-
Applied Psychology. Health and... May 2022Studies show positive impacts of social support on childcare practices, but there is limited research on child toilet training. Social support with toilet training may...
Studies show positive impacts of social support on childcare practices, but there is limited research on child toilet training. Social support with toilet training may be especially important for rural Indian caregivers as this is a new childcare practice for many and mothers face an already demanding workload. The aim of this study was to examine the role of social support in toilet training using mediation and conditional process analyses. We surveyed 570 caregivers of children <5 years old living in rural Odisha, India. We found certain types of support aid toilet training through three mechanisms: directly, by improving self-efficacy, and by buffering against stress. Informational and instrumental support had a positive direct effect on toilet training while emotional support had no effect. Instrumental support also aided toilet training indirectly through bolstering a caregiver's perceived self-efficacy. These effects of instrumental support were not moderated by the caregiver's support network size. Additionally, we found perceived stress had a negative indirect effect on caregivers' toilet training efforts through diminishing self-efficacy, but this effect was buffered (i.e. moderated) by social support. These findings offer useful programmatic insights and expand the evidence-base on how social support functions to another childcare practice and cultural context.
Topics: Caregivers; Child; Child, Preschool; Female; Humans; India; Rural Population; Social Support; Toilet Training
PubMed: 34668329
DOI: 10.1111/aphw.12311 -
Research and Reports in Urology 2014To determine whether age of toilet training is associated with dysfunctional voiding in children.
OBJECTIVE
To determine whether age of toilet training is associated with dysfunctional voiding in children.
MATERIALS AND METHODS
We compared patients referred to the urologic clinics for voiding dysfunction with age-matched controls without urinary complaints. Characteristics including age and reason for toilet training, method of training, and encopresis or constipation were compared between both groups.
RESULTS
Initiation of toilet training prior to 24 months and later than 36 months of age were associated with dysfunctional voiding. However, dysfunctional voiding due to late toilet training was also associated with constipation.
CONCLUSION
Dysfunctional voiding may be due to delayed emptying of the bowel and bladder by children. The symptoms of dysfunctional voiding are more common when toilet training early, as immature children may be less likely to empty in a timely manner, or when training late due to (or in association with) constipation.
PubMed: 25328866
DOI: 10.2147/RRU.S66839 -
Indian Journal of Public Health 2022Open defecation is the leading cause for malnutrition and diarrhoeal deaths in low- and middle-income countries. The negative public health impacts of open defecation...
BACKGROUND
Open defecation is the leading cause for malnutrition and diarrhoeal deaths in low- and middle-income countries. The negative public health impacts of open defecation could be neutralized by toilet usage. However, the usage of improved sanitation facilities is unsatisfactory in rural India.
OBJECTIVES
The study was carried out to find the psycho-social barriers among households for not having toilets and for not using the owned toilets and to develop and find out the effect of Behaviour Change Communication (BCC) strategy on toilet construction and usage.
METHODS
A community-based Embedded Experimental Mixed Methods study was undertaken in the four field practice villages of Urban Health Training Centre, Villupuram. For baseline and end-line surveys, 422 independent sample households who were not having or not using the toilets were selected by Simple Random Sampling. After IEC clearance, interviews and direct observation of the toilets were undertaken. Context-specific multi-faceted BCC strategy was employed through community participation. The data were analyzed in SPSS software. Chi-square test was used to determine the significance of difference and effect size was calculated to estimate the size of the difference between the baseline and end-line data.
RESULTS
Toilet ownership and utilization improved by 21.3% and 23.3% points, respectively. There was a significant reduction in households' perceived psychosocial barriers in toilet adoption.
CONCLUSION
Our intervention demonstrated considerable improvements in both toilet construction and usage surpassing the psycho-social barriers. Future sanitation promotion interventions should focus more on community participation and the key messages should be reinforced multiple times using different channels.
Topics: Humans; Bathroom Equipment; Toilet Facilities; India; Diarrhea; Public Health; Sanitation; Rural Population
PubMed: 37039168
DOI: 10.4103/ijph.ijph_1707_21 -
Evidence Report/technology Assessment Dec 2006The objectives of this report are to determine the following: (1) the effectiveness of the toilet training methods, (2) which factors modify the effectiveness of toilet... (Review)
Review
OBJECTIVES
The objectives of this report are to determine the following: (1) the effectiveness of the toilet training methods, (2) which factors modify the effectiveness of toilet training, (3) if the toilet training methods are risk factor for adverse outcomes, and (4) the optimal toilet training method for achieving bowel and bladder control among patients with special needs.
DATA SOURCES
MEDLINE, Ovid MEDLINE In-Process & Other Non-Indexed Citations, Ovid OLDMEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, CINAHL, PsycINFO, ERIC, EBM Reviews, HealthSTAR, AMED, Web of Science, Biological Abstracts, Sociological Abstracts, OCLC ProceedingsFirst, OCLC PapersFirst, Dissertation Abstracts, Index to Theses, National Research Register's Projects Database, and trials registers.
REVIEW METHODS
Two reviewers assessed the studies for inclusion. Studies were included if they met the following criteria:
STUDY DESIGN
RCT, CCT, prospective or retrospective cohort, case-control, cross-sectional or case-series;
POPULATION
infants, toddlers, or children with or without co-morbidities, neuromuscular, cognitive, or behavioral handicaps disabilities;
INTERVENTION
at least one toilet training method; and
OUTCOME
bladder and/or bowel control, successes, failures, adverse outcomes. Methodological quality was assessed independently by two reviewers. Data were extracted by one reviewer and a second checked for accuracy and completeness. Due to substantial heterogeneity, meta-analysis was not possible.
RESULTS
Twenty-six observational studies and eight controlled trials were included. Approximately half of the studies examined healthy children while the remaining studies assessed toilet training of mentally or physically handicapped children. For healthy children, the Azrin and Foxx method performed better than the Spock method, while child-oriented combined with negative term avoidance proved better than without. For mentally handicapped children, individual training was superior to group methods; relaxation techniques proved more efficacious than standard methods; operant conditioning was better than conventional treatment, and the Azrin and Foxx and a behavior modification method fared better than no training. The child-oriented approach was not assessed among mentally handicapped children. For children with Hirschsprung's disease or anal atresia, a multi-disciplinary behavior treatment was more efficacious than no treatment.
CONCLUSIONS
Both the Azrin and Foxx method and the child-oriented approach resulted in quick, successful toilet training, but there was limited information about the sustainability of the training. The two methods were not directly compared, thus it is difficult to draw definitive conclusions regarding the superiority of one method over the other. In general, both programs may be used to teach toilet training to healthy children. The Azrin and Foxx method and operant conditioning methods were consistently effective for toilet training mentally handicapped children. Programs that were adapted to physically handicapped children also resulted in successful toilet training. A lack of data precluded conclusions regarding the development of adverse outcomes.
Topics: Child, Preschool; Disabled Children; Encopresis; Female; Humans; Infant; Male; Persons with Mental Disabilities; Toilet Training
PubMed: 17764212
DOI: No ID Found -
Canadian Family Physician Medecin de... Feb 2008One of my patients is in the third trimester of her first pregnancy. She has recently experienced spotting during her bowel movements. She has hemorrhoids. What...
QUESTION
One of my patients is in the third trimester of her first pregnancy. She has recently experienced spotting during her bowel movements. She has hemorrhoids. What medications are safe?
ANSWER
The treatment is mainly symptomatic for most patients. Most forms of the condition can be treated by increasing fibre content in the diet, administering stool softeners, increasing liquid intake, and training in toilet habits. Although none of the topical antihemorrhoidal agents commonly used have been assessed for safety in pregnancy, it is unlikely that the constituent parts (anesthetic, corticosteroids, and anti-inflammatory agents) will harm the third-trimester infant. In most women, most symptoms of the condition will resolve spontaneously soon after giving birth.
Topics: Female; Hemorrhoids; Humans; Pregnancy; Pregnancy Complications
PubMed: 18272631
DOI: No ID Found -
OTJR : Occupation, Participation and... Jul 2023Independence in toileting is a vital skill, yet toilet-training interventions for children with autism are limited.
BACKGROUND
Independence in toileting is a vital skill, yet toilet-training interventions for children with autism are limited.
OBJECTIVES
We investigated the acceptability and preliminary efficacy of a hybrid telehealth intervention that used synchronous individualized coaching sessions and asynchronous online educational materials to support parents in toilet training their children with autism.
METHOD
Participants included 34 families of children with autism ages 2 to 8 years. Measures were administered at pre- and postintervention (10-12 weeks) and included the Toileting Behavior Questionnaire, Goal Attainment Scaling, and Canadian Occupational Performance Measure.
RESULTS
Twenty-five families completed all intervention procedures. Parents found the intervention highly acceptable and reported significant improvements in child toileting behaviors; however, families accessed the asynchronous intervention materials at a low rate.
CONCLUSION
A parent coaching model delivered through telehealth may be a promising method to increase toileting independence among families of young children with autism.
Topics: Humans; Child; Child, Preschool; Autistic Disorder; Toilet Training; Autism Spectrum Disorder; Canada; Parents; Telemedicine
PubMed: 36942902
DOI: 10.1177/15394492231159903 -
Behavior Analysis in Practice Mar 2024Behavior-analytic toilet training (BATT) methods to support urine continence have been reviewed and replicated in numerous studies. Despite empirical validations of... (Review)
Review
Behavior-analytic toilet training (BATT) methods to support urine continence have been reviewed and replicated in numerous studies. Despite empirical validations of BATT, children with disabilities may not experience successful toilet training nor access the associated health and social benefits of urinary continence. It is possible these outcomes are partially due to practical barriers that arise throughout urine training. In practice, barriers may interfere with toilet training to the extent that training is postponed or discontinued, resulting in long-term incontinence and other related problems. Examples of barriers include problem behavior, excessive urine retention, recurrent accidents, and excessive or insufficient independent self-initiations to toilet. Researchers have sometimes described strategies to address these types of barriers. However, practitioners may not be aware of these strategies because they are secondary to the purpose of an investigation and may only apply to a subset of participants. The purpose of this review article is to synthesize the collection of barrier solutions described in published research on urine training for children with developmental disabilities. Results may assist practitioners in modifying BATT according to an evidence-based practice framework until their clients overcome barriers to achieve urine continence.
PubMed: 38405293
DOI: 10.1007/s40617-023-00891-0 -
Cureus Jan 2024Constipation suffered by children is a global public health problem. Functional constipation (FC) brings about deteriorating effects in the children's lives who suffer... (Review)
Review
Constipation suffered by children is a global public health problem. Functional constipation (FC) brings about deteriorating effects in the children's lives who suffer from it. The risk factors for the development of constipation include the consumption of a diet low in fiber and high in calories (such as the consumption of fast food), a sedentary lifestyle with a lack of exercise, a family history of constipation, and emotional and psychological stress endured by children in their families. It is one of the most common causes of stomachaches in children. FC may lead to fecal incontinence (FI), anal fissures, recurrent urinary tract infections (RUTI), and enuresis in children. Severe constipation may result in stool becoming rock-hard and inflexible in the rectum, which is clinically identified as fecal impaction. It is imperative to perform clinical evaluation and treatment, including pharmacological (the use of stimulant and osmotic laxatives) and non-pharmacological (education, changes in diet, intervention to promote positive behavior and address any emotional issues, toilet training, and physiotherapy for the pelvic floor) interventions. In the case of refractory patients, neuromodulation, the irrigation of the anal canal, and surgical management may be needed. It is essential to lead a healthy, stress-free lifestyle with plenty of exercise and a balanced diet rich in fiber (such as fruits and vegetables) so children can have regular bowel habits and thrive.
PubMed: 38249647
DOI: 10.7759/cureus.52551 -
American Journal of Infection Control Jan 2021The COVID-19 outbreak has highlighted the role of hospital-acquired infections in spreading epidemics. Adequately cleaning surfaces in patient rooms is an essential part...
BACKGROUND
The COVID-19 outbreak has highlighted the role of hospital-acquired infections in spreading epidemics. Adequately cleaning surfaces in patient rooms is an essential part of this fight to reduce the spread. Traditional audits, however, are insufficient. This study assesses surface cleaning practices using ultravoilet (UV) marker technology and the extent to which this technology can help improve cleaning audits and practices.
METHODS
One hundred and forty-four audits (1,235 surfaces) were retrieved. UV-marker cleaning audits conducted at a major teaching hospital in 2018 after implementing a new cleaning protocol. In addition, semi-structured interviews were conducted with cleaning staff and supervisors.
RESULTS
On average, 63% of surfaces were appropriately cleaned. Toilet handles (80%) and toilet seats underside (83%) scored highest while main room sink fixtures (54%), light switch (55%), and bedrails (56%) scored lowest. Training, staffing and time constraints may play a role in low cleaning rates.
DISCUSSION
The high-touch patient surfaces in the bedroom remain neglected and a potential source of infections. UV marker audits provided an objective measure of cleaning practices that managers and staff were unaware of.
CONCLUSIONS
UV-markers audits can play a key role in revealing deficiencies in cleaning practices and help in raising awareness of these deficiencies and improving cleaning practices.
Topics: Bathroom Equipment; Beds; COVID-19; Cross Infection; Disinfection; Equipment Contamination; Hospital Units; Hospitals, Teaching; Housekeeping, Hospital; Humans; Infection Control; Patients' Rooms; Personnel, Hospital; SARS-CoV-2; Time Factors; Ultraviolet Rays; Workload
PubMed: 32599097
DOI: 10.1016/j.ajic.2020.06.187 -
Neuroscience and Biobehavioral Reviews Aug 2020Typically, cattle urinate and defecate with little or no control over time and place. The resulting excreta contributes to a range of adverse effects on the environment... (Review)
Review
Typically, cattle urinate and defecate with little or no control over time and place. The resulting excreta contributes to a range of adverse effects on the environment and the animals themselves. These adverse effects could be substantially ameliorated if livestock could be toilet trained. Toilet training requires an animal to suppress impending voiding (a reflexive-like behavior), move to a latrine (voluntary behavior) and reinitiate voiding. Here, we review the neurophysiological processes and learning mechanisms regulating toileting. The suppression and initiation of voiding occur primarily via the coordinated activity of smooth and striated anal and urinary sphincter muscles. The autonomic and somatic nervous systems, along with central processes, regulate these muscles. In several mammalian species, voluntary control of the sphincters has been demonstrated using classical and/or operant conditioning. In this review, we demonstrate that the neurophysiological and behavioral regulation of voiding in cattle is likely to be similarly conditionable. The management of excreta deposition in cattle could have major benefits for reducing livestock greenhouse gas emissions and improving animal health/welfare.
Topics: Animal Welfare; Animals; Autonomic Nervous System; Cattle; Conditioning, Operant; Learning
PubMed: 32461081
DOI: 10.1016/j.neubiorev.2020.05.006