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1

Ginsburg, Amy Sarah, Susanne May, Evangelyn Nkwopara, Gwen Ambler, Eric D. McCollum, Tisungane Mvalo, Ajib Phiri, and Norman Lufesi. "Clinical Outcomes of Pneumonia and Other Comorbidities in Children Aged 2-59 Months in Lilongwe, Malawi: Protocol for the Prospective Observational Study “Innovative Treatments in Pneumonia”." JMIR Research Protocols 8, no. 7 (July 29, 2019): e13377. http://dx.doi.org/10.2196/13377.

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Background Pneumonia is the leading infectious cause of death worldwide among children below 5 years of age. Clinical trials are conducted to determine optimal treatment; however, these trials often exclude children with comorbidities and severe illness. Conclusions Given the paucity of data from Africa, African-based research is necessary to establish optimal management of childhood pneumonia in malaria-endemic settings in the region. An expanded evidence base that includes children with pneumonia and other comorbidities, who are at high risk for mortality or have other complications and are therefore typically excluded from childhood pneumonia clinical trials, can contribute to future iterations of the World Health Organization Integrated Management of Childhood Illness guidelines. Methods The study enrolled 1000 children with pneumonia presenting to the outpatient departments of Kamuzu Central or Bwaila District Hospitals in Lilongwe, Malawi, who were excluded from concurrent randomized controlled clinical trials investigating fast breathing and chest indrawing pneumonia and who met the inclusion criteria for this prospective observational study. Each child received standard care for their illnesses per Malawian guidelines and hospital protocol and was prospectively followed up with scheduled study visits on days 1, 2 (if hospitalized), 6, 14 (in person), and 30 (by phone). Our primary objectives are to describe the clinical outcomes of children who meet the inclusion criteria for this study and to investigate whether the percentages of children cured at day 14 among those with either fast breathing or chest indrawing pneumonia and comorbidities such as severe malaria, anemia, severe acute malnutrition, or HIV are lower than those in children without these comorbidities in the standard care groups in concurrent clinical trials. This study was approved by the Western Institutional Review Board, Malawi College of Medicine Research and Ethics Committee, and the Malawi Pharmacy, Medicines and Poisons Board. Objective This prospective observational study aimed to assess the clinical outcomes of children aged 2-59 months with both pneumonia and other comorbidities in a malaria-endemic region of Malawi. Results The Innovative Treatments in Pneumonia project was funded by the Bill and Melinda Gates Foundation (OPP1105080) in April 2014. Enrollment in this study began in 2016, and the primary results are expected in 2019. International Registered Report Identifier (IRRID) DERR1-10.2196/13377
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2

Abou-Khadra, Maha K. "Sleep of children living in institutional care facilities." Sleep and Breathing 16, no. 3 (September 14, 2011): 887–94. http://dx.doi.org/10.1007/s11325-011-0592-z.

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3

Vandjelovic, Nathan Douglas, Eric Masao Sugihara, Wakisa Mulwafu, and David Nathan Madgy. "The Creation of a Sustainable Otolaryngology Department in Malawi." Ear, Nose & Throat Journal 99, no. 8 (June 6, 2019): 501–2. http://dx.doi.org/10.1177/0145561319855366.

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There is a significant lack of surgeons in the developing world. Malawi Africa is one of the poorest and medically underserved countries in the World, with surgical care particularly lacking. Providing surgical services has numerous barriers, such as availability of well-trained surgeons, infrastructure, continuity of care, and access to care. There is currently one otolaryngologist in Malawi who provides complete access to this subspecialty. The development of the otolaryngology department was successful through institutional, local, national, and international collaboration, with a long-term goal of sustainability. An established department can train the next generation of surgeons for the preservation and growth of the surgical workforce. Once the department approaches independence, the role of outside collaboration transforms primarily from financial to a bi-directional partnership encompassing education, training, and leadership.
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4

Rohta, Sonam. "Institutional care for the vulnerable children in India: The perspective of institutional caregivers." Children and Youth Services Review 121 (February 2021): 105777. http://dx.doi.org/10.1016/j.childyouth.2020.105777.

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5

Lavy, Vicky. "Presenting symptoms and signs in children referred for palliative care in Malawi." Palliative Medicine 21, no. 4 (June 2007): 333–39. http://dx.doi.org/10.1177/0269216307077689.

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6

King, Carina, Masford Banda, Naor Bar-Zeev, James Beard, Neil French, Charles Makwenda, Eric McCollum, et al. "Care-seeking patterns amongst suspected paediatric pneumonia deaths in rural Malawi." Gates Open Research 4 (December 4, 2020): 178. http://dx.doi.org/10.12688/gatesopenres.13208.1.

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Background: Pneumonia remains a leading cause of paediatric deaths. To understand contextual challenges in care pathways, we explored patterns in care-seeking amongst children who died of pneumonia in Malawi. Methods: We conducted a mixed-methods analysis of verbal autopsies (VA) amongst deaths in children aged 1-59 months from 10/2011 to 06/2016 in Mchinji district, Malawi. Suspected pneumonia deaths were defined as: 1. caregiver reported cough and fast breathing in the 2-weeks prior to death; or, 2. the caregiver specifically stated the child died of pneumonia; or 3. cause of death assigned as ‘acute respiratory infection’ using InterVA-4. Data were extracted from free-text narratives based on domains in the ‘Pathways to Survival’ framework, and described using proportions. Qualitative analysis used a framework approach, with pre-specified themes. Results: We analysed 171 suspected pneumonia deaths. In total, 86% of children were taken to a healthcare facility during their final illness episode, and 44% sought care more than once. Of children who went to hospital (n=119), 70% were admitted, and 25% received oxygen. Half of the children died within a healthcare setting (43% hospital, 5% health centre and 2% private clinics), 64 (37%) at home, and 22 (13%) in transit. Challenges in delayed care, transport and quality of care (including oxygen), were reported. Conclusions: Healthcare was frequently sought for children who died of suspected pneumonia, however several missed opportunities for care were seen. Sustained investment in timely appropriate care seeking, quick transportation to hospital and improved case management at all levels of the system is needed.
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7

King, Carina, Masford Banda, Naor Bar-Zeev, James Beard, Neil French, Charles Makwenda, Eric D. McCollum, et al. "Care-seeking patterns amongst suspected paediatric pneumonia deaths in rural Malawi." Gates Open Research 4 (May 6, 2021): 178. http://dx.doi.org/10.12688/gatesopenres.13208.2.

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Background: Pneumonia remains a leading cause of paediatric deaths. To understand contextual challenges in care pathways, we explored patterns in care-seeking amongst children who died of pneumonia in Malawi. Methods: We conducted a mixed-methods analysis of verbal autopsies (VA) amongst deaths in children aged 1-59 months from 10/2011 to 06/2016 in Mchinji district, Malawi. Suspected pneumonia deaths were defined as: 1. caregiver reported cough and fast breathing in the 2-weeks prior to death; or, 2. the caregiver specifically stated the child died of pneumonia; or 3. cause of death assigned as ‘acute respiratory infection’ using InterVA-4. Data were extracted from free-text narratives based on domains in the ‘Pathways to Survival’ framework, and described using proportions. Qualitative analysis used a framework approach, with pre-specified themes. Results: We analysed 171 suspected pneumonia deaths. In total, 86% of children were taken to a healthcare facility during their final illness episode, and 44% sought care more than once. Of children who went to hospital (n=119), 70% were admitted, and 25% received oxygen. Half of the children died within a healthcare setting (43% hospital, 5% health centre and 2% private clinics), 64 (37%) at home, and 22 (13%) in transit. Challenges in delayed care, transport and quality of care (including oxygen), were reported. Conclusions: Healthcare was frequently sought for children who died of suspected pneumonia, however several missed opportunities for care were seen. Sustained investment in timely appropriate care seeking, quick transportation to hospital and improved case management at all levels of the system is needed.
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8

Bátki, Anna. "Emotion regulation development of children adopted from institutional care." Magyar Pszichológiai Szemle 68, no. 1 (March 1, 2013): 105–25. http://dx.doi.org/10.1556/mpszle.68.2013.1.8.

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Számtalan nemzetközi vizsgálat igazolta, hogy az intézetekből örökbefogadott gyerekek, bár sok területen jelentős fejlődést mutatnak, még évekkel családba kerülésük után is sok szocioemocionális problémával küzdenek. Nagyon keveset tudunk azonban azokról a folyamatokról, amelyeken keresztül a korai élmények ezekhez a fejlődési problémákhoz vezetnek. Az itt bemutatott vizsgálat célja az érzelemregulációs képességek fejlődésének jobb megismerése örökbefogadott gyermekeknél, mivel ezen képességek alapvető feltételei a pszichés egészségnek, a hatékony társas működésnek. A vizsgálat központi hipotézise, hogy azok a gyerekek, akik életük első (minimum) 6 hónapját intézetben töltötték, fejletlenebb érzelemregulációs képességgel rendelkeznek. A vizsgálatban 90 4 és 6 év közötti gyerek vett részt, akik a 3 vizsgálati csoport egyikébe tartoztak: 1. olyan gyerekek, akik születésükkor gyermekotthonba kerültek, és ott éltek örökbefogadásukig, de leg¬alább 6 hónapos korukig; 2. csecsemőkorban (6 hetes koruk előtt) örökbefogadott gyerekek; 3. (kontroll) vér szerinti családjukban élő gyerekek. A vizsgálat során az érzelemregulációs képességet a játék-narratívák elemzésével (MacArthur Story Stem Battery) vizsgáltuk. A három vizsgálati csoport összehasonlításának eredményeit összefoglalva elmondható, hogy igazolódott az a hipotézis, miszerint az intézeti gondozás egyik fontos következménye az elmaradás az érzelemregulációs képességekben. Ugyanakkor az eredmények arra is felhívják a figyelmet, hogy az újszülött korban örökbefogadott gyerekek bizonyos érzelemregulációs képességei is, bár jóval kevésbé, de eltérnek a vér szerinti kontrollcsoportétól. Ez az eredmény összefüggésbe hozható egyrészt pre- és perinatális tényezőkkel, másrészt pedig az örökbefogadó szülők és család jellegzetességeivel, valamint az örökbefogadottság tényéből következő vulnerabilitással.
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9

Johnson, Rebecca, Kevin Browne, and Catherine Hamilton-Giachritsis. "Young Children in Institutional Care at Risk of Harm." Trauma, Violence, & Abuse 7, no. 1 (January 2006): 34–60. http://dx.doi.org/10.1177/1524838005283696.

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10

K Jose, Minimol. "Strength-based Case Management for Children in Institutional Care." Institutionalised Children Explorations and Beyond 2, no. 2 (September 2015): 181–89. http://dx.doi.org/10.1177/2349301120150207.

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11

Sellick, Clive. "The use of institutional care for children across europe." European Journal of Social Work 1, no. 3 (September 1998): 301–10. http://dx.doi.org/10.1080/13691459808413791.

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12

Jose, Minimol K. "Strength-based case management for children in institutional care." Institutionalised Children Explorations and Beyond 2, no. 2 (2015): 181. http://dx.doi.org/10.5958/2349-3011.2015.00013.4.

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13

van IJzendoorn, Marinus H., Jesús Palacios, Edmund J. S. Sonuga-Barke, Megan R. Gunnar, Panayiota Vorria, Robert B. McCall, Lucy Le Mare, Marian J. Bakermans-Kranenburg, Natasha A. Dobrova-Krol, and Femmie Juffer. "I. CHILDREN IN INSTITUTIONAL CARE: DELAYED DEVELOPMENT AND RESILIENCE." Monographs of the Society for Research in Child Development 76, no. 4 (December 2011): 8–30. http://dx.doi.org/10.1111/j.1540-5834.2011.00626.x.

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14

Larsson, Gunilla, Ann-Britt Bohlin, and Marlene Stenbacka. "Prognosis of children admitted to institutional care during infancy." Child Abuse & Neglect 10, no. 3 (January 1986): 361–68. http://dx.doi.org/10.1016/0145-2134(86)90011-6.

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15

Mulemba, Tadala, Rhahim Bank, Memory Sabantini, Virginia Chopi, Grace Chirwa, Stuart Mumba, Mary Chasela, Selina Lemon, and Marilyn Hockenberry. "Improving peripheral intravenous catheter care for children with cancer receiving chemotherapy in Malawi." Journal of Pediatric Nursing 56 (January 2021): 13–17. http://dx.doi.org/10.1016/j.pedn.2020.09.019.

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16

Shin, Sun Hee, and Sun Hee Ko. "Comparison Discourse Comprehension Between Children in Institutional Care and Children Reared at Home." Journal of speech-language & hearing disorders 29, no. 2 (April 30, 2020): 97–104. http://dx.doi.org/10.15724/jslhd.2020.29.2.097.

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17

de Jesus Fontel Cunha Donato, Lilian, Celina Maria Colino Magalhaes, and Laiane da Silva Corrêa. "Practices of Care from Educators at Institutional Shelters for Children." Psychology 08, no. 08 (2017): 1161–70. http://dx.doi.org/10.4236/psych.2017.88075.

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18

Vávrová, Soňa. "Children and Minors in Institutional Care: Research of Self-Regulation." Procedia - Social and Behavioral Sciences 171 (January 2015): 1434–41. http://dx.doi.org/10.1016/j.sbspro.2015.01.265.

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19

Shin, Sunhee, and Sunhee Ko. "The Abilities of Predictive Inference in Children in Institutional Care." Journal of Special Education 36, no. 3 (December 31, 2020): 123–34. http://dx.doi.org/10.31863/jse.2020.12.36.3.123.

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20

Browne, Kevin, Catherine Hamilton-Giachritsis, Rebecca Johnson, and Mikael Ostergren. "Overuse of institutional care for children in Europe: Table 1." BMJ 332, no. 7539 (February 23, 2006): 485–87. http://dx.doi.org/10.1136/bmj.332.7539.485.

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21

Bergin, John. "Dysfunctional Organization? Institutional Abuse of Children in Care in Ireland." Journal of Management, Spirituality & Religion 4, no. 4 (January 2007): 461–85. http://dx.doi.org/10.1080/14766080709518679.

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22

Shin, Sunhee, and Sunhee Ko. "The Abilities of Predictive Inference in Children in Institutional Care." Journal of Special Education 36, no. 3 (December 31, 2020): 123–34. http://dx.doi.org/10.31863/jse.2020.12.36.3.123.

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23

Rohta, Sonam. "Children living in institutional care in northern India: A study." Developmental Child Welfare 2, no. 4 (December 2020): 278–92. http://dx.doi.org/10.1177/2516103220985873.

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A very large number of children live without parental care in the entire world. Poverty is considered to be the main reason behind institutionalization of the children because 80% of children living in care have at least one parent alive. The present paper emphasizes on the trends of institutional care in India where the large population is poor. Keeping in view the socio-economic conditions of the country, it is an attempt to explore the challenges and living conditions of children in institutional care run by government and non-governmental organizations in the regions of Punjab and Chandigarh in northern India. The findings of the study are based on the empirical data that included around 177 institutionalized children both boys and girls between the age group of 5 and 18 years living in four different children’s institutions. The study also provides suitable recommendations for better alternative care in countries with large populations of vulnerable children.
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24

Gallagher, Joe, Master Chisale, Sudipto Das, Richard J. Drew, Nadezhda Gleseva, Dermot Michael Wildes, Cillian De Gascun, Tsung-Shu Joseph Wu, Mark T. Ledwidge, and Chris Watson. "Aetiology and severity of childhood pneumonia in primary care in Malawi: a cohort study." BMJ Open 11, no. 7 (July 2021): e046633. http://dx.doi.org/10.1136/bmjopen-2020-046633.

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ObjectiveTo determine the aetiology of community acquired pneumonia in children presenting to primary care in Northern Malawi, and to ascertain predictors for identification of children requiring hospitalisation.DesignThe BIOmarkers TO diagnose PnEumonia study was a prospective cohort study conducted from March to June 2016.SettingPrimary care in Northern Malawi.Patients494 children aged 2 –59 months with WHO defined pneumonia.Main outcome(s) and measure(s)Number of children with bacterial infection identified and the sensitivity/specificity of WHO markers of severity for need for hospitalisation.Results13 (2.6%) children had a bacterium consistent with pneumonia identified. A virus consistent with pneumonia was identified in in 448 (90.7%) of children. 56 children were admitted to hospital and two children died within 30 days. 442 (89.5%) received antibiotic therapy. Eleven children (2.6%) had HIV. WHO severity markers at baseline demonstrated poor sensitivity for the need for hospitalisation with a sensitivity of 0.303 (95% CI 0.188 to 0.441) and a specificity 0.9 (95% CI 0.868 to 0.926). A prediction rule to indicate the need for hospitalisation was developed.Conclusions and relevanceThe low rate of bacterial infection and high use of antibiotics in the setting of high immunisation rates highlights the changing profile of childhood pneumonia. Similarly, the markers of need for hospitalisation may have changed in the setting of extended immunisation. Further studies are required to examine this.
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Ptacek, R., H. Kuzelova, L. Celedova, and R. Cevela. "P01-335-Stress and trauma in children in foster and institutional care." European Psychiatry 26, S2 (March 2011): 337. http://dx.doi.org/10.1016/s0924-9338(11)72046-6.

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Current studies show that individuals who were in foster or institutional care experience higher rates of physical and psychiatric morbidity than the general population. Children in foster care have a higher probability of having Attention Deficit Hyperactivity Disorder, and deficits in executive functioning, anxiety as well other developmental problems. These children experience higher degrees of incarceration, poverty, homelessness, and suicide.Recent studies show alarming occurrence of trauma and high stress load in children in institutional but as well as foster care.We have conducted an extensive study (n = 360) monitoring occurrence of trauma in history of children in foster care (n = 120), in institutional care (n = 120) and in functional biological families (n = 120). We have also evaluated levels of social emotional development and occurrence of child psychopathology.The results of the presented study showed that children in institutional and foster care show substantially higher occurrence of trauma in their history, higher incidence of reactive psychopathology (i.e. depression) and their level of social emotional development is substantially lower comparing to children from functional biological families (p < 0.01).The study proposes that children in foster and institutional care require substantial psychosocial support and attention.SUPPORTED BY THE RESEARCH GRANT GK MPSV-01-202.
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26

Vadlamudi, Eswari. "Deinstitutionalisation of Children in Care with Special Focus on Institutional Care in South Asia." Institutionalised Children Explorations and Beyond 5, no. 1 (March 2018): 18–29. http://dx.doi.org/10.1177/2349301120180104.

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Vadlamudi, Eswari. "Deinstitutionalisation of children in care with special focus on institutional care in South Asia." Institutionalised Children Explorations and Beyond 5, no. 1 (2018): 18. http://dx.doi.org/10.5958/2349-3011.2018.00001.4.

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28

Bruce, Jacqueline, Amanda R. Tarullo, and Megan R. Gunnar. "Disinhibited social behavior among internationally adopted children." Development and Psychopathology 21, no. 1 (January 2009): 157–71. http://dx.doi.org/10.1017/s0954579409000108.

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AbstractPostinstitutionalized children frequently demonstrate persistent socioemotional difficulties. For example, some postinstitutionalized children display an unusual lack of social reserve with unfamiliar adults. This behavior, which has been referred to as indiscriminate friendliness, disinhibited attachment behavior, and disinhibited social behavior, was examined by comparing children internationally adopted from institutional care to children internationally adopted from foster care and children raised by their biological families. Etiological factors and behavioral correlates were also investigated. Both groups of adopted children displayed more disinhibited social behavior than the nonadopted children. Of the etiological factors examined, only the length of time in institutional care was related to disinhibited social behavior. Disinhibited social behavior was not significantly correlated with general cognitive ability, attachment-related behaviors, or basic emotion abilities. However, this behavior was negatively associated with inhibitory control abilities even after controlling for the length of time in institutional care. These results suggest that disinhibited social behavior might reflect underlying deficits in inhibitory control.
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29

Zeanah, Charles H., and Kathryn L. Humphreys. "Global prevalence of institutional care for children: a call for change." Lancet Child & Adolescent Health 4, no. 5 (May 2020): 343–44. http://dx.doi.org/10.1016/s2352-4642(20)30055-9.

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30

Zhukova, Marina A., Sergey A. Kornilov, Stella N. Tseitlin, Marina B. Eliseeva, Elena A. Vershinina, Rifkat J. Muhamedrahimov, and Elena L. Grigorenko. "Early lexical development of children raised in institutional care in Russia." British Journal of Developmental Psychology 38, no. 2 (December 2, 2019): 239–54. http://dx.doi.org/10.1111/bjdp.12314.

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31

Dozier, Mary, Charles H. Zeanah, Allison R. Wallin, and Carole Shauffer. "Institutional Care for Young Children: Review of Literature and Policy Implications." Social Issues and Policy Review 6, no. 1 (March 2012): 1–25. http://dx.doi.org/10.1111/j.1751-2409.2011.01033.x.

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ZEANAH, CHARLES H., ANNA T. SMYKE, and ALINA DUMITRESCU. "Attachment Disturbances in Young Children. II: Indiscriminate Behavior and Institutional Care." Journal of the American Academy of Child & Adolescent Psychiatry 41, no. 8 (August 2002): 983–89. http://dx.doi.org/10.1097/00004583-200208000-00017.

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Večerka, Kazimír, Jakub Holas, Markéta Štěchová, and Simona Diblíková. "Criminological Characteristics of Children with Court-Ordered Institutional and Protective Care." Czech Sociological Review 37, no. 1 (February 1, 2001): 89–102. http://dx.doi.org/10.13060/00380288.2001.37.1.14.

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34

Sanyahumbi, A., M. Hosseinipour, J. Carapetis, M. Chiume, T. Mkaliainga, K. O. Murray, D. J. Penny, C. A. Sable, T. Tambala, and P. N. Kazembe. "PO604 Rheumatic Heart Disease With Late Presentation Among Children In Malawi." Global Heart 13, no. 4 (December 2018): 508. http://dx.doi.org/10.1016/j.gheart.2018.09.466.

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35

Neves, Eliane Tatsch, Andressa da Silveira, Andrea Moreira Arrué, Greice Machado Pieszak, Kellen Cervo Zamberlan, and Raíssa Passos dos Santos. "Network of care of children with special health care needs." Texto & Contexto - Enfermagem 24, no. 2 (June 2015): 399–406. http://dx.doi.org/10.1590/0104-07072015003010013.

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This is a qualitative study that aimed to describe the care network of children with special health care needs in different levels of the health care system, during the follow-up after discharge. The data were produced through the development of the dynamics of creativity and sensitivity, the speaking map and the creative and sensitive method, involving five children's families between 2009 and 2011. The caregivers' discourse pointed out that these children's care network comprises the institutional and familial dimensions. The first showed to be broad and diverse but scattered, comprising various health and education professionals. The second consists of members of the close female relatives, such as mothers and grandmothers, showing an exclusively familial care. The expansion and consolidation of multiprofessional care networks is recommended to facilitate the access to health care and quality of life for these children and their family caregivers.
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Simoes Lourêiro, Kevin, and Sascha Neumann. "Young children as actors of institutional language policies and practices in day care centres." European Journal of Applied Linguistics 8, no. 2 (September 11, 2020): 157–80. http://dx.doi.org/10.1515/eujal-2020-0008.

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AbstractAs children’s agency in influencing institutional language practices is often not carefully reflected in early childhood education curricula, the objective of this paper is to offer meaningful insights about how institutional language policies are both reproduced and transformed by children’s everyday use of language. For this purpose, we will combine conceptual resources from social theory, sociolinguistics and childhood studies in order to analyse children’s linguistic behaviour by applying a structure-agency perspective as a relational approach. Drawing on data from ethnographic field research within institutional day care centres in Luxembourg, our findings demonstrate that the status of children as actors in institutional language practices is strongly connected to institutional policies as a structural condition. However, this does not mean that children just enact these language policies, because they are actors of both maintaining, undermining and alternating them. In this respect, especially the translanguaging of children and caregivers plays a crucial role in the Luxembourgish context as it allows to build a bridge between the official institutional language policy and the individual linguistic repertoires. Considering the goal of establishing a plurilingual environment in early childhood education which now is paramount to the educational language policy of the Luxembourgish government, this article suggests that translanguaging practices should be considered as one of the key starting points to create a plurilingual ecology in and through everyday practice in the day care centres.
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Nimante, Dita, Linda Daniela, and Baiba Martinsone. "Promotion of Positive Behaviour and Social Emotional Development in Institutional Care." International Journal of Smart Education and Urban Society 9, no. 4 (October 2018): 63–76. http://dx.doi.org/10.4018/ijseus.2018100106.

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Personnel working in institutional care have the important role of providing for the development of children who have experienced the trauma of being separated from their families. Personnel need to be emotionally responsive, able to form consistent, trusting, and long-term relationships with children, believe in them, support them in continuing education, and have high expectations for them. Despite these facts, there is no Latvian legal requirement for personnel working in institutional care to have a pedagogical education. This article describes the implementation of two professional in-service training programs: “Promotion of Positive Behaviour in Children with Institutional Care Experience” and “Social Emotional Development” in one children's home-shelter and the effects of the programs at the level of personnel, children, and organization.
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Brookhouser, Patrick E. "Ensuring the Safety of Deaf Children in Residential Schools." Otolaryngology–Head and Neck Surgery 97, no. 4 (October 1987): 361–68. http://dx.doi.org/10.1177/019459988709700404.

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In 1983, 75,000 to 90,000 children and youth in the United States had hearing impairments severe enough to warrant some sort of special education, and 28% of that total (i.e., 21,000 to 25,000) were in residential schools. Deaf youngsters in institutional settings are at risk for maltreatment by surrogate caretakers—foster parents or institutional child care workers. Attempts to report the abuse may produce denials by institutional administrators who do not want to believe that children under their care have been abused or who fear serious personal and/or institutional consequences should the abuse report become public. Clearly, steps must be taken to ensure the safety of deaf children being educated in residential institutions. Health providers must assume a special responsibility for detecting and preventing abuse/neglect of handicapped children for whom they are providing medical care on a continuing basis. This article will explore relevant aspects of the present system for delivery of health services to deaf children, as well as present specific strategies for detection, documentation, and prevention of maltreatment of these particularly vulnerable children.
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39

Boswell, Gwyneth. "Children in Secure Accommodation: A Gendered Exploration of Locked Institutional Care for Children in Trouble." Child & Family Social Work 7, no. 3 (July 19, 2002): 229–30. http://dx.doi.org/10.1046/j.1365-2206.2002.t01-1-00247.x.

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40

Phiri, Sam, Joe Gumulira, Hannock Tweya, Lameck Chinula, Agnes Moses, Bongani Kaimila, Christopher Stanley, et al. "The Malawi Cancer Consortium – Catalyzing Cancer Care and Research in Southern Africa." Journal of Global Oncology 2, no. 3_suppl (June 2016): 3s—4s. http://dx.doi.org/10.1200/jgo.2016.003780.

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Abstract 68 Background: Cancer burden is increasing in Malawi, particularly for HIV-associated malignancies. Methods: With support from the National Cancer Institute, the Malawi Cancer Consortium (MCC) was initiated in September 2014. Partners include the UNC Lineberger Comprehensive Cancer Center, Malawi Ministry of Health, University of Malawi College of Medicine, and Lighthouse Trust. Spanning Malawi’s two major cities, Lilongwe and Blantyre, MCC includes three support cores (administration, analysis, mentoring) and three multi-institution research projects: (1) a national HIV-cancer match study to assess cancer incidence in the ART era; (2) a longitudinal cohort to identify clinical and molecular correlates of KS chemotherapy response; and (3) a longitudinal cohort to elucidate lymphoma biology and develop better treatments for HIV-associated lymphoma. Results: For project 1, 65,500 records from the Malawi National Cancer Registry and Malawi HIV cohorts have been abstracted, and initial data harmonization completed. Record linkage is planned for February 2016, will be updated at regular intervals, and will contribute to regional analyses through the IeDEA- Southern Africa network. For project 2, KS studies through MCC have led to descriptions of KS biologic subtypes defined by viral gene expression profiling, and detailed characterization of multicentric Castleman disease. Malawi has also led enrollment into multinational phase III KS clinical trials implemented by the AIDS Clinical Trials Group and AIDS Malignancy Consortium. For project 3, more than 300 adults and children with lymphoma have been enrolled since June 2014, with approximately 2/3 of adults being HIV-infected. Patients receive standardized treatment and supportive care, and standardized clinical and laboratory evaluations. Specimen-based correlative studies (virologic, genomic, biomarker studies) are ongoing. Finally, the consortium provides a platform for pilot studies in breast and esophageal cancer, and facilitates career development for Malawian cancer investigators. Conclusions: MCC has initiated a national coalition to address cancer in Malawi, and continued progress is anticipated. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST: Sam Phiri No relationship to disclose Joe Gumulira No relationship to disclose Hannock Tweya No relationship to disclose Lameck Chinula No relationship to disclose Agnes Moses No relationship to disclose Bongani Kaimila No relationship to disclose Christopher Stanley No relationship to disclose Edwards Kasonkanji No relationship to disclose Steady Chasimpha No relationship to disclose Richard Nyasosela No relationship to disclose Leo Masamba No relationship to disclose Tamiwe Tomoka No relationship to disclose Steve Kamiza No relationship to disclose Mina Hosseinipour No relationship to disclose Nora Rosenberg Research Funding: NIH/NCI Ron Mataya No relationship to disclose Charles Dzamalala No relationship to disclose George Liomba No relationship to disclose Irving Hoffman No relationship to disclose Dirk Dittmer No relationship to disclose Yuri Fedoriw Honoraria: Alexion Pharmaceuticals Blossom Damania No relationship to disclose Satish Gopal No relationship to disclose
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41

Purcell, Laura N., Meghan Prin, John Sincavage, Clement Kadyaudzu, Michael R. Phillips, and Anthony Charles. "Outcomes Following Intensive Care Unit Admission in a Pediatric Cohort in Malawi." Journal of Tropical Pediatrics 66, no. 6 (May 15, 2020): 621–29. http://dx.doi.org/10.1093/tropej/fmaa025.

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Abstract Introduction The burden of critical illness in low- and middle-income countries (LMICs) is high; however, there is a paucity of data describing pediatric critical care outcomes in this setting. Methods We performed a prospective observational study of the pediatric (≤18 years) intensive care population in Malawi, from August 2016 to May 2018. Data collected include patient demographics and clinical data, admission criteria and outcome. A multivariate Poisson regression was performed to determine risk factors for mortality. Results Over the study period, 499 patients were admitted to the intensive care unit (ICU) and 105 (21.0%) were children. The average age was 10.6 ± 5.4 years. Primary indications for ICU admission were sepsis (n = 30, 30.3%) and traumatic brain injury (TBI, n = 23, 23.2%). Of those who died, sepsis (n = 18, 32.7%), acute respiratory failure (n = 11, 20.0%) and TBI (n = 11, 20.0%) were the primary admission diagnoses. Overall, ICU mortality was 54.3% (n = 57). Multivariate regression for increased ICU mortality revealed: age ≤5 years [risk ratio (RR) 1.96, 95% CI 1.10–2.26, p &lt; 0.001], hemoglobin &lt; 10 g/dl (RR 1.58, 95% CI 1.08—2.01, p = 0.01) and shock requiring epinephrine support (RR 2.76, 95% CI 1.80–4.23, p &lt; 0.001). Conclusions Pediatric ICU mortality is high. Predictors of mortality were age ≤5 years, anemia at ICU admission and the need for epinephrine support. Training of pediatric intensive care specialists and increased blood product availability may attenuate the high mortality for critically ill children in Malawi.
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Brough, Helen, and Tiwaope Kachaje. "Follow-Up Care for Pediatric Hearing Aid Users at an Audiology Clinic in Malawi." Perspectives of the ASHA Special Interest Groups 5, no. 6 (December 17, 2020): 1809–12. http://dx.doi.org/10.1044/2020_persp-20-00129.

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Purpose Hearing loss can have a negative impact on a child's development. Hearing aids, if fitted appropriately, maintained well, and used regularly, can offer benefit to children with hearing loss. Regular reviews of hearing aid users can help to monitor a child's progress and provide timely intervention when problems arise or needs change. This study investigates the follow-up care received by children fitted with hearing aids at a clinic in Malawi. Method A clinical audit was done of the frequency of face-to-face follow-up appointments, following which all pediatric hearing aid users who had not recently received follow-up care were called to invite them for a review, and then a re-audit was conducted. Results Of the 47 children in the audit, 46 had not had a recent face-to-face follow-up appointment. Strenuous efforts were made to call those 46 children to the clinic for review: 20 caregivers agreed to bring their child for review, 10 of whom attended. It was not possible to contact 24 caregivers. Conclusions Reasons for low attendance for review at this service are not known, but may be related to the financial circumstances of the patients' families as well as difficulty in maintaining contact with families. It has not yet been possible to establish a system for routine follow-up care for pediatric hearing aid users at this well-established clinic in a low-income country.
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Molyneux, E. M., V. Lavy, M. Bunn, Z. Palmer, and F. Chiputula. "Developing a palliative care service for children in the Queen Elizabeth Central Hospital, Blantyre, Malawi." Archives of Disease in Childhood 98, no. 9 (July 29, 2013): 698–701. http://dx.doi.org/10.1136/archdischild-2013-303722.

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44

North, Kate, Joan Marston, Maryann Muckaden, Pradnya Talawadekar, Anilkumar Paleri, Lameck Thambo, and Jean Tauzie. "P-158 Empowering children in the development of children’s palliative care in india and malawi." BMJ Supportive & Palliative Care 5, Suppl 3 (November 2015): A56.3—A57. http://dx.doi.org/10.1136/bmjspcare-2015-001026.158.

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45

Flax, Valerie L., Chrissie Thakwalakwa, and Ulla Ashorn. "Perceptions of Child Body Size and Health Care Seeking for Undernourished Children in Southern Malawi." Qualitative Health Research 26, no. 14 (July 9, 2016): 1939–48. http://dx.doi.org/10.1177/1049732315610522.

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Child undernutrition affects millions of children globally, but little is known about the ability of adults to detect different types of child undernutrition in low-income countries. We used focused ethnographic methods to understand how Malawian parents and grandparents describe the characteristics they use to identify good and poor child growth, their actual or preferred patterns of health seeking for undernourished children, and the perceived importance of child undernutrition symptoms in relation to other childhood illnesses. Malawians value adiposity rather than stature in assessing child growth. Symptoms of malnutrition, including wasting and edema, were considered the least severe childhood illness symptoms. Parents delayed health care seeking when a child was ill. When they sought care, it was for symptoms such as diarrhea or fever, and they did not recognize malnutrition as the underlying cause. These findings can be used to tailor strategies for preventing and treating growth faltering in Malawian children.
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46

Hutyrová, Miluše. "INSTITUTIONAL EDUCATION FOR CHILDREN AND ADOLESCENTS WITH RISKY BEHAVIOUR." SOCIETY, INTEGRATION, EDUCATION. Proceedings of the International Scientific Conference 3 (July 24, 2015): 213. http://dx.doi.org/10.17770/sie2014vol3.696.

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In the Czech Republic, the model of life in schools for institutional education is structured. The main of focus of the article is to map diverse approaches of various professionals to the current process of transformation of Czech system of care of children at risk and to search for a feasible solution of the situation. The children are taken care of, in particular, from the material perspective since these schools’ level corresponds to the level of a middle-income family. The institution’s role ends upon the achievement of child’s adulthood or upon the completion of his/her education, and it is then solely up to the young individual to cope with life outside the institution on his/her own. A young individual leaving an institutional education facility should be able to manage various social skills, in particular, when it comes to activities relating to self-management and housekeeping.
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47

Varela, Carlos, Asgaut Viste, Sven Young, Reinou S. Groen, Leonard Banza, Bip Nandi, Nyengo Mkandawire, and Bente Elisabeth Moen. "Paediatric surgical conditions in Malawi - A cross-sectional nationwide household survey." Malawi Medical Journal 33, no. 2 (June 30, 2021): 73–81. http://dx.doi.org/10.4314/mmj.v33i2.2.

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BackgroundUntreated surgical conditions may lead to lifelong disability in children. Treating children with surgical conditions may reduce long-term effects of morbidity and disability. Unfortunately, low- and middle-income countries have limited resources for paediatric surgical care. Malawi, for example, has very few paediatric surgeons. There are also significantly inadequate infrastructures and personnel to treat these children. In order to strengthen resources that could provide such services, we need to begin by quantifying the need.AimTo estimate the approximate prevalence of surgical conditions among children in Malawi, to describe the anatomical locations and diagnoses of the conditions and the presence of injuries.MethodsA cross-sectional, nationwide survey of surgical needs was performed in 28 of 29 districts of Malawi. Villages, households and household members were randomly selected. A total of 1487 households were visited and 2960 persons were interviewed. This paper is a sub analysis of the children in the dataset. Information was obtained from 255 living children and inquiry from household respondents for the 255 children who had died in the past year. The interviews were conducted by medical students over a 60-day period, and the validated SOSAS tool was used for data collection. ResultsThere were 67 out of 255 (26.3%) total children living with a surgical condition at the time of the study, with most of the conditions located in the extremities. Half of the children lived with problems due to injuries. Traffic accidents were the most common cause. Two-thirds of the children living with a surgical condition had some kind of disability, and one-third of them were grossly disabled. There were 255 total deceased children, with 34 who died from a surgical condition. The most prevalent causes of death were congenital anomalies of the abdomen, groin and genital region. ConclusionAn extrapolation of the 26% of children found to be living with a surgical condition indicates that there could be 2 million children living with a condition that needs surgical consultation or treatment in Malawi. Congenital anomalies cause significant numbers of deaths among Malawian children. Children living with surgical conditions had disorders in their extremities, causing severe disability. Many of these disorders could have been corrected by surgical care.
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WINDSOR, JENNIFER, ANA MORARU, CHARLES A. NELSON, NATHAN A. FOX, and CHARLES H. ZEANAH. "Effect of foster care on language learning at eight years: Findings from the Bucharest Early Intervention Project." Journal of Child Language 40, no. 3 (May 14, 2012): 605–27. http://dx.doi.org/10.1017/s0305000912000177.

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ABSTRACTThis study reports on language outcomes at eight years from the Bucharest Early Intervention Project, a randomized controlled study of foster care. We previously have shown that children placed in foster care by age two have substantially stronger preschool language outcomes than children placed later and children remaining in institutional care. One hundred and five children participated in the current study, fifty-four originally assigned to foster care and fifty-one to continued institutional care. Even though current placements varied, children originally in foster care had longer sentences and stronger sentence repetition and written word identification. Children placed in foster care by age two had significant advantages in word identification and nonword repetition; children placed by age 1 ; 3 performed equivalently to community peers. The results show the continuing adverse effects of early poor institutional care on later language development and the key importance of age of placement in a more optimal environment.
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Gunnar, Megan R., and Brie M. Reid. "Early Deprivation Revisited: Contemporary Studies of the Impact on Young Children of Institutional Care." Annual Review of Developmental Psychology 1, no. 1 (December 24, 2019): 93–118. http://dx.doi.org/10.1146/annurev-devpsych-121318-085013.

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There is clear evidence that early deprivation in the form of early institutional care affects children both immediately and long after they are removed from the institution. This article reviews the modern literature on the impact of institutional care from animal models to longitudinal studies in humans. Importantly, we examine the current understanding of neuroendocrine regulation in the context of early deprivation. We discuss the opportunities and limitations of studying the effects of deprivation in previously institutionalized children, review behavioral findings and related neurobiological studies, and address the physical health ramifications of institutional care. Finally, we touch on future directions for both science and intervention.
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Hil, Richard, Joanna Penglase, and Gregory Smith. "Closed worlds. Reflections on institutional care and child slavery in Australia." Children Australia 33, no. 1 (2008): 12–17. http://dx.doi.org/10.1017/s1035077200000067.

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This article deals with various implications arising from evidence of slavery experienced by children placed in orphanages and children's homes between 1910 and 1974. Slavery was an integral part of the day-to-day realities of many of these children who also experienced forms of sexual, physical and emotional abuse in institutions that were supposedly responsible for their care. It is argued that slave labour in care settings contravened various provisions contained in welfare legislation of the period and was used to supplement the incomes of care institutions. The end result was that children were often compelled to work rather than receive the education to which they were entitled, rendering them ill-prepared to deal with various challenges in later life. This largely hidden story of slavery among the ‘Forgotten Australians’ is one of crude exercise of self-serving authority over children – authority aimed at serving the interests of institutions rather than the children they were meant to help.
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