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"Nurturing behavior in children."
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Navigating health care for children with disabilities: Perspectives of male caregivers in rural Kenya
Introduction: UN Sustainable Development Goal 3 and the nurturing care framework highlight the importance of healthcare services and preventive measures to ensure optimal health outcomes for children, including those with disabilities. However, the contributions of male caregivers in the general care of children with disabilities in Sub-Saharan African contexts are often overlooked. This article therefore aims to understand how male caregivers navigate and negotiate healthcare options for their children with disabilities in rural Kenya.
Methods: A qualitative approach was adopted, following the phenomenological tradition, to collect data from 22 male caregivers of children with neurodevelopmental disabilities in rural Kenya using four focus group discussions. The data were analyzed using inductive thematic analysis. The interpretation of the findings was guided by the theoretical approach of critical disability studies.
Results: The article contributes new knowledge to the understanding of the roles and experiences of male caregivers in the healthcare of children with disabilities in rural Sub-Saharan African contexts. Four emergent themes are presented: '... hospitals around cannot offer a solution to their problems...', '... regarding finances, I have to struggle alone...', '... the only place one can pity you is the traditional herbalist...' and 'I pray to God to heal him'.
Conclusion: Faced with significant challenges in accessing conventional healthcare services, male caregivers employ the local cultural resources available to them to address the healthcare needs of their children with disabilities. This emphasizes the need to complement their efforts by mobilizing the healthcare system to offer quality, equitable, culturally sensitive and inclusive healthcare solutions.
Journal Article
Innovations and adaptations of a national music therapy program during covid lockdowns
Children thrive when their parents have access to the resources they need to provide a nurturing environment, including the knowledge, skills and capacity to develop secure and responsive relationships. Sing and Grow is an Australian, evidence-based music therapy program supporting parents to build these skills, and increase their children's resilience in the face of adversity. COVID restrictions and lockdowns increased community need for this program, as social isolation and other stressors had a significant impact on parental capacity to create nurturing environments. However, challenges arose for both Sing and Grow and families in the necessary pivot from face-to-face services.
The national music therapy team responded by adapting not only the way services were delivered, but the way in which they worked together to create content. Three working groups were formed, and an interconnected workflow was developed. Enablers and barriers to families accessing the adapted services, as well as outcomes, were gathered via verbal and written feedback from clients, staff and collaborating organisations. This also provided the opportunity to learn about the emerging needs in the community. By integrating the adaptations into Sing and Grow's regular suite of services, and aligning them within a Targeted Universalism framework, a wider cross-section of the Australian community can benefit from the inclusion of music therapy and music therapy-informed services to improve child outcomes.
Journal Article
Extra-Familial Care: Perspectives from India
This paper aims to give an overview of out-of-home care in India. It looks at the history and culture of extra-familial care in the country, the urgent need for organised out-of-home care, and tries to understand the role of the state, including legislation and policies. The belief that individual families should solve their children’s problems is deeply ingrained. There are different support systems that cater to the children’s needs and right to healthy living in home and with family. While the government and community choose and decide for the children of the country, the government drags its feet in drafting policies which recognise that large number of children are growing up without families. More research is needed to look at the need and quality parameters for out-of-home care. Action from both government and non-government organisations (NGOs) will require a large number of institutions that, in turn, will require sufficient budgets and trained staff to ensure an environment of protection, support and appropriate development for an estimated 20 million children in need of good quality out-of-home care in India.
Journal Article
Maternal Perception and Childhood Overweight: Examining Parenting Styles and Eating Behaviors Among Preschoolers: A Cross-Sectional Study from Samsun, Türkiye
Background: Accurate maternal perceptions of children’s weight status are crucial for early childhood obesity prevention, with evidence suggesting that maternal misperception may delay timely interventions. This study investigated the accuracy of maternal perceptions of child weight and examined associations with parenting styles and children’s eating behaviors and demographic factors among preschool-aged children in Samsun, Türkiye. Methods: This cross-sectional study included 318 mother–child pairs recruited from preschools in socio-economically diverse areas of Samsun. Maternal perceptions of child weight status were assessed using a visual scale, while children’s anthropometric measurements (height, weight) were recorded to calculate BMI-for-age Z-scores. Parenting styles and children’s eating behaviors were evaluated using the Parental Attitude Scale (PAS) and the Children’s Eating Behavior Questionnaire (CEBQ), respectively. Data analysis involved chi-square tests and multiple logistic regression to explore associations between maternal perception accuracy, parenting styles, and children’s eating behaviors. Results: Among 318 mother–child pairs, 59.7% underestimated their child’s weight status, with this figure being 84.9% among overweight children. Authoritative parenting was the most common style (78%); no significant association was found between parenting style and maternal perception accuracy. Accurate estimators showed significantly higher scores for food responsiveness (median: 9 (7–12), p = 0.028) and the enjoyment of food (mean: 16.3 ± 4.8, p = 0.003), whereas underestimators scored higher for satiety responsiveness (mean: 23.2 ± 5.7, p = 0.042) and slowness in eating (mean: 11.2 ± 4.2, p = 0.004). Conclusions: Maternal underestimations of child weight are prevalent, particularly for overweight children, are associated with children’s specific eating behaviors. Targeted educational interventions focusing on improving maternal awareness and promoting responsive feeding practices are essential to combat childhood obesity.
Journal Article
The PAX Good Behavior Game: One Model for Evolving a More Nurturing Society
This paper describes the culture and components of the PAX Good Behavior Game and offers it as one model for how to enhance the well-being of populations through the diffusion of nurturing practices into several venues of society. The PAX components, also known as evidence-based kernels, are proposed to be useful in classrooms, families, organizations, criminal justice, and in improving public discussion and government. Kernels affect behavior in the short- and long-term through combinations of antecedents, reinforcers, relational networks, and physiological effects. Identifying common strategies, tools, and clear targets of change is suggested as a way to work towards evolving freely available evidence-based tools that can be combined to improve social conditions in multiple contexts.
Journal Article
Parental Sensitivity and Nurturance
Parental sensitivity and nurturance are important mechanisms for establishing biological, emotional, and social functioning in childhood. Sensitive, nurturing care is most critical during the first three years of life, when attachment relationships form and parental care shapes foundational neural and physiological systems, with lifelong consequences. Sensitive, nurturing care also buffers children from the negative effects of growing up in difficult circumstances such as poverty.
In this article, Carrie DePasquale and Megan Gunnar examine several interventions that directly or indirectly target parental sensitivity and nurturance, and demonstrate the causal role that this type of care plays in children's development, especially during the first three years of life. They note that even though sensitive, nurturing care is still helpful after infancy and early childhood, it doesn't completely mitigate the effects of not receiving this type of care early in life. And because sensitive care involves knowing when to respond and when to let the child manage more independently, excessive responsiveness, overinvolvement, and intrusiveness are also forms of insensitive care.
Sensitive and nurturing parent behaviors vary across cultures, and numerous other factors influence parental sensitivity as well. For example, children's temperament and emotional reactivity may affect parents' behavior and/or alter the effects of parenting behavior on children's development. Physiological, cognitive, and emotional self-regulatory capabilities, as well as socioeconomic and environmental factors, can also affect a parent's ability to provide sensitive, nurturing care. Based on the expansive research related to parental sensitivity and nurturance, the authors recommend that policy makers should aim to increase family and community access to programs that enhance sensitive, nurturing care and support parents so they can provide high-quality care to their children.
Journal Article
Nurturing care practices for children with developmental disabilities in sub-Saharan Africa: A scoping review protocol
The majority of children with neurodevelopmental disorders (NDDs) reside in low- and middle-income countries (LMICs). NDDs are a public health concern in countries in sub-Saharan Africa (SSA). Nurturing care has been recommended as a pathway for addressing the developmental needs and unlocking the full potential of children, including those with NDDs. However, little information exists on the strategies to support children with NDDs using the Nurturing Care Framework in many countries in SSA. This review aims to synthesize information on nurturing care practices for children with NDDs in SSA. The review will also determine gaps in the provision of nurturing care for children with NDDs. Further, the review will highlight the drivers of care as well as the experiences of the caregivers.
The review will be implemented in six steps: specification of the research question, identification of relevant studies, selection of studies to be included, extracting, mapping, and charting the data, collating, summarizing, and reporting the results, and stakeholder consultation. We propose a database search followed by a manual search for the literature synthesis. We will search the following electronic databases: PubMed, ScienceDirect, Scopus, Open Grey and African Journals Online (AJOL). All studies published after May 2018 to May 2023 that include relevant terms will be identified and included. The research team will develop a data extraction form for use in capturing relevant information from each of the included studies. A patterning chart that will summarize and analyze the key findings of each article will be created.
We anticipate that the study will provide evidence on the existing nurturing care practices and unearth gaps in the provision of nurturing care for children with NDDs. Key determinants of care and the experiences of the parents/caregivers of children will also be identified. The study will provide key recommendations on interventions to improve the quality of care for children with NDDs. Through this study, awareness of the unmet nurturing care needs of these children will be increased. The evidence generated may assist policymakers and stakeholders in addressing the needs of children with NDDs.
Journal Article
Socio-demographic, maternal, and infant characteristics associated with pacifier use among six-months old infants in Clark County, Nevada
Pacifier use can interfere with nurturing care practices such as breastfeeding, soothing, and sleeping. Due to contradicting beliefs, recommendations, and the high frequency of pacifier use, understanding its associations may support shaping equitable public health recommendations. This study explored the socio-demographic, maternal, and infant characteristics associated with pacifier use among six-months old infants in Clark County, Nevada.
Cross-sectional survey was conducted in 2021 with a sample of mothers (n = 276) of infants under six months old in Clark County, Nevada. Participants were recruited through advertisements in birth, lactation, pediatric care centers, and social media. We used binomial and multinomial logistic models to assess the association between pacifier use and the age of pacifier introduction, respectively, with household, maternal, infant, healthcare characteristics, and feeding and sleeping practices.
More than half of the participants offered pacifiers (60.5%). Pacifier use was higher among low-income households (OR (95% CI) 2.06 (0.99-4.27)), mothers who identified as non-Hispanic (OR (95% CI) 2.09 (1.22-3.59)), non-first-time mothers (OR (95% CI) 2.09 (1.11-3.05)), and bottle-feeding infants (OR (95% CI) 2.76 (1.35-5.65)). Compared to those who did not introduce a pacifier, non-Hispanic mothers (RRR (95% CI) 2.34 (1.30-4.21)) and bottle-fed infants (RRR (95% CI) 2.71 (1.29-5.69)) had a higher risk of introducing pacifier within two weeks. Likewise, infants living in food insecure households (RRR (95% CI) 2.53 (0.97-6.58)) and mothers who have more than one child (RRR (95% CI) 2.44 (1.11-5.34)) had a higher risk of introducing a pacifier after two weeks.
Pacifier use is independently associated with maternal income, ethnicity, parity, and bottle feeding among six-month-old infants living in Clark County, Nevada. Household food insecurity increased the relative risk of introducing a pacifier after two weeks. Qualitative research on pacifier use among families with diverse ethnic/racial backgrounds is needed to improve equitable interventions.
Journal Article
Integrative Multi-omics Analysis of Childhood Aggressive Behavior
This study introduces and illustrates the potential of an integrated multi-omics approach in investigating the underlying biology of complex traits such as childhood aggressive behavior. In 645 twins (cases = 42%), we trained single- and integrative multi-omics models to identify biomarkers for subclinical aggression and investigated the connections among these biomarkers. Our data comprised transmitted and two non-transmitted polygenic scores (PGSs) for 15 traits, 78,772 CpGs, and 90 metabolites. The single-omics models selected 31 PGSs, 1614 CpGs, and 90 metabolites, and the multi-omics model comprised 44 PGSs, 746 CpGs, and 90 metabolites. The predictive accuracy for these models in the test (N = 277, cases = 42%) and independent clinical data (N = 142, cases = 45%) ranged from 43 to 57%. We observed strong connections between DNA methylation, amino acids, and parental non-transmitted PGSs for ADHD, Autism Spectrum Disorder, intelligence, smoking initiation, and self-reported health. Aggression-related omics traits link to known and novel risk factors, including inflammation, carcinogens, and smoking.
Journal Article