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The psychological study of resilience has increasingly underscored the need for children and families to access material and psychological resources to positively adapt to significant stress. Redistributive policies-policies that downwardly reallocate society's social and economic resources-can offer economically disadvantaged families sustained access to these resources and mitigate the harmful impacts of adversity. This conceptual article builds upon and integrates insights from psychological and policy research to develop a unifying multilevel resilience framework, which we call the Social Determinants of Resilience. We examine four U.S. redistributive policies that have been extensively studied for their effects on child and family outcomes as case studies: (1) Medicaid expansion; (2) the Earned Income Tax Credit; (3) childcare subsidies; and (4) Temporary Assistance for Needy Families. Informed by a scoping review of each policy, we propose that redistributive policies promote children's resilience through three mechanisms by (1) increasing families' resource and service access; (2) reducing family stress; and (3) enhancing adaptive cognitions, emotions, behaviors, and interpersonal processes that protect against the development of psychopathology and promote positive mental health outcomes. Highlighting current evidence for these resilience mechanisms as well as gaps in knowledge, we conclude by setting a multidisciplinary research agenda that can leverage this conceptual framework to advance the science on how redistributive policies enable children and families to thrive. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Background: Bereaved parents experience life-long grief after the death of their child from cancer. Parents who can integrate their grief and maintain their social functioning early in bereavement, even in the setting of concurrent psychosocial distress, have improved outcomes. Identifying the factors associated with bereaved parents' early social functioning can guide future supportive interventions., Methods: The authors surveyed parents of children who died from cancer at two large centers 6-24 months after death, assessing bereavement experiences using validated and pilot tested tools. Univariable and multivariable logistical regression models were used to examine which family and child demographic, treatment, and end-of-life (EOL) factors were associated with maintained parental social functioning (T scores ≥40 on the Patient-Reported Outcomes Measurement Information System Ability to Participate in Social Roles and Activities-Short Form questionnaire)., Results: One hundred twenty-eight parents of 88 children participated (38% household response rate); most parents identified as female (63%) and White (88%). Parents' median age was 47 years (interquartile range, 10 years); and the median time from the child's death to survey completion was 13 months (interquartile range, 10 months). In multivariate modeling, parents without household material hardship and those who felt prepared for EOL circumstances had increased odds of maintained social functioning (odds ratio, 4.7 [95% confidence interval, 1.6-13.7; p < .004] and 5.5 [95% confidence interval, 1.9-15.9; p < .002], respectively)., Conclusions: Parents who felt prepared for their child's EOL and those without household material hardship were more likely to have maintained social functioning in the first 2 years after their child's death. Interventions targeting EOL preparedness and alleviating household material hardship may improve bereavement outcomes., (© 2024 American Cancer Society.)

Introduction: The exploration of the relationship between parental and child happiness, particularly in the context of shared childcare responsibilities, has not been examined in Korean families., Methods: Using a two-wave longitudinal design and data from 1,403 families from the Panel Study on Korean Children, this study employed the actor-partner interdependence model to examine the dynamics of childcare sharing between mothers and fathers in South Korea., Results: Mothers' childcare sharing was found to have no significant impact on their own and their partner's happiness, reflecting traditional gender norms that undervalue mothers' contributions. In contrast, fathers' childcare sharing had a positive impact on their own and their spouse's happiness, suggesting a growing recognition of fathers' involvement. Furthermore, fathers' active participation in childcare was found to promote their children's happiness through their own happiness., Discussion: This study reflects the complexity of evolving family roles and the covert persistence of traditional gender roles in modern Korean parenting. It suggests the importance of work and family policies that support changes in family dynamics by providing a more nuanced understanding of how changing family roles and responsibilities can enhance overall family well-being., Competing Interests: The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Lee.)

Background: In the context of the global aging challenge, an increasing number of middle-aged and older adults (MAOAs) are engaging in grandparenting. However, the effect of grandparenting on the mental health of caregivers has shown inconsistent findings. To effectively promote healthy aging, it is imperative to adopt a comprehensive perspective and employ a rigorous approach to further investigate the relationship between these two social phenomena., Methods: The data from the Harmonized China Health and Retirement Longitudinal Study were analyzed, focusing on MAOAs with at least one grandchild. Mental health assessments used the center for epidemiologic studies depression scale scale. The study employed a series of difference-in-differences (DID) models, especially complemented by propensity score matching, to evaluate the average treatment effect for the treated (ATT) on mental health of caregivers, considering covariates like personal and family characteristics. The intervention perspective includes both the provision and cessation of grandparenting., Results: The study found that providing grandchildren care does not have a significant effect on the mental health of grandparents, in comparison to those who have never engaged in such care (ATT = -0.172, T = 0.65, p = 0.517 in the PSM-DID model). Furthermore, ceasing this care also appears to have no substantial effect on the mental health of the caregivers, relative to individuals who have consistently offered grandchildren care (ATT = 0.060, T = 0.26, p = 0.795 in the PSM-DID model). Furthermore, subsequent robustness analyses consistently supported these findings, even when considering data from different survey waves., Conclusions: In contrast to many prior studies that have reported either positive or negative effects, our research reveals that grandparenting exerts no significant effect on the mental health of MAOAs. Consequently, health practitioners and policymakers should carefully consider the diverse cultural context when tailoring interventions and support strategies., (© 2024 John Wiley & Sons Ltd.)

Background: Japan has a shortage of childcare personnel, and the high levels of stress causing turnover in childcare workers must be urgently resolved. However, there is a lack of knowledge regarding the characteristics and influencing factors of job stress in Japanese childcare workers., Objective: This study aimed to evaluate the job stress of childcare workers and explore the influence of demographic factors and the COVID-19 pandemic on such stress., Methods: The data were collected through an Internet survey from 2,472 respondents. A 23-item version of the Brief Job Stress Questionnaire was used to measure occupational stress in childcare workers. The instrument is recommended in the stress-check program implemented as a mental health measure in workplaces in Japan., Results: The percentage of childcare workers with high stress exceeded that of general workers. Multiple regression analyses showed that the only factor affecting all job stressors and social support was the fear of contracting COVID-19. Job stressors and the COVID-19 pandemic had a significant large effect on stress responses. Additionally, being married and having children moderated childcare workers' stress., Conclusions: This study provided basic data regarding job stress in Japanese childcare workers and compared them with those of other professionals. In the future, it will be necessary to clarify how stress is related to turnover intention and turnover in Japanese childcare workers to promote their career continuity.

Background: The practice of grandparenting has been growing in popularity worldwide, particularly in Asian societies. Nevertheless, there is a lack of thorough studies investigating the mental health effects of grandchild care on grandparents, particularly within the family context. The present study aimed to explore the impact of grandparenting on depressive symptoms in older Chinese adults, taking into account the functional role of intergenerational support., Methods: Using the China Longitudinal Aging Social Survey (CLASS, 2014 and 2018, N = 9,486), we employed the Pooled Ordinary Least Square method (POLS) to explore the association between depressive symptoms and grandparenting intensity as well as include the interaction terms to investigate the role of intergenerational support among grandparents aged from 60 to 80., Results: After adjusting for control variables, both non-intensive (-0.17; 95% CI: -0.30, -0.03) and intensive (-0.69; 95% CI: -0.95, -0.43) childcare, as well as giving financial support to adult children (-0.06; 95% CI: -0.08, -0.04) and emotional closeness with them (-0.94; 95% CI: -1.15, -0.72), were found to have a positive impact on the mental health of grandparents. Giving financial support (non-intensive: -0.04, 95% CI: -0.07, -0.01; intensive: -0.06, 95% CI: -0.13, -0.01) and providing instrumental support to adult children (non-intensive: -0.12, 95% CI: -0.24, -0.01; intensive: -0.19, 95% CI: -0.37, -0.02) moderated the association between grandparenting and the mental health of older adults, regardless of care intensity. However, the moderating role of receiving financial support (-0.07; 95% CI: -0.12, -0.02) only existed when non-intensive childcare was provided., Conclusion: Grandchild care predicted better mental health in grandparents, mainly when they engaged in intensive grandparenting. Emotional closeness and providing financial support to adult children brought mental health benefits to grandparents involved in childcare. Giving financial support and providing instrumental support to adult children moderated the association between grandparenting and the mental health of older adults. However, the moderating role of receiving financial support from adult children only existed when non-intensive childcare was provided., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Objectives: Although studies have researched the mental effects of intergenerational care, little is known about the impact of transformations in caregiving intensity on depression. This study explores grand-parents' depressive symptom outcomes in terms of changes over time in grandparental childcare, with considerations for subgroup differences., Method: Using data from the 2015-2018 China Health and Retirement Longitudinal Study on grandparents aged 45 and older, we adopted generalized estimating equations to estimate the effects of seven category changes [(1) continued to provide high-intensity or (2) low-intensity care at both waves; (3) never provided care; (4) started caregiving; (5) ended caregiving; (6) provided less intensive care; and (7) provided more intensive care] over time in grandparental childcare on depressive symptoms among 17,701 grandparents with at least one grandchild, as well as how the impact varies by gender and urban/rural areas., Results: Grandparents who decreased the intensity of care, stopped childcare, or offered continuous low-intensity care were associated with a lower level of depression compared with those providing no childcare. In addition, the benefit of continuous caregiving on mental health was especially noticeable in urban grandmothers., Conclusion: Providing continuous low-intensity, decreased-intensity grandparenting and the cessation of caregiving were associated with a decreased level of depression for Chinese grandparents; however, there were complex interactions at play. Policies aimed at supporting grandparenting should consider caregiving intensity transitions relevant to gender and urban/rural residence., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Hong and Xu.)

Background: Grandparents play an essential role in childrearing and fill the parenting gap for dual-earner Chinese families. Many Chinese grandparents engage heavily in childcare, which may increase the risk of child abuse., Objective: This study aimed to examine grandparental use of psychological and physical aggression toward children and explore its associated risk factors., Participants and Setting: This was a cross-sectional study which involved purposive sampling of 278 grandparents (204 females and 74 males) taking care of at least one grandchild below 18 years old in Shenzhen, China., Methods: Information on childcare was collected, including grandparents' use of psychological and physical aggression and their involvement in childcare in terms of intensity and activity., Results: An alarming percentage (57.1 %) of grandparents had used psychological aggression, while 26.5 % had used corporal punishment, in the past year. The average use of psychological aggression and corporal punishment was 16.10 times and 10.08 times per year, respectively. Grandparents taking care of two or more grandchildren were more likely to use psychological aggression and corporal punishment compared to those taking care of only one grandchild. Higher mental and physical health summary scores were associated with lower likelihood of psychological and physical aggression of grandparents., Conclusions: This study advances our understanding of negative grandparenting behavior in childcare. As grandparents play a significant role in childcare, we need to improve their grandparenting skills, provide more formal childcare services to ease their childcare burden, and support their physical and mental well-being to reduce the risk of child abuse., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Objectives: Policies aiming at reducing rates of hospitalization and death from coronavirus disease 2019 (COVID-19) encouraged older people to reduce physical interactions. In England, until July 2021, provision of care for grandchildren was allowed only under very limited circumstances. Evidence also suggests that reduced face-to-face interactions took a toll on mental health during the pandemic. This study aims to investigate associations between changes in grandchild care provision during the first 8/9 months of the pandemic and grandparents' mental health., Methods: Using prepandemic data from Wave 9 (2018/2019) and the second COVID-19 substudy (November/December 2020) of the English Longitudinal Study of Ageing, we first describe changes in grandchild care provision during the pandemic to then investigate, using regression models, associations between changes in grandchild care provision and mental health (depression, quality of life, life satisfaction), while controlling for prepandemic levels of the outcome variables., Results: About 10% of grandparents stopped looking after grandchildren altogether during the first 9 months of the pandemic, with 22% reporting an overall decrease in the amount of grandchild care provided. Compared to grandparents who mostly maintained unchanged their grandchild care provision, those who stopped altogether and those who mostly reduced the amount of grandchild care provided were more likely to report poorer mental health, even accounting for prepandemic health., Discussion: While measures to limit physical contact and shield older people were necessary to reduce the spread of COVID-19, policymakers should acknowledge potential adverse consequences for mental health among grandparents who experienced changes in their roles as grandchild caregivers., (© The Author(s) 2022. Published by Oxford University Press on behalf of The Gerontological Society of America.)

Older individuals commonly go through a few major life transitions which can impact their health and well-being. While transitions like that into retirement have been extensively investigated, little research focused on the transition into grandparenthood. Understanding effects of this highly common event is not only important from a descriptive viewpoint, but is also informative for the active aging policies that are increasingly pursued to deal with aging populations. Using data from ten Western European countries, we show that grandparenthood on average leads to a reduction in well-being while hardly impacting physical, cognitive and mental health. The effect is heterogeneous by family closeness, though. Grandparenthood reduces well-being for those having relatively little family contact and not providing child care. But it leaves well-being unaffected while improving health along some dimensions among those with the opposite profile. The only exception to the latter are grandmothers providing daily child care, for whom grandparenthood appears to be burdensome. This pattern of results suggests that involving grandparents non-intensively in child care may lead to beneficial side-effects. Becoming a grandparent induces people to retire, but retirement seems no relevant channel for well-being and health effects., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Alloparenting by and with genetically unrelated individuals is evolutionarily novel; thus, the Savanna-IQ Interaction Hypothesis predicts that more intelligent parents are more likely to resort to paid childcare by strangers. Analyses of individual data (National Child Development Study) in the United Kingdom (Study 1) and macrolevel data from the United States (Study 2) and economically developed Organization for Economic Cooperation and Development (OECD) nations (Study 3) confirmed the hypothesis. Net of education, earnings, sex, current marital status, and number of children, more intelligent British parents were more likely to resort to paid childcare at ages 33 and 42; net of female labor force participation rate, median household income, median cost of childcare, and mean education, U.S. states with higher average intelligence had higher proportions of children (ages 0-4) in paid childcare; and net of maternal employment, gross domestic product (GDP) per capita, cost of childcare, and female educational attainment, OECD nations with higher average intelligence had higher proportions of infants (ages 0-2) in paid childcare. The results were remarkably consistent; both across the 50 U.S. states and 45 economically developed OECD nations, a one IQ point increase in the average intelligence of the population was associated with a 1.8% increase in the proportion of children in paid childcare. Contrary to earlier findings, there was some suggestive evidence that the experience of paid daycare might harm the cognitive development of children. The studies point to the importance of evolutionary perspective in developmental psychology and child development., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Background and Objectives: Grandparenting trends have been increasing due to rises in female employment, economic stressors, and single-parent families. Because the level of grandparental involvement could either result in beneficial or adverse physical and mental health outcomes, this review aims to use a social-ecological model to compare the childcare experiences of primary and nonprimary grandparent caregivers and the effects of childcare on their physical and emotional health., Research Design and Methods: This is a systematic review. CINAHL, Embase, PsycINFO, PubMed, and Scopus were searched for qualitative papers. A thematic analysis was conducted, and data were framed using the social-ecological model., Results: Seventy-four qualitative studies were included. Four themes were generated: intrapersonal: attitudes and motivations (obligation and sense of responsibility, limited physical health, and emotional resources), interpersonal: relationships with grandchildren and adult children (grandparental roles and gendered differences, forging bonds with grandchildren, role ambiguities, conflicts and drawing boundaries, and support and relationships with others), organizational: social services and educational needs, and policy: financial and legal issues. Grandparental well-being is likely to be dependent on the context of the childcare provided, relational bonds with adult children and grandchildren, and the availability of a community and institutional, legal, and financial support., Discussion and Implications: The act of grandparenting is laden with cost and reward. To ensure a better quality of life in grandparents' later years, joint efforts between policymakers, educators, and organizations are required to meet their childcare support needs such that they can fulfill their grandparenting roles with ease., (© The Author(s) 2020. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Objectives: Provision of grandchild care has been found to be associated with a youthful subjective age. Yet, previous studies on this topic were cross-sectional and ignored the increasing proportions of older people growing old without the opportunity to become a grandparent. This study investigates the effects of childcare to grandchildren and to other children on subjective age using panel data., Methods: We exploit the longitudinal nature of data from the German Ageing Survey (DEAS) to examine the association between grandparental childcare and care to other children with subjective age, using fixed-effects regression analyses on a sample of 50-85 years old individuals (men: N = 11,151; n = 3,984; women: N = 10,687; n = 3,746, where N is the number of observations and n is the number of individuals)., Results: The results from cross-sectional analyses show a "rejuvenating effect" of provision of both types of childcare in later life, especially for women. However, longitudinal analyses find very small and statistically insignificant effects., Discussion: We show for the first time that both grandchild care and childcare outside the grandparent-grandchild relationship are associated with a youthful subjective age for older people. However, these associations are likely due to selection effects, that is, unobserved characteristics of people that make them more likely to engage in childcare and are also associated with subjective age. Our results warn against causal interpretation of associations found in previous studies, but also open up new research questions on the role played by childcare other than to grandchildren., (© The Author(s) 2021. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: The early postpartum period is recognized cross-culturally as being important for recovery, with new parents receiving increased levels of community support. However, COVID-19-related lockdown measures may have disrupted these support systems, with possible implications for mental health. Here, we use a cross-sectional analysis among individuals who gave birth at different stages of the pandemic to test (i) if instrumental support access in the form of help with household tasks, newborn care, and care for older children has varied temporally across the pandemic, and (ii) whether access to these forms of instrumental support is associated with lower postpartum depression scores., Methods: This study used data from the COVID-19 And Reproductive Effects (CARE) study, an online survey of pregnant persons in the United States. Participants completed postnatal surveys between April 30 - November 18, 2020 (n = 971). Logistic regression analysis tested whether birth timing during the pandemic was associated with odds of reported sustained instrumental support. Linear regression analyses assessed whether instrumental support was associated with lower depression scores as measured via the Edinburgh Postnatal Depression survey., Results: Participants who gave birth later in the pandemic were more likely to report that the pandemic had not affected the help they received with household work and newborn care (p < 0.001), while access to childcare for older children appeared to vary non-linearly throughout the pandemic. Additionally, respondents who reported that the pandemic had not impacted their childcare access or help received around the house displayed significantly lower depression scores compared to participants who reported pandemic-related disruptions to these support types (p < 0.05)., Conclusions: The maintenance of postpartum instrumental support during the pandemic appears to be associated with better maternal mental health. Healthcare providers should therefore consider disrupted support systems as a risk factor for postpartum depression and ask patients how the pandemic has affected support access. Policymakers seeking to improve parental wellbeing should design strategies that reduce disease transmission, while facilitating safe interactions within immediate social networks (e.g., through investment in COVID-19 testing and contact tracing). Cumulatively, postpartum instrumental support represents a potential tool to protect against depression, both during and after the COVID-19 pandemic., (© 2021. The Author(s).)

Background: Assessment of parental satisfaction with child nursing is the key issue in evaluation of the care quality, enabling the adjustment of the services provided to the needs and expectations of recipients, and thus ensuring safety and achieving better long-term health effects., Aim: Assessment of parental satisfaction with child nursing in paediatric wards including its determinants., Material and Methods: The study covered 1030 parents of children hospitalised in paediatric and surgical wards of seven hospitals of different levels of health security in Poland. The Polish adaptation of the Empathic standardised questionnaire for assessment of the level of parents' satisfaction with nursing care, developed by Latour et al. and the self-constructed summary of socio-demographic data were applied in the study., Results: More than 90% of respondents expressed high level of satisfaction with nurses' Availability, the lowest, but still high score of respondents' satisfaction was observed for Parental Participation. The highest satisfaction was observed among the parents of children at the preschool, early school and puberty stage, admitted to the hospital on the elective basis, referred for diagnostic assessment and with the length of hospital stay less than 7 and longer than 28 days. Achieving preschool age was the strongest factor which increased assessment of satisfaction in most domains., Conclusions: There is a need for optimising nursing care especially in the area of parental participation. The nursing care' quality improvement plan in paediatric departments should focus particularly on early childhood patients and their parents who are the most critical in satisfaction' assessment., Competing Interests: The authors have declared that no competing interests exist.

Introduction: Knowledge and beliefs of people on congenital malformations and their causes differ from society to society. As a result, there is a paucity of understanding community perceived knowledge and beliefs towards congenital malformations and their risk factors among children's parents. Therefore, I sought to identify perceived knowledge and beliefs of parents on congenital malformations and their causes., Methods: An in-depth discussion and interview were carried out on purposively selected forty participants (women and men) in the Amhara region, Ethiopia. The data were collected from June to July, 2015. Semi-structured guiding topics/questions were used during the discussions and in-depth interviews. Note and audio records were taken while the participants discussed the topics. After the discussions and in-depth interviews were completed, the transcripts were read repeatedly to understand the participant's words, phrases, ideas, and concepts. Then notes were taken to combine pieces of similar transcripts. I have employed thematic framework analysis. The relevant transcripts were scrutinized, labeled and coded manually based on their relevance to the objective of the study. Then the coded transcripts were determined and categorized according to the type of thematic variables., Results: The participants responded on three aspects of lived experience, perceived knowledge and beliefs on congenital malformations and their causes. Nearly half of the participants' beliefs on the causes of congenital malformations were related to sin, contraceptive pills, un-prescribed drugs/medication use, and fertilizers (that is eating crops grown by using fertilizers). Almost all said that raising a child with a major congenital malformation was very difficult. About half of the participants' belief on congenital malformations were traditional and resulted from poor awareness., Conclusion: The findings of the present study highlight the challenges and impacts of congenital malformations on parents who had children with and without congenital malformation. Lived experience, perceived knowledge and beliefs of children parents on congenital malformation and their causes can be helpful information for designing preventive actions. Hence, planning a preventive strategy and providing health education on congenital malformations and their causes for children parents are very necessary., Competing Interests: The author has declared that no competing interests exist.

During the transition from home to childcare, 70 15-month-old infants were videotaped, and their negative emotions were rated. Infants' attachments to mothers were assessed prior to child care entry and to care providers five months later using the Strange Situation Procedure (SSP). Infant heart rate was monitored at home, during adaptation to childcare (mothers present), and during subsequent separations. Respiratory sinus arrhythmia (RSA) was computed from the beat-to-beat measures of heart rate to reflect vagal tone, which is reduced during chronic states of stress, and was collected upon Arrival, during in-group Play, and when in the Group more generally. All infants responded to childcare entry with low RSA levels indicating stress. However, during adaptation with the mother present, RSA was higher for securely attached infants. On the first separation day, 35.3% of the infants fussed and cried extensively. These intense protests predicted later secure attachments to care providers, which adaptively helped to reduce stress, especially in infants who protested extensively, as if summoning their mothers back. Because extensive protest suggests limited regulatory capacities, infants risk overburdening the stress system when left unsupported., (© 2021 The Authors. Developmental Psychobiology published by Wiley Periodicals LLC.)

Competing Interests: Competing interests: We have read and understood BMJ policy on declaration of interests and have no relevant interests to declare.

Few studies have investigated fathers' roles in child care in Madagascar. This study explored the perceptions, attitudes, and practices regarding fathers' involvement in child care using qualitative methods. Ten focus group discussions were conducted among parents of children aged 6-23 months; seven were among mothers, and three among fathers. In-depth semi-structured interviews (n = 8) were also conducted with key informants. Discussions and interviews were audio-recorded and the verbatim transcripts in Malagasy were translated into English. Data were analyzed using the thematic analysis approach. Provision of financial and material support as well as teaching and playing with the child were the main perceived roles of fathers. In practice, fathers spent their time alone with their children playing and holding them when the mother was unavailable. Busy schedules and separation due to work were major barriers to fathers' involvement. Traditional gender roles for child care in which the mother is seen as primarily responsible for the child were salient across the data. Consequently, men involved in child care activities and their wives were often criticized by the community. Nevertheless, there was self-reported interest from both mothers and fathers in involving men more in child care. Interventions aimed to increase fathers' involvement in child care may be more successful when they focus on shifting the community perceptions on the division of responsibilities between fathers and mothers., Competing Interests: The authors have declared that no competing interests exist.

The association between child temperament characteristics and total diurnal saliva cortisol in 84 children (M = 2.3 years, SD = 0.6) attending out-of-home, center-based child care and 79 children (M = 2.0 years, SD = 0.5) attending at-home parental care was examined. Saliva samples were collected during two consecutive days, that is, Sunday and Monday, with four samples taken per day. While children higher in surgency had higher total diurnal cortisol production, we did not find evidence that temperament moderated the associations between child-care context and total diurnal cortisol. Negative affectivity and effortful control were not related to cortisol output. Our findings suggest that temperamental surgency may be associated with higher total cortisol production in early childhood across child-care settings., (© 2020 The Authors. Child Development published by Wiley Periodicals LLC on behalf of Society for Research in Child Development.)

This study aimed to understand school nurses' perceptions regarding barriers to and facilitators for health care services for children with chronic diseases in school settings. Using the PubMed, Cumulative Index to Nursing and Allied Health Literature, Embase, and Web of Science databases, a mixed studies review was conducted for literature published between January 2011 and June 2020. We performed a mixed-methods systematic review using a convergent integrated approach. A quality appraisal of the included studies was conducted using a mixed-methods appraisal tool. Twenty-seven articles (10 qualitative, 10 quantitative, and seven mixed-methods) that met the inclusion criteria were analyzed. Integrated findings that emerged from data synthesis were categorized into four levels (intrapersonal level, interpersonal level, institutional level, and community and public policy level) based on a socio-ecological model framework. This mixed systematic review provides a comprehensive understanding of school nurses' perceived barriers and facilitators when providing school health care for students with chronic diseases and how these barriers and facilitators interact across multiple systems. Further policies and strategies should be developed to provide effective school health services considering this study's findings., (© 2020 John Wiley & Sons Australia, Ltd.)

Background: There is an identified need to improve the evidence-base in relation to contact visits for children in the out-of-home-care (OOHC) system, to ensure optimal outcomes., Objective: The aim of this cluster randomized controlled trial (RCT) was to test the effectiveness of a contact intervention for parents having supervised contact with children in long-term OOHC., Participants: 183 study children in 15 clusters (OOHC services) and their parent(s) were randomized to the intervention (8 clusters, 100 children) and control groups (7 clusters, 83 children) in three Australian jurisdictions., Setting: The manualized intervention consisted of increasing the preparation and support provided by caseworkers to parents before and after their contact visits., Method: Interviews were conducted with carers, parents and caseworkers of the study children at baseline and nine months post-randomization. Interviews included standardized assessment tools measuring child and adult wellbeing and relationships, carer and caseworker ability to support contact, and contact visit cancellations by the parent., Results: Compared with controls, the intention-to-treat (ITT) analyses showed that fewer visits were cancelled by parents in the intervention group at follow-up (-10.27; 95 % CI: -17.04 to -3.50, p = .006). In addition, per-protocol (PP) analyses showed higher caseworker receptivity to contact (6.03; 95 % CI: 0.04-12.03, p = .04), and higher parent satisfaction with contact (7.41; 95 % CI: 0.70-14.11, p = .03) in the intervention group at follow-up., Conclusions: While the intervention did not have an effect on child wellbeing, as measured by the SDQ, the trial reports significant positive findings and demonstrates the benefits of the kC kContact intervention in providing support to parents to attend contact visits. The findings of the current study provide an important contribution to knowledge in an area where few RCTs have been completed, notwithstanding the null findings., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Background: As the coronavirus disease pandemic spread across the United States and protective measures to mitigate its impact were enacted, parents and children experienced widespread disruptions in daily life. Our objective with this national survey was to determine how the pandemic and mitigation efforts affected the physical and emotional well-being of parents and children in the United States through early June 2020., Methods: In June 2020, we conducted a national survey of parents with children age <18 to measure changes in health status, insurance status, food security, use of public food assistance resources, child care, and use of health care services since the pandemic began., Results: Since March 2020, 27% of parents reported worsening mental health for themselves, and 14% reported worsening behavioral health for their children. The proportion of families with moderate or severe food insecurity increased from 6% before March 2020 to 8% after, employer-sponsored insurance coverage of children decreased from 63% to 60%, and 24% of parents reported a loss of regular child care. Worsening mental health for parents occurred alongside worsening behavioral health for children in nearly 1 in 10 families, among whom 48% reported loss of regular child care, 16% reported change in insurance status, and 11% reported worsening food security., Conclusions: The coronavirus disease pandemic has had a substantial tandem impact on parents and children in the United States. As policy makers consider additional measures to mitigate the health and economic effects of the pandemic, they should consider the unique needs of families with children., Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose., (Copyright © 2020 by the American Academy of Pediatrics.)

Background and Objectives: The outbreak of coronavirus disease 2019 has changed American society in ways that are difficult to capture in a timely manner. With this study, we take advantage of daily survey data collected before and after the crisis started to investigate the hypothesis that the crisis has worsened parents' and children's psychological well-being. We also examine the extent of crisis-related hardships and evaluate the hypothesis that the accumulation of hardships will be associated with parent and child psychological well-being., Methods: Daily survey data were collected between February 20 and April 27, 2020, from hourly service workers with a young child (aged 2-7) in a large US city ( N = 8222 person-days from 645 individuals). A subsample completed a one-time survey about the effects of the crisis fielded between March 23 and April 26 (subsample n = 561)., Results: Ordered probit models revealed that the frequency of parent-reported daily negative mood increased significantly since the start of the crisis. Many families have experienced hardships during the crisis, including job loss, income loss, caregiving burden, and illness. Both parents' and children's well-being in the postcrisis period was strongly associated with the number of crisis-related hardships that the family experienced., Conclusions: Consistent with our hypotheses, in families that have experienced multiple hardships related to the coronavirus disease 2019 crisis, both parents' and children's mental health is worse. As the crisis continues to unfold, pediatricians should screen for mental health, with particular attention to children whose families are especially vulnerable to economic and disease aspects of the crisis., Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose., (Copyright © 2020 by the American Academy of Pediatrics.)

Purpose This study was conducted in a large Midwestern metropolitan area to examine the language environments at home and in center-based childcare for young children who are living in poverty. We compared child language use and exposure in the home and childcare settings using extended observations with automated Language Environment Analysis to gain a deeper understanding of the environmental factors that may affect change in language outcomes for young children. Method Thirty-eight children, along with parents ( n = 38) and childcare providers ( n = 14) across five childcare centers, participated in this study. Each child completed a standardized language assessment and two daylong recordings with Language Environment Analysis to determine the number of adult words, conversational turns, and child vocalizations that occurred in each setting. Data were analyzed at 5-min intervals across each recording. Results Comparisons between home recordings in this sample and a comparison group showed reliably higher rates of adult words and conversational turns in the home setting. Linear mixed-effects regression models showed significant differences in the child language environments, with the home setting providing higher levels of language input and use. These effects were still meaningful after accounting for the time of day, participant demographic characteristics, and child language ability. Conclusions Practical implications for supporting child language development across settings are discussed, and suggestions for further research are provided. Supplemental Material https://doi.org/10.23641/asha.12042678.

Little is known about needs of grandparents of young children with autism in family and community settings. This study investigated perceived needs of grandparents of preschool-aged children diagnosed with ASD in the cultural context of Sweden. Participants were 120 grandparents of children enrolled into autism intervention programs provided by the public disability services in Stockholm. The Grandparents' Needs Survey and the SDQ Impact supplement were used to collect data. Grandparents expressed most needs in topic areas of information and childcare. No significant relations were found between grandparents' demographics and perceptions of needs; grandparents' needs were predicted by their perceived burden. The findings provide insight into understanding of grandparents' needs essential for planning and provision of quality family-centered early intervention services.

This study explored the prevalence of expulsion in home-based child care (HBCC) settings using a nationally representative sample of HBCC providers from the National Survey of Early Care and Education. In addition to prevalence, enrollment and provider characteristics that predicted expulsion were examined. Although there is increasing awareness of the prevalence of early childhood suspension and expulsion in early care and education settings and the negative effects it has on children's development, few studies have included or focused on HBCC, where many children receive care. This study highlights that many home-based providers, especially listed providers, report that they expelled at least one child within the last year. Significant predictors of expulsion emerged, including enrollment characteristics such as caring for children with disabilities, enrolling more children, and caring for children unrelated to the provider. Provider characteristics, including years of experience, provider education, and provider age, also predicted provider report of expulsion. These results provide insight as to possible strategies that may be effective in reducing expulsion rates in this caregiving context., (© 2020 Michigan Association for Infant Mental Health.)

Objective: To explore the status quo of occupational stress and its influencing factors of nursing staff for orphaned and disabled children in Nanjing, and to put forward measures for adverse reactions to occupational stress, so as to ensure the psychological health of this occupational population. Methods: From February to May 2017, 236 nursing assistants for orphans and disabled children in Nanjing social welfare home were selected by cluster sampling method. The occupational stress index(occupational stress indictor, OSI) was used to investigate occupational stress response and occupational stress factors. Partial correlation and multiple linear regression were used for statistical analysis. Results: The scores of job satisfaction, mental health and depressive symptoms in occupational stress reaction were (43. 99±6. 83) , (36. 09±4. 59) and (17. 31±2. 44) re- spectively. In terms of job satisfaction, work monotony, logic and compound change were the contributing fac- tors ( P <0. 05) , task strategy and task control were negative factors ( P <0. 05) ; on mental health, opportunities were raised and participation in decision-making Self-esteem, technology utilization, environmental control, time management, task strategy and support of colleagues as contributing factors ( P <0. 05) , ambition and role conflicts as negative factors ( P <0. 05) ; on depression, work input, participation Decision-making, promotion opportunities and behavioral characteristics were protective factors ( P <0. 05 ) . Conclusion: Occupational stress among caregivers of orphans and disabled children cannot be ignored. Occupational stress reaction is serious. Occupational stress factors should be reduced and individual stress coping ability should be enhanced.

Early care and education settings, such as family child care homes (FCCHs), are important venues for children's health promotion. Keys to Healthy Family Child Care Homes evaluated a FCCH-based intervention's impact on children's diet and physical activity. This study enrolled 496 children aged 1.5-4 years and 166 FCCH providers into a cluster-randomized control trial (intervention = 242 children/83 FCCHs, control = 254 children/83 FCCHs) conducted during 2013-2016. The 9-month intervention addressed provider health, health of the FCCH environment, and business practices, and was delivered through three workshops, three home visits, and nine phone calls. The attention control arm received a business-focused intervention. Primary outcomes were children's diet quality (2 days of observed intakes summarized into Healthy Eating Index scores) and moderate to vigorous physical activity (3 days of accelerometry) at the FCCH. Secondary outcomes were child body mass index (BMI), FCCH provider health behaviors, and FCCH nutrition and physical activity environments and business practices. Repeated measures analysis, using an intent-to-treat approach, accounting for clustering of children within FCCHs and adjusting for child age, sex, and BMI, was used to evaluate change (completed in 2018). Compared to controls, intervention children significantly improved their diet quality (5.39, p = .0002, CI = 2.53, 8.26) but not MVPA (0.31, p = .195, CI = -0.16, 0.79). Intervention FCCH providers significantly improved their diet quality and several components of their FCCH environment (i.e., time provided for physical activity, use of supportive physical activity practices, and engagement in nutrition and physical activity education/professional development). FCCHs are malleable settings for health promotion, especially diet quality. TRIAL REGISTRATION: This study is registered at www.clinicaltrials.govNCT01814215., Competing Interests: Declaration of competing interest Drs. Ward, Burney, Hales, Benjamin-Neelon, Tovar, Østbye, and Mrs. Vaughn have been funded by the National Heart, Lung, and Blood Institute (HL108390)., (Copyright © 2019. Published by Elsevier Inc.)

Purpose: Many children with complex needs exhibit eating, drinking, and/or swallowing disorders (dysphagia). These children often have associated learning needs, and require assistance from carers for daily tasks such as eating and drinking. The aim of this study was to identify which strategies to manage dysphagia were challenging for family carers, and reasons for any non-adherence. Method: In this service evaluation researchers observed carers during mealtimes, and investigated carer opinions of strategies used to minimise the risks of dysphagia. Eight children with complex needs aged 3.4-7.5 years and their primary family caregiver participated. Results: Adherence with speech and language pathologists' dysphagia recommendations overall was over 50% in all but one case. For specific strategies, the highest adherence was observed for diet modifications of foods (89%), communication during the mealtime (83%), amount of food to present (81%), and the pacing of fluids and foods (81%). Lower levels of adherence were identified in relation to postural management (58%), environmental changes (58%), utensils (56%), and preparatory strategies (49%). Conclusions: Adherence with use of strategies to support mealtimes was over 50% in all but one case. Findings suggest that support is essential to promote safe mealtimes, reduce family carers' stress and increase knowledge, confidence, and adherence in implementing dysphagia guidelines in the family home. Implications for rehabilitationDifficulties with eating, drinking and swallowing (dysphagia) can impact on the parent-child mealtime experience.Mealtime strategies as recommended by a speech-language pathologist can support children who have difficulties eating, drinking, and swallowing.Some strategies to support eating, drinking, and swallowing are easier for carers to adhere to than others.

Physical inactivity is a significant risk factor for childhood obesity. Preventing obesity in the early years reduces the risk of developing chronic health conditions later. Early childhood education and care (ECEC) services are important settings to establish good preschooler physical activity behaviors. This natural experiment investigated the influence of ECEC outdoor physical environment upgrade on preschoolers' physical activity (aged 2-5 years). Centers implemented upgrades without researcher input. Physical activity was measured by 7-day accelerometry for intervention (n = 159; 6 centers) and control (n = 138; 5 centers) groups. ECEC outdoor space was assessed using a modified Environment and Policy Assessment and Observation (EPAO) Instrument. Key outcomes were measured at baseline and 6-12 months follow-up. Fixed sandboxes, balls, portable slides, portable floor play equipment (e.g., tumbling mats), and natural grassed areas were positively associated with activity levels; fixed tunnels and twirling equipment were negatively associated with activity levels (all p < 0.05). Post-upgrade portable play equipment (balls, twirling equipment, slides, floor play equipment) increased intervention preschoolers' moderate-vigorous physical activity (MVPA) levels compared to control ( p < 0.05). Intervention preschoolers were more active than control at follow-up (58.09 vs. 42.13 min/day increase in total physical activity; 30.46 vs. 19.16 min/day increase in MVPA (all p < 0.001)). Since few preschoolers meet daily activity recommendations while at ECEC, the findings may help ECEC providers to optimize outdoor physical environments and encourage more active play among preschoolers.

Objectives Child care involves mentally and physically intensive work. Women involved in child care are prone to various cognitive failures (e.g., forgetting to carry something or missing an appointment) because of being overburdened with child care activities and chores, constantly limited attention for coping with the frequent demands of children, and cognitive deterioration in the perinatal period. We conducted a survey of women caring for children aged 3 months to 6 years old, aiming to 1) develop a Japanese version of the cognitive failure scale (named the Short Inventory of Minor Lapses [SIML]), and 2) examine the psychometric properties of the scale (including factor structure, validity, reliability, and score distribution), and comparing the scale score according to job status, the youngest child's age, and the number of children.Methods We used data obtained through an internet research company from 310 women (aged 25-45 years; 155 full-time workers and 155 housewives), caring for children aged 3 months to 6 years old. We used the 15-item SIML with a five-point Likert-type scale. We also collected information about employment status, maternal age, the youngest child's age, the number of children, income, the status of using child-care services, sleep duration, fatigue, and neuroticism.Results The scale consisted of one factor. Cognitive failure was found to have the following correlations with memory complaints (polyserial correlation=0.66), sleep duration (r=-0.17), fatigue (r=0.32), and neuroticism (r=0.22). Cronbach's alpha for the scale was 0.94. A three-way analysis of variance (including main effects of working status, the youngest child's age, and the number of children) in cognitive failure revealed significant main effects of the youngest child's age (aged 0-3 years: mean (standard deviation [SD])=34.9 (11.5) point, > aged 4-6 years: mean (SD)=32.6 (10.5) point, partial η 2 =0.013), and the number of children (only one: mean (SD)=32.4 (11.3) points < two or more: mean (SD)=34.9 (10.9) points, and partial η 2 =0.014). A three-way analysis of covariance in cognitive failure adjusted for mother's age demonstrated a significant main effect of the youngest child's age (partial η 2 =0.014).Conclusion Our findings confirmed the psychometric properties of the Japanese version of SIML among women involved in child care (including factor structure, validity, reliability, and score distribution).

Grandparents caring for grandchildren has become a common experience in China. However, the health implications of grandparenting, especially for health self-management, remain unclear. A cross-sectional study was conducted to investigate the effects of grandparenting on health self-management in older adults in China. Information on socioeconomic characteristics, grandparenting, and health self-management was collected through interviewer-administered questionnaires. Age less than 50, male gender, higher education level, being a local resident, having a chronic illness, and supporting themselves financially were all factors that were significantly positively associated with health self-management (P < .05) in grandparents. Grandparenting characteristics, including caring for grandchildren at night, a caregiving burden of more than 50%, poorly behaved grandchildren, caring for grandchildren more than 6 hours per day, and caring for grandchildren less than 1 year in age were significantly negatively associated with health self-management in grandparents (P < .05). Multiple regression analyses indicated that grandparent age, receiving financial support from children, being a local resident, education level, grandchild behavior and age, and being an urban resident were all statistically significant factors associated with health self-management in grandparents involved in grandparenting. Taken together, these results suggested that financial condition and caregiving burden might be the major factors affecting health self-management in grandparents involved in grandparenting., (© 2019 John Wiley & Sons, Ltd.)

Since failed reunification is a detrimental outcome for children, particularly infants and toddlers, the aim of this study was to gain insight into support to families in multiple-problem situations to help them achieve sustainable good-enough parenting. Therefore, we examined outcomes of an assessment-based inpatient family preservation program. We prepared a thorough target-population description (n = 70) using file analysis. Next, we examined atypical parental behavior during the intervention using the Atypical Maternal Behavior Instrument for Assessment and Classification with a repeated measures design (n = 30). The family files revealed a great number of issues at the family, parent, and child levels, such as practical matters, problems in parent functioning and between parents, and difficulties in the broader environment. We found a significant decline in three dimensions of atypical parental behavior over time. This program has great potential in supporting vulnerable families in their pursuit of family preservation., (© 2019 The Authors. Infant Mental Health Journal published by Wiley Periodicals, Inc. on behalf of Michigan Association for Infant Mental Health.)

Early childhood education and care (ECEC) settings have a pivotal role in the promotion of physical activity for young children, and thus, the number of ECEC-based physical activity interventions has exponentially increased in the last two decades. The aim of this study was three-fold: (1) to discuss some of the similarities and differences in ECEC-based physical activity interventions, (2) to highlight current trends and issues in the ECEC sector relating to such interventions, and (3) to provide recommendations for future interventions. Twenty-four individual studies are discussed. Most studies have targeted children aged between 3 and 5 years and involved children participating in additional physical activity opportunities while at childcare. In all studies, educators participated in some professional development either prior or during the intervention. Less the half of the studies discussed reported significant positive changes in physical activity outcomes. Those involved in developing future interventions will need to consider current national and international trends in the ECEC sector (e.g., over-crowded curriculum, administrative requirements, and more highly-qualified educators devoting time for business development), as well as creative and unique ways of delivering ECEC-based physical activity interventions.

Objective: This paper examines the joint impact of maternal employment and childcare during infancy on childhood weight at ages three and five in the context of weak social support for early childhood care and education., Method: Using three waves of longitudinal data from the Growing-Up in Ireland survey (n = 8,393 age three, n = 8,039 age five), propensity score matching is used to address the endogeneity of employment and childcare decisions. Selection on observables is used to assess potential bias arising from selection on unobservables whereby unobserved characteristics of the mother or child may jointly influence child weight and maternal employment and childcare., Results: Full-time maternal employment at nine months combined with either formal or informal childcare increases the likelihood of being overweight at three years by 8.1% and 5.9% respectively, but only for children of highly educated mothers. Similar results are observed for part-time employment coupled with informal (7.5%) or parental (8.0%) care. The results for mothers with lower levels of education are either not significant or favourable. While the majority of the effects dissipate by age five, there is some evidence that full-time maternal employment coupled with informal care increases the risk of being overweight at both ages three and five for children of higher-educated mothers. An assessment of selection bias finds that the estimates of full-time employment combined with formal childcare by well-educated mothers are a lower bound, such that the true effect on child weight may be understated., Conclusions: The findings for Ireland are consistent with studies from the United States and the United Kingdom, and are in contrast to findings from the rest of Europe, suggesting the role of institutional factors, such as the lack of subsidised, universal, high-quality childcare., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Objective: To understand the nurses' moral deliberation in the face of an ethical problem involving breastfeeding., Method: Qualitative study based on the methodological theoretical framework of deliberative bioethics. Data collection was through a vignette-based interview and results were organized by thematic analysis., Results: Nurses tend to take over intermediate courses of action, although extreme courses of action are found as well., Final Considerations: When they tend to take extreme courses of action, nurses approach decisions focused on the child welfare to the detriment of the mother's need as a working woman.

In fathers testosterone levels are suggested to decrease in the context of caregiving, but results seem inconsistent. In a meta-analysis including 50 study outcomes with N = 7,080 male participants we distinguished three domains of research, relating testosterone levels to parental status (Hedges' g = 0.22, 95% CI: 0.09 to 0.35; N = 4,150), parenting quality (Hedges' g = 0.14, 95% CI: 0.03 to 0.24; N = 2,164), and reactivity after exposure to child stimuli (Hedges' g = 0.19, 95% CI: -0.03 to 0.42; N = 766). The sets of study outcomes on reactivity and on parenting quality were both homogeneous. Parental status and (higher) parenting quality were related to lower levels of testosterone, but according to conventional criteria combined effect sizes were small. Moderators did not significantly modify combined effect sizes. Results suggest that publication bias might have inflated the meta-analytic results, and the large effects of pioneering but small and underpowered studies in the domains of males' parental status and parenting quality have not been consistently replicated. Large studies with sufficient statistical power to detect small testosterone effects and, in particular, the moderating effects of the interplay with other endocrine systems and with contextual determinants are required., (Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The number of au-pairs in Germany is on the rise. In 2017, about 13,500 au-pairs were living in German families, almost half of them originating from non-European Union (EU) countries and many of them from Spanish speaking countries. Knowledge about mental health among au-pairs in Germany is limited. Therefore, the main objective of this study was to assess the prevalence of Major Depressive Syndrome (MDS) and its potential association with time of residence among Spanish speaking au-pairs living in Germany via an exploratory analysis. This study included a sample of 409 Spanish speaking au-pairs living in Germany. We classified the au-pairs into those who lived less than three weeks in Germany (newcomer au-pairs) and those who lived more than three weeks (experienced au-pairs). The participants were recruited by an online survey (Facebook and Instagram) from August 2018 to June 2019. Socio-demographic characteristics, time of residence in Germany and the level of education were assessed. MDS was assessed by the Patient Health Questionnaire depression module (PHQ-9). Poisson regression models were calculated to evaluate the association between time of residence in Germany and prevalence of MDS. Most of the participants were female (91%). Almost half of them came from Colombia (48%) and were in the age range between 22-24 years (40%). Prevalence of MDS was 8% among newcomers and 19% among experienced au-pairs ( p = 0.002). Differences remained statistically significant after adjustment for potential confounders (age, level of education and time of residence in Germany) (prevalence ratio 2.25; 95% confidence interval: 1.22-4.14). In conclusion, au-pairs may develop mental symptoms during their time abroad. Future prospective studies should aim at identifying potential risk factors and preventive measures.

Grandparents, especially grandmothers, are highly involved in childcare globally. There is a rising interest in studying the relationship between providing care and grandmothers' economic well-being in social science and health literature. However, little is known about how grandmothers' behavior responds to a government's family policy. This paper examines the effects of a large government-led formal childcare expansion on the well-being of working-age grandparents living with their adult children in China. We exploit the variation in program intensity across provinces and years and find that a higher coverage rate of center-based childcare increases the employment of grandmothers. By contrast, grandfathers' employment is not responsive. Further investigation reveals that the effect is stronger among the women who were richer, more educated, lived in urban areas, and paternal grandmothers. We find that the childcare expansion decreases grandmothers' chance of having chronic disease and depression., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

The development of attachment during the perinatal and/or postnatal periods between a child their mother, father and family as whole can be observed. This attachment provides the child with the safety and security feelings and may provide satisfaction to the mother and other family members. In children with physical and mental developmental disability, attachment may be challenged immediately after birth. It is typically recovered after a certain period. The authors describe the development of attachment of family members to children with somatic, mental or social disability based on an analysis of nine case reports. They conclude that the attachment of parents/mothers to their child with a disability is typically established after a certain period of time only. In the first period, there is a caregiving attitude of the mother even though the period of the origination of this tie takes place later. The mother is most frequently the person establishing attachment. However, this is not always the rule. In our cases, there were two fathers, who made the attachment earlier than respective mothers. Attachment was also evident in some grandparents and siblings. The parents, mostly the fathers, can lose the attachment established. Analysis of the degree of attachment to the child by parents may be complicated due to difficulty in assessing the extent and degree of the attachment of children with severe disabilities to their parents.

Background: Residential child care is a very complex measure and has been the subject of heated debate in many countries. However, there is a paucity of studies that examine quality assessments of these services, much less that have asked the children and young people receiving those services about their own evaluations., Method: This study interviewed 209 young people between 11 and 20 years of age, in 21 residential facilities, about their degree of satisfaction with the care they receive. These residential facilities are differentiated into three types of programs that will be compared: preparation for adult life (PAL), therapeutic care for behavioral problems (TRC) and general programs for children and young people without any specific profile (GRC). The instrument used is an interview that includes both quantitative and qualitative assessments., Results: The results show a trend toward positive average scores on practically all aspects, highlighting the support from as well as the connection they feel with the educators who care for them. On the other hand, young people in TRC displayed lower scores on almost all aspects evaluated while those in PAL were the most positive., Conclusions: The main implications for the practice will be discussed from these youths&rsquo; perspective.

Background: Infant mental health has emerged as a unique area of practice and research distinguished from child and youth sub-specialties by its advocacy for a relational practice framework with an emphasis on parents/caregivers being integral to assessment, treatment, and prevention initiatives. A diverse array of initiatives offered across a broad spectrum of delivery methods is available to clinicians. However, to date, a large-scale mapping of the research evidence regarding these interventions has yet to be completed to help inform clinician's decisions regarding the best approaches for their clients. To address this knowledge gap, this study aimed to report on the landscape of research pertaining to mental health interventions for infants and preschoolers (0-5 years), and their families at risk for socio-emotional difficulties and negative developmental outcomes., Method: A scoping review methodology was used to conduct a large-scale mapping of the intervention research pertaining to infants and preschoolers (0-5) at risk for socio-emotional difficulties. We searched MEDLINE, PsycINFO, EMBASE, Web of Science, The Cochrane Library, CINAHL, LILACS, ProQuest Nursing & Allied Health Source, World Cat, and ClinicalTrials.gov , from inception to December 31, 2012. We extracted information regarding publication date, geographical location, study design, level of risk, population, key intervention mechanism, and outcome measures., Results: We identified 533 potential studies from 1233 title and abstracts after the first round of screening. Full text article review in the second round of screening resulted in a total of 162 included articles for the final analysis. Results indicated that over 50% of interventions evaluated were randomized controlled trials conducted in Westernized countries. Most studies could be subdivided by level of risk within a preventative public health framework including universal, selected, indicated, and direct treatment for children formally diagnosed with a mental disorder. Risk factors experienced by children and their families were heterogeneously defined and numerous outcome measures across included studies. The results of this study are limited to the last search date of 2012., Conclusions: Key intervention mechanisms spanned a range of approaches including parenting groups, dyadic, in-home, cognitive-behavioral therapy, and day care-based interventions. The findings are discussed in terms of implications for broad trends and gaps in research and policy for this population.

Background: The Scottish Child Abuse Inquiry (SCAI) commissioned the research project to document the outcomes of institutional abuse in long-term child care in Scotland., Objective: To profile the experiences of survivors abused in long-term child care in Scotland, and to develop a model which linked maltreatment, risk and protective factors, and outcomes., Participants and Setting: 225 survivors of historical institutional abuse in Scotland, who made witness statements to SCAI., Methods: Data were extracted from witness statements using a coding frame developed through a thematic analysis of a subsample of 52 statements., Results: Survivors had been in care in predominantly Catholic and non-religious residential institutions in Scotland for an average of 8 years, having entered at an average age of 6.8 years. They had suffered multiple forms of maltreatment. Maltreatment rates were: physical abuse, 95.6%; emotional abuse, 85.3%; sexual abuse, 60.4%; emotional neglect, 51.1%; and physical neglect, 37.3%. Across the lifespan survivors had negative outcomes in psychosocial adjustment (96%), mental health (84%), and physical health (43%). The effect of maltreatment in care on psychosocial problems was mediated by both risk and protective factors; and on mental health was mediated by risk factors, but not protective factors. Maltreatment in care had a direct effect on physical health which was not mediated by risk or protective factors. The effects of the cumulative number of risk factors on adverse mental health and psychosocial outcomes was greater than that of maltreatment, and protective factors had a limited impact on adverse outcomes., Conclusions: Evidence-based child protection policies and practices should be implemented to prevent institutional abuse and treat child abuse survivors in Scotland., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

In the current study, we examined associations among early childcare workers' emotional competence, observed responsiveness, comfort with socioemotional teaching practices, and the quality of their relationships with children in their care. The participants were 100 early childcare workers (72 center-based Early Head Start teachers and 28 family childcare providers). Results showed that caregivers' emotion regulation ability was positively associated with caregiver-child relational closeness. Understanding and regulation of emotion were both positively associated with childcare workers' comfort with socioemotional teaching practices. Their observed responsiveness was positively related to relational closeness and negatively related to relational conflict. Findings are consistent with aspects of the prosocial classroom model, which asserts that educators high in emotional and social competence tend to adopt childcare practices that result in supportive relationships with children. Results provide insight into whether childcare workers' responsiveness to young children and their perceived socioemotional teaching practices provide a pathway between emotional competence and the quality of caregiver-child relationships., (© 2019 Michigan Association for Infant Mental Health.)

Background: Parents often struggle against the negativism of 3-year-old children in exerting parental control. Although most research on parental control is from western cultures, Japanese mothers may face unique challenges because of their sociocultural background. We therefore explored mothers' challenges in exerting parental control over 3-year-old children in Japan., Methods: A descriptive qualitative approach was adopted. The participants were 10 Japanese mothers with children aged 3-4 years. We conducted individual semistructured interviews and analysed the data via qualitative content analysis., Results: We found four categories and a structure of the challenges mothers faced in exerting parental control. Mothers' control attempts had four main intentions, each with a different subject (i.e., the children, themselves, the family, and society). Most challenges with parental control stemmed from mothers' "consciousness of parental responsibility." In confronting the child in their attempts to exert parental control, mothers perceived a "struggle with the child's negativism," which led them to recognize that they could not find a correct method of discipline. Furthermore, in the face of conflicting roles, mothers experienced "confusion in seeking the righteous answer as a parent." Some mothers began to feel that they were discovering their maternal role in their own way rather than finding a correct answer, which formed a "conviction that my own parenting is not incorrect.", Conclusions: The challenges mothers faced in exerting parental control over their 3-year-old children served as a turning point for them to reflect on themselves as parents. However, due to societal monitoring of parents and mothers' multiple roles in the family, it can be difficult for mothers to fully overcome the challenges of parental control. It is necessary to foster social capital in the community to which the mother belongs and to create an atmosphere in which community members can watch over parents warmly., (© 2019 John Wiley & Sons Ltd.)

Background: For mothers who experience transplants, pregnancy and childcare can have significant consequences on their quality of life. This study aims to investigate the childcare-related suffering faced by women who gave birth following kidney transplantation., Methods: Data were collected from 65 Japanese kidney transplant recipients from 21 hospitals who had given birth after transplant. The questionnaire included questions concerning the childcare-related suffering of the female kidney transplant recipients. The data were analyzed using KH Coder for the qualitative text mining analysis., Results: The results of the co-occurrence network of words and hierarchical cluster analysis revealed 6 categories that were identified regarding the difficulties in childcare experienced by mothers who gave birth after kidney transplantation: comparing themselves with healthy mothers, parenting priorities, getting tired, not being able to take medicine on time, carefully giving the child a hug, being unable to give breast milk, having regular doctor checkups, and having to leave the child., Conclusion: Recipients experience suffering related to the lifestyle changes that occur as a matter of course during childcare. Recipients are exhausted because of how busy they are with childcare, and they sometimes forget to take their medicine. It is necessary to confirm the living situations of recipients after birth and provide support for their self-management based on their new lifestyles., (Copyright © 2019 Elsevier Inc. All rights reserved.)