Identification of Key Factors Influencing the Choice of the Type of Vaginal Pessary for Women Presenting with Pelvic Organ Prolapse: Semi-Directive Interviews and Development of an Algorithm.

(1) Background: Pelvic organ prolapse (POP) can be managed using a vaginal pessary. However, the decision-making process whereby health professionals choose the right pessary is unclear. The objective of this study was to focus on the experience of experts in pessary use and to propose an algorithm. (2) Methods: A prospective study, based on face-to-face semi-directive interviews and group discussions, was conducted on a multidisciplinary panel of professional experts specialized in pessary prescriptions. A consensual algorithm was established, and its accuracy was assessed by expert and non-expert panels. The Consolidated Criteria for Reporting Qualitative Studies (COREQ) were used. (3) Results: 17 semi-directive interviews were conducted. The parameters involved in the decision-making process regarding the choice of vaginal pessaries were: desire for self-management (65%), associated urinary stress incontinence (47%), POP type (41%), and POP stage (29%). The algorithm was developed step by step (4 iterations) using the Delphi technique. Most of the expert panel (76%) rated the relevance of the algorithm as 7 or more out of 10 on a visual analog scale according to their own experience (reference activity). Finally, most (81%) of the non-expert panel (n = 230) rated the usefulness of this algorithm as 7 or more out of 10 on a visual analog scale. (4) Conclusions: This study provides an expert panel-based algorithm that may help in the prescription of pessaries for POP.

A window into different cultural worlds: young children's everyday activities in the United States, Brazil, and Kenya.

A powerful means to understand young children's normative development in context is to examine their everyday activities. The daily activities of 79 children (3 years old) were observed, for 20 hr each, in their usual settings. Children were selected from 4 cultural groups: European American and African American (Greensboro, United States), Luo (Kisumu, Kenya), and European descent (Porto Alegre, Brazil), evenly divided by social class. Examining children's naturally occurring engagement in school-relevant activities, both in and out of child care, revealed the importance of ecological context. The variation in activities was not explainable simply by cultural group (including race within the United States) or social class, but by the intersection of culture and class. The developmental implications of these findings are discussed.

Parents' participation in cultural practices with their preschoolers / Parents' participation in cultural practices with their preschoolers

In this article we discuss cross-cultural similarities and variations in parents' engagement in the everyday activities in which their preschool-age children engage, focusing on mothers' and fathers' presence in the same setting as their children, the impact of their presence on the types of activities in which the children engaged, and the extent of mothers' and fathers' involvement with their children in those activities. The data were gathered from different societies - the United States, Korea, Russia, Estonia and Kenya. They reveal that the children were involved primarily in play (more than in lessons, work, or conversation), and this was unaffected by the presence of either parent. However, parents were relatively less likely to be involved in their children's play than in the other activities. Mothers, not surprisingly, were more likely to be found in the same setting as their children and, even when taking account of their greater presence, were more likely to be involved with their children than were fathers.In this article we discuss cross-cultural similarities and variations in parents' engagement in the everyday activities in which their preschool-age children engage, focusing on mothers' and fathers' presence in the same setting as their children, the impact of their presence on the types of activities in which the children engaged, and the extent of mothers' and fathers' involvement with their children in those activities. The data were gathered from different societies - the United States, Korea, Russia, Estonia and Kenya. They reveal that the children were involved primarily in play (more than in lessons, work, or conversation), and this was unaffected by the presence of either parent. However, parents were relatively less likely to be involved in their children's play than in the other activities. Mothers, not surprisingly, were more likely to be found in the same setting as their children and, even when taking account of their greater presence, were more likely to be involved with their children than were fathers (AU)

Desenvolvimento infantil em contexto cultural: o impacto do engajamento de pre-escolares em atividades do cotidiano familiar

Utilizamos o modelo Pessoa-Processo-Contexto-Tempo, de Bronfenbrenner (1995) para examinar as atividades cotidianas de criancas em idade pre-escolar em cidades de porte similar nos Estados Unidos, Russia, Estonia, Finlandia, Coreia e Quenia. Estudamos 'processos proximais' atraves da observacao das criancas em suas atividades, parceiros, papeis e settings durante 20 horas, no curso de uma semana, e examinamos o auto-direcionamento das criancas (uma caracteristica 'pessoal') em termos da iniciacao das criancas nas atividades. Sao apresentados aqui os dados quanto a atividades. Contexto foi estudado nao apenas ao nivel da sociedade, mas tambem dentro de cada sociedade, examinando-se criancas de diferentes classes sociais. O objetivo do projeto e acompanhar as criancas durante os primeiros anos na escola, embora no momento tenhamos dados longitudinais apenas para criancas norte-americanas. Os resultados revelaram similaridades e diferencas entre as culturas, e tambem interessantes variacoes em termos de classe social.