Early Child Development in Social Context: A Chartbook

Reviews more than 30 key indicators of health and development for children up to age 6, as well as social factors in families and communities that affect these outcomes. Offers practical suggestions for health practitioners and parents

Perceived social support and parental education as determinants of adolescents’ physical activity and eating behaviour: a cross-sectional survey

Abstract Purpose: To examine the role of perceived social support and parental education on physical activity and eating behaviour of Ghanaian adolescents. Methods: Seven hundred and seventy Senior High School students (504 boys and 266 girls) between the ages of 14–21 years participated by completing questionnaires on perceived social support, physical activity and eating behaviour. The highest education attained by either parent or guardian was also obtained. Multivariate analysis of covariance was the main statistical test used to analyse the data. Results: The results showed significant gender differences in physical activity and eating behaviour combined, with boys more likely to engage in physical activity than girls, and girls also more likely to engage in healthy eating behaviour than boys, albeit the effect was not statistically significant. While perceived social support had a significant positive effect on eating behaviour and physical activity, parental education had a significant effect only on eating behaviour but not physical activity. Conclusion: Perceived social support from family coupled with parental education provides more opportunities for adolescents to engage in healthy eating behaviour. Also, parents’ educational attainment alone does not necessarily guarantee that adolescents will engage in physical activity; providing the needed social support and conducive home environment is more likely to induce physical activity behaviours. Finally, physical activity and eating behaviour should not be construed as alternative health behaviours as suggested by gender differentials in these health behaviours.</jats:p

Family Loneliness: Its Effects in the Development of Empathy, Teamwork and Lifelong Learning Abilities in Medical Students

Context: Family offers an important source of social support where individuals acquire social abilities that are necessary to create positive human relationships. This influence has been discussed by different sociological and psychological theories along the life span of individuals. In medicine, empathy, teamwork, and lifelong learning have been described as specific elements of professionalism that have special importance in the interaction with patients and in physicians’ well-being at the workplace. This study was performed with the aim of demonstrating the following hypothesis: In the absence of specific training in empathy and teamwork and lifelong learning abilities, their development in medical students is associated with the students’ perception of loneliness from their family environment. Methods: A cross-sectional study was performed in the only two medical schools of Cusco (Peru), one private and the other public. Jefferson Scales of Empathy, Teamwork, and Lifelong Learning were used as the main measures. Mother–son and father–son relationships and family loneliness were measured to characterize the family environment. In addition, information related to sex, medical school, academic achievements, and place of origin were collected to control possible biases. Comparative, correlation, and multiple regression analyses were performed among the variables studied. Results: In a sample of 818 medical students, differences by school appeared in empathy, teamwork, lifelong learning, and family loneliness. In addition, family loneliness showed an inverse correlation with empathy, teamwork, and learning measures. While having a positive relationship with the mother was associated with a greater development of empathy and learning abilities in the entire sample, a similar effect was observed in father–son relationships, but only in the private medical school group. Finally, in the public medical group, a multiple regression model explained 43% of the variability of empathy based on a lineal relationship with teamwork (p < 0.001), lifelong learning (p < 0.001), and family loneliness (p < 0.001). Conclusion: These findings confirm how family loneliness is detrimental to the development of medical professionalism. Also, they support the important role that the family, and especially parents, plays in the development of empathy, teamwork, and abilities in medical students. Finally, these findings highlighted important differences among students enrolled in public and private medical schools.National Council of Science, Technology and Technological Innovation (CONCYTEC)National University San Antonio Abad del Cusco (UNSAAC) E041-2017-UNSAAC-0

Strategies to reduce medication errors with reference to older adults

Background  In Australia, around 59% of the general population uses prescription medication with this number increasing to about 86% in those aged 65 and over and 83% of the population over 85 using two or more medications simultaneously. A recent report suggests that between 2% and 3% of all hospital admissions in Australia may be medication related with older Australians at higher risk because of higher levels of medicine intake and increased likelihood of being admitted to hospital. The most common medication errors encountered in hospitals in Australia are prescription/medication ordering errors, dispensing, administration and medication recording errors. Contributing factors to these errors have largely not been reported in the hospital environment. In the community, inappropriate drugs, prescribing errors, administration errors, and inappropriate dose errors are most common. Objectives  To present the best available evidence for strategies to prevent or reduce the incidence of medication errors associated with the prescribing, dispensing and administration of medicines in the older persons in the acute, subacute and residential care settings, with specific attention to persons aged 65 years and over. Search strategy  Bibliographic databases PubMed, Embase, Current contents, The Cochrane Library and others were searched from 1986 to present along with existing health technology websites. The reference lists of included studies and reviews were searched for any additional literature. Selection criteria  Systematic reviews, randomised controlled trials and other research methods such as non-randomised controlled trials, longitudinal studies, cohort or case-control studies, or descriptive studies that evaluate strategies to identify and manage medication incidents. Those people who are involved in the prescribing, dispensing or administering of medication to the older persons (aged 65 years and older) in the acute, subacute or residential care settings were included. Where these studies were limited, evidence available on the general patient population was used. Data collection and analysis  Study design and quality were tabulated and relative risks, odds ratios, mean differences and associated 95% confidence intervals were calculated from individual comparative studies containing count data where possible. All other data were presented in a narrative summary. Results  Strategies that have some evidence for reducing medication incidents are: •  computerised physician ordering entry systems combined with clinical decision support systems; •  individual medication supply systems when compared with other dispensing systems such as ward stock approaches; •  use of clinical pharmacists in the inpatient setting; •  checking of medication orders by two nurses before dispensing medication; •  a Medication Administration Review and Safety committee; and •  providing bedside glucose monitors and educating nurses on importance of timely insulin administration. In general, the evidence for the effectiveness of intervention strategies to reduce the incidence of medication errors is weak and high-quality controlled trials are needed in all areas of medication prescription and delivery

`Managing' Poverty: Care and Control in Peruvian Street Children's Everyday Lives

Thesis (Ph.D.)--University of Washington, 2012This dissertation examines the contradictory and complementary ways in which both neoliberal development and children's rights legislation shape national development and child poverty in Lima and Cusco, Perú. It uses childhood as a lens through which to more critically analyze struggle over meanings of development, poverty and appropriate uses of public space, looking at the ways in which children's rights and neoliberalism shape the regulation of poor children through a number of spaces, including social services, urban space, and street children's everyday lives. The project is based on 14 months of in-depth ethnographic research, participant observation and interviews with street children, as well as conversations with policy makers, educators, government officials and social workers. My research design was specifically concerned with both recognizing children as active producers of knowledge and with connecting their everyday experiences with broader systemic changes and processes of development and governance. Rather than focusing on either a macro-scale or a more localized analysis, it links the subjectivity of the poor both with political-economic shifts and discourses and with identity projects. By focusing on street children's everyday lives, this dissertation combines work on the governance of poverty, most of which has remained focused on the global north, with insights from critical development scholars regarding a need for a historical and sociopolitical account of poverty to actively politicize the ways in which Peruvian street children negotiate control, care and survival. Despite beliefs that children are outside of politics, childhoods play important roles in shaping national development and reproducing particular value systems. This dissertation considers how linking dominant development ideologies with the language of children's rights serves to mitigate critiques that development negatively affects the poor, reinforcing dominant development ideologies by allowing them to be packaged in a more socially acceptable way. It analyzes in what ways children's rights discourse provides moral justification for international intervention and the increased regulation of childhood based on Western models. In doing so, it contributes to critical poverty and development studies by linking narratives of development, childhood and rights with the maintenance of poverty. However, rights themselves are subject to competing interpretations and have also provided an important organizing tool for local social movements, such as Peru's child workers' movement. Additionally, children themselves are not simply passive in the face of increased state intervention. They `manage' their poverty in varied and often creative ways, engaging in spatial strategies to evade police and social workers' efforts to regulate their behavior, creating work opportunities for themselves in the street, and in some cases, even playing up their own poverty and vulnerability in order to more successfully street vend. There is a danger, however, in celebrating all acts of survival as resistance. Instead, many forms of children's agency represent contradictory resistance; while in some ways they create more opportunities for themselves or avoid increased state regulation their actions often lead to further marginalization or work to exclude them in other ways. This necessitates both a more nuanced analysis of resistance as well as a need to more closely examine the indicators being used to measure international development and urban `revitalization'. My project concludes with an in-depth discussion of how feminist care ethics can inform more inclusive rights-based approaches to development