Resourcefulness Intervention Efficacy for Parent Caregivers of Technology-Dependent Children: A Randomized Trial

Parent caregivers of children who require lifesaving technology (e.g., mechanical ventilation, feeding tubes) must maintain a high level of vigilance 24/7. A two-arm randomized controlled trial tested the efficacy of a resourcefulness intervention on parents’ mental/physical health and family functioning at four time points over six months. Participants ( n = 93) cared for their technology-dependent children <18 years at home. The intervention arm received teaching on social (help-seeking), personal (self-help) resourcefulness skills; access to the intervention video and skill application video-vignettes; four weeks of skills reinforcement using daily logs; four weekly phone contacts; and booster sessions at two- and four-month postenrollment. The attention control arm received phone contact at identical time points plus the current standard of care. Statistically significant improvement was noted; fewer depressive cognitions and improved physical health for the intervention participants than attention control participants over time after controlling for covariates. The findings support the resourcefulness intervention efficacy.

Prioritizing Parents

Should parents or other primary caregivers of dependent children receive some priority when health care resources are scarce? This paper argues they should. The COVID-19 pandemic has given new urgency to discussions about resource allocation and yet there has been little to no discussion of the important role parents play in protecting and promoting the health of their dependent children. Historically, priority for parents was justified on questionable grounds of social value and this may have led bioethicists and policy makers to overlook more plausible justifications for prioritizing parents. After discussing and criticizing several such justifications for their violation of principles of pluralism and neutrality, a new justification is offered and defended from objections. The reason we should grant some priority to primary caregivers of dependent children is that research shows that doing so would protect and promote the health and lives of children.

Sedentarisation and maternal childcare networks: role of risk, gender and demography

Worldwide mothers receive help with childcare from a diverse range of individuals (allomothers). Nonetheless, little exploration has occurred into why we see such diversity, such as different strategies used to buffer risk. Wide maternal childcare networks may be a consequence of situations of little material wealth and food storage - as is common in mobile hunter-gatherers - where households rely on the pooling of risk in informal insurance networks. In contrast, when households settle and accumulate wealth and food, they are able to retain the risk by absorbing losses within the household. Thus, the size and composition of mothers’ childcare networks may depend on whether households pool or retain risk, as captured by mobile and settled households in the Agta, a diverse Philippine foraging population. From in-depth observational data on 78 children, we find that childcare from grandmothers and sisters was higher in settled camps, while childcare from male kin was lower. Our findings offer little support for risk buffering, and additional analyses demonstrated that girls’ workloads were increased in settled camps, unlike boys, while grandmothers had fewer dependent children, increasing their availability as allomothers. These results point to gender-specific changes associated with shifting demographics as camps become larger and more settled.

Effects of Maternal Nightshift Work on Evening Energy Intake, Diet Quality and Meal Timing in the Family: An Observational Study

The percentage of women working regular nightshift work has increased in the past decade. While nightshift work has the potential to exert adverse effects on dietary habits, little is known about the impact of a parent working nightshifts on dietary habits in the family. We analysed energy intake, meal timing, and diet quality among dependent children and male partners of 20 female UK National Health Service (NHS) nurses working rotational nightshifts. Comparing nightshift against non-nightshift conditions, we hypothesised that maternal nightshift work would affect the evening energy intake, diet quality and time of eating of dependent children and adult partners. Primary outcomes were absolute energy intake and the proportion of daily energy intake consumed in the evening (16:00–23:59 h). Our results show that in pre-teen children aged 8–12 years (n = 13, mean ± SD, 9.9 ± 1.6 yrs; 9 males), the proportion of total daily energy intake consumed during periods of nightshift work was significantly greater compared to periods of non-nightshifts (45.7% ± 8.8% vs. 39.7% ± 7.0%, mean ± SD, p = 0.012). There was no effect of nightshift work on dietary habits in teenage children or partners. The finding of a greater proportion of daily energy consumed in the evening period in pre-teen children is noteworthy, as it suggests that pre-teen children more dependent than older teenage children may be more vulnerable to disruptions to dietary patterns associated with maternal nightshift work.

The Heavy Burden of “Dependent Children”: An Italian Story

This paper analyses multidimensional fuzzy monetary and non-monetary deprivation in households with children by using two different definitions: households with children under 14 years old, and the EU definition of households with dependent children. Eight dimensions of non-monetary deprivation were found using 34 items from the EU-SILC 2016 survey. Dealing with subpopulations, it is essential to compute standard errors for the presented estimators. Thus, a relevant added value of the paper is fuzzy poverty measures and associated standard errors, which were also computed. Moreover, a comparison was made between the measures obtained concerning the two subpopulations across countries. With a focus on Italy, an Italian macro-region is presented.

Breaking the silence about illness and death: Potential effects of a pilot study of the family talk intervention when a parent with dependent children receives specialized palliative home care

Objective The entire family is affected when a parent is severely ill. Parents often need and appreciate professional support when talking to children about illness and death. The family talk intervention (FTI) is family-centered and intends to promote communication about the illness and its consequences, support parenting to enhance family coping and help family members share experiences with each other to create a shared family history. This study aimed to explore potential effects of FTI in specialized palliative home care, as reported by parents. Method This pre-post test intervention pilot was conducted in specialized palliative home care. A convergent mixed-method design was used to analyze interview and questionnaire data. Twenty families with dependent children were recruited from two specialized palliative home care units in Stockholm, Sweden. Results Parents reported that family communication improved after participation in FTI as family members learned communication strategies that facilitated open sharing of thoughts and feelings. Increased open communication helped family members gain a better understanding of each other's perspectives. Parents reported that relationships with their partner and children had improved as they now shared several strategies for maintaining family relationships. Parents were also less worried following participation in FTI. The ill parents stated that they gained a sense of security and were less worried about the future. Significance of results This study adds to the evidence that FTI may be a useful intervention for families with dependent children and an ill parent in a palliative care setting. This trial is registered at ClinicalTrials.gov Identifier NCT03119545.