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Norwegian youth in out‐of‐home care move three times as frequently as their peers. Such placement instability is linked to negative outcomes in terms of social attachment, well‐being, educational achievements, health, and future opportunities. Norway implemented a new child welfare service reform in 2022 that increased the municipalities responsibilities for out‐of‐home care. The "incentive package" and "Barneløftet" were measures implemented to prepare the municipalities for these changes. This study evaluates how the implemented measures affect the number of moves within out‐of‐home care in Trøndelag county. An event‐study design with difference‐in‐difference estimates was used to study the effect of the measures. The data are Norwegian registers that include most children in out‐of‐home care from 2013 to 2021. The findings of this study indicate that increased support for foster care homes significantly reduces the number of moves. Increased placement stability is associated with an increased sense of belonging, thus facilitating positive development. [ABSTRACT FROM AUTHOR]

The COVID−19 pandemic has impacted child welfare practice and outcomes. This study examines the perspectives of families and professionals on child welfare practice during the COVID−19 pandemic. Qualitative data from feedback surveys and focus groups were used to provide a comprehensive examination of the concepts being explored. Results of this study suggested positive outcomes of virtual meetings and trainings and raised attention to delays in achieving permanency during the pandemic. This study will provide important implications for navigating social work best practices and strategies for addressing children and families' needs to improve child welfare outcomes. [ABSTRACT FROM AUTHOR]

This study examines how fostered individuals, foster carers, bio-legal children of foster carers and birth parents use discourse to construct and maintain family identity and what may influence this use. Focus group and interview data show how family terminology may create a sense of family, affirm and strengthen ties, erase distinctions, promote inclusion and conformity and protect, refute and explain ties to in- and outsiders. Family terminology use is dynamic and can be influenced by (conflicting) beliefs about who is entitled to these terms and the difficulty of sharing terms. Stakeholders showed many commonalities. Practice and research implications are discussed. [ABSTRACT FROM AUTHOR]

Research on foster youth often focuses on risk, rather than adaptation, strengths, and assets. Some researchers have shifted the narrative by examining resiliency, but there is limited understanding on how to define and measure resilience specifically among current and former foster youth. This study begins with a meta-synthesis of the qualitative research (n = 31, 1990-2020) that discuss resilience with foster youth. We then examine data from twenty-two qualitative interviews regarding resilience with key stakeholders in child welfare. The findings inform an understanding of resiliency that is inclusive and culturally responsive to current and former foster youth. [ABSTRACT FROM AUTHOR]

Objective: This article aims to identify new risks for foster families and their institutional environment resulting from the COVID‐19 pandemic. Background: During the pandemic, the government in Poland introduced significant restrictions, including social isolation and closures of public institutions. It caused challenges in the foster care system where self‐care has been major issue. Method: In‐depth interviews were conducted with 45 people who were involved in the foster care system. Participants were recruited using a purposive approach and the snowball method. The interviews were analyzed using a six‐stage thematic analysis. Results: The functioning of the foster care system in response to the COVID‐19 pandemic evidenced some practices that challenged carers and children. Conclusion: The foster care system, which is based on the deinstitutionalization paradigm, requires changes and procedural approaches that need to be put in place for the system to be able to adapt to a similar crisis. Implications: This article suggests some social policy solutions to improve the quality of care and parenting services, and the conditions for foster families when institutions in the social environment are closed. [ABSTRACT FROM AUTHOR]

Professional quality of life (ProQOL) refers to workers' subjective feelings associated with work involved in helping others who have experienced trauma. It consists of positive and negative aspects, that is, subscales of compassion satisfaction, and burnout and secondary traumatic stress. Foster and kinship caring inherently involves risks associated with exposure to the trauma responses of children in their care. This exposure can lead to poor ProQOL, carer attrition, and placement instability. While limited studies specifically explore ProQOL of carers, many studies have examined factors and interventions related to ProQOL. However, there is a lack of synthesis of these studies. To fill such a research gap, we undertook a scoping review of 70 empirical studies from Australia, the United Kingdom, and the United States, published from 2012 to 2022 reporting on ProQOL, and its related factors and concepts. We applied a multilevel ecosocial construct to examine complex interrelationships between private and governance settings to better understand factors related to ProQOL of carers and interventions aimed to improve it in these dynamic systems. In our review, some studies showed positive outcomes for carers, such as reduced stress or burnout associated with training. However, there was insufficient attention to factors associated with ProQOL at relational and sociopolitical levels. It is crucial to improve carers' ProQOL or well-being to ensure their retention and placement stability. Long-term systemic improvements require interventions across different levels of the system. [ABSTRACT FROM AUTHOR]

In their care of children and young people, foster carers report experiencing social isolation and a lack of support. This study examines the social network experiences of Australian foster carers who are members of Mockingbird Family. While well established in the United States and United Kingdom, Mockingbird Family was introduced to Australia offering a new approach to address the unique challenges of foster caring for vulnerable children and young people. The model geographically networks 6–10 foster care households in a 'constellation' with a central 'hub home provider' tasked with providing information, support, and respite care. This study employed a cross-sectional explanatory sequential mixed methods approach to investigate social connections and supports in the first four Australian Mockingbird Family constellations. A social network tool was used to survey participants (n = 27) and two focus groups (n = 20) to gather their experiences. Analysis found the highest mean social network connections with people from within their own Mockingbird Family constellations. Three measures of centrality were used indegree, betweenness and closeness, to report the connections and role of members within each constellation. Comparing constellations at different stages of maturity, the hub home provider was consistently ranked with high betweenness centrality as the bridge. In the longer-running constellations, the hub home provider was ranked with high indegree centrality or the primary source of advice or expert support. This indicated micro-network evolution that may potentially result in reduced reliance on statutory and other formal system supports over time. Changes to micro-dynamics in social support within constellations were explained qualitatively through three themes: leadership and expertise, information diffusion and communication, and trust and familiarity. Mockingbird Family was found to provide social connections and support networks amongst foster carers, indicating the model's capacity to strengthen supports to carers thereby strengthening the immediate environment of children and young people in care. [ABSTRACT FROM AUTHOR]

Background: Foster families may represent an alternative model for dependent older adults in many countries where nursing homes are insufficiently developed. This study aimed to assess the prevalence of malnutrition and its determinants in older adults living in foster families in Guadeloupe (French West Indies). Methods: This cross-sectional study was gathered from the KASAF (Karukera Study of Ageing in Foster families) study (n = 107, 41M/66F, Mdn 81.8 years). Nutritional status was assessed with the Mini Nutritional Assessment Short‐Form (MNA‐SF). Clinical characteristics and scores on geriatric scales (Mini-Mental State Examination (MMSE), Activities of Daily Living (ADL), Short Physical Performance Battery (SPPB), Center for Epidemiologic Studies- Depression (CESD) and Questionnaire Quality of Life Alzheimer's Disease (QoL-AD)) were extracted. Bivariate analysis and logistic models adjusted for age and gender were performed to test the association of nutritional status with socio-demographic variables and geriatric scales. Results: Thirty (28.0%) older adults were malnourished (MNA-SF score ≤7). In bivariate analysis, malnutrition was associated with an increased prevalence of cardiovascular diseases (46.7% versus 19.5%, p = 0.004), the presence of hemiplegia (30.0% versus 6.5%, p = 0.003), a poorer cognitive status (MMSE score 4.7 ± 7.1versus 9.7 ± 10.7; p = 0.031), higher risk of depression (CESD score 27.3 ± 23.0 versus 13.5 ± 14.4; p = 0.035) and dependency (ADL score 1.9 ± 1.9 versus 2.3 ± 2.1; p<0.001). Malnutrition was also associated with lower caregivers'rating of QoL (QoL-AD score 21.8 ± 6.4 versus 26.0 ± 5.7; p = 0.001) but not by older adult's rating (24.1 ± 11.2 versus 28.3 ± 7.7; p = 0.156). Similar associations were observed in logistic models adjusted for age and gender. Conclusion: Malnutrition was common among foster families for older adults. Special attention towards the prevention and treatment of malnutrition in older adults from cardiovascular diseases, cognitive impairment, dependency and depression is necessary in this model of dependency support. [ABSTRACT FROM AUTHOR]

Adolescents in foster care are removed from their families of origin and are placed with foster families for temporary care until they are able to be granted a more permanent placement. This purpose of this qualitative study was to explore the bonding experience of adolescents in foster care = with their foster parents. This study included 10 foster parents who had an African-American adolescent between the ages of 12 to 18 in their care. Interviews were audio recorded and transcribed verbatim. The analysis began with coding to develop an understanding of the bonding experiences between adolescents and their foster parents. Four processes emerged that seemed to influence bonding: communicating in conflict with empathy or assertion, sharing personal time, creating rituals, and offering support. Foster parents appeared to demonstrate the processes when there was a focus on the adolescent being a part of the family. This present study has implications for theory, research, and practice. [ABSTRACT FROM AUTHOR]

Background: Summer camp is an experiential learning setting that supports youth development. Due to high fees, youth from low-income backgrounds often have fewer opportunities to attend. Subsequently, there is little literature about these youth's camp experiences. Purpose: This research examined growth and the characteristics supporting growth in memorable camp experiences shared by youth more than one year after attending camps for youth from low-income backgrounds. Methodology: We collected written narratives via an online survey distributed May 2022. A total of 352 youth (M age=16.06; SD age=0.88) provided narratives. About 56% of youth identified as female and about 23% of youth identified as a youth of color (36% identified as white; race/ethnicity data was not available for about 40% of youth). Considering the entire narrative as the unit of analysis, we inductively coded narratives for growth and characteristics supporting growth. Findings: We identified growth in 33% of youth's narratives (e.g., adopting new perspectives, discovering passions, value clarification, developing resilience). Growth occurred when youth had opportunities to try new activities, overcome challenges, or felt accepted and connected with peers or staff. Implications: These findings provide useful information for practitioners and serve as a foundation for research about youth from low-income backgrounds' camp experiences. [ABSTRACT FROM AUTHOR]

Background: The All4Children project addresses the urgent need to transition from institutionalization to family-based care for out-of-home children in Portugal. Despite evidence highlighting the detrimental effects of institutionalization, only a small percentage of children (less than 4%) are currently placed in family foster care in the country. In response to European directives for deinstitutionalization, Portuguese legislation now prioritizes non-kinship family foster care as the preferred alternative for young children in need of care. To facilitate this transition, the Integrated Model of Family Foster Care (MIAF) was developed, offering a comprehensive framework covering the entire spectrum of family foster care. Objective: This research aims to investigate the initial implementation stage of the MIAF to promote high-quality family foster care in Portugal. Method: The study will conduct a mixed-method and longitudinal research project in family foster care agencies across different regions of Portugal, focusing on evaluating the implementation and outcomes of the MIAF model using a multi-informant and multi-method approach. The participants will include caseworkers, children aged 0–9 years entering foster care, and their respective foster families enrolled in the MIAF program. Process evaluation will assess fidelity, feasibility, appropriateness, and acceptability of MIAF modules, while outcome evaluation will examine child safety, stability, well-being, as well as foster family well-being and quality of relational care. Outcomes: The insights gained from this research initiative will serve as a foundation for the ongoing enhancement of MIAF. Consequently, this project has the capacity to advance evidence-based child welfare practices by refining processes and strategies to better serve vulnerable children and youth. Conclusion: Facilitated by a multidisciplinary team, this project will contribute to advancing research in the field, enhancing practice, and informing policy during a pivotal stage of deinstitutionalization in Portugal. [ABSTRACT FROM AUTHOR]

Social media practices are situated within the contexts that people are located in, including family and peer relationships. LGBTQIA+ young people carefully curate social media spaces to find similar others in careful ways. However, less is understood about how existing connections to families of origin (re)shape social media practices. Drawing on interview and focus group data with 65 LGBTQIA+ young people, we examine family considerations in social media practices and curation strategies. Findings reveal that considerations about familial relations play an important role in how young people use social media for maintaining and fostering ties with family members. Young LGBTQIA+ people narrativise their social media practices as intensely affective experiences, where issues of care, concern, and love for family, (re)shapes their social media use. We argue that queer young people's social media practices can be conceptualised as family practices and consider the implications this has for making sense of social media for queer young people. [ABSTRACT FROM AUTHOR]

Laying a strong foundation for emotional development in children birth to 5 is of critical importance, but the extent to which this is considered following child abuse and/or neglect, foster care placement, reunification, and potential re‐entry into foster care remains unclear. Using a convergent mixed methods design, we investigated perceptions among child welfare professionals given the contributing role they could play in both initiating provider–parent dialogue and connecting families with timely resources to better support early emotional development post‐abuse/neglect. Fifty eight child welfare professionals in an urban, Northeastern County of the USA participated (73% response rate). Survey data and focus group insights shed light on satisfaction with and roadblocks to supporting foster and biological parents in promoting emotional development. A low proportion of respondents offered advice on emotional development, referred families to relevant parent education, or perceived biological or foster parents as extremely prepared. Self‐reported likelihood of providing advice to families was positively associated with access to information on emotional development, years employed, and job satisfaction. Multilevel roadblocks were identified. Results inform systems‐level, family‐centred initiatives and information sharing to better support emotional development post‐abuse and/or neglect. [ABSTRACT FROM AUTHOR]

Given that the number of children and young people needing care keeps rising and fewer people are becoming foster carers, efforts to support carers and workers in foster caring are essential. This paper considers the experiences of carers and foster care agency workers involved in Australia's piloting of the Mockingbird Family. With a view understanding experience, data were collected via focus groups with carers and agency workers (n = 20) involved in piloting, implementation and evaluation. Deductive analysis applied the theory of experience to generate understanding of experience, as both intrinsic and extrinsic dimensions to capture strengths in the Mockingbird Family's foster caring networks. These dimensions of experience included collective passions of carers and workers; experiential change over time; collective experiences as a moving force; and experiences as transformational. Understanding of experience associated with the perceived strengths of the Mockingbird Family, including strategies to promote strong professional relationships between carers and workers, is an important element in strengthening environments of children and young people in care. Safe and stable environments are crucial for wellbeing. [ABSTRACT FROM AUTHOR]

This longitudinal study examines the child's place in the foster family through the use of conventional names for familial figures (e.g., 'mum/dad') and through the foster parents' intention to adopt the child. Data were collected at two time points during childhood and adolescence, among children placed in kinship and non‐kinship foster care in Norway. Children placed at a younger age and children in non‐kinship foster care were more likely to call their foster parents for 'mum/dad'. Children placed at an older age and children in non‐kinship care were more often presented as 'foster child' by their foster parents. Only 25%–34% of foster parents reported having considered adoption. The most common reason for not considering adoption was that they already deemed to be a family. The use of conventional names for familial figures in foster families might not necessarily reflect the child's integration into a foster family as it seems to be related to the age of the child at placement rather than to the duration of placement. Intention to adopt was relatively low, mostly because foster parents considered adoption as not necessary. [ABSTRACT FROM AUTHOR]

Literature on the delivery and impact of foster parent training, such as the Nurturing Parenting Program (NPP), is sparse, particularly for relative foster parents. This study investigates (a) how NPP referral, initiation, and completion rates vary between relative and non-relative foster parents, (b) reasons for not initiating NPP, and (c) changes in parenting attitudes and behaviors for relative and non-relative foster parents after participating in NPP. The study analyzed data from the Illinois Birth to Three (IB3) study for 722 relative and 397 non-relative foster parents of children ages three and younger. Relative and non-relative foster parents had similar NPP referral and initiation rates, but relatives had significantly lower completion rates. Content analysis of case notes for 498 cases showed that relative foster parents more frequently noted barriers (e.g., childcare, transportation) to NPP initiation. Among NPP completers, both groups reported similar levels of improvements in parenting attitudes and behaviors at the end of NPP, but a pattern of lower scores was observed for relative foster parents. The findings suggest a need for more support for foster parents, particularly relative foster parents. [ABSTRACT FROM AUTHOR]

According to government data, there is a slow decline in foster care in Italy, especially for teenagers, caused by an insufficient number of available foster families. The need to provide an intense stimulus to foster care is evident. This study conducted individual qualitative interviews with 126 foster parents of teenagers, transcribed and analysed using Atlas.ti software. Valuable indications for social services were individuated. The importance of the foster parents' intrinsic motivations and the suggestion for social services to emphasize them in the recruitment campaigns were reaffirmed. The appropriateness of directing the proposal towards foster parents with previous experience in parenting, foster parenting or working with teenagers was also confirmed. Additionally, results revealed that foster parents connected to foster parents' associations/networks and religious groups are preferred. The importance of the relationship between foster parents and social services and suitable support for the ongoing fostering is pivotal. Establishing a relationship based on trust and the diffusion of the foster care invitation through testimonies and word‐of‐mouth was also highlighted. The initiatives promoting spaces and occasions for teens needing foster care and potential candidates for fostering to meet them have promising outcomes. [ABSTRACT FROM AUTHOR]

Early childhood teachers routinely facilitate play-based learning experiences in their physical classrooms; however, the pivot to virtual teaching platforms created a barrier for providing age appropriate, play-based learning opportunities during the COVID-19 pandemic. There are few studies exploring how to promote play in the virtual classroom or what types of activities and learning experiences promote play in synchronous and asynchronous settings. Therefore, this study explored the barriers and challenges to fostering play through virtual teaching and the types of play-based instruction teachers were effectively able to implement in their virtual classroom. This study used content analysis along with descriptive analysis of an online survey with open-ended prompts that early childhood teachers completed (n = 76). Findings revealed two major themes related to challenges and barriers in teachers' efforts to foster play-based learning through virtual formats. Even though teachers noted significant challenges and barriers they identified multiple play-based activities they were able to facilitate effectively through virtual formats. These activities were categorized through the theoretical framework of Piaget's stages of the development of play with the addition of guided play. Implications for how play can be fostered through virtual teaching in early childhood classrooms were discussed. [ABSTRACT FROM AUTHOR]

FosterCARE training is a behaviorally based, empirically supported program developed to provide foster parents with skills for interacting effectively with youth (aged 2–18) with trauma histories. In this paper, we suggest that the trauma-informed skills, wide age range, and focus on parent–child interactions inherent within the FosterCARE model could provide a promising foundation to serve LGBTQIA+ foster youth and their families. This article describes potential additions to the FosterCARE model and provides the rationale for the use of a FosterCARE-LGBTQIA+ module. Recommendations for the future pilot testing of the FosterCARE LGBTQIA+ module using an evidence-based framework are included, with limitations discussed. [ABSTRACT FROM AUTHOR]

Between 2006 and 2021, the Hungarian Twin Registry (HTR) operated a volunteer twin registry of all age groups (50% monozygotic [MZ], 50% dizygotic [DZ], 70% female, average age 34 ± 22 years), including 1044 twin pairs, 24 triplets and one quadruplet set. In 2021, the HTR transformed from a volunteer registry into a population-based one, and it was established in the Medical Imaging Centre of Semmelweis University in Budapest. Semmelweis University's innovation fund supported the development of information technology, a phone bank and voicemail infrastructure, administrative materials, and a new website was established where twins and their relatives (parent, foster parent or caregiver) can register. The HTR's biobank was also established: 157,751 individuals with a likely twin-sibling living in Hungary (77,042 twins, 1194 triplets, 20 quadruplets, and one quintuplet) were contacted between February and March of 2021 via sealed letters. Until November 20, 2022, 12,001 twin individuals and their parents or guardians (6724 adult twins, 3009 parents/guardians and 5277 minor twins) registered, mostly online. Based on simple self-reports, 37.6% of the registered adults were MZ twins and 56.8% were DZ; 1.12% were triplets and 4.5% were unidentified. Of the registered children, 22.3% were MZ, 72.7% were DZ, 1.93% were triplets, and 3.05% were unidentified. Of the registered twins, 59.9% were female (including both the adult and minor twins). The registration questionnaire consists of eight parts, including socio-demographic and anthropometric data, smoking habits and medical questions (diseases, operations, therapies). Hungary's twin registry has become the sole and largest population-based twin registry in Central Eastern Europe. This new resource will facilitate performing world-class modern genetic research. [ABSTRACT FROM AUTHOR]

Objective: The aim of the current study was to identify constructive interpersonal behaviors that may make relational partners more resilient while foster caregiving. Background: Foster caregiving can be stressful due to the unique demands of the role. Consistent with the theory of resilience and relational load, we propose one possible way for couples to manage stress and promote resilience is by investing in their relationships through repetitive and positive relationship maintenance behaviors. Method: Two‐parent foster caregiving couples (N = 227) completed online surveys measuring perceptions of their own and their partners' relationship maintenance and conflict management behaviors, as well as individual reports of depressive symptoms and parenting stress. Results: Structural equation actor–partner interdependence modeling indicated significant direct and indirect actor effects, but no partner effects. Both men's and women's perceptions of the couple's relationship maintenance were positively associated with their perceptions of the couple's conflict management, which, in turn, were negatively related with their own depressive symptoms and parenting stress. Conclusion: Couples' prosocial and constructive behaviors are related to lower mental distress in foster caregivers. Implications: Couple‐focused interventions may be helpful in promoting behaviors that enhance couple functioning and promote the well‐being of foster caregivers. [ABSTRACT FROM AUTHOR]

Objective: This study aims to document birth parents' commitment from a systemic perspective. Characteristics of birth parent's mental health (depressive symptoms), placement characteristics (family reunification, parent–child contact), and systemic characteristics (parent's perception of the foster parent's opinion on parent–child contact) are examined. Background: Foster placement creates a highly vulnerable situation within families of origin. Moreover, birth parents are liable to have been exposed to multiple risk factors. Foster placement comes with many challenges that are not without consequences on the parenting experience, including loss of parenting responsibilities and redefinition of the parenting role. Method: Parents (n = 59) participated for 70 parent–child dyads in 90‐minute home visits where data on sociodemographic characteristics, mental health status, experience of the placement measure and parent–child contact, as well as level of parental commitment were gathered. Results: Three‐step hierarchical regression models were used to examine the independent contribution of the parent's perception of the foster parent's opinion on contact on parental commitment after accounting for the birth parent's mental health and placement characteristics. Results suggest that parent–child contact and parent's perception of foster parent's opinion on contact have a significant contribution to parental commitment. Conclusion: These findings underscore the importance of addressing parenthood in placement situations and the relevance of examining parental commitment from a systemic perspective. Implications: A deeper understanding of this vulnerable population would require reflecting on the psychosocial practices in Child Protective Services while accounting for the needs of birth parents in the placement system. [ABSTRACT FROM AUTHOR]

This article reports on one of the objectives of a larger study aiming at the development of an adolescent risk-behavior management program for foster parents. The objective relevant to this article entailed the exploration of parenting behaviors and attitudes of parents fostering adolescents presenting with risk behavior. The respondents were recruited from the clientele of designated welfare organizations in the North West Province of South Africa. A quantitative survey using the multi-dimensional Parental Style Dimension Questionnaire (PSDQ) was administered to a purposive sample of 150 respondents. A response rate of 64.5% was achieved, with only foster mothers participating in the study. Data analysis was done by the Statistical Consultation Services of the North-West University (Potchefstroom Campus) using IBM SPSS Statistics Version 25, Release 25.0 SPSS. In addition, T-Tests and ANOVAs were used to test the hypothesis at a 0.05 level of significance and Spearman's correlations examine correlations between sub-scale scores and biographical data. Sub-scales of the PSDQ were tested for internal consistency reliability and reasonable coefficients were rendered, except for the permissive parenting style scale that was excluded from analysis. The results showed a significant, positive correlation between authoritative and authoritarian parenting styles amongst the respondents. Parental attitudes and responses to risk behavior significantly affected their actual behavior towards fostered adolescents presenting with risk behavior. The researchers concluded that consideration of parenting styles in the foster care relationship context will greatly determine the nature of further interventions. [ABSTRACT FROM AUTHOR]

Understanding the distinctive features of kinship and non-kin foster care has sparked research interest aimed at developing policies and programs. This study analyses 930 cases of fostered children (35.5% in non-kin foster care and 64.5% in kinship care) based on the information provided by child care professionals and the evaluations made by 221 foster carers (34.8% in non-kin foster care and 65.2% in kinship care) using different questionnaires. Significant differences were obtained between kinship and non-kin foster care, indicating more favourable results on stability in kinship placements, although the less favourable results regarding the education and employment of kinship carers. Significant differences were observed in how foster carers perceived their role, with kinship carers reporting greater facility in raising the fostered child and higher satisfaction with the placement. However, they were less satisfied with the financial support. Cluster analysis confirmed these differences, identifying two groups based on the overall evaluation of raising foster children and satisfaction with the placement. The findings serve to provide evidence in support of kinship care and also indicate the need to re-examine the role played by the information made available to non-kin foster parents about the biological family and the impact on the foster placement. [ABSTRACT FROM AUTHOR]

This study explores educational resilience in primary education, focusing on how teachers can effectively nurture this crucial trait amidst rapid societal changes and an information-rich environment. Utilizing qualitative focus group discussions with ten primary school teachers, the research examines four key themes: student-teacher dynamic, peer influence, family and community engagement, and school environment. The findings reveal that while teachers recognize the importance of building resilience in students, they face challenges due to curriculum demands and resource limitations. Teachers expressed a desire to foster empathetic relationships, positive peer interactions, and engage families and communities but often found these goals hindered by systemic constraints. This research underscores the need for a holistic approach to education beyond traditional academic learning. It highlights the need for professional development, strengthened school-community partnerships, and educational policy reforms that prioritize comprehensive student development. The study concludes that fostering resilience in primary education requires addressing classroom practices and systemic barriers, aligning with contemporary resilience theories and emphasizing the need for classroom interventions to support students' overall well-being and competence. [ABSTRACT FROM AUTHOR]

Mothers who exceed their ideal family size (IFS) may find themselves caring for more children than desired. In the absence of reliable and desirable prenatal controls of family size, mothers may foster‐out children to reduce burdens of childrearing, particularly in contexts where fostering is common. Using six rounds of Demographic and Health Surveys collected in Uganda between 1988 and 2016, I explore the relationship between exceeding IFS and child out‐fostering, proposing that fostering‐out may serve to manage excess fertility and that this relationship may change as actual and desired fertility declines. Models are run separately for mothers and children aged 0–17 to explore mothers' overall out‐fostering behavior versus out‐fostering strategies for children. Results at the mother level suggest a strong positive relationship between exceeding IFS and out‐fostering that remains relatively stable over time, but results at the child level indicate children's age explains the relationship between mothers' exceeding IFS and being fostered‐out, demonstrating the nuances of how family size preferences might impact family life in practice. Though mothers report a desire for smaller families over time, childbearing and childrearing behaviors, including high fertility and child out‐fostering, remain consistent over the course of Uganda's fertility transition, signifying the central role out‐fostering plays in Ugandan families. [ABSTRACT FROM AUTHOR]

This review comprehensively analyzes the contemporary Greek legislative foster care system according to N4538/2018, exploring all the relevant international agreements such as the United Nations Convention on the Rights of the Child and the European Union's Charter of Fundamental Rights, that influenced its enactment. It highlights the rights and protection afforded to children in foster care, detailing provisions from the Hague Convention on the Rights of the Child and European legislation. It explores thoroughly the recent legislative reforms in Greece, including the establishment of the National Council for Foster Care and Adoption. It emphasizes the development and adherence to National and Special Registers for minors in the modern Child Protection System, as well as the implementation of Individual Family Rehabilitation Plans. It reveals that the recent legislation framework has many advantages but also a few weaknesses that could be amended. The legal procedures and criteria for placing minors in fostering in Greece, and the required criteria to ensure that foster parents meet the necessary guidelines to protect the best interests of children are discussed. This paper also examines the legal and procedural steps required to link children to foster families, the arrangements for supervision of foster parents and the consequences of fostering in cases of noncompliance. It is also proven that social workers play a key role in all stages and procedures of the application of the institution of foster care since they have taken up the main responsibilities for its implementation, prior, during and after the children are placed in foster parents. The article concludes that there is an imperative need for informed policies and practices that will ensure the adequate care and protection of minors in the foster system, recommending a synergy of legal, institutional, and educational strategies to optimize the welfare of foster children and support foster parents. [ABSTRACT FROM AUTHOR]

This research paper explores the foster care framework in Greece, with a particular focus on the triadic relationship among foster carers, biological parents, and foster children. It refers to the current 30 hours compulsory training program of foster parents, emphasizing the necessity of a further specialized comprehensive training, on the ground that well prepared foster carers can better face the complexities of fostering. There is also an imperative need for ongoing support for foster parents, which will be provided in the context of social workers' supervision to meet the behavioral and emotional challenges presented by foster children. The study investigates the potential hindrances faced during the child's placement within the foster home and the vital role social workers play in addressing these difficulties. It delves into the backgrounds of biological parents, foster carers, and foster children, examining the psychological issues and trauma they may confront. The paper highlights the paths of creating an emotional bond, trusting relationships, amongst the child and his/her foster parents and contact issues between foster and biological parents, asserting that these elements are crucial for the child's well-being and his/her integration into the foster family. Moreover, it recognizes the need for policy makers and practitioner's collaboration and interdisciplinary approaches within the foster care system. The study concludes that well-structured support, the empowerment of children through resilience building, and a stable legal framework are foundational to successful application of the institution of fostering. It encourages future research in the form of longitudinal studies, the evaluation of training models, and cross-national comparisons that include Greek foster care organizations to ameliorate the effectiveness of foster care system. The research incorporates theoretical and research studies articles as well as selected books in the field to underline the importance of evidence-based practices in advancing the application of the institution of foster care as well as the experiences of both foster care children, biological and foster parents. [ABSTRACT FROM AUTHOR]

Early detection of micrognathia during prenatal care is crucial to mitigate the associated risks and prevent unforeseen emergencies requiring invasive procedures, like tracheostomy. It enables proper planning for delivery in specialized tertiary care centers staffed with experienced teams in managing such cases. This proactive approach enhances clinician readiness, facilitates decision-making regarding management strategies in advance, and fosters improved family education and support. The primary goals of this paper are to provide a comprehensive review of diverse diagnostic techniques for micrognathia and to suggest a clear and pragmatic prenatal approach to addressing this condition. Furthermore, we present relevant ultrasonographic pictures of fetal micrognathia from our personal database. [ABSTRACT FROM AUTHOR]

Background: Previous literature suggests that children removed from home due to parental substance use disorder (SUD) and placed with older adult foster parents are more likely to achieve permanency than children placed with younger foster parents; however, little, if any, literature has examined this trend across racial identities. Objective: The aim of this study was to examine the intersectional effects of removal due to parental SUD, child's race/ethnicity, and foster parent age on likelihood of, and time to, child permanency. Methods: Twelve years of Adoption and Foster Care Analysis and Reporting System data were linked to capture all children in the U.S. foster care system between January 1, 2007 and September 30, 2018. Application of multiple sampling procedures resulted in a final analytic sample of 1,943,280. Results: All children with older adult foster parents were more likely to achieve permanency than those with younger foster parents. However, white children with substance-related removals were 17% more likely to achieve permanency when placed with an older adult foster parent than with a younger foster parent. In contrast, children of color with substance-related removals were only 9% more likely to achieve permanency when placed with an older adult foster parent than with a younger foster parent. Conclusions: These findings suggest that older adult foster parents are associated with beneficial effects that may mitigate the deleterious impact of parental SUD on permanency. However, the strength of this protective effect was diminished for children of color. These findings call for attention to the supports available to older adults who foster children of color. [ABSTRACT FROM AUTHOR]

This paper uses a case study to critically reflect on contemporary discourses in Norway connected to ethnic minority childhoods and children's rights to education and work. Based on a narrative interview with an ethnic minority girl, Sadja (aged 16), who is in state custody and lives with a foster family, we use a decolonial lens to explore the tensions in expectations and rights in her life and education. The tensions encountered are situated along three axes. The first axis illustrates tensions related to education, work, and responsibilities, as Sadja's family responsibilities are perceived by teachers and child welfare workers as preventing her from having "a proper childhood". The second axis explores tensions connected to independence, educational choice, and "belonging to the state", where Sadja experiences that being in state custody results in being unable to "follow her dream". The third axis reflects the tensions between parental expectations of "dreaming big" versus her surrounding environment's anticipation of her simply getting a job. In sum, Sadja's experiences suggest that contemporary Western discourses—such as individualism, self-autonomy, and children as human capital—paradoxically curtail the educational rights and trajectories of ethnic minority children in foster care in Norway in unforeseen and unfortunate ways. [ABSTRACT FROM AUTHOR]

This study explored the experiences of children and young people in the Mockingbird Family, South Australia, during implementation and roll-out. The study involved semi-structured interviews with a diverse group of 54 participants, including 21 children and young people, 12 foster carers, and 14 agency workers. Thematic analysis, with the application of Axel Honneth's recognition theory, showed the Mockingbird Family model to validate the emotional, cognitive, and social support needs of children and young people. Through interconnected experience, the nurturing of care and the promotion of rights-based, holistic approaches were crucial for achieving social recognition, dignity, and developmental growth. The study indicates the potential benefits of the Mockingbird Family model for addressing the needs of children and young people in care. The research suggests that a community-based support model such as the Mockingbird Family should be considered in child welfare practices. However, further research is necessary to fully understand the model's long-term effects and justify its integration into wider child welfare policies. [ABSTRACT FROM AUTHOR]

Parent's beliefs about intelligence can influence children's learning through parenting practices. It is unclear how parents' perceptions of the child's ability may affect these processes. This experimental study explored the joint effects of mothers' growth mindset and perceptions of child competence on their learning involvement. Children (N = 121, 52% female, ages 9-15) completed a set of problem-solving tasks, and mothers were told that their children had either performed well or poorly; or received no feedback. In a subsequent problem-solving task, mothers' growth mindset positively predicted supportive behaviors, and mothers' low competence beliefs positively predicted unsupportive and controlling behaviors. No interactions were found. Findings suggest parental growth mindset may help foster positive parenting practices, regardless of their children's academic competence. [ABSTRACT FROM AUTHOR]

Objetive: The aim of this study was to conduct an exhaustive synthesis to determine which instruments and variables are most appropriate to evaluate foster care programs (foster, kinship, and professional families). This evaluation includes the children, their foster families, their families of origin, professionals, and foster care technicians. Method: The systematic review included randomized, quasi-randomized, longitudinal, and control group studies aimed at evaluating foster care interventions. Results: A total of 86 studies, 138 assessment instruments, 18 constructs, and 73 independent research teams were identified. Conclusions: (1) although the object of the evaluations was the children, the informants were usually the people in charge of their care; therefore, effort should be made to involve the children in a more participatory way; (2) psychosocial functioning, behavior, and parenting are transversal elements in most evaluations, while quality of life and coping are not sufficiently well incorporated; (3) practical instruments (brief and easy to apply and correct) that are widely used and carry scientific guarantees should be prioritized to ensure the comparability and reliability of the conclusions; and (4) progress should be made in the study of evaluation models for all forms of foster care, including foster, extended, and specialized families. [ABSTRACT FROM AUTHOR]

Guided by the communicated sense-making (CSM) theoretical model (Koenig Kellas, J., & Kranstuber Horstman, H. (2015). Communicated narrative sense-making: Understanding family narratives, storytelling, and the construction of meaning through a communicative lens. In L. H. Turner, & R. West (Eds.), The sage handbook of family communication (2nd ed, pp. 76–90). Sage), the current study explored foster parent–child sense-making within conversations about the child's exit from the foster parent's care (i.e. foster exit conversations; henceforth, FECs). Specifically, this study examined the CSM devices animating FECs, as reported by 21 U.S. foster parents. Findings revealed the use of (a) accounts, including concessions, excuses, and justifications (b) CPT in the form of agreement, attentiveness, positive tone, and providing space to talk, and (c) transition metaphors in FECs. Findings highlight useful ways to facilitate sense-making, resilience, and coping for foster youth and families amid transitions. The conclusion discusses limitations and directions for future research. [ABSTRACT FROM AUTHOR]

Kinship placement has been shown to be superior to foster care in increasing permanency and safety for children. Despite the many benefits of kinship placement, kinship caregivers receive less support than foster family, and this creates unique challenges. This study analyzes data from a state-wide kinship caregiver survey with 868 respondents. Caregivers reported their top three challenges and needs, which were stratified by caregiver-reported income, location of residence, and reasons for the child's placement into kinship care. We found striking differences in reported challenges and needs based on income, region, and reason for placement. This further demonstrates the need for support for kinship families and can help develop targeted policies to alleviate challenges faced by kinship caregivers across the state. [ABSTRACT FROM AUTHOR]

Kinship caregivers raise relative children who are unable to be cared for by their parents. Most kinship caregiving takes place outside the child welfare system ("informal" care), meaning that caregivers do not have access to foster care payments to offset the costs of child rearing. The main source of financial support for informal kinship caregivers is Child-Only TANF, which is inadequate to meet the full range of caregiver needs. To address this funding gap, the authors present a comparative policy analysis of seven programs in six states that have implemented supplemental state funds for informal kinship caregivers. The authors analyze key features of each program and compare the socioeconomic and political characteristics of states that offer supplemental caregiver benefits to those of states that do not. Recommendations for policy and practice are discussed. [ABSTRACT FROM AUTHOR]

Based on interviews, this article explores how the monitoring of foster homes is experienced by children and youths who have been exposed to what they consider abusive behaviour by foster parents. Using a thematic narrative theoretical framework, the article shows that a common narrative in the youths' accounts is a story of mistrust towards social workers and monitoring officers, which relates to a general mistrust towards the child welfare service. The young individuals are reluctant to tell monitoring officers about how they truly experience their situation in their foster home. At the same time, some of the youths have difficulty comprehending what normal parenting behaviour is like, due to previous experiences of neglect from adults. The article discusses how successful monitoring of foster homes largely stands or falls on the children's and youths' ability to disclose their experiences to their supervisors and monitoring officers. We argue that the youths' narratives tell a story of disempowerment. This represents a dilemma in the monitoring of Norwegian foster homes and in the children's right to protection. [ABSTRACT FROM AUTHOR]

For the court to grant a parental order recognising intended parents as legal parents of a surrogate-born child, the gametes of at least one of the intended parents must have been used to create the embryo, under section 54(1)(b) and section 54A(1)(b) Human Fertilisation and Embryology Act 2008. In the Law Commission and Scottish Law Commission's consultation paper, there was a provisional proposal to remove the genetic link requirement in cases of medical necessity. However, this proposal was not included in the Law Commissions' Final Report, instead recommending the retention of the requirement for a genetic link in almost all circumstances. This article contends that the Law Commissions' recommendation should be reconsidered in light of the child's right to identity. By reviewing how identity has been used by the courts when determining whether to grant a parental order, as well as a developing interpretation of Article 8 of the United Nations Convention on the Rights of the Child and European Convention on Human Rights, it can be asserted that the identity of surrogate-born children necessitates recognition of the relationship between the child and intended parent(s), irrespective of a genetic link. On this basis, it is argued that there should be the possibility for intended parents to establish legal parenthood following surrogacy without the requirement for a genetic link. [ABSTRACT FROM AUTHOR]

Adoption and foster care posits itself as an evolutionary paradox, especially when there is no kinship involved. Adopting non-related eggs or infants proximately comes with a cost in the form of sharing resources and can lead to death of own progeny in extreme cases. However, in most of the cases, the foster parents derive some fitness benefits from a foster child, which seems to be the ultimate causation and hence has evolved in different species across various taxonomic classes. Adoptions are also reported among members of two different species which is an interesting scenario and calls for further research and experimentation in order to determine if any evolutionary fitness benefits accrue due to such behaviour. Similarly, "brood parasitism" a form of "forced foster care" is a live example of biological species at arms race. In this short review, we provide cost and benefit analysis of adoption among genetically related and unrelated individuals with a special emphasis on brood parasites. [ABSTRACT FROM AUTHOR]

The conditions of upbringing at an early age have a significant impact on the subsequent development, reproduction, and formation of behavioral characteristics of mammals, including rodents. Parents, primarily nursing females, are the main component of the social environment in the early period of postnatal ontogenesis in the majority of mammals. Therefore, the upbringing of mammalian pups in foster families of their own species or another one, even taxonomically distant ones, is one of the main methods for assessing the influence of early experience and the maternal environment on the formation of the behavioral characteristics and the choice of a sexual partner. Rearing of the adopted pups by females of their own or another species is used to preserve valuable species. This necessitates the development of the most effective methods of transferring offspring with maximum survival of the young. In this regard, we analyzed the survival rate and possible causes of mortality of young of a number of rodent species in foster families of mammals of their own and other species. We carried out cross-fostering (interspecific cross-upbringing) and in-fostering (intraspecific cross-upbringing) experiments using house (Mus musculus) and mound-building (Mus spicilegus) mouse pups, yellow steppe lemming (Eolagurusluteus) and brown rat (Rattus norvegicus) pups, and rearing of brown rat pups in foster families of the black polecat (Mustela putorius). As when feeding their own offspring, the main forms of maternal behavior ("maternal behavior complex") of the studied species in relation to adopted young during interspecific transfer are included and manifested in a complex manner if the adoptive mother accepts the young. The survival rate of adopted offspring depends on the degree of taxonomic proximity of the parent taxa: the highest rate was observed during cross-transfer between representatives of species belonging to the supraspecific complex Mus musculus s. l., while the lowest rate is observed when the pups are transferred between representatives of different families and orders of mammals. The success of upbringing adopted young can be determined by the similar composition of milk and the duration of lactation, the similarity of parental behavior (including the degree of male participation in raising the offspring), similar features of the ontogeny of young in closely related forms, and the significant difference in these characteristics in taxonomically distant species. However, successful upbringing of foster offspring is possible if there is similarity in the maternal behavior of taxonomically distant species and taking into account the suitability of milk (for example, feeding of rat pups by female black polecats). According to the results of the analysis of our data and published material, factors influencing the survival and mortality of pups in foster families also include the age of the pups at the time of transfer, species-specific differences in odor, the level of stress of the mother and offspring, the female's previous experience in rearing her own and other pups, and the expression of maternal instinct. All this must be taken into account when using the method of cross-fostering pups in experimental work. [ABSTRACT FROM AUTHOR]

Treatment foster care (TFC) provides critical mental health supports for youth with emotional, behavioral, and social difficulties who are at risk for adverse long-term outcomes. Existing evidence-based models of TFC are effective, yet resource-intensive, and they have relied primarily on evidence of implementation effectiveness with samples of non-minority parents. Recent research highlights the efficacy of an emerging, socially acceptable model that integrates existing evidence-based practices with usual care. This study applied the new model, Together Facing the Challenge (TFTC), within an urban TFC program. Trained TFC program staff delivered the TFTC training to foster parents in two cohorts. Foster parents reported child problem and prosocial behaviors pre-, mid-, and post-training, as well as 1, 3, and 12 months after the training. Results indicated that foster parents demonstrated an increase in knowledge of TFTC skills following the training and were satisfied with the training. Child problem behaviors significantly decreased over time. There were no significant changes in prosocial behavior over time. Implications of this study include the replication and extension of the use of TFTC, an evidence-based and resource-efficient intervention, to reduce problem behaviors of TFC children in urban settings. [ABSTRACT FROM AUTHOR]

Egg rejection is an effective and widespread antiparasitic defense to eliminate foreign eggs from the nests of hosts of brood parasitic birds. Several lines of observational and critical experimental evidence support a role for learning by hosts in the recognition of parasitic versus own eggs; specifically, individual hosts that have had prior or current experience with brood parasitism are more likely to reject foreign eggs. Here we confirm experimentally the role of prior experience in altering subsequent egg-rejection decisions in the American robin Turdus migratorius, a free-living host species of an obligate brood parasite, the brown-headed cowbird Molothrus ater. We then model the coevolutionary trajectory of both the extent of mimicry of host eggs by parasitic eggs and the host's egg rejection thresholds in response to an increasing role of learning in egg recognition. Critically, with more learning, we see the evolution of both narrower (more discriminating) rejection thresholds in hosts and greater egg mimicry in parasites. Increasing host clutch size (number of eggs/nest) and increasing parasite load (parasitism rate) also have narrowing effects on the egg-rejection threshold. Together, these results suggest that learning from prior experience with egg rejection may play an important role in the coevolution of egg-mimetic lineages of brood parasites and the refined egg rejection defenses of hosts. Lay Summary: Obligate brood parasitic birds lay their eggs in the nests of other species. In response to such parasitism, which reduces the fitness of the foster parents, hosts have evolved refined foreign-egg rejection abilities, while parasites have evolved increasing mimicry of the host eggs. But how do hosts recognize and accept their own eggs? Here we hypothesized that hosts learn about their own and foreign eggs through experience with unusual eggs in an early clutch and then they become increasingly better at rejecting the parasite's egg in subsequent nests and breeding attempts. We confirmed such a learning mechanism with a simple field experiment on the American robin, an egg rejecter host of the brown-headed cowbird. In turn, a complex mathematical model revealed that with more learning by the host we see the evolution of an increasingly fine-tuned egg recognition system by the would-be foster parents and a greater mimetic match of the host eggs by the parasites. [ABSTRACT FROM AUTHOR]

This article analyzes ethical issues arising in transreligious foster care placements in relation to foster children's needs regarding religious socialization and identification. Applying Urban Walker's expressive-collaborative framework to 30 qualitative interviews with foster parents, foster children, parents, and professionals, we elaborate and apply a three-level reflection on Christian foster parents' ethics of care in everyday practice of foster care. A first-level reflection demonstrates that integrating the foster child in the foster family often leads to predominant Christian socialization of foster children. A second-level reflection demonstrates asymmetry between foster parents and birth parents in the religious socialization of foster children, leading to confusion for the foster child and (potential) conflict with birth parents. Finally, a normative reflection leads us to conclude that foster children in transreligious placements need loose and hybrid moral frames in which they can alter, shift, and navigate their multiple identifications and partialities as part of their development. [ABSTRACT FROM AUTHOR]

Many ethnoreligious-minority foster children in several western countries, including the Netherlands, are placed and permanently live with ethnically and religiously non-matched foster families (i.e., in trans-religious foster care). We examine whether and which moral dilemmas exist around the issue of how religion should be weighted in trans-religious foster care to provide ethnoreligious-minority foster children with healthy identity development. We applied a thematic analysis to 17 qualitative interviews (seven foster parent/foster child dyads and three foster parents) taken from two pre-existing datasets. We retrieved five moral dilemmas in trans-religious foster care placements, which are discussed in relation to the following ethical arguments: (1) pressure from birth parents and parents of foster children to abide by their religious praxis; (2) objections of the foster family to the faith of the birth family; (3) a switch to the faith of the foster family by the foster child; (4) challenges to the religious identity searches of foster children due to ethnoreligious boundary drawing between majority and minority groups; and (5) the impact of religious traditions on the bodily integrity of foster children. We argue that it is in the best interest of foster children to have a foster family who, when making (some) religious choices on their behalf, is sensitive to the particular child and their developing identity with regard to their religious ideas and beliefs. Foster families need support regarding religious reflection and religious self-determinism in their foster children. [ABSTRACT FROM AUTHOR]

This qualitative study examines how 17 elementary school counsellors perceive their work with out‐of‐home foster‐care children. Three main themes emerged from the in‐depth semi‐structured interviews, highlighting the challenges and conflicts faced by these counsellors: (1) shying away from providing deep therapy but helping with specific issues, (2) the professional and ethical dilemmas of having to report to the authorities about foster families' domestic neglect or abuse while maintaining positive work relationships with these families and the children and (3) prevailing admiration towards the foster parents. The study recommends comprehensive training for school counsellors, administrators and staff as well as professional peer‐support groups for counsellors. [ABSTRACT FROM AUTHOR]

Foster children's emotional and behavioral difficulties are often a challenge for foster caregivers, who may experience reduced feelings of competence in their parental role, as well as increased levels of parental stress. In turn, these difficulties can negatively affect the quality of the interactions between them. In the present work, our first objective was to analyze the quality of the interactions between 49 Spanish foster children aged 4–9 years and their main caregivers, and its relationship with some variables, which were studied as potential predictors: the caregivers' parental stress and sense of competence, the children's psychological adjustment difficulties, and the children and caregivers' socio-demographic profile. We assessed caregiver-child interactions using an observational task (Co-Construction Task). The caregivers completed standardized questionnaires regarding their parental stress (Parenting Stress Index-Short Form; PSI-SF), parental sense of competence (Parenting Sense of Competence Scale; PSOC), and foster children's psychological adjustment difficulties (Strengths and Difficulties Questionnaire; SDQ). Also, we obtained their socio-demographic information through the families' caseworkers. The second objective was to examine whether caregivers' parental sense of competence mediated the relationship between children's psychological adjustment difficulties and caregivers' parental stress. Results concerning our first objective showed that caregivers' parental stress and children's age were significant predictors of the quality of caregiver-child interactions. As for the second objective, our mediation model indicated that parental sense of competence partially mediated the relationship between children's psychological adjustment difficulties and caregivers' parental stress. Lastly, we comment on some practical implications based on our results, which point to the need to include both self-report and observational measures when assessing and intervening with foster families. Highlights: Few studies explore caregiver-child interactions in foster care using observational methods In foster care, more studies are needed to explore the relationship between caregiver-child interactions, the family context, and children's characteristics The quality of caregiver-child interactions in a Spanish sample of foster care dyads is predicted by caregivers' parental stress and children's age Foster caregivers' parental sense of competence mediates the relation between children's psychological adjustment difficulties and parental stress [ABSTRACT FROM AUTHOR]

Abandoning infants was a heritage of the Roman Empire. Foundling hospitals were established in Italy earlier and in greater number than in other countries; their goal was to prevent infanticides. The Foundling Hospital in Rome, established in the Santo Spirito Church in 1204, paved the way toward modern hospital care and child protection. The Order of the Holy Spirit was appointed by Pope Innocent III to care for foundlings, and set up a network of infant nurseries all over Europe. Poor unmarried pregnant women received obstetric services free of charge. Infants were admitted anonymously by the ruota, a baby hatch or turning wheel. The Order's rule regulated infants' admission, care, nutrition by wet nurses, and boarding out to foster families in the countryside. Chief physicians of the Santo Spirito Hospital were often Sapienza University professors and/or personal physicians to the Popes. Among them were Realdo Colombo, Andrea Caesalpino, Giovanni Lancisi, Giuseppe Flajani, Domenico Morichini, and Tommaso Prelà. They made major scientific progress in anatomy and surgery: descriptions of the pulmonary blood transit, embryonic formation, fetal circulation, malaria transmission from mosquitos, and surgery for congenital malformations such as hydrocephalus, anal atresia, and cleft lip. Per year, 800–1,000 exposed infants were admitted. Despite sufficient funding and meticulous regulation of care and nutrition, mortality in the hospital during the first month of life was around 70%; the causes were neglected surveillance, cleanliness, and artificial nutrition. The institution persisted for more than 700 years due to numerous connections with the Vatican. [ABSTRACT FROM AUTHOR]