Surveying family access: kangaroo mother care and breastfeeding policies across NICUs in Italy

Background Studies on the application of developmental care initiatives in Italian NICUs are rather scarce. We aimed to assess parental access to the NICUs and facilities offered to the family members and to test “the state of art” regarding kangaroo mother care (KMC) and breastfeeding policies in level III Italian NICUs. Methods A questionnaire both in paper and in electronic format was sent to all 106 Italian level III NICUs; 86 NICUs (i.e., 80% of NICUs) were completed and returned. The collected data were analysed. In addition, a comparison between the 2017 survey results and those of two previous surveys conducted from 2001 to 2006 was performed. Results In total, 53 NICUs (62%) reported 24-h open access for both parents (vs. 35% in 2001 and 32% in 2006). Parents were requested to temporarily leave the unit during shift changes, emergencies and medical rounds in 55 NICUs (64%). Some parental amenities, such as an armchair next to the crib (81 units (94%)), a room for pumping milk and a waiting room, were common, but others, such as family rooms (19 units (22%)) and adjoining accommodation (30 units (35%)), were not. KMC was practised in 81 (94%) units, but in 72 (62%), i.e., the majority of units, KMC was limited to specific times. In 11 (13%) NICUs, KMC was not offered to the father. The average duration of a KMC session, based on unit staff estimation, was longer in 24-h access NICUs than in limited-access NICUs. KMC documentation in medical records was reported in only 59% of questionnaires. Breastfeeding was successful in a small proportion of preterm infants staying in the NICU. Conclusion The number of 24-h access NICUs doubled over a period of 13 years. Some basic family facilities, such as a dedicated kitchen, rooms with dedicated beds and showers for the parents, remain uncommon. KMC and breastfeeding have become routine practices; however, the frequency and duration of KMC sessions reported by NICU professionals still do not meet the WHO recommendations.

Family involvement practices for persons with psychotic disorders in community mental health centres – a cross-sectional fidelity-based study

Background Family involvement for persons with psychotic disorders is supported by scientific evidence, as well as legal and ethical considerations, and recommended in clinical practice guidelines. This article reports a cross-sectional measurement of the level of implementation of such guidelines in fifteen community mental health centre units in Norway, and presents a novel fidelity scale to measure basic family involvement and support. The aim was to investigate current family involvement practices comprehensively, as a basis for targeted quality improvement. Methods We employed three fidelity scales, with 12–14 items, to measure family involvement practices. Items were scored from 1 to 5, where 1 equals no implementation and 5 equals full implementation. Data was analysed using descriptive statistics, a non-parametric test, and calculation of interrater reliability for the scales. Results The mean score was 2.33 on the fidelity scale measuring basic family involvement and support. Among patients with psychotic disorders, only 4% had received family psychoeducation. On the family psychoeducation fidelity assessment scale, measuring practice and content, the mean score was 2.78. Among the eight units who offered family psychoeducation, it was 4.34. On the general organizational index scale, measuring the organisation and implementation of family psychoeducation, the mean score was 1.78. Among the units who offered family psychoeducation, it was 2.46. As a measure of interrater reliability, the intra-class correlation coefficient was 0.99 for the basic family involvement and support scale, 0.93 for the family psychoeducation fidelity assessment scale and 0.96 for the general organizational index scale. Conclusions The implementation level of the national guidelines on family involvement for persons with psychotic disorders was generally poor. The quality of family psychoeducation was high, but few patients had received this evidence-based treatment. Our novel fidelity scale shows promising psychometric properties and may prove a useful tool to improve the quality of health services. There is a need to increase the implementation of family involvement practices in Norway, to reach a larger percentage of patients and relatives. Trial registration ClinicalTrials.gov Identifier NCT03869177. Registered 11.03.19.

Microfinance Institutions (MFIs) Intervention in Poverty Alleviation of Households in Lopez, Quezon Province, Philippines

This paper investigates Microfinance Institutions (MFIs) Intervention in poverty alleviation of households in the locality of Lopez, Quezon province, Philippines. It focuses on five specific objectives to: Determine the personal profile of MFIs household members, their membership profile, examine the goal congruence between MFIs and households, investigate the circumstances during MFIs intervention and, finally find out threats in availing loans from MFIs. This paper adopts quantitative type of research primarily the descriptive questions survey where 117 were considered as the representative sample of MFIs in the municipality. Likewise, purposive sampling was used in the determination of samples and survey form for data collection. This study utilized the SPSS to generate the frequency distribution and weighted mean. It was revealed in the analysis that microfinance interventions that offer both savings and loans contributed to a higher standard of living of households. More so, the results show that microfinance institutions provide supplemental income for families which may adhere to basic family needs, health, education, and lessen debts to specific persons. Therefore, It was found out that both microfinance savings and microfinance credit appreciably and undoubtedly changed the conditions of every household after availing the MFIs services. The study recommends that MFIs should continuously pay closer attention on their interventions that will provide assistance that are favorable to the welfare of every member and the society as well.

The Child Rearing Roles and Responsibilities of Women in Terms of Gender

The familial scene is one in which human emotions are displayed, and the child's role in this scene is to observe and experience human relations in all their complex aspects. This includes both positive behaviors, such as agreement, compromise, and loyalty and cooperation, as well as negative behaviors, such as disagreement, dispute, and conflict. In a healthy family, family members develop positive behaviors based on mutual respect and cooperation in accordance with responsibilities and roles of parents and children. Children learn about their roles and status in the society through the roles and responsibilities developed in line with basic family functions. Since individuals are born without any specific abilities, they need their families to acquire certain means and resources they need both personally and socially. Therefore, one of the most basic concepts for explaining the family's connection with society is that of gender and related processes.

Representation of the “family” cultural image by characters in Russian tales (based on images of a wolf, fox and hare)

The research considers Russian folk tales, the characters of which are a wolf, fox and hare. It is substantiated that in Russian tales, a WOLF, FOX and HARE have representative qualities – they serve as a representative of a person, that is, they are quite definite metaphorical representatives of a person’s behavior strategy, actions and behavior in the family. Images of these animals, widely presented in the folklore and ethnographic context, reflect a typical pattern of behavior in the family, thinking and appreciation of any person with a Russian mentality. It is emphasized that the roots of Russian folklore are deeply and inextricably linked with its basic family values, which in folklore reflect the images of the animal world, presented in a bright and accessible artistic form. Images of a wolf, fox and hare are transmitted over many generations, through folklore texts, introducing both children and adults to the family's basic values and consolidating a strong harmonious national and cultural foundation. It is proved that in Russian folk tales, the relationship between a wolf and a fox is built taking into account the gender factor, which allows to reveal the pattern of behavior in the relationship between a man and a woman.