings to overturn historic patterns of care for children. The experience of custody stalking is explored through three composite narratives derived from twelve mothers who participated in an exploratory, qualitative study on the involuntary loss of maternal care time following separation. The losses suffered caused these mothers tremendous grief, damaged their psychological wellbeing and had a detrimental effect on their mothering relationships. Yet custody stalking, as a form of malevolent attack, is not well recognised and mothers’ resultant losses are largely culturally invisible. This is in marked contrast to paternal filicides, another form of post-separation avenging attack committed by some fathers that also leads to maternal loss experiences, albeit more absolute.

Cultural and historical diversity in early relationship formation

Attachment theory has been challenged as representing exclusively Western middle class child care philosophy. In particular, the conception of a single, primary adult caregiver does not correspond with the reality of many early child care patterns worldwide. Different models of care that have been identified and described by cultural anthropologists, cultural and cross-cultural psychologists over the last decades are presented. It is apparent that in many cultural communities children and grandparents are significant caretakers and attachment figures. Caregiving is adapted to the sociocultural environments in which children are born and raised to become competent adults. Sociocultural environments also change over historical time, especially with respect to the amount of formal schooling and, as a corollary, maternal age at first birth, the number of children in the household, and household composition. In the second part of the paper, sociodemographic changes in different cultural environments are documented. Concomitant changes in socialization goals and socialization strategies involving babies are presented; these involve comparing different generations (mothers and grandmothers), and different cohorts over historical time. In the discussion the interplay between change and continuity as related constructs for understanding human development and well-being is considered, along with how universality and cultural/historical specificity co-exist in early relationship formation and thus attachment.

A critical review of the advantages and limitations of using large-scale national surveys to examine childcare patterns and the ECEC workforce in Britain

OECD countries have established statistical collections to ensure quality within Early Childhood Education and Care (ECEC). Focusing on one part of ECEC – preschool ‘childcare services’ – this paper critically reviews statistical collections specifically designed to measure childcare patterns in England alongside UK data collected for other purposes which can be used to examine childcare patterns. The paper evaluates how far these data provide a reliable basis for examining the childcare workforce, how well childcare usage and provision patterns can be analysed and the degree to which the data provide comparable geographical coverage. Results show analysis is restricted by the various ways data-sets count and classify occupations. Differences in geographical coverage make them difficult to compare. More refinement of occupation categories would make existing sources more useful. The themes discussed here are relevant for other countries seeking to understand how best to utilise their statistical collections for examining childcare patterns.

Parental child care during and outside of typical work hours

It has been argued that child care should be treated separately from leisure or housework when analyzing time use data. This is because child care has a positive income gradient, whereas leisure and housework do not. Using U.S. data from PSID-CDS, this paper computes parental child care during and outside of typical work hours (TWH) by income quintile for two-parent families. The TWH distinction is important because the opportunity cost of spending time with children is first and foremost in terms of forgone earnings during TWH; outside of TWH, leisure or housework mainly constitute this opportunity cost. Indeed, I find that child care decreases with income during TWH and, hence, behaves similarly to leisure and other household chores. While maternal child care also slightly decreases with income outside of TWH, paternal care increases with income outside of TWH. Also, the discrepancy between paternal and maternal child care is smaller outside of TWH than it is during TWH. This is particularly pronounced in high income families. Theoretical implications are derived in a static framework of time allocation and child quality production encompassing the recent literature on the topic. Variation in child care during TWH can be rationalized by assuming a high elasticity of substitution between leisure, consumption and child quality. This is the standard explanation for the patterns observed in leisure and housework. Within this widely used framework, however, the facts outside of TWH point to systematic differences by income in preferences or productivity. Further exploration of child care patterns during and outside of TWH is needed to inform us about the dimensions in which this widely used framework should be extended.

Patterns of grandparental child care across Europe: the role of the policy context and working mothers' need

ABSTRACTAcross Europe grandparents play very different roles. This paper studies to what extent grandparents' role as providers of child care relates to the country policy context, focusing on public child-care services and parental leave regulation, and to the availability of part-time jobs for women. We also explore whether mothers' needs to combine family and work differently influence the frequency of grandparental child care across countries. The analysis combines micro-data from the Survey of Health, Ageing and Retirement in Europe and macro-indicators from the Multilinks database and Eurostat. We find a clear association between policy context and frequency of grandparental child care. Three models emerge. In countries close to the familialism by default model (i.e. characterised by scarce public child-care services and parental leave), when grandparents provide child care they often do it daily. In countries characterised by defamilialisation and supported familialism policies (with generous public services and parental leave) grandparents take on a marginal role. An intermediate model emerges in countries characterised by a limited offer of child care or parental leave, where grandparental child care complements state support and tends to be offered on a weekly basis. Our analysis corroborates the idea that the highly intensive involvement of grandparents in countries with low availability of part-time jobs for women is influenced by the need (unmet by the welfare) of mothers to combine work and family.

Health Care Utilization and Costs of Publicly-Insured Children with Diabetes in California

To examine diabetes-related health care utilization and costs for a population-based sample of children with presumed type 1 diabetes (T1D) enrolled in the California Children's Services program. Our data source was the California Children's Services claims data for the period July 1, 2009, to June 30, 2012. We studied a sample of 652 children aged 0-21 years who were continuously enrolled for at least 365 days, had an outpatient visit for T1D, and were taking insulin. Compared with the younger age groups, individuals in the 19-21 year age group had the highest rates of hospitalization, T1D-specific bed-days, and emergency department visits. The overall median cost for this population was $7654. The overall median costs per year (and proportion of total costs) were $5603 (59%) for hospitalizations, $58 (0.4%) for emergency department visits, $144 (1.3%) for outpatient utilization, $2930 (23%) for insulin, and $1579 (13%) for blood glucose monitoring supplies. For those who used them, the median cost of pumps was an additional $2162. Further studies are needed to provide more insight into patterns of care and adverse health outcomes for children with T1D as they transition into young adulthood. The costs of insulin, glucose monitoring supplies, and pump therapy for children with T1D is substantial and may factor into future policy considerations regarding coverage and cost-sharing with families.

Understanding discursive barriers to involved fatherhood: the case of Australian stay-at-home fathers

Western societies are argued to be experiencing a shift to ‘involved’ models of fatherhood, and representations of stay-at-home fathers are becoming increasingly commonplace in the popular media, which plays a role in discursively producing ideal versions of fatherhood. Policymakers are simultaneously seeking to disrupt engrained gendered assumptions around parenthood in order to accomplish a gender egalitarian division of labour. I adopt a Foucauldian discourse analysis to uncover the construction of fatherhood in the news media and I explore how stay-at-home fathers negotiate these discourses. I find that the media constructs a superior breadwinning ‘involved father’ alongside an inferior ‘househusband’ who is coerced into stay-at-home fatherhood and is incapable of nurturing children. Participants embraced and rejected the ‘househusband’ discourse in ambivalent ways, revealing the struggles they have with discourses of contemporary fatherhood and the challenge that policymakers face in changing gendered patterns of childcare.

Examining the relationship between immigrant status and after-school care usage of young children in the US

Using the 2005 National Household Education Survey, this study examines the relationship between parental nativity and the after-school care use patterns of U.S. children. Results indicate that child-care usage patterns vary across households by parental nativity as well as by immigrant generational status. That is, immigrants are less likely to use nonparental care than natives. Among immigrants who use nonparental care, first-generation immigrant children were more likely to be placed in nonrelative care or activities, while second-generation immigrant children were more likely to be cared for by relatives. In terms of the time use pattern of youths in such nonparental care settings, second-generation immigrants were less likely to play sports and more likely to watch television or listen to music than natives. Lastly, the study found significant moderation effects of maternal employment status on the association between parental nativity and the type of child care used.

Essential pediatric hypertension: defining the educational needs of primary care pediatricians.

BackgroundIn order to better understand the educational needs regarding appropriate recognition, diagnosis and management of pediatric hypertension (HTN), we asked practicing pediatricians questions regarding their educational needs and comfort level on this topic.MethodsWe conducted 4 focus group sessions that included 27 participants representing pediatric residents, adolescent medicine physicians, clinic based pediatricians and office based pediatricians. Each focus group session lasted for approximately an hour and 90 pages of total transcriptions were produced verbatim from audio recordings.ResultsFour reviewers read each transcript and themes were elucidated from these transcripts. Overall, 5 major themes related to educational needs and clinical concerns were found: utilization of resources to define blood pressure (BP), correct BP measurement method(s), co-morbidities, barriers to care, and experience level with HTN. Six minor themes were also identified: differences in BP measurement, accuracy of BP, recognition of HTN, practice pattern of care, education of families and patients, and differences in level of training. The focus group participants were also questioned on their preferences regarding educational methods (i.e. e-learning, small group sessions, self-study, large group presentations) and revealed varied teaching and learning preferences.ConclusionsThere are multiple methods to approach education regarding pediatric HTN for primary care pediatricians based on provider preferences and multiple educational activities should be pursued to achieve best outcomes. Based on this data, the next direction will be to develop and deliver multiple educational methods and to evaluate the impact on practice patterns of care for children and adolescents with HTN.

Patterns of Childcare Arrangements and Cognitive Development

Objectives: The current study investigated (a) whether identifiable patterns of childcare arrangements from birth to 51 months exist and (b) whether these patterns moderate cognitive development from 18 months to 51 months in relation to maternal stimulation of language and infant difficult temperament controlling for SES and child gender. Methods: Of the 1201 who participated in the Families, Children Childcare Study, 978 were included in the current study. Data were collected when children were 3, 18, 36 and 51 months old regarding their mother-reported childcare arrangements, mother-reported child temperament and objective tests of cognitive and language abilities. Results: Six prevailing patterns of childcare arrangements were identified. Variations were found across these in predicting cognitive development. For all types, cognitive ability at 18 months influenced language ability at 36 months, which in turn influenced cognitive ability at 51 months. Cognitive scores at 18 months were directly and significantly influential on cognitive ability at 51 months only in the ‘maternal to centre-based care’ and ‘multi types’ patterns of childcare. Early and ongoing centre-based care predicted higher language ability at 36 months but its impact was not evident at 51 months. When girls entered centre-based care after they were 3 years old, their cognitive scores were negatively influenced. Low family SES was a risk factor for language ability at 36 months when children were not introduced to any non-parental care before the age of three years. Conclusion: This study helped to understand that the particular childcare pathway from birth to the start of school interacts with family and child factors to contribute to child cognitive outcomes at 51 months. This information should be relevant to families as they make decisions about when to start or stop different types of child care during infancy and preschool years.

Patterns of Child and Adolescent Mental Health Care in Greece

During the last 20 years the mental health care system in Greece underwent a dramatic change; the implementation of the EEC Reg. 815/84 programme contributed to a significant shift towards the extramural care and rehabilitation of patients with long-term mental health problems. The child and adolescent mental health (CAMH) care system was transformed by this change to a lesser degree. Despite bureaucratic obstacles and other difficulties, a substantial number of CAMH outpatient services have been developed in Greece. They are concentrated mainly in the larger cities and they focus on providing assessment and to some extent therapy and counselling; prevention and promotion of CAMH are not yet perceived as priority areas. In addition, there is a lack of specialised day care services for specific populations such as young people with disorders of the autistic spectrum and intellectual disabilities. There have been some recent improvements in education and research in the field of CAMH but these sectors are in need of further investment and development. Unfortunately, the current economic crisis has affected both the development of new services and the optimal functioning of those already in operation. Nevertheless, Greece must invest in CAMH and the rights of the children and young people should be protected.

Lone mothers and the puzzles of daily life: do care regimes really matter?

Kröger T. Lone mothers and the puzzles of daily life: do care regimes really matter?Int J Soc Welfare 2010: 19: 390–401 © 2009 The Author, Journal compilation © 2009 Blackwell Publishing Ltd and the International Journal of Social Welfare.This article studies childcare patterns and day‐to‐day strategies of 111 working lone mothers from Finland, France, Italy, Portugal and the UK, and asks whether their arrangements are prescribed by care regimes. Lone mothers' arrangements are grouped into five based on the availability and use of different formal and informal childcare resources. The article argues that, even though lone mothers have a more favourable starting point in Finland and France compared with Britain, Italy and Portugal where formal childcare coverage is patchier, childcare arrangements are not very dissimilar within different care regimes. Instead, similarities across care regimes are highlighted. Formal provisions have their limitations in all the countries studied and in all cases significant expectations are placed on informal childcare. The availability of informal childcare cannot, however, be taken for granted in any country, and working lone mothers whose informal and formal resources do not adequately meet their childcare needs were located in every care regime, facing care poverty.

Orphanhood and the Living Arrangements of Children in Sub-Saharan Africa

Increasing adult mortality due to HIV/AIDS in Sub-Saharan Africa raises considerable concerns about the welfare of surviving children. Studies have found substantial variability across countries in the negative impacts of orphanhood on child health and education. One hypothesis for this variability is the resilience of the extended family network in some countries to care for orphans-networks under increasing pressure by the sheer number of orphans in many settings. Using household survey data from 21 countries in Africa, this study examines trends in orphanhood and living arrangements, and the links between the two. The findings confirm that orphanhood is increasing, although not all countries are experiencing rapid rises. In many countries, there has been a shift toward grandparents taking on increased childcare responsibility-especially where orphan rates are growing rapidly. This suggests some merit to the claim that the extended network is narrowing, focusing on grandparents who are older and may be less able to financially support orphans than working-age adults. However there are also changes in childcare patterns in countries with stable orphan rates or low HIV prevalence. This suggests future work on living arrangements should not exclude low HIV/AIDS prevalence countries, and explanations for changes should include a broader set of factors.

Studies on the Relationship between Time Schedule of Home-makers and Pattern of Child-care

Studies on the Relationship between Time Schedule of Home-makers and Pattern of Child-care

Enhancing the Medical Homes Model for Children With Asthma

Medical Home is an evolving concept of patient-centered care yet little information is available on its effect on health care expenditures for children. To quantify differences in patterns of care and costs to the North Carolina (NC) Medicaid program for children with asthma across 3 programs: fee-for-service (FFS), primary care case management (PCCM), and Medical Homes. NC Medicaid claims from 1998-2001 for children with asthma were used to examine monthly expenditures and patterns of health care use, including emergency department and hospital use. Children in the FFS program served as controls for trends in asthma care over the study period. Tests examined the potential for selection by program and fixed-effect 2-part model regressions were used to control for differences in program enrollees. Children under age 21 with asthma. Monthly Medicaid expenditures and measures of health service use. We found considerable evidence of quality improvement in patterns of care for children enrolled in both the PCCM and Medical Homes models in NC. After controlling for selection into these programs, use of maintenance as well as rescue medications increased, use of services increased, and emergency department and hospital use went down. Total spending (asthma and nonasthma related) on children in the Medical Homes program was $148 greater than spending for FFS children (95% bootstrapped confidence interval: $140-$158) per child per month and no difference in spending between Medical Homes and PCCM was detected. Our results indicate that enhancement of PCCM programs is one way for Medicaid programs to improve care, but may require substantial investments by states.